bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clearing the water? The impact of the Central Environmental Protection Inspection on water quality
Authors: Liu Minhui , Yuan Qianqian , Yang Feng 
Published: January 2022

Abstract
This study examined whether China’s Central Environmental Protection Inspection (CEPI), an innovative environmental regulation, has successfully reduced water pollution. We compiled a new water pollution data file and found that the third round of inspection significantly reduced the concentrations of ammoniacal nitrogen (NH3-H) and chemical oxygen demand using potassium permanganate as an oxidizing agent (CODMn) (indicators often mentioned in government reports). However, no improvements were found in DO concentrations (not mentioned in reports). This suggests that a more comprehensive water quality indicator system or standard should be provided in advance to better guide water quality improvement. Additionally, based on the characteristics of the CEPI, this research explored water pollution externalities. We found that the inspection mitigates water pollution externalities across jurisdictional boundaries when it is judged by NH3-N concentrations.
Multi-stakeholder Validation of Entrustable Professional Activities in Family Medicine
Authors: Francois Jose , Clendenning Ben , Fisk Derek , Buchel Tamara 
Published: January 2022

Abstract
Background:The development of Entrustable Professional Activities (EPAs) has generally focused on expert panel approaches, which are often limited to physician stakeholders. Optimally, a much wider group of stakeholders should be consulted and include all people gaining value from trainees’ patient care performance. The present study explored the perceptions of a variety of stakeholder groups regarding the relevance and comprehensiveness of EPAs developed for a Canadian Family Medicine Residency program.Methods: Through the use of an online survey consisting of dichotomous and open-ended questions, this study explored and compared the perceptions of a variety of stakeholder groups (policy makers, health administrators, health professionals, teachers, and public) regarding the relevance and comprehensiveness of 25 EPAs articulated by a family medicine residency program.Results:Agreement on appropriateness of the 25 articulated EPAs ranged from 90% to 100%, displaying a high level of alignment between stakeholders. Stakeholders identify two gap areas within the EPA framework: 1) provision of surgical assistance and 2) addictions care.Conventional content analysis identified three key themes that cut across multiple areas of the survey: 1) Interprofessional collaboration (IPC), 2) Inclusivity, and 3) Scope of EPAs. Comparative analysis consisted of exploring agreements, gaps, and other differences of perspectives between stakeholder groups. Although many of the stakeholder groups made comments regarding IPC and Inclusivity, the patient group in particular was more likely to raise these themes. Comments from patient groups were also overall more general, identifying overarching trends rather than specific pinpoint issues. Physicians, other health professionals, and resident groups, (Ie. health professional groups) on the other hand tended to answer with much more specificity, identifying issues relating to scope of EPAs.Conclusions: The present study demonstrates that a multi-stakeholder approach can feasibly be used to validate an EPA framework. In addition to confirming that a previously articulated set of EPAs largely reflected the range of activities expected of family physicians serving a population, it identified a number of potential areas of improvement in the framework.
Establishing Level-Area-Volume Relationships of Darawat Reservoir Using Time Series Remote-Sensing Images
Authors: Hameed Fahad , Qureshi Muhammad Ateeq , Khalil Rao Muhammad Zahid 
Published: January 2022

Abstract
The study aims to determine the level-area-volume relationship for the newly constructed Darawat reservoir on non-perennial channels located in the Kirthar National park in Jamshoro district of Sindh, Pakistan. Landsat-8, Digital Elevation Model (DEM), Modified Normalized Difference Water Index (MNDWI), and In-situ data, were used. A set of equations represented the relationship between three parameters (Level-area-volume) derived from five different models (exponential, linear, logarithmic, polynomial, and power). Results showed a significant relationship in Level-area-volume. The coefficient of determination showed relationships for water level-surface area range from 0.941 to 0.991, for water level-volume a range reflected from 0.943 to 0.998, and for area-volume represented a range from 0.928 to 0.994. The study estimated results validated by the percentage difference (PD), the root means square error (RMSE), and coefficient of determination (R2) using surface areas of the year 2019 and in-situ water levels. Power model relatively showed the best results, PD=0.227, RMSE=0.335, and R2= 0.982. The study suggests the remote sensing techniques may utilize, if pre-constructed bathymetry data is available, to estimate level-area-volume relationships for rainwater resources management, flood control, and environmental monitoring.
Combining the Multivariate Statistics and Dual Stable Isotopes Methods for Nitrogen Source Identification in Coastal Rivers of Hangzhou Bay, China
Authors: Zhou Jia , Hu Minpeng , Liu Mei , Yuan Julin , Ni Meng , Zhou Zhiming , Chen Dingjiang 
Published: January 2022

