Significant Regional Variation Research Articles

Is Access to Optimal Concussion Care for Pediatric Athletes Limited by Geography?

To evaluate access to optimal concussion care based on a pediatric patients' geography; the hypothesis is that differential access across the Unites States exists. Employed a novel strategy using internet searches to find local care, mimicking what families might do in different parts of the country. Virtual internet searches. Not applicable. Various metropolitan and rural geographic regions within each state in the United States. Evaluate access (defined as distance to clinic and ability to see pediatric patients) and optimal care (defined as self-referral process and presence of multidisciplinary care). Search strategy yielded 490 results. Overall ∼60% were within 50 miles of searched locations with significant differences in access based on rural versus metropolitan areas ( P < 0.0001); in rural areas, only ∼22% of results were within 50 miles. Only about one-third of the results (n = 157) saw pediatric patient with no differences between regions. There was significant regional and geographic variation for optimal care regarding both self-referral processes and access to multidisciplinary care. A diverse group of specialists was represented in search results for concussion care. Nationwide, there is an overall lack of access to multidisciplinary concussion care for pediatric patients. Additionally, those in rural communities face more limitations related to access to facilities with increased distances from closest clinic sites.

Species pool and soil properties in mangrove habitats influence the species-immigration process of diazotrophic communities across southern China.

Microbial immigration is an ecological process in natural environments; however, the ecological trade-off mechanisms that govern the balance between species extinction and migration are still lacking. In this study, we investigated the mechanisms underlying the migration of diazotrophic communities from soil to leaves across six natural mangrove habitats in southern China. The results showed that the diazotrophic alpha and beta diversity exhibited significant regional and locational variations. The diazotrophic species pool gradually increased from the leaves to nonrhizosphere soil at each site, exhibiting a vertical distribution pattern. Mantel test analyses suggested that climate factors, particularly mean annual temperature, significantly influenced the structure of the diazotrophic community. The diazotrophic community assembly was mainly governed by dispersal limitation in soil and root samples, whereas dispersal limitation and ecological drift were dominant in leaves. Partial least squares path modeling revealed that the species pool and soil properties, particularly the oxidation-reduction potential and pH, were closely linked to the species-immigration ratio of diazotrophic communities. Our study provides novel insights for understanding the ecological trait diversity patterns and spread pathways of functional microbial communities between below- and aboveground habitats in natural ecosystems.IMPORTANCEEnvironmental selection plays key roles in microbial transmission. In this study, we have provided a comprehensive framework to elucidate the driving patterns of the ecological trade-offs in diazotrophic communities across large-scale mangrove habitats. Our research revealed that Bradyrhizobium japonicum, Marinobacterium lutimaris, and Agrobacterium tumefaciens were more abundant in root-associated soil than in leaves by internal and external pathways. The nonrhizospheric and rhizospheric soil samples harbored the most core amplicon sequence variants, indicating that these dominant diazotrophs could adapt to broader ecological niches. Correlation analysis indicated that the diversities of the diazotrophic community were regulated by biotic and abiotic factors. Furthermore, this study found a lower species immigration ratio in the soil than in the leaves. Both species pool and soil properties regulate the species-immigration mechanisms of the diazotrophic community. These results suggest that substantial species immigration is a widespread ecological process, leading to alterations in local community diversity across diverse host environments.

Regional variation in donation after circulatory death heart allograft utilization

ObjectiveRandomized data support transplantation of hearts from donors after circulatory death. This may lead to a sizeable increase in the donor pool. Regional variations in donors after circulatory death heart use were examined to help elucidate barriers to donor pool expansion. MethodsThe United Network for Organ Sharing deceased donor dataset was queried for adult (age ≥ 18 years) donors after circulatory death donors of at least 1 organ between January 2020 and December 2023. Donors were stratified by the extent their respective cardiac allografts progressed through the donation process. United Network for Organ Sharing region-level use rates and annual trends were assessed. ResultsOf 17,239 adult donors after circulatory death donors who donated at least 1 organ for transplant during the study period, 1196 (9.4%) were heart donors. Regional donors after circulatory death heart donor pursuit rates ranged from 97% to 100%, consent attainment rates from 94% to 99%, and heart recovery rates from 5% to 10%. The transplantation rate of recovered organs ranged from 90% to 97%. Multivariable logistic regression demonstrated United Network for Organ Sharing region to be independently associated with donors after circulatory death heart use after controlling for baseline differences in donor risk. ConclusionsTransplantation of donors after circulatory death heart allografts has increased in the United States since 2020, but the overall number of hearts procured and transplanted from donors after circulatory death donors remains low. The operational barriers to transplantation of donors after circulatory death hearts require further investigation. Further, significant regional variation exists regarding rates of progression of donors after circulatory death hearts through the donation process. Sharing of successful practices among Organ Procurement Organizations and transplant centers will facilitate maximal use of this new donor pool.

