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As a crucial component of the ecological security pattern, ecological source (ES) plays a vital role in providing ecosystem service value (ESV) and conserving biodiversity. Previous studies have mostly considered ES only from either landscape change pattern or ecological function perspectives, and have ignored their integration and spatio-temporal evolutionary modeling. In this study, we proposed a multi-perspective framework for the spatio-temporal characteristics of ES by ESV incorporating landscape aesthetics, carbon sink characteristics, ecological quality, and kernel NDVI (kNDVI). By integrating the revised ESV and the kernel normalized difference vegetation index as a foundation, we employed the spatial priority model to identify ES. This improvement aims to yield a more practical and specific ESV result. Applying this framework to the Three-River Headwaters Region (TRHR), a significant spatio-temporal change in ecological sources has been observed from 2000 to 2020. This performance provided a reference for ecological conservation in the TRHR. The results indicate that this ecological source identification framework has reliable accuracy and efficiency compared with the existing NRs in the TRHR. This method could reveal more precise spatio-temporal distributions of ES, enhancing ecosystem integrity and providing technical modeling support for developing cross-scale spatial planning and management strategies for nature reserve boundaries. The framework proposed in our research could serve as a reference for building ecological networks in other ecologically fragile areas. [ABSTRACT FROM AUTHOR]

Wearing gloves during machinery operation in workshops is essential for preventing accidental injuries, such as mechanical damage and burns. Ensuring that workers are wearing gloves is a key strategy for accident prevention. Consequently, this study proposes a glove detection algorithm called YOLOv8-AFPN-M-C2f based on YOLOv8, offering swifter detection speeds, lower computational demands, and enhanced accuracy for workshop scenarios. This research innovates by substituting the head of YOLOv8 with the AFPN-M-C2f network, amplifying the pathways for feature vector propagation, and mitigating semantic discrepancies between non-adjacent feature layers. Additionally, the introduction of a superficial feature layer enriches surface feature information, augmenting the model's sensitivity to smaller objects. To assess the performance of the YOLOv8-AFPN-M-C2f model, this study conducted multiple experiments using a factory glove detection dataset compiled for this study. The results indicate that the enhanced YOLOv8 model surpasses other network models. Compared to the baseline YOLOv8 model, the refined version shows a 2.6% increase in mAP@50%, a 63.8% rise in FPS, and a 13% reduction in the number of parameters. This research contributes an effective solution for the detection of glove adherence. [ABSTRACT FROM AUTHOR]

With the rapid development of urbanization, it is an important goal for urban green space (UGS) to meet the needs of residents' production and life using a supply–demand evaluation method of ecosystem service (ES). However, most studies have considered all functional types of UGS as the supply side, or rely solely on a single supply or demand side to conduct ecosystem service function (ESF) evaluation, resulting in less accurate and targeted research findings. As a result, a novel methodological framework for matching each ESF with corresponding functional types of UGS, and considering both supply and demand sides have been required. Firstly, the object-oriented approach combining support vector machine (SVM) and normalized difference vegetation index (NDVI) was used to automatically identify UGS, and integrated Point of Interest (POI), urban built-up area, road land, parcel, and socio-economic data to classify six functional types of UGS using the near-convex-hull. Next, matching the functional types of UGS with five ESFs, both supply and demand status were evaluated using the carbon sequestration and release analysis, Gaussian two-step floating catchment area, and spatial equilibrium degree methods. This method was demonstrated in Beijing, China. The results show: (1) the ES supply–demand situation provided by each functional type of UGS is different in five ESFs; (2) considering both supply and demand is more intuitive to see whether the city's demand for UGS has been met. Our results provide a new perspective for evaluating the contribution of UGS and have practical implications for UGS planning. [ABSTRACT FROM AUTHOR]

