bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flood-based Critical Sub-Watershed Mapping: Comparative Application of MCDM and Hydrological Modeling Approach
Authors: Khiavi Ali Nasiri Nasiri , Vafakhah Mehdi , Sadeghi Seyed Hamidreza 
Published: June 2022

Abstract
The effects of Sub-Watersheds (SWs) on each other can be more important in Flood Generation Potential (FGP). Therefore, the present study aims for prioritizing SWs based on FGP using Multi-Criteria Decision Making (MCDM) Methods including Game Theory (GT), Best-Worst Method (BWM), Analytic Hierarchy Process (AHP), Analytical Network Process (ANP), Fuzzy Analytic Hierarchy Process (FAHP), Fuzzy Analytical Network Process (FANP) and comparing its results with Hydrological Modeling Approach (HMA) in the Cheshmeh-Kileh Watershed, Iran. In GT, Condorcet algorithm were used. The best and worst criteria were identified using the BWM and compared with other criteria. In AHP and ANP, expert opinions were used and the final weight of criteria and alternative was calculated using Expert Choice and Super Decision softwares. ArcGIS10.1 software was also used to fuzzy and provide FAHP and FANP. In HMA, HEC-HMS software was used to calculate the discharge with return periods of 10- and 100-year, and finally, in all methods, FGP maps were prepared in three classes and SWs were prioritized. Based on the results of different methods, SWs 9, 2, 7, 10 and 11 were given high FGP priority. Downstream SWs were also in a non-critical state due to dense forest cover and low slope. A comparative evaluation between the methods showed that BWM had the same result as the field evidence and HMA results and this method provided the best result. Based on SWs prioritization in BWM, high and low FGP were 33.33 and 46.67% of the study area, respectively. After BWM, GT gave a relatively good result. AHP, ANP, FAHP and FANP presented different results, but had poor performance in identifying critical areas. This study showed that optimal MCDM approaches can be used for flood management.
Effect of intravenous fluid volume on biomarkers of endothelial glycocalyx shedding and inflammation during initial resuscitation of sepsis
Authors: Macdonald Stephen , Bosio Erika , Keijzers Gerben , Burrows Sally , Hibbs Moira , O’Donoghue Helen , Taylor David , Mukherjee Ashes , Kinnear Frances , Smart Lisa , Ascencio-Lane Juan-Carlos , Litton Edward , Fraser John , Shapiro Nathan I. , Arendts Glenn , Fatovich Daniel 
Published: June 2022

Abstract
INTRODUCTIONIntravenous (IV) fluid resuscitation is recommended first line therapy in septic shock, but the effectiveness and safety of this approach has been questioned. To investigate potential mechanisms of harm from IV fluid resuscitation, we measured biomarkers of endothelial glycocalyx (EG) shedding, activation of the vascular endothelium and inflammation over the first 24 hours in a clinical trial comparing a fluid-restricted resuscitation regimen to usual care with no IV fluid restriction. METHODSA planned biomarker sub-study of the REFRESH trial in which emergency department (ED) patients) with suspected sepsis and a systolic blood pressure of <100mmHg after at least 1000ml of crystalloid fluid were randomised to restricted fluids (with a vasopressor infusion if needed to restore perfusion targets) or additional IV fluid resuscitation with later vasopressor if required (usual care). Blood samples were collected at randomisation (T0) and at 3 hours (T3), 6 hours (T6)- and 24 hours (T24) for measurement of Pro-Atrial Natriuretic Peptide (Pro-ANP); EG biomarkers - Syndecans 1 & 4 (SYN-1, SYN-4), Hyaluronan, Heparan Sulphate; Endothelial cell markers - Vascular Cell Adhesion Molecule (VCAM), Intercellular Adhesion Molecule (ICAM), E-selectin, Vascular Endothelial Growth Factor 1 (VEGFR-1); and inflammatory biomarkers - Interleukins 6 & 10 (IL-6, IL-10), Neutrophil Gelatinase Associated Lipocalin (NGAL) and Resistin. RESULTSBlood samples were obtained in 95 of 99 enrolled patients (46 usual care, 49 restricted fluid). Differences in the change in biomarker over time between the groups were observed for Hyaluronan (2.2-fold from T3-T24, p=0.03), SYN-4 (1.5-fold T3 to T24, P=0.01) and IL-6 (2.5-fold from T0 to T3, p=0.03). No difference over time was observed between groups for the other biomarkers. CONCLUSIONSDifferences in the change over time for Hyaluronan, SYN-4 and IL-6 were observed during the first 24 hours among patients with suspected sepsis randomised to difference resuscitation regimens. This supports the hypothesis that IV fluids can lead to shedding of the endothelial glycocalyx and promote inflammation. Conversely no effect was seen for other EG components (SYN-1 and Heparan Sulphate), or for a range of endothelial activation and inflammatory markers. TRIAL REGISTRATIONAustralia New Zealand Clinical Trials Registry ACTRN126160000006448 Registered 12 January 2016
Anthropometric characteristics and body composition of Taiwanese older adults: Age and gender differences
Authors: Su Yan-Jhu , Lee Po-Fu , Lin Chi-Fang , Hung Chang-Tsen , Chen Yun-Tsung , Lo Kai-Yang , Chen Hui-Ling , Ho Chien-Chang 
Published: June 2022

