Understanding the influences of climate change and human activities on vegetation change is the foundation for effective ecosystem management. Based on the 250 m MODIS-NDVI data from 2002 to 2020, we employed Theil-Sen Median trend analysis and the Mann-Kendall test to quantify vegetation change in Hunan Province. By combining with meteorological, nighttime light index, land cover and other data, residual analysis and correlation analysis, we examined the impacts of human activities and climate change on vegetation dynamics at both the pixel level and the county level. The results showed that the normalized difference vegetation index (NDVI) in Hunan Province exhibited a spatial pattern of \"overall improvement with localized degradation\" during 2002-2020. Approximately 64.9% of the study area experienced significant vegetation improvement, mainly occurring in the western and central-southern parts of Hunan Province. 1.4% of the study area experienced significant vegetation degradation, mostly in the newly developed urban areas and the farmland in the Dongting Lake Plain. Human activities and climate change jointly promoted vegetation improvement in 67.9% of the study area. Human activities and climate contributed to 96% and 4% of the NDVI change, respectively. At the county level, human activities contributed to over 80% of the NDVI change in each district or county. The impacts of human activities on vegetation change exhibited significant spatial heterogeneity. Urban expansion led to vegetation degradation in the newly developed areas, while vegetation growth appeared in the old developed urban areas. The ecological restoration projects promoted vegetation restoration in the western part of Hunan Province. This study could help us better understand the spatiotemporal variations of vegetation and their responses to climate change and human activities, which would offer scientific basis for effective ecological restoration policy.
研究气候变化和人类活动对植被变化的影响是有效生态系统管理的基础。本研究基于2002—2020年250 m MODIS-NDVI数据,采用Theil-Sen Median斜率估计和Mann-Kendall趋势分析从像元尺度量化了湖南省植被动态演变趋势;结合气象、夜间灯光指数、土地覆盖等数据,采用残差分析和相关分析等方法,从像元和县域两个尺度揭示了人类活动和气候变化对植被动态演变的影响。结果表明: 2002—2020年,湖南省归一化植被指数(NDVI)动态演变呈“整体改善、局部退化”的空间格局,显著改善的区域占研究区总面积的64.9%,主要分布于湖南省西部和中南部;显著退化的区域占研究区总面积的1.4%,主要分布于城市化区域和洞庭湖平原的耕地区域。人类活动和气候变化共同促进研究区67.9%的植被改善;人类活动和气候变化单独对植被NDVI动态演变的贡献率分别为96%、4%;人类活动对所有区县植被演变的贡献率均超过80%。人类活动对植被演变的影响存在显著空间异质性。城市扩张导致新城区植被退化,但老城区出现植被恢复的现象;生态工程则促进了湖南省西部植被恢复。本研究结果有助于深入认识湖南省植被演变时空格局及其对气候变化和不同人类活动的响应,可为制定有效的生态恢复策略提供科学依据。.

China\'s rural reform is reliant on farmers\' cooperatives as a key organization vehicle. It plays an important role in promoting rural revitalization. Such as, realizing the organic connection between small farmers and agricultural modernization. This study used the nearest neighbor index and kernel density estimation to analyze the spatial distribution and structural characteristics of farmer cooperatives in Hunan Province. It revealed the spatial differentiation law of cooperatives. Also using geographical detectors to figure out the main factors that affect the spatial distribution. The results show that: ① Hunan Farmers Cooperatives show significant spatial agglomeration. The overall spatial distribution shows the spatial characteristics of \"one core, one circle, and multiple points\". And the spatial distribution pattern of \"large agglomeration, finger-shaped radiation distribution\". Among them, the distribution of provincial demonstration cooperatives is relatively balanced. ② Cooperatives in six types of industries, such as planting, forestry, and feeding, showed agglomeration distribution. Different industrial cooperatives spread out in different ways, such as in an anti-\"L\" shape, a dual-core shape, or a one-center area. ③ The 24 influence factors selected from the five dimensions of the natural environment, social economic basis, production basis, output capacity, and facility basis have high, general, and weak influence on cooperatives\' spatial distribution. The development and distribution of cooperatives mainly depend on resource endowment, social and economic development level, and market dependence. The spatial distribution heterogeneity of different professional cooperatives is mainly affected by slope, per capita disposable income of rural residents, road density, and other factors. ④ The progression of farmer cooperatives in Hunan Province should prioritize high-quality development, emphasizing the need for innovative approaches and transformative strategies within rural industrial organizations. It is imperative to optimize the spatial distribution of cooperatives, strategically contributing to the establishment of a novel framework for modern agricultural development in Hunan Province. Additionally, there is a critical emphasis on spearheading collaborative initiatives among cooperatives of varied industrial types, aimed at fostering the integrated development of rural primary, secondary, and tertiary industries.

