Average Annual Decrease Research Articles

The statistical projection of global GHG emissions from a consumption perspective

Projections of future emissions based on current trends are vital to assess the performance of mitigation efforts and to devise mitigation strategies. However, previous studies are uncertain how the persistence and convergence of mitigation efforts may impact future trajectories from the consumption perspective. Here we assume regional convergence over time after finding strong supporting historical evidence and develop a Markov Chain Monte Carlo (MCMC) Bayesian analysis of historical and projected consumption-based emissions during 1995–2050 via a modified Kaya identity. We find global emissions of 21–94 GtCO 2 eq yr −1 by 2050, slightly higher than SSP1-2.6 and encompassing SSP3-7.0, resulting in 1.4–2.9 °C of warming above pre-industrial levels mid-way through the century. The median projection shows a 2028 peak of 42 GtCO 2 eq yr −1 and an annual average decrease of 0.25 GtCO 2 eq thereafter. Future emission decreases result from the interplay between a rapid reduction driven by decreasing consumption-based emission intensities, especially in clothing and transport, and the change of final demand structure (−1.53 GtCO 2 eq yr −1 ) against increases from economic and population growth (+1.33 GtCO 2 eq yr −1 ). This highlights the importance in continually updating projections and considering models that reflect convergence and consumption structure changes, in order to better inform climate policy.

Analysis of Vertical Distribution Changes and Influencing Factors of Tropospheric Ozone in China from 2005 to 2020 Based on Multi-Source Data.

The vertical distribution of the tropospheric ozone column concentration (OCC) in China from 2005 to 2020 was analysed based on the ozone profile product of the ozone monitoring instrument (OMI). The annual average OCC in the lower troposphere (OCCLT) showed an increasing trend, with an average annual increase of 0.143 DU. The OCC in the middle troposphere showed a downward trend, with an average annual decrease of 0.091 DU. There was a significant negative correlation between the ozone changes in the two layers. The monthly average results show that the peak values of OCCLT occur in May or June, the middle troposphere is significantly influenced by topographic conditions, and the upper troposphere is mainly affected by latitude. Analysis based on multi-source data shows that the reduction in nitrogen oxides (NOx) and the increase in volatile organic compounds (VOCs) weakened the titration of ozone generation, resulting in the increase in OCCLT. The increase in vegetation is closely related to the increase in OCCLT, with a correlation coefficient of up to 0.875. The near-surface temperature increased significantly, which strengthened the photochemical reaction of ozone. In addition, the increase in boundary layer height also plays a positive role in the increase in OCCLT.

Prevalence and Incidence Rates of Atrial Fibrillation in Denmark 2004-2018.

To estimate the prevalence and incidence of atrial fibrillation (AF) in Denmark during 2004-2018 and to investigate whether methodological choices influence these estimates. A register-based cohort study was conducted of all individuals aged ≥18 years in Denmark 2004-2018. The cumulative prevalence of AF at the end of the study period was calculated as the number of AF cases alive with at least one inpatient or two outpatient diagnoses during 1994-2018 divided by the number of Danish residents in 2018. Incidence rates were calculated as the number of annual AF cases with no previous diagnosis in the past 10 years (ie, a 10-year washout period) divided by the person-time contributed by the population free of AF on 1 January in the same calendar year. Furthermore, the influence of varying case definitions was investigated. The cumulative prevalence of AF was 3.0% in 2018. The incidence rate increased from 391 to 481 per 100,000 person-years (PYs) from 2004 to 2015 (1.7% average annual increase) after which it declined to 367 per 100,000 PYs in 2018 (8.5% average annual decrease). This pattern was observed in both sexes irrespective of age. Methodological choices, particularly the case definition's strictness and the length of the washout period, had a substantial influence on the reported estimates. The cumulative prevalence of AF is currently around 3.0% in the Danish population, but the incidence has declined since 2015. As these estimates are influenced by methodological choices, future studies should strive for precise reporting of study methodology.

