Lower Strata Research Articles

Estimation of Environmental Burden of Disease related to Arsenic exposure in European Populations

Abstract Background Arsenic (As) exposure poses significant health risks to exposed populations, with exposure occurring predominantly via diet for the general population as recently referred by the European Food Safety Authority. This study assesses the environmental burden of disease (EBD) for three cancer types related to arsenic, across Europe. Methods A literature review was conducted to 1) identify the dose-response function (DRF) to assess the cancer risk in European populations, and 2) define EBD approaches applicable to the available data. Country-specific data (Belgium, Denmark, Portugal) for EBD calculation (exposure, socioeconomic status, health outcomes) were gathered. Disability-Adjusted Life Years (DALY) estimations were performed by calculating attributable cases (AC). Results Two main references are used for DRF: the United States Food and Drug Administration DRF for assessing bladder and lung cancer risks, and the United States Environmental Protection Agency DRF for skin cancer. Preliminary results for Belgium indicate that inorganic arsenic dietary exposure ranges from 0.084 [0.080 - 0.088] to 0.102 [0.097 - 0.107] µg/kg body weight per day, varying with education level. Stratified estimates suggest that individuals with higher educational attainment (ISCED levels 5 & 6) have a marginally higher average daily intake of arsenic compared to those with lower educational attainment (ISCED levels 0, 1 & 2). DALY attributable to inorganic arsenic exposure follow the same trend as exposure levels, i.e. individuals with a higher education level bear a higher burden of disease than individuals of the low education stratum. This concerns the three studied cancers. Conclusions This study quantifies DALY related to inorganic arsenic from dietary exposure for different European countries. Our findings will contribute to better target public health policies and interventions for arsenic risk mitigation. Key messages • Exposure to inorganic arsenic is confirmed in European countries. • EBD studies guide action priorities to tackle chemical risk factors.

Determinants of International Non-governmental Organization’s Aid Upon Dalit in Bringing Behavioral Policy Governance

The caste system is the stratification of social structure based on Hinduism that has placed the Dalits in the lower strata and made to face various forms of inhuman atrocities and discrimination. The post-independent era of India is influenced by the different types of aid from international non-governmental organizations (INGO). The study looked at the effectiveness of international NGOs intervention in the Dalit community especially in promoting human rights and enhancing socio-economic development, especially in Villupuram District of Tamil Nadu. The struggle of resistance against discrimination by the Dalit community has been a continuous process and it is found that the situation has improved a lot after a lot of activism, social action, and community work through the help of NGOs. Continued efforts by INGOs advocating Dalit-driven policies at various levels are required to liberate the Dalits with the support of the government and various stakeholders.

Relationship between Residential Patterns and Socioeconomic Statuses Based on Multi-Source Spatial Data: A Case Study of Nanjing, China

The relationship between residential patterns and socioeconomic statuses highlights the complex interactions between the economic regime, welfare system, and neighborhood effects, which are crucial in urban inequality studies. With the diversification of the housing demand and supply system, the traditional analysis conducted separately from the ethnic or spatial segregation perspective fails to capture the rising inequalities and changing socio-spatial context. Taking Nanjing as an example, based on a multi-source database including the housing price, residential environmental quality, surrounding support facilities, and mobile phone user portrait data, this paper proposed a modified method for discovering the coupling relationship between residential patterns and socioeconomic statuses. It is found that socioeconomic status contributes to residential spatial aggregation and that the relationship between social and spatial dimensions of residential differentiation is tightly coupled and related. The lower socioeconomic strata were displaced to the periphery and the older urban core, while affluent inhabitants were more likely to settle voluntarily in segregated enclaves to isolate themselves from the general population through more flexible housing options. The heterogeneity of the urban socioeconomic dimension is primarily affected by consumption and occupational status, while housing prices mainly determine the divergence of spatial distribution.