Mutual effects of gestational diabetes and schizophrenia: how can one promote the other?: A review.

Although the physical complications of gestational diabetes mellitus (GDM) are well known, emerging evidence suggests a significant link with psychiatric conditions such as schizophrenia (SCZ). This review aimed to explore the extent, nature, and implications of the association between GDM and SCZ, exploring how the 2 conditions may reciprocally influence each other. We conducted a comprehensive literature review and, analyzed clinical and mechanistic evidence supporting the mutual effects of GDM and SCZ. This review examined factors such as neurodevelopment and the impact of antipsychotics. The study found that Maternal GDM increases the risk of SCZ in offspring. Conversely, women with SCZ were more prone to hyperglycemic pregnancies. The research highlights significant regional variations in GDM prevalence, with the highest rate in the Middle East, North Africa, and South-East Asia regions. These regional variations may have an impact on the epidemiology of SCZ. Furthermore, this review identifies the potential biological and environmental mechanisms underlying these associations. There is a bidirectional relationship between GDM and SCZ, with each disorder potentially exacerbating the others. This relationship has significant implications for maternal and offspring health, particularly in regions with high GDM prevalence. These findings underline the need for integrated care approaches for women with SCZ during pregnancy and the importance of monitoring and managing GDM to mitigate the risk of SCZ in the offspring. Notably, this study recognizes the need for further research to fully understand these complex interactions and their implications for healthcare.

Visualized analysis of microplastics in residents' diets and regional investigation of China

Microplastics are widely distributed in ecosystems and are increasingly found in food. This poses a potential threat to human health. However, current detections of microplastic in food primarily focused on the simple matrices, such as water, milk, and beverages, with relatively few methods available for complex matrices. Due to the strong matrix interference, non-destructive detection of microplastics in food has always been challenging. Thus, in this study, infrared spectral imaging approach was employed in tandem with chemometrics to perform nondestructive and in-situ characterization of microplastics in twelve diverse Chinese diets including meat and seafood stuffs. Results demonstrate that the proposed method can efficiently characterize common microplastics, such as polypropylene (PP), polyethylene terephthalate (PET), and polyethylene (PE), etc., in various complex matrices. The IR spectral imaging was subsequently applied to the detection of microplastics in seafood samples collected from 24 provinces across China. Results revealed the widespread presence of microplastics in seafood diets with significant regional variations. Overall, this study offers an innovative and applicable means for detecting microplastics in complex foods and provides a reference for the rapid detection of microplastics in various materials.

Environmental Regulation, Industrial Structure and Low-Carbon Development

&lt;p&gt;In this paper, the provincial panel data of china from the year 2006 to 2019 are used to analyze the association among environmental regulations, industrial structure od industries and low-carbon development. The results show that regional industrial CO2 emissions in China's east, center, and west were greatly decreased by environmental restrictions. The most significant deterrent to carbon emissions in the central region was, notably, environmental regulatory measures. By encouraging improvements in industrial structure and increasing its efficiency, the study shows that these rules helped to lower industrial carbon emissions. The examination of the sub-sample mechanism reveals significant regional variations: an advanced industrial structure was a major force behind low-carbon development in the western region, whereas high-efficiency industrial structures were critical in the eastern region. Through structural changes in the business, environmental restrictions can effectively promote low-carbon economic growth, as this study highlights. Across a range of control factors, environmental regulation considerably decreased regional industrial carbon emissions by about 0.196 to 0.033. Trade openness, urbanization, and the development of human capital all helped to reduce carbon emissions by roughly 1.057 to 4.104. The efficacy of regulatory tools was verified by endogeneity tests, which yielded coefficients varying between -0.891 and -0.156 for distinct factors. The results offering actual proof of the varying effects of environmental laws in various geographical areas and highlight the necessity of specialized policy strategies to promote sustainable development.&lt;/p&gt;

