Search Results (2,495)

The Yangtze River Economic Belt (YREB) is a critical region for ecological and environmental protection in China, exerting significant influence on regional and national development. However, the intensification of climate change poses severe challenges to its ecological service patterns. To address this, climate scenarios based on Shared Socioeconomic Pathways (SSPs) are integrated with the Annual Water Yield (AWY) module in the InVEST model to examine changes in water yield ecosystem services from 2000 to 2060. A quantitative impact assessment model was established to analyze these changes. The research findings reveal the following: (i) From 2000 to 2020, the total water yield of the YREB was 1.68 × 10¹² m³. The average annual water yield under the four future SSP scenarios (2022–2060) is projected to range from 1.73 × 10¹² m³ to 1.82 × 10¹² m³. (ii) Among the four SSP scenarios, SSP1-2.6 exhibits the highest increase in water yield services, followed by SSP5-8.5, SSP3-7.0, and SSP2-4.5. (iii) The climate change impact index on water yield services (K) demonstrates a spatial distribution trend of high values in the east and low values in the west, with pronounced spatial variations. (iv) The comprehensive change index of water yield services (K*) across the 11 provinces and cities affected by climate change ranges from −0.0954 to 0.1005 under the four scenarios, indicating that climate change exerts both positive and negative impacts on water yield services in the YREB. (v) The quantitative impact assessment model constructed in this study offers scientific support for ecosystem restoration and water resource management optimization in the YREB. Full article

The combined effects of climate change and socio-economic development have intensified the risk of water supply–demand imbalance in China. To project future trends, this study develops a multi-scenario coupled prediction framework integrating climate, socio-economic, and human activity drivers, combining data-driven and physically based modeling approaches to assess terrestrial water storage imbalance in nine major river basins under six representative SSP–RCP scenarios through the end of the 21st century. Using ISIMIP multi-model runoff outputs along with GDP and population projections, agricultural, industrial, and domestic water demands were estimated. A Water Conflict Index was proposed by integrating the Water Supply–Demand Stress Index and the Standardized Hydrological Runoff Index to identify high-risk basins. Results show that under high-emission scenarios, the WCI in the Yellow River, Hai River, and Northwest Rivers remains high, peaking during 2040–2069, while low-emission scenarios significantly alleviate stress in most basins. Water allocation inequity is mainly driven by insufficient supply in arid northern regions and limited redistribution capacity in resource-rich southern basins. Targeted strategies are recommended for different risk types, including inter-basin water transfer, optimization of water use structure and pricing policies, and the development of resilient management systems, providing scenario-based quantitative support for future water security and policy-making in China. Full article

Background: Physical inactivity during adolescence remains a major public health concern, yet its multifactorial determinants are not fully understood in low- and middle-income settings. Objective: To identify and quantify the determinants of physical activity (PA) among Brazilian adolescents using a hierarchical logistic regression model that reflects the theoretical ordering of distal to proximal factors. Methods: A cross-sectional study was conducted with 856 adolescents (13–19 years). Data were obtained from the validated Brazilian Youth Risk Behavior Survey and the Brazilian Economic Classification Criteria (ABEP) socioeconomic questionnaire. PA was dichotomized according to World Health Organization recommendations. Hierarchical logistic regression examined five theoretical blocks: sociodemographic, anthropometric, substance use, weight/diet, and sedentary behavior. Results: Overall, 5 out of 17 predictors were significant in the full model. extended Body mass index (eBMI) was negatively associated with physical activity (OR = 0.331, 95% CI: 0.169–0.647, p = 0.001), while body mass was positively associated (OR = 2.078, 95% CI: 1.045–4.135, p = 0.037). Working status (OR = 1.235, 95% CI: 1.035–1.475, p = 0.019) and weight loss attempts (OR = 1.327, 95% CI: 1.042–1.690, p = 0.022) increased the odds of being active, whereas current smoking reduced it (OR = 0.715, 95% CI: 0.517–0.990, p = 0.043). Model discrimination improved progressively (AUC = 0.577 to 0.692). Conclusions: Physical activity among Brazilian adolescents was primarily influenced by behavioral and perceptual rather than demographic factors. These findings highlight the need for integrated interventions promoting muscle development, body positivity, and smoking prevention. Full article