Mustard, which belongs to the family Brassicaceae, is an annual or biennial herb and is considered as one of the most important native vegetables in China. Glucosinolates are important secondary metabolites containing sulfur and nitrogen in plants, which form a network with other metabolic pathways that play important roles in plant growth, development, and interaction with the environment. We studied varied phenotypic and glucosinolate contents of 60 mustard resources collected from various areas of China. The results showed both agronomic traits and glucosinolates varied greatly among mustard resources. We detected nine glucosinolates in mustard resources and the contents of total glucosinolates ranged from 1.2023 to 30.7310 μmol/g. Through the correlation analysis, we preliminarily found a significant negative correlation between leaf color and glucosinolate contents but needed further validation. For mustard resource JC 18-56, we analyzed the glucosinolate contents in different organs of different growth stages. The results indicated a significant difference among organs in both glucosinolates concentration and composition. The contents of glucosinolatess in alabastrums at bolting stage were highest, up to 140.1257 μmol/g dry weight (DW). We found that the main glucosinolates in roots were 4-methoxyglucobrassicin, while in other organs the glucosinolates were sinigrin. The contents of glucosinolatess in different organs of mustard were as follows: alabastrums > seeds > flowers > siliques > leaves > flower stems > stems > roots. This study provides important references for the selection and cultivation of high-quality mustard varieties. [ABSTRACT FROM AUTHOR]

The revised consensus guidelines for optimizing vancomycin doses suggest that maintaining the area under the concentration-time curve to minimal inhibitory concentration ratio (AUC/MIC) of 400–600 mg·h/L is the target pharmacokinetic/pharmacodynamic (PK/PD) index for efficacy. AUC-guided dosing approach uses a first-order pharmacokinetics (PK) equation to estimate AUC using two samples obtained at steady state and one-compartment model, which can cause inaccurate AUC estimation and fail to achieve the effective PK/PD target early in therapy (days 1 and 2). To achieve an efficacy target from the third or fourth dose, two innovative approaches (Method 1 and Method 2) to estimate vancomycin AUC at steady state (AUCSS) using two-compartment model and three or four levels after the first dose are proposed. The feasibility of the proposed methods was evaluated and compared with another published dosing algorithm (Method 3), which uses two samples and a one-compartment approach. Monte Carlo simulation was performed using a well-established population PK model, and concentration-time profiles for virtual patients with various degrees of renal function were generated, with 1000 subjects per group. AUC extrapolated to infinity (AUC0–∞) after the first dose was estimated using the three methods, whereas reference AUC (AUCref) was calculated using the linear-trapezoidal method at steady state after repeated doses. The ratio of AUC0–∞: AUCref and % bias were selected as the indicators to evaluate the accuracy of three methods. Sensitivity analysis was performed to examine the influence of change in each sampling time on the estimated AUC0–∞ using the two proposed approaches. For simulated patients with various creatinine clearance, the mean of AUC0–∞: AUCref obtained from Method 1, Method 2 and Method 3 ranged between 0.98 to 1, 0.96 to 0.99, and 0.44 to 0.69, respectively. The mean bias observed with the three methods was −0.10% to −2.09%, −1.30% to −3.59% and −30.75% to −55.53%, respectively. The largest mean bias observed by changing sampling time while using Method 1 and Method 2 were −4.30% and −10.50%, respectively. Three user-friendly and easy-to-use excel calculators were built based on the two proposed methods. The results showed that our approaches ensured sufficient accuracy and achieved target PK/PD index early and were superior to the published methodologies. Our methodology has the potential to be used for vancomycin dose optimization and can be easily implemented in clinical practice. [ABSTRACT FROM AUTHOR]

