Significant Decreasing Trends Research Articles

A Combined Seasonal Mann–Kendall and Innovative Approach for the Trend Analysis of Streamflow Rate in Two Croatian Rivers

Climate change profoundly impacts hydrological systems, particularly in regions such as Croatia, which is renowned for its diverse geography and climatic variability. This study examined the effect of climate change on streamflow rates in two Croatian rivers: Bednja and Gornja Dobra. Using seasonal Mann–Kendall (MK) tests, overall streamflow trends were evaluated. Additionally, innovative polygon trend analysis (IPTA), innovative visualization for innovative trend analysis (IV-ITA), and Bayesian changepoint detection and time series decomposition (BEAST) algorithms were used to assess the trends’ magnitudes and transitions. The seasonal MK analysis identified significant decreasing trends, primarily during summer. The results of IPTA and IV-ITA revealed consistent decreasing trends throughout most months, with a notable increase in September, especially at high flow values. The rivers’ behavior differed between the first and second halves of the month. BEAST analysis detected abrupt changes, including earlier shifts (1951–1968) in the Bednja and more recent ones (2013–2015) in both the Bednja and, to a lesser extent, the Gornja Dobra rivers. This comprehensive approach enhances our understanding of long-term streamflow trends and short-term fluctuations induced by climate change.

Risk-adjusted trend in national inpatient fall rates observed from 2011 to 2019 in acute care hospitals in Switzerland: a repeated multicentre cross-sectional study

ObjectivesThis study aimed to investigate whether a significant trend regarding inpatient falls in Swiss acute care hospitals between 2011 and 2019 could be confirmed on a national level, and whether...

Examining the spatial and temporal vulnerability to drought in Odisha, India

ABSTRACT The research focuses on investigating the spatial and temporal vulnerability to drought in Odisha, India, utilizing the Standard Precipitation Index (SPI), Drought Index (DI), and Rainfall Anomaly Index (RAI). The historical precipitation data are utilized to identify areas with prolonged rainfall deficits, quantifying the severity and duration of drought conditions. Preliminary analysis includes Normality and Homogeneity tests to ensure the validity of the precipitation datasets. The results depict the use of a non-parametric test for which Mann–Kendall trend test and Sen's Slope test are conducted. The districts exhibiting significant decreasing trends are identified as most critical for drought assessment. The findings from drought indices indicate that most districts have been affected by drought for approximately 50 years, with some districts experiencing severe or extreme conditions for over 10 years. Among the nine districts exhibiting a decreasing trend, four districts demonstrate a significant trend at a 5% significance level. These four districts are experiencing extremely and severely dry conditions, and while they display a significant decreasing trend, they are potentially vulnerable to the adverse impacts of drought conditions in the future. The study will serve in understanding and addressing the vulnerability to drought in Odisha, providing crucial insights for effective mitigation and management strategies.

Analysis of drying characteristic, effective moisture diffusivity and energy, exergy and environment performance indicators during thin layer drying of tea in a convective-hot air dryer

The objective of this study is mainly to analyze the drying kinetic parameters, effective diffusivity, and thermodynamic performance indicators (energy, exergy, heat, and mass transfer coefficients) of tea under different drying conditions of different drying temperatures (DT) and thin layer thicknesses (TT). Experimental drying was conducted at drying temperatures of 70°C, 80°C, and 90°C with thin layer thicknesses of 10 mm, 15 mm, and 20 mm. The results show that a higher drying temperature and a lower thin layer thickness can increase evaporation moisture content and shorten drying time. By evaluating and comparing the fitting of five drying models adopted by the coefficient of determination (R2) and chi-square (χ2), it can be found that the logarithmic model is the best to describe drying behavior. The effective moisture diffusivity shows a positively correlated trend with the increase in DT and TT, with the value of activation energy ranging from 14.030 to 22.344 kJ mol−1 K−1. The specific moisture evaporation rate (SMER), energy efficiency, exergy efficiency, and sustainability index (SI) descend as the TT increases at all DT; the specific energy consumption (SEC) and improvement potential (IP) rate perform in an opposite manner, but the TT remains unchange. The conclusion drawn from the thermodynamic parameters is opposite to the aforementioned. As the TT increases, the heat and mass transfer coefficients show a significant decrease trend. In addition, the heat and mass transfer coefficients are given as functions of DT and TT, and further knowledge shows that the mass transfer coefficient is positively correlated with DT but the heat transfer coefficient is negatively correlated. In conclusion, this article provides new insights into the effects of drying characteristics, energy consumption characteristics and heat and mass transfer characteristics in the process of tea drying under different drying conditions, and provides certain theoretical reference bases for promoting the optimization of industrialized tea drying production machinery design and drying process optimization.

