Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implicatio...Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.展开更多
Shandong is a significant province for foreign trade in China;however,it still faces shortcomings in the development of its service trade,as outlined below.Firstly,the scale of service trade is limited.Shandong’s ser...Shandong is a significant province for foreign trade in China;however,it still faces shortcomings in the development of its service trade,as outlined below.Firstly,the scale of service trade is limited.Shandong’s service trade volume ranked sixth in China in 2022,lagging considerably behind Shanghai,Guangdong,Beijing,Zhejiang,and Jiangsu.Secondly,the proportion of service trade in Shandong compared to the overall national services trade volume falls below the national average,with the per capita scale even lower than the national average.Thirdly,Shandong’s service trade accounts for less than 10% of the province’s foreign trade,which is 3 percentage points below the national average.The insufficient development of Shandong’s service trade is mainly attributed to the weak performance of its own service industry and the limited scale of attracting foreign services investment.Accelerating the development of producer services in Shandong,promoting the intelligent upgrading of consumer services,and continuously promoting reform and opening up in the service sector will be conducive to achieving high-quality development of services trade in Shandong.展开更多
This paper aims to present the experience gathered in the Italian alpine city of Bolzano within the project“Bolzano Traffic”whose goal is the introduction of an experimental open ITS platform for local service provi...This paper aims to present the experience gathered in the Italian alpine city of Bolzano within the project“Bolzano Traffic”whose goal is the introduction of an experimental open ITS platform for local service providers,fostering the diffusion of advanced traveller information services and the future deployment of cooperative mobility systems in the region.Several end-users applications targeted to the needs of different user groups have been developed in collaboration with local companies and research centers;a partnership with the EU Co-Cities project has been activated as well.The implemented services rely on real-time travel and traffic information collected by urban traffic monitoring systems or published by local stakeholders(e.g.public transportation operators).An active involvement of end-users,who have recently started testing these demo applications for free,is actually on-going.展开更多
April 24-25, Seoul, Republic of Korea The International Telecommunication Union(ITU) is organizing the Regional Digital Financial Services Security Clinic for Asia Pacific Region on April 24-25, 2024 in Seoul, Republi...April 24-25, Seoul, Republic of Korea The International Telecommunication Union(ITU) is organizing the Regional Digital Financial Services Security Clinic for Asia Pacific Region on April 24-25, 2024 in Seoul, Republic of Korea. The event is being jointly held with FNSV Korea and the Korean Fintech Center.展开更多
China is striving to build an elderly-friendly society,with comfortable living facilities,convenient transportation,and accessible leisure services.THE Chinese path to modernization entails the modernization of a huge...China is striving to build an elderly-friendly society,with comfortable living facilities,convenient transportation,and accessible leisure services.THE Chinese path to modernization entails the modernization of a huge population.Part of this,as was declared at the 20th National Congress of the Communist Party of China(CPC),means China will pursue a proactive national strategy in response to population aging,and develop elderly care programs and services.To actively respond to population aging,there is more to care than just the physical health of the elderly.Their needs are multi-level and diverse.To some extent,it’s fair to say that a society’s happiness is largely dependent on whether or not the elderly are happy.The silver economy,which meets the needs of the elderly for a better life,therefore has enormous development potentials.展开更多
From the perspective of situational communication,this paper aims to explore how to promote cultural integration and provide better educational services for international students in China.This paper first analyzes th...From the perspective of situational communication,this paper aims to explore how to promote cultural integration and provide better educational services for international students in China.This paper first analyzes the basic assumptions and key factors of situational communication based on international students in China.Secondly,the relationship between situational communication and cultural integration and educational services for international students in China is discussed in depth.Additionally,the role of situational communication in educational services for international students in China,such as promoting cross-cultural communication,solving language barriers,and enhancing mutual understanding,is proposed.Lastly,from the perspective of situational communication,an optimization path of educational services and cultural integration for international students in China is proposed,including the provision of diversified educational resources,the enhancement of cross-cultural communication,and the establishment of an effective communication mechanism.This study expands the perspective of educational services for international students in China,provides a new theoretical framework and practical path,and offers a reference for promoting cultural integration and improving educational services for international students in China.展开更多
Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hyp...Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.展开更多
Mountain ecosystems play an essential role in supporting regional sustainable development and improving local ecological environments. However, economic development in mountainous areas has long been lagging, and mult...Mountain ecosystems play an essential role in supporting regional sustainable development and improving local ecological environments. However, economic development in mountainous areas has long been lagging, and multiple conflicts related to resource assurance, ecological protection, and economic development have emerged. An accurate grasp of the current status and evolutionary trends of mountain ecosystems is essential to enhance the overall benefits of ecosystem services and maintain regional ecological security. Based on the In VEST(Integrated Valuation of Ecosystem Services and Trade-offs) model, this study analyzed the spatiotemporal evolution patterns and the trade-offs and synergies among ecosystem services(ES) in the Dabie Mountains Area(DMA) of eastern China. The Markov-PLUS(Patch-generating Land Use Simulation) model was used to conduct a multi-scenario simulation of the area's future development. Water yield(WY) and soil conservation(SC) had overall increasing trends during 2000-2020, carbon storage(CS)decreased overall but slowed with time, and habitat quality(HQ) increased and then decreased. The ecological protection scenario is the best scenario for improving ES in the DMA by 2030;compared to 2020, the total WY would decrease by 3.77 × 10^(8) m^(3), SC would increase by 0.65 × 10^(6) t, CS would increase by 1.33 × 10^(6) t, and HQ would increase by 0.06%. The comprehensive development scenario is the second-most effective scenario for ecological improvement, while the natural development scenario did not have a significant effect. However, as the comprehensive development scenario considers both environmental protection and economic development, which are both vital for the sustainable development of the mountainous areas, this scenario is considered the most suitable path for future development. There are trade-offs between WY, CS, and HQ, while there are synergies between SC, CS, and HQ. Spatially, the DMA's central core district is the main strong synergistic area, the marginal zone is the weak synergistic area, and trade-offs are mainly distributed in the transition zone.展开更多