Global spatial distribution of vegetation and 20-years dynamic changes

Global spatial distribution of vegetation is determined jointly by climate, monsoon, ocean current and human activities. In recent decades, surface vegetation changes caused by global warming, extreme climate events and intensified human activities need a further understood. In this paper, we adopted available MODIS land cover dataset (MCD12Q1) to investigate the spatial distribution feature of global vegetation sand dynamics during the past 20 years. Results show that: (1) the spatial distribution pattern of global vegetation formed by the long-term ecosystem evolution exhibits stable with less variation in both latitude and vertical dimensions. Generally, the percent of forest, shrubland, grass and cropland respectively are 15.27%, 9.39%, 39.46% and 8.91% of surface covers, with a distinct land cover transition trend from rainforest at equator region to moss and lichen at the north and south pole. (2) In the past 20 years, the global forest land decreased by 3.0×105 km2, with an average annual decrease of 1.255%, open shrubs experienced slight fluctuations in 2001-2017 and increased sharply by 1.6×105 km2 in 2017-2018. And the grassland, croplands and cropland/natural vegetation mosaics had different degrees of growth rate, with an average annual dynamic increase of 0.021%, 0.019% and 0.502%, respectively. (3) There are about 4.2×106 km2 of forest changed into grassland in West Siberia and the Amazon, and 2.5×106 km2 of grassland into shrubs, as well as 1.9×106 km2 of grassland vegetation into farmland, and 9.4×104 km2 of forest into shrubs.

Spatial and Temporal Characteristics and Drivers of Agricultural Carbon Emissions in Jiangsu Province, China.

Scientific measurement and analysis of the spatial and temporal distribution characteristics of agricultural carbon emissions (ACEs) and the influencing factors are important prerequisites for the formulation of reasonable ACEs reduction policies. Compared with previous studies, this paper fully considers the heterogeneity of rice carbon emission coefficients, measures and analyzes the spatial and temporal characteristics of ACEs in Jiangsu Province from three carbon sources, including agricultural land use, rice cultivation, and livestock and poultry breeding, and explores spatial clustering patterns and driving factors, which can provide a reference for agricultural low-carbon production. The results indicate that from 2005 to 2020, Jiangsu’s ACEs showed a decreasing trend, with an average annual decrease of 0.32%, while agricultural carbon emission density (ACED) showed an increasing trend, with an average annual increase of 0.16%. The area with the highest values for ACEs is concentrated in the northern region of Jiangsu, while the areas with the highest values for ACED are distributed in the southern region. The spatial clustering characteristics of ACEs have been strengthening. The “H-H” agglomeration is mainly concentrated in Lianyungang and Suqian, while the “L-L” agglomeration is concentrated in Zhenjiang, Changzhou, and Wuxi. Each 1% change in rural population, economic development level, agricultural technology factors, agricultural industry structure, urbanization level, rural investment, and per capita disposable income of farmers causes changes of 0.112%, −0.127%, −0.116%, 0.192%, −0.110%, −0.114%, and −0.123% in Jiangsu’s ACEs, respectively. To promote carbon emission reduction in agriculture in Jiangsu Province, we should actively promote the development of regional synergistic carbon reduction, accelerate the construction of new urbanization, and guide the coordinated development of agriculture, forestry, animal husbandry, and fisheries industries.

The driving forces of wetland degradation in Bure and Wonberma Woredas, Upper Blue Nile basin, Ethiopia.

