Search Results (6,641)

Background: Varicella remains a prevalent vaccine-preventable disease, but breakthrough infections are increasingly reported. However, long-term, population-based studies investigating the temporal and demographic characteristics of breakthrough varicella remain limited. Methods: This retrospective study analyzed surveillance data from Jinhua City, China, from 2016 to 2024. Varicella case records were obtained from the China Information System for Disease Control and Prevention (CISDCP), while vaccination data were retrieved from the Zhejiang Provincial Immunization Program Information System (ISIS). Breakthrough cases were defined as infections occurring more than 42 days after administration of the varicella vaccine. Differences in breakthrough interval were analyzed across subgroups defined by dose, sex, age, population category, and vaccination type. A bivariate cubic regression model was used to assess the combined effect of initial vaccination age and dose interval on the breakthrough interval. Results: Among 28,778 reported varicella cases, 7373 (25.62%) were classified as breakthrough infections, with a significant upward trend over the 9-year period (p < 0.001). Most cases occurred in school-aged children, especially those aged 6–15 years. One-dose recipients consistently showed shorter breakthrough intervals than two-dose recipients (M = 62.10 vs. 120.10 months, p < 0.001). Breakthrough intervals also differed significantly by sex, age group, population category, and vaccination type (p < 0.05). Regression analysis revealed a negative correlation between the initial vaccination age, the dose interval, and the breakthrough interval (R² = 0.964, p < 0.001), with earlier and closely spaced vaccinations associated with longer protection. Conclusions: The present study demonstrates that a two-dose varicella vaccination schedule, when initiated at an earlier age and administered with a shorter interval between doses, provides more robust and longer-lasting protection. These results offer strong support for incorporating varicella vaccination into China’s National Immunization Program to enhance vaccine coverage and reduce the public health burden associated with breakthrough infections. Full article

To evaluate water pollution status and sustainable development potential in the Huai River Basin, this study focused on the spatiotemporal evolution and influencing factors of the grey water footprint (GWF) across 35 cities in the basin from 2005 to 2020. This study quantifies the GWF from agricultural, industrial, and domestic perspectives and analyzes its spatial disparities by incorporating spatial autocorrelation analysis. The Tapio decoupling model was applied to explore the relationship between pollution and economic growth, and geographic detectors along with the STIRPAT model were utilized to identify driving factors. The results revealed no significant global spatial clustering of GWF in the basin, but a pattern of “high in the east and west, low in the north and south” emerged, with high-value areas concentrated in southern Henan and northern Jiangsu. By 2020, 85.7% of cities achieved strong decoupling, indicating improved coordination between the environment and economy. Key driving factors included primary industry output, crop sown area, and grey water footprint intensity, with a notable interaction between agricultural output and grey water footprint intensity. The quantitative analysis based on the STIRPAT model demonstrated that seven factors, including grey water footprint intensity and total crop sown area, exhibited significant contributions to influencing variations. Ranked by importance, these factors were grey water footprint intensity > total crop sown area > urbanization rate > population size > secondary industry output > primary industry output > industrial wastewater discharge, collectively explaining 90.2% of the variability in GWF. The study provides a robust scientific basis for water pollution control and differentiated management in the river basin and holds significant importance for promoting sustainable development of the basin. Full article

With rapid global urbanization development, impermeable surface increase, urban population growth, building area expansion, and rising energy consumption, the urban heat island (UHI) effect is becoming increasingly serious. However, the spatial distribution of the UHI cannot be accurately extracted. Therefore, we focused on Luoyang City as the research area and combined the Getis-Ord-Gi* statistic and the greenest image to extract the UHI based on the Google Earth Engine using land surface temperature–spatial autocorrelation characteristics and seasonal changes in vegetation. As bare land considerably influenced the UHI extraction results, we combined the greenest image with the initial extraction results and applied the maximum normalized difference vegetation index threshold method to remove this effect on UHI distribution extraction, thereby achieving improved UHI extraction accuracy. Our results showed that the UHI of Luoyang continuously expanded outward, increasing from 361.69 km² in 2000 to 912.58 km² in 2023, with a continuous expansion rate of 22.95 km²/year. Furthermore, the urban area had a higher UHI area growth rate than the county area. Analysis indicates that the UHI effect in Luoyang has increased in parallel with the expansion of the building area. Intensive urban construction is a primary driver of this growth, directly exacerbating the UHI effect. Additionally, rising temperatures, population growth, and gross domestic product accumulation have collectively contributed to the ongoing expansion of this phenomenon. This study provides scientific guidance for future urban planning through the accurate extraction of the UHI effect, which promotes the development of sustainable human settlements. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

