Protective Measures Research Articles

Assessing the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease hospitalizations in residents of Panzhihua City: a multi-districts study using a distributed lag non-linear model

BackgroundTemperature fluctuations can impact the occurrence and progression of respiratory system diseases. However, the current understanding of the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains limited. Therefore, our study aims to investigate the relationship between daily mean temperature (DMT) and the risk of AECOPD hospitalizations within Panzhihua City.MethodsWe systematically collected data on AECOPD hospitalizations at Panzhihua Central Hospital from 2015 to 2020 and meteorological factors across Panzhihua City’s districts. A two-stage analysis method was used to establish a distributed lag non-linear model to elucidate the influence of DMT on the frequency of admissions for AECOPD. Subgroup analyses were conducted by gender and age to identify populations potentially susceptible to the impact of DMT.ResultsA total of 5299 AECOPD hospitalizations cases were included. The DMT and the risk of AECOPD hospitalization showed a non-linear exposure–response pattern, with low temperatures exacerbating the risk of hospitalizations. The lag effects of low temperature and relatively low temperature peaked at 2th day, with the lag effects disappearing at 16–17 days. Females and elders aged ≥ 65 years were more sensitive to effects of low and relatively low temperature at lag 0–4 days, while male AECOPD patients exhibited longer lasting lag effects.ConclusionsLow temperatures are associated with an increased risk of AECOPD hospitalizations. Females or elders aged ≥ 65 years with chronic obstructive pulmonary disease should pay more attention to taking protective measures in cold environments. These findings are crucial for the formulation of public health policies, as they will help significantly alleviate the burden of AECOPD and improve respiratory health in the face of climate challenges.

All-cause mortality and hospital admissions for nursing home residents during the COVID-19 pandemic: a Norwegian register-based cohort study

BackgroundThis paper investigates the consequences of the COVID-19 pandemic on mortality and hospitalization among nursing home residents in Norway. While existing evidence shows that nursing home residents were overrepresented among COVID-19-related deaths, suggesting inadequate protection measures, this study argues that the observed overrepresentation in mortality and hospitalization may partly stem from the inherent frailty of this demographic. Using nationwide administrative data, we assessed excess deaths and hospitalization by comparing pandemic-era rates to those of a pre-pandemic cohort.MethodsWe compared mortality and hospitalization rates between a pandemic cohort of nursing home residents as of September 2019 (N = 30,052), and a pre-pandemic cohort as of September 2017 (N = 30,429). Both cohorts were followed monthly for two years, beginning in September 2019 and 2017, respectively. This analysis was conducted at the national level and separately for nursing home residents in areas with low, medium, and high SARS-CoV-2 community transmission. Event studies and difference-in-difference models allowed us to separate the impact of the pandemic on mortality and hospitalization from secular and seasonal changes.ResultsThe pandemic cohort experienced a non-significant 0.07 percentage points (95% confidence interval (CI): − 0.081 to 0.221) increase in all-cause mortality during the 18 months following pandemic onset, compared to the pre-pandemic cohort. Moreover, our findings indicate a substantial reduction in hospitalizations of 0.27 percentage points (95% CI: − 0.464 to − 0.135) and a non-significant decrease of 0.80 percentage points (95% CI: − 2.529 to 0.929) in the proportion of nursing home residents hospitalized before death. The effect on mortality remained consistent across regions with both high and low levels of SARS-CoV-2 community transmission.ConclusionsOur findings indicate no clear evidence of excess all-cause mortality in Norway during the pandemic, neither nationally nor in areas with high infection rates. This suggests that early implementation of nationwide and nursing home-specific infection control measures during the pandemic effectively protected nursing home residents. Furthermore, our results revealed a decrease in hospitalizations, both overall and prior to death, suggesting that nursing homes adhered to national guidelines promoting on-site treatment for residents.