Although the land use/land cover (LULC) of inland wetlands has been dynamic over the last 100 years, the extent of their LULC dynamics and its driving forces are poorly understood particularly in Ethiopia. Thus, this study analyzed spatiotemporal dynamics of four (Alefa, Chakun, Denbun, Kotilan) wetlands LULC and its driving forces in the Bure and Wonmbera Woredas, Upper Blue Nile Basin, Ethiopia for the period from 1985 to 2020. The Landsat images downloaded from Google Earth Engine were used to analyze the LULC of four wetland watersheds. These images were classified into 7 classes by using the maximum likelihood algorithm in ArcGIS 4. Besides, a survey of 347 households, 4 focus group discussions, and 12 key informant interviews and transect walks were used to generate the data on the drivers of wetland changes. The LULC analysis showed that the four wetlands area in 1985, 2002, and 2020 occupied 6027 ha, 5203 ha, and 4348 ha, respectively, which indicated that the areas of wetlands have declined by 1679 ha or 27.9% in the past 35 years, with an average annual decrease rate of 48.4 hectares. Wetlands were lost at a higher rate (16.4%) from 2002 to 2020. The cultivated land expansion has taken a substantial share (67.9%) of wetlands' decline. The expansion of cultivated land due to an increase of rural households along with a lack of alternative livelihoods resulted in the conversion of wetlands to cultivated land. Gully erosion and sediment deposits due to wetlands buffer degradation, overgrazing, and change in crop production driven by market opportunities have exacerbated the wetlands loss. Thus, interventions such as the promotion of alternative livelihood activities, stall livestock feeding or zero-grazing, and non-conventional livestock feeds are needed to curb wetland degradation. Delineation of buffer zone and protection of shrubland or woodlands found in buffer areas of the wetlands are needed as well for the sustainability of wetlands.

Local Ecological Knowledge and Trend of Catches on Pseudotolithus typus, Lutjanus goreensis and Sphyraena afra from Lagos Coastal Waters, Lagos State, Nigeria

The present study examined the fishers’ knowledge and a ten-year (2009 -2018) trend analysis of prices and catches on Pseudotolithus typus, Lutjanus goreensis and Sphyraena afra from Lagos coastal waters. While data for local ecological knowledge (LEK) were obtained with the aid of a semi-structured questionnaire, secondary data collected from both the field and the Federal Department of Fisheries were used to estimate the trend analysis of prices and catch composition respectively. The results showed that prices of all the fish species changed annually, with an annual average increase of 10.85%, 9.25% and 12.03% for P. typus, L. goreensis and S. afra respectively. L. goreensis and S. afra had an annual average increase of fish catch landed of 5.39% and 2.77%, while P. typus had -8.98% annual average decrease of fish landed. All the fishers were males and their modal age group was 41-60years (92.31%), while the least was 21-24years (7.69%). Sixty-nine percent (69%) and 31% of the fishers had secondary and primary school education respectively. Most fishers (69%) had a fishing experience of 21-25 years while the least fishing experience was 6-10 years. Most of the fishers had vast knowledge of the habitat of the fish species, morphological identification, causes of declined fish catches, conservation strategy, seasons of catch and problems of overfishing. In conclusion, this study showed a high level of agreement of fishers' ecological knowledge with the scientific literature, and such synergy could provide important additional biological information that could be used in the process of participative and sustainable management of marine resources.

Spatial–temporal prediction model for land cover of the rural–urban continuum axis between Ar-Riyadh and Al-Kharj cities in KSA in the year of 2030 using the integration of CA–Markov model, GIS-MCA, and AHP

The spatiotemporal analysis of land use/land cover change and monitoring, modeling, and forecasting the future of land uses are considered challenges facing planners and decision-makers in developing countries. These challenges are increased in neighborhood areas surrounding large cities, which are known as the “rural–urban continuum”. These areas have become the preferred areas for resettlement for most urban residents. The objectives of the present study were to (1) monitor the land cover change in the rural–urban continuum axis between the Ar-Riyadh and Al-Kharj cities during the period 1988–2020, (2) simulate the future growth of land cover up to the year 2030 using the Cellular Automated Markov Model (CA-Markov), and (3) improve the ability of CA-Markov to predict the future by integrating multi-criteria analysis based on geographic information systems (GIS-MCA) and analytic hierarchy process (AHP) method. The results of the study revealed large changes in the land cover in the rural–urban continuum axis between the Ar-Riyadh and Al-Kharj cities. About 60 km2 of agricultural land has been lost, with an average annual decrease of 2 km2. The industrial and urban areas were increased with growth rate of 4%. There were five categories of spatial suitability, ranging between 32 and 86%, and 70% or higher is the recommended percentage for future land uses. The industrial use was the most likely land use in 2030, as it recorded an increase of 27.1 km2 over the year 2020.