Skin Barrier Function and Microtopography in Patients with Atopic Dermatitis.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease whose incidence is increasing. Skin barrier dysfunction plays an important role in this disease. It has been observed that AD patients have higher transepidermal water loss (TEWL) and lower stratum corneum hydration (SCH); however, there is little information about skin microtopography in this pathology. The objective of this study is to evaluate skin barrier dysfunction and structural changes in patients with AD. Methods: A cross-sectional study was conducted including patients with AD. Parameters of skin barrier function were measured (TEWL, temperature, erythema, pH, skin hydration, elasticity) and also other topographical parameters (scaliness, wrinkles, smoothness, surface, contrast, variance) in both healthy skin and flexural eczematous lesions. Results: A total of 32 patients with AD were included in the study. Flexural eczematous lesions had higher erythema (369.12 arbitrary unit (AU) vs. 223.89 AU, p < 0.001), higher TEWL (27.24 g/h/m2 vs. 13.51 g/h/m2, p < 0.001), lower SCH (20.3 AU vs. 31.88 AU, p < 0.001) and lower elasticity (0.56% vs. 0.65%, p = 0.05). Regarding topographic parameters, flexural eczematous lesions presented greater scaliness (5.57 SEsc vs. 0.29 SEsc, p = 0.02), greater smoothness (316.98 SEsm vs. 220.95 SEsm p < 0.001), more wrinkles (73.33 SEw vs. 62.15 SEw p = 0.03), greater surface area (836.14% vs. 696.31%. p < 0.001), greater contrast (2.02 AU vs. 1.31 AU p = 0.01), greater variance (6.22 AU vs. 4.96 AU p < 0.001) and a lower number of cells (105.5 vs. 132.5 p < 0.001) compared to unaffected healthy skin, reflecting a decrease in skin quality in AD patients. Conclusions: Both skin barrier function and skin topography are damaged in patients with AD, with differences between healthy skin and flexural eczema.

Stratum corneum hydration levels are negatively correlated with HbA1c levels in the elderly Chinese.

Highlights Stratum corneum hydration levels are negatively correlated with HbA1c levels and positively correlated with skin surface pH. Individuals with type 2 diabetes display lower levels of stratum corneum hydration. Because low stratum corneum hydration levels can increase circulating levels of proinflammatory cytokines, which are linked to the pathogenesis of type 2 diabetes, improvement in stratum corneum hydration can be an alternative approach in the management of type 2 diabetes.

Diversity, structure, and composition of melliferous and non-melliferous vegetation surrounding meliponaries of the Yucatan Peninsula, Mexico

Background: Although the loss of Melipona beecheii colonies in meliponaries suggests insufficient availability of melliferous blooming plants, there is limited knowledge about the diversity and conditions of the surrounding vegetation. Question: What is the diversity, structure, and composition of the melliferous and non-melliferous vegetation surrounding meliponaries, and how does it affect the availability of food sources for bees? Study site and dates: The vegetation surrounding nine meliponaries, three in each political state of the Yucatán Peninsula encompassing the main vegetation types, was studied in 2022 and 2023. Methods: Four 150-meter-long transects with the point-centered quadrants method were traced in each meliponary to estimate plant species composition, the availability of melliferous and blooming plants (IVI), diversity parameters (Hill-numbers), tree density, and diameter per strata. Results: 312 taxa, 250 genera, and 73 plant families were recorded. In five meliponaries, blooming melliferous plants accounted for less than 9 % of the IVI, with one meliponary having no blooming species. The highest diversity was found in a meliponary surrounded by semi-evergreen forest. The high stratum had a mean tree height of 5.5 (SD ± 2.9) meters and 3,390 (SD ± 2,702) trees/hectare across vegetation types. The tree diameter was lowest in meliponaries located in the semi-deciduous forest. Conclusions: The meliponaries are surrounded by young secondary vegetation with high density of small trees and predominance of the low stratum. We found a similar vegetation diversity among meliponaries and scarce blooming melliferous plants. Human activity seems to impact plant diversity and food availability for M. beecheii.