Unmasking vulnerabilities by a pioneering approach to securing smart IoT cameras through threat surface analysis and dynamic metrics

The concept of the Internet of Things (IoT) threat surface refers to the overall susceptibility of smart devices to potential security risks. This vulnerability includes the combined impact of security weaknesses, gaps in protective measures, and potential vulnerabilities within the device OS, installed libraries, and applications, as well as the infrastructure involved. This comprises both identified and unforeseen risks that could potentially compromise the device’s integrity, data, logs, and hosted applications. By minimizing the extent to which the device’s components are exposed, it becomes possible to reduce the vulnerabilities inherent in the device, thereby decreasing its overall threat surface area. This research introduces an innovative framework for assessing Smart IoT cameras within the ecosystem. This framework involves the identification and categorization of webcam devices, followed by an analysis of potential threats based on various exposure indicators present within each layer. Subsequently, this information is used to determine the possible paths through which a device might be compromised, allowing for the evaluation of severity and both maturity levels. The authors present metrics that aid in reevaluating and recalibrating the security levels, considering the discovered threat surface elements. These refined metrics offer a fresh perspective on security, offering valuable insights for stakeholders who are engaged in the development, deployment, and evaluation of the security aspects of such devices.

Study on the relationship between economic input growth in Marine protected areas and environmental governance in the North Pacific Coast of Costa Rica: Based on reef fish assemblages

Reef fish communities under fishing pressure often experience reduced biomass, abundance, and altered size structure. The establishment of marine protected areas (MPAs) can help mitigate these declines. However, the success of MPAs, especially in developing countries with financial and socioeconomic challenges, largely hinges on effective enforcement. This study utilized underwater visual surveys (UVS) and baited remote underwater video stations (BRUVS) to evaluate population density, size distribution, and biomass of both economically valuable (e.g., target and ornamental species) and ecologically important (e.g., small/large predators and herbivores) fish groups within and outside a no-take MPA on the northern Pacific coast of Costa Rica.The results indicated that protective measures did not significantly affect the biomass of economically valuable fish species. However, there were notable differences in fish abundance and size distribution between no-take zones (where fishing is prohibited) and open-fishing zones. This suggests that, despite potential illegal fishing activities within the MPA, certain fish community components benefit from the protective measures.Specifically, herbivores and ornamental fish, which are often targeted by artisanal compressor fishing and the aquarium trade, exhibited higher biomass and abundance levels within the MPA. Additionally, significant shark species such as Galeocerdo cuvier, Carcharhinus leucas, and Carcharhinus limbatus were exclusively found within the MPA.The study also highlighted the crucial role of habitat quality, particularly high coral cover, in enhancing the biomass of ornamental fish.This research contributes to the growing body of evidence that MPAs, even with limited enforcement, consistently offer ecological benefits for reef fish communities

Spatiotemporal Dynamics of Plankton Communities in the Chongqing Section of the National Nature Reserve for Rare and Endemic Fishes in the Upper Yangtze River

In order to understand the community structure of plankton and environmental factors in the Chongqing section of the National Nature Reserve for Rare and Endemic Fishes (referred to as the “Reserve”) along the upper Yangtze River, this study investigated phytoplankton and zooplankton in the water body from 2021 to 2022. The results revealed a diverse phytoplankton community with 243 species from 105 genera and 8 phyla, dominated by Bacillariophyta and Chlorophyta. Phytoplankton showed average densities of 1.7 × 106 cells/L and biomass of 2.6221 mg/L, following a seasonal pattern of summer > spring > winter. Zooplankton analysis identified 141 species from 77 genera and 4 phyla, with rotifers most abundant, followed by protozoa. Zooplankton displayed average densities of 0.17 × 104 ind./L and biomass of 0.3226 mg/L, also following a seasonal pattern of summer > spring > winter. Total phosphorus (TP) emerged as the primary environmental factor influencing plankton community structure, positively correlating with phytoplankton density and zooplankton biomass. Plankton biodiversity indices classified water quality in the Chongqing section of the “Reserve” as oligo-/mesotrophic. Overall, plankton diversity in this section is notably rich, with similar species composition between mainstems and tributaries but seasonal variations in community structure. While mainstem water quality generally meets standards, some tributaries exhibit varying degrees of pollution, underscoring the need for improved ecological management and protection measures. This is crucial for maintaining the sustainability of the ecosystem.