Understanding the climatology and long-term trends in solar radiation using ground based in-situ observations in India

Understanding the variations of solar power potential over the country is essential for the optimum utilisation of solar energy in power generation, which demands accurate information of solar radiation and its variations. In the present study, we investigate the climatology and trends of global radiation (GR), diffuse radiation (DR), bright sunshine hours (BHS) and technical potential of solar power (Solar Photovoltaic potential; SPV potential) using in-situ data procured from India Meteorological Department for the period 1985-2019. GR is high (low) over the northwest and inland areas of peninsular (extreme north and northeast) India, whereas DR is high (low) over the coastal stations (extreme northern parts of the country). BHS is more (less) over northwest (north, northeast and southern peninsular) India. The country has SPV potential in the range of 1800-3400 Wm-2 with substantial regional variations. High (low) SPV potential is observed in the northwest regions (north, northeast and southern peninsular India). The GR and BHS (DR) have (has) a significant decreasing (increasing) trend in most parts of the country. However, the rate of decreasing (increasing) of GR (DR) has been weakened (strengthened) in the recent decade. The technical potential of solar power has a significant decreasing trend in most of the selected stations which is alarming. It necessitates the wide use of solar panels with better efficiency to meet the energy requirements from solar resources.

Abstract 3467: Tumor immune and microbial characteristics of colorectal cancer according to age at diagnosis and detailed anatomical location

Abstract Background: Colorectal cancer is a heterogeneous disease, exhibiting spectra of tumor characteristics that vary across age at diagnosis and anatomical location. We hypothesized that tumor immune and microbial characteristics of colorectal cancer might change with age at diagnosis and detailed anatomical location. Methods: We utilized a pooled dataset of colorectal cancer cases (N= 958 to1413 depending on variables) with available immune cell density or microbial data in the Nurses' Health Study, Health Professionals Follow-up Study, and Ontario Familial Colon Cancer Registry. We examined whether there were statistically significant trends in tumor immune and microbial according to age at diagnosis and detailed primary tumor location (cecum, ascending, hepatic flexure, transverse, splenic flexure, descending, sigmoid, rectosigmoid, rectum) using Spearman’s correlation test. The densities of immune cells were determined by using multiplex immunofluorescence, including T cells (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3) and macrophages (CD68, M1-like, and M2-like) in tumor intraepithelial and stromal regions. We conducted stratified analyses by microsatellite instability (MSI) status. Results: The density of memory (both CD4+ and CD8+) T cells in tumor epithelial areas continuously increased as age at diagnosis increased (P for trend <0.005). Compared to later-onset colorectal cancer, early-onset colorectal cancer had a lower density of memory T-cells. With respect to tumor site, CD3+CD4+ and CD3+CD8+ T densities in tumor epithelial areas were highest in the cecum compared to other subsites, and there was a statistically significant decreasing trend from the cecum to rectum (P for trend <0.005). We also observed significant decreasing trends for CD68+, M1-like, and M2-like macrophage densities in combined tumor (intraepithelial and stromal) regions from the cecum to rectum (P for trend <0.005). The proportion of F. nucleatum-positive colorectal cancers gradually decreased from the cecum to rectum (P for trend <0.005). Similar trends were observed in separate analyses in non-MSI-high cases. Conclusions: This study suggests that certain tumor immune and microbial characteristics in the tumor microenvironment, specifically T cell and macrophage densities and Fusobacterium nucleatum positivity, change gradually according to age at diagnosis and/or detailed anatomical location. Age and anatomical location spectra in tumor immune and microbial characteristics will shed light on the etiology of colorectal cancer (including early-onset colorectal cancer), leading to better-personalized cancer prevention and treatment. Citation Format: Tomotaka Ugai, Yasutoshi Takashima, Yuxue Zhong, Juha P. Väyrynen, Daniel Buchanan, Jeroen Huyghe, Li Hsu, Conghui Qu, Sushma Thomas, Claire Thomas, Steve Gallinger, Robert Grant, Ulrike Peters, Amanda I. Phipps, Jonathan Nowak, Shuji Ogino. Tumor immune and microbial characteristics of colorectal cancer according to age at diagnosis and detailed anatomical location [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3467.