Abstract
A previous study provided reference data on the age and gender distribution of anthropometric parameters in Taiwanese adults. However, there are few large-scale analyses of anthropometric data of older adults in Taiwan. Therefore, the main purpose of this study was to describe gender- and age-specific distributions of anthropometric measurements and body composition of Taiwanese older adults. This was a cross-sectional study conducted on 22,389 older adults who participated in Taiwan’s National Physical Fitness Survey 2014–2015.The anthropometric measurements and body composition included in the present study were assessment of height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The results showed statistically significant differences in weight, height, WC, HC, and WHR among Taiwanese individuals aged 65 years and older. However, there was no significant difference in BMI between men and women in our sample. Anthropometric status provides an initial assessment of the overall health of the population. This study uses a representative population of Taiwanese older adults over the age of 65 for analysis and provides detailed information on anthropometric data distribution.
Utilization and influencing factors of Magnetic Resonance Imaging in Three Provinces in China
Authors: Jiang Zhi-xin , Wei Yan , Chen Ying-yao 
Published: June 2022

Abstract
Background: The annual utilization of Magnetic resonance imaging (MRI) can show trends in the hospital setting and the policy implications. The Chinese government launched a new health care system reform in 2009. The reform focused on reconstructing the public hospitals and expanding primary health care. The objective of this paper is to describe the utilization of MRI services in three provinces of China during the nine years from 2009 to 2017 after the health care system reform and identify the influencing factors.Methods: We collected data from the information system and the database of 46 sample hospitals in three provinces. The approval of the research ethics board was not required as the study involved no individual patient information. The panel data was constructed to calculate the utilization rate. The research team also built the random-effects and the fixed-effect model to analyze the relevant factors.Results: The utilization of MRI services in China increased from 2009 to 2017. The average utilization rate of MRI equipment in the outpatient and emergency was 1.07%, which was relatively stable and far less than that of hospitalization (18.89%). Panel regression analysis indicates that the number of MRI equipment and beds significantly impacts utilization.Conclusion: The study demonstrated a sharply increasing trend of MRI utilization in China since the new medical reform, and also of waiting time brings both clinical benefits and financial burden. It will be possible to set up regional image centers, which may improve the efficiency of existing idle devices, and alleviate the problem of long waiting in tertiary hospitals.
Factors Shaping Good and Poor Nurse-Client Relationships in Maternal and Child Care in Rural Tanzania
Authors: Isangula Kahabi , Pallangyo Eunice Siaity , Mbekenga Columba , Ndirangu-Mugo Eunice , Shumba Constance 
Published: June 2022

