Search Results (9,849)

Background/Objectives: Growing evidence suggests that cholecystectomy is associated with adverse health outcomes, including the development of metabolic diseases. However, data on the association between cholecystectomy and kidney disease are limited. The present study aimed to investigate the association between cholecystectomy and chronic kidney disease (CKD) using a nationwide longitudinal cohort. Methods: Participants aged ≥20 years with cholecystectomy between 2010 and 2014 (n = 116,748) and age- and sex-matched control participants without cholecystectomy (n = 116,748) were analyzed using the Korea National Health Insurance Service data. The adjusted hazard ratios (aHRs) were calculated for incident CKD in the cholecystectomy group compared with the nonoperative controls. Results: A total of 233,496 participants were included (mean age, 54.7 ± 12.7 years; 52.6% men). During the mean follow-up period of 4.8 ± 1.7 years, 6450 patients (5.5%) were newly diagnosed with CKD in the cholecystectomy group. Cholecystectomy was an independent risk factor for the development of CKD after adjustment for confounders, including age, sex, income, health behaviors, and comorbidities. The risk of CKD was 21% higher in the cholecystectomy group compared to the non-cholecystectomy group (aHR, 1.21; 95% CI, 1.17–1.26). The increased risk of CKD in the cholecystectomy group was consistently significant when a stratified analysis by age, sex, and presence or absence of comorbidities was conducted. Conclusions: Cholecystectomy was independently associated with an increased risk of developing CKD in a nationwide population-based study. Therefore, careful and long-term monitoring of the risk of CKD after cholecystectomy is necessary. Full article

Reports from the World Tourism Organization indicate that tourism activity has been increasingly booming; this sector is essential for economic growth and may affect the environment. Tourism is one of the key strategic sectors for planned growth in Saudi Arabia’s Vision 2030. This study is designed to evaluate the long-termning association between tourist arrivals, growth domestic product (GDP), and CO₂ emissions in the Kingdom of Saudi Arabia (KSA). The data related to these variables were assessed for the period 2010 to 2020. The autoregressive distributed lag (ARDL) bounds results revealed that there are long-established relations between tourist arrivals and growth domestic product and tourist arrivals and CO₂ emissions. The dynamic ordinary least squares (DOLS) and fully modified ordinary least squares (FMOLS) model outcomes were compatible with the outcomes of the ARDL model. In reference to the Granger causality test, tourist arrivals cause (affect) the GDP. Such a result confirms the conception that tourism encourages economic growth. No causality runs from tourist arrivals towards CO₂ accumulation. This result may reflect the governmental effort to reduce CO₂ accumulation and/or to perform tourism activities in a sustainable way. The results predicted that the growth rate of tourist arrivals, GDP, and CO₂ accumulation equal 0.0023, 0.048, and 0.0169, respectively, during the forecast period (2021–2030), which appeared to be increasing for tourist arrivals and GDP and decreasing for CO₂ accumulation. The study recommended that, to increase economic growth, tourist arrivals should be increased alongside performing tourism activities in a sustainable way. These findings point to the benefits of governance in ensuring effective policies to decarbonize the environment, and policy proposals are put forward accordingly. Full article

Following the educational reforms of 2010 and the revision of the curriculum in 2018, Swedish preschool principals have a special responsibility for ensuring that preschool teachers have the necessary conditions to assume their responsibility for the teaching and to lead the work team. This indicates that integrating leadership with management is essential for a sustainable and successful preschool education. This study explores this assumption. Building on the concepts of management and leadership, with a qualitative research design, this study analyses data from seven interviews with preschool principals. The results showed a lack of a combination of management and leadership among the principals in relation to their special responsibility of ensuring that preschool teachers are given conditions necessary to be responsible for teaching in the preschool. The principals either lacked both management and leadership or focused on management only with a lack of leadership. Our findings suggest the necessity for principals to combine management and leadership and move from a previous flat organisational structure towards a focus on increasing preschool teachers’ responsibilities and leadership within the work team. Support for principals is needed to be able to perform a combination of management and leadership when their mission is complex and time-consuming. Full article

