Moderate Risk Levels Research Articles

The Impact of Obesity on the Incidence of Type 2 Diabetes Mellitus Among Women with Polycystic Ovary Syndrome

Background The nature of the independent relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes (DM2) remains unclear. Few studies have aimed to clarify this relationship independent of obesity, in longitudinal population-based cohorts. Methods We undertook a retrospective cohort study of women aged 18-23 over 15 years (2000-2015), surveyed three-yearly, from the ongoing Australian Longitudinal Study on Women's Health (ALSWH). We undertook survival analysis using Cox Proportional Hazard Model to identify predictors of DM2 and person-time analysis to calculate incidence rates of DM2/1000 person-years (PY). Findings During a follow-up of 1,919 years of person-time, 186 women developed DM2. The incidence rates were 4·19/1000 and 1·02/1000 PY (p<0.001) in PCOS and controls. On sub-group analyses by body mass index (BMI) categories across healthy-weight, overweight, and obese women, the incidence rate-ratios for DM2 were 4·68, 3·52, and 2·36 (p<0·005) in cases vs. controls. In multivariate Cox regression for the entire cohort, PCOS was one of the most influential predictors for DM2 (HR: 3·23, 95% CI: 2·07, 5·05, p<0·001) adjusting for BMI, education, area of residence, and family history of DM2. Interpretation Women with PCOS are at an increased risk of DM2, irrespective of age and BMI. Based on the moderate level of absolute clinical risk demonstrated here, guideline recommendations should consider DM2 screening at least three-yearly in all women with PCOS, across BMI categories and age ranges, influenced by local resources and patient preference. Funding Monash International Post-graduate Research Scholarship, NHMRC-Early Career Fellowship, and NHFA-Future Leader Fellowship support NSK, HJT, LJM, and AEJ. Conflict of Interests: No authors have any conflict of interest. Ethical Approval Statement: The Human Research Ethics Committees of the University of Newcastle and the University of Queensland approved the study methods.

基于土地利用变化的细河流域景观生态风险评估

PDF HTML阅读 XML下载 导出引用 引用提醒 基于土地利用变化的细河流域景观生态风险评估 DOI: 10.5846/stxb201708111440 作者: 作者单位: 辽宁师范大学城市与环境学院,辽宁师范大学城市与环境学院,辽宁师范大学,辽宁师范大学城市与环境学院,辽宁师范大学城市与环境学院 作者简介: 通讯作者: 中图分类号: 基金项目: 国家自然科学基金项目（41701208）；辽宁省教育厅课题（L201683678） Landscapeecological risk assessment of Xi river Basin based on land-use change Author: Affiliation: Liaoning Normal University,,,Liaoning Normal University,,, Fund Project: 摘要 | 图/表 | 访问统计 | 参考文献 | 相似文献 | 引证文献 | 资源附件 | 文章评论 摘要:以辽宁省细河流域为研究对象，利用1985、1995年和2005年3个时期的Landsat TM及2015年Landsat OLI遥感数据，进行了细河流域土地利用解译，定量分析了流域近30年来土地利用动态变化特征；根据景观生态学理论引入景观生态风险评价模型，将研究区划分为340个生态风险评价单元，基于地统计学和空间自相关方法，对1985-2015年细河流域景观生态风险时空分布特征及空间关联格局进行了评价。结果表明：（1）自1985年以来，研究区的6种土地利用类型皆发生了变化，其中建设用地由于林地和耕地的大量转入增加最明显。（2）1985-2015年流域高、较高和中生态风险区面积增加，且向流域南部转移；低、较低生态风险区面积减少，且向流域北部集聚；流域整体生态风险呈增高趋势。（3）研究区各时期景观生态风险呈现正的空间相关性，在空间上趋于集聚。人类活动干扰导致景观破碎，是影响该区域景观生态风险最重要的原因。 Abstract:Land-use change (LUC) affects environmental factors such as soil, atmosphere, and water. Moreover, it threatens regional ecological and environmental health. Landscape pattern is an important indicator that reflects the characteristics of land-use structure, composition and spatial configuration.Landscape changes and their eco-environmental effects have received much attention from researchers and the public. Landscape ecological risk assessment focuses on spatial heterogeneity and the correlations of landscape patterns with ecological processes. The identification of ecological elements and processes in a watershed, particularly within the context of rapid urbanization and environmental change, is of great significance for landscape ecological risk assessment. The Xi River, a tributary of the Taizi River, is located in Liaoning province and runs from south to north through Benxi city. Benxi city is an important heavy industry base in China. It is famous for its metallurgical and mining industries. In recent years, mining has caused many serious environmental problems, which include environmental pollution, mining-induced desertification, and geo-environmental hazards. The landscape pattern of the Xi River Basin has changed significantly because of large-scale mining exploration and deforestation. In this study, remote sensing data, such as those acquired from Landsat TM in 1985, 1995, and 2005, and Landsat OLI in 2015, are used. Land-use types were interpreted, and the dynamic changes in the landscape pattern were analyzed. The whole basin was then divided into 340 ecological risk assessment units. In addition, landscape ecological risks of the Xi River Basin were evaluated using the ERI (Ecological risk index). Geostatistical methods and spatial autocorrelation methods were also used to explore the spatial distribution and accumulation characteristics of landscape ecological risks. The results showed that (1) since 1985, all six types of land use have changed, and the area of construction land has increased the most because of large amount of forest and farmland changing into it. (2) from 1985 to 2015, the regions with highest, higher, and moderate levels of ecological risk have increased and moved from north to south, whereas the regions with the lowest and lower levels of ecological risk have decreased and moved from south to north, thus causing ecological risks for the whole basin to increase; (3) the landscape ecological risks showed positive spatial correlation characteristics, which implied that they were prone to gathering. This study has revealed that the main reason for the temporal and spatial variation of ecological risks in the Xi River Basin is human activity. Land-use changes have the most important effects on ecological risk factors.The assessment of ecological risks in the Xi River Basin can provide a reference for ecological conservation efforts. Managers should determine an optimal combination of the present land-use types with improved reasonable land-use types to improve the land-use structure. We should undertake integrative and rational planning and land-use management aimed at alleviating ecological risks in the Xi River basin, while considering water and environmental pollution, as well as soil erosion problems together. 参考文献 相似文献 引证文献