Routine Climate Monitoring in the State of Hawai‘i: Establishment of State Climate Divisions

Abstract The Hawaiian Islands have some of the most spatially diverse rainfall patterns on earth, affected by prevailing trade winds, midlatitude disturbances, tropical cyclones, and complex island topography. However, it is the only state in the U.S. that does not have assigned climate divisions (boundaries defining climatically homogeneous areas), which excludes it from many national climate analyses. This study establishes, for the first time, official climate divisions for the State of Hawai‘i using cluster analysis applied to monthly gridded rainfall data from 1990 to 2019. Twelve climate divisions have been identified: two divisions were found each for the islands of Kaua‘i (Leeward Kaua‘i and Windward Kaua‘i), O‘ahu (Waianae and Ko‘olau), and Maui County (Leeward Maui Nui and Windward Maui Nui), and six divisions were identified for Hawai‘i Island (Leeward Kohala, Windward Kohala, Kona, Hawai‘i Mauka, Ka‘u, and Hilo). The climate divisions were validated using a statewide area-weighted division-average rainfall index which successfully captured the annual cycle and interannual rainfall variations in the statewide average rainfall series. Distinct rainfall seasonality features and interannual/decadal variability are found among the different divisions; Leeward Maui Nui, Leeward Kaua‘i, Kona, and Hawai‘i Mauka displayed the most significant rainfall seasonality. The western Hawai‘i Island divisions show the most significant long-term decreasing trends in annual rainfall during the past 100 years (ranging from -2.5% to -5.0% per decade). With these climate divisions now available, Hawai‘i will have access to numerous operational climate analyses that will greatly improve climatic research, monitoring, education and outreach, as well as forecasting applications.

Growth, survival and reproductive traits of chemical induced and tetraploid-derived triploid Hong Kong oysters (Crassostrea hongkongensis)

Chemical induction (inhibition of polar body II release) and crossing between tetraploid and diploid oysters (mating triploids) are 2 distinct and typical methods for obtaining triploids, and systematic comparative analysis on the phenotypic traits of these two triploids is rare. We tracked and compared the growth, survival, reproductive characteristics and ploidy composition of diploids, induced triploids, and mating triploids, and conducted interaction analysis between genotypes and sites. The results showed that the shell height of larvae showed a significant decrease trend of 3 NTD > 3 NCB > 2 N, while the D larval rate and survival rate of 3 NCB were the lowest, which may be related to the long-term effects of CB toxicity. During offshore farming, from the 180th to 700th day, the shell heights of the three groups followed a significantly decreasing order at both sites, namely 3 NTD > 3 NCB > 2 N (except on the 270th day at Beihai site), and the triploid advantage of shell height in 3 NTD was generally higher than that in 3 NCB, with the same trend in the whole weight. Genotypes and sites always had significant effects on shell height, but their interactions were not significant. The incremental survival rates of the 2 triploid groups were higher than that of the diploid at both sites on the 270th and 700th day, while that of the 3 NTD was significantly higher than the 3 NCB only on the 270th day. In addition, both triploids had some individuals fertile and could produce mature gametes, but the proportion was much lower than that of diploids. Triploid gonadal development is characterized by feminization and a high proportion of hermaphroditism. The fertility ratio and gamete production of 3 NTD were higher than that of 3 NCB, but the relatively high fertility of 3 NTD had no significant effect on its growth and survival. Ploidy composition tracking found that the ploidy composition of 2 N and 3 NTD groups was stable, but the ploidy composition of 3 NCB varied over time. These results indicate that 3 NTD has better performance and higher triploid advantages than 3 NCB, making it more suitable for the commercial production and promotion of triploid C. hongkongensis.