Background/Objectives: Physical performance is becoming increasingly critical in basketball, as it directly influences players’ agility, power, and endurance. This study aimed to assess the progression of body composition and physical performance metrics across different ages and genders, establishing age- and gender-specific reference values for Tunisian basketball athletes. Methods: A total of 469 Tunisian basketball players (239 boys and 230 girls) were assessed and grouped by age. Anthropometric measures—including standing and sitting height, body mass, leg length, body mass index, fat mass, fat-free mass, body fat percentage, wingspan, and leg muscle volume—were collected alongside physical performance metrics. Performance tests included countermovement and squat jumps, change-of-direction speed, maximal oxygen uptake, flexibility, the five-jump test, and 5 m, 10 m, and 20 m sprints with and without the ball. Normative data were generated based on age and gender categories. Results: The findings revealed significant age-related improvements in both anthropometric and performance parameters. Boys consistently outperformed girls in physical and fitness-related measures, with gender differences becoming more pronounced with age. Stepwise regression analyses indicated that, for boys, body fat percentage, leg muscle volume, standing height, and wingspan were the best predictors of physical performance. For girls, body fat percentage, standing height, and sitting height were identified as key predictors. Conclusions: The newly established Tunisian reference values for physical performance in youth basketball provide valuable benchmarks that can support the development of explosive power and strength in players, aiding in talent identification and potentially enhancing individual and team performance outcomes. Full article

The urban heat island (UHI) effect is one of the most prominent surface climate changes driven by human activities. This study examines the UHI characteristics and influencing factors in the Southern Xinjiang urban agglomeration using MODIS satellite data combined with observational datasets. Our results reveal a significant increase in impervious surfaces in the region between 1995 and 2015, with the most rapid expansion occurring from 2010 to 2015. This urban expansion is the primary driver of changes in UHI intensity. The analysis from 2000 to 2015 shows substantial spatial variation in UHI effects across cities. Hotan recorded the highest annual average daytime UHI intensity of 3.7 °C, while Aksu exhibited the lowest at approximately 1.6 °C. Daytime UHI intensity generally increased during the study period, with the highest intensities observed in the summer. However, nighttime UHI trends varied across cities, with most showing an increase in intensity. Temperature, precipitation, and aerosol optical depth (AOD) were identified as the main factors influencing annual average daytime UHI intensity, while PM10 concentration showed a weak and inconsistent correlation with UHI intensity, varying by city and season. Full article

Background and Objective: The role of urine cytology during follow-up for low-grade (LG) non-muscle-invasive bladder cancer (NMIBC) is not well established, although cytology has low sensitivity in detecting LG recurrences. Our study aims to evaluate the impact of urine cytology as a complementary method to cystoscopy during follow-up for LG NMIBC. Methods: Patients diagnosed with primary LG TaT1 bladder cancer (BC) between 2010 and 2020 were included. Patients were stratified according to the EAU NMIBC scoring model. Urine cytology was performed during follow-up cystoscopy. The outcomes of the study were BC recurrence and upgrading to high-grade (HG). Cytology utility was established by assessing whether its result led to management change. Results: We included 337 patients with LG TaT1 BC. EAU risk group distribution was low in 262 (77.7%), intermediate in 57 (16.9%), and high-risk in 18 (5.3%) cases. With a median follow-up of 5 years, 166 (49.3%) patients experienced recurrence. Cystoscopy was positive in 154 (92.8%) and suspicious in 12 (7.2%) cases. Urine cytology was positive in 33 (19.9%) cases but only changed management in 3 (0.89%), all with suspicious cystoscopy. Positive cytology at first recurrence was associated with higher risk of upgrading during follow-up (HR 2.781, p = 0.006) and lower upgrading-free survival (p = 0.001). Conclusion: The role of urine cytology to detect first recurrences during follow-up for primary LG TaT1 NMIBC might be limited to patients with non-conclusive lesions in the cystoscopy. A positive cytology at first recurrence is associated with a higher risk of upgrading to HG BC during follow-up. Full article

There is limited information regarding the grain sorghum production trends from early in the millennium towards the 2020s. The main objective of this study was to quantify the grain sorghum production area, economic value, productivity, annual production variation, relationship with changing weather patterns, and yield gap and to identify future areas of intervention and research. The results indicated that the grain sorghum production area in Kansas has increased in the most recent decade (2010–2022) at an average rate of 8 thousand ha year⁻¹. With the current 1.2 million ha harvest area, Kansas continues to allocate more land area for sorghum than any other state in the USA. The average current annual economic value of sorghum in Kansas is USD 0.5 billion. The average sorghum grain productivity for recent years (2000–2022) was 4.3 Mg ha⁻¹ in Kansas. The year-to-year yield variation in the grain sorghum average for Kansas in the years 1929–1956 was ±0.5 Mg ha⁻¹ but increased to ±2 Mg ha⁻¹ for the years 1957–2022. The results also showed a 66 to 96% yield gap between the actual yield (USDA data) and potential non-irrigated yield (Kansas State Grain Sorghum Hybrid Performance Trial data). There was a significant positive correlation between the July–August precipitation and a significant negative correlation between air temperatures and sorghum yield. We conclude that there was an increasing sorghum harvest area trend in Kansas for the years 2010 to 2022. Further research that identifies more unique and important agronomic and economic advantages of sorghum, increasing productivity per unit area across different environments, communicating existing benefits, and developing crop production management best practices are essential to sustain gains in the production area. Full article