This paper provides geospatial and correlation analysis of heavy metal distribution in the soil cover of the city of Temirtau and its industrial zones. Based on 25 soil samples taken in 2024, concentrations of nine heavy metals (As, Pb, Zn, Cu, Ni, Co, Mn, Cr, Ba) were determined using X-ray fluorescence analysis. Spatial data interpolation was performed using the Kriging method in the ArcGIS Pro environment. The results showed the presence of localized extreme pollution zones, primarily near the Qarmet JSC metallurgical plant. The most significant exceedances of maximum permissible concentrations (MPC), up to 348× MPC for Cr, 160× MPC for Zn, and 72× MPC for As, were recorded at individual locations. Correlation analysis revealed a moderate positive relationship between several elements, particularly Mn and Cu (r = 0.64). Comparison of the spatial distribution of pollution with population data allowed for the assessment of potential environmental risks. This research emphasizes the need to implement systematic monitoring, sustainable land management practices, ecological maps, and preventive measures to reduce the long-term impact of heavy metals on ecosystems and public health, and to promote environmental sustainability in industrial regions. Full article

The rapid adoption of electric vehicles (EVs) has driven a strong need for optimizing locations of electric vehicle charging stations (EVCSs). Previous methods for locating EVCSs rely on statistical and optimization models, but these methods have limitations in capturing complex nonlinear relationships and spatial dependencies among factors influencing EVCS locations. To address this research gap and better understand the spatial impacts of urban activities on EVCS placement, this study presents a spatially aware machine learning (SAML) method that combines a multi-layer perceptron (MLP) model with a spatial loss function to optimize EVCS sites. Additionally, the method uses the Shapley additive explanation (SHAP) technique to investigate nonlinear relationships embedded in EVCS placement. Using the city of Wuhan as a case study, the SAML method reveals that parking site (PS), road density (RD), population density (PD), and commercial residential (CR) areas are key factors in determining optimal EVCS sites. The SAML model classifies these grid cells into no EVCS demand (0 EVCS), low EVCS demand (from 1 to 3 EVCSs), and high EVCS demand (4+ EVCSs) classes. The model performs well in predicting EVCS demand. Findings from ablation tests also indicate that the inclusion of spatial correlations in the model’s loss function significantly enhances the model’s performance. Additionally, results from case studies validate that the model is effective in predicting EVCSs in other metropolitan cities. Full article

Background: This cross-sectional study examined the association between body mass index (BMI) and executive function (EF) in older adults, with a focus on the moderating role of attitudes toward own aging (ATOA). Method: A total of 431 community-dwelling elderly individuals from Yakumo Town and Kyoto City, Japan, participated between 2023 and 2024. EF was assessed using the Digit Cancellation Test (D-CAT), and ATOA was measured via a validated subscale of the Philadelphia Geriatric Center Morale Scale. Results: Multiple linear regression analyses adjusted for demographic and health covariates revealed a significant interaction between BMI and ATOA in the younger-old cohort. Specifically, higher BMI was associated with lower executive function only in individuals with lower ATOA scores. No such association was observed in those with more positive views on aging. Conclusions: These results indicate that positive psychological constructs, particularly favorable self-perceptions of aging, may serve as protective factors against the detrimental cognitive consequences of increased body mass index in younger-old populations. Full article

Wellington, New Zealand, is highly vulnerable to disaster-induced food security crises due to its geography and geological characteristics, which can disrupt transportation and isolate the city following disasters. Urban agriculture (UA) has been proposed as a potential alternative food source for post-disaster scenarios. This study examined the potential of urban agriculture for enhancing post-disaster food security by calculating vegetable self-sufficiency rates. Specifically, it evaluated the capacity of current Wellington’s community gardens to meet post-disaster vegetable demand in terms of both weight and nutrient content. Data collection employed mixed methods with questionnaires, on-site observations and mapping, and collecting high-resolution aerial imagery. Garden yields were estimated using self-reported data supported by literature benchmarks, while cultivated areas were quantified through on-site mapping and aerial imagery analysis. Six post-disaster food demand scenarios were used based on different target populations to develop an understanding of the range of potential produce yields. Weight-based results show that community gardens currently supply only 0.42% of the vegetable demand for residents living within a five-minute walk. This rate increased to 2.07% when specifically targeting only vulnerable populations, and up to 10.41% when focusing on gardeners’ own households. However, at the city-wide level, the current capacity of community gardens to provide enough produce to feed people remained limited. Nutrient-based self-sufficiency was lower than weight-based results; however, nutrient intake is particularly critical for vulnerable populations after disasters, underscoring the greater challenge of ensuring adequate nutrition through current urban food production. Beyond self-sufficiency, this study also addressed the role of UA in promoting food diversity and acceptability, as well as its social and psychological benefits based on the questionnaires and on-site observations. The findings indicate that community gardens contribute meaningfully to post-disaster food security for gardeners and nearby residents, particularly for vulnerable groups with elevated nutritional needs. Despite the current limited capacity of community gardens to provide enough produce to feed residents, findings suggest that Wellington could enhance post-disaster food self-reliance by diversifying UA types and optimizing land-use to increase food production during and after a disaster. Realizing this potential will require strategic interventions, including supportive policies, a conducive social environment, and diversification—such as the including private yards—all aimed at improving food access, availability, and nutritional quality during crises. The primary limitation of this study is the lack of comprehensive data on urban agriculture in Wellington and the wider New Zealand context. Addressing this data gap should be a key focus for future research to enable more robust assessments and evidence-based planning. Full article