Busulfan is a bifunctional alkylating agent that is widely used before hematopoietic stem cell transplantation (HSCT), in combination with other chemotherapeutic drugs. As of 2020, there is no population pharmacokinetic (popPK) model for busulfan in Chinese pediatric patients. A systemic external evaluation of 11 published popPK models was conducted in Chinese pediatric patients undergoing HSCT. Forty pediatric patients were enrolled in this study, with a total of 183 blood concentrations. The relative prediction error (PE%), median PE%, median absolute PE%, and percentage of PE% within ±20% and ±30% were calculated in prediction‐based diagnostics. Simulation‐based diagnostics were conducted through a prediction‐ and variability‐corrected visual predictive check and the normalized prediction distribution error. The relative individual prediction error was calculated using Bayesian forecasting with 1 to 3 concentration points. The 1‐compartment open linear popPK model, which was built by Su‐jin Rhee et al (model H), incorporating the patient's body surface area, age, dosing day, and aspartate aminotransferase as significant covariates had preferable predictability than other popPK models. In prediction‐based diagnostics, the median PE%, percentage of PE% within ±20%, and percentage of PE% within ±30% of model H were 8.48%, 45.35%, and 59.56%, respectively. The normalized prediction distribution error of model H showed that it followed the normal distribution. Based on Bayesian forecasting, model H showed good predictive performance. Thus, model H was the most appropriate model that can be used clinically for individualized dosage adjustments in Chinese pediatric HSCT patients. [ABSTRACT FROM AUTHOR]

• convergence analyses. • consensus-alternating direction method of multipliers. • general quadratically constrained quadratic programs. • monotonically non-increasing of augmented Lagrangian function value. • boundedness of augmented Lagrangian function. We analyze the convergence properties of the consensus-alternating direction method of multipliers (ADMM) for solving general quadratically constrained quadratic programs. We prove that the augmented Lagrangian function value is monotonically non-increasing as long as the augmented Lagrangian parameter is chosen to be sufficiently large. Simulation results show that the augmented Lagrangian function is bounded from below when the matrix in the quadratic term of the objective function is positive definite. In such a case, the consensus-ADMM is convergent. [ABSTRACT FROM AUTHOR]

• Off-grid DOA estimation. • Grid-based DOA estimation. • Second-order Taylor approximation. • Proportionality relationship. • Block restricted isometry property. The problem of off-grid direction-of-arrival (DOA) estimation is investigated. We develop a grid-based method to jointly estimate the closest spatial frequency (the sine of DOA) grids, and the gaps between the estimated grids and the corresponding frequencies. By using a second-order Taylor approximation, the data model under the framework of joint-sparse representation is formulated. We point out an important property of the signals of interest in the model, namely the proportionality relationship, which is empirically demonstrated to be useful in the sense that it increases the probability of the mixing matrix satisfying the block restricted isometry property. Simulation examples demonstrate the effectiveness and superiority of the proposed method against several state-of-the-art grid-based approaches. [ABSTRACT FROM AUTHOR]