Factors Affecting the Fund Selection Capability of Mutual Fund Advisors

The Mutual Fund Industry of India traces its origin from the establishment of the Unit Trust of India in 1964. The mutual fund industry of India has seen a tremendous growth since its incorporation. A number of research studies have been carried out so far to understand the nature of the Indian mutual fund industry. However, every study attempts to bring forth something that is of great interest to the stakeholders of the industry. Much has been discussed by the researchers regarding the evolution and growth of Indian Mutual fund Industry, the performance evaluation of different mutual fund schemes, the investors’ behaviour towards mutual funds etc. However, no major study has been done so far regarding the fund selection capability of the mutual fund advisors in India. Undoubtedly, the contribution of the mutual fund advisors in taking the Indian Mutual Fund Industry to new heights is self-explanatory. Such a huge growth of Assets under Management (Rs 10827.57crore, as of March 31, 2015) can be attributed mainly to the expertise of the fund advisors/managers. Thus, the main objective of the study is to find the factors that matter to the financial advisors while making recommendations about the mutual fund schemes to the Indian mutual fund investors. The important factors that are considered by the fund advisors include the Past Performance of a Mutual Fund, the Risk associated with the Fund, Brand equity of the fund and the Current market conditions. The average performing funds which involve moderate level of risk and are mostly debt oriented are recommended by the financial advisors mostly. Regarding the current market conditions factor, the presence of optimistic conditions is believed to be conducive for the better returns on fund investments. If the brand equity for a particular fund is high, the advisors perceive such funds as the mouth-watering ones.

Assessment of the distribution, bioavailability and ecological risks of heavy metals in the lake water and surface sediments of the Caohai plateau wetland, China.

In this study, selected heavy metals (Hg, As, Cd, Pb, Cr, Cu and Zn) in the lake water and sediments from the Caohai wetland, which is a valuable state reserve for migrant birds in China, were investigated to assess the spatial distribution, sources, bioavailability and ecological risks. The results suggested that most of the higher concentrations were found in the eastern region of the lakeshore. The concentration factor (CF) revealed that Hg, Cd and Zn were present from moderate risk levels to considerable risk levels in this study; thus, based on the high pollution load index (PLI) values, the Caohai wetland can be considered polluted. According to the associated effects-range classification, Cd may present substantial environmental hazards. An investigation of the chemical speciation suggested that Cd and Zn were unstable across most of the sites, which implied a higher risk of quick desorption and release. Principal component analysis (PCA) indicated that the heavy metal contamination originated from both natural and anthropogenic sources.

