Determinants of health poverty vulnerability in rural areas of Western China in the post-poverty relief era: an analysis based on the Anderson behavioral model.

BACKGROUND: Although China has eliminated absolute poverty, the effects of sickness still pose a threat to the prospect of returning to poverty in western rural areas. However, poverty governance extends beyond solving absolute poverty, and should enhance the family's ability to resist risks, proactively identify the existence of risks, and facilitate preventive measures to reduce the probability of falling into poverty again. This study aimed to assess the health poverty vulnerability of rural households in western China and decompose its determinants. METHODS: Based on survey data from 2022, the three-stage feasible generalized least squares method was used to calculate the health poverty vulnerability index. Then, Anderson's health behavior theory model was extended to analyse various influencing factors using binary logistic regression, and the contribution of each influencing factor was decomposed using the Shapley index. Finally, Tobit regression and the censored least absolute deviations estimation (clad) method were used to test the model's robustness. RESULTS: A total of 5455 families in the rural Ningxia region of western China were included in the study. The health poverty vulnerability index of the sample population in 2022 was 0.3000 ± 0.2223, and families with vulnerability ≥0.5 accounted for 16.9% of the sample population. From the Anderson behavioral model, the three models including propensity, enabling, and demand factors had the best fit, and the AIC and BIC values were the smallest. The Shapley decomposition showed that the dimensions of the propensity factor, number of residents, age and educational level of the household head, and dependency ratio were the most important factors influencing vulnerability to health poverty. Tobit regression and the clad method proved the reliability of the constructed model through a robustness test. CONCLUSION: Rural areas still face the risk of becoming poor or falling into poverty owing to residents' health problems. Health poverty alleviation should gradually change from a focus on treatment to prevention, and formulate a set of accurate and efficient intervention policies from a forward-looking perspective to consolidate the results of health poverty alleviation and prevent widescale poverty return.

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study.

This study aims to identify multimorbidity patterns and examine whether health poverty vulnerability (HPV) varies among adults aged 45 years or more. Data from 4338 participants were extracted from a Chinese cross-sectional study. Latent class analysis was used to identify multimorbidity patterns based on 11 self-reported chronic diseases. A 3-stage feasible generalized least-squares method was used to measure the HPV. The associations and influencing factors were analyzed using the Tobit model. The mean HPV values were 0.105 ±â€…0.225 and 0.329 ±â€…0.357, based on extreme poverty and those of low- and middle-income countries' poverty line, respectively. Four latent multimorbidity patterns were identified, comprising hypertension (57.33%), cardiovascular diseases (19.94%), the musculoskeletal system (13.09%), and spine (9.64%). The HPV value from hypertension (coefficient [Coef] =0.03, 95% confidence interval (CI) = 0.00-0.05) was significantly higher than that of the musculoskeletal system based on extreme poverty. In addition, the HPV values for hypertension (Coef =0.08, 95% CI = 0.05-0.11), spine (Coef =0.06, 95% CI = 0.02-0.11), and cardiovascular diseases (Coef =0.07, 95% CI = 0.03-0.11) were significantly high based on low- and middle-income countries' poverty line. Age ≥75 years, registered poor households, catastrophic medical expenditure, and toilet style were major risk factors. Although the multimorbidity pattern-induced HPV has been significant improved on extreme poverty, it still poses a very serious challenge with regard to low- to middle-income countries' poverty line. The sensitivity analysis proved the robustness of the results. Policymakers should focus on adults with 3 multimorbidity patterns, namely, registered poor households, age ≥75 years, and catastrophic health expenditure, to adopt targeted interventions to prevent and eliminate HPV.

Housing conditions, cooking fuels, and health-related quality of life among rural middle-aged and elderly in northwest China: A ten-year balanced panel study.

To investigate the impacts of improving housing conditions and transitioning to clean cooking fuels on health-related quality of life (HRQOL) among middle-aged and elderly populations in rural China. METHODS: Using a 10-year longitudinal follow-up study, we examined changes in housing conditions, cooking fuel use, and HRQOL among 690 Chinese adults aged 45 above in rural areas. HRQOL was assessed using the European Quality of Life-5 Dimensions 3 Levels (EQ-5D-3L) questionnaire. Generalized estimating equations were utilized to analyze correlations between variables. RESULTS: Using four-period balanced panel data of 10 years, there were significant differences in the self-reporting of mobility, self-care, usual activities, pain / discomfort and anxiety / depression in rural middle-aged and elderly people (p < 0.05). In terms of the EQ-5D index score and EQ-VAS score, showed a decreasing trend (p < 0.05). The housing area, housing material type, utilization of sanitary toilets, separation of housing and kitchen were separated and non-solid fuels used as cooking fuel were significantly associated with high HRQOL (p < 0.05). CONCLUSIONS: This study found that good housing conditions and the use of non-solid cooking fuel had positive effects on health-related quality of life of middle-aged and elderly people in rural areas of northwest China.

The mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China: A cross-sectional survey.