Tectonic evolution of the Qiangtang Basin (northern Tibet): Constraints from detrital zircon geochronology

The Mesozoic evolution of the Qiangtang Basin in the Tibetan Plateau, which potentially hosts oil and gas resources, is not fully understood, particularly in the context of the opening and closure of the Tethyan oceans. To better understand the tectonic evolution of the Qiangtang Basin and the history of sedimentation, we obtained 788 new U-Pb detrital zircon ages from 12 sandstone samples. Our results show that the provenance of the Mesozoic strata varies both in space and time. In the central part of the basin (Central Qiangtang), older sedimentary rocks are characterized by unimodal age spectra (300–233 Ma) that indicate a proximal arc source. Trace-element compositions of Permian to Triassic zircons from Lower Triassic strata are characteristic of crystallization in arc and backarc environments, thus supporting previous suggestions that the Qiangtang Basin formed as a backarc basin during subduction of the Paleo-Tethys oceanic lithosphere. Younger (Upper Triassic and Jurassic) strata in the Qiangtang Basin received detrital zircons from diverse sources that included Cambrian to Triassic magmatic rocks and Paleozoic strata in the Central Qiangtang, and Triassic flysch deposits in the Songpan-Garze Terrane. We suggest that this change in provenance — from a unimodal arc source that produced zircons in Lower–Middle Triassic rocks to the diverse provenance recognized in the Upper Triassic strata — marks the closure of the Paleo-Tethys Ocean during the Late Triassic. Jurassic sedimentation in the Qiangtang Basin occurred during the expansion of the Meso-Tethys Ocean (Early–Middle Jurassic) and the subsequent subduction of this ocean (since the Callovian). During the Early Cretaceous, the closure of the Meso-Tethys Ocean led to an uplift and a sedimentary hiatus that marked the end of marine sedimentation in the Qiangtang Basin.

Clinico-demographic profile and visual outcomes of pseudophakic bullous keratopathy in a multi-tier eyecare network in India

Abstract Purpose: The purpose of this study is to present the clinico-demographic characteristics of pseudophakic bullous keratopathy (PBK), its visual outcomes, factors associated with the choice of treatment, and poor visual outcomes of PBK. Methods: In this hospital-based retrospective study, electronic medical records data of new patients who presented to a multi-tier ophthalmology hospital network in India (November 2010–June 2022) were extracted. Patients with at least 4 weeks of follow-up were analyzed for visual outcome data. Bivariate analysis and multivariate logistic regression were used to determine the factors associated with the treatment choice and poor visual outcomes. Results: Of the 3,323,247 electronic records (with an average follow-up of 293 days) examined, 10,522 eyes of 10,158 patients (0.3%) had PBK. The majority were managed non-surgically (n = 7372; 70.1%), with increased odds of poor visual outcome by 3.46 times (AdjOR: 3.04–3.92, P &lt; 0.001). Those belonging to the non-paying category had higher odds of poor visual outcome (AdjOR: 1.48, 95%CI: 1.29–1.69; P &lt; 0.001). Surgical management improved vision by 0.72 logMAR (95%CI: 0.60–0.73; P &lt; 0.001). A total of 41.2% (n = 113/274) of cases that underwent Descemet’s membrane endothelial keratoplasty and 18.4% (n = 285/1551) of Descemet’s stripping endothelial keratoplasty attained last follow-up visual acuity (LVA) of 6/18 or better. Conclusion: About three in every thousand patients had PBK. Surgical interventions improved visual acuity significantly. About four in ten patients who underwent DMEK attained a vision of 6/18 or better at the last follow-up visit. Markers of lower socioeconomic strata were independently associated with poor visual outcomes.

B - 51 Are my Constructs Bass-Ackwards? A Hierarchical Approach to Neuropsychological Factors in Traumatic Brain Injury