Noise in operating theatres, is it safe?

Noise-Induced Hearing Loss (NIHL) is a condition caused by repeated exposure to loud noise, with operating theatre personnel potentially at risk. The aims of this study were to establish the typical noise levels in orthopaedic theatres and to compare these to The Control of Noise at Work Regulations 2005. We measured the average noise levels in 40 trauma and orthopaedic surgeries in a single centre. We used the Decibel X app to take measurements, then performed corrections to ascertain noise levels at the surgeon's ear (Leq). The daily noise exposure level for theatre staff for each procedure (LEP, d) and the LEP, d over an average 8-hour working day when performing different groups of procedures were calculated. Data were analysed using descriptive statistics, ANOVA, t-test and the Pearson coefficient of correlation. The LEP, d lower action value (80 dBA) as set by the Health and Safety Executive (HSE) was met by performing a single revision total knee replacement or a right open ankle debridement. Assuming three procedures are conducted per list, lists consisting of joint replacements (82 dBA) or medium elective procedures (81 dBA) exceed this lower limit. Additionally, lists comprising large and medium bone fractures would be within 1 dB of the limit (79 dBA and 79 dBA, respectively). Soft tissue (74 dBA), arthroscopic (73 dBA), and small bone fracture (71 dBA) procedures had the lowest LEP, d. The greatest contributors to noise levels were surgical instruments. The number of people in the room made a significant difference to noise levels (p = 0.032). We have established the baseline noise levels in various orthopaedic procedures. Measures should be taken to meet UK regulations. Further research should determine suitable measures for protection from hearing damage for theatre staff and evaluate the risks high noise levels pose to patients.

Transient hydraulic analysis of the water delivery pipeline in mountainous areas for cascade pressurized pump stations

ABSTRACT Aiming at the problem that cascade pressurized pump stations in mountainous areas are more prone to pump shutdown accidents compared to single-stage pressurized pump stations. Various pump shutdown accidents that may occur in the pressurized water supply system of the terrace pumping station were analyzed in a targeted manner. Additionally, it was also explored that in addition to water hammer protection measures, remote-control measures for water pumps based on PLC (Programmable Logic Controller) may be used to reduce the severity of accidents. A single-factor experimental method was used to numerically analyze various accident conditions of a simplified model of a three-stage series pressurized water delivery system consisting of a water intake pump station, a midway pump station, and a final-stage pump station, without water hammer protection devices. The impact of different control variables on the transient hydraulic calculations of pumping stations at all levels was evaluated. The results showed that optimizing the precedence of shutdowns, and the sequential shutdown times of each stage pump station could be assisted to some extent in water hammer protection by the PLC. This provides technical support and detailed optimization for the scientific control of cascade booster pumping stations in mountainous areas.

A Protocol of Prevention and Protection Measures on New Occupational Risk Factors in Green Jobs in Italian Workplaces

The Green Transition aims to protect the health of our planet through changes at the economic, political, and social levels while also having a significant impact on the world of work through the creation of sustainable occupations, referred to as ‘Green Jobs’. The aim of our research was to identify the new emerging occupational risks associated with Green Jobs and to propose a protocol to promote the adoption of more appropriate prevention and protection measures. Starting with a few keywords chosen by the authors, we conducted a narrative review of the scientific articles published in the literature. The results obtained show that the new occupational risks emerging in the activities involved in the green transition are mainly related to the introduction of new materials or new technologies and to modes of production processes. These risks may pose a danger to those exposed to them on a daily basis, causing damage to health. Our protocol proposal calls for a more careful and adequate risk assessment for Green Jobs, providing specific training on these issues for new professionals in the sector and introducing specific prevention and protection measures for the different occupational risks analysed in the workplace. By adopting these recommendations in the workplace and conducting in-depth research on these issues, it will be possible to contribute to the improvement of prevention and protection for these new emerging occupational risks, achieving a positive economic impact and better safety conditions for workers.