Abstract
Background
Evidence indicates that poor nurse-client relationships within maternal and child health (MCH) continues to impact trust in formal healthcare systems, service uptake, continuity with care and MCH outcomes. This necessitates contextualized innovative solutions that places both nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation. This study explored nurses and clients’ perspectives on the factors shaping nurse-client relationships in MCH care to generate evidence to guide designing effective strategies for improving therapeutic relationships by piloting human-centered design (HCD) in Shinyanga, Tanzania.
Methods
Qualitative descriptive design was employed. About 9 Focus Group Discussions (FGDs) and 12 Key Informant Interviews (KIIs) with purposefully selected nurses and midwives, women attending MCH services and administrators were conducted using semi-structured interview guides in Swahili language. Data were transcribed and translated simultaneously, managed using Nvivo Software and analyzed thematically.
Results
Factors shaping nurse-client relationships were heuristically categorized into nurse, client and health system factors. Nurse contributors of poor relationship ranged from poor reception and hospitality, not expressing care and concern, poor communication and negative attitudes, poor quality of services, job dissatisfaction and unstable mental health. Client contributors of poor relationship include being ‘much know’, late attendance, non-adherence to procedures and instructions, negative attitudes, poor communication, inadequate education and awareness, poverty, dissatisfaction with care, faith in traditional healers and unstable mental health. Health system contributors were inadequate resources, poor management practices, inadequate policy implementation and absence of an independent department or agency for gathering and management of complaints. Suggestions for improving nurse-client relationship included awards and recognition of good nurses, improving complaints mechanisms, continued professional development, peer to peer learning and mentorship, education and sensitization to clients, improving service quality and working conditions, improving renumeration and incentives, strengthening nursing school’s student screening and nursing curriculum and improving mental health for both nurses and clients.
Conclusions
The factors shaping poor nurse- client relationships appear to extend beyond nurses to both clients and healthcare facilities and system. Implementation of effective interventions for addressing identified factors considering feasibility and acceptance to both nurses and clients using novel strategies such as HCD could pave the way for employing good nurse-client relationships as a tool for improving performance indicators and health outcomes within MCH care.
Perfusion Change of Hepatocellular Carcinoma during Atezolizumab plus Bevacizumab Treatment: A Pilot Study
Authors: Onuoha Ezinwanne , Smith Andrew D. , Cannon Robert , Khushman Mohd , Kim Harrison 
Published: June 2022

Abstract
Purpose
To investigate whether the early perfusion change in hepatocellular carcinoma (HCC) predicts the long-term therapeutic response to atezolizumab plus bevacizumab.
Methods
We retrospectively selected 19 subjects (median age: 62 years, 4 females and 15 males) having advanced HCC and treated with atezolizumab alone (n = 3) or in combination with bevacizumab (n = 16). The 4-phased CT or MRI imaging was performed for each subject before and at 9 ± 2 and 21 ± 5 weeks after therapy initiation. The tumor-to-liver signal ratio in the arterial phase was used to estimate the tumor perfusion. The change in tumor perfusion from the baseline to the 1st follow-up exam was correlated with the tumor response evaluated using mRECIST at the 2nd follow-up exam. The difference between favorably responding and non-responding groups was statistically analyzed using one-way ANOVA.
Results
The mean tumor long axis in the baseline image was 59 ± 47 mm. The HCC perfusion changes were − 26 ± 18% for complete (or partial) response (CR/PR, n = 8), -24 ± 12% for stable disease (SD, n = 8), and 9 ± 13% for progressive disease (PD, n = 3). The HCC perfusion change of the CR/PR groups was significantly lower than that of the PD group (p = 0.0040). The HCC perfusion changes between the SD and PD groups were also significantly different (p = 0.0135). The sensitivity and specificity of the early perfusion change to predict the long-term progressive disease were 100% and 94%, respectively.
Conclusion
The early change in HCC perfusion may predict the long-term therapeutic response to atezolizumab plus bevacizumab, promoting personalized treatment for HCC patients.
Mental health task-sharing in South Africa – a role for clinical associates?
Authors: Moodley Saiendhra Vasudevan , Wolvaardt Jacqueline , Grobler Christoffel 
Published: June 2022