Objectives: Patients with hematological malignancies are prone to invasive fungal disease due to long-term chemotherapy or radiotherapy. Voriconazole is a second-generation triazole broad-spectrum antibiotic used to prevent or treat invasive fungal infections. Many population pharmacokinetic (pop PK) models have been published for voriconazole, and various diagnostic methods are available to validate the performance of these pop PK models. However, most of the published models have not been strictly evaluated externally. The purpose of this study is to evaluate these models externally and assess their predictive capabilities. Methods: The external dataset consists of adults receiving voriconazole treatment at Fujian Medical University Union Hospital. We re-established the published models based on their final estimated values in the literature and used our external dataset for initial screening. Each model was evaluated based on the following outcomes: prediction-based diagnostics, prediction- and variability-corrected visual predictive check (pvcVPC), normalized prediction distribution errors (NPDE), and Bayesian simulation results with one to two prior observations. Results: A total of 237 samples from 166 patients were collected as an external dataset. After screening, six candidate models suitable for the external dataset were finally obtained for comparison. Among the models, none demonstrated excellent predictive performance. Bayesian simulation shows that all models' prediction precision and accuracy were significantly improved when one or two prior concentrations were given. Conclusions: The published pop PK models of voriconazole have significant differences in prediction performance, and none of the models could perfectly predict the concentrations of voriconazole for our data. Therefore, extensive evaluation should precede the adoption of any model in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Hepatic infarction is a rare liver condition. The purpose of this study is to report a case of hepatic infarction caused by thrombus formation following portal vein stent implantation in a patient with hepatocellular carcinoma and portal vein tumor thrombus, and to explore the underlying causes. Case report: The patient in this study was a 52-year-old male admitted with diffuse hepatocellular carcinoma involving the right lobe and portal vein tumor thrombus. After undergoing portal vein stent implantation and 125I particle strand implantation treatment, the portal vein was patent, and the pressure decreased. However, multiple instances of hepatic artery chemoembolization combined with targeted immunotherapy resulted in gradual reduction in the diameter of the hepatic artery and affecting hepatic arterial blood flow. Two months post-stent implantation, thrombus formation within the stent was noted, and the patient’s condition did not improve with anticoagulant therapy, as evidenced by follow-up CT scans showing an increase in thrombi. Six months later, the patient suffered from gastrointestinal bleeding and, despite emergency esophagogastric variceal ligation and hemostatic treatment, developed hepatic parenchymal infarction and liver function failure. Conclusions: We reveal the underlying cause is that (1) thrombus formation within the portal vein stent, leading to portal vein embolism and obstructed blood flow due to exacerbate portal hypertension after various treatments; and (2) the effect of hepatic artery chemoembolization, immunotherapy, and targeted therapy on tumor angiogenesis, causing reduced hepatic artery diameter and impaired arterial blood flow. These factors disrupt the liver’s dual blood supply system, ultimately contributing to hepatic infarction. To our knowledge, this is the first report of hepatic infarction as a complication following portal vein stent implantation for hepatocellular carcinoma with portal vein tumor thrombus, and it holds significant reference value for guiding the treatment of hepatocellular carcinoma with concurrent portal vein tumor thrombus in a clinical setting. [ABSTRACT FROM AUTHOR]

The Grain for Green project (GGP), initialized by the Chinese government in 1999, has achieved substantial achievements accompanied by a decrease in surface runoff on the Loess Plateau, but the impacts of large-scale afforestation on regional water resources are uncertain. Hence, the objective of this study was to explore the impact of land use change on generalized water resources and ecological water stress using the blue and green water concepts, taking the Yanhe River Basin as the case study. The Soil and Water Assessment Tool (SWAT) was applied to quantify the green water and blue water, which are defined as generalized water resources. The ecological water requirement of vegetation (forest and grass), agricultural water footprint and virtual water flow are considered regional water requirements. The land use types of 1980 (Scenario I) and 2017 (Scenario II) were entered into the SWAT model while keeping the other parameters constant to isolate the influence of land use changes. The results show that the average annual differences in blue, green and generalized water resources were -72.08 million m3, 24.34 million m3, and -47.74 million m3, respectively, when the simulation results of Scenario II were subtracted from those of Scenario I, which shows that land use change caused by the GGP led to a decrease in blue and generalized water resources and an increase in green water resources. Surface runoff in Scenario I was more than that in Scenario II in all of the years of the study period from 1980–2017, and green water storage in Scenario I was more than that in Scenario II in all of the years of the study period except in 1998; although lateral flow in Scenario I was less than that in Scenario II except in 2000 and 2015, as was groundwater runoff in 1992, 2000 and 2015, and green water flow in 1998. Blue water flow, green water storage and green water flow in Scenario II were less than those in Scenario I in the whole basin, 12.89 percent of the basin and 99.21 percent of the basin, respectively. The total water footprint increased from 1995 to 2010 because the forest water footprint increased significantly in this period, although the agricultural water footprint and grass water footprint decreased. The ecological water stress index values had no obvious temporal change trends in either land use scenario, but the ecological water stress index in Scenario II was greater than that in Scenario I, which illustrates that the GGP led to an increase in ecological water stress from the perspective of generalized water resources. [ABSTRACT FROM AUTHOR]

