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Abstract: Toxic cyanobacterial blooms (CBs) are becoming more frequent globally, posing a threat to freshwater ecosystems. While making long‐range forecasts is overly challenging, predicting imminent CBs is possible from precise monitoring data of the underlying covariates. It is, however, infeasibly costly to conduct precise monitoring on a large scale, leaving most lakes unmonitored or only partially monitored. The challenge is hence to build a predictive model that can use the incomplete, partially‐monitored data to make near‐future CB predictions. By using 30 years of monitoring data for 78 water bodies in Alberta, Canada, combined with data of watershed characteristics (including natural land cover and anthropogenic land use) and meteorological conditions, we train a Bayesian network that predicts future 2‐week CB with an area under the curve (AUC) of 0.83. The only monitoring data that the model needs to reach this level of accuracy are whether the cell count and Secchi depth are low, medium, or high, which can be estimated by advanced high‐resolution imaging technology or trained local citizens. The model is robust against missing values as in the absence of any single covariate, it performs with an AUC of at least 0.78. While taking a major step toward reduced‐cost, less data‐intensive CB forecasting, our results identify those key covariates that are worth the monitoring investment for highly accurate predictions.

Background Stigma in adolescents with type 1 diabetes mellitus (T1DM) is closely associated with their health outcomes. Currently, there is a lack of stigma assessment tools for this population. Objective To translate the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) and test its reliability and validity in Chinese adolescents with T1DM. Methods A total of 194 patients with T1DM admitted to the First Affiliated Hospital with Nanjing Medical University and Children's Hospital of Nanjing Medical University were selected as the study subjects by using the convenient sampling method from March 2022 to March 2023. The English version of DSAS-1 was directly translated, back-translated and culturally adapted by using Brislin's classical back translation model to form a Chinese version. The Self-designed General Information Questionnaire, the Chinese version of the DSAS-1, the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale was used to conduct investigation. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity of the scale, and the internal consistency of the version was evaluated by calculating the Cronbach's α coefficients. Correlation analyses with the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale were conducted to confirm the effect of the Chinese version of DSAS-1 in detecting stigma among adolescents. Results A total of 194 valid questionnaires were recovered. The exploratory factor analysis and confirmatory factor analysis results showed that the Chinese version of DSAS-1 for adolescents was categorized into three dimensions of differential treatment, complaints and comments and identity concerns, with good structural validity (all factor load>0.55, cumulative variance=67.98%), convergent validity (AVE>0.5), and discriminant validity (correlation coefficients of each dimension less than the square root of AVE). The reliability test results showed good internal consistency of the scale (Cronbach's α coefficient of 0.930). The total score of the Chinese version of DSAS-1 for adolescents was negatively correlated with the total scores of the Diabetes Strengths and Resilience Measure for Adolescents (r=-0.425, P

Objective To compare the efficacy and safety of programmed cell death protein 1 (PD-1) inhibitor + albumin paclitaxel and platinum + PD-1 inhibitor + albumin-paclitaxel in the treatment of advanced metastasis or recurrent cervical cancer. Methods The clinical data of patients who had advanced metastatic or recurrent cervical cancer were treated with PD-1 inhibitor + albumin paclitaxel + platinum (group A) or anti-PD-1 + albumin-bound paclitaxel (group B) in more than second-line therapy in the Affiliated Cancer Hospital of Nanjing Medical University from September 2018 to December 2022 were retrospectively analyzed. The objective response rate (ORR), progression-free survival (PFS) and the incidence of adverse reactions between the two groups were compared. Results A total of 54 patients were collected, 37 in group A and 17 in group B. The median age was 53 years old, and the average follow-up time was 10 months. Among the patients, 45 cases were squamous cell carcinoma, 6 cases were adenocarcinoma, 1 case was adenosquamous carcinoma, and 2 cases were neuroendocrine small cell carcinoma. There was no statistically significant difference in the ORR between group A and group B (35.30% vs 35.14%, P>0.05). There was no statistical significant difference in PFS between group A and group B (11.7 month vs 7.3 month, P>0.05). The differences in the incidence of adverse reactions, the incidence of adverse reactions with grade 3 and above, and the incidence of immune-related adverse reactions between the two groups were not statistically significant (P>0.05). Conclusion The PD-1 inhibitor + albumin paclitaxel + platinum regimen does not increase the efficacy compared with the PD-1 inhibitor + albumin paclitaxel regimen in more than second-line therapy of advanced metastatic and recurrent cervical cancer.

[Objective] At the core of geographic research, the theory of regional human-nature system is also an important theoretical basis for the study of sustainable development of the coastal zone, where the interaction between land and sea is intense. It is of great significance to clarify the characteristics of the spatial association network and the formation mechanism of coastal human-nature system resilience, which will help to grasp the cross-regional synergistic development of the resilience level and enrich the scientific research of the coastal zone. [Methods] Based on the panel data of 17 cities in the coastal zone of the Bohai Rim region from 2005 to 2019, this study used the variable fuzzy identification method to measure the level of coastal human-nature system resilience, and applied the modified gravitational model and the social network analysis method to study its spatial association network characteristics and formation mechanism. [Results] (1) There was a significant spatial association between coastal human-nature system resilience in the Bohai Rim region, but the network structure was relatively loose; (2) Tianjin, Qingdao, Yantai, and Dalian dominated the association network, and Cangzhou, Rizhao, and Dandong were in the periphery of the spatial association network; (3) Jinzhou, Yingkou, and Huludao belonged to the “net beneficiary” block, Weifang, Binzhou, and Dongying belonged to the “two-way spillover” block, Qingdao, Tangshan, and Tianjin belonged to the “net spillover” block, and Yantai and Dalian belonged to the “broker” block. (4) The QAP regression model revealed that geographic proximity, differences in economic development levels, differences in environmental quality, differences in human capital, and differences in informationization levels are the dominant factors in the formation mechanism of spatial association network of coastal human-nature system resilience. [Conclusion] To realize the development of a close-knit network of spatial linkages for coastal human-nature system resilience, it is necessary to promote the orderly flow of resource elements between regions and solve the problem of factor mismatch, so as to effectively enhance the complementarity of strengths and the mechanism for cooperation and exchange.