With the global economic restructuring and the consequent population mobility, urban shrinkage has become a common phenomenon. The Qinling–Daba Mountains, a zone with a key ecological function in China, have long experienced population decline and functional degradation. Clarifying the dynamics and influencing factors of urban shrinkage plays a vital role in supporting the sustainable development of the region. This study, using permanent resident population growth rates and nighttime light data, classified cities in the region into four spatial patterns: expansion–growth, intensive growth, expansion–shrinkage, and intensive shrinkage. It further examined the spatial characteristics of shrinkage across four periods (2005–2010, 2010–2015, 2015–2020, and 2020–2022). A Geographically and Temporally Weighted Regression (GTWR) model was applied to examine core influencing factors and their spatiotemporal heterogeneity. The results indicated the following: (1) The dominant pattern of urban shrinkage in the Qinling–Daba Mountains shifted from expansion–growth to expansion–shrinkage, highlighting the paradox of population decline alongside continued spatial expansion. (2) Three critical indicators significantly influenced urban shrinkage: the number of students enrolled in general secondary schools (X₅), the per capita disposable income of urban residents (X₇), and the number of commercial and residential service facilities (X₁₂), with their effects exhibiting significant spatiotemporal heterogeneity. Temporally, X₁₂ was the most influential factor in 2005 and 2010, while in 2015, 2020, and 2022, X₅ and X₇ became the dominant factors. Spatially, X₇ significantly affected both eastern and western areas; X₅’s influence was most pronounced in the west; and X₁₂ had the greatest impact in the east. This study explored the patterns and underlying drivers of urban shrinkage in underdeveloped areas, aiming to inform sustainable development practices in regions facing comparable challenges. Full article

This research addresses urban inequality by focusing on the rehabilitation of communal rooftops in Ciutat Vella, Barcelona, the city’s historic district, where residential vulnerability is concentrated in a particularly dense heritage urban environment with a shortage of outdoor spaces. Using participatory methodologies, this research develops low-cost, removable, and recyclable prototypes aimed at improving social interaction, technical performance, and environmental conditions. The focus is on vulnerable populations, particularly the elderly. The approach integrates a bottom–up process and scalable solutions presented as a Toolkit of micro-projects. These micro-projects are designed to improve issues related to health, safety, durability, accessibility, energy savings, and acoustics. In addition, several possible material solutions for micro-projects are examined in terms of sustainability and cost. These plug-in interventions are designed for adaptability and replication throughout similar urban contexts and can significantly improve the quality of life for people, especially the elderly, in dense historic environments. Full article

The study of historical monuments within both architectural and literary frameworks reveals a dynamic interplay between scientific observation and artistic interpretation—a vital characteristic of travel writing/the travelogue. This approach, exemplified by British traveler and writer Henry Finnis Blosse Lynch (1862–1913), reflects how factual detail and creative representation are seamlessly integrated in depictions of sites, landscapes, and cultural scenes. This case study highlights Lynch as a pioneering explorer who authored the first comprehensive volume on Armenian architecture and as a writer who vividly portrayed Armenian monuments through both verbal description and photographic imagery, becoming the first traveler to document such sites using photography. Additionally, this paper emphasizes the significance of Lynch’s detailed accounts of architectural monuments, churches, monasteries, cities, villages, populations, religious communities, and educational institutions in vivid language. The careful study of his work can contribute meaningfully to the investigation of the travelogue as a literary genre and to the preservation and protection of the architectural heritage of historical and contemporary Armenia, particularly in regions facing cultural or political threats. Full article