Drug Resistance Patterns and Trends in Patients with Suspected Drug-Resistant Tuberculosis in Dalian, China: A Retrospective Study.

PurposeThe emergence of drug-resistant tuberculosis (DR-TB) represents a threat to the control of tuberculosis. This study aimed to estimate the patterns and trends of DR-TB in patients with suspected DR-TB. In addition, risk factors for multidrug-resistant tuberculosis (MDR-TB) were identified among suspected DR-TB patients in Dalian, China.Patients and MethodsA total of 5661 patients with suspected DR-TB from Jan 1, 2013 to Dec 31, 2020 were included in the final analysis. The resistance pattern of all resistant strains was determined by drug susceptibility testing (DST) using the conventional Lowenstein-Jensen Proportion Method (LJ). DR-TB trends were estimated from 2013 to 2020. During the research period, the chi-square test was employed to analyze the significance of linear drug-resistance trends across time. Bivariate and multivariate logistic regression were performed to assess factors associated with MDR-TB.ResultsFrom 2013 to 2020, the resistance rates of rifampicin (RFP) and isoniazid (INH) decreased significantly, whereas the resistance rates of ethambutol (EMB) and streptomycin (SM) increased in patients with suspected DR-TB. From 2013 to 2020, the prevalence of DR-TB decreased in all patients from 34.71% to 28.01% with an average annual decrease of 3.02%. Among new cases, from 2013 to 2020, the prevalence of DR-TB (from 26.67% to 24.75%), RFP-resistant TB (RR-TB) (from 15.09% to 3.00%) and MDR-TB (from 6.08% to 2.62%) showed a significant downward trend. Among patients with a previous treatment history, DR-TB (from 54.70% to 37.50%), RR-TB (from 44.16% to 11.49%) and MDR-TB (from 26.90% to 10.34%) showed a significant downward trend from 2013 to 2020. Males (AOR 1.28, 95% CI 1.035–1.585), patients 45 to 64 years of age (AOR 1.75, 95% CI 1.342–2.284), patients 65 years and older (AOR 1.65, 95% CI 1.293–2.104), rural residents (AOR 1.24, 95% CI 1.014–1.519) and a previous treatment history (AOR 3.94, 95% CI 3.275–4.741) were risk factors for MDR-TB.ConclusionThe prevalence of DR-TB, RR-TB and MDR-TB was significantly reduced from 2013 to 2020. Considerable progress has been made in the prevention and treatment of DR-TB during this period. However, the increasing rate of drug resistance in EMB and SM should be taken seriously. Suspected DR-TB patients who are male, older than 45 years of age, live in rural areas, and have a history of TB treatment should be given priority by health care providers.

Impact of climate change on future precipitation amounts, seasonal distribution, and streamflow in the Omo-Gibe basin, Ethiopia

This study projected the impact of climate change on the amount of precipitation, seasonal distribution, and streamflow of the Omo-gibe basin, Ethiopia. Projections of climate change using the results of high-resolution multimodal ensembles from fifteen regional climate models (RCMs) of the Coordinated Regional Climate Reduction Experiment (CORDEX)-Africa were statistically downscaled and bias-adjusted using a quantile mapping approach. Precipitation and temperature were projected under RCP 8.5 and RCP 4.5 emission scenarios. Climate and streamflow projections from a mean ensemble of RCMs in the near future (2025–2050), medium future (2051–2075), and far future (2076–2100) were compared to the reference (1989–2019). Mann-Kendall (MK) trend testing was used to determine if a change is statistically significant and to detect trends in temperature, precipitation, and streamflow. The Soil and Water Assessment Tool (SWAT) hydrological model was used to project the impact of climate change on the streamflow. According to RCP4.5 and RCP8.5, the emission scenarios predicted significant positive (rising) temperature, but significant negative (decreasing) precipitation and streamflow. The average temperature projected increases range from 2.40-3.34 °C under the RCP 4.5 emission scenarios and 2.6–4.54 °C under the RCP 8.5 emission scenarios. Annual average precipitation projected decreases range between 10.77-13.11% under the RCP 4.5 emission scenario, while the RCP 8.5 emission scenarios decrease range between 11.10-13.86% in the rainy summer season (June–August) and the irregular rain season (March–May). Projected annual average streamflow decrease range between 7.08-10.99% under the RCP 4.5 emission scenarios and 10.98–12.88% under the RCP 8.5 emission scenarios. Results on projected temperature increases and reductions in precipitation and streamflow will help to develop effective adaptation measures to reduce the ongoing impacts of climate change and draw up long-term water resource management plans in the river basin. Both the results and the multidisciplinary approach will be vital to irrigation and hydropower project planners.