Slope farmland is an important component of farmland resources in China.The utilization and change of slope farmland have significant effects on ecosystems,and understanding the impact of slope farmland change on ecos...Slope farmland is an important component of farmland resources in China.The utilization and change of slope farmland have significant effects on ecosystems,and understanding the impact of slope farmland change on ecosystem services(ESs)is critical for effective land utilization and ecosystem protection.This study aims to analyze slope farmland changes in China between 2000 and 2020 and quantify the impact of these changes on ESs by the use of a land use dynamic attitude study,and an ecosystem services value(ESV)equivalent.Results show that the area of slope farmland in China was mainly concentrated on slopes of 2°-6°,and exhibited a downward trend between 2000 and 2020.There were significant differences in the spatial distribution of the farmland,which was mainly located in the Taihang,Qinling,Wushan,and Xuefeng mountains.ESV increased by$179.235 million due to the conversion between slope farmland and forest,grassland,and construction land from 2000-2010.Conversely,from 2010 to 2020,ESV decreased by$2613.919 million due to the conversion of forest and grassland to slope farmland as well as the conversion of slope farmland to construction land.展开更多
Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial sca...Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial scale, biophysical and ecological structure, and functionality. This requires conducting studies at the local level to understand how, for example, the watershed ecosystem contributes to humanity locally and nationally. This study focuses on selected regulatory ecosystem services (RES) in Kenya’s catchment area ecosystems (Elgeyo and Nyambene). Field-based sampling and Landsat imagery with secondary information were used to generate biophysical and ecological data. The study used market price-based, cost-based, and unit transfer methods for RES valuation. The study estimates the total value of the six selected regulatory ecosystem services (RES) at KES 41.4 billion (US$386.7 million) and KES 14.73 billion (US$137.71 million) for Elgeyo and Nyambene, respectively. This equates to KES 1.64 million (US$15,331.19) and KES 2.72 million (US$25,375) per hectare per year. Extrapolating the study estimates to the national level, the country’s regulatory ecosystem services would range from US$18.4 billion to US$30.45 billion annually. This equates to between 16.7% and 27.7% of Kenya’s GDP in 2021, underscoring the importance of watersheds to the national economy.展开更多
In any organization where SOA has been implemented, all of the web services are registered in UDDI and users’ needs are served by using appropriate web services. So in this paper, we will try to discover a service fr...In any organization where SOA has been implemented, all of the web services are registered in UDDI and users’ needs are served by using appropriate web services. So in this paper, we will try to discover a service from repository first that can provide the required output to the user. The process becomes difficult when a single service is not able to fulfill a user’s need and we need a combination of services to answer complex needs of users. In our paper, we will suggest a simpler approach for dynamic service composition using a graph based methodology. This will be a design time service composition. This approach uses the functional and non-functional parameters of the services to select the most suitable services for composition as per user’s need. This approach involves “service classification” on the basis of functional parameters, “service discovery” on the basis of user’s need and then “service composition” using the selected services on the basis of non-functional parameters like response time, cost, security and availability. Another challenge in SOA implementation is that, once the composition has performed, some services may become faulty at runtime and may stop the entire process of serving a user’s need. So, we will also describe a way of “dynamic service reconfiguration” in our approach that will enable us to identify and replace a faulty service that is violating the SLA or is not accessible anymore. This service reconfiguration is done without redoing or reconfiguring the entire composition. In the end, to simulate the proposed approach, we will represent a prototype application built on php 5.4 using My SQL database at backend.展开更多
Land use/land cover(LULC)change and climate change are two major factors affecting the provision of ecosystem services which are closely related to human well-being.However,a clear understanding of the relationships b...Land use/land cover(LULC)change and climate change are two major factors affecting the provision of ecosystem services which are closely related to human well-being.However,a clear understanding of the relationships between these two factors and ecosystem services in Central Asia is still lacking.This study aimed to comprehensively assess ecosystem services in Central Asia and analyze how they are impacted by changes in LULC and climate.The spatiotemporal patterns of three ecosystem services during the period of 2000-2015,namely the net primary productivity(NPP),water yield,and soil retention,were quantified and mapped by the Carnegie-Ames-Stanford Approach(CASA)model,Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model,and Revised Universal Soil Loss Equation(RUSLE).Scenarios were used to determine the relative importance and combined effect of LULC change and climate change on ecosystem services.Then,the relationships between climate factors(precipitation and temperature)and ecosystem services,as well as between LULC change and ecosystem services,were further discussed.The results showed that the high values of ecosystem services appeared in the southeast of Central Asia.Among the six biomes(alpine forest region(AFR),alpine meadow region(AMR),typical steppe region(TSR),desert steppe region(DSR),desert region(DR),and lake region(LR)),the values of ecosystem services followed the order of AFR>AMR>TSR>DSR>DR>LR.In addition,the values of ecosystem services fluctuated during the period of 2000-2015,with the most significant decreases observed in the southeast mountainous area and northwest of Central Asia.LULC change had a greater impact on the NPP,while climate change had a stronger influence on the water yield and soil retention.The combined LULC change and climate change exhibited a significant synergistic effect on ecosystem services in most of Central Asia.Moreover,ecosystem services were more strongly and positively correlated with precipitation than with temperature.The greening of desert areas and forest land expansion could improve ecosystem services,but unreasonable development of cropland and urbanization have had an adverse impact on ecosystem services.According to the results,ecological stability in Central Asia can be achieved through the natural vegetation protection,reasonable urbanization,and ecological agriculture development.展开更多