Background: Vulnerability to health-related poverty can predict the probability of families falling into poverty due to health risk impact. In this study, we measured the vulnerability to health-related poverty and examined the mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China. Methods: This cross-sectional study was conducted in Ningxia, China, in February 2019. A multi-stage stratified cluster-randomized design was used to obtain a representative sample in each county. We included participants aged 60 years and older, who had lived there for more than 1 year. A total of 3,653 rural residents older than 60 years old were selected as the research subjects. The three-stage generalized least square method was used to calculate the expected vulnerability to poverty. We used mediating effect model to test the mediation path of poverty vulnerability related to the physical multimorbidity. Results: Under different poverty line standards, i.e., $1.9/day as low vs. $3.1/day as the high poverty line, the proportion of families that could fall into poverty in the future was 5.3 and 53.7%, respectively. The prevalence of chronic diseases and physical multimorbidity among rural residents >60 years old was 64.62 and 21.24%, respectively. The results of mediating effect test showed that self-rated health status (indirect effect a × b = -0.0052), non-agricultural employment (a × b= -0.0046), household cattle production (a × b = 0.0004), housing type (a × b = -0.0008), gift expenses (a × b = 0.0006) and loan for illness (a × b = 0.0034) were the mediation paths of poverty vulnerability related to the physical multimorbidity. Conclusions: Concerted efforts are needed to reduce poverty vulnerability related to the physical multimorbidity. The strategy of alleviating poverty should emphasis on promoting non-agricultural employment of vulnerable groups sustainability and developing rural economy, which are important paths to reduce family's vulnerability to health-related poverty.

Genome-wide transcriptome profiling provides overwintering mechanism of Agropyron mongolicum.

BACKGROUND: The mechanism of winter survival for perennials involves multiple levels of gene regulation, especially cold resistance. Agropyron mongolicum is one important perennial grass species, but there is little information regarding its overwintering mechanism. We performed a comprehensive transcriptomics study to evaluate global gene expression profiles regarding the winter survival of Agropyron mongolicum. A genome-wide gene expression analysis involving four different periods was identified. Twenty-eight coexpression modules with distinct patterns were performed for transcriptome profiling. Furthermore, differentially expressed genes (DEGs) and their functional characterization were defined using a genome database such as NT, NR, COG, and KEGG. RESULT: A total of 79.6% of the unigenes were characterized to be involved in 136 metabolic pathways. In addition, the expression level of ABA receptor genes, regulation of transcription factors, and a coexpression network analysis were conducted using transcriptome data. We found that ABA receptors regulated downstream gene expression by activating bZIP and NAC transcription factors to improve cold resistance and winter survival. CONCLUSION: This study provides comprehensive transcriptome data for the characterization of overwintering-related gene expression profiles in A. mongolicum. Genomics resources can help provide a better understanding of the overwintering mechanism for perennial gramineae species. By analyzing genome-wide expression patterns for the four key stages of tiller bud development, the functional characteristics of the DEGs were identified that participated in various metabolic pathways and have been shown to be strongly associated with cold tolerance. These results can be further exploited to determine the mechanism of overwintering in perennial gramineae species.

[Association between SLC22A12 rs1529909 and rs7929627 polymorphism and hyperuricemia].

OBJECTIVE: To investigate the relationship between SLC22A12 gene rs1529909 and rs7929627 polymorphism and hyperuricemia of residents in Yinchuan, Ningxia province. METHODS: Through retrospective analysis in healthy subjects from April to November in 2014, 365 patients with hyperuricemia were selected. 1∶ 1 matched casecontrol study was carried out, matched with age( ± 5 years old), gender, race, and selected 365 people with normal serum uric acid levels as the control group. All subjects were investigated by questionnaire, had a physical examination, and collected fastingvenous blood for biochemical markers and gene polymorphism detection. Paired t test was used to compare the mean of two samples, and the influencing factors were analyzed by conditional logistic regression. The interaction of two sites on hyperuricemia was analyzed by MDR software. RESULTS: The body mass index, blood uric acid, creatinine, total cholesterol and triglyceride in the case group were higher than those in the control group, the difference was statistically significant( P < 0. 05). There was a significant differences between male cases and control group in the allele frequency of rs1529909( χ~2= 4. 887, P = 0. 027). There had a significant difference in the frequency of rs7929627 between the Hui case and control group( χ~2= 14. 906, P = 0. 002), also a significant difference between the male case and control group( χ~2= 9. 749, P = 0. 021). Additionally, theresult of interaction analysis showed that the distribution of high risk and low risk genotype had a statistically significant difference( χ~2= 8. 338, P = 0. 004). The risk of hyperuricemia with high genotype was 1. 536 times of those who had low-risk genotypes( OR = 1. 536, 95% CI1. 147-2. 057). CONCLUSION: rs1529909 and rs7929627 were associated with hyperuricemia among men. rs7929627 was related to it in the Hui. There may be a strong antagonistic effect on hyperuricemia between rs1529909 and rs7929627.

Grazing effects on ecosystem CO2 fluxes differ among temperate steppe types in Eurasia.

Grassland ecosystems play a critical role in regulating CO2 fluxes into and out of the Earth's surface. Whereas previous studies have often addressed single fluxes of CO2 separately, few have addressed the relation among and controls of multiple CO2 sub-fluxes simultaneously. In this study, we examined the relation among and controls of individual CO2 fluxes (i.e., GEP, NEP, SR, ER, CR) in three contrasting temperate steppes of north China, as affected by livestock grazing. Our findings show that climatic controls of the seasonal patterns in CO2 fluxes were both individual flux- and steppe type-specific, with significant grazing impacts observed for canopy respiration only. In contrast, climatic controls of the annual patterns were only individual flux-specific, with minor grazing impacts on the individual fluxes. Grazing significantly reduced the mean annual soil respiration rate in the typical and desert steppes, but significantly enhanced both soil and canopy respiration in the meadow steppe. Our study suggests that a reassessment of the role of livestock grazing in regulating GHG exchanges is imperative in future studies.