A population pharmacokinetic (pop PK) model of polymyxin B was developed using nonlinear mixed‐effects (NONMEM) modeling based on free plasma concentrations to determine whether dose adjustment is required in critically ill patients. One thousand pharmacokinetic profiles for virtual patients with a body weight of 70 kg were simulated using Monte Carlo simulation at different dose scenarios, and area under the concentration–time curve of free drug (fAUC) was computed. The probability of target attainment (PTA) at each minimum inhibitory concentration (MIC) was calculated using fAUC/MIC as a pharmacokinetic/pharmacodynamic (PK/PD) index. The final population PK model was a 2‐compartment model. PTA showed that 3.5 mg/kg/day regimens of polymyxin B effectively achieved the fAUC/MIC target of 10 (one log10 kill) against Pseudomonas aeruginosa strains with MIC of 1 mg/L or less (PTA, 90.7% or greater), while the dose regimen were ineffective against strains with an MIC of 2 mg/L or greater (PTA, 56.9% or less). For Klebsiella pneumoniae, the fAUC/MIC target of 17.4 (one log10 kill) was achieved in more than 90.4% of cases for MIC of 0.5 mg/L or less with 3 mg/kg/day regimens. However, the PTA decreased dramatically as MICs increased above 1 mg/L (PTA, 56.1% or less). The polymyxin B dosage regimen of 3.5 mg/kg/day and 3 mg/kg/day are sufficient to treat P. aeruginosa infections with an MIC of 1 mg/L or less and K. pneumoniae infections with an MIC of 0.5 mg/L or less, respectively. The current recommended dose (1.5–3 mg/kg/day) of polymyxin B appears inadequate to attain the PK/PD target for therapeutic efficacy against infections caused by P. aeruginosa and K. pneumoniae isolates when MIC is above the values. [ABSTRACT FROM AUTHOR]

Based on the two most recent assessments of Chinese higher plants in 2013 and 2020, of 34,450 and 39,330 species, respectively, we analysed the threatened status of Chinese higher plants. In 2020, around 4,088 (10.39%) of the assessed species in China are threatened, 2,875 (7.31%) Near Threatened, 27,593 (70.16%) not currently threatened and categorised as Least Concern and 4,752 (12.08%) categorised as Data Deficient. While in 2013, 3,767 (10.93%) of the assessed higher plants in China are threatened, 2,723 (7.90%) Near Threatened, 24,296 (70.53%) Least Concern and 3,612 (10.48%) Data Deficient. Estimates of the Red List Index in the two years show different patterns when using different weighting methods with the equal steps weighting method showing a slight decrease (0.91675–0.91495) and the extinction risk weighting method showing a slight increase (0.98792–0.98797). We inferred that China's threatened plant species were likely / relatively effectively protected. However, attention should also be given to the non-threatened species in the future as an additional strategy for their conservation, to maintain their non-threatened status. [ABSTRACT FROM AUTHOR]

• Theoretical framework of water-energy-carbon nexus on land use was established. • The carbon emission/absorption and its intensity vary among different land use types. • The carbon emissions from different land use types will reach peak at different time. • It has great potential of carbon emission reduction under the scenario of water-energy-land saving. The rapid urban expansion of China has led to a large amount of water and energy consumption, and caused drastic growth of carbon emissions. Discovering the water–energy–carbon nexus of different land use types helps explain the interactions between resources capacity and environmental effects of land use activities, as well as provides reasonable options for land use management based on water–energy conservation and carbon emission reduction. In this paper, carbon emission/absorption of different land use types was estimated and the water–energy–carbon nexus of different land use types in Zhengzhou was analyzed. Through the SD model, the future carbon emissions of different scenarios were predicted under water, energy, and land constraints. It showed that total carbon emission increased and carbon absorption reduced along with the land use change during the rapid urbanization process of Zhengzhou city. The water and energy consumption and carbon emissions of different land use types were determined by the different intensities and their spatial patterns of human activities. Therefore, carbon emission and its intensity varied with land use types and water–energy–carbon nexus was closely related to land use types. The carbon emission prediction showed that the carbon emission reduction potential was the highest and the peak carbon emission (40.18 × 106 t) occurred in 2025 under a comprehensive scenario, which was designed with water–energy saving and optimization of land use structure. This study could provide references for policy–makers to formulate differentiated strategies for different land use activities, and contribute to realize water–energy saving and efficient utilization of land and the emission reduction of Zhengzhou city. [ABSTRACT FROM AUTHOR]