Rates of intravenous antibiotic starts among outpatient hemodialysis patients using NHSN dialysis event reporting, 2016–2020

Background: Nearly one-third of patients on hemodialysis receive intravenous (IV) antibiotics annually, but national data characterizing antibiotic use in this population are limited. Using NHSN surveillance data for outpatient dialysis facilities, we estimated temporal changes in the rate of IV antibiotic starts (IVAS) among hemodialysis patients as well as the proportion of IVAS that were not supported by a reported clinical indication. Methods: IVAS events were obtained from the NHSN Dialysis Event module between 2016 and 2020, excluding patients who were out of network, receiving peritoneal or home dialysis, or with unspecified vascular access. IVAS unsupported by documentation were defined as new IVAS without a collected or positive blood culture, pus, redness or swelling event, or an associated clinical symptom. Pooled mean rates of total and unsupported IVAS were estimated per 100 patient months yearly and stratified by vascular access type. Differences in IVAS rates by year were estimated with negative binomial regression. Results: Between 2016 and 2020, 7,278 facilities reported 648,410 IVAS events; 161,317 (25%) were unsupported by documentation (Table 1). In 2016, 3,340 (54%) facilities with ≥1 IVAS event reported an IVAS unsupported by documentation, which increased to 4,994 (73%) in 2020. Total IVAS rates decreased by an average of 8.2% annually (95% CI, 7.1%–9.3%; P < .001). The average annual percentage decrease did not differ significantly by vascular access site. The total IVAS rate was lowest in 2020 (2.17 per 100 patient months; 95% CI, 2.18–2.17). IVAS rates in 2020 were greatest for patients with catheter access (4.79 per 100 patient months; 95% CI, 4.75–4.83), followed by graft (1.71 per 100 patient months; 95% CI, 1.68–1.73), and lowest for patients with fistulas (1.30 per 100 patient months; 95% CI, 1.29–1.31). The overall pooled mean rate of unsupported IVAS was 0.64 per 100 patient months (95% CI, 0.63–0.64), which did not significantly change by year (Fig. 1). Conclusions: Total IVAS rates among outpatient hemodialysis patients have decreased since 2016, and rates among catheter patients remain highest compared to patients with fistulas or grafts. However, unsupported IVAS rates did not change, and the proportion of facilities reporting an unsupported IVAS increased annually. Targeted efforts to engage facilities with unsupported IVAS may help improve accurate reporting and prescribing practices.Funding: NoneDisclosures: None

The usage of renewable energy sources and its effects on GHG emission intensity of electricity generation in Turkey

The aim of this study is to analyze the use of renewable energy resources in electricity generation and its impacts on greenhouse gas emissions mitigation in terms of emission intensity in Turkey. Thus, annual development of Turkey's electricity generation by renewable energy resources and its share in general total were examined. Annually, total greenhouse gas emissions from electricity production are determined and divided by total electricity production so that the emission intensity from electricity production is found in gCO2e/kWh. The effect of each source used in electricity generation on the emission intensity is demonstrated. Although there are volatilities in some years, it is revealed that the emission intensity, which was 563 gCO2e/kWh in 2008, decreased to 437 gCO2e/kWh in 2020 with an annual average decrease of 2.1%. These emission data belonging to Turkey are compared with the values of the European Union since it is a candidate country. As a result, it has been suggested that Turkey, which has a large renewable energy potential, should use this potential more effectively in order to further reduce its emissions from electricity generation.