In order to implement the dual-carbon strategy and achieve sustainable economic development, it is essential to guarantee environmental protection through the establishment of an effective environmental rule of law. This study employs a quasi-natural experiment, namely the establishment of environmental protection courts in China’s intermediate people’s courts, to investigate the impact on the ESG performance of A-share listed companies from 2010 to 2022. A double-difference model is utilized for this purpose. This study reveals that the specialization of environmental justice is an effective means of promoting the ESG performance of enterprises. The results of mechanism tests indicate that the specialization of environmental justice has a positive impact on the ESG performance of enterprises, primarily by enhancing external supervision and garnering greater media attention and analyst interest. Furthermore, heterogeneity analysis reveals that the influence of environmental justice specialization on corporate ESG performance is particularly pronounced in eastern regions, contexts characterized by high environmental uncertainty and heavily polluting enterprises. These findings offer invaluable insights into the development of environmental justice and the advancement of sustainable economic growth. Full article

This research investigates the influence of economic policy uncertainty (EPU) and its squared term (squared EPU) on the advancement of environmental technologies and the registration of environmental patents in the BRICS nations over the period from 2010 to 2022. Employing the cross-section autoregressive distributed lag (CS-ARDL) technique, the analysis reveals a significant negative relationship liaison between EPU and both environmental innovation and patent registrations, indicating that an increased uncertainty discourages investment in sustainable technologies. Conversely, a positive relationship was found with square EPU, suggesting that elevated levels of uncertainty may stimulate innovative responses as firms seek to differentiate themselves in a competitive market. These findings underscore the necessity for stable and transparent policy frameworks to foster long-term commitments to environmental innovation. This research enriches the literature by illustrating the dual nature of EPU and its differentiated effects on eco-innovation. Full article

This paper presents the development of a U-Net model using four basic optical bands and SRTM data to analyze changes in mangrove forests from 1990 to 2024, with an emphasis on the impact of restoration programs. The model, which employed supervised learning for binary classification by fusing multi-temporal Landsat 8 and Sentinel-2 imagery, achieved a superior accuracy of 99.73% for the 2020 image classification. It was applied to predict the long-term mangrove maps in Wunbaik Mangrove Forest (WMF) and to detect the changes at five-year intervals. The change detection results revealed significant changes in the mangrove forests, with 29.3% deforestation, 5.75% reforestation, and −224.52 ha/yr of annual rate of changes over 34 years. The large areas of mangrove forests have increased since 2010, primarily due to naturally recovered and artificially planted mangroves. Approximately 30% of the increased mangroves from 2015 to 2024 were attributed to mangrove plantations implemented by the government. This study contributes to developing a deep learning model with multi-temporal and multi-source imagery for long-term mangrove monitoring by providing accurate performance and valuable information for effective conservation strategies and restoration programs. Full article

Background: Antipseudomonal β-lactams (APBL) are commonly used for empirical therapy of Gram-negative bloodstream infections (BSI). This retrospective cohort study examines risk factors for prolonged APBL use (≥48 h) in patients with Enterobacterales BSI and compares 28-day mortality between early de-escalation of APBL and prolonged APBL therapy. Methods: Adult patients admitted to two community hospitals in South Carolina with Enterobacterales BSI from January 2010 to June 2015 were included in this study. Data were extracted manually from medical records. Multivariate logistic regression and Cox proportional hazards analyses were used to examine predictors of prolonged APBL therapy and mortality, respectively. Results: Among 993 patients with Enterobacterales BSI, 491 (49%) underwent early de-escalation of APBL and 502 (51%) received prolonged APBL therapy. Cancer, immune compromised status, residence at a skilled nursing facility, a high Pitt bacteremia score, non-urinary source of infection, and BSI due to AmpC-producing Enterobacterales were independently associated with prolonged use of APBL. Antimicrobial stewardship interventions were inversely associated with prolonged APBL use. Early de-escalation of APBL was not associated with increased mortality. Conclusions: This study exemplifies the safety and effectiveness of early de-escalation of APBL in Enterobacterales BSI. Antimicrobial stewardship strategies should be implemented to encourage the practice of early de-escalation of antimicrobial therapy, including in high-risk populations. Full article