The right to health for all people means that healthcare services and programs are available,accessible,and acceptable for everyone in need.However,certain groups in the society may be marginalized from their needed h...The right to health for all people means that healthcare services and programs are available,accessible,and acceptable for everyone in need.However,certain groups in the society may be marginalized from their needed healthcare services.In this regard,this paper discusses the challenges in providing HIV-related services to sex workers,a group that remains marginalized in Philippine society.展开更多
Diabetes is a non-communicable ailment that has adverse effects on the individual’s overall well-being and productivity in society.The main objective of this study was to examine the empirical literature concerning t...Diabetes is a non-communicable ailment that has adverse effects on the individual’s overall well-being and productivity in society.The main objective of this study was to examine the empirical literature concerning the association between diabetes and poverty and the accessibility and utilization of medical care services among diabetic patients.The diabetes literature was explored using a literature review approach.This review revealed that diabetes is an ailment that affects all individuals irrespective of socioeconomic status;however,its prevalence is high in low-income countries.Hence,despite the higher prevalence of diabetes in developing countries compared with developed countries,diabetes is not a poor man’s ailment because it affects individuals of all incomes.While the number of diabetic patients that access and utilize diabetes medical care services has increased over the years,some personal and institutional factors still limit patients’access to the use of diabetes care.Also,there is a lacuna in the diabetes literature concerning the extent of utilization of available healthcare services by diabetic patients.展开更多
Management of forest lands considering multi-functional approaches is the basis to sustain or enhance the provi-sion of specific benefits,while minimizing negative impacts to the environment.Defining a desired managem...Management of forest lands considering multi-functional approaches is the basis to sustain or enhance the provi-sion of specific benefits,while minimizing negative impacts to the environment.Defining a desired management itinerary to a forest depends on a variety of factors,including the forest type,its ecological characteristics,and the social and economic needs of local communities.A strategic assessment of the forest use suitability(FUS)(namely productive,protective,conservation-oriented,social and multi-functional)at regional level,based on the provision of forest ecosystem services and trade-offs between FUS alternatives,can be used to develop management strategies that are tailored to the specific needs and conditions of the forest.The present study assesses the provision of multiple forest ecosystem services and employs a decision model to identify the FUS that sup-ports the most present and productive ecosystem services in each stand in Catalonia.For this purpose,we apply the latest version of the Ecosystem Management Decision Support(EMDS)system,a spatially oriented decision support system that provides accurate results for multi-criteria management.We evaluate 32 metrics and 12 as-sociated ecosystem services indicators to represent the spatial reality of the region.According to the results,the dominant primary use suitability is social,followed by protective and productive.Nevertheless,final assignment of uses is not straightforward and requires an exhaustive analysis of trade-offs between all alternative options,in many cases identifying flexible outcomes,and increasing the representativeness of multi-functional use.The assignment of forest use suitability aims to significantly improve the definition of the most adequate management strategy to be applied.展开更多
Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded...Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.展开更多
The plantation of non-native species is one of the most expensive ecological restoration measures in arid and semi-arid areas,while its impacts on local communities are largely ignored.This study assessed the rate of ...The plantation of non-native species is one of the most expensive ecological restoration measures in arid and semi-arid areas,while its impacts on local communities are largely ignored.This study assessed the rate of change and the dynamic degree of the economic values of ecosystem services related to local conservation(water yield,stocking rate and aesthetic value)and preserving the future(carbon sequestration,soil protection,soil stability and habitat provision)to determine the restoration success of the plantation of non-native species Haloxylon ammodendron(C.A.Mey.)Bunge ex Fenzl(15-and 30-year-old)in parts of arid rangelands of Bardsir region,Kerman Province,Iran.We investigated the impacts of the two plantations on the seven ecosystem services and ecosystem structures(horizontal and vertical structures,vegetation composition and species diversity)based on field sampling and measurements at four sampling sites(i.e.,control,degraded,and 15-and 30-year-old plantation sites)in spring and summer of 2022.The restoration success of the plantation of non-native species was then examined by assessing the rate of change and the dynamic degree of the total economic value of all ecosystem services as well as the rate of change and the dynamic degree of the economic values of ecosystem services for the two groups(local conservation and preserving the future).Although the plantation of non-native species H.ammodendron enormously improved the vertical and horizontal structures of ecosystems,it failed to increase species diversity and richness fully.Further,despite the plantation of non-native species H.ammodendron had significantly increased the economic values of all ecosystem services,it was only quite successful in restoring carbon sequestration.Path analysis showed that plantation age had a significant impact on restoration success directly and indirectly(through changing ecosystem structures and services).The dynamic degree of the economic values of ecosystem services related to local conservation and preserving the future at the 15-and 30-year-old plantation sites indicated that the two plantations successfully restored the ecosystem services related to preserving the future.The presented method can help managers select the best restoration practices and predict their ecological-social success,especially for the plantation of high-risk non-native species in arid and semi-arid areas.展开更多