Climate change can impact the yield and water footprint of crops. Therefore, assessing such impacts carries great significance for regional water and food security. This study validated and verified the variety parameters of winter wheat for the Decision Support System for Agrotechnology Transfer (DSSAT) model, using the long-term (1993–2013) growth and yield data observed from six agricultural experiment stations in the Haihe River Basin (HRB), China. The growth process was simulated under three representative concentration pathways (RCPs), named RCP2.6, RCP4.5, and RCP8.5—climate scenarios driven by the HadGEM2-ES model. The variety parameters of winter wheat showed high accuracy in the simulation of the anthesis and maturity dates, and could be used for long-term prediction of the growth process. The trends of climate change had positive impacts on the water footprint of winter wheat but adverse impacts on the yield. The growing period was shortened by 3.6 days, 4.7 days, and 5.0 days per decade in the RCP2.6, RCP4.5, and RCP8.5 scenarios, respectively, due to the rapid accumulation of heat. The yield would be increased in lower emissions scenarios (17% in RCP2.6), but decreased in high-emissions scenarios due to high temperatures, which may restrict the growth of wheat. The water footprint was decreased by 10%, 11%, and 13% in the RCP2.6, RCP4.5, and RCP8.5 scenarios, respectively, indicating that the water-use efficiency could be improved in the future. The results showed broad application prospects of the DSSAT model in simulating the response of crop growth to climate change. [ABSTRACT FROM AUTHOR]

Objectives: To explore the role of core self-evaluation in mediating between depressive symptoms and suicidal ideation in Chinese adolescents.Methods: We used the cluster sampling method to analyze 11,563 students from five primary and secondary schools in China for depressive symptoms, core self-evaluation, and suicidal ideation using the following scoring scales: Core Self-Evaluation Scale (CSES), Center for Epidemiologic Survey Depression Scale (CES-D), the Second Edition of the Beck Depression Inventory (BDI- II), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Adolescent Self-Rating Life Events Checklist (ASLEC).Results: The incidence of depression was 29.7%; anxiety, 34.2%; and suicidal ideation, 28.0%. Core self-evaluation was a protective factor for suicidal ideation [OR 0.947, 95% CI 0.937-0.959, p<0.001]. Conversely, depression as measured by the CSES score was a risk factor for suicidal ideation (OR 1.084, 95% CI 1.073-1.096, p<0.001), as were anxiety as measured by the SCARED score (OR 1.011, 95% CI 1.006-1.016, p<0.001) and adolescent life events according to ASLEC score groups (OR 1.524, 95% CI 1.434-1.621, p<0.001). Core self-evaluation mediated the relationship between depression and suicidal ideation with an effect size of 13.9%.Conclusions: Better core self-evaluation is a protective factor against suicidal ideation and mediates the relationship between depression and suicidal ideation. We may be able to reduce the risk of suicidal ideation and therefore suicide among adolescents by improving their core self-evaluation. [ABSTRACT FROM AUTHOR]

Polyaniline/poly(vinyl alcohol)/TiO2 (PANI/PVA/TiO2) hybrid hydrogels with improved mechanical and electrochemical properties were fabricated via in situ oxidative polymerization of aniline (ANI) and in situ synthesized TiO2 with sol–gel method. Due to the combination of hydrogen bonds and electrostatic interactions among PANI, PVA, and TiO2, this inorganic hybrid crosslinking structures enabled the PANI/PVA/TiO2 hybrid hydrogel to possess reinforced tensile/compressive strength (26.5 kPa/8.2 MPa) and unprecedented self-healing performance. Moreover, with the optimized conductive pathways in the hybrid hydrogel, its conductivity was up to 1.38 S/m, which meets the requirement of being utilized as high-performance flexible solid-state supercapacitors. At current density of 0.5 A/g, the hydrogel-based supercapacitor provided a large capacitance of 41.0–127.5 F/g and a high energy density of 0.9–2.8 Wh/kg, which were superior to other flexible supercapacitors. The easily fabricated PANI/PVA/TiO2 conducting hydrogels provides a novel strategy to prepare hydrogel electrodes for flexible energy storage devices. [ABSTRACT FROM AUTHOR]