The assessment of public perception towards chronic kidney disease in Jordan: a cross-sectional study

Objectives Kidney diseases are considered silent killers due to the lack of well-defined symptoms. Public knowledge about chronic kidney disease (CKD) management has been shown to decrease the risk of CKD onset and progression to end-stage renal disease and renal failure. The main objective of this study was to assess the knowledge of kidney function, CKD symptoms, etiology, prevention and treatment in the general population. Methods A cross-sectional study using a validated questionnaire was conducted in Jordan to assess public knowledge of CKD. Public knowledge of CKD was assessed using a questionnaire consisting of 32 knowledge questions, including risk factors, symptoms, treatment, protective measures and kidney function. The knowledge level was classified according to the total score: poor (0–50%), intermediate (51–70%) and good/high (71–100%). Multiple regression analysis was performed to compare knowledge scores (KS) and predict associations with the participants’ baseline characteristics. Results The level of knowledge about CKD among the 2181 participants was intermediate. The KS was significantly higher among participants with health issues such as hypertension, diabetes and heart problems, first-degree relatives working in the medical field, majors relevant to health, married, employed, highly educated, high-income and smokers. The main sources of knowledge about CKD were health professionals, TV shows, books and magazines. Multiple regression analysis showed an association between KS and age, sex, functional status, educational level and field, income, smoking status, having a family member/spouse work in the medical field, and knowledge source. Conclusions The public level of knowledge about CKD management is greatly influenced by participants’ health and social factors. Thus, improving public knowledge and perception through education and the media will significantly reduce CKD prevalence and incidence.

Research on visual experience evaluation of fortress heritage landscape by integrating SBE–SD method and eye movement analysis

Urbanization has led to homogenizing heritage site landscapes, and the protective measures have become disconnected from public needs. Additionally, the complex and diverse overall characteristics of heritage sites and the uneven distribution of values across different areas are related to the lack of landscape experience assessment. The “subjective + objective” cognitive evaluation and visual perception framework that adopts the Scenic Beauty Estimation Procedure-Semantic Differential (SBE–SD) method and eye-tracking analysis can compensate for the limitations of a single evaluation method by integrating quantitative and qualitative analysis. This research takes the Yi’an Fortress in Zhangpu County, Fujian Province, as the object and examines the visual experiences of different areas and types of landscapes within the Yi’an Fortress. The findings reveal several key insights: (1) Significant differences were found in the landscape experiences of different areas within the heritage site. The visual experience score of the core building area of Yi’an Fortress is (1.01) > the heritage entrance area (0.897) > the residential area (0.841) > the natural ecological area (0.784), indicating that the natural ecological area should be the focus of future protection and development efforts, with a particular emphasis on enhancing the ‘landscape aesthetic’ and ‘landscape cultural’ aspects. (2) The landscape experience scores can be used to understand the reasons for the differences in participants’ experiences of different landscapes. The architectural heritage landscape of the Yi’an Fortress scored highest in the experience evaluation due to its superior performance in terms of ‘landscape form’ factors. The cultural decorative landscape scored next, while the garden greening landscape scored the lowest, due to their poorer performance in terms of ‘landscape form’ and ‘landscape aesthetics’. (3) The eye-tracking data was consistent with the results of the subjective evaluation, validating the “subjective + objective” cognitive evaluation and visual perception framework, employing the SBE–SD method and eye-tracking analysis is a scientific and effective method for assessing the visual experience of heritage landscapes. These results provide a scientific basis for the heritage planners and managers of the Yi’an fortress to improve the landscape environment, better meet public needs, and preserve the unique character of this vital cultural resource. Furthermore, this study offers a new research method and approach for the protection of other heritage landscapes.