Abstract Objective This study examined neuropsychological measures within a hierarchical framework in a traumatic brain injury (TBI) sample. Methods 270 individuals (M = 32 years old, SD = 14.8; 70% male, 94% white) with mixed TBI severity (73.7% mild TBI) completed the Meyers Neuropsychological Battery (MNB). Principal Components Analyses (PCAs) were conducted using Goldberg’s (2006) “bass-ackwards” hierarchical approach commonly used to evaluate “stratum” in personality and psychopathology. This involves an iterative top-down approach extracting a single general factor, then using the same data to extract two factors, then three factors, and continues as long as theoretically feasible. Extracted factors are saved as factor scores and correlated to reveal pathways between stratum. Results Iterative PCAs revealed a 4-stratum model. The first unrotated principal component (FUPC) was defined by loadings for Arithmetic, AVLT, RCFT, and Block Design. The second stratum factors were defined by AVLT and BNT (factor 1) and RCFT and Block Design (factor 2). The third stratum was defined by RCFT, Block Design, and Finger Localization nondominant (factor 1); Information and BNT (factor 2); and AVLT, Coding, and Finger Tapping dominant (factor 3). Stratum 4 was RCFT and Block Design (factor 1); AVLT (factor 2); Sentence Repetition, Similarities, and Information (factor 3); and Finger Tapping bilateral, Coding, and Trails Making Test (factor 4). Correlational pathways between factors ranged from 0.50 to 0.98. Conclusion Factors at lower stratum generally aligned with functions for cortical lobes. For example, Stratum 4 can be conceptualized as right temporoparietal (factor 1), left temporal (factor 2), left frontotemporal (factor 3), and bilateral frontal (factor 4).

Discursive and institutional standards of justice in the modern world-system

In the article the essence of standards of justice in the modern world-system is outlined in a general way. It is shown that these standards emerged in the European capitalist world-economy in consequence of the French Revolution. Standards of justice are interpreted as ideological semantic constructions that have been institutionalized simultaneously with establishment, first, of the ideology of liberalism as the geoculture of the modern world-system and, second, — of model of liberal state. Standards of justice are considered within theoretical theses and methodological guiding lines of I. Wallerstein's theory of the modern world-system. However, some theoretical theses of J. Alexander's civil society theory are also used to supplement and concretize considered in the article problems with some new arguments. For instance, Alexander's conceptual toolkit helped to distinguish discursive and institutional standards of justice. Reasons and peculiarities of establishment of standards of justice are considered and role these standards played in the providing of development of the modern world-system is shown. In particular, it is elucidated that owing to these standards elites of the core countries of the modern world-system managed to redirect the rebellion energy of the lower strata from antisystemic revolutions to struggle for inclusion to liberal state. This helped to calm the lower strata down and to guard structures of the modern world-system against essential damages. Standards of justice contributed to legitimation of social order of the modern world-system. Full integration of the lower strata to newly created national societies reinforced social solidarity, and this strengthened the core states even more. It is shown that for today in particular countries of periphery and semi-periphery trends of revision of current standards of justice and their replacement by alternative semantic constructions become visible.

Characteristics of the structure and hydrocarbon prospectivity of the deeply buried strata in the eastern Precaspian basin

The article examines the geological structure and oil and gas prospects of the pre-salt complex in the eastern Precaspian Basin (PB). Based on the synthesis and comprehensive analysis of geological exploration (GE) results and the analysis of geological-geochemical criteria for hydrocarbon potential, the oil and gas geological zoning has been updated, and effective directions for GE have been identified. The justification of a new hydrocarbon resources base within the eastern PB margin can be ensured by further investigating of the deeply buried Devonian-Middle Carboniferous horizons in the known petroleum plays, as well as within the less explored Sakmar-Kokpektinsky segment of the Ural fold-and-thrust belt. Within the productive KT-I and KT-II formations, there is an unrealized hydrocarbon potential at depths of 5-6 km. Using the example of the Bozoba West area, the oil and gas prospects of the Visean-Bashkirian and Lower Permian strata are examined, highlighting the significance of faults as elements of the hydrocarbon system. The applied set of 3D seismic survey data and deep drilling allowed for the interpretation of deep seismic sections, up to depths of 7.0-7.5 km. The Middle-Upper Devonian strata are considered prospective but have not been extensively explored by deep drilling. To establish a new hydrocarbon resource base within the eastern Precaspian Basin margin, it is recommended to conduct advanced regional seismic surveys and parametric exploration drilling.

Histological comparison of shark dermis across various ecomorphologies.