Abstract
Coastal rivers contributed the majority of anthropogenic nitrogen (N) loads to coastal waters, often resulting in eutrophication and hypoxia zones. Accurate N source identification is critical for optimizing coastal river N pollution control strategies. Based on a 2-year seasonal record of dual stable isotopes (δ15N-NO– 3 and δ18O-NO– 3) and water quality parameters, this study combined the dual nitrate (NO– 3) stable isotope method and the absolute principal component score-multiple linear regression (APCS-MLR) model to elucidate N dynamics and sources in two coastal rivers of Hangzhou Bay. Water quality/trophic level indices indicated light-to-moderate eutrophication status for the studied rivers. Spatio-temporal variability of water quality was associated with seasonal agricultural, aquaculture and domestic activities, as well as the seasonal precipitation pattern. The APCS-MLR model identified soil + domestic wastewater (69.5%) and aquaculture tailwater (22.2%) as the major nitrogen pollution sources. Further, the dual stable isotope method identified soil N, aquaculture tailwater, domestic wastewater and atmospheric deposition N contributions of 35.3 ±21.1%, 29.7 ±17.2%, 27.9 ±14.5%, and 7.2 ±11.4% to riverine NO– 3 in the Cao’e River (CER) and 34.4 ±21.3%, 29.5 ±17.2%, 27.4 ±14.7%, and 8.7 ±12.8% in the Jiantang River (JTR), respectively. The APCS-MLR model and dual stable isotope method showed consistent results for riverine N source identification. Combining these two methods for riverine N source identifications effectively distinguished the mix-source components from the APCS-MLR method and alleviated the high cost of stable isotope analysis, thereby providing reliable N source apportionment results with low requirements for water quality sampling and isotope analysis costs. Moreover, this study highlights the importance of soil N management and aquaculture tailwater treatment in coastal river N pollution control.
Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder Among Amputees Attending Jaipur Foot Trust Artificial Limb Centre in Kenya
Authors: Mohamed Illham , Mutavi Teresia , Gitau Catherine 
Published: January 2022

Abstract
Background: Amputees have been noted to present with various psychiatric disorders including anxiety, body image disturbances, depression, and Post-Traumatic Stress Disorder (PTSD). However, there is limited data available on the prevalence of anxiety, depression, and PTSD among amputees in Kenya despite the high incidences of amputations in Kenyan hospitals. This study aimed at finding out the prevalence of anxiety, depression, and post-traumatic stress disorder among amputees attending the Jaipur Foot Trust Center in Kenya.Method: This study took a cross-sectional descriptive study design. One hundred and forty-one patients attending the Jaipur Foot Trust were recruited to participate in the study after giving informed consent using a non-probability purposive sampling method. A socio-demographic questionnaire was used to collect socio-demographic characteristics. The Patient Health Questionnaire (PHQ-9) was used to assess the patient's depression. The Generalized Anxiety Disorder (GAD-7) scale was used to assess the patient's anxiety level and The Impact of Event Scale (IES-R) was used to assess the severity of post-traumatic stress disorder (PTSD). Data analysis was done using Statistical Package for Social Science (SPSS) version 23. Results: Findings from this study showed high rates of psychiatric morbidity where two-thirds of the patients reported PTSD (65%) with more than three-quarters of patients being diagnosed with depression (89.4%) and anxiety (91.5%). Also, there was a significant correlation between depression, anxiety, and PTSD, such that participants who had higher scores on anxiety and depression had significantly higher PTSD scores.Conclusion: Anxiety, Depression, and PTSD are very common psychological reactions in patients who have undergone amputation. The researchers expected that some of the sociodemographic factors and some amputation-related characteristics would have a relation with psychiatric comorbidity. However, the findings of this study did not show any such relationship except the relation between anxiety, depression, and PTSD. Early psychological assessment and interventions after amputations will help alleviate psychological distress
An evaluation of the efficacy of percutaneous screw fixation without bone grafting in Sanders Type-II and Type-III displaced intra-articular calcaneal fractures
Authors: Luo Gang , Fan Chongyin , Gao Peili , Huang Wei , Ni Weidong 
Published: January 2022