Monitoring and disaster prevention of high and steep sandstone slopes along highways under construction

High and steep sandstone slopes along highway line are at high risk of disasters such as landslides, cracking of support structures, and so on. The monitoring, early warning, and emergency response of such slope disaster face enormous challenges, especially during the rainy season. In this paper, intelligent monitoring, early warning and forecasting system were carried out for the high steep sandstone slope with a transmission line tower at the slope crest along the highway under construction in Guangxi, China. The automatic monitoring data, emergency rescue program and rescue effect were analyzed, and emergency rescue measures for high steep slope protection were taken. The research results show that timely access to disaster warning information can effectively support the analysis of disaster causes and the evaluation of disposal programs. Deep-hole monitoring of deformation characteristics can determine the stable state of slopes, and the tangent angle warning criterion can be used for early warning and prediction of high steep slope landslides. By analyzing the location of the sliding surface and taking timely emergency disposal measures such as layered counterpressure method and micropipes, the landslide activities can be effectively controlled to prevent further acceleration of slope collapse. This study can provide an important reference for the monitoring, early warning, forecasting and emergency rescue of sandstone slopes along highways under construction.

The effectiveness of plant protection products against Lobesia botrana Den. U Schift. in Zakarpattya

Goal. To establish the effectiveness of chemical protection of vineyards against pests, taking into account the peculiarities of their biology, distribution, harmfulness, seasonal dynamics of flight in Zakarpattya Ukraine. Methods. The research was conducted in accordance with the generally accepted methods in entomology and viticulture in 2021—2022 on the basis of Chateau Chizay LLC. The dynamics of the pest’s flight were studied in the field using the pheromone monitoring method using «Atrakon» pheromone traps and synthetic sex pheromones from the company «Csalomon» (Hungary). The research was conducted on Muscat, Chersegui, Sovignon Blanc, Pinot Noir, Cabernet Sovignon, Merlot, Rhine Riesling, and Pino Blan varieties. In 2022, in the vineyards of Chateau Chizay LLC, Zakarpattia Oblast, chemical plant protection agents were tested against grape leaf curl: Karate Zeon 050 CS, SK (liambda-tsyhalotryn, 50 h/l), 0.65 l/ha, Korahen 20, KS (khlorantraniliprol, 200 h/l), 0.15 l/ ha, Mavrik, EV (tau-fliuvalinat, 240 h/l), 0.2 l/ha, Voliam Fleksi 300 SC, KS (tiametoksam, 200 h/l + khlorantraniliprol, 100 h/l), 0.3 l/ha according to generally accepted methods. Results. Prolonged spring cooling in 2022 delayed the start of the flight of the first generation of cluster leafhopper, which began only in the first days of May. The second generation of this pest has been actively developing since the end of June. Grape damage on different varieties ranged from 2.1% on Muscat to 8.0% on Pino Blan. In the control (not treated with insecticides) plots, this indicator averaged 96.1%. The yield in the farm by variety averaged about 8 t/ha and ranged from 7.1 t/ha for the Muscat variety to 9.0 t/ha for the Merlot variety. In the control plot, the yield was low, only 1.4 t/ha. The effectiveness of protective measures on all grape varieties reached 90.5%. Conclusion. It was established that the protracted spring cooling caused the late start of flight of the grape leafhopper, which made adjustments to the calendar of protective measures, especially chemical ones. At the same time, thanks to pheromone monitoring, it was possible to establish the exact date of the start of Lobesia botrana’s flight and specify the timing of the application of chemical insecticides at the most favorable time, which made it possible to achieve an efficiency of more than 90%. Use of plant protection products against Lobesia botrana Den. et Schiff. in vineyards, LLC «Chateau Chizay», Zakarpattia Oblast contributed to the reduction of grape damage up to 94% and the preservation of the harvest up to 6.5 t/ha.