Background: Open appendectomy, laparoscopic appendectomy, and non-surgical treatment are three options to treat acute appendicitis during pregnancy. Previous studies on the association of different treatment methods for acute appendicitis with pregnancy outcomes have been limited by small sample sizes and residual confounding, especially with respect to hospital-level factors. This study aimed to investigate the association of treatment method for acute appendicitis with pregnancy outcomes using a multi-level analysis. Methods: A retrospective cohort study was conducted based on a large electronic health records database in the United States during the period 2000 to 2016. All pregnancies diagnosed with acute appendicitis and treated in participating hospitals during the study period were included. We conducted multi-level hierarchical logistic regression to analyze both individual- and hospital-level factors for abortion, preterm labor, and cesarean section. Results: A total of 10,271 acute appendicitis during pregnancy were identified during the study period. Of them, 5,872 (57.2%) were treated by laparoscopic appendectomy, 1,403 (13.7%) by open appendectomy, and 2,996 (29.2%) by non-surgical treatment. Compared with open appendectomy, both laparoscopic appendectomy (adjusted OR, 0.6, 95% CI, 0.4, 0.9) and non-surgical treatment (adjusted OR, 0.4; 95% CI, 0.3–0.7) showed a decreased risk of preterm labor. Other important individual-level determinants of adverse pregnancy outcomes included maternal age, gestational hypertension, and anemia during pregnancy, the hospital-level determinant included the number of beds. Conclusions: Compared with open appendectomy, both laparoscopic appendectomy and non-surgical treatment may be associated with a lower risk of preterm labor, without increased risks of abortion and cesarean section. [ABSTRACT FROM AUTHOR]

Rapid urbanization process has a negative or positive impact on vegetation growth. Net primary productivity (NPP) is an effective indicator to characterize vegetation growth status. Taking the core development area of the Central Plains urban agglomeration as the study area, we estimated the NPP and its change trend in the past four decades using the Carnegie-Ames-Stanford Approach (CASA) model and statistical analysis based on meteorological and multi-source remote sensing data. Meanwhile, combined with the urbanization impact framework, we further analyzed urbanization's direct and indirect impact on NPP. The results showed that the urban area increased by 2688 km2 during a high-speed urbanization process from 1983 to 2019. As a result of the intense urbanization process, a continuous NPP decrease (direct impact) can be seen, which aggravated along with the acceleration of the urban expansion, and the mean value of direct impact was 130.84 g C·m−2·a−1. Meanwhile, urbanization also had a positive impact on NPP (indirect impact). The indirect impact showed an increasing trend during urbanization with a mean value of 10.91 g C·m−2·a−1. The indirect impact was mainly related to temperature in climatic factors. The indirect impact has a seasonal heterogeneity, and high-temperature environments of urban areas are more effective in promoting vegetation growth in autumn and winter than in summer. Among different cities, high-speed development cities have higher indirect impact values than medium's and low's because of better ecological construction. This study is of great significance for understanding the impact of urbanization on vegetation growth in the Central Plains urban agglomeration area, supporting urban greening plans, and building sustainable and resilient urban agglomerations. • The direct impact of urbanization has led to a decline in NPP. • The indirect impact of urbanization has improved the vegetation growth environment. • The indirect impact is mainly related to temperature and is greater in urban areas. • The indirect impact has increased regional carbon sinks. • The direct and indirect impacts are both greater in high-speed development cities. [ABSTRACT FROM AUTHOR]