The aim of the work was to determine the spatial distribution of activity in the forest on the area of the Forest Promotional Complex“Sudety Zachodnie”using mobile phone data.The study identified the sites with the ...The aim of the work was to determine the spatial distribution of activity in the forest on the area of the Forest Promotional Complex“Sudety Zachodnie”using mobile phone data.The study identified the sites with the highest(hot spot)and lowest(cold spot)use.Habitat,stand,demographic,topographic and spatial factors affecting the distribution of activity were also analyzed.Two approaches were applied in our research:global and local Moran’s coefficients,and a machine learning technique,Boosted Regression Trees.The results show that 11,503,320 visits to forest areas were recorded in the“Sudety Zachodnie”in 2019.The most popular season for activities was winter,and the least popular was spring.Using global and local Moran’s I coefficients,three small hot clusters of activity and one large cold cluster were identified.Locations with high values with similar neighbours(hot-spots)were most often visited forest areas,averaging almost 200,000 visits over 2019.Significantly fewer visits were recorded in cold-spots,the average number of visits to these areas was about 4,500.The value of global Moran’s I was equal to 0.54 and proved significant positive spatial autocorrelation.Results of Boosted Regression Trees modeling of visits in forest,using tree stand habitat and spatial factors accurately explained 76%of randomly selected input data.The variables that had the greatest effect on the distribution of activities were the density of hiking and biking trails and diversity of topography.The methodology presented in this article allows delineation of Cultural Ecosystem Services hot spots in forest areas based on mobile phone data.It also allows the identification of factors that may influence the distribution of visits in forests.Such data are important for managing forest areas and adapting forest management to the needs of society while maintaining ecosystem stability.展开更多
Karst environmental issues have become one of the hot spots in contemporary international geological research. The same problem of water shortage is one of the hot spots of global concern. The peak-cluster depression ...Karst environmental issues have become one of the hot spots in contemporary international geological research. The same problem of water shortage is one of the hot spots of global concern. The peak-cluster depression basins in southwest of Guangxi is an important water connotation and ecological barrier areas in the Pearl River Basin of China. Thus, studying the spatial and temporal variations and the influencing factors of its water yield services is critical to achieve the sustainable development of water resources and ecological environmental protection in this region. As such, this paper uses the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST) model to assess the spatial and temporal variabilities of water yield services and its trends in the peak-cluster depression basins in southwest of Guangxi from 2000 to 2020. This work also integrates precipitation(Pre), reference evapotranspiration(ET), temperature(Tem), digital elevation model(DEM), slope, normalized difference vegetation index(NDVI), land use/land cover(LULC) and soil type to reveal the main factors that influence water yield services with the help of Geodetector. Results show that: 1) in time scale,the total annual water yield in the study area show a fluctuating and increasing trend from 2000 to 2020, with a growth rate of 7.3753 × 10^(8)m^(3)/yr, and its multi-year average water yield was 538.07 mm;2) in spatial pattern, with high yield areas mainly distributed in the south of the study area(mainly including Shangsi County, Pingxiang City, Ningming County, Longzhou County and Jingxi County), and low yield areas mainly distributed in Baise City and Nanning City;3) the dominant factor of water yield within karst and non-karst landforms is not necessarily controlled by precipitation, and the explanation degree of DEM factors in karst areas is significantly higher than that in non-karst areas;4) amongst the climatic factors, Pre, ET and Tem are dominant in the spatial pattern of region water yield capacity. among which Pre has the highest explanatory power for the spatial heterogeneity of annual water production, with q values above0.8, and each driver showed a significant interaction on the spatial distribution of water yield, with Pre exhibiting the strongest interaction with LULC.展开更多
BACKGROUND The impact of age on outcomes in cardiogenic shock(CS)is poorly described in the pre-hospital setting.We assessed the impact of age on outcomes of patients treated by emergency medical services(EMS).METHODS...BACKGROUND The impact of age on outcomes in cardiogenic shock(CS)is poorly described in the pre-hospital setting.We assessed the impact of age on outcomes of patients treated by emergency medical services(EMS).METHODS This population-based cohort study included consecutive adult patients with CS transported to hospital by EMS.Successfully linked patients were stratified into tertiles by age(18-63,64-77,and>77 years).Predictors of 30-day mortality were assessed through regression analyses.The primary outcome was 30-day all-cause mortality.RESULTS A total of 3523 patients with CS were successfully linked to state health records.The average age was 68±16 years and 1398(40%)were female.Older patients were more likely to have comorbidities including pre-existing coronary artery disease,hypertension,dyslipidemia,diabetes mellitus,and cerebrovascular disease.The incidence of CS was significantly greater with increasing age(incidence rate per 100,000 person years 6.47[95%CI:6.1-6.8]in age 18-63 years,34.34[32.4-36.4]in age 64-77 years,74.87[70.6-79.3]in age>77 years,P<0.001).There was a step-wise increase in the rate of 30-day mortality with increasing age tertile.After adjustment,compared to the lowest age tertile,patients aged>77 years had increased risk of 30-day mortality(adjusted hazard ratio=2.26[95%CI:1.96-2.60]).Older patients were less likely to receive inpatient coronary angiography.CONCLUSION Older patients with EMS-treated CS have significantly higher rates of short-term mortality.The reduced rates of invasive interventions in older patients underscore the need for further development of systems of care to improve outcomes for this patient group.展开更多
基金supported by the Innovation Capability Support Program of Shaanxi Province,China(2023-CX-RKX-102)the Key Research and Development Program of Shaanxi Province,China(2022FP-34)+1 种基金the Open Foundation of the Key Laboratory of Natural Resource Coupling Process and Effects(2023KFKTB008)the Open Fund of Shaanxi Key Laboratory of Land Consolidation,China(300102352502).