The integument plays essential roles in the structural support, protection, and hydrodynamic capability among fishes. Most research on shark skin has focused on the external epidermal layer, while the larger dermis anchoring the dermal denticles has been mostly ignored. Shark dermis is composed of two layers, the upper stratum laxum and the lower stratum compactum, holding supportive collagen and elastic fibers. There may be morphological and compositional differences in the dermis across various species of sharks that could relate to their different swimming modes and ecologies. The goal of this study was to characterize and describe the dermis among three shark species, Ginglymostoma cirratum, Sphyrna mokarran, and Isurus oxyrinchus, each representing a different swimming mode. Histological characterizations were performed at 16 locations along the body of each shark; variables such as dermal thickness, abundance of collagen and elastic fibers, and fiber size were quantified. Results showed G. cirratum has the thickest skin overall, and the largest fiber size for both collagen and elastic fibers, with overall patterns of increased amounts of collagen fibers and decreased amount of elastic fibers. At the opposite end of the spectrum, I. oxyrinchus showed the thinnest dermis along the flank region, with overall patterns of increased elastic fibers and decreased collagen fibers. These findings may challenge our original assumptions of a rigid body in fast moving sharks and a more flexible body in slower moving sharks and highlight the diversity of the shark integument.

Factors Associated with the Practice of Low-Carb and Low-Fat Diets among Participants of the Longitudinal Study of Adult Health (ELSA-Brasil).

In the field of nutrition, both low-carbohydrate (LCD) and low-fat (LFD) diets were initially intended for specific subgroups but are now being embraced by the broader population for various purposes, including aesthetics and overall health. This study aims to assess sociodemographic, health, and lifestyle factors influencing diet choices among public servants in the ELSA-Brasil cohort. Diets were classified as LCD or LFD based on the Brazilian Diabetes Society (<45%) and WHO guidelines (<30%) respectively. A total of 11,294 participants were evaluated (45.3% men; 54.7% women) with a mean age of 52 ± 0.08 years. Having overweight, altered waist circumference, and a history of smoking confers higher chances of adopting an LCD compared to the usual diet, while being over 52 years, non-White race/skin color, in a lower income stratum, and having diagnosis of hypertension and/or diagnosis of diabetes mellitus decrease these chances. Regarding LFDs, belonging to the non-White race/skin color, being over 52 years old, being divorced, and practicing low physical activity decrease the chances of following such a diet compared to the usual diet. In conclusion, factors like age, socioeconomic status, health, and physical activity levels can be the key to understanding why individuals choose restrictive diets beyond clinical advice.

Geochemistry and clay mineralogy of shales in the Sulu Orogenic Belt, East China: suggestion for continental weathering during an Early Cretaceous hyperthermal interval

ABSTRACT Understanding past weathering–climate feedback mechanisms under greenhouse conditions has significance for guiding the development of climate mitigation strategies. The continental paleoweathering state of Early Cretaceous shales in the Sulu Orogenic Belt of East China during a hyperthermal interval related to oceanic anoxic event 1a (OAE1a) was investigated via geochemical and clay mineralogical analyses of shale samples. The resulting diagrams of ternary 15Al2O3–Zr–300TiO2 discrimination, Th/Sc and Zr/Sc show that the geochemical composition was mainly controlled by source composition. This is supported by observations of low Zr contents, high indexes of compositional variability (ICV; &amp;gt; 1), and micropetrological characteristics. All samples showed narrow SiO2/Al2O3 and (Fe2O3 + MgO)/Al2O3 ranges that were within the predicted weathering trends of the ternary A-CN-K diagram, indicating that the shale geochemistry was not influenced by silicification and K-metasomatism. The chondrite-normalized rare-earth-element pattern suggests that all samples had the same felsic igneous parent rock. The geochemistry of whole rocks and their silicate fractions indicates that the shale had low chemical indexes of alteration (CIA) but high ICV values compared to post-Archean Australian Shale, indicating low sediment maturity and extremely weak chemical weathering in the source terrane and/or sedimentary basin under hot-dry conditions. Moreover, the clay minerals in the shale were mainly illite, suggesting low mineral weathering. Thus, during the OAE1a-related hyperthermal interval, chemical weathering was relatively weak in some mid-latitude arid inland areas. This may be mainly due to aridification decreasing water–rock reactions. Chemostratigraphic analysis suggests that the CIA, Ga/Rb, and Rb/Sr values of shales from the upper strata of the Yangjiazhuang and Shuinan formations were greater than those from lower strata. Moreover, the opposite trend in K2O/Al2O3 ratios was found. These indices suggest gradual increases in chemical weathering as the climate changed from hot-dry to warm-humid. In contrast, proxy indices of shale from the Zhifengzhuang Formation showed the opposite trend, suggesting a gradual decrease in chemical weathering as the climate changed from warm-humid to hot-dry. Considering the composition of the clay minerals, it is speculated that continental weathering was dependent on atmospheric humidity rather than temperature under the extreme greenhouse conditions, resulting in ineffective climate regulation by chemical weathering. This comprehensive study advances our understanding of the weathering–climate feedback mechanism under greenhouse regimes.