Evaluation of temporary seasonal variation of heavy metals and their potential ecological risk in Nzhelele River, South Africa

AbstractSurface water is often used as alternative source of drinking water in many regions of the world where the potable water supply is erratic or not present. The concentration of heavy metals was assessed using an Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES). The impact of temporary seasonal variation on the contamination level was also assessed. Contamination factor (CF) and Hakanson’s potential ecological risk (Erand RI) indices were used to evaluate the toxicity levels of the metals in the sediments of the river. Higher concentrations of Fe, Mn, Pb, Cu and Zn were determined in the dry season in the river water whereas in the sediments higher levels were recorded for Al, Fe, Cd, Cr, Cu and Zn in the wet season. The average CF values for all the metals showed a low contamination level in the sediment, except for Cu and Cd which had moderate and considerable contamination levels, respectively. Similarly, Cu showed a moderate ecological risk level (Er= 62.90) only in March 2014, for other months Cu and the other metals investigated had Ervalues &lt; 40 which implies low ecological risk. The mean relative abundance of heavy metals in the sediments follows the trend Al&gt;Fe&gt;Mn&gt;u&gt;Zn&gt;Cr&gt;Pb&gt;Cd.

Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is associated with cough, sputum production or dyspnoea and a reduction in lung function, quality of life and life expectancy. Apart from smoking cessation, there are no other treatments that slow lung function decline. Roflumilast and cilomilast are oral phosphodiesterase 4 (PDE4) inhibitors proposed to reduce the airway inflammation and bronchoconstriction seen in COPD. This is an update of a Cochrane review first published in 2011 and updated in 2013. To evaluate the efficacy and safety of oral PDE4 inhibitors in the management of stable COPD. We identified randomised controlled trials (RCTs) from the Cochrane Airways Trials Register (date of last search October 2016). We found other trials from web-based clinical trials registers. We included RCTs if they compared oral PDE4 inhibitors with placebo in people with COPD. We allowed co-administration of standard COPD therapy. One review author extracted data and a second review author checked the data. We reported pooled data in Review Manager as mean differences (MD), standardised mean differences (SMD) or odds ratios (OR). We converted the odds ratios into absolute treatment effects in a 'Summary of findings' table. Thirty-four separate RCTs studying roflumilast (20 trials with 17,627 participants) or cilomilast (14 trials with 6457 participants) met the inclusion criteria, with a duration of between six weeks and one year. These included people across international study centres with moderate to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades II-IV), with a mean age of 64 years.We considered that the methodological quality of the 34 published and unpublished trials was acceptable overall. Treatment with a PDE4 inhibitor was associated with a significant improvement in forced expiratory volume in one second (FEV1) over the trial period compared with placebo (MD 51.53 mL, 95% confidence interval (CI) 43.17 to 59.90, 27 trials with 20,585 participants, moderate-quality evidence due to moderate levels of heterogeneity and risk of reporting bias). There were small improvements in quality of life (St George's Respiratory Questionnaire (SGRQ), MD -1.06 units, 95% CI -1.68 to -0.43, 11 trials with 7645 participants, moderate-quality evidence due to moderate levels of heterogeneity and risk of reporting bias) and COPD-related symptoms, but no significant change in exercise tolerance. Treatment with a PDE4 inhibitor was associated with a reduced likelihood of COPD exacerbation (OR 0.78, 95% CI 0.73 to 0.83; 23 trials with 19,948 participants, high-quality evidence). For every 100 people treated with PDE4 inhibitors, five more remained exacerbation-free during the study period compared with placebo (number needed to treat for an additional beneficial outcome (NNTB) 20, 95% CI 16 to 26). More participants in the treatment groups experienced non-serious adverse events compared with controls, particularly a range of gastrointestinal symptoms such as diarrhoea, nausea, vomiting or dyspepsia. For every 100 people treated with PDE4 inhibitors, seven more suffered from diarrhoea during the study period compared with placebo (number needed to treat for an additional harmful outcome (NNTH) 15, 95% CI 13 to 17). Roflumilast in particular was associated with weight loss during the trial period and an increase in insomnia and depressive mood symptoms. There was no significant effect of treatment on non-fatal serious adverse events (OR 0.99, 95% CI 0.91 to 1.07) or mortality (OR 0.97, 95% CI 0.76 to 1.23), although mortality was a rare event during the trials. Participants treated with PDE4 inhibitors were more likely to withdraw from the trials because of adverse effects; on average 14% in the treatment groups withdrew compared with 8% in the control groups. In people with COPD, PDE4 inhibitors offered benefit over placebo in improving lung function and reducing the likelihood of exacerbations; however, they had little impact on quality of life or symptoms. Gastrointestinal adverse effects and weight loss were common, and safety data submitted to the US Food and Drug Administration (FDA) have raised concerns over psychiatric adverse events with roflumilast. The findings of this review give cautious support to the use of PDE4 inhibitors in COPD. They may be best used as add-on therapy in a subgroup of people with persistent symptoms or exacerbations despite optimal COPD management. This is in accordance with the GOLD 2017 guidelines. Longer-term trials are needed to determine whether or not PDE4 inhibitors modify FEV1 decline, hospitalisation or mortality in COPD.