THE INFLUENCE OF THE CAUSES OF INTENTIONALLY SELF-INFLICTED INJURIES IN THE REGIONS OF BRAZIL IN 2015 AND 2020

Suicide is a growing public health issue in Brazil, with patterns and causes of self-inflicted injuries varying between regions and local cultures. This study analyzes the causes of self-inflicted injuries in the 27 federal units of Brazil in 2015 and 2020. Using data from DATASUS, variables of intentional self-harm injuries were identified, classified in the ICD-10 group. Analyses were conducted using the NeatMap and Psych packages, generating heatmaps and tables that allow visualization of the distribution and intensity of cases over the years. The results indicate an increase in suicides in 2020 compared to 2015, influenced by the pandemic period, during which many cases were not reported, yet there was still an increase. Hanging was the most common method in both years, reflecting the easy accessibility of this means in everyday life. States like São Paulo, Minas Gerais, and Rio Grande do Sul showed a higher association with the studied variables, indicating regional concern that demands specific public policies. Rio de Janeiro stood out with a significant increase in injuries related to cliffs and high places in 2020, due to specific geographical and cultural factors of the state. These injuries are associated with easy access to elevated areas and exacerbated social and economic pressure during the pandemic. It is concluded that patterns of self-inflicted injuries remained consistent, with some significant regional variations. These results are crucial for associating regions and causes of self-inflicted injuries, assisting in the development of future preventive measures, such as psychological support programs and specific community interventions for each region.

Effect of citizenship status on access to pediatric liver and kidney transplantation

Transplantation of non-US citizen residents remains controversial. We evaluate national trends in transplant activity among pediatric noncitizen residents (PNCR). Pediatric liver and kidney transplant data were obtained from the Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients. Data on transplanted organs, region, waitlist additions, procedures, and citizenship status were analyzed from 2012-2022. Rates of PNCR transplantation activity were compared with population rates from the US Census Bureau. On average, 713 ± 47 pediatric liver and 1039 ± 51 kidney patients were added to the waitlist, with 544 ± 32 liver and 742 ± 33 kidney transplants performed annually. Of these, PNCR comprised 1.5% and 3.3% of liver and kidney waitlist additions and 1.5% and 2.9% of liver and kidney transplant procedures, respectively. There were no significant changes in waitlist or transplant activity nationwide over the study period. There was a significant geographic variation in the percentage of waitlist additions and transplants across the United Network for Organ Sharing regions among the PNCR for liver and kidney transplantation. This is the first study to evaluate national trends in transplantation activity among PNCRs. The significant regional variation in transplantation activity for PNCR may suggest multilevel structural and systemic barriers to transplant accessibility.

Assessing Knowledge, Attitude, and Behavior in Household Solid Waste Management in Northern Vietnam

Abstract Rapid urbanization and population growth in Northern Vietnam have exacerbated in domestic solid waste (DSW), posing environmental challenges. Law on environmental protection (2020) promoting source separation, a disconnect persists between policy and public action. This study addresses this gap by employing a Knowledge, Attitude, and Behavior (KAB) approach to conduct a novel regional analysis of DSW management practices. A stratified random sampling design was utilized, with 1,000 people participating from five different regions of Northern Vietnam: delta rural areas, mountainous rural areas, coastal rural areas, tourism development areas, and urban areas. Data analytic techniques, including descriptive statistics, exploratory factor analysis and multiple regression analysis, were employed to uncover factors that influence DSW management behavior in each location. The research revealed significant regional variations in KAB aspects of DSW services. While positive attitudes towards responsible SWM practices (80% of people) were evident, the number of factors influencing DSW management varied (3-6) across regions. These findings provide valuable insights for policymakers, guiding the development of targeted interventions that align with national law. This paves the way for more effective, regionally-tailored waste management practices in Vietnam.

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study.

Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

Co-Infection of SARS-CoV-2 and Klebsiella pneumoniae: A Systematic Review and Meta-Analysis.

