BACKGROUND: Social environment may broadly impact multifaceted frailty; however, how environmental differences influence frailty in older adults with diabetes remains unclear. This study aimed to investigate regional differences in frailty in urban and rural areas among older adults with diabetes.
METHODS: This cross-sectional study was conducted as part of the frailty prevention program for older adults with diabetes study. Older adults aged 60-80 years who could independently perform basic activities of daily living (ADLs) were enrolled sequentially. Trained nurses obtained patient background, complications, body weight, body composition, blood tests, grip strength, frailty assessment, and self-care score results. Regional differences in frailty were evaluated using logistic and multiple linear regression analyses.
RESULTS: This study included 417 participants (269 urban and 148 rural). The prevalence of robustness was significantly lower in rural areas than in urban areas (29.7% vs. 43.9%, p = 0.018). Living in rural areas was associated with frailty (odds ratio [OR] 2.55, 95% confidence interval [CI] 1.38-4.71) and pre-frailty (OR 2.10, 95%CI 1.30-3.41). Lower instrumental ADL (B 0.28, standard error [SE] 0.073) and social ADL (B 0.265, SE 0.097) were characteristics of rural residents.
CONCLUSIONS: Regional differences in frailty were observed. Older adults with diabetes living in rural areas have a higher risk of frailty owing to a decline in instrumental and social ADLs. Social environment assessment and intervention programs that include communication strategies to enable care and social participation across environments are crucial to the effective and early prevention of frailty.

UNASSIGNED: This article analyses mass accommodation facilities to examine the development of Czech tourism during the COVID-19 pandemic of 2020 and 2021.
UNASSIGNED: The questionnaire survey was carried out in March 2021 in mass accommodation facilities. 131 responses were received from hotels and guesthouses throughout Czechia, which represents a return rate of 20%. Data were processed using Pearson\'s chi-square test to determine the effect of changes in facility type and category, quality, location, and primary focus before the outbreak of the pandemic. A statistical analysis of data on overnight stays was also used with data from the public database of the Czech Statistical Office.
UNASSIGNED: The study confirmed the increasing importance of domestic tourism and the greater sensitivity of destinations dependent on foreign tourists. Future strategies should be associated with destination rather than corporate management. The challenges are linked to the strengthening of environmentally friendly and sustainable tourism. To what extent the post-covid situation will return to the original model and to what extent it will at least partially reflect the changes that took place during the crisis period is a question for future research.
UNASSIGNED: Moving from operational to strategic measures would be advisable.

Cerebrovascular and neurological diseases exhibit sex-specific patterns in prevalence, severity, and regional specificity, some of which are associated with altered cerebral blood flow (CBF). Females often exhibit higher resting CBF, but understanding the impact of sex per se on CBF is hampered by study variability in age, comorbidities, medications, and control for menstrual cycle or hormone therapies. A majority of studies report whole brain CBF without differentiating between grey and white matter, or without assessing regional CBF. Thus, fundamental sex differences in regional or whole-brain CBF remain unclarified. While controlling for the above confounders, we tested the hypothesis that females will exhibit higher total grey and white matter perfusion as well as regional grey matter perfusion. Adults 18-30 years old (females=22, males=26), were studied using arterial spin labeling (ASL) magnetic resonance imaging (MRI) scans followed by Computational Anatomy Toolbox (CAT12) analysis in Statistical Parametric Mapping (SPM12) to quantify CBF relative to brain volume. Females displayed 40% higher perfusion globally (females =62±9, males=45±10mL/100g/min, p<0.001), grey matter (females=75±11, males=54±12mL/100g/min, p<0.001), and white matter (females=44±6, males=32±7mL/100g/min, p<0.001). Females exhibited greater perfusion than males in 67 of the 68 regions tested, ranging from 14-66% higher. A second MRI approach (4D flow) focused on large arteries confirmed the sex difference in global CBF. These data indicate strikingly higher basal CBF in females at global, grey, and white matter levels and across dozens of brain regions, and offer new clarity into fundamental sex differences in global and regional CBF regulation prior to aging or pathology.