Validity, reliability, and responsiveness to change of the "Osteoporosis and You" knowledge scale.

The goal of this study was to confirm the measurement properties of the Osteoporosis and You (O&Y) knowledge scale using classic test theory methods in the 7749 men and women participating in the Patient Activation After DXA Result Notification (PAADRN) randomized controlled trial. We hypothesized a simple factor structure that would reflect the four-factor model previously published. We conducted psychometric analyses which included item analysis, internal consistency reliability, construct validity using exploratory and confirmatory factor analysis (EFA and CFA), comparing knowledge levels across pre-specified groups, and responsiveness to change. PAADRN participants were predominantly college educated, White females with low bone density, and a moderate level of 10-year fracture risk. EFA revealed four domains closely matching those in two previous reports. While overall scale reliability was minimally acceptable at 0.68, the reliabilities of the domain subscales were unacceptably low (0.59, 0.64, 0.45, and 0.36 for the Biological, Lifestyle, Consequences, and Prevention and Treatment subscales). CFA revealed the data fit the hypothesized model reasonably well with the items loading on their expected latent variable. The scale was not responsive to change, but although not significant, improved knowledge indicated better DXA result recall at 12 and 52weeks. In the PAADRN population, the O&Y knowledge scale had psychometric properties similar to those previously reported. Over 12 and 52weeks, participants did not demonstrate significant changes in knowledge, but those with higher knowledge at baseline were more likely to accurately recall their baseline DXA result.

3D City Models as a Visual Support Tool for the Analysis of Buildings Seismic Vulnerability: The Case of Lisbon

3D city models associate a database of a city to a rigorous geospatial representation that is close to the visible reality by combining appearance, geometry, and semantics. As such, these models may include tools that convey attribute analysis, not only at the statistical level but also in terms of visual appearance of the objects, thus allowing the generation of new knowledge about a phenomenon or its effects. Lisbon is a city with a moderate level of seismic risk, and has been hit in the past by strong earthquakes. Several seismic vulnerability studies of buildings have been carried out in Lisbon. These studies generate different scenarios that consider the magnitude and source location of potential earthquakes. The results of these studies were presented as maps obtained from crossing information contained in 2D layers and presented in a GIS environment. In the present study a seismic vulnerability assessment of Lisbon’s buildings held in 2D is extended to the third dimension, which refines the resolution and the set of parameters and explores the gains of spatial analysis in 3D representations. The numerous parameters that contribute to assess seismic vulnerability of buildings may be analyzed individually or simultaneously as well as in multiple seismic scenarios. Although covering all residential buildings in Lisbon, the application of the 3D city model is demonstrated with more detail in three pilot areas.