Comparison of the CASA and InVEST models’ effects for estimating spatiotemporal differences in carbon storage of green spaces in megacities

Urban green space is a direct way to improve the carbon sink capacity of urban ecosystems. The carbon storage assessment of megacity green spaces is of great significance to the service function of urban ecosystems and the management of urban carbon zoning in the future. Based on multi-period remote sensing image data, this paper used the CASA model and the InVEST model to analyze the spatio-temporal variation and driving mechanism of carbon storage in Shenzhen green space and discussed the applicability of the two models to the estimation of carbon storage in urban green space. The research results showed that, from 2008 to 2022, in addition to the rapid expansion of construction land, the area of green space and other land types in Shenzhen showed a significant decrease trend. The estimation results of the carbon storage model showed that the carbon storage of green space shows a significant trend of reduction from 2008 to 2022, and the reduction amounts are 0.8 × 106 t (CASA model) and 0.64 × 106 t (InVEST model), respectively. The evaluation results of the model show that, in megacities, the spatial applicability of InVEST model is lower than that of CASA model, and the CASA model is more accurate in estimating the carbon storage of urban green space. The research results can provide a scientific basis for the assessment of the carbon sink capacity of megacity ecosystems with the goal of "dual carbon".

Análisis de la incidencia y la letalidad del infarto agudo de miocardio en la provincia de Girona durante las tres últimas décadas

Introduction and objectivesMyocardial infarction (MI) incidence and case fatality trends are highly informative but relatively untested at the population level. The objective of this work was to estimate MI incidence and case fatality in the Girona population aged 35-74 years, and to determine their 30-year trends (1990-2019). MethodsThe REGICOR (Girona Heart Registry) monitored MI incidence and case fatality rates from 1990 to 2008. For the period 2008 to 2019, we linked discharges from Girona hospitals (n=4 974 977) and mortality registry (n=70 405) during this period. Our linkage algorithm selected key MI diagnostic codes and removed duplicates. Estimates from the linkage algorithm and the REGICOR registry were compared using chi-square tests for overlapping years (2008-2009). We estimated the annual percent change (APC) of standardized MI incidence and 28-day case fatality, and analyzed their trends using joinpoint regression. ResultsMI incidence and case fatality estimates were similar in the linkage algorithm and the REGICOR registry. We observed significant decreasing trends in the incidence of MI. The trend was APC, -0.96% (95% confidence interval (95%CI), –1.4 to –0.53) in women from 1990 to 2019 and –4.2% (95%CI, –5.5 to –3.0) in men from 1994 to 2019. The largest decrease in case fatality was –3.8% (95%CI, -5.1 to –2.5) from 1995 to 2003 in women and –2.4% (95%CI, –2.9 to –1.9) from 1995 to 2004 in men, mainly due to prehospital case fatality declines: -1.8% (95%CI, –2.6 to –1.1) in men and –3.2% (95%CI, –4.6 to –1.8) in women. ConclusionsIn Girona, MI incidence and case fatality decreased between 1990 and 2019. The incidence showed a slow but continuous decrease while case fatality only stabilized in the last decade, particularly in women.

The mean reticulocyte volume is a valuable index in early diagnosis of cancer-related anemia.

Cancer-related anemia (CRA) is a functional iron deficient anemia, and the early diagnosis will improve the prognosis of the patients. This prospective study aimed to investigate the utility of mean reticulocyte volume (MRV) in the early diagnosis of CRA. A total of 284 first-diagnosed cancer patients were enrolled, and the subjects were assigned anemia and non-anemia groups by hemoglobin (Hb) concentrations. The mature RBC and reticulocyte indices were detected with BC-7500 blood analyzer, and the MRV, reticulocyte hemoglobin (RHE) content, and reticulocyte production index (RPI) were obtained. ROC curves were constructed in identifying anemia diagnosed by the combination of RHE and RPI. An adjusted multivariate analyse and quartiles were used to assess the associations of MRV with early CRA diagnosed by combining RBC indices (MCV, MCH and MCHC), respectively. No statistical differences were observed in MCV, RHE and MRV levels between anemia and non-anemia subjects (p>0.05). MRV exhibited a complete or high correlation with the RHE levels (r=1.000, p<0.001), or MCV, MCH, and MCHC in anemia patients (R: 0.575-0.820, p<0.001). ROC curves analyse indicated a highest area under curve of 0.829 (95% CI [0.762-0.895]) and 0.884 (95% CI [0.831-0.936]) for MRV in identifying anemia in male and female patients, respectively (p<0.001). When the optimal cutoff values of MRV were set at 100.95 fl in males and 98.35 fl in females, the sensitivity and specificity were 1.00 and 0.68, and 1.00 and 0.73, respectively. The regression analyse showed that, when being as a categorical variable, MRV showed an odds ratio of 19.111 (95% CI [6.985-52.288]; p<0.001) for the incidence of CRA. The incidence of overall anemia demonstrated a more significant decrease trend along with the increase of MRV quartiles (p-trend < 0.001). This study revealed that the MRV can be used as a convenient and sensitive index in early diagnosis of cancer-related anemia, and decreased MRV level may be the powerful predictor of overt anemia in cancer patients.