BACKGROUND: Loneliness represents a significant health risk and is associated with numerous mental and physical conditions. The aim of this paper was to describe the prevalence of loneliness in Bavaria before and during the COVID-19 pandemic with respect to socio-demographic attributes.
METHODS: Data sources were the German Ageing Survey (DEAS) and the Socio-Economic Panel (SOEP). Univariate statistical analyses were carried out for different socio-demographic attributes, such as age, gender, type of household, education, and financial resources.
RESULTS: According to the SOEP, the proportion of adults who are often or very often lonely increased from 2.3% in 2017 to 16.2% in 2021. In 2021, women had a higher prevalence of loneliness than men (21.0% vs. 11.3%), and younger adults had the highest prevalence of loneliness (18 to 25 years: 31.7%) compared to the other age groups.
CONCLUSIONS: During the COVID-19 pandemic, loneliness increased in almost every population subgroup in Bavaria. Further studies are needed to examine whether this development is temporary or represents a long-term effect even after the measures to prevent the spread of COVID-19 have been lifted.
UNASSIGNED: HINTERGRUND: Einsamkeit stellt ein bedeutsames Gesundheitsrisiko dar und steht in Zusammenhang mit zahlreichen körperlichen und psychischen Erkrankungen. Die vorliegende Arbeit verfolgt das Ziel, die Häufigkeit von Einsamkeit in Bayern vor und während der COVID-19-Pandemie nach soziodemografischen Merkmalen zu quantifizieren.
METHODS: Als Datenquellen wurden Sonderauswertungen des Deutschen Alterssurveys (DEAS) und des Sozio-oekonomischen Panels (SOEP) analysiert. Die Auswertungen erfolgten univariat nach soziodemografischen Merkmalen, darunter u. a. Alter, Geschlecht, Haushaltstyp, Bildung und finanzielle Ressourcen.
UNASSIGNED: Der Anteil der häufig oder sehr häufig einsamen Erwachsenen in Bayern stieg dem SOEP zufolge von 2,3 % im Jahr 2017 auf 16,2 % im Jahr 2021, wobei Frauen im Jahr 2021 mit 21,0 % deutlich häufiger betroffen waren als Männer mit 11,3 %. Besonders hohe Einsamkeitsprävalenzen waren im Jahr 2021 bei den 18- bis 25-Jährigen zu beobachten (31,7 % häufig oder sehr häufig einsam).
UNASSIGNED: Das Einsamkeitsempfinden nahm im Zuge der COVID-19-Pandemie in so gut wie allen betrachteten Subgruppen in Bayern zu. Ob diese Entwicklung nach dem Wegfall der COVID-19-Schutzmaßnahmen im Jahr 2023 fortbesteht und sich die Einsamkeit chronifiziert, sollte Gegenstand zukünftiger Untersuchungen sein.

Using Origin2022Pro, PAST4.09, GraphPad, and ArcGIS, this study analyzed the big data of the fourth national survey of traditional Chinese medicine resources in Jilin province from five dimensions: differences in resource quantity, taxonomic group, family, and genus, regional distribution, and spatiotemporal distribution, aiming to fully elucidate the biodiversity of medicinal plants in Jilin province. The results indicated that 2 241 species of medicinal plants existed in Jilin province, belonging to 881 genera of 243 families, with 20 dominant families and 3 dominant genera. There were 1 901 species of medicinal plants(belonging to 778 genera of 227 families) in the eastern mountainous region, 1 503 species(belonging to 690 genera of 225 families) in the mid-mountainous areas of the central mountainous region, and 811 species(belonging to 436 genera of 136 families) in the western plain region. The biodiversity of medicinal plants in Jilin province was high and presented a trend of high in the east and low in the west. The medicinal plant resources were mainly concentrated in the eastern mountainous region, and the number of medicinal plant groups had significant diffe-rences between regions, following the trend of western region > central region > eastern region. The species richness was in the order of eastern region > western region > central region. The species diversity structure in the central region was similar to that in the eastern and western regions, while it was significantly different between the western and eastern regions. Compared with the third national survey of traditional Chinese medicine resources, the fourth survey showed an increase of 1 417 species, a decrease of 580 species, and 824 common species, indicating significant changes in the biodiversity of medicinal plants in Jilin province. The reasons for these changes need to be further explored. This article elucidates the background and biodiversity changes of medicinal plant resources in Jilin province, laying a foundation for the protection, utilization, and industrial development of traditional Chinese medicine resources in Jilin province.

UNASSIGNED: In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)-related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination.
UNASSIGNED: We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease-related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions.
UNASSIGNED: During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region.
UNASSIGNED: HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission.