Risk Assessment of Total Coliform in X WTP’s Water Production Using Failure Mode And Effect Analysis Method

The greatest risk of drinking water supply is a failure to provide safe drinking water for communities. Based on IPA Kedunguling testing report on March 2016 noted that sample exceeding the quality standart of Peraturan Menteri Kesehatan RI No 492/2010 for the total coliform quality standart. The presence of total coliforms indicating water contamination by pathogen means the water is not safe to consume. The disinfection process has an importance rule in pathogen inactivation. Disinfectant performance is influenced by temperature, pH, turbidity, and the presence of organic materials. One way to control the quality of water produced by using a risk management approach Failure Modes and Effect Analysis (FMEA) methods. The potential risks should be measured to determine causes of the problems and find the appropriate risk reduction. The risk assessment is using Risk Priority Number (RPN) scale as a basis prioritization of remedial action on issues. Based on identification and risk analysis using FMEA known that the greatest risk of failure is the stipulation of chlorine dose and organic substances (category of high risk level); residual chlorine (category of moderate risk level); turbidity and pH (very low risk level category). Improvement proposal that can be done to reduce total coliforms presence in IPA Kedunguling is by increasing residual chlorine to 0.6 mg/l, set a daily chlorine level, controlling DBPs forming by lowering the concentration of organic precursor using granular activated carbon (GAC) or aeration, by lowering the dose of disinfectant, set aside DBPs after the compound is formed using granular activated carbon (GAC), turbidity and pH monitoring, and regularly washing the filters

A new comprehensive ecological risk index for risk assessment on Luanhe River, China.

With the enhancement of human activities which influence the physical and chemical integrity of ecosystem, it was bound to increase ecological risk to the ecosystem, and the risk assessment of small scale, single pollutant, or only on water quality have been not satisfied the demand of sustainable development of basin water environment. Based on the response relationship between environmental flow requirements guarantee ratio (GEF) and river ecological risk index (ERI), the Sediment Quality Guideline Quotient index (SQG-Q), and the Biotic Index (BI), we construct a new comprehensive ecological risk index (CERI) to evaluate the ecological risk of Luanhe River, China. According to the response relationship between GEF and ERI, upper and lower reaches of Luanhe River (Goutaizi to Hanjiaying) were at moderate risk level (0.41<ERI<0.56) in dry season, and all sites were at low risk level (ERI<0.40) in wet season; considering the contribution of heavy metals contamination in the SQG-Q, the Luanhe River was the most influenced by higher levels of heavy metals in dry season and wet season; when this index was applied to the PAHs levels, only 30 and 20% of the sampling sites appeared to be moderately impacted (0.1<SQG-Q PAHs<0.5) by the PAHs in dry season and wet season, respectively. The results of BI showed that half of the sites appeared to be at moderately polluted level (50% of the sites, 0.25<BI<0.32) and heavily polluted level (Zhangbaiwan, BI=0.36) in dry season, and 40% of the sites appeared to be at moderately polluted level (0.26<BI<0.29) in wet season. The CERI showed that 70 and 30% of the sites were at moderate risk level in dry season (0.25<CERI<0.36) and wet season (0.26<CERI<0.29), respectively. The results could give insight into risk assessment of water environment and decision-making for water source security.

Hazard, Vulnerability and Capacity Mapping for Landslides Risk Analysis using Geographic Information System (GIS)

This research analyzed the levels of disaster risk in the Citeureup sub-District, Bogor Regency, West Java, based on its potential hazard, vulnerability and capacity, using map to represent the results, then Miles and Huberman analytical techniques was used to analyze the qualitative interviews. The analysis conducted in this study is based on the concept of disaster risk by Wisner. The result shows that the Citeureup sub-District has medium-low risk of landslides. Of the 14 villages, three villages have a moderate risk level, namely Hambalang, Tajur, and Tangkil, or 49.58% of the total land area. Eleven villages have a low level of risk, namely Pasir Mukti, Sanja, Tarikolot, Gunung Sari, Puspasari, East Karang Asem, Citeureup, Leuwinutug, Sukahati, West Karang Asem West and Puspanegara, or 48.68% of the total land area, for high-risk areas only around 1.74%, which is part of Hambalang village. The analysis using Geographic Information System (GIS) prove that areas with a high risk potential does not necessarily have a high level of risk. The capacity of the community plays an important role to minimize the risk of a region. Disaster risk reduction strategy is done by creating a safe condition, which intensified the movement of disaster risk reduction.