Temporal trends of carbonated soft-drink consumption among adolescents aged 12-15 years from eighteen countries in Africa, Asia and the Americas.

Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.

Trend Analysis of Inpatient Medical Adverse Events in Taiwan (2014-2020): Findings From Taiwan Patient Safety Reporting System.

Medical adverse event (MAE) reporting and management are essential for patient safety campaigns. An epidemiological assessment of MAE trends is crucial for understanding the effectiveness of patient safety improvement efforts. This study analyzed the trends of inpatient MAEs, focusing on MAE incidence and harm severity. Longitudinal secondary data (over 2014-2020) on MAEs reported by 18 hospitals were retrieved from the Taiwan Patient-safety Reporting system. The numbers and incidence rates (per 1000 inpatient days) of reported MAEs were calculated. The harm severity levels of six major MAE categories were analyzed. Trend and generalized estimating equation analyses were conducted to investigate changes in MAE patterns. Trend analyses revealed significant decreasing trends in the number (4763-3107 per year; Jonckheere-Terpstra test = -1.952, P = 0.05) and incidence rates (0.92-0.62 per 1000 inpatient days; β = -0.5017, P = 0.00) of harmful MAEs over 7-year study period. Among the most frequently reported MAEs, tube-related events exhibited the most significant decreasing trend (28%-23.8%; Jonckheere-Terpstra test = -2.854, P = 0.00). The reported numbers, incidence rates, and severity of falls and tube-related events dropped significantly. By analyzing representative longitudinal MAE data, this study demonstrated the effectiveness of nationwide patient safety improvement campaigns in Taiwan. Our data reveal significant reductions in the reported numbers, incidence rates, and severity of several major MAEs. Specifically, our data indicate significant reductions in the incidence and severity of tube-related events, which can be beneficial for patient safety improvement efforts.

Comprehensive analysis of spatiotemporal variability of rainfall-based extremes and their implications on agriculture in the Upper Ganga Command Area.

The agricultural sector in India primarily relieson monsoon rains, making it necessary for agricultural water managers to study variations in water availability by analyzing rainfall patterns. This information is critical for deciding cropping patterns and irrigation approaches, managing water resources, and improving crop water productivity. The long-term spatiotemporal variability over the command area, India Meteorological Department (IMD) based selection of thresholds for extremes indices, and thorough analysis of the consequences of extreme on agriculture make the study unique. These aspects collectively enhance the perception of the climate-agriculture relationship, which is essential for promoting agriculture resilience under changing rainfall patterns. This type of research is very limited in the literature. Therefore, the present study focuses on comprehensively analyzing the spatiotemporal variability of rainfall and extreme precipitation indices and their implications on agriculture. The study is carried out in the UpperGanga Command Area (UGCA), India's oldest irrigation canal system, by using long-term (1901-2021) high-resolution (0.25 × 0.25°) daily rainfall gridded data obtained from IMD, Pune. Eight different extreme rainfall indices are used to assess spatiotemporal variations. The Mann-Whitney-Pettitt test identified 1970 as a significant change point. Rainfall trends and extreme indices for pre- and post-1970 periods were examined using the non-parametric modified Mann-Kendall test. The results show significant increases in rainfall trends for the annual, monsoon, and kharif seasons from 1901 to 1970, but significant decreases were observed during 1971-2021. This difference resulted in a noticeable decrease in average precipitation in the latter period, approximately 62mm less than in 1901-1970. Similarly, extreme precipitation indices, including the number of rainy days (NxRainy), consecutive dry days (CWD), simple daily intensity index (SDII), and total precipitation (PRCPTOT), exhibited increasing trends in 1901-1970, but they showed significant decreasing trends in 1971-2021. In addition, there is a strong positive correlation between these indices and total precipitation. The study also found that geographical factors influence these trends, with all indices, except SDII, strongly correlated with latitude and elevation, but not with longitude. The implications of these negative rainfall and extreme rainfall trends were further analyzed, and the results indicate a significant impact on the cropping patterns in the study area. The present research findings will be beneficial for regional water resource managers and policymakers in better understanding the existing trends in rainfall distribution over the UGCA.