Clinical scores associated with immunological biomarker in the assessment of severity in congenital heart surgery

Abstract Background Congenital heart disease is a common disorder that often results in surgical procedures and intensive care. In this way, the use of validated scales and biomarkers can be incorporated into care practice as a tool for assessment and care planning. Purpose We aimed to investigate the association between the Therapeutic Intervention Scoring System (TISS-28), the risk-adjusted score for surgery in congenital heart disease (RACHS-1) and the triggering receptor expressed on myeloid cells-1 (sTREM-1) in assessing the clinical severity of cardiac surgery in pediatric patients. Methods This is an exploratory, translational cross-sectional study of 32 children undergoing cardiac surgical repair between 2021 and 2022. The severity of heart disease was determined using the RACHS-1 score and clinical severity using the TISS-28, the scores were stratified into C4, C3, C2 and C1, with C4 being the highest severity and C1 being the lowest, according to each assessment instrument, and the associations with sTREM-1 (pre- and post-surgery), measured by the ELISA method. The data were analyzed using the Statistical Package for the Social Sciences - SPSS version 29.0 software, considering statistical significance values of p &amp;lt; 0.05. Results Regarding the mean sTREM-1 values preoperative in comparison to the RACHS-1 categories, there was a significant difference between category C4 (241.33 pg/mL) and C3 (161.5 pg/mL) (p = 0.019), and postoperatively between C4 (355.82 pg/mL) and C1 (222.53 pg/mL), C2 (291.02 pg/mL) and C3 (296.66 pg/mL) (p = 0.005; 0.040; and 0.040, respectively). Preoperative, compared to the TISS-28 and sTREM-1 categories, there was a significant difference between category C4 (241.33 pg/mL) and C3 (161.5 pg/mL) (p = 0.020), and postoperatively, between categories C4 (355.82 pg/mL) and C2 (275.22 pg/mL) (p = 0.040). Conclusions We concluded that, both pre- and postoperatively, the mean sTREM-1 values were higher in the group of patients classified as more severe according to the RACHS-1 and TISS-28, when compared to those in the lower strata, showing that patients with higher sTREM-1 values preoperative evolved to greater severity postoperatively, a fact that was repeated in the post-operative evaluation.Table - RACHS-1 and sTREM-1Table - TISS-28 and sTREM-1

Novel MAGIC composite scores using both clinical symptoms and biomarkers best predict treatment outcomes of acute GVHD

