Analysis of the Evolution Pattern and Driving Mechanism of Lakes in the Northern Ningxia Yellow Diversion Irrigation Area

In the northern part of the Ningxia Autonomous Region, there are rich lake resources, which are known as the “South of the Seas”. In recent years, the natural evolution of the water system and human activities have caused significant changes in the lake area. In order to fully understand the evolution of lakes in the northern Ningxia Yellow Irrigation Area, Landsat, Sentinel-2 images and ArcGIS were used to extract relevant information, and the cumulative distance level curve and Mann–Kendall trend analysis were used to analyze the trends of each driving factor in depth. The results showed that (1) the lake surface area in the northern Yellow Diversion Irrigation Area showed a significant increasing trend from 1986 to 2019. (2) The annual average temperature in the Ningxia Yellow River Irrigation Area has shown an increasing trend over the past 39 years, and no year has obvious cyclical changes, but in 1998, there was a sudden change in temperature and the temperature began to rise sharply; the annual average precipitation showed an increasing trend with a large variation, and the annual average precipitation from 1980 to 2018 showed a fluctuating increasing trend. (3) There is no significant linear pattern of runoff from upstream during 1986–2015, and it is characterized by fluctuating changes; the precipitation in the Yellow Irrigation Area is much lower than the average level in Ningxia, and it is classified as a typical arid area; the water consumption is all decreasing, but its linear trend is not significant; the most significant impact of the change in the substratum on the water surface is the construction of fields around the lake after 1990, followed by the Lake engineering treatment. (4) The water surface area of the mainstream is significantly and positively correlated with the incoming water from upstream, is significantly and negatively correlated with the area of grassland, and is significantly and positively correlated with the areas of arable land and construction land. The effect of land cover on the water surface area of the mainstream is lower than that on the water surface area other than the mainstream

Analysis of the Evolution Pattern and Driving Mechanism of Lakes in the Northern Ningxia Yellow Diversion Irrigation Area

In the northern part of the Ningxia Autonomous Region, there are rich lake resources, which are known as the “South of the Seas”. In recent years, the natural evolution of the water system and human activities have caused significant changes in the lake area. In order to fully understand the evolution of lakes in the northern Ningxia Yellow Irrigation Area, Landsat, Sentinel-2 images and ArcGIS were used to extract relevant information, and the cumulative distance level curve and Mann–Kendall trend analysis were used to analyze the trends of each driving factor in depth. The results showed that (1) the lake surface area in the northern Yellow Diversion Irrigation Area showed a significant increasing trend from 1986 to 2019. (2) The annual average temperature in the Ningxia Yellow River Irrigation Area has shown an increasing trend over the past 39 years, and no year has obvious cyclical changes, but in 1998, there was a sudden change in temperature and the temperature began to rise sharply; the annual average precipitation showed an increasing trend with a large variation, and the annual average precipitation from 1980 to 2018 showed a fluctuating increasing trend. (3) There is no significant linear pattern of runoff from upstream during 1986–2015, and it is characterized by fluctuating changes; the precipitation in the Yellow Irrigation Area is much lower than the average level in Ningxia, and it is classified as a typical arid area; the water consumption is all decreasing, but its linear trend is not significant; the most significant impact of the change in the substratum on the water surface is the construction of fields around the lake after 1990, followed by the Lake engineering treatment. (4) The water surface area of the mainstream is significantly and positively correlated with the incoming water from upstream, is significantly and negatively correlated with the area of grassland, and is significantly and positively correlated with the areas of arable land and construction land. The effect of land cover on the water surface area of the mainstream is lower than that on the water surface area other than the mainstream

Heterogeneity Analysis of Spatio-Temporal Distribution of Vegetation Cover in Two-Tider Administrative Regions of China

Vegetation cover is a crucial component of regional ecological environments that plays a vital role in maintaining ecosystem balance. This investigation utilized Google Earth Engine and MODIS NDVI products to examine the spatiotemporal heterogeneity of regional vegetation coverage based on the multi-year average NDVI in China. Using the multi-year average NDVI, multi-year change trend slope, coefficient of variation, and Hurst exponent, the spatial and temporal heterogeneity of provincial and prefectural administrative regions were quantified. The results indicated an upward trend in vegetation coverage from 2000 to 2021 at both provincial and prefectural levels, with growth rates of 0.032/10a and 0.03/10a, respectively. Moreover, the multi-year average NDVI significantly correlated with regional precipitation. Notably, vegetation growth was fastest in the Loess Plateau, while degradation was observed in southern Jiangsu and northern Zhejiang. Additionally, the degree of vegetation cover change in Ningxia and Macau was particularly prominent. These findings support the effectiveness of the Loess Plateau greening project and highlight the potential cost of economic and population growth on the ecosystem in eastern and southeastern coastal areas, where local vegetation degradation occurs. This study can serve as a valuable reference for ecosystem restoration and developmental planning at the administrative regional level, with the goal of enhancing vegetation management and conservation efforts in China

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society