A LEI MARIA DA PENHA E OS DESAFIOS POLICIAIS NA PROTEÇÃO DA MULHER

Violence against women is not something new, but rooted in the historical-cultural system of female subordination, with its protection addressed in detail in the Maria da Penha Law. This law was created to also protect victims of domestic violence, the focus of this article, whether they are victims of psychological, physical, property or moral violence. Thus, this article seeks to highlight the importance and impacts of police activity in protecting women, highlighting the Maria da Penha Patrol, which is a police patrol created to monitor victims, their protective measures and necessary follow-up after a complaint. With this, the article highlights the importance of reporting as a duty of all people, in addition to demonstrating the difficulties faced by the police in implementing protective measures and the insensitivity of approaches, highlighting the importance of community involvement. The slowness of the judiciary allowing punishments to expire brings insecurity to women who avoid reporting. As a result, research shows an increase in the number of femicides, and more policies should be created for campaigns to encourage reporting. To this end, the methodology used was secondary bibliographic research of academic articles and books.

Environmental, Geographical, and Economic Impacts of Inbound Tourism in China: A Mixed-Effects Gravity Model Approach

This study examines the dynamics of inbound tourism in China, utilizing a mixed-effects gravity model to analyze data from urban clusters around China’s three major airports. The research methodology of the study includes applying advanced econometric techniques, such as the Poisson pseudo-maximum likelihood estimation, to ensure robust and accurate results. The study focuses on international tourist arrivals and foreign exchange earnings, identifying key drivers such as tourism resources, transportation safety, and service quality. Our findings indicate a 10% increase in per capita GDP correlates with a 0.88% rise in inbound tourist numbers. Additionally, proximity to major urban centers like Beijing, Shanghai, and Guangzhou significantly influences tourist arrivals, with every 100 km increase in distance resulting in a 5.56% decrease in tourist numbers. The study also explores the impact of environmental factors on tourism, suggesting that improvements in green coverage and reductions in industrial waste and traffic fatalities could enhance tourist arrivals. Conversely, environmental protection measures can both positively and negatively impact tourism. This research provides a strategic blueprint for policymakers and professionals in tourism and environmental sustainability, emphasizing the importance of integrated environmental sustainability in tourism development strategies. The model accounts for up to 79% of the variability in inbound tourism flows, offering robust evidence that economic and policy dimensions impact tourism.

The politics of belonging in Arunachal Pradesh: rules of exclusion and differentiated citizenship

ABSTRACT This paper unravels the politics of belonging, the legal-political regime of exclusion, and differentiated citizenship in the multi-layered social and political context of Arunachal Pradesh, India. This paper aims to engage with the institutional arrangements of the Indian state that accommodate the ethno-cultural differences in a multi-ethnic society. Set amidst the changing social and economic realities of Arunachal Pradesh, this study relates to the emerging contestations around the protection of Indigenous identity and the need for differential treatment of people in multiethnic societies by embedding these discussions within policy debates on Inner Line Regulation and land legislations in the state. This paper adopts an incisive approach to understand the implications of such protective measures on the conceptualization of citizenship in states with a significant Indigenous population. It argues for examining the implications of ethnicised forms of governance in favour of democratic power sharing structures and representative institutions of the economy.

Early diagnosis of small airway disease in asymptomatic polishing sector workers of a leather factory

Background: The leather industry stands as one of India’s burgeoning sectors, boasting significant manpower. Workers in the finishing sector, particularly those involved in polishing, face heightened risks due to exposure to formaldehyde, aniline, and resins, which can lead to respiratory complications. Aims and Objectives: The aims and objectives of the study are to determine the small airway obstruction in asymptomatic finishing sector workers of a leather factory. Materials and Methods: The current study was a cross-sectional study conducted in a leather factory located in Chennai, Tamil Nadu. A random sample of 60 workers was drawn from different sectors of a leather factory. Basic demographic details, smoking history, nature of work, exposure to irritants along with duration, and respiratory symptoms were collected. All workers were subjected to spirometry as per ATS guidelines and the results were analyzed. Association between length (years) of exposure, respiratory symptoms, and spirometry impairment among the workers were analysed. Results: Out of 60 samples, 38 were exposed to irritants and 22 were not exposed to irritants. Out of 38, 25 had small airway disease, seven had large airway obstruction, one had a restrictive pattern, and five had normal spirometry. 42.1% of them were asymptomatic. Conclusion: Small airway obstruction is notably prevalent, especially among asymptomatic workers in the polishing sector. Prolonged exposure is associated with the development of large airway obstructive disease. This study underscores the importance of continuous monitoring for airway diseases in occupationally exposed workers, advocating for timely preventive and protective measures to curb disease progression.