Long‐Term Variability and Trends in Snow Depth and Cover Days Throughout Iranian Mountain Ranges

AbstractIn Iran, the mountain snow cover generally feeds major rivers and thereby largely provides water resources required for improving human lives and protecting nature. Hence, understanding historical variability and trends in mountainous snowpack water resources in Iran in response to global warming and climate change can play a critical role in the sustainable development of this country. Accordingly, this study investigated long‐term (1982–2018) snowpack climatology at 13 hydrometeorological measurement stations scattered throughout the Iranian mountain ranges, with a focus on Elburz, Azerbaijan, Zagros, and Khorasan mountainous regions. The non‐parametric Mann‐Kendall test was used to detect statistically significant (p &lt; 0.05) trends, the Pettitt test to identify possible abrupt shift years, the Pearson's correlation coefficient to measure relationships among different time series, and the partial correlation to determine the most important climate factor influencing snowpack dynamics The annual snow depth (maximum snow depth) significantly declined throughout Iranian mountain ranges during 1982–2018, with an average rate of 1.0 (3.4) cm decade−1. The annual snow cover days (SCDs) also showed significant decreasing trends, ranging from 3 to 15 days decade−1 during 1982–2018, in 69% of the stations studied. Such considerable reductions in snow depth and cover days were mainly related to the compound effects of substantial increases in temperature, sunshine, and wind speed as well as decreases in precipitation and cloudiness during the SCDs across the Iranian mountain ranges. However, precipitation was the most influential climate factor controlling snow resources throughout both the Elburz and Zagros mountains in Iran.

Effects of coal mining and climate-environment factors on the evolution of a typical Eurasian grassland

Coal mining can significantly impact vegetation evolution, yet the limited information on its patterns and driving factors hampers efforts to mitigate these effects and reclaim abandoned mines. This study aimed to 1) examine vegetation evolution in a semiarid steppe watershed in northeast China; and 2) characterize the driving factors behind this evolution. We analyzed the impact of twelve selected driving factors on fractional vegetation coverage (FVC) from 2000 to 2021 using a dimidiate pixel model, Sen's slope analysis, Mann-Kendall trend test, coefficient of variation analysis, and Geodetector model. At a significance level of α = 0.05, our findings revealed a south-to-north decline pattern in FVC, a significant decrease trend in proximity to coal mines, and a notable increase trend adjacent to river channels. Approximately 37% of the watershed exhibited low FVC, while the overall temporal trend across the watershed was deemed insignificant. Areas surrounding the mines experienced a substantial reduction in FVC due to coal mining activities, while FVC variations across the watershed were linked to precipitation, temperature, and soil type. FVC predictions improved notably when interactions between multiple two-way factors were considered. Each driving factors displayed an optimal range (e.g., precipitation = 63–71 mm) for maximizing FVC. Given the study watershed's status as a national energy base, understanding vegetation responses to coal mining and climate-environment changes is crucial for sustaining fragile terrestrial ecosystems and socioeconomic development. Achieving a long-time balance between coal extraction and ecological protection is essential. The study outcomes hold significant promise for advancing ecological conservation, vegetation restoration, and mitigation of environmental degradation in semiarid regions affected by extensive coal mining and climate fluctuations. These findings contribute to the strategic management of such areas, promoting sustainable practices amidst evolving environmental challenges.