Abstract
Background: The aim of this retrospective monocentric study was to investigate the clinical efficacy of percutaneous screw fixation without bone grafting in Sanders Type II and Type III displaced intra-articular calcaneal fractures (DIACFs).Methods: This retrospective case–control study analysed 38 patients with type Sanders Type-II and Type-III DIACFs admitted from January 2018 to January 2020, including 30 males and 8 females aged 21 to 61 years [(42.6±9.6) years]. According to the Essex-Lopresti classification, 27 of the fractures were the tongue type, and 11 were the joint compression type. According to the Sanders classification, 27 of the fractures were type II, and 11 were type III. All patients were treated with percutaneous screw fixation, and no patients received bone grafting. The radiologic parameters evaluated included the BÖhler angle, Gissane angle and height of the calcaneum. In addition, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores, Maryland Foot Score (MFS), and visual analog scale (VAS) score were determined.Results: All patients were followed up for 18-42 months [(25.2±9.5) months]. All fractures healed, and immediately postoperatively, the calcaneal height had recovered to 39.8±2.1 mm, the BÖhler angle had recovered from 4.2°±13.6° preoperatively to 27.2°±3.4° (P=0.000) immediately postoperatively, and the Gissane angle had recovered from 103.3°±9.7° preoperatively to 129.6°±5.1° (P =0.000). No differences were found in the outcome measures six-months postoperatively (BÖhler angle, p=0.24; Gissane angle, p=0.77; calcaneal height, p=0.82) or at final follow-up (BÖhler angle, p=0.33; Gissane angle, p=0.69; calcaneal height, p=0.28) compared to the immediately postoperative values. At the final follow-up, the AOFAS score was 91.7±7.4 points, with an excellent and good rate of 92.1%; the MFS was 90.3±7.8 points, with an excellent and good rate of 92.1%; and the VAS score was 2.2±1.5 points. None of the patients had incision complications, and one patient developed traumatic arthritis.Conclusion: Percutaneous screw fixation without bone grafting in Sanders Type-II and Type-III DIACFs can achieve good recovery and maintenance of the BÖhler angle, Gissane angle and calcaneum height. Moreover, it has the advantage of a low complication rate.
Cyanobacterial diversity through culture-dependent and independent approaches in Chapada das Mesas National Park, Maranhão, Brazil
Authors: Butarelli Ana Carolina de Araújo , Ferreira Lucas Salomão de Sousa , Riyuzo Raquel , Dall'Agnol Hivana Melo Barbosa , Piroupo Carlos Morais , Silva Aline Maria da , Setubal João Carlos , DallAgnol Leonardo Teixeira 
Published: January 2022

Abstract
The Chapada das Mesas National Park (CMNP) is a Conservation Unit in brazilian Cerrado biome, which is considered a hotspot for biodiversity conservation and possess important rivers, waterfalls and springs with economical and touristic importance. This study objective was to characterize the total and microbial photosynthetic community of the CMNP from surface sediment samples from waterfalls of two touristic sites: Pedra Caída and Farinha river. These samples were cultivated in selective medium for photosynthesizers and both the raw samples and the enriched ones were submitted to DNA extraction and sequencing of the V3-V4 hypervariable region of the 16S rRNA gene on the Ion Torrent platform. The reads were analyzed using QIIME2 software and the Phyloseq package. The enrichment allowed detecting and identifying many genera of cyanobacteria in the Chapada das Mesas National Park, which would probably not be possible without the combination of approaches. A total of 34 genera of photosynthetic microorganisms were classified in the samples from the consortia, highlighting “Chloroplast” (45.60%) and Synechocystis_CCALA_700 (10.10%) as the most abundant groups in the tropical alkaline lakes of Maranhão. As for the functional analysis, metabolic functions associated with methanotrophy and methylotrophy, hydrocarbon degradation, phototrophy and nitrogen fixation were predicted. The results highlight a great diversity of photosynthetic microorganisms in Cerrado and the importance of using a combination of approaches when analyzing target groups who usually are underrepresented like photosynthetizers.
Central Asia Subtropical Westerly Jet Influences Interannual Variability of Northwest Indian Summer Monsoon rainfall
Authors: Sadaf Nabeela , Lin Yanluan , Dong Wenhao 
Published: January 2022