The study aimed to assess the prevalence of COVID-19 and Klebsiella spp. coinfection across continents. Conducted following PRISMA guidelines, a systematic review utilized PubMed, Embase, SCOPUS, ScienceDirect, and Web of Science databases, searching for literature in English published from December 2019 to December 2022, using specific Health Sciences descriptors. A total of 408 records were identified, but only 50 were eligible, and of these, only 33 were included. Thirty-three references were analyzed to evaluate the correlation between COVID-19 and Klebsiella spp. infections. The tabulated data represented a sample group of 8741 coinfected patients. The findings revealed notable disparities in co-infection rates across continents. In Asia, 23% of individuals were infected with Klebsiella pneumoniae, while in Europe, the proportion of co-infected patients stood at 15%. Strikingly, on the African continent, 43% were found to be infected with Klebsiella pneumoniae, highlighting significant regional variations. Overall, the proportion of Klebsiella pneumoniae co-infections among COVID-positive individuals were determined to be 19%. Particularly concerning was the observation that 1 in 6 ICU coinfections was attributed to Klebsiella pneumoniae, indicating its substantial impact on patient outcomes and healthcare burden. The study underscores the alarming prevalence of co-infection between COVID-19 and Klebsiella pneumoniae, potentially exacerbating the clinical severity of patients and posing challenges to treatment strategies. These findings emphasize the importance of vigilant surveillance and targeted interventions to mitigate the adverse effects of bacterial coinfections in the context of the COVID-19 pandemic.

Global aviation contrail climate effects from 2019 to 2021

Abstract. The current best-estimate of the global annual mean radiative forcing (RF) attributable to contrail cirrus is thought to be 3 times larger than the RF from aviation's cumulative CO2 emissions. Here, we simulate the global contrail RF for 2019–2021 using reanalysis weather data and improved engine emission estimates along actual flight trajectories derived from Automatic Dependent Surveillance–Broadcast telemetry. Our 2019 global annual mean contrail net RF (62.1 mW m−2) is 44 % lower than current best estimates for 2018 (111 [33, 189] mW m−2, 95 % confidence interval). Regionally, the contrail net RF is largest over Europe (876 mW m−2) and the USA (414 mW m−2), while the RF values over East Asia (64 mW m−2) and China (62 mW m−2) are close to the global average, because fewer flights in these regions form persistent contrails resulting from lower cruise altitudes and limited ice supersaturated regions in the subtropics due to the Hadley Circulation. Globally, COVID-19 reduced the flight distance flown and contrail net RF in 2020 (−43 % and −56 %, respectively, relative to 2019) and 2021 (−31 % and −49 %, respectively) with significant regional variations. Around 14 % of all flights in 2019 formed a contrail with a net warming effect, yet only 2 % of all flights caused 80 % of the annual contrail energy forcing. The spatiotemporal patterns of the most strongly warming and cooling contrail segments can be attributed to flight scheduling, engine particle number emissions, tropopause height, and background radiation fields. Our contrail RF estimates are most sensitive to corrections applied to the global humidity fields, followed by assumptions on the engine particle number emissions, and are least sensitive to radiative heating effects on the contrail plume and contrail–contrail overlapping. Using this sensitivity analysis, we estimate that the 2019 global contrail net RF could range between 34.8 and 74.8 mW m−2.

Lipidomics profile and volatile compounds of squids (Illex argentinus, Ommastrephes Bartram and Dosidicus gigas) in the Argentine, North Pacific Ocean, Equator and Peru by UPLC-triple TOF-MS and HS-SPME-GC-O-MS

Comprehensive lipid and volatile compound analyses were performed with squids collected from four varied geographical locations to discriminate the regional characteristics. A total of 1442 lipid molecules and 110 volatiles were detected in the squid muscle samples. There were significant differences in the lipid profiles between Argentine squid (Illex argentinus, AGT), North Pacific Ocean squid (Ommastrephes Bartram, NPO), Equatorial squid (Dosidicus gigas, EQ), and Peruvian squid (Dosidicus gigas, PR) muscle. Phosphatidylcholines (14.64%), triacylglycerols (12.42%), and ceramides (10.97%) were the main lipid components. The contents of polyunsaturated fatty acid in phospholipids and in glycerolipids were 30.35–52.05% and 18.11–25.15%, respectively. The volatiles in squids exhibited significant regional variation; 1-pentanol and 1-octanol, 2-ethyl-1-hexanol and terpinen-4-ol, 2,7-ethyl-1-hexanol, 3-methy-1-butanol and 2-propyl-1-pentanol were identified as characteristic flavor compounds in AGT, NPO, EQ, and PR, respectively. Sphingomyelin, phosphatidylserine, phosphatidylethanolamine, and ceramide were strongly correlated with volatiles in squid muscle. Our study is a reference for the lipid nutritional value and flavor compounds of squids.

Unveiling sex-based geographical disparities in myelodysplastic syndrome mortality trends in Spain (1999-2022).