Extreme rainfall events variation during 1860–1909 in the Korean Peninsula: Investigation of the possible circulation mechanism by a method of analogue

In the present paper, we made an investigation of extreme rainfall events for 1860―1909 in the Korean Peninsula, and the possible atmospheric circulation state by comparing recent rainfall variability with atmospheric circulation indices. In the present study, very significant historical rainfall records and flood damage records since the mid-19th century, modern rainfall records and global climate reanalysis data were applied. Results show: (1) Pentad extreme rainfall events had undergone a clear decrease, with an abrupt falling after shifting point of 1879―1880. (2) The monthly frequencies of extreme rainfall events revealed remarkable descent trends for June–October, which changed from 29 time/pentad to 7.3 time/pentad on average, especially for July–September. (3) Almost all climate zones except for northern land displayed significant decreasing trends, nevertheless no clear incidence of extreme rainfall event was found over the typical pluvial regions. (4) Through an analogue method by comparing the extreme precipitation weather and the atmospheric mechanism for recent decades (1961―2016), we suggested that West Pacific Subtropical High had experienced a strengthen change for the past period and the typhoon-related torrential rain processes had been suppressed for the study area, and the upper air jet stream might have been displaced poleward during 1860―1909. This study made a first investigation of the extreme rainfall events since the mid-19th century applying both instrumental and documental records in the study area, and some significant findings were obtained, which will help in understanding extreme climate variability and its mechanism of late 19th century and early 20th century in the Korean Peninsula.

Real-World Effectiveness and Safety of Hetrombopag for Delayed Platelet Engraftment Post-Allogeneic Hematopoietic Stem Cell Transplantation

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) serves as a critical therapeutic approach for various malignant and non-malignant hematopoietic disorders. Notwithstanding successful hematopoietic recovery in most patients following allo-HSCT, a subset may encounter delayed platelet engraftment (DPE), a prevalent and potentially serious complication that stems from myeloablative conditioning. Occurring in approximately 5%-37% of allo-HSCT recipients, DPE is a known harbinger of increased transplant-related mortality and diminished quality of survival. Despite its clinical significance, a well-established standard treatment protocol for post-allo-HSCT DPE remains elusive. Multiple platelet transfusions, often administered in such cases, not only exacerbate the economic burden but also induce toxicities, thereby undermining the patient's quality of life. An alternative to platelet transfusion lies in the utilization of thrombopoietin-receptor agonists (TPO-RAs), advocated for enhancing platelet engraftment. These agents interact with the thrombopoietin receptor, stimulating intracellular signaling pathways inclusive of JAK/STAT, PI3K/AKT, and ERK1/2, which in turn, promote megakaryocyte proliferation and differentiation, thereby augmenting platelet production. Hetrombopag, a novel, orally administered, non-peptide, small-molecule TPO-RA, has been validated to effectively boost platelet engraftment and reduce the necessity for platelet transfusions post-allo-HSCT in a pilot study. Our study sought to investigate the effectiveness and safety of hetrombopag in treating DPE following allo-HSCT within a real-world setting. Methods: In this retrospective study, we evaluated adult patients with hematopoietic disorders who underwent allo-HSCT and subsequently experienced DPE in our center, treated with hetrombopag between March 2022 and April 2023. Given the lack of a consensus definition, we deemed DPE as a platelet count (PLT) &amp;lt; 20 × 10 9/L or a significant and rapid decreasing trend past day 28 post-allo-HSCT. Hetrombopag dosages of 2.5 mg, 5 mg, or 7.5 mg/day were prescribed based on individual patient conditions. Response criteria post-treatment were as follows: complete response: PLT &amp;gt; 50 × 10 9/L without platelet transfusion; partial response: PLT between 20 and 50 × 10 9/L without platelet transfusion; no response: PLT &amp;lt; 20 × 10 9/L. Results: A total of 20 patients were included in the analysis, with a median age of 52, and 60% of them were male. Hetrombopag administration commenced at a median of 58 days following allo-HSCT at a median dose of 5 mg/day, with a median treatment duration of 44 days. The initial platelet count was 24.5 × 10 9/L and serum ferritin levels stood at 3351.1 ng/mL. Post-hetrombopag treatment, platelet counts escalated to 67.5 × 10 9/L while serum ferritin levels decreased to 2726.0 ng/mL. Of the 20 patients, 13 patients (65%) exhibited a complete response, 6 patients (30%) achieved a partial response, and 1 patient (5%) displayed no response. Hetrombopag was well tolerated with only 5 patients reporting increased alanine aminotransferase/aspartate aminotransferase or total bilirubin levels (all grade 1 or 2), and the association with hetrombopag was undetermined. Conclusion: Our findings suggest that hetrombopag yields a sustained response with acceptable tolerability in patients who experienced DPE following allo-HSCT, and could potentially offer a novel approach for managing such patients. Future large-scale, prospective studies are warranted to further assess the potential benefits of hetrombopag for improving patient outcomes following allo-HSCT.