Quantifying and Mapping Human Appropriation of Net Primary Productivity in Qinghai Grasslands in China

Human appropriation of net primary productivity (HANPP) is an important indicator for assessing ecological sustainability. However, the spatiotemporal dynamics of HANPP in the Qinghai grasslands remain unclear. In this study, we used the spatially explicit Biome-BGCMuSo model to quantify and map HANPP in the Qinghai grasslands from 1979 to 2018. Generally, the actual net primary productivity (NPPact) was slightly lower than the potential net primary productivity (NPPpot), and the difference between the NPPpot and NPPact increased slightly over time. From 1979 to 2001, the NPPpot and NPPact were relatively stable; however, from 2001 to 2018, both showed significant fluctuating upward trends. From 1979 to 2018, HANPP showed a fluctuating upward trend from 6.36 to 31.85 gC/m2/yr, with an average increase of 2.14 gC/m2/yr. The average HANPP was 16.90 gC/m2/yr, which represented 18.80% of the NPPpot of Qinghai grasslands. High HANPP mainly occurred in eastern Qinghai, whereas it was low in central and western Qinghai. Conversely, from 1979 to 2018, the HANPP efficiency decreased in a fluctuating way from 98.28% to 72.05%, with an average annual decrease of 0.66%. The interannual variations in the HANPP efficiency and harvest were negatively correlated, with a correlation coefficient of −0.46 (p < 0.01). The average HANPP efficiency was 85.33%, and the values in most grids were between 80% and 100%, being relatively low in southern and eastern Qinghai. In rare cases, the HANPP efficiency was greater than 1. This study clarifies the details of spatiotemporal dynamics of HANPP in the Qinghai grasslands and indicates the need to optimize local management of grassland resources to ensure future ecological sustainability.

MODIS-observed spatiotemporal changes in surface albedo of Karakoram glaciers during 2000-2018

The role of albedo is very important in modulating the surface energy balance of glaciers. The main objective of this study is to assess the spatiotemporal variability in surface albedo of the Karakoram glaciers in Pakistan during the summer seasons (June, July and August) for the period from 2000-2018. We used Moderate Resolution Imaging Spectroradiometer (MODIS) data to estimate the amount of glacier surface albedo. We combined the MODIS Terra- and Aqua-derived albedo products to reduce the amount of cloud influence and to improve the estimation of glacier surface albedo. Our results indicate that the average annual decrease in albedo is ~0.041% during the summer. The decrease in albedo was relatively high during recent years, with an annual rate of decrease of ~0.45%. The decreasing trend in albedo is towards the north-western part of the Karakoram mountain range. Climate change is the potential cause of albedo variations in the study area. Albedo has a strong negative correlation with temperature (r = -0.811) and a strong positive correlation with precipitation (r = 0.809). The present study concludes that trend in decreasing albedo is higher during the recent years than the last decade and climate change is playing a vital role in it.

Pollution Characteristics and Influencing Factors of PM2.5 in Shanxi Province Based on Wavelet Transform

