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Purpose: This study aimed to investigate ocular manifestations in patients with neurosyphilis and their association with general indexes. Methods: This retrospective study was conducted among patients who were hospitalized for neurosyphilis from 2012 to 2022. Clinical manifestations, laboratory tests, brain MRI, and ocular examinations were reviewed and analyzed. Results: A total of 106 neurosyphilis patients were included, of which 10 patients presented with ocular signs as their initial symptoms. The most common main complaint was reduced vision (6/10), followed by diplopia (2/10) and ptosis (2/10). The causes of vision loss included optic neuropathy (4/6) and posterior uveitis (2/6), with all six patients showing optic nerve involvement. A total of 29 (27.4%) patients exhibited pupil abnormalities. A lumbar puncture was performed on all 106 patients, and abnormal cerebrospinal fluid (CSF) findings were revealed in 101 (95.3%) patients, indicating central nervous involvement. The median white blood cell count in the CSF of the patients with pupil abnormalities was significantly higher than that of those without pupil abnormalities (14.0 vs. 6.0 cells/μl, p = 0.037). In addition, the patients with abnormal pupillary light reflex (PLR) were more likely to have multiple brain lesions compared to those with normal PLR (77.3% vs. 29.2%, p < 0.001). Conclusion: Optic nerve involvement is the main cause of vision loss in neurosyphilis. Patients with optic neuropathy or posterior uveitis should undergo prompt diagnostic evaluation for syphilis. Pupil abnormalities can serve as indicators of more severe CSF and MRI findings. [ABSTRACT FROM AUTHOR]

Tripterygium wilfordii Hook F (TwHF) has been shown to substantially reduce proteinuria in patients with diabetic kidney disease (DKD); however, the effect of TwHF on renal outcomes in DKD remains unknown. Accordingly, we aimed to establish the effects of TwHF on renal outcomes in patients with DKD. Overall, 124 patients with DKD, induced by type 2 diabetes mellitus, with 24-h proteinuria > 2 g, and an estimated glomerular filtration rate > 30 mL/min/1.73 m2 were retrospectively investigated. The renal outcomes were defined as doubling serum creatinine levels or end-stage kidney disease. Kaplan-Meier curves and Cox regression analyses were performed to analyze prognostic factors for renal outcomes. By the end of the follow-up, renal outcomes were observed in 23 and 11 patients in the non-TwHF and TwHF groups, respectively (p = 0.006). TwHF significantly reduced the risk of renal outcomes (adjusted hazard ratio [HR] 0.271, 95% confidence interval [CI] 0.111–0.660, p = 0.004) in patients with chronic kidney disease (CKD) G3 (adjusted HR 0.274, 95%CI 0.081–0.932, p = 0.039). Based on the Kaplan-Meier analysis, 1- and 3-year proportions of patients without renal outcomes were significantly lower in the non-TwHF group than those in the TwHF group (92.8% vs. 95.5% and 47.2% vs. 76.8%, respectively; p = 0.0018). In DKD patients with severe proteinuria, TwHF could prevent DKD progression, especially in patients with CKD G3. A randomized clinical trial is needed to elucidate the benefits of TwHF on renal outcomes in patients with DKD. [ABSTRACT FROM AUTHOR]

Farmers' livelihoods are critical for global sustainable development and the conservation and transmission of rural heritage. However, neglecting farmers' livelihoods increases the risks to living heritage conservation. Therefore, it is essential to explore the impact of livelihood capital on farmers' landscape services cognition and their behavioral intentions. Based on the Sustainable Livelihoods Approach, this study examines the rural areas of Mulanbei irrigation district, which was recognized as a World Heritage Irrigation Structure in 2014, and uses a structural equation model to investigate the relationships between farmers' livelihood capital, landscape services cognition and behavioral intentions. The study's key findings include the following: (1) The levels of human capital (0.541), social capital (0.671), and cultural capital (0.645) are relatively high, while the levels of natural, physical, and financial capital are comparatively low. (2) There are significant differences in landscape service cognition and behavioral intentions among farmers of different livelihood strategies, with diversified livelihood farmers demonstrating the highest levels of both cognition and intentions, while subsidy-dependent farmers show the lowest levels. (3) Natural, cultural and financial capital play a crucial role in influencing farmers' landscape services cognition and their behavioral intentions. Landscape service cognition mediates the relationship between livelihood capital and behavioral intentions. (4) To increase farmers' willingness to protect and promote rural heritage, efforts should focus on enhancing natural, physical, and financial capital while fostering cultural capital to promote advocacy. [ABSTRACT FROM AUTHOR]