Multi-drug resistance of bacteria producing extended-spectrum β-lactamase (ESBL) is a public health challenge. Thus, this study aimed to investigate the antimicrobial susceptibility of ESBL-producing Escherichia coli (ESBL-EC) in Hunan Province, China. A total of 1366 fecal samples were collected from pig, chicken, and cattle farms over a six-year period, which were assessed using strain isolation, 16S rRNA identification, polymerase chain reaction, drug sensitivity testing, whole-genome sequencing, and bioinformatics analysis. The results showed an overall prevalence of 6.66% for ESBL-EC strains, with ESBL positivity extents for pigs, chickens, and cattle isolates at 6.77%, 6.54%, and 12.5%, respectively. Most ESBL-EC isolates were resistant to cefotaxime, tetracycline, and trimethoprim-sulfamethoxazole; however, all the isolates were susceptible to meropenem, with relatively low resistance to amikacin and tigecycline. Various multi-locus sequence types with different origins and similar affinities were identified, with ST155 (n = 16) being the most common subtype. Several types of resistance genes were identified among the 91 positive strains, with beta-lactamase blaCTX-M-55 being the most common ESBL genotype. IncFIB was the predominant plasmid type. Widespread use of antibiotics in animal farming may increase antibiotic resistance, posing a serious threat to the health of farmed animals and, thus, to human food security and health.

Background: Chlamydia is a Gram-negative obligate intracellular bacterium that is pathogenic for humans and a large variety of veterinary animal species. However, there is no continuous monitoring of chlamydia infection data in pigs in Hunan province, southern China. Therefore, in order to evaluate the seroprevalence and identify risk factors associated with Chlamydia infection in pigs within this region, a comprehensive study was conducted. Methods: A total of 3848 serum samples were collected from pigs (from farmers and companies) between May 2017 and August 2018. The presence of specific antibodies against Chlamydia was determined through the employment of the indirect hemagglutination assay (IHA). Results: The overall seroprevalence of Chlamydia was determined to be 26.90% (1038/3848, 95% confidence interval: 25.60-28.40). By employing statistical analysis using SPSS software (p < 0.05), factors such as altitude, sampling regions, and rearing systems of pigs were identified as potential risk factors for Chlamydia infection. Conclusion: These findings elucidate a substantial prevalence of Chlamydia in pigs within the mountainous region of Hunan province, southern China, thereby highlighting a potential risk to human health. These results underscore the need for proactive measures and targeted interventions to mitigate the transmission of Chlamydia in porcine populations, safeguarding both animal welfare and public health.

BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a major public health threat in Hunan Province, with an increasing clinical burden in recent years. This study aimed to identify socio-demographic and clinical factors associated with DR-TB in Hunan province, China.
METHODS: A case-control study was conducted in Hunan province. Cases were all DR-TB patients who were confirmed by culture and Drug susceptibility testing (DST) and enrolled at the DR-TB treatment center of Hunan Chest Hospital from 2013 to 2018. Controls were all Drug Susceptible TB (DS-TB) patients confirmed by DST and enrolled at the same hospital during the same period. A multivariable logistic regression model was fitted to identify factors significantly associated with DR-TB.
RESULTS: A total of 17,808 patients (15,534 DS-TB controls and 2274 DR-TB cases) were included in the study, with a mean age of 42.5 years (standard deviation (SD) ± 17.5 years) for cases and 46.1 years (SD ± 19.1 years) for controls. Age 15-64 years (Adjusted odds ratio (AOR = 1.5, 95% CI; 1.4, 1.8)), ethnic minorities (AOR = 1.5; 95% CI; 1.4, 1.8), and a history of previous TB treatment (AOR) = 1.84; 95% CI: 1.57, 2.15) was significantly associated with DR-TB. Being resident in a province outside Hunan was also a significant risk factor (AOR = 1.67; 1.27, 2.21) for DR-TB.
CONCLUSIONS: To prevent the occurrence of DR-TB in Hunan Province, interventions should be targeted at high-risk demographic groups such as ethnic minorities, individuals of productive age, and residents living outside the province. Interventions must also be targeted to previously treated cases, suggesting the appropriateness of diagnosis, treatment, and follow-up. Understanding the risk factors at the province level helps design strategies for controlling DR-TB due to variations by socioeconomic differences, quality of health care, and healthcare access.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a global health threat associated with high morbidity and mortality rates. Diagnosis and treatment delays are associated with poor treatment outcomes in patients with MDR-TB. However, the risk factors associated with these delays are not robustly investigated, particularly in high TB burden countries such as China. Therefore, this study aimed to measure the length of diagnosis and treatment delays and identify their risk factors among patients with MDR-TB in Hunan province.
METHODS: A retrospective cohort study was conducted using MDR-TB data from Hunan province between 2013 and 2018. The main outcomes of the study were diagnosis and treatment delay, defined as more than 14 days from the date of symptom to diagnosis confirmation (i.e., diagnosis delay) and from diagnosis to treatment commencement (i.e., treatment delay). A multivariable logistic regression model was fitted, and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify factors associated with diagnosis and treatment delay.
RESULTS: In total, 1,248 MDR-TB patients were included in this study. The median length of diagnosis delays was 27 days, and treatment delays were one day. The proportion of MDR-TB patients who experienced diagnosis and treatment delay was 62.82% (95% CI: 60.09-65.46) and 30.77% (95% CI: 28.27-33.39), respectively. The odds of experiencing MDR-TB diagnosis delay among patients coming through referral and tracing was reduced by 41% (AOR = 0.59, 95% CI: 0.45-0.76) relative to patients identified through consultations due to symptoms. The odds of experiencing diagnosis delay among ≥ 65 years were 65% (AOR = 0.35, 0.14-0.91) lower than under-15 children. The odds of developing treatment delay among foreign nationalities and people from other provinces were double (AOR = 2.00, 95% CI: 1.31-3.06) compared to the local populations. Similarly, the odds of experiencing treatment delay among severely ill patients were nearly 2.5 times higher (AOR = 2.49, 95% CI: 1.41-4.42) compared to patients who were not severely ill. On the other hand, previously treated TB cases had nearly 40% (AOR = 0.59, 95% CI: 0.42-0.85) lower odds of developing treatment delay compared with new MDR-TB cases. Similarly, other ethnic minority groups had nearly 40% (AOR = 0.57, 95% CI: 0.34-0.96) lower odds of experiencing treatment delay than the Han majority.
CONCLUSIONS: Many MDR-TB patients experience long diagnosis and treatment delays in Hunan province. Strengthening active case detection can significantly reduce diagnosis delays among MDR-TB patients. Moreover, giving attention to patients who are new to MDR-TB treatment, are severely ill, or are from areas outside Hunan province will potentially reduce the burden of treatment delay among MDR-TB patients.

The potential deleterious effects of microplastics on environmental integrity and human health have elicited global attention. Particularly vulnerable to microplastics are Danxia landforms, characterized by their unique topographical features and ecologically fragile milieu. Notwithstanding, empirical studies assessing the prevalence of microplastics in these unique landforms remain strikingly limited. The present investigation comprehensively examined the abundance of microplastics in surface water, sediment, and groundwater across six cities and six counties within the Danxia landforms. Comparative analysis revealed a moderate level of microplastic contamination in the urban rivers of the Danxia region relative to other freshwater rivers. Anthropogenic activities, notably urban wastewater treatment and tourism, emerged as principal contributors to microplastic pollution. Sedimentary microplastics exhibited an accumulative trend from upstream to downstream locations. The risk assessment revealed a high potential ecological risk in counties and a moderate risk in cities. Cluster analysis suggested that groundwater microplastics were a confluence of hydraulic interactions between surface and subsurface waters within the Danxia region. This investigation elucidates the microplastic contamination profile, origins, migratory patterns, and associated risks in Danxia\'s urban rivers, thereby furnishing scientific underpinning for health and ecological preservation strategies within urbanized Danxia landscapes.

This study aimed to investigate the distribution and migration characteristics of lead (Pb) and zinc (Zn) in paddy soils in Hunan Province, China. A total of 343 soil samples from 63 profiles were collected from typical regions. The concentration, spatial distribution, and migration behaviors of Pb and Zn in the paddy soils were examined. The results showed that (1) the concentration ranges of Pb and Zn in the surface layer were 17.62-114.07 mg/kg and 44.98-146.84 mg/kg, respectively. (2) The content was higher in the middle and lower reaches of the Xiangjiang River basin horizontally and exhibited shallow enrichment characteristics vertically. (3) Pb migration was weaker than Zn migration, and the parent material had the most significant influence on Pb and Zn content in the bottom soil layer. The research results will clarify the characteristics of Pb and Zn contents in paddy soils in Hunan Province, further understand the horizontal distribution and vertical migration and transformation characteristics of Pb and Zn contents in paddy soils, and provide basic data for scientific rice cultivation and safe food production.