To comprehensively analyze trends in myelodysplastic neoplasm (MDS) mortality across Spain (1999-2022), examining sex and regional differences. We analyzed nationwide death records and population data, calculating age-standardized mortality rates (ASMRs) and standardized mortality ratios (SMRs) stratified by sex and Autonomous Community (AC). Joinpoint regression identified significant shifts in trends. Across Spain, MDS mortality risk varied among men, with rates ranging from 1.08 to 4.38 per 100,000 across regions, while women's rates ranged from 1.23 to 2.02. Five regions had higher risks than the national average, while six had lower risks. Joinpoint analysis revealed three periods nationally: a decline until 2008, and an increase until 2017, followed by a significant decrease. Despite the overall stable national trend (-0.5% annual change), significant regional variations emerged. Andalusia stood out with a worrying increase in MDS mortality, while Aragon and Murcia demonstrated promising declines. Extremadura displayed a unique trajectory with an initial rise followed by stabilization, while Galicia exhibited a contrasting trend with an initial decline and subsequent increase. Notably, men consistently faced a higher risk of MDS mortality compared to women, with significant disparities across regions. Extremadura, in particular, showed a marked difference in risk between genders. MDS mortality trends in Spain are complex, and influenced by gender, region, and time. Further research is needed to understand regional disparities, recent national decline, and higher risk in specific demographics. Tailored interventions based on local factors and targeted research are crucial to address these complexities and improve patient outcomes.

Genomic perspectives on foodborne illness.

Whole-genome sequencing of bacterial pathogens is used by public health agencies to link cases of food poisoning caused by the same source of contamination. The vast majority of these appear to be sporadic cases associated with small contamination episodes and do not trigger investigations. We analyzed clusters of sequenced clinical isolates of Salmonella, Escherichia coli, Campylobacter, and Listeria that differ by only a small number of mutations to provide a new understanding of the underlying contamination episodes. These analyses provide new evidence that the youngest age groups have greater susceptibility to infection from Salmonella, Escherichia coli, and Campylobacter than older age groups. This age bias is weaker for the common Salmonella serovar Enteritidis than Salmonella in general. Analysis of these clusters reveals significant regional variations in relative frequencies of Salmonella serovars across the United States. A large fraction of the contamination episodes causing sickness appear to have long duration. For example, 50% of the Salmonella cases are in clusters that persist for almost three years. For all four pathogen species, the majority of the cases were part of genetic clusters with illnesses in multiple states and likely to be caused by contaminated commercially distributed foods. The vast majority of Salmonella cases among infants < 6 months of age appear to be caused by cross-contamination from foods consumed by older age groups or by environmental bacteria rather than infant formula contaminated at production sites.

National Trends, Mortality and Outcomes in Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in the United States.

Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have become increasingly utilized in patients undergoing percutaneous coronary intervention (PCI). Despite these purported advantages, prior reports regarding the use of IVUS and OCT have indicated that contemporary use of intravascular imaging remains low with significant regional variation. Here, we present the findings of an updated contemporary analysis regarding the use of IVUS/OCT guided PCI vs. angiography-guided PCI in the United States. We also evaluated in-hospital mortality and clinical outcomes between IVUS/OCT-guided PCI versus angiography-guided PCI-only over million patients in the United States. There has been a significant decrease in the number of PCIs performed, while there has been increasing in trend of IVUS/OCT-guided PCI over this period. Most importantly, we found that IVUS/OCT guided PCI were associated with better clinical outcomes in terms of in-hospital mortality, compare with angiography guided PCI.

Study on the Typical Environmental Factors in the Middle Part of Zhoushan Fishery Based on HY-1C/D and Other Multi-Source Data