Urban tree canopy is increasingly recognized as a health-protective form of green infrastructure, yet its distribution remains uneven across socioeconomically stratified neighborhoods. This study quantifies fine-scale tree-canopy inequity across Census Block Groups (CBGs) in Baltimore and examines associations with socioeconomic deprivation and modeled pollution-related cancer risk. We integrated (i) 2023 US Forest Service canopy estimates aggregated to CBGs, (ii) Area Deprivation Index (ADI) national and state ranks, (iii) American Community Survey 5-year population counts, and (iv) EPA NATA/HAPs cancer-risk estimates aggregated to CBGs using population-weighted means. Associations were assessed using Spearman correlations and visualized with LOESS smoothers. Canopy was negatively associated with ADI national and state ranks (ρ = −0.509 and −0.503), explaining 29–31% of canopy variation. Population-weighted canopy declined from 47–51% in the least deprived decile to 13–15% in the most deprived (3.4–4.1× disparity). Beyond socioeconomic gradients, overall distributional inequity was quantified using a population-weighted Tree Canopy Inequality Index (TCI; weighted Gini), yielding TCI = 0.312, indicating substantial inequality. The population-weighted Atkinson index rose sharply under increasing inequality aversion (A_0.5 = 0.084; A₂ = 0.402), revealing extreme canopy deficits concentrated among the most disadvantaged neighborhoods. Canopy was also negatively associated with modeled cancer risk (ρ = −0.363). We constructed a Triple Burden Index integrating canopy deficit, deprivation, and cancer risk, identifying spatially clustered high-burden neighborhoods that collectively house over 86,000 residents. These findings demonstrate that canopy inequity in Baltimore is structurally concentrated and support equity-targeted greening and sustained maintenance strategies guided by distributional justice metrics. Full article

Drought is a pervasive and intensifying climate hazard with profound implications for food security, water availability, and socioeconomic stability, particularly in sub-Saharan Africa. In Kenya, where over 80% of the landmass comprises arid and semi-arid lands (ASALs), recurrent droughts have become a critical threat to agricultural productivity and climate resilience. This study presents a comprehensive spatiotemporal analysis of seasonal drought dynamics in Kenya for June–July–August–September (JJAS) from 2000 to 2024, leveraging remote sensing-based drought indices and geospatial analysis for climate risk planning. Using the Standardized Precipitation Evapotranspiration Index (SPEI), Vegetation Condition Index (VCI), Soil Moisture Anomaly (SMA), and Fraction of Absorbed Photosynthetically Active Radiation (FAPAR) anomaly, a Combined Drought Indicator (CDI) was developed to assess drought severity, persistence, and impact across Kenya’s four climatological seasons. Data were processed using Google Earth Engine and visualized through GIS platforms to produce high-resolution drought maps disaggregated by county and land-use class. The results revealed a marked intensification of drought conditions, with Alert and Warning classifications expanding significantly in ASALs, particularly in Garissa, Kitui, Marsabit, and Tana River. The drought persistence analysis revealed chronic exposure in drought conditions in northeastern and southeastern counties, while cropland exposure increased by over 100% while rangeland vulnerability rose nearly 56-fold. Population exposure to drought also rose sharply, underscoring the socioeconomic risks associated with climate-induced water stress. The study provides an operational framework for integrating remote sensing into early warning systems and policy planning, aligning with global climate adaptation goals and national resilience strategies. The findings advocate for proactive, data-driven drought management and localized adaptation interventions in Kenya’s most vulnerable regions. Full article

In semi-arid areas like Southeastern Anatolia, where agricultural productivity and water supply are extremely climate-sensitive, drought is a significant environmental and socioeconomic problem. Comprehensive assessment of drought and soil moisture dynamics is fundamental to sustainable agriculture and water security in semi-arid regions. This study analyzes drought patterns across seven provinces in the Southeastern Anatolia (GAP) region of Türkiye (Adıyaman, Diyarbakır, Gaziantep, Kilis, Mardin, Siirt, and Şanlıurfa) from 1963 to 2022, employing four drought indices (SPI, SPEI, CZI, and RDI) at multiple timescales (1-, 3-, and 12-month) to support evidence-based strategies for sustainable water and agricultural resource management. A more thorough evaluation is made possible by this multi-index and multi-scale method, which is rarely used concurrently at the provincial level. Additionally, the drought characterization was validated and enhanced through the analysis of ERA5-Land soil moisture data (1950–2022). According to the findings, the provinces with the lowest median index values and the highest frequency of extreme drought episodes are Diyarbakır and Şanlıurfa. The SPEI-12 (THW) median values showed a neutral long-term drought–wetness balance with seasonal changes, ranging from −0.0714 (Adıyaman) to 0.188 (Şanlıurfa). Particularly after 2009, soil moisture levels decreased to as low as 2–3 mm during the summer, indicating heightened evapotranspiration stress. RDI-12’s reliability in long-term drought evaluation was confirmed by its strongest correlation with other indices (r = 0.87–0.97). According to spatial research, the frequency of moderate droughts in the southwest was as high as 39%, whilst the eastern provinces experienced severe and intense droughts as high as 8%. However, with frequency above 53%, wet occurrences were more common in the east, particularly in Siirt. By clarifying long-term drought and soil moisture patterns, this study provides essential insights for sustainable irrigation planning and agricultural water allocation in the GAP region. Full article