Based on the daily average concentration of PM2.5, social influencing factor data, and meteorological data of 11 cities in Shanxi Province from 2015 to 2019, the concentration period of PM2.5 was determined using wavelet transform. The correlation between PM2.5 and social influencing factors and meteorological factors was explored respectively through Spearman correlation and the wavelet coherence spectrum, and the main influencing factors of long-term and short-term management and control of PM2.5 were determined. The results showed that the concentration of PM2.5 in Shanxi Province showed an upward trend from 2015 to 2017, with an average annual increase rate of 4.3% and a downward trend from 2018 to 2019, with an average annual decrease rate of 4.2%. The average concentration of PM2.5 showed a "U" distribution, with the highest value in January (95 μg·m-3) and the lowest in August (34 μg·m-3); the average value in winter was approximately twice that in summer. The ρ(PM2.5) in southern cities such as Linfen was 62 μg·m-3, and the average value in Datong and other northern cities was 45 μg·m-3, which was high in the south and low in the north. There were significant periodic changes in PM2.5 concentration in the 11 cities, including a long period of approximately 293 d and a short period of approximately 27 d. Among them, the energy consumption level and industrial structure were the strong driving factors affecting the PM2.5 concentration in the long period of Shanxi Province. In the short period, it was greatly affected by the change in atmospheric circulation, and different cities were affected by typical meteorological factors. Linfen, Yuncheng, Datong, Shuozhou, and Xinzhou were vulnerable to wind speed; Jinzhong and Luliang were vulnerable to temperature; and Taiyuan, Jincheng, Yangquan, and Changzhi were uniquely and significantly affected by relative humidity. Therefore, industrial structure adjustment and energy structure adjustment are key to the long-term control of atmospheric PM2.5 and the long-term improvement of air quality in Shanxi Province. The differential impact of different urban meteorological factors on PM2.5 should be considered when carrying out short-term regional joint prevention and control.

Decadal Variation and Regulation Mechanisms of the Suspended Sediment Concentration in the Bohai Sea, China

AbstractBohai Sea, with the highest suspended sediment concentration in the world, has experienced a sharp decrease in sea surface suspended sediment concentration (SSSC) in the latest two decades. However, limited by the shortage of long‐term field observations, the spatiotemporal characteristics and mechanisms of the long‐term variation in the SSSC are still unclear. Based on remote sensing data, this study reconstructed the spatiotemporal SSSC distribution from 2003 to 2016, and found significant spatial difference in decadal SSSC variation in the Bohai Sea. The largest decadal SSSC decrease was observed in the southern Bohai Sea with an average annual decrease of 1.3 mg/L (decrease of 4.4% per year), while significant SSSC increase was observed in the central Bohai Sea with largest annual increase of 0.4 mg/L (increase of 5.0% per year). Significant seasonal differences in the SSSC decreasing were also revealed, and the SSSC decrease in winter and spring (0.46 mg/L/a) was 27.8% higher than that in summer and autumn (0.36 mg/L/a). Decadal wind speed data measured at 14 meteorological stations around the Bohai Sea indicated that wind speed reduction played the most important role in the decadal decrease in SSSCs, and significant SSSC decrease can only be found in sea areas with a significantly reduced wind speed. In addition, although the runoff and sediment discharge of the Yellow River also decreased during 2003–2016, they were not related to the spatiotemporal variation of SSSCs and their direct impact was limited to the range of 15 km from the estuary.

Climate change impact on cryosphere and streamflow in the Upper Jhelum River Basin (UJRB) of north-western Himalayas.

The critical significance of keeping the current information about the extent and dynamics of the cryosphere in the Himalayas cannot be understated. The climate of the Himalayas is vulnerable and interlinked with global-scale climate changes, and the hydrology of the region mainly depends on the cryosphere. This is the first study that has created glacier and glacier lake inventory that links the impact of cryosphere on streamflow to land system dynamic changes under the changing climate of the Upper Jhelum River Basin (UJRB) of the Kashmir Himalayan region. This study uses a series of satellite data (1980-2016) to assess the depletion of snow cover area (SCA), deglaciation, and dynamics of glacial lakes. Moreover, observational long-term hydrometeorological data were used to understand the variability in temperature, precipitation, and track changes of land system dynamics under depletion of streamflow. The results suggested an overall rise in temperature (TMax = 0.05 ºC a-1; TMin = 0.02 ºC a-1; Tavg = 0.06 ºC a-1) and a decrease in precipitation (2.9mm a-1) between 1980 and 2016 with a significant increase in annual average temperature and decrease in annual precipitation at stations located at higher altitudes. The SCA showed a significantly decreasing (p < 0.01) trend in the glacierized sub-basins with an annual rate of decrease of -0.78% a-1, -0.15% a-1, -0.03% a-1 -0.90% a-1 for Lidder, Sindh, Vishow, and Rambiara sub-basins, respectively. The findings of this study reveal the high occurrence of glacier disintegration and deglaciation. During the period 2010-2016, a rapid rate of deglaciation was observed (18.34 ± 0.14 km2), followed by 1992-2000 (15.61 ± 0.13 km2). The average rate of retreat was observed to be 6.81 ± 1.5m a-1 with a total retreat of 267 ± 80m during 1980-2016, which is higher than reported from surrounding mountain ranges in the Himalayas. The mapped 244 glacial and high-altitude lake inventory covers a total surface area of around 15 km2, with 5.87 km2 (40%) covered by 25 bedrock-dammed lakes. The glacial expansion and creation of new lakes are observed to be because of increasing glacier and snow melting between 1980 and 2016, which increases the risk of GLOF events in the future. The annual average discharge in UJRB significantly increased from 1991 to 1998 and was observed to be higher than the annual average of the respected gauge stations but shows significant depletion from 1998 onwards. The streamflow depletion under climate change is one of the reasons for land system dynamics in UJRB. The area under agriculture has decreased up to 63% with a massive expansion of built-up (399%), aquatic vegetation (523%), and plantation (765%) between 1992 and 2015.