文摘Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.
文摘Shandong is a significant province for foreign trade in China;however,it still faces shortcomings in the development of its service trade,as outlined below.Firstly,the scale of service trade is limited.Shandong’s service trade volume ranked sixth in China in 2022,lagging considerably behind Shanghai,Guangdong,Beijing,Zhejiang,and Jiangsu.Secondly,the proportion of service trade in Shandong compared to the overall national services trade volume falls below the national average,with the per capita scale even lower than the national average.Thirdly,Shandong’s service trade accounts for less than 10% of the province’s foreign trade,which is 3 percentage points below the national average.The insufficient development of Shandong’s service trade is mainly attributed to the weak performance of its own service industry and the limited scale of attracting foreign services investment.Accelerating the development of producer services in Shandong,promoting the intelligent upgrading of consumer services,and continuously promoting reform and opening up in the service sector will be conducive to achieving high-quality development of services trade in Shandong.
文摘This paper aims to present the experience gathered in the Italian alpine city of Bolzano within the project“Bolzano Traffic”whose goal is the introduction of an experimental open ITS platform for local service providers,fostering the diffusion of advanced traveller information services and the future deployment of cooperative mobility systems in the region.Several end-users applications targeted to the needs of different user groups have been developed in collaboration with local companies and research centers;a partnership with the EU Co-Cities project has been activated as well.The implemented services rely on real-time travel and traffic information collected by urban traffic monitoring systems or published by local stakeholders(e.g.public transportation operators).An active involvement of end-users,who have recently started testing these demo applications for free,is actually on-going.
文摘April 24-25, Seoul, Republic of Korea The International Telecommunication Union(ITU) is organizing the Regional Digital Financial Services Security Clinic for Asia Pacific Region on April 24-25, 2024 in Seoul, Republic of Korea. The event is being jointly held with FNSV Korea and the Korean Fintech Center.
文摘China is striving to build an elderly-friendly society,with comfortable living facilities,convenient transportation,and accessible leisure services.THE Chinese path to modernization entails the modernization of a huge population.Part of this,as was declared at the 20th National Congress of the Communist Party of China(CPC),means China will pursue a proactive national strategy in response to population aging,and develop elderly care programs and services.To actively respond to population aging,there is more to care than just the physical health of the elderly.Their needs are multi-level and diverse.To some extent,it’s fair to say that a society’s happiness is largely dependent on whether or not the elderly are happy.The silver economy,which meets the needs of the elderly for a better life,therefore has enormous development potentials.
文摘From the perspective of situational communication,this paper aims to explore how to promote cultural integration and provide better educational services for international students in China.This paper first analyzes the basic assumptions and key factors of situational communication based on international students in China.Secondly,the relationship between situational communication and cultural integration and educational services for international students in China is discussed in depth.Additionally,the role of situational communication in educational services for international students in China,such as promoting cross-cultural communication,solving language barriers,and enhancing mutual understanding,is proposed.Lastly,from the perspective of situational communication,an optimization path of educational services and cultural integration for international students in China is proposed,including the provision of diversified educational resources,the enhancement of cross-cultural communication,and the establishment of an effective communication mechanism.This study expands the perspective of educational services for international students in China,provides a new theoretical framework and practical path,and offers a reference for promoting cultural integration and improving educational services for international students in China.
文摘Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.
基金Under the auspices of National Natural Science Foundation of China (No. U2102209)。
文摘Mountain ecosystems play an essential role in supporting regional sustainable development and improving local ecological environments. However, economic development in mountainous areas has long been lagging, and multiple conflicts related to resource assurance, ecological protection, and economic development have emerged. An accurate grasp of the current status and evolutionary trends of mountain ecosystems is essential to enhance the overall benefits of ecosystem services and maintain regional ecological security. Based on the In VEST(Integrated Valuation of Ecosystem Services and Trade-offs) model, this study analyzed the spatiotemporal evolution patterns and the trade-offs and synergies among ecosystem services(ES) in the Dabie Mountains Area(DMA) of eastern China. The Markov-PLUS(Patch-generating Land Use Simulation) model was used to conduct a multi-scenario simulation of the area's future development. Water yield(WY) and soil conservation(SC) had overall increasing trends during 2000-2020, carbon storage(CS)decreased overall but slowed with time, and habitat quality(HQ) increased and then decreased. The ecological protection scenario is the best scenario for improving ES in the DMA by 2030;compared to 2020, the total WY would decrease by 3.77 × 10^(8) m^(3), SC would increase by 0.65 × 10^(6) t, CS would increase by 1.33 × 10^(6) t, and HQ would increase by 0.06%. The comprehensive development scenario is the second-most effective scenario for ecological improvement, while the natural development scenario did not have a significant effect. However, as the comprehensive development scenario considers both environmental protection and economic development, which are both vital for the sustainable development of the mountainous areas, this scenario is considered the most suitable path for future development. There are trade-offs between WY, CS, and HQ, while there are synergies between SC, CS, and HQ. Spatially, the DMA's central core district is the main strong synergistic area, the marginal zone is the weak synergistic area, and trade-offs are mainly distributed in the transition zone.