Background: Black transgender women experience high rates of intersectional discrimination contributing to post-traumatic stress disorder (PTSD) symptoms. While sleep typically buffers psychological distress among general populations, these relationships remain underexplored among Black transgender women, and existing protective sleep literature derives primarily from non-Hispanic White, cisgender, socioeconomically advantaged populations. Methods: This exploratory secondary cross-sectional analysis of 155 Black transgender women (aged 18+) examined whether sleep quality (Pittsburgh Sleep Quality Index) moderates associations between discrimination (Intersectional Discrimination Index) and PTSD symptoms (PTSD Symptom Checklist-DSM-5) using moderated multiple linear regression models, controlling for age (n = 139–149). Results: Contrary to expectations, better sleep quality strengthened associations between day-to-day (p = 0.0126) and major discrimination (p = 0.0235) and the PTSD symptom severity. Conclusions: These exploratory findings reveal paradoxical sleep-distress relationships among Black transgender women that contradict patterns documented among general populations, highlighting critical limitations in applying existing psychological frameworks to multiple marginalized communities. Results underscore urgent needs for culturally validated assessment instruments and comprehensive measurement of structural determinants (housing stability, economic security, and neighborhood safety) before concluding psychology in populations experiencing intersectional oppressions. Full article

Background/Objectives: Ethnic disparities in type 2 diabetes (T2D) outcomes remain a significant public health challenge in Aotearoa New Zealand (NZ), but are not accurately reported in large datasets. This cross-sectional study used linked regional health records to examine ethnic inequities in glycaemic control and achievement of clinical targets among adults with T2D in the Waikato and Auckland regions. Methods: A cross-sectional analysis was conducted on 57,734 adults aged 18–75 years with confirmed T2D enrolled in four Primary Healthcare Organisations. Clinical and sociodemographic data from February 2021 to December 2023 were linked via National Health Index numbers. Key outcomes included the percentage of patients at target for HbA1c, blood pressure, lipid profiles, renal and liver function tests. Logistic regression assessed associations between ethnicity, socioeconomic deprivation, and clinical target attainment. Results: The mean age was 56.5 ± 12.4 years, and 86.8% of the cohort were overweight or obese. Overall, only 46.3% achieved the HbA1c target (<53 mmol/mol) in their most recent test, with Māori (OR 1.35) and Pacific (OR 1.84) ethnicities, higher deprivation, obesity, and younger age independently associated with elevated HbA1c. Hypertension affected two-thirds of participants (71.9% above target), notably Asians and Pacific peoples. Māori and Pacific peoples had over twice the odds of renal impairment and were 2.5 times more likely to have elevated albumin-to-creatinine ratios. Abnormal liver function test decreased with age (OR ≤ 0.65), though Asians had over twice the odds of elevated ALT and AST compared to Europeans. Conclusions: Significant ethnic inequities exist in glycaemic and clinical target attainment among people with T2D in NZ. These findings highlight critical gaps in diabetes management and underscore the urgent need for targeted, equity-focused interventions addressing both socioeconomic and ethnic disparities to improve outcomes and reduce health inequities. Full article

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults. Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and the Instrumented Five Times Sit-to-Stand (i5TSTS) test. Kruskal–Wallis tests and general linear models in SAS 9.4 analyzed the relationship between ADI and mobility measures. Results: Higher ADI scores were significantly associated with poorer performance on the i5TSTS test (p = 0.0004). While overall iTUG duration did not differ significantly across ADI groups, the sit-to-stand phase of the iTUG showed a significant relationship with ADI (p = 0.0026). These associations remained significant after adjusting for age, weight, race, and education level. Conclusions: These findings suggest that neighborhood context plays a crucial role in mobility health, particularly in functions related to postural transitions. Clinicians should consider area-level disadvantage when screening for mobility limitations and may need to prioritize sit-to-stand interventions for patients living in high-deprivation areas. Full article