“It Became No Man’s Land”: The Burden of Moderating Online Harassment in Newswork

ABSTRACT Online harassment against media workers has been on the rise, prompting academic and international organizations to call for comprehensive measures that could protect journalists from intimidation and threats on social media platforms. Despite these efforts, research shows little success in curbing the issue of hostility towards media professionals. With this article, we aim to explore journalists’ perceptions regarding online harassment and the responsibility that they attribute to the media organizations they work for, as well as digital platforms for allowing violence to spread online. Our study is based on ethnographic fieldwork conducted in two Chilean newsrooms, including interviews with media professionals responsible for moderating hate. This article discusses the experiences of reporters who have faced online threats and attacks while reporting the news. Our findings show that digital platforms have provided new opportunities for violent behavior against journalists. More remarkably, some journalists are worried that their media organizations might prefer to benefit from the increased engagement and metrics that come with such aggressive actions. Our findings shed light on the challenges journalists face in the digital age and the need for more significant protection measures.

Analysis of the Spatiotemporal Changes in Cropland Occupation and Supplementation Area in the Pearl River Delta and Their Impacts on Carbon Storage

In recent years, the “dual carbon” issue has become a major focus of the international community. Changes in land use driven by anthropogenic activities have a profound impact on ecosystem structure and carbon cycling. This study quantitatively assesses the spatiotemporal changes in cropland occupation and supplementation in the Pearl River Delta from 2000 to 2020 using the InVEST model, analyzing the spatial clustering of carbon storage changes caused by variations in cropland area. The PLUS model was employed to simulate land-use patterns and the spatial distribution of carbon storage in four future development scenarios. The results indicate the following: (1) From 2000 to 2020, the net change rate of cropland area in the Pearl River Delta was −0.81%, with a decrease of 16.49 km2 in cropland area, primarily converted to built-up land and forest land. (2) Carbon storage in the Pearl River Delta exhibited a pattern of lower values in the center and higher values in the periphery. The terrestrial ecosystem carbon storage in the Pearl River Delta was 534.62 × 106 t in 2000, 518.60 × 106 t in 2010, and 512.57 × 106 t in 2020, showing an overall decreasing trend. The conversion of cropland and forest land was the main reason for the decline in total regional carbon storage. (3) The area of carbon sequestration lost due to cropland occupation was significantly greater than the area of carbon loss compensated by new cropland, indicating an imbalance in the quality of cropland occupation and supplementation as a crucial factor contributing to regional carbon loss. (4) Under the ecological priority scenario, the expansion of built-up land and the reduction in ecological land such as cropland and forest land were effectively controlled, resulting in the minimal loss of carbon storage. The soil organic carbon pool of cropland is the most active carbon pool in terrestrial ecosystems and has a significant impact on carbon storage. Clarifying the relationship between “cropland protection measures–land use changes–ecosystem carbon storage” will improve cropland protection policies, provide references for regional carbon sequestration enhancement, and support sustainable socio-economic development.

Is Ocular Safety in Orthopaedics Overlooked? A Systematic Review of Annual Ocular Radiation Exposure and Protective Measures.

Intraoperative fluoroscopy is increasingly common in orthopaedics, although recent guidelines have reduced the maximum recommended exposure to 20 mSv annually. A systematic review of the literature was conducted to comprehensively assess current adherence to exposure guidelines, identify practice settings at increased risk for exposure, and determine the best practices and personal protective equipment for ocular radiation risk mitigation. In this systematic review we asked: (1) Is the annual amount of eye irradiation received by orthopaedic surgeons below the recommended limit of 20 mSv? (2) What is the effectiveness of leaded glasses in reducing the eye's exposure to radiation? (3) Which imaging setups and operative techniques reduce ocular irradiation? PubMed, Medline, EBSCOhost, and Google Scholar were queried on September 28, 2023, to identify studies assessing intraoperative ocular radiation exposure among orthopaedic surgeons. Studies that measured radiation in or around the eye (such as the bridge of the nose or eyebrows) during orthopaedic procedures were included. Exclusion criteria were duplicate studies, studies that only estimated eye radiation based on the radiation dose recorded at parts of the body distant from the eyes, nonoriginal research, case reports, and articles without full-text English versions available. A total of 393 unique articles were retrieved, and after title, abstract, and full-text screening, 23 dosimetry studies were included, comprising 12 prospective observational studies, 7 phantom models, 1 cadaver model, 2 observational studies, and 1 randomized control trial. Risk of bias was determined via the Methodological Index for Nonrandomized Studies (MINORS) tool. Study quality was generally good to excellent, with noncomparative studies having a mean MINORS score of 14 ± 0 of 16 and comparative studies achieving a mean score of 19 ± 1 of 24, with higher scores representing better study quality. Due to extensive heterogeneity in study design, a meta-analysis was not conducted, with the results rather presented as a narrative summary of key findings. The vast majority of surgeons conducting a variety of orthopaedic and traumatologic procedures were not exposed to a hazardous level of eye irradiation annually, but surgeons who perform a high volume of fluoroscopy-intensive procedures may exceed guidelines. Leaded eyeglasses reduced eye radiation by about 90%, with sport wrap-around glasses offering better shielding than alternatives, although leaded glasses overall were largely underutilized. Positioning mini C-arms in the standard vertical configuration was shown to provide up to a 13-fold decrease in radiation exposure compared with inverted configuration, while standing perpendicular to the fluoroscope further reduced eye irradiation. We found that orthopaedic surgeons who perform a high volume of fluoroscopy-intensive procedures may be at risk of exceeding recommendations on annual radiation exposure, although exposure can be mitigated through various simple strategies. In particular, this analysis found that the use of sport wrap-around leaded glasses, positioning of mini-C arms in the standard vertical configuration, and standing perpendicular to the fluoroscope provide the most effective means of limiting ocular radiation exposure. As ophthalmic radiation exposure presents a potentially important occupational health hazard to orthopaedic surgeons, further investigations of radiation exposure specific to high-volume, fluoroscopy-intensive orthopaedic practices and long-term ophthalmic outcomes will help determine the extent of the potential harm posed by frequent exposure to intraoperative radiation over the span of a career. Level III, therapeutic study.

Intensive care of a patient undergoing combined multi-organ cluster ("larynx-trachea-thyroid-hypopharynx-esophagus") transplantation: A case report.

The aim of this study was to summarize the intensive care experience of a patient undergoing combined multi-organ cluster ("larynx-trachea-thyroid-hypopharynx-esophagus") transplantation. The intensive care management plan for this case was developed by a multidisciplinary team, with focus on 6 aspects: (1) stabilizing the circulation and reducing anastomotic tension by position management to improve the survival chances of transplanted organs, (2) adopting goal-directed analgesia and sedation protocols, as well as preventing anastomotic fistula, (3) implementing a bedside ultrasound-guided nutrition plan, (4) employing "body-mind" synchronous rehabilitation to facilitate functional recovery, (5) taking antirejection treatment and protective isolation measures, (6) monitoring and nursing thyroid function. During the intensive care, the patient's vital signs were stable. The patient was successfully weaned from the ventilator and transferred to the general ward for further treatment at 9 days postoperatively, and discharged upon recovery at 58 days postoperatively. The patient was in good condition during follow-up. This study provides reference for the care of patients who undergo similar transplantation in the future.