基金supported in part by grants from the National Natural Science Foundation of China(Grant Nos.42001187 and 41701629)。
文摘Slope farmland is an important component of farmland resources in China.The utilization and change of slope farmland have significant effects on ecosystems,and understanding the impact of slope farmland change on ecosystem services(ESs)is critical for effective land utilization and ecosystem protection.This study aims to analyze slope farmland changes in China between 2000 and 2020 and quantify the impact of these changes on ESs by the use of a land use dynamic attitude study,and an ecosystem services value(ESV)equivalent.Results show that the area of slope farmland in China was mainly concentrated on slopes of 2°-6°,and exhibited a downward trend between 2000 and 2020.There were significant differences in the spatial distribution of the farmland,which was mainly located in the Taihang,Qinling,Wushan,and Xuefeng mountains.ESV increased by$179.235 million due to the conversion between slope farmland and forest,grassland,and construction land from 2000-2010.Conversely,from 2010 to 2020,ESV decreased by$2613.919 million due to the conversion of forest and grassland to slope farmland as well as the conversion of slope farmland to construction land.
文摘Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial scale, biophysical and ecological structure, and functionality. This requires conducting studies at the local level to understand how, for example, the watershed ecosystem contributes to humanity locally and nationally. This study focuses on selected regulatory ecosystem services (RES) in Kenya’s catchment area ecosystems (Elgeyo and Nyambene). Field-based sampling and Landsat imagery with secondary information were used to generate biophysical and ecological data. The study used market price-based, cost-based, and unit transfer methods for RES valuation. The study estimates the total value of the six selected regulatory ecosystem services (RES) at KES 41.4 billion (US$386.7 million) and KES 14.73 billion (US$137.71 million) for Elgeyo and Nyambene, respectively. This equates to KES 1.64 million (US$15,331.19) and KES 2.72 million (US$25,375) per hectare per year. Extrapolating the study estimates to the national level, the country’s regulatory ecosystem services would range from US$18.4 billion to US$30.45 billion annually. This equates to between 16.7% and 27.7% of Kenya’s GDP in 2021, underscoring the importance of watersheds to the national economy.
文摘In any organization where SOA has been implemented, all of the web services are registered in UDDI and users’ needs are served by using appropriate web services. So in this paper, we will try to discover a service from repository first that can provide the required output to the user. The process becomes difficult when a single service is not able to fulfill a user’s need and we need a combination of services to answer complex needs of users. In our paper, we will suggest a simpler approach for dynamic service composition using a graph based methodology. This will be a design time service composition. This approach uses the functional and non-functional parameters of the services to select the most suitable services for composition as per user’s need. This approach involves “service classification” on the basis of functional parameters, “service discovery” on the basis of user’s need and then “service composition” using the selected services on the basis of non-functional parameters like response time, cost, security and availability. Another challenge in SOA implementation is that, once the composition has performed, some services may become faulty at runtime and may stop the entire process of serving a user’s need. So, we will also describe a way of “dynamic service reconfiguration” in our approach that will enable us to identify and replace a faulty service that is violating the SLA or is not accessible anymore. This service reconfiguration is done without redoing or reconfiguring the entire composition. In the end, to simulate the proposed approach, we will represent a prototype application built on php 5.4 using My SQL database at backend.
基金This study was supported by the Strategic Priority Research Program of Chinese Academy of Sciences,the Pan-Third Pole Environment Study for a Green Silk Road(Pan-TPE)(XDA2004030202).
文摘Land use/land cover(LULC)change and climate change are two major factors affecting the provision of ecosystem services which are closely related to human well-being.However,a clear understanding of the relationships between these two factors and ecosystem services in Central Asia is still lacking.This study aimed to comprehensively assess ecosystem services in Central Asia and analyze how they are impacted by changes in LULC and climate.The spatiotemporal patterns of three ecosystem services during the period of 2000-2015,namely the net primary productivity(NPP),water yield,and soil retention,were quantified and mapped by the Carnegie-Ames-Stanford Approach(CASA)model,Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model,and Revised Universal Soil Loss Equation(RUSLE).Scenarios were used to determine the relative importance and combined effect of LULC change and climate change on ecosystem services.Then,the relationships between climate factors(precipitation and temperature)and ecosystem services,as well as between LULC change and ecosystem services,were further discussed.The results showed that the high values of ecosystem services appeared in the southeast of Central Asia.Among the six biomes(alpine forest region(AFR),alpine meadow region(AMR),typical steppe region(TSR),desert steppe region(DSR),desert region(DR),and lake region(LR)),the values of ecosystem services followed the order of AFR>AMR>TSR>DSR>DR>LR.In addition,the values of ecosystem services fluctuated during the period of 2000-2015,with the most significant decreases observed in the southeast mountainous area and northwest of Central Asia.LULC change had a greater impact on the NPP,while climate change had a stronger influence on the water yield and soil retention.The combined LULC change and climate change exhibited a significant synergistic effect on ecosystem services in most of Central Asia.Moreover,ecosystem services were more strongly and positively correlated with precipitation than with temperature.The greening of desert areas and forest land expansion could improve ecosystem services,but unreasonable development of cropland and urbanization have had an adverse impact on ecosystem services.According to the results,ecological stability in Central Asia can be achieved through the natural vegetation protection,reasonable urbanization,and ecological agriculture development.