The evolution of “Production–Living–Ecological” spaces (PLESs) in mountainous rural areas is shaped by complex interactions between terrain gradients and socio-economic factors. However, existing research lacks a targeted exploration of their evolution and driving mechanisms at the town scale. This study takes Taiji Town in Chongqing, China, as a case study and identifies land use data for mountainous rural areas. Based on this, “Production–Living–Ecological” attributes are assigned to each land use class, terrain gradients are delineated using the Terrain Niche Index, and the gradient-specific characteristics and spatiotemporal distribution patterns of PLES evolution in mountainous rural areas are analyzed. Additionally, the nonlinear driving mechanisms of PLES evolution are explored by incorporating variables such as terrain gradient, geographical location, social development, and ecological landscape. The results show that the evolution of PLES in Taiji Town generally follows a trend of decreasing production space, expanding living space, and steadily increasing ecological space. Furthermore, topographic constraints form a bottleneck in the evolution of production space in mountainous rural areas, with some production space boundaries extending into higher-gradient areas. Analysis of the driving mechanisms reveals that the interactions between land use degree evolution and elevation, as well as between land use degree evolution and slope, are key factors influencing the evolution of PLES, with significant differences across villages with varying topographic conditions. This study provides a scientific basis and methodological reference for observing spatial evolution and optimizing spatial planning at the town scale. Full article

Background: Probiotic supplementation for very preterm infants is a common practice in many neonatal units. Assessing the effects of early postnatal exposure to probiotics on long-term neurodevelopment, growth, and atopy-related outcomes is important. Extremely preterm (EP: <28 weeks) infants enrolled in our previously reported randomized trial (SiMPro) comparing short-term effects of single (SS: B. breve M-16V) versus triple-strain (TS: B. breve M-16V, B. longum subsp. infantis-M63, B. longum subsp. longum-BB536) probiotic provided a unique opportunity to study this issue. Methods: This follow-up study assessed the five-year outcomes of SiMPro trial infants, including neurodevelopment (cognition (Full Scale Intelligence Quotient/ FSIQ using WPPSI-IV), behavior (Strengths and Difficulties Questionnaire), executive function (BRIEF–P)), growth (anthropometry) and blood pressure (BP). Atopy-related outcomes were evaluated at six to seven years using the ISAAC questionnaire. A linear mixed model was used for longitudinal outcomes. Impairment indicators were modeled using logistic regression and adjusted for Socio-Economic Indexes for Areas (SEIFA) centiles. Results: Follow-up rates (SS: 89.2% versus TS: 95%), neurodevelopmental outcomes [severe impairment (FSIQ < 70): SS: 7.4% versus TS: 4.3%; p = 0.68], growth, BMI, and BP were comparable between the SS and TS groups. The total difficulty score or BRIEF–P executive indices, disability rates (none: 66.7% versus 55.4%), and atopy-related outcomes were comparable between groups. Conclusions: Both TS and SS Bifidobacterium probiotic formulations were safe, with comparable neurodevelopmental, growth, and atopy-related outcomes at school age. Full article

Quantitative assessment of ecosystem health (EH) effectively provides a scientific reference for regional landscape ecological development and socio-ecological system coordination. This study combined the VORSH framework and the XGBoost-SHAP model to assess EH and its spatiotemporal driving factors in the Pinglu Canal Economic Zone. The results show that the comprehensive ecosystem health index (EHI) generally remained at a moderate level during this period, exhibiting a pattern of initial decline followed by recovery, resulting in an overall improving trend. The period from 2005 to 2010 was identified as a critical transitional phase, during which EH began to recover and gradually improve. The Pinglu Canal Economic Zone exhibits distinct spatial heterogeneity in EH. Areas with poor and unhealthy grades are primarily distributed around urban peripheries, plain regions, and near certain water bodies. In contrast, healthy and relatively healthy areas are predominantly located in the densely vegetated mountainous regions of the southwest, north, and east. Between 2000 and 2020, the EH status demonstrated a significant overall upward trend, with most areas experiencing slight improvement and only a few regions exhibiting significant degradation. Topography and temperature were the primary factors driving the spatiotemporal variations in EH, while the influence of human activities continued to intensify with ongoing socioeconomic development. Full article