Abstract
In addition to various factors over the tropics, the interannual variability of northwest Indian summer monsoon (NWISM) rainfall is also regulated by extratropical signals. We defined a subtropical westerly jet index (SWJI) based on the meridional position and intensity of 200-hPa zonal wind within [25-55°N, 40-90°E]. It is found that SWJI exhibits a significant positive correlation with summer rainfall over the NWISM region during 1951-2015. During positive (negative) SWJI years, an upper-level anticyclonic (cyclonic) anomaly over Central Asia along with positive (negative) rainfall anomaly and low-level easterly (westerly) anomalies were observed over the NWISM region. The upper-level anticyclonic (cyclonic) anomaly was accompanied by the descending (ascending) motion and warm (cold) tropospheric temperature anomalies. The anticyclonic (cyclonic) anomaly increased (decreased) the land-ocean thermal contrast by warm (cold) air advection and modified the local meridional circulation. Interannual variability of rainfall over the NWISM region is associated with the meridional position and intensity of the jet that manifest in both upper- and low-level circulation anomalies. Further analysis showed that the interannual variability of SWJI is correlated with Arctic Oscillation (AO). During the positive phase of AO, an upper-level anticyclonic anomaly appeared over Central Asia and favored convection over the NWISM region.
Real-world Effectiveness of Casirivimab Plus Indevimab in a Dedicated Ambulatory Unit Created for Patients With Early COVID During a Massive Delta Variant Wave
Authors: Markowicz Samuel , Trioux Theo , Rulquin Clemence , Guillou Chloé Le , Ouissa Rachida , Loraux Cécile , Saliège Marion , Roger Pierre-Marie 
Published: January 2022

Abstract
Only few data are available on real-life effectiveness of neutralizing monoclonal antibodies to avoid hospitalization in high-risk patients with early COVID-19 not requiring supplemental oxygen. Our study analyzed the efficacy of casirivimab plus indevimab to prevent unfavorable outcomes in these patients. A dedicated Hospital Day Unit was created to treat during our 4th COVID wave 217 patients infected by the Delta variant. Mean age was 64 years, 94% had at least one comorbidity, and mean duration of symptoms was 2.9 days. Oxygen request, hospitalization, and mortality rates were respectively of 10, 6, and 2.8%. These results suggest efficacy of neutralizing antibodies infused in a dedicated ambulatory unit created for high-risk patients infected with a Delta variant at an early stage.
Magnesium Fertilizer Application and Soil Warming Improves Magnesium Absorption and Yield of Tomatoes in Greenhouse
Authors: Li Junliang , Jin Shengai , Zhou Weiwei , Meng Lifen , Song Xiangyun , Chen Qing , Shi Honglei , Wang Yuxia 
Published: January 2022

Abstract
Background: Magnesium (Mg) is an essential macronutrient that plays an important role in numerous physiological and biochemical processes in plants. However, Mg deficiency is common worldwide, especially in greenhouse vegetable systems, due to the overuse or misuse of fertilizers. This study aimed to investigate different Mg application strategies for alleviating Mg deficiency in tomatoes grown in a greenhouse vegetable system. Methods: Six field treatments were used: the farmer conventional fertilization practice (CK), CK + soil application of Mg fertilizer (MgS), CK + foliar spray of Mg fertilizer (MgF), CK + the combination of soil and foliar spray of Mg fertilizer (MgSF), CK + soil warming (T), and MgSF + soil warming (MgSFT). Results: The results showed that the foliar spray of Mg fertilizer treatments (MgF, MgSF, and MgSFT) increased the total Mg uptake and Mg content of functional leaves in both winter-spring and autumn-winter seasons. Soil warming treatments (T and MgSFT) were also beneficial for Mg uptake and chlorophyll biosynthesis compared with no-warming treatments (CK and MgSF), especially in the autumn-winter season. Additionally, Mg fertilizer application and soil warming increased tomato yields; the MgSFT treatment had the highest increase in yields compared with the CK treatment.Conclusion: Therefore, foliar Mg fertilizer application combined with soil warming, while considering seasonal variation, is feasible for reducing Mg deficiency in tomatoes under greenhouse vegetable systems.
“SDM:HOSP” – A Generic Model for Hospital-Based Implementation of Shared Decision Making
Authors: Steffensen Karina Dahl , Hansen Dorte Gilsa , Espersen Kurt , Lauth Susanne , Fosgrau Peter , Pedersen Anders Meinert , Groen Peter Sigerseth , Sauvr Christian , Olling Karina 
Published: January 2022