AbstractAcute graft-versus-host disease (GVHD) grading systems that use only clinical symptoms at treatment initiation such as the Minnesota risk identify standard and high-risk categories but lack a low-risk category suitable to minimize immunosuppressive strategies. We developed a new grading system that includes a low-risk stratum based on clinical symptoms alone and determined whether the incorporation of biomarkers would improve the model’s prognostic accuracy. We randomly divided 1863 patients in the Mount Sinai Acute GVHD International Consortium (MAGIC) who were treated for GVHD into training and validation cohorts. Patients in the training cohort were divided into 14 groups based on similarity of clinical symptoms and similar nonrelapse mortality (NRM); we used a classification and regression tree (CART) algorithm to create three Manhattan risk groups that produced a significantly higher area under the receiver operating characteristic curve (AUC) for 6-month NRM than the Minnesota risk classification (0.69 vs 0.64, P = .009) in the validation cohort. We integrated serum GVHD biomarker scores with Manhattan risk using patients with available serum samples and again used a CART algorithm to establish 3 MAGIC composite scores that significantly improved prediction of NRM compared to Manhattan risk (AUC, 0.76 vs 0.70, P = .010). Each increase in MAGIC composite score also corresponded to a significant decrease in day 28 treatment response (80% vs 63% vs 30%, P < .001). We conclude that the MAGIC composite score more accurately predicts response to therapy and long-term outcomes than systems based on clinical symptoms alone and may help guide clinical decisions and trial design.

Failure Mechanism and Structural Optimization of the Primary Support Structure for Expressway Tunnel in Soft Rock: A Case Study

When the highway tunnel crosses the soft rock, the primary support structure often fails and damages because it cannot withstand the excessive surrounding rock pressure. For the Magu tunnel in Yunnan Province, which is in the upper hard and lower soft stratum, the surrounding rock deformation is large, and the primary support structure occurs spray concrete cracking, steel arch frame twisting deformation. According to the convergence constraint curve, this paper proposes to adopt the primary support optimization design scheme of "shortening the bench length + optimizing the length and arrangement of anchor rods". According to the numerical simulation results of FLAC3D, the important indexes such as deformation convergence, surrounding rock stress, anchor axial force and thickness of plastic zone in different excavation support conditions are analyzed. The conclusions are as follows: 1. The soft rock at the foot of the benches does not provide sufficient support resistance, resulting in large settlement and convergence deformation that can cause the primary support structure to fail and become damaged. 2. The length of the middle bench and the primary support strength and stiffness contribute most to the deformation. 3. The deformation control effect of the short anchor rods on the surrounding rock is relatively weak. Increasing the length of anchor can better play the role of anchor suspension enhancement and give full play to the surrounding rock's own bearing capacity. Finally, the deformation of the tunnel is under control after adopting the optimized primary support structure, which ensures the smooth construction.

Analysis Of Food Security, Social Health, Environmental And Household Food Security On Stunting Incidence Of Children Aged 12-59 Months In Coastal Households In Bengkulu Province

The natural wealth of coastal areas is not accompanied by the welfare of the people who occupy a lower economic stratum than other land communities, including in fulfilling nutrition. The study aims to analyze the influence of food security and social, health, environmental and household food security factors on the incidence of stunting in children aged 12-59 months in coastal households in Bengkulu Province. The research methodology used a mixed approach, between quantitative and qualitative. Data analysis used Structural Equation Modeling (SEM). The study results showed that the policy aspect significantly affected food security (β=0.085; t=1.979; and p-value &lt; 0.05) but is non-significant on stunting. There was a significant positive effect of health on food security with a value of β=0.237, value t = 7.157, and p-value &lt;0.05. Health had no significant effect on stunting with a value of β=-0.040, value t = 0.963, and p-value &gt; 0.05. Environmental aspects had a substantial adverse impact on food security (β=-0.492; t=12.846; and p-value &lt;0.05) and a significant positive effect on stunting (β=0.155; t=2.781; and p-value &lt; 0.05). The social aspect had a non-significant relationship with both food security and stunting. Food security was significantly related to stunting (β=0.441; t=7.971; and p-value &lt;0.05). The research conclusion is that food security had a significant favorable association with stunting.

Association Between the COI and Excess Health Care Utilization and Costs for ACSC.