Factors Influencing Lay and Professional Health Workers’ Self-efficacy in Identification and Intervention for Alcohol, Tobacco, and Other Substance Use Disorders in Kenya

The global burden of substance use disorders (SUDs), including alcohol and tobacco, disproportionately affect low- and middle-income countries (LMICs), considering their rising disease burden and low service capacity. Nested within a Kenyan training program, this study explores factors associated with healthcare providers' self-efficacy to treat SUD. Surveys of 206 healthcare workers were used to perform regression and sensitivity analysis assessing various factors association with self-efficacy. Self-efficacy for SUD was lower in those practicing in public facilities and perceiving a need for alcohol use disorder (AUD) training; while higher self-efficacy correlated with a higher proportion of patients with AUD in one's setting, access to mental health worker support, cannabis use at a moderate risk level, and belief that AUD is manageable in outpatient settings. Increasing awareness about SUD prevalence, identification, and treatment skills could improve the self-efficacy of LMICs' health care providers and therefore the willingness to implement more services for patients with SUDs.

209. Risk of Violence in Attenuated Psychosis Symptoms Syndrome and its Relationship With Symptomology

Abstract Background: Contrary to popular belief the majority of patients with schizophrenia will never commit an act of severe violence. Highest risk for violent offending appears to be during the first episode of psychosis (FEP), a meta-analysis by Large and Nielssen (2010) reporting that about a third of patients in the FEP exhibited some violent behavior before initial treatment. However, most acts involve minor violence and fewer than 1 in 100 patients committed assaults resulting in serious injury. Risk of violence in clinical high risk populations, those with attenuated psychosis symptoms (APS) remains unexplored although recent findings by Marshall and colleagues (2016) suggest that a significant amount of APS involve violent content although most is self-directed violence. The aim of the current study was to explore risk of violence in individuals with attenuated psychosis symptom syndrome (APSS). We were also interested to investigate whether risk of violence as assessed was associated with symptomology. Methods: The Structured Assessment of Violence Risk in Youth (SAVRY) was completed for 285 individuals who met criteria for APSS as well as 44 Healthy Controls. The SAVRY is a clinician rated assessment tool and provides a clinical risk rating for each individual by assessing multiple domains including Historical Risk Factors, Social/Contextual Risk Factors, and Individual/Clinical Factors. Results: Violence risk was significantly different between the two groups with healthy controls assessed to be at a lower risk than individuals in the attenuated psychosis symptoms group, χ2(2) = 13.03, P < .001. Only 2 of the APSS group and none of the healthy controls were rated to be at high level of risk for violence. Violence risk was not different between men and women, χ2(2) = 4.58, P = 1.01. A between-group ANOVA conducted to compare severity of attenuated psychotic symptoms and risk of violence within the APSS group showed that symptom severity was significantly different across levels of violence risk, F(2, 235) = 6.32; P < .002. This was largely driven by negative symptoms severity. Individuals with low risk for violence as compared to moderate level of violence risk had lower negative symptoms, F(2, 235) = 13.42; P < .000. Severity of positive, disorganized, or general symptoms independently did not differ across levels of violence risk. This relationship remained unchanged when income level was adjusted. Level of income, age, ethnicity, or parental education was not associated with level of risk. Conclusion: To our knowledge this is the first study to assess violence risk in individuals with APSS. While, the APSS group was assessed to be at a higher risk for violence as compared to healthy controls, the majority were judged to be at a moderate risk and high risk ratings were rare. In the APSS group higher risk was associated with symptoms. Specifically, results suggest that negative symptoms uniquely contribute to risk of violence.

Cardiovascular risk of patients with gout seen at rheumatology clinics following a structured assessment

ObjectivesGout-associated cardiovascular (CV) risk relates to comorbidities and crystal-led inflammation. The aim was to estimate the CV risk by prediction tools in new patients with gout and to assess whether...