Abstract
BackgroundSouth Africa (SA) lacks the specialised workforce needed to provide mental health services particularly in the public sector and in rural areas. Mid-level medical workers offer a potential option for mental health task-sharing in countries where they exist including SA. The objectives of the study were to explore the roles that SA’s mid-level medical worker cadre (clinical associates) could play in mental health service delivery, and to explore views on advanced training in mental health for this cadre.MethodsThis was an explorative, qualitative study involving key informants linked to the three clinical associate training programmes in SA. A total of 19 in-depth interviews were conducted with university-based academic staff, facility-based trainers, and student representatives. The interviews were audio-recorded and professionally transcribed. Atlas.ti software was used to analyse the data and themes were identified.ResultsTwo themes were identified viz. ‘there is a place for them at the table’ and ‘earning a seat at the table’. Participants felt that there was a definite role for clinical associates in mental health service provision. The levels of care thought most appropriate were primary health care facilities and district hospitals. The most frequently identified role for clinical associates was in providing immediate care and stabilising mental health patients presenting in emergency settings. Other potential settings included inpatient wards, outpatients’ departments, and in communities (e.g. home visits). There was virtually unanimous support for additional training and in particular a postgraduate clinical specialisation in mental health . Participants felt a clinical specialisation in mental health would strengthen the health system by addressing workforce shortages as well as access and equity issues. They also held the view it would strengthen the profession by creating a career path and providing more employment opportunities for clinical associates.ConclusionsThere was broad support for a role for clinical associates in mental health service delivery in SA as well as for the establishing a clinical specialisation in mental health for clinical associates. Clinical associates with advanced training in mental health could potentially play an important role in rural settings to alleviate the shortage of specialist mental health practitioners.
Frictional energy dissipation due to phonon resonance in two-layer graphene system
Authors: Wei Zhiyong , Tao Yi , Lu Xi , Kan Yajing , Zhang Yan , Chen Yunfei 
Published: June 2022

Abstract
The frictional energy dissipation mechanism of a supported two-layer graphene film under the excitation of the model washboard frequency is investigated by molecular dynamics simulations. The results show that two local maxima in the energy dissipation rate occur at special frequencies as the excitation frequency increases from 0.1 to 0.6 THz. By extracting the vibrational density of states of the graphene, it is found that large numbers of phonons with frequencies equal to the excitation frequency are produced. A two-degree of freedom mass-spring model is proposed to explain the molecular dynamics results. Our study indicates that the phonons would resonate with the frictional excitation once the washboard frequency is close to the natural frequency of the frictional system, leading to remarkable local maxima in energy dissipation rate.
An Analysis of the Perspective of Last Year Medical Students in Training Allocated to Manage COVID-19 Hospital Patients in Mexico
Authors: Moreno Gabriela Y.C. , Ruiz Miguel Jesús Torres , Padilla Eleazar Lara , Zarazúa Rosalba Garduño , Vadillo Antonio Franco , Romero José de Jesús Peralta , Ramírez José Bruno Mendoza , Heald Adrian , Ramírez Javier Mancilla 
Published: June 2022

Abstract
BackgroundIn order to address the COVID-19 pandemic, health systems have used all their resources, including health care workers in training. Knowing the insights of these workers is of the utmost importance to generate adequate educative/political /administrative strategies. Methods An anonymous cross-sectional online survey was made by the General Directorate of Quality and Health Education in Mexico, in a convenience sample of 6,020 participants who belong to personnel in training for the health area, which included practitioners and professional technologists, undergraduate doctors, nursing, and residents in several specialties.ResultsDifferent positive and negative feelings were identified by the health workers who participated in facing this health emergency; emphasizing elements such as the need for Personal Protection Equipment (PPE) that, when deficient or lacking, generate concerns that raise questions about the medical/epidemiological attention to the pandemic. Based on an analysis of feelings, 8 main feelings were identified, which by frequency of appearing were: distrust(24.83%), fear(21.97%), sadness(12.45%), anticipation(11.65%), anger(10.71%), disgust(9.69%), joy(4.97%) and surprise(3.72%) which influence health workers in training and their wrok performance day to day.Concerning their positive and negative evaluation of their experience facing this health emergency, 13.83% of participants had a positive perception about participating in this kind of health emergency to support the country, 49.94% showed a negative evaluation, and 36.23% kept a neutral evaluation about their participation.ConclusionsThe health workers in training in Mexico gave a negative evaluation of the management of the health emergency. Distrust as a response to the absence of timely information from the education/health institutions, as well as concern about lack of personal protection equipment/inputs, are the main conflicts reported. We must establish a credible globally relevant continuity plan for the education of health care personnel in training, facing emergencies and disasters, so that next time we are properly prepared.
A comparative assessment of CMIP5 and CMIP6 in hydrological responses of the Yellow River Basin, China
Authors: Guo Yuxue , Yu Xinting , Xu Yue-Ping , Wang Guoqing , Xie Jingkai , Gu Haiting 
Published: June 2022