文摘The right to health for all people means that healthcare services and programs are available,accessible,and acceptable for everyone in need.However,certain groups in the society may be marginalized from their needed healthcare services.In this regard,this paper discusses the challenges in providing HIV-related services to sex workers,a group that remains marginalized in Philippine society.
文摘Diabetes is a non-communicable ailment that has adverse effects on the individual’s overall well-being and productivity in society.The main objective of this study was to examine the empirical literature concerning the association between diabetes and poverty and the accessibility and utilization of medical care services among diabetic patients.The diabetes literature was explored using a literature review approach.This review revealed that diabetes is an ailment that affects all individuals irrespective of socioeconomic status;however,its prevalence is high in low-income countries.Hence,despite the higher prevalence of diabetes in developing countries compared with developed countries,diabetes is not a poor man’s ailment because it affects individuals of all incomes.While the number of diabetic patients that access and utilize diabetes medical care services has increased over the years,some personal and institutional factors still limit patients’access to the use of diabetes care.Also,there is a lacuna in the diabetes literature concerning the extent of utilization of available healthcare services by diabetic patients.
基金the Catalan Government Predoctoral Schol-arship(AGAUR-FSE 2020 FI_B200147)SuFoRun Marie Sklodowska-Curie Research and Innovation Staff Exchange(RISE)Program(Grant No.691149)the Spanish Ministry of Science and Innovation(PID2020-120355RB-IOO).
文摘Management of forest lands considering multi-functional approaches is the basis to sustain or enhance the provi-sion of specific benefits,while minimizing negative impacts to the environment.Defining a desired management itinerary to a forest depends on a variety of factors,including the forest type,its ecological characteristics,and the social and economic needs of local communities.A strategic assessment of the forest use suitability(FUS)(namely productive,protective,conservation-oriented,social and multi-functional)at regional level,based on the provision of forest ecosystem services and trade-offs between FUS alternatives,can be used to develop management strategies that are tailored to the specific needs and conditions of the forest.The present study assesses the provision of multiple forest ecosystem services and employs a decision model to identify the FUS that sup-ports the most present and productive ecosystem services in each stand in Catalonia.For this purpose,we apply the latest version of the Ecosystem Management Decision Support(EMDS)system,a spatially oriented decision support system that provides accurate results for multi-criteria management.We evaluate 32 metrics and 12 as-sociated ecosystem services indicators to represent the spatial reality of the region.According to the results,the dominant primary use suitability is social,followed by protective and productive.Nevertheless,final assignment of uses is not straightforward and requires an exhaustive analysis of trade-offs between all alternative options,in many cases identifying flexible outcomes,and increasing the representativeness of multi-functional use.The assignment of forest use suitability aims to significantly improve the definition of the most adequate management strategy to be applied.
文摘Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.
基金supported by the University of Jirof, Iran (4813-00-1)
文摘The plantation of non-native species is one of the most expensive ecological restoration measures in arid and semi-arid areas,while its impacts on local communities are largely ignored.This study assessed the rate of change and the dynamic degree of the economic values of ecosystem services related to local conservation(water yield,stocking rate and aesthetic value)and preserving the future(carbon sequestration,soil protection,soil stability and habitat provision)to determine the restoration success of the plantation of non-native species Haloxylon ammodendron(C.A.Mey.)Bunge ex Fenzl(15-and 30-year-old)in parts of arid rangelands of Bardsir region,Kerman Province,Iran.We investigated the impacts of the two plantations on the seven ecosystem services and ecosystem structures(horizontal and vertical structures,vegetation composition and species diversity)based on field sampling and measurements at four sampling sites(i.e.,control,degraded,and 15-and 30-year-old plantation sites)in spring and summer of 2022.The restoration success of the plantation of non-native species was then examined by assessing the rate of change and the dynamic degree of the total economic value of all ecosystem services as well as the rate of change and the dynamic degree of the economic values of ecosystem services for the two groups(local conservation and preserving the future).Although the plantation of non-native species H.ammodendron enormously improved the vertical and horizontal structures of ecosystems,it failed to increase species diversity and richness fully.Further,despite the plantation of non-native species H.ammodendron had significantly increased the economic values of all ecosystem services,it was only quite successful in restoring carbon sequestration.Path analysis showed that plantation age had a significant impact on restoration success directly and indirectly(through changing ecosystem structures and services).The dynamic degree of the economic values of ecosystem services related to local conservation and preserving the future at the 15-and 30-year-old plantation sites indicated that the two plantations successfully restored the ecosystem services related to preserving the future.The presented method can help managers select the best restoration practices and predict their ecological-social success,especially for the plantation of high-risk non-native species in arid and semi-arid areas.