The Impacts of Albuminuria and eGFR on Cardiovascular Disease

Albuminuria is often used as a surrogate marker for the risk of fatal and non-fatal events in clinical trials of antihyperglycemic medications or in antihypertensive therapy. Similarly, low estimated glomerular filtration rate (eGFR), which is a common manifestation of progressed diabetic nephropathy, has also been demonstrated to be an independent risk factor for cardiovascular events and death. Recent evidence suggests that both high albuminuria and low eGFR are independent risk factors for progressive kidney failure and cardiovascular disease. The purpose of this study was to investigate the impacts of albuminuria and low eGFR on the risk of cardiovascular disease. A cross-sectional design was used. Data were collected through adults’ health examinations by a hospital in a certain area in Pingtung County between 2011 and 2015. The health data base included participants’ basic information, physical examination and blood examination results. Use abbreviated modification of diet in renal disease, aMDRD (Abbreviated modification of diet in renal disease) formula to estimate eGFR. Use metabolic syndrome to define the criteria of rising blood pressure, blood sugar, blood lipids as an important cardiovascular disease (CVD) indicator and then calculation of the 10-year risk for CVD was completed using data from the Framingham Heart Study and a computer was used to determine risk values. In this study, ≤ 10% was defined as low risk, 11-20% was defined as moderate risk, and > 20% was defined as high risk. As albuminuria and eGFR approached critically high values, initially moderate and high 10-year risk levels for CVD tended to increase. Logistic regression analysis showed that patients with severe albuminuria and severe eGFR had higher risks of metabolic syndrome, abnormal waist circumference, hyperglycemia, reduced high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia, and elevated blood pressure. The study concluded that albuminuria and eGFR are risk factors for CVD and can increase a patient’s 10-year risk of CVD.

Effect of Chinese medicine treatment based on pattern identification on cellular immunophenotype of myelodysplastic syndrome.

To observe the influence of treatment based on Chinese medicine pattern identification on cellular immunophenotype of the myelodysplastic syndrome (MDS). Sixty patients with MDS were randomly and equally assigned to the treatment group and the control group using a randomized digital table. Thirty patients in each group included 3 risk levels (low, moderate and high risks) with each level 10 patients according to the international prognostic scoring system. The control group was given conventional therapy which was also used in the treatment group. While the treatment group was given Zuogui Pill () and Yougui Pill () for low risk patients; Qingwen Baidu Decoction () and Bazhen Decoction () for moderate risk patients; Gexia Zhuyu Decoction () and Qinghao Biejia Decoction () combined with Shiquan Dabu Decoction () for high risk patients. After the treatment, the differences of overall response rate and immunophenotype (CD13, CD14, CD15, CD33 and CD34) of each group were analyzed. The overall response rate of the treatment group was significantly higher than the control group in low risk and moderate risk patients (P=0.029), there was no statistical differences of overall response rate between the treatment group and the control group in high risk patients (P=0.089). The expressions of CD13, CD14, CD33 and CD34 in all three risk levels of the treatment group were obviously decreased after the treatment, while CD15 in all three risk levels of the treatment group was obviously increased after the treatment (P<0.05 or P<0.01). Meanwhile, the difference values of CD13 and CD33 in low risk level of the treatment group, CD33 and CD34 in moderate risk level of the treatment group as well as CD34 and CD15 in high risk level of the treatment group, were all greater than the control groups and they were statistically significant (P<0.05 or P<0.01). It shows a better therapeutic effect if the MDS patients treated with Chinese medicine pattern identification in addition to conventional therapy. Since the treatment may inhibit the malignant clones and improve the dysmaturity of granulocyte differentiation, it is a feasible option in clinical practice.

Contribution of fibroblast growth factor 23 to Framingham risk score for identifying subclinical atherosclerosis in Chinese men

Background and aimsFibroblast growth factor 23 (FGF23) was demonstrated to be involved in the occurrence and development of cardiovascular disease (CVD). The goal of the present study was to investigate the relationship between serum FGF23 levels and carotid intima-media thickness (C-IMT) in men with a low-to-moderate CVD risk. Methods and ResultsSubjects with normal kidney function were selected from the Shanghai Obesity Study. Serum FGF23 levels were determined by sandwich enzyme-linked immunosorbent assay. C-IMT was measured by ultrasonography. The Framingham risk score (FRS) was used to assess CVD risk. A total of 392 men with low CVD risk and 372 men with moderate CVD risk were enrolled. The recognition rate of an elevated C-IMT was 85.66% with the combination of a moderate CVD risk and high serum FGF23 levels, which was greater than that with either parameter alone (65.44% and 61.03%, respectively). Subjects with high serum FGF23 levels, and either low or moderate CVD risk, were more likely to have elevated C-IMT than those with low serum FGF23 levels and low CVD risk (P = 0.014 and 0.001, respectively). The serum FGF23 levels were independently and positively associated with C-IMT in subjects with low or moderate CVD risk (both P = 0.007). ConclusionIn men with low-to-moderate CVD risk, serum FGF23 levels were associated independently and positively with C-IMT. As a complementary index, serum FGF23 levels strengthen the capacity of the FRS to identify subclinical atherosclerosis.