Herpes zoster (HZ) brings a significant economic burden. The HZ vaccine was introduced in China for the first time in 2020, and there is a lack of up-to-date information on the hospitalization costs and characteristics prior to vaccination. This study aimed to describe the characteristics and economic burden of HZ inpatients in Hunan Province, China, and analyze the factors influencing the length of stay (LOS) and costs. This was a retrospective study and we extracted information from the Chinese National Health Statistics Network Reporting System on HZ inpatients in Hunan Province, China from 2017 to 2019. Spatial join tools and Global or Local Moran\'s Index were used for the geographic analysis of hospitalized HZ incidence. Multivariate linear regression models were used to analyze the factors influencing LOS and costs. There were 44,311 HZ inpatients included in this study, incurring a total of $31,857,734 medical costs. These patients had a median LOS of 8 days and a median expenditure of $573.47. Older age, more comorbidities, and the presence of complications with nervous system involved were all significantly associated with longer LOS and higher costs. HZ infection resulted in a large direct medical cost and heavy disease burden, especially in patients with advanced age or underlying medical conditions. The HZ vaccine has the potential to effectively reduce the disease burden and should be widely popularized especially among high-risk groups.

Being the leading cause of death among both urban and rural residents in Hunan Province, China, cardiovascular and cerebrovascular diseases hold a significant position in the region\'s public health landscape. Their prevalence and impact not only underscore the urgency of effective disease prevention and control but also provide crucial guidance for future initiatives. Consequently, the Hunan Province Cardiovascular and Cerebrovascular Health and Disease Report Summary (2020) hereinafter referred to as the \"Annual Report\", serves as an extensive and informative document. It meticulously examines the current status of these diseases, highlighting both the existing challenges and opportunities for prevention and control efforts in Hunan Province. The primary objective of this report is to furnish valuable insights and evidence that will empower and enrich future endeavors aimed at combatting cardiovascular and cerebrovascular diseases within the region. In 2017, the year of life expectancy lost due to cardiovascular and cerebrovascular diseases in Hunan Province remained higher than the national average. Additionally, the per capita life expectancy in 2019 (77.1 years) was slightly lower by 0.2 years compared with the national average (77.3 years). Alarmingly, the mortality rates associated with cardiovascular and cerebrovascular diseases were consistently ranking highest, indicating an upward trajectory. Moreover, the prevalence and mortality rates of conditions such as hypertension, coronary heart disease, and stroke, all encompassed within the domain of cardiovascular and cerebrovascular diseases, surpassed the national averages. Consequently, the economic burden attributable to cardiovascular and cerebrovascular diseases is on the rise. And under vertical comparison, in 2019, the life expectancy per capita in Hunan Province increased by 1.26 years compared with 2015. The incidence rate of cardiovascular and cerebrovascular events decreased by 8.34% compared with 2017. A new model of hypertension medical and preventive integration has been established with the efforts of many experts in Hunan Province, and full coverage of standardised outpatient clinics for hypertension at the grassroots level has been realised. The rate of standardised management of patients with hypertension under management in Changsha County, a demonstration area, rose to 65.27%, and the incidence rate of cardiovascular and cerebrovascular events, the incidence rate of stroke, and the mortality rate due to cardiovascular and cerebrovascular events were reduced by 28.08%, 28.62%, and 25.00%, respectively. Hunan Province has made significant strides in the prevention and control of cardiovascular and cerebrovascular diseases in recent years.
心脑血管疾病作为湖南省城乡居民的首位死因，其现状是湖南省疾病预防和控制(以下简称“防控”)成效的体现和未来工作方向的基础和依据。因此，《湖南省心血管健康与疾病报告概要》(2020)(以下简称“年报”)描述和总结了湖南省心脑血管疾病防控的现状及问题，以对未来推动和强化心脑血管疾病防控提供参考和证据支撑。湖南省2017年心脑血管疾病的寿命损失年仍高于全国平均水平，且2019年人均期望寿命(77.1岁)较全国平均期望寿命(77.3岁)减少0.2岁；心脑血管疾病死亡率占居首位，且呈现上升趋势，心脑血管疾病中的高血压、冠心病及脑卒中的患病率、死亡率均高于全国水平，心脑血管疾病负担不断加重。而纵向比较下，2019年湖南省人均期望寿命较2015年增长1.26岁；心脑血管事件发生率较2017年下降8.34%；并在湖南省众多专家的努力下建立了高血压医防融合新模式，实现了基层高血压规范化门诊全覆盖；2020年示范区长沙县在管高血压患者规范管理率上升到65.27%，心脑血管事件发生率、脑卒中发生率、因心脑血管事件死亡率较2016年分别降低了28.08%、28.62%、25.00%。近年来湖南省心脑血管疾病防控工作取得了一定进展和成就，但同样仍面临十分严峻的问题和挑战。.