基金Funded by the National Science Centre,Poland under the OPUS call in the Weave programme(project No.2021/43/I/HS4/01451)funded by Ministry of Education and Science(901503)。
文摘The aim of the work was to determine the spatial distribution of activity in the forest on the area of the Forest Promotional Complex“Sudety Zachodnie”using mobile phone data.The study identified the sites with the highest(hot spot)and lowest(cold spot)use.Habitat,stand,demographic,topographic and spatial factors affecting the distribution of activity were also analyzed.Two approaches were applied in our research:global and local Moran’s coefficients,and a machine learning technique,Boosted Regression Trees.The results show that 11,503,320 visits to forest areas were recorded in the“Sudety Zachodnie”in 2019.The most popular season for activities was winter,and the least popular was spring.Using global and local Moran’s I coefficients,three small hot clusters of activity and one large cold cluster were identified.Locations with high values with similar neighbours(hot-spots)were most often visited forest areas,averaging almost 200,000 visits over 2019.Significantly fewer visits were recorded in cold-spots,the average number of visits to these areas was about 4,500.The value of global Moran’s I was equal to 0.54 and proved significant positive spatial autocorrelation.Results of Boosted Regression Trees modeling of visits in forest,using tree stand habitat and spatial factors accurately explained 76%of randomly selected input data.The variables that had the greatest effect on the distribution of activities were the density of hiking and biking trails and diversity of topography.The methodology presented in this article allows delineation of Cultural Ecosystem Services hot spots in forest areas based on mobile phone data.It also allows the identification of factors that may influence the distribution of visits in forests.Such data are important for managing forest areas and adapting forest management to the needs of society while maintaining ecosystem stability.
基金Under the auspices of National Natural Science Foundation of China (No. 42061020)Natural Science Foundation of Guangxi Zhuang Autonomous Region (No. 2018JJA150135)+3 种基金Guangxi Key Research and Development Program (No. AA18118038)Science and Technology Department of Guangxi Zhuang Autonomous Region (No. 2019AC20088)The Program of Improving the Basic Research Ability of Young and Middle-aged Teachers in Guangxi Universities (No. 2021KY0431)High Level Talent Introduction Project of Beibu Gulf University (No. 2019KYQD28)。
文摘Karst environmental issues have become one of the hot spots in contemporary international geological research. The same problem of water shortage is one of the hot spots of global concern. The peak-cluster depression basins in southwest of Guangxi is an important water connotation and ecological barrier areas in the Pearl River Basin of China. Thus, studying the spatial and temporal variations and the influencing factors of its water yield services is critical to achieve the sustainable development of water resources and ecological environmental protection in this region. As such, this paper uses the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST) model to assess the spatial and temporal variabilities of water yield services and its trends in the peak-cluster depression basins in southwest of Guangxi from 2000 to 2020. This work also integrates precipitation(Pre), reference evapotranspiration(ET), temperature(Tem), digital elevation model(DEM), slope, normalized difference vegetation index(NDVI), land use/land cover(LULC) and soil type to reveal the main factors that influence water yield services with the help of Geodetector. Results show that: 1) in time scale,the total annual water yield in the study area show a fluctuating and increasing trend from 2000 to 2020, with a growth rate of 7.3753 × 10^(8)m^(3)/yr, and its multi-year average water yield was 538.07 mm;2) in spatial pattern, with high yield areas mainly distributed in the south of the study area(mainly including Shangsi County, Pingxiang City, Ningming County, Longzhou County and Jingxi County), and low yield areas mainly distributed in Baise City and Nanning City;3) the dominant factor of water yield within karst and non-karst landforms is not necessarily controlled by precipitation, and the explanation degree of DEM factors in karst areas is significantly higher than that in non-karst areas;4) amongst the climatic factors, Pre, ET and Tem are dominant in the spatial pattern of region water yield capacity. among which Pre has the highest explanatory power for the spatial heterogeneity of annual water production, with q values above0.8, and each driver showed a significant interaction on the spatial distribution of water yield, with Pre exhibiting the strongest interaction with LULC.
基金supported by National Heart Foundation(NHF)Fellowshipsupported by a National Health and Medical Research Council(NHMRC)+4 种基金a NHF Post Graduate Scholarshipssupported by a NHMRC Early Career Fellowshipa NHF Future Leader Fellowshipsupported by an NHMRC postgraduate scholarshipsupported by an NHMRC Senior Principal Research Fellowship。
文摘BACKGROUND The impact of age on outcomes in cardiogenic shock(CS)is poorly described in the pre-hospital setting.We assessed the impact of age on outcomes of patients treated by emergency medical services(EMS).METHODS This population-based cohort study included consecutive adult patients with CS transported to hospital by EMS.Successfully linked patients were stratified into tertiles by age(18-63,64-77,and>77 years).Predictors of 30-day mortality were assessed through regression analyses.The primary outcome was 30-day all-cause mortality.RESULTS A total of 3523 patients with CS were successfully linked to state health records.The average age was 68±16 years and 1398(40%)were female.Older patients were more likely to have comorbidities including pre-existing coronary artery disease,hypertension,dyslipidemia,diabetes mellitus,and cerebrovascular disease.The incidence of CS was significantly greater with increasing age(incidence rate per 100,000 person years 6.47[95%CI:6.1-6.8]in age 18-63 years,34.34[32.4-36.4]in age 64-77 years,74.87[70.6-79.3]in age>77 years,P<0.001).There was a step-wise increase in the rate of 30-day mortality with increasing age tertile.After adjustment,compared to the lowest age tertile,patients aged>77 years had increased risk of 30-day mortality(adjusted hazard ratio=2.26[95%CI:1.96-2.60]).Older patients were less likely to receive inpatient coronary angiography.CONCLUSION Older patients with EMS-treated CS have significantly higher rates of short-term mortality.The reduced rates of invasive interventions in older patients underscore the need for further development of systems of care to improve outcomes for this patient group.