Background/Objectives: Evidence links children’s health-related quality of life (HRQoL) to overall diet, but data on specific, actionable habits are limited. We tested whether vegetable intake ≥2 portions/day and fish intake ≥2–3 times/week were associated with risk of low HRQoL (KIDSCREEN-10 Index score <40) and assessed their joint effect and robustness to overall diet quality. Methods: In three waves (2020–2023) in Madrid (Spain), 1127 observations from 771 children (8–12 years) were analysed. Logistic Generalised Estimating Equations (GEE) adjusted for age, sex, socioeconomic status (four levels), moderate-to-vigorous physical activity (MVPA), screen time, body mass index (BMI) z-score, wave and school ownership. Marginal predicted probabilities were computed for four exposure combinations (neither, vegetables only, fish only, both). Sensitivity models added school area and the Mediterranean Diet Quality Index (KIDMED; KIDMED_wo_FV and total); hybrid within–between GEE and a linear mixed model for continuous KIDSCREEN-10 were also fitted. Results: Vegetables ≥2/day and fish ≥2–3/week were inversely associated with low HRQoL (odds ratio (OR) 0.49 (95% confidence interval (CI) 0.30–0.82) and 0.61 (0.43–0.87)). The interaction was positive (OR 2.50 (1.39–4.53)). Adjusted probabilities were 40.1% (neither), 25.8% (vegetables only; −14.3 percentage points (p.p.)), 29.7% (fish only; −10.5 p.p.), and 34.0% (both; −6.1 p.p.). Findings persisted with KIDMED_wo_FV and attenuated with total KIDMED. MVPA related inversely and screen time directly to risk. Conclusions: Vegetables ≥2/day and fish ≥2–3/week were associated with lower odds of low HRQoL, with non-additive combined effects. These simple targets may complement physical-activity promotion and reduced screen time; longitudinal/experimental studies should test causality and dose–response. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common and linked to obesity; however, its association with colorectal cancer (CRC) risk in women remains unclear. Materials and Methods: This retrospective cohort study used the Korean National Health Insurance Service health-screening database, including 483,401 women aged 40–59 years examined between 2013 and 2016, followed through 2021. MASLD was defined as hepatic steatosis (hepatic steatosis index ≥ 36 or ICD-10 K76.0) with ≥1 metabolic abnormality and no heavy alcohol use (≥20 g/day). Incident CRC (ICD-10 C18–C20) was analyzed using Cox regression adjusted for demographic, socioeconomic, and metabolic variables. Effect modification was tested across key covariates. Results: MASLD was found in 128,642 participants (26.6%). During a median 7.5-year follow-up, 2432 CRC cases occurred (702 with MASLD). The 7-year cumulative CRC risk was higher in the MASLD group (0.47% vs. 0.43%; p = 0.006). MASLD independently increased CRC risk (adjusted HR 1.10; 95% CI 1.00–1.20). Effect modification was observed for age, dyslipidemia, and waist circumference. MASLD significantly increased CRC risk among women aged 40–49 years (HR 1.26; 95% CI 1.05–1.49), those without dyslipidemia (HR 1.15; 95% CI 1.03–1.28), and with waist < 85 cm (HR 1.15; 95% CI 1.02–1.30). Conclusions: MASLD modestly increases CRC risk in Korean women, particularly among younger, normolipidemic, and non-obese individuals, indicating the need for age- and metabolism-specific risk stratification and suggesting a need for closer clinical attention and metabolic optimization. Full article

Background: Skin cancer is known to be associated with aging, oxidative stress, and inflammation. The present study aimed to explore the association between PhenoAge, dietary inflammatory index (DII), and dietary oxidative balance index (DOBS) with skin cancer risk. Methods: A total of 474 individuals aged over 20 years who had information on DII, DOBS, PhenoAge, socioeconomic and demographic factors, and self-reported skin cancer, and 16,154 without skin cancer were included in the National Health and Nutrition Examination Survey database (2005–2018). The combination of DII/DOBS was categorized into 3 categories: inflammation- and oxidation-promoting diet, inflammation- and oxidation-reducing diet, and composite diet. We applied logistic regression to estimate odds ratios (ORs) for the association of DII/DOBS and PhenoAge with skin cancer risk, after adjusting for covariates and survey year. Results: PhenoAge was associated with an increased likelihood of skin cancer (OR 1.07, 95% CI 1.06 to 1.08, p < 0.001). DII and DOBS were associated with PhenoAge advancement of OR 1.28 (95% CI 1.20 to 1.36), OR 0.95 (95% CI 0.94 to 0.96), respectively (p < 0.001). After adjusting for all covariates, the comparison between the inflammation–oxidation-promoting diet and the inflammation–oxidation-reducing diet had a positive relationship with skin cancer (OR 2.19, 95% CI 1.29 to 3.72, p = 0.004). PhenoAge mediated 28.06% of the associations between DII/DOBS and skin cancer risk (p < 0.05). The association remained in the subgroup analysis. Conclusion: Our results suggest that an inflammation- and oxidation-promoting diet is related to increased skin cancer risk and may be partly mediated by PhenoAge. Full article