In recent years, global climate change and human alterations to land use have led to a decrease in ecosystem services, making ecosystems more vulnerable. However, unlike the well-established risk assessment frameworks used in natural disaster research, the concept of ecological risks arising from changes in land use is still in its early stages, with its nuances and assessment methodologies yet to be clearly defined. This study proposes a new framework for assessing ecological risks resulting from changes in land use in the Tarim River Basin. The framework employs a coupled PLUS and Invest model to evaluate the ecological risks of land use change under three development scenarios projected for the Tarim River Basin in Xinjiang by 2035. The findings indicate that: (1) Between 2000 and 2020, the predominant land use types in the Tarim River Basin in Xinjiang were primarily unused land, followed by grassland and cropland. Conversely, grassland, water, and construction land were relatively less prevalent. During this period, the area of unused land and cultivated land increased, while grassland, forest land, and water exhibited a declining trend. Moving forward, under the three scenarios from 2020 to 2035, land use changes in the study area are characterized by the expansion of cropland and unused land, coupled with a significant decrease in grassland area, while other land categories demonstrate minor fluctuations. (2) From 2020 to 2035, across various scenarios, the total ecosystem service within the study area demonstrates an overall increasing trend in both the northern and southern marginal zones. Specifically, under the baseline scenario, the total amount of ecosystem services in the study area decreased by 15.247% compared to 2020. Similarly, under the economic development scenario, this decrease amounted to 13.358% compared to 2020. Conversely, under the ecological protection scenario, the decrease reached 19.852% compared to 2020. (3) The structure of ecological risk levels from 2020 to 2035, across multiple scenarios, demonstrates a consistent pattern, characterized by a predominant proportion of moderate risk. Conversely, other risk levels occupy relatively smaller proportions of the area. [ABSTRACT FROM AUTHOR]

Background: The concept of the gut-retinal axis proposed by previous scholars primarily focused on the relationship between intestinal microbiota and retinal diseases, and few further expanded the relationship between intestinal diseases and retinal diseases. To further substantiate the concept of the gut-retinal axis, we analyzed inflammatory bowel disease (IBD) and diabetic retinopathy (DR) using Mendelian randomization (MR), and use mediation analysis to further explore the potential substances that influence this causal relationship., Methods: The genome-wide association study's (GWAS) summary statistics for genetic variations were utilized in a Mendelian randomization (MR) investigation. GWAS data on IBD (including ulcerative colitis (UC), Crohn's disease (CD), and IBD) for non-Finnish Europeans (NFE) were sourced from published articles. In contrast, data on DR (including DR and diabetic maculopathy (DMP)) were obtained from FinnGen R9. The causal relationship has been investigated using inverse variance weighted (IVW), MR-Egger, and weighted median and sensitivity analysis was applied to verify the stability of the results. In addition, we applied mediation analysis to investigate whether circulating inflammatory proteins and plasma lipids played a mediating role, and calculated its effect ratio., Results: The causal relationship between IBD and DR was discovered by employing the inverse variance weighted (IVW) method and weighted median method. In forward MR, UC was significantly associated with lower risk of DR (IVW: OR=0.874; 95%CI= 0.835-0.916; P value= 1.28E-08) (Weighted median: OR=0.893; 95%CI= 0.837-0.954; P value= 7.40E-04). In reverse MR, it was shown that DR (IVW: OR=0.870; 95%CI= 0.828-0.914; P value= 2.79E-08)(Weighted median: OR=0.857; 95%CI= 0.801-0.916; P value= 6.40E-06) and DMP (IVW: OR=0.900; 95%CI= 0.865-0.937; P value= 3.34E-07)(Weighted median: OR=0.882; 95%CI= 0.841-0.924; P value= 1.82E-07) could reduce the risk of CD. What's more, DR is associated with a lower risk of IBD according to genetic prediction (IVW: OR=0.922; 95%CI= 0.873-0.972; P value= 0.002) (Weighted median: OR=0.924; 95%CI= 0.861-0.992; P value= 0.029). Fibroblast growth factor 21 (FGF21), phosphatidylcholine (PC), and triacylglycerol (TG) serve as mediators in these relationships., Conclusions: Our research offers novel insights and sources for investigating the gut-retina axis in the genetic relationship between IBD and DR. We discover four mediators and more about the association between the intestine and retinal disorders and provide more evidence for the gut-retinal axis theory., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lin, Cheng, Gu, Song, Zhang, Li and Ling.)