Integrated Flood Risk Assessment of Rural Communities in the Oti River Basin, West Africa

Flood damage in West Africa has increased appreciably during the last two decades. Poor communities are more at risk due to the vulnerability of their livelihoods, especially in rural areas where access to services and infrastructures is limited. The aim of this paper is to identify the main factors that contribute to flood risk of rural communities in the Oti River Basin, Togo. A community-based disaster risk index model is applied. The analyses use primary data collected through questionnaires during fieldwork, the analytic hierarchy process (AHP) method, population and housing census data and flood hazard mapping of the study area. The results showed a moderate level of flood risk despite a high level of hazard and vulnerability for all investigated communities. In addition, the results suggest that decreasing vulnerability through creation of new income-generating opportunities and increasing capacity of communities to manage their own flood risk should be paramount in order to reduce flood risk in the study area. The results of this work contribute to the understanding of flood risk and can be used to identify, assess, and compare flood-prone areas, as well as simulating the impacts of flood management measures in the Oti River Basin.

Polybrominated diphenyl ethers in marine sediments of Sanggou Bay in east China

Polybrominated diphenyl ethers (PBDEs) were measured in the surface sediments collected in August 2015 in Sanggou Bay, China. The total concentrations of 13 PBDEs, including BDE-17, -28, -47, -66, -71, -85, -99, -100, -138, -153, -154, -183 and -190, and concentrations of BDE-209 were 0.223–1.259ng/g and 0.865–9.275ng/g, respectively. The PBDE levels increased from the outer bay to the inner bay. BDE-209 was the predominant congener, followed by BDE-47, BDE-71, and BDE-99. Significant positive correlations were observed for tri-BDEs with organic carbon (r=0.598, p<0.05) and with clay content (r=0.592, p<0.05). Principal component analysis revealed that PBDEs in Sanggou Bay were mainly derived from the usage, dismantling and degradation of commercial products (penta-, octa-, and deca-BDEs), which were then transported through continental runoff and atmospheric deposition. The ecological risks were mainly attributed to deca-BDE congeners with moderate risk level.

Assessment and Pollution Characteristics of Heavy Metals in Soil of Different Functional Areas in Luoyang

The residential areas, science and education areas, urban green lands, commercial districts, urban arterial roads, industrial zones and urban and rural junction districts in seven different functional zones of Luoyang City were taken as research subjects, and sixty-three soil samples were gathered. The concentrations of soil heavy metals were measured and their pollution levels were evaluated by single pollution index and Nemerow complex pollution indices. The ecological risks of soil heavy metals were discussed with Hakanson potential ecological risk index (RI) and their geneses and sources were indicated by the principal component analysis (PCA). The results showed that the average level of all heavy metals exceeded the background values of Henan Province. The pollution degree of single gene index was in the following order:Cd> Zn> Pb> Cu> Ni> Cr. Nemerow complex pollution indices indicated heavy metals had the highest concentration and the heaviest pollution in industrial zones. A single heavy metal potential ecological harm (<i>E</i>rⁱ) showed Cd had the highest risk index. RI was ranked as industrial zones> urban arterial roads> commercial districts> residential areas> science and education areas> urban green lands> rural junction districts. The heavy metal pollution in industrial zones, urban arterial roads and commercial districts reached strong levels, and the pollution in residential areas, science and education areas, urban green lands reached moderate risk levels, but that in rural junction districts belonged to slight risk level. Cu, Zn, Pb and Cd were called anthropogenic factors and came from industrial wastes and transport emissions, but Cr and Ni were explained as natural factors and their contents depended upon the parent materials of soil.