This study utilizes satellite data, including HY-1C/D, along with reanalysis data, to unveil the typical environmental characteristics of the sea surface in the middle of Zhoushan fishery. The article addresses three main issues. The first one is the development of an ocean primary productivity (OPP) inversion algorithm model. The second one is the study of chlorophyll-α (Chl-α) concentration and OPP distribution characteristics in Zhoushan fishery using China’s domestically produced ocean satellite HY-1C/D CZI data. The last one is the revelation of the characteristics of typical environmental factors on the sea surface at Zhoushan fishery by combining HY-1C/D with multi-source data. The results show the following: (1) The middle part of Zhoushan fishery exhibits significant seasonal and regional variations in Chl-α concentration and OPP. Chl-α concentration ranges mainly between 0.2 and 2.9 µg/L, with higher concentrations in spring and summer and lower Chl-α concentrations in autumn and winter. Spatially, Chl-α concentration gradually decreases from west to east. The OPP in the study area ranges from 100 mg·m−2d−1 to 1000 mg·m−2d−1, with high OPP values distributed on the western side, ranging from 400 mg·m−2d−1 to 1000 mg·m−2d−1, and gradually decreasing seaward. The highest OPP occurs in summer and the lowest in winter. (2) The correlation analysis between Chl-α concentration and OPP revealed a strong positive relationship. Consequently, this study developed an empirical model for estimating OPP based on Chl-α concentration and validated its feasibility. The model applies to areas with Chl-α concentrations ranging from 0.2 to 4 µg/L. (3) The convergence of freshwater injection, multiple ocean currents, and seasonal upwelling in the study area brings about a rich supply of nutrients. Additionally, the region is characterized by suitable conditions, including optimal Chl-α concentrations, OPP, SST, salinity, currents, and geological water depths. The synergistic effect of these factors together contributed to the formation of Zhoushan fishery.

Significant regional disparities in riverine microplastics

Research on riverine microplastics has gradually increased, highlighting an area for further exploration: the lack of extensive, large-scale regional variations analysis due to methodological and spatiotemporal limitations. Herein, we constructed and applied a comprehensive framework for synthesizing and analyzing literature data on riverine microplastics to enable comparative research on the regional variations on a large scale. Research results showed that in 76 rivers primarily located in Asia, Europe, and North America, the microplastic abundance of surface water in Asian rivers was three times higher than that in Euro-America rivers, while sediment in Euro-American rivers was five times more microplastics than Asia rivers, indicating significant regional variations (p < 0.001). Additionally, based on the income levels of countries, rivers in lower-middle and upper-middle income countries had significantly (p < 0.001) higher abundance of microplastics in surface water compared to high-income countries, while the opposite was true for sediment. This phenomenon was preliminarily attributed to varying levels of urbanization across countries. Our proposed framework for synthesizing and analyzing microplastic literature data provides a holistic understanding of microplastic disparities in the environment, and can facilitate broader discussions on management and mitigation strategies.

Exploring the causes of the prevalence of vancomycin-resistant Enterococcus faecalis

BackgroundBacterial drug resistance represents a significant global concern, with vancomycin-resistant Enterococcus faecalis posing a particularly grave threat to contemporary healthcare systems. This study aims to reveal the reasons for the prevalence of VRE in China.MethodsThis study collected data from the China Antimicrobial Resistance Detection System, China Statistical Yearbook, and China Meteorological Network. The collected data are meticulously organized and subjected to both single-factor and multi-factor analyses. An accurate multiple linear regression model was developed by utilizing this comprehensive dataset.ResultsSingle-factor analysis revealed significant regional variations in the resistance rate of vancomycin-resistant Enterococcus faecalis (P = 0.003). Specifically, there were noteworthy disparities observed between regions experiencing temperate and monsoon climates (P = 0.029; P = 0.005). Furthermore, multi-factor regression analysis demonstrated a negative correlation between the drug resistance rate and both rainfall and rGDP, while a positive correlation was observed with nPI.ConclusionWe successfully established a prediction model for the VRE and found that the resistance rate was low in areas with high rainfall and high per capita economic income, but high in areas with many specialized public health institutions. This is critical for public health strategies and helps policymakers and healthcare practitioners tailor antibiotic resistance approaches to local geography, meteorology, economic conditions.

Mapping Higher Education Internationalisation as a Research Space via Natural Language Processing (NLP) Techniques

The productivity of a specific research field hinges on the periodic examination of both the knowledge produced and the knowledge production activities. By harnessing the strength of traditional bibliometric analyses and a variety of Natural language processing (NLP) techniques, this study portrayed a holistic landscape of higher education internationalisation (HEI) research that incorporated time and region through a spatial lens. The findings reveal the field's evolution into establishment, significant regional variations in research focus, and the expansion of networks for disseminating knowledge. These factors collectively contribute to a diverse ‘lived’ space of HEI research. However, the dominance of Western-centric key concepts, theories, and discourses highlights a homogenous ‘conceived’ space, pointing to an underlying tension between these spaces. Despite these challenges, opportunities for breakthroughs exist. Additionally, the study underscores the immense potential of NLP techniques in facilitating the exploration of how research fields evolve, further enriching our understanding of HEI.