Tracing the temporal trends of modifiable risk factors in dementia: insights from the English Longitudinal Study of Ageing (2004–2019)

BackgroundDementia's growing impact, especially in ageing societies such as the UK, emphasises the importance of modifiable risk factors as primary prevention targets. Despite this, the temporal progression and the population attributable fraction (PAF) of dementia attributable to these factors remain unclear. This investigation aims to examine the temporal trajectories of the modifiable risk factors for dementia in England from 2004 to 2019. MethodsWe used data from the English Longitudinal Study of Ageing collected between June, 2004, and July, 2019, covering 76 904 participants. We calculated the PAFs for 12 modifiable risk factors, as recommended by the Lancet Commission on dementia prevention, intervention, and care, and the individual weighted PAFs (IW-PAFs) for each risk factor. We analysed temporal trends to understand the changes in the overall PAF and IW-PAF over the study period. FindingsThe overall PAF for dementia showed a decrease from 46·31% in 2004–05 to 43·95% in 2018–19, but this trend was not significant (p=0·226). Hypertension, with an average IW-PAF of 8·67%, has been the primary modifiable determinant of dementia, trailed by obesity (6·42%), social isolation (5·84%), hearing loss (5·02%), depression (4·89%), low education (4·80%), physical inactivity (3·40%), diabetes (2·61%), smoking (2·08%), excessive alcohol consumption (1·22%), air pollution (0·44%), and traumatic brain injury (0·28%). During 2004–19, only IW-PAFs of low education (p=0·001), social isolation (p=0·034), and smoking (p=0·007) showed significant decreasing trends, whereas IW-PAFs of other factors had either stagnated with insignificant changes or, worryingly, climbed upwards. InterpretationThis investigation provides valuable insights into the temporal trends of modifiable risk factors for dementia in England. The observed trends underscore the continuing relevance of these risk factors and the need for targeted public health strategies to address them. Notable, PAF was based on a theoretical scenario in which dementia risk can be wholly eliminated by removing risk factors, which should be explained with caution in practice. FundingUK Foreign, Commonwealth and Development Office; National Institute for Health and Care Research (NIHR).

Assessment of the Spatiotemporal Changes in the Extreme Precipitation Climate Indices over the Chungcheong Region of South Korea during 1973–2020

This study analyzed the changes and trends in twelve extreme precipitation-based climate indices obtained using daily data from 10 synoptic stations in the Chungcheong region of South Korea during the 1973–2020 period. The climate indices were used to assess the trends in the extreme precipitation characteristics of duration, frequency, and intensity using the innovative trend analysis (ITA) method. The results of the ITA were further compared with two other non-parametric test methods such as Mann–Kendall (MK) and Spearman’s rho (SR). The results showed that most stations exhibited significant increasing trends in all the investigated climate indices at a 95% confidence level as indicated by the ITA method, with only a few stations indicating significant decreasing trends in R95p, R99p, Rx3day, and Rx5day. The sub-trend analysis further revealed the dominance of neutral behavior around the low-value cluster, especially for the extreme precipitation duration. At the same time, increasing trends dominate the high-value cluster at most stations. Meanwhile, only R10mm, R99p, and R95p exhibited monotonic trends in the Boeun and Seosan stations, respectively. Further, the ITA exhibited superior performance over the MK and SR methods by indicating the presence of more significant trends in the climate indices at most stations. The distribution of the extreme precipitation indices for duration, frequency, and intensity indicate the pronounced risk of flood conditions around the north–central and some parts of southern regions, while the western region indicates a potential drought risk, which could greatly impact the water resources and consequently agricultural activities in the study area. The results of this study provide essential information for addressing the climate-related problems of water resource management and agriculture in the study area and other related climatic regions.