This article examines the potential of fuzzy set theory for analysing gradual changes in land use patterns within peri-urban areas. The primary objective of the study was to propose a methodology based on fuzzy set theory for the precise delineation of city boundaries and the identification and spatial localisation of the urban–rural transition zone. The analysis focused on elucidating the defining parameters of this area and the scope of land use changes within the urban–rural transition zone. The analysis employed data from four discrete time points. The data were collected in 2005, 2010, 2017, and 2022. The characteristics of the urban–rural transition zone were evaluated through an examination of historical data and the current land use patterns in regions experiencing direct urbanization pressure. The study demonstrated that, although spatial barriers remain, the city’s development has continued at a consistent pace. Between 2005 and 2010, the area of land classified as urban exhibited a 10% increase, with a further 7% increase observed in the subsequent period, spanning 2010 to 2017. In the most recent period under examination, the urban land area increased by 9%, a figure that is consistent with the rates observed in previous years. These results indicate the stability of urbanization processes in the analysed city, while also revealing significant changes in the limits of urban development and in the intensity of land use. The research project concentrated on the city of Olsztyn and the neighbouring suburban areas, which are subject to direct influence from the city’s expansion. The area under study encompasses 202.4 km² within an eight-km radius of the city centre. The authors of the study emphasized the necessity for systematic monitoring of changes in the transition zone between urban and rural areas. This is to ensure effective control of spatial development and ongoing adjustment of planning tools to effectively prevent uncontrolled expansion. The methodology used enabled the precise delimitation of urban development and the transition zone. This allowed for an in-depth analysis of changes in land use intensity. Full article

Tropical rainforests are of vital importance to the environment, as they contribute to weather patterns, biodiversity and even human wellbeing. Hence, in the face of tropical deforestation, it becomes exigent to quantify and assess the contribution of ecosystem services associated with tropical rainforests to the environment and especially to the people. This study adopted a nuanced approach, different from traditional economic valuations, to estimate the water-related ecosystem services (WRESs) received by the people from 2010 to 2020 in the Hainan Tropical Rainforest National Park (HTRNP). The study focused on water yield, soil conservation, and water purification using InVEST, the SCS-CN_GIS model, and spatial analysis. The results show (1) significant land cover changes within the HTRNP, as forest decreased by 4433 ha and water bodies increased by 4047 ha, indicating the active presence of human activities. However, land cover changes were more pronounced within the 5 km buffer area around the HTRNP, suggesting the effectiveness of the tropical rainforest conservation efforts in place. (2) The water yield of the HTRNP in the years studied decreased by 307.03 km³, based on the water yields in 2010 and 2020, which were 5625.7 km³ and 5318.7 km³, respectively. (3) Change detection showed that runoff mitigation in the rainforest has a negative mean (−0.21), indicating a slight overall decrease in soil conservation and runoff mitigation in the rainforest from 2010 to 2020; however, the higher curve number indicates areas susceptible to surface runoff. (4) The ecological effectiveness of water purification to absorb and reduce nitrogen load was better in 2020 (145,529 kg/year), as it was reduced from 506,739 kg/year in 2010, indicating improved water quality. (5) Population growth is more pronounced in areas with high water yields. Overall, the proposed framework has shown that the water yield potential of the HTRNP can meet the water consumption demands of people and industries situated within the buffer area. However, analysis of the study shows that it does not meet the crop water requirements. This study provides insights for decision makers in identifying potential beneficiaries and the essence of effective area-based conservation measures, and the proposed framework can be applied to any area of interest, offering a different approach in ecosystem services assessment. Full article

Background and aim: The coronavirus (COVID-19) pandemic led to significant changes in health service delivery. Despite the risk in high-exposure environments, frontline workers such as dental staff were expected to continue delivering essential services. This study specifically sought to explore the experiences of dental staff in New South Wales and determine their perceptions of dental care delivery during a pandemic. Methods: Purposive sampling was used to recruit twenty-four dental staff from two local health districts. A deductive framework, as described by Braun and Clark, was used to analyse the transcripts. Four major focus areas were identified: responding to protocol changes, adapting to the impact of changes in policy and protocol, modifying dental treatment planning and recommendations for training and implementation of policies. Results: Dental staff reported that management staff were doing all they could and were most supported working in a team. Reduced contact with patients and personal protective equipment helped staff feel safe when seeing patients. Mental health and remote dentistry services could be more supported. Conclusions: Unique challenges were experienced by dental staff and their management during the global COVID-19 pandemic. Future considerations include improved support for staff and further investigation into the effectiveness of options such as teledentistry. Full article

The existence of intra-amniotic and placental microbiomes during pregnancy has been the source of considerable debate, with research yielding conflicting evidence. This study evaluated investigations into the putative presence of these microbiomes in healthy pregnancies by identifying design and data interpretation issues, particularly concerning contamination in samples with low-density bacterial DNA. Positive findings from diverse populations suggest a consistent presence of microbiota in the intra-amniotic space. Negative conclusions regarding the existence of these prenatal microbiomes emphasise the impact of contamination in the analysis of samples with low-density bacterial DNA. This study concluded that there is no definitive evidence to refute the existence of intra-amniotic microbiomes in healthy pregnancies. Also, it provides suggestions for controlling potential contamination factors in future research on intra-amniotic and placental microbial populations. Full article