This study provides prevalence and mortality data for 0- to 19-year-old children and adolescents with medically documented life-threatening and life-shortening diagnoses in Germany. A secondary data analysis of more than 12 million insured persons documented by the statutory health insurance funds in Germany from 2014 to 2019 was conducted in collaboration with the German Association of Statutory Health Insurance Funds (GKV-SV) and the Institute for Applied Health Research Berlin (InGef), whose data sets vary in collection methods. Diagnosis prevalence and mortality were calculated based on selected International Classification of Diseases, 10th Revision (ICD-10) codes reported in inpatient and outpatient care settings. In Germany, the diagnosis prevalence of life-threatening and life-shortening diseases in children and adolescents ranges between 319 948 (InGef-adapted Fraser list) and 402 058 (GKV-SV). These diagnoses can be differentiated into different disease groups (Together-for-Short-Lives [TfSL] 1-4). The TfSL-1 group in which curative treatment can be feasible represents the largest one, with 190 865 persons. In 2019, approximately 1458 children and adolescents with life-threatening and life-shortening diseases died. The current diagnostic and mortality data of affected children and adolescents in Germany serve as the essential foundation for further research into the health care of the target group.

Worldwide, nurse shortages constitute a problem, including in the Netherlands. Every region in the country has a shortage of all types of nurses. At the same time, there are large hidden reserves: persons who have been trained as a nurse but do not work in the healthcare sector. The size of the hidden reserve exceeds the shortage of nurses. Until now, the literature has not paid much attention to spatial aspects of the nursing shortage problem. In this paper, we analyze the size of the hidden reserves and how they are distributed over the country, across large and smaller cities, and across different nurse categories. We find that especially densely populated areas have relatively small shares of trained nurses as well as large hidden reserves relative to their population. These areas are also facing the largest nurse shortages. As nurse labor markets are local, policies that are more focused on local situations are necessary to activate these hidden reserves.

UNASSIGNED: Migrant workers in China are migrants from the rural to the urban areas who usually work in the cities and return to the countryside after a certain period. Due to China\'s strict household registration system, they differ significantly from urban residents\' access to public services. However, at the same time, China\'s workers are facing a severe phenomenon of overwork, and the group of migrant workers is even more hard-hit by overwork, which will cause various adverse effects on workers and society and should attract the attention of all sectors of society.
UNASSIGNED: This paper focuses on the impact of digital financial inclusion on the overwork of migrant workers. This study considered cross-sectional data containing 98,047 samples based on the 2017 China Migrants Dynamic Survey 2017 (CMDS) and China Municipal Statistical Yearbook after robustness tests and heterogeneity analysis using probit models.
UNASSIGNED: (1) digital financial inclusion can effectively alleviate overwork among migrant workers; (2) the impact of digital finance on overwork is more significant for the new generation, digitized industries, and self-employed migrant workers; it is also more significant for the South, East, and small and medium-sized cities than for the North, the Midwest, and large cities; (3) job quality and income are crucial factors in how digital financial inclusion affects overwork among migrant workers. Digital financial inclusion can improve the quality of employment for migrant workers and alleviate overwork. However, the income substitution effect partially reduces the inhibitory impact of digital financial inclusion on overwork.
UNASSIGNED: Continuously promote the development of digital inclusive finance, improve laws and regulations, and protect the labor rights and interests of migrant workers. At the same time, vocational training and skills upgrading for rural migrant workers should be strengthened to improve the quality of their employment so that they can leave the secondary labor market and enter the primary labor market.

This study primarily focused on the regional disparities in both water quality criteria and ecological risks attributed to cadmium presence within the surface waters of the Yangtze River Basin. In the initial phase, the long-term water quality criteria for cadmium were recalibrated in accordance with the guidelines outlined in China\'s \"Water Quality Criteria for Freshwater Aquatic Organisms-Cadmium,\" accounting for the prevalent hardness distribution within the Yangtze River Basin\'s surface water. Subsequently, a more refined revision was undertaken considering the specific characteristics of the species residing within the Yangtze River Basin. This undertaking led to a comprehensive interpretation of the regional variations in both the distribution of long-term water quality criteria values and the risk quotient distribution of cadmium throughout the Yangtze River Basin. The incorporation of hardness and species-specific attributes resulted in a revised range of long-term water quality criteria for cadmium across different urban locales within the Yangtze River Basin. Notably, the recalibrated values ranged from 0.08 μg·L-1 as the lowest threshold to 0.75 μg·L-1 as the upper limit, signifying a tenfold differentiation. Correspondingly, the urban average annual risk quotient associated with cadmium exposure demonstrated a variation from 0.035 to 1.12, marking a significant 32-fold discrepancy between the lowest and highest values. It is essential to highlight that regions of paramount importance, such as the confluence area connecting the upper and middle stretches of the Yangtze River Basin and the intricate Dongting Lake system, exhibited noteworthy ecological risks attributed to cadmium presence. Consequently, further in-depth investigations into these critical regions are imperative for a comprehensive understanding of the associated risks.