The authors of previous work have associated the Childhood Opportunity Index (COI) with increased hospitalizations for ambulatory care sensitive conditions (ACSC). The burden of this inequity on the health care system is unknown. We sought to understand health care resource expenditure in terms of excess hospitalizations, hospital days, and cost. We performed a retrospective cross-sectional study of the Pediatric Health Information Systems database, including inpatient hospitalizations between January 1, 2016 and December 31, 2022 for children <18 years of age. We compared ACSC hospitalizations, mortality, and cost across COI strata. We identified 2 870 121 hospitalizations among 1 969 934 children, of which 44.5% (1 277 568/2 870 121) were for ACSCs. A total of 49.1% (331 083/674 548) of hospitalizations in the very low stratum were potentially preventable, compared with 39.7% (222 037/559 003) in the very high stratum (P < .001). After adjustment, lower COI was associated with higher odds of potentially preventable hospitalization (odds ratio 1.18, 95% confidence interval [CI] 1.17-1.19). Compared with the very high COI stratum, there were a total of 137 550 (95% CI 134 582-140 517) excess hospitalizations across all other strata, resulting in an excess cost of $1.3 billion (95% CI $1.28-1.35 billion). Compared with the very high COI stratum, there were 813 (95% CI 758-871) excess deaths, with >95% from the very low and low COI strata. Children with lower neighborhood opportunity have increased risk of ACSC hospitalizations. The COI may identify communities in which targeted intervention could reduce health care utilization and costs.

Correlation between serum HDL/LDL and t-PINP /β-CTX and osteoporotic vertebral fractures in elderly women

To explore high density lipoprotein (HDL)/low density lipoprotein (LDL) and total typeⅠcollagen amino terminal extender peptide (t-PINP)/ C-terminal peptide of typeⅠcollagen β special sequence(β-CTX)and risk of osteoporosis vertebral fractures (OPVFs) in elderly women. The clinical data of 446 female OPVFs patients aged above 60 years old from January 2019 to December 2020 were retrospectively analyzed. According to whether or not fracture, patients were divided into non-fracture group (186 patients) and fracture group(260 patients). Univariate analysis was performed to analysis age, body mass index(BMI), N-terminal mioldle molecular fragment of osteocalcin, N-MID OC), t-PINP, β-CTX, 25-hydroxyvitamin D[25-(OH) VitD], blood sugar (Glu), total cholesterol(TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), Ca, P, Mg, urea (UREA), creatinine (Cr) and Cystatin C(CysC), and correlation between OPVFs and the above indexes and lipid, bone metabolism indexes between two groups;Logistic regression was performed to analyze risk factors and stratification relationship between vertebral fracture and HDL/LDL, t-PINP/β-CTX. Logistic regression was used to analyze risk factors and stratification relationship between OPVFs and HDL/LDL, t-PINP/β-CTX. There were no significant difference in age and BMI between non-fracture group and fracture group (P>0.05). Compared with non-fracture group, contents of HDL, t-PINP/β-CTX and HDL/LDL in fracture group were decreased, and contents of β-CTX were increased (P<0.05). OPVFs was positively correlated with β-CTX (r=0.110, P<0.05), and negatively correlated with HDL, HDL/LDL and t-PINP/β-CTX (r=-0.157, -0.175, -0.181, P<0.05). HDL and HDL/LDL were negatively correlated with β-CTX (r=-0.22, -0.12, P<0.05) and t-PINP (r=-0.13, -0.10, P<0.05). 25-(OH) VitD was positively correlated with TC and HDL (r=0.11, 0.18, P<0.05). HDL/LDL was positively correlated with t-PINP/β-CTX(r=0.11, P=0.02). t-PINP/β-CTX[OR=0.998, 95%CI(0.997, 1.000), P<0.05], HDL/LDL[OR=0.228, 95%CI(0.104, 0.499), P<0.01] were risk factors for vertebral fracture. The lower levels between two tristratified indicators, the higher the vertebral fracture rate. The risk of fracture was 2.5 and 2 times higher in the lowest stratum than in the highest stratum, with an adjusted OR was[2.112, 95%CI(1.310, 3.404)] and [2.331, 95%CI(1.453, 3.739)], respectively. Serum low HDL/LDL and t-PINP /β-CTX are independent risk factors for OPVF in elderly women, and have good predictive value for OPVF risk.