Rickettsia, Anaplasma, and Ehrlichia species are emerging tick-borne pathogens that cause zoonotic diseases, including rickettsiosis, anaplasmosis, and ehrlichiosis in both human and animal populations. This study aimed to investigate the prevalence of these pathogens in cattle-associated ticks from Ganzhou City, Jiangxi Province, China. Through molecular characterization using multilocus sequence analysis (16S rRNA, gltA, groEL, and ompA genes), we analyzed 392 Rhipicephalus microplus ticks collected from March to September in 2022. The PCR results showed that eight Rickettsiales bacteria were detected, including two species of Rickettsia (51/392, 13.0%), four species of Anaplasma (52/392, 13.3%), and two species of Ehrlichia (70/392, 17.9%). Notably, the circulation of multiple pathogen species within R. microplus populations demonstrates significant microbial diversity in this region. Further consideration and investigation should be given to the possible occurrence of rickettsiosis, ehrlichiosis, and anaplasmosis in humans and domestic animals. Our study provides critical baseline data for developing targeted surveillance strategies and informing public health interventions against tick-borne diseases in southeastern China. Full article

The spatiotemporal evolution of the regional water use structure holds significant theoretical value for optimizing regional water resource allocation, adjusting industrial structures, and achieving sustainable water resource development. Shandong Province, located at the lowest reach of the Yellow River Basin in China, is a major economic, agricultural, and populous province, as well as a region with one of the most prominent water supply–demand imbalances in the country. As a result, exploring how water use patterns change over time and space in this region has become crucial. Using analytical methods like the Lorenz curve, Gini coefficient, cluster analysis, and spatial statistics, we examine shifts in Shandong’s water use structure from 2001 to 2023. We find that while agriculture remained the largest water consumer over this period, industrial, household, and ecological water use steadily increased, signaling a move toward more balanced resource distribution. Across Shandong’s 16 regions (cities), the water use patterns varied considerably, particularly in terms of agriculture, industry, and ecological needs. Among these, agricultural, industrial, and domestic water use were distributed relatively evenly, whereas ecological water use showed greater regional disparities. These results may have the potential to guide policymakers in refining water allocation strategies, improving industrial planning, and boosting the water use efficiency in Shandong and the country ore broadly. Full article

Urban forests, as a form of green infrastructure, play a vital role in enhancing urban resilience, environmental health, and quality of life. However, users perceive and utilize these spaces in diverse ways. This study aims to identify latent perception types among urban forest visitors and analyze their behavioral, demographic, and policy-related characteristics in Incheon Metropolitan City (Republic of Korea). Using latent class analysis, four distinct visitor types were identified: multipurpose recreationists, balanced relaxation seekers, casual forest users, and passive forest visitors. Multipurpose recreationists preferred active physical use and sports facilities, while balanced relaxation seekers emphasized emotional well-being and cultural experiences. Casual users engaged lightly with forest settings, and passive forest visitors exhibited minimal recreational interest. Satisfaction with forest elements such as vegetation, facilities, and management conditions varied across visitor types and age groups, especially among older adults. These findings highlight the need for perception-based green infrastructure planning. Policy recommendations include expanding accessible neighborhood green spaces for aging populations, promoting community-oriented events, and offering participatory forest programs for youth engagement. By integrating user segmentation into urban forest planning and governance, this study contributes to more inclusive, adaptive, and sustainable management of urban green infrastructure. Full article

Urban heat islands (UHIs) are a growing sustainability challenge impacting public health, energy use, and climate resilience, especially in hot, arid cities like San Antonio, Texas, where land surface temperatures reach up to 47.63 °C. This study advances a data-driven, interdisciplinary approach to UHI mitigation by integrating Machine Learning (ML) with physical and socio-demographic data for sustainable urban planning. Using high-resolution spatial data across five functional zones (residential, commercial, industrial, official, and downtown), we apply three ML models, Random Forest (RF), Support Vector Machine (SVM), and Gradient Boosting Machine (GBM), to predict land surface temperature (LST). The models incorporate both environmental variables, such as imperviousness, Normalized Difference Vegetation Index (NDVI), building area, and solar influx, and social determinants, such as population density, income, education, and age distribution. SVM achieved the highest R² (0.870), while RF yielded the lowest RMSE (0.488 °C), confirming robust predictive performance. Key predictors of elevated LST included imperviousness, building area, solar influx, and NDVI. Our results underscore the need for zone-specific strategies like more greenery, less impervious cover, and improved building design. These findings offer actionable insights for urban planners and policymakers seeking to develop equitable and sustainable UHI mitigation strategies aligned with climate adaptation and environmental justice goals. Full article