Abstract
Background: Shared decision making (SDM) is a core element in the meeting between patient and healthcare professionals, but has proved difficult to implement and sustain in routine clinical practice. One of the five Danish regions responsible for public health care set out to succeed and to develop a model that can ensure lasting SDM based on learnings from large-scale real-world implementation initiatives that go beyond the 'barriers' and 'facilitators' research approach. This paper aims to describe this process and the development of a generic model, SDM:HOSP for systematic implementation of SDM at somatic and mental health care hospitals.Methods: This project was carried out in the Region of Southern Denmark with five major hospital units, including mental health care service. Based on existing theory of SDM, SDM implementation, implementation science including the System of Profound Knowledge and The South Danish Improvement Model, a process of four phases were described; development of conceptual elements, field-testing, evaluation, and development of the final implementation model. The conceptual elements developed aimed to train leaders, teach clinicians to become SDM teachers, clinicians to perform SDM, support development of patient decision aids (PtDAs), and support systematic planning, execution and follow-up of the implementation. Field testing was done including continuous participant evaluations. After one year of implementation, an overall evaluation was done. Results: Data from field testing and learnings from the implementation process, illustrated the need for a dynamic and easy adjustable model. The final SDM:HOSP model included four themes; i)Training of Leaders, ii) Training of Teachers and Clinicians, iii) Decision Helper, and iv) ‘Process’, each with details in three levels, 1) shared elements, 2) recommendations, and 3) local adaption. Conclusions: A feasible and acceptable generic model for implementation of SDM across hospitals and departments that accounts for different organizations and cultures was developed. The overall design can easily be adapted to other organizations and can be adjusted to fit the specific organization and culture. The results from the ongoing and overall evaluation suggest promising avenues for future work in further testing and research of the usability of the model.
An Immune Gene Signature for Prediction of Overall Survival and Response to Immune Checkpoint Inhibitors Therapy in Patients with Lung Adenocarcinoma
Authors: Chen Hongquan , Lin Renxi , Lin Weibin , Chen Qing , Ye Dongjie , Li Jing , Feng Jinan , Cheng Wenxiu , Zhang Mingfang , Qi Yuanlin 
Published: January 2022

Abstract
Lung adenocarcinoma is one of the most common malignant tumors worldwide. The purpose of this study was to construct a stable immune gene signature for prediction of prognosis (IGSPP) and response to immune checkpoint inhibitors (ICIs) therapy in LUAD patients. Five genes were screened by weighted gene coexpression network analysis, Cox regression and LASSO regression analyses and were used to construct the IGSPP. The survival rate of the IGSPP low-risk group was higher than that of the IGSPP high-risk group. Multivariate Cox regression analysis showed that IGSPP could be used as an independent prognostic factor for the overall survival of LUAD patients. IGSPP genes were enriched in cell cycle pathways. IGSPP gene mutation rates were higher in the high-risk group. CD4 memory-activated T cells, M0 and M1 macrophages had higher infiltration abundance in the high-risk group, which was associated with poor overall survival. In contrast, the abundance of resting CD4 memory T cells, monocytes, resting dendritic cells and resting mast cells associated with a better prognosis was higher in the low-risk group. TIDE scores and the expressions of different immune checkpoints showed that patients in the high-risk IGSPP group benefited more from ICIs treatment. In short, an IGSPP of LUAD was constructed and characterized. It could be used to predict the prognosis and benefits of ICIs treatment in LUAD patients.