Abstract
Investigation of the role of multiple general circulation model (GCM) ensembles in obtaining comprehensive knowledge of hydrological responses across the Yellow River Basin (YRB), China, is still of substantial importance. This study evaluates the performance of the Coupled Model Intercomparison Project Phase 6 (CMIP6) models in simulating the hydrological regime in the YRB and compares the results with those from CMIP 5 (CMIP5). The comparison is performed between 21 GCMs from CMIP6 under three Shared Socioeconomic Pathway scenarios and 18 GCMs from CMIP5 under three Representative Concentration Pathway scenarios. Raw CMIP outputs are first corrected and downscaled by the Bias Correction and Spatial Disaggregation methods, and the bias-corrected GCM outputs are then employed to drive the Soil and Water Assessment Tool hydrological model and project streamflow. After correction and downscaling, areal averages for future changes (relative to 1971–2000) of temperature and precipitation are found larger in CMIP6 than in CMIP5. The emblematic annual mean temperature of CMIP6 increases by 1.64–2.20 and 2.31–5.29 °C for the future period of 2026–2055 and 2066–2095, while the counterpart of CMIP5 is 1.92–2.39 and 1.68–4.76 °C, respectively. In terms of precipitation, for CMIP6, it increases by 3.45–4.70 and 6.77–15.40%, and for CMIP5 by 2.58–2.96 and 3.83–9.95%. It is further concluded that: (1) future streamflow will probably decrease less under CMIP6 than that under CMIP5 in most cases, and climate changes of this kind will affect regional water supply and security in the YRB; (2) uncertainty in the projected streamflow is dominated by GCMs uncertainty with the contribution rate of &gt;75%; (3) the streamflow is more sensitive to precipitation changes in comparison with temperature changes in the near future. In contrast, streamflow reduction is more attributed to an increase in temperature with a contribution rate of almost &gt;60% than in precipitation in the far future.
Quantifying water-related ecosystem services potential of the Kangchenjunga Landscape in the eastern Himalaya: a modeling approach
Authors: Shrestha Manish , Nepal Santosh 
Published: June 2022

Abstract
Quantifying water-related ecosystem services (WES) helps to secure limited and valuable water resources sustainably. Mainstreaming these ecosystem services into policy and decision-making requires accurate information at the local level. This paper aims to quantify provisioning and regulating freshwater ecosystem services potential in the Kangchenjunga Landscape using a hydro-ecological model. This study is the first to use the J2000 hydrological model to estimate annual and seasonal WES. The model output was validated against snow-cover and river discharge, after conducting a sensitivity analysis of the input parameter. High precipitation and low evapotranspiration resulted in rich water availability in the landscape. It was found that the precipitation amount in the landscape is highly seasonal, resulting in high variation in water availability. Snowfall, accounting for 4% of the total precipitation still plays an important role in regulating water resources. Nearly 100% of the discharge during the dry period originates from groundwater and melt runoff. This study highlights the importance of the presence of snow and glacier to sustain the ecosystem in the landscape. This model-derived information could further be used for decision-making and evaluating the impact of climatic and land use changes.