Keeping It Simple With Febrile Seizures

Keeping It Simple With Febrile Seizures

Evaluation of quality and effectiveness of rendering medical care to patients with gonococcal infection in medical institutions

Objective. To assess the intensity of epidemic process in a long-term dynamics of gonorrhea sickness rate and evaluate the quality and effectiveness of rendering medical care to patients with this infection in medical institutions of Perm.&#x0D; Materials and methods. In this work, the data of official statistics of the State Budgetary Institution of Public Healthcare Perm Regional Clinical Dermatovenerological Dispensary are presented: official statistical form 12 Information on the number of diseases as well as accounting forms accepted by the Ministry of Public Health of Perm Krai. Epidemiological, descriptive-evaluative and analytical studies of the type case-control, sociological (questioning method) and statistical methods were used.&#x0D; Results. A long-term dynamics of gonococcal infection morbidity among the population of Perm for 19902020 was characterized by a marked tendency to decrease, an average annual decrease rate was 7.5 %. Despite the tendency to decline, from 2018 to 2020, there was observed an activation of epidemic process of the gonococcal infection. The growth rate was 137.5 %. Based on special investigations, it was established that 55.4 % of patients addressed to private clinics, 44.6 % (p0.05) to state ones (SBIPH PK RCDVD). In general, 76.5 % of patients from state and private clinics remained uncontrolled from the side of medical services. Thus, in three thirds of the foci, an active search of the sources of the infectious agent was not carried out. While studying medical documentation of 666 foci, epidemic diagnostics was performed only in 166 (24.9 %), in 500 foci the infectious agent source was not detected and investigated. At the same time, out of 500 foci, in 340 (68.0 %) one sexual partner for each focus remained unexamined, in 125 (25.0 %) foci two-three sexual partners, and in 35 (7.0 %) foci more than three sexual partners.&#x0D; Conclusions. Recent years have witnessed the activation of epidemiological process of gonococcal infection in Perm. The gonococcal infection morbidity 2.5 times exceeded the indicators in the country as a whole. Patients with gonococcal infection addressed to state and private clinics in 55.4 % and 44.6 % of cases, respectively. Three thirds of patients with gonorrhea receive medical care not in a full volume, and with bad quality. In the state institutions, such patients make 15 %, in private ones 85 %.

Decreased Hospital Visits and Increased Mortality Rate in Emergency Department during the COVID-19 Pandemic: Evidence from Albania.

.Objective:To investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017–2019).Methods:Secondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. This is a retrospective study. We used the hard copy of the patients’ health register records. The data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the emergency department. The causes of admission were categorized in 14 different disease categories. All registered patients admitted to the Vlora regional hospital were included in the study.Results:Study population included 44,917 patients during 2017–2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12,407) and the lowest in 2020 (n=9,266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract was observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of 7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval=42.7% to 214.8%, p-value=0.27).Conclusions:The number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel.