Moderate Priority Research Articles

Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials.

LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health benefits. This study systematically identifies and evaluates implementation strategies for LGBTQ-affirmative CBT. First, we identified and operationalized implementation strategies used across five trials of LGBTQ-affirmative CBT using the Pragmatic Implementation Reporting Tool. Second, we evaluated the relative importance of these strategies via a quantitative assessment (N = 31 unique trial implementers). Survey responses were analyzed descriptively within each trial. Across all trials, we organized strategies as (1) high priority, (2) moderate priority, and (3) optional (if resources are available) for implementing LGBTQ-affirmative CBT. Within each trial, we identified 20 or more implementation strategies that were used, many of which overlapped across trials. We identified nine high priority strategies (e.g., working with clients to engage them in LGBTQ-affirmative CBT), nine moderate priority strategies (e.g., conducting ongoing training in LGBTQ-affirmative CBT), and nine optional/resource dependent strategies (e.g., showing visual indicators of LGBTQ affirmation within the physical spaces where LGBTQ-affirmative CBT is delivered). LGBTQ-affirmative CBT is a complex intervention requiring a package of implementation strategies. Our findings provide guidance for implementers in settings with different levels of resources regarding the highest priority strategies that may be needed to preserve the effectiveness of LGBTQ-affirmative CBT as it is translated into real-world settings.

Panzara River Watershed Prioritization Based on Geomorphometric and LULC Change Analysis using Geo-Spatial Techniques

Human activities can significantly influence the quality of water flowing from a watershed, either positively or negatively. As water moves through the system, these impacts accumulate, with all land-based activities having the potential to affect the water quality and quantity experienced by downstream stakeholders. Similarly, the actions of upstream landowners impact the water that flows across others' properties. Geospatial techniques like remote sensing and geographic information systems (GIS) are invaluable tools for analysing drainage patterns within a watershed and the associated changes in land use and cover. This study focuses on the Panzara river basin, a principal tributary of the larger Tapi river basin, situated in central India between the westward-flowing Godavari and Narmada river systems, which both ultimately discharge into the Arabian Sea. The study area spans latitudes from 20°42'0" N to 21°18'0" N and longitudes from 74°06'0" E to 75°00'0" E, covering a geographical area of 2,986.05 square kilometers with a perimeter of 570.51 kilometers. The watershed delineation was carried out using Shuttle Radar Terrain Mapper (SRTM) data with a 30-meter resolution. For land use and land cover (LULC) analysis, Landsat 5 TM C2L1 and Landsat 8 OLI/TIRS C2L1 datasets, both with 30-meter resolution, were utilized. The present study conducts a morphometric analysis and assesses LULC changes within the Panzara river basin between 2000 and 2021. Morphometric parameters such as linear parameters [Drainage density (Dd), Stream frequency (Fs), Mean bifurcation ratio (Rbm), Drainage texture ratio (Dt), Length of overland flow (Lo)] and areal parameters [Elongation ratio (Re), Circulatory ratio (Cr), Form factor (Rf), Compactness coefficient (Cc)] were used to prioritize sub-watersheds. Furthermore, the study classifies the observed LULC changes between satellite imagery datasets from 2000 and 2021, quantifying the percentage changes in the respective LULC classes across the sub-watersheds over the two decades. The overall accuracy of the LULC classification was 81.82% for 2000 and 88.88% for 2021, with Kappa coefficients of 0.772 and 0.85, respectively. In terms of prioritizing sub-watersheds, common sub- watersheds such as SW-1, SW-10, and SW-15 were classified under moderate priority, while SW-5, SW-8, and SW-14 were classified under the lowest priority. The results of this study, particularly the prioritization of sub-watersheds, can be instrumental for hydraulic engineers in planning and managing water resources in the Panzara river basin.

Adaptive and Priority-Based Data Aggregation and Scheduling Model for Wireless Sensor Network

Wireless Sensor Networks (WSN) use sensor nodes placed in potential places to collect sensitive information. These sensor nodes monitor necessary data and send it to the sink node. Sensor nodes have resource constraints, especially energy and power depletion. The majority of sensor and battery power is wasted on redundant data transmission. The redundant data transmission consumes a significant amount of the sensor and battery life, decreasing the total lifespan of the sensor nodes. Data aggregation is an approach that expands the useful lifetime of sensor nodes overall and removes unnecessary data and delays. There are many types of data aggregation techniques, such as centralized, tree-based, in-network, and cluster-based. The available tree-based data aggregation mechanism performs well, but the whole tree may be down due to single-node failure. Due to bottlenecks, node data aggregation suffers from an increased packet failure ratio. Another limitation is that every node aggregates data into slices, which consumes more energy. For this purpose, an adaptive and priority-based data aggregation and scheduling model (APB-DASM) for WSNs is proposed in this paper to address these issues. It is proposed that APB-DASM be used to improve quality of service (QoS) with regard to energy consumption and data transmission. The APB-DASM model aggregates sensor data into cluster heads and divides it into three formats: The first format categorizes the most important data that consists of four slices, and the second format categorizes the important data that consists of three slices. Format three data is represented in two slices, which is normal data. These three types of format data are aggregated on a priority basis, such that the highest priority is given to the first format, i.e., most important data; moderate priority is given to the second format, i.e., important data; and then low priority is given to the normal data. Due to an efficient priority-based data aggregation and scheduling algorithm, our proposed model sends the most important data first, and so on. Theoretical study and simulation research demonstrate that our proposed approach improves the existing tree-based models. By using APB-DASM, significant decreases in energy usage, packet delivery ratio, and overall QoS are achieved, and as a result, the WSNs' lifetime is thus increased. The proposed model is implemented in MATLAB, and the results are compared with existing tree-based models. Simulations comparing our model to the most recent models indicate that it worked effectively, reducing the packet failure ratio and energy usage by 36.8% and 30%, respectively, for CBF-ADA, D-SMART, and WDARS. This article emphasizes how the suggested methodology can be effectively used in the aggregation of coronavirus patient data. It demonstrates how adaptable and applicable our method is in the real world.

Cardiac adverse events associated with lacosamide: a disproportionality analysis of the FAERS database

Lacosamide was the first approved third-generation antiepileptic drug. However, real-world data regarding its adverse cardiac reactions in large samples still need to be completed. We evaluated the cardiac safety profile of lacosamide using the Food and Drug Administration Adverse Event Reporting System (FAERS). We performed disproportionality analysis computing reporting odds ratio (ROR) as a quantitative metric to assess the signal of lacosamide-related cardiac adverse events (AEs) from 2013 Q1 to 2022 Q4. The signal was considered significant when the lower limit of the 95% confidence interval (CI) of the ROR exceeded 1, and ≥ 5 AEs were reported. Serious and nonserious cases were compared by statistical analysis, and signals were further prioritized using a rating scale. A total of 812 cardiac AEs associated with lacosamide were identified, and 92 signals were detected, of which 17 AEs were significantly associated signals. The median time-to-onset (TTO) for moderate priority signals was 10 days, whereas for weak priority signals, it was 54 days. Notably, all cardiac AEs exhibited an early failing pattern, indicating the risk gradually decreasing. Based on the comprehensive analysis of the FAERS database and prioritization of cardiac AE signals, our research enhances the awareness among healthcare professionals regarding cardiac AEs associated with lacosamide.

Building consensus on priority areas for Sub-Saharan Africa's ageing population research: An e-Delphi study protocol.

Improvement in medico-social services has increased life expectancy and population ageing in Sub-Saharan Africa (SSA). It was estimated that about 163 million people aged 65 and older will be resident in SSA by 2050. There is inadequate ageing research capacity in SSA which necessitates this study to (a) identify a decade-long ageing research opportunities, challenges, and solutions, and (b) prioritize critical ageing research areas and methodologies relevant to the SSA. We designed an e-Delphi protocol following the Reporting Guideline for Priority Setting of Health Research with Stakeholder. The stakeholders will be researchers, practitioners, older adults, and caregivers purposively selected through snowballing quota sampling to complete three rounds of e-Delphi surveys. Round 1 will involve open-ended questions derived from the study objectives. Responses from round 1 will be prepared as a checklist for stakeholders to rate during rounds 2 & 3, using a 9-point scale: low priority (1-3), moderate priority (4-6), and high priority (7-9). The criterion for reaching a consensus will be ≥ 70% of stakeholders rating an item "high priority" and ≤ 15% as "low priority." Quantitative data will be analysed using descriptive statistics, Wilcoxon matched-pairs signed-rank test will be used to assess the stability of stakeholders' responses, and qualitative comments will be analysed using content analysis. Setting aging research/practice priorities will help maximize the benefits of research investment and provide valuable direction for allocating public and private research funds to areas of strategic importance.

Prioritization of Sub-Watershed Based on Soil Loss Estimation Using RUSLE Model

Soil erosion is one of the most crucial land degradation problems and is considered the most critical environmental hazard worldwide. The present study uses remote sensing data integrated with the geographical information system (GIS) technique and the revised universal soil loss equation (RUSLE) model for assessing the annual average soil loss of the Digaru watershed of India for 1999 and 2020. The estimated mean gross yearly soil loss from the entire watershed was 102716 t yr-1 in 1999 and 178931.6 t yr-1 in 2020. The overall average soil loss rate increased significantly between 1999 and 2020, rising from 4.73 t—ha-1yr-1 to 8.43 t—ha-1yr-1. The sub-watersheds are prioritized as high (≥ 40 t ha−1yr−1), moderate (20–40 t ha−1yr−1), and low (<20 t ha−1yr−1) based on the spatial distribution of soil erosion. Seven sub-watersheds have been grouped under low priority, followed by seven under moderate priority and one under high priority. This study demands instant attention for soil and water conservation efforts in highly eroded watershed areas.

A control banding method for chemical risk assessment in occupational settings in France.

This study describes a method whose aim is to help companies assess the chemical occupational risks related to labeled products and industrial chemical emissions. The method is intended to be used by industrial hygienists at the scale of one company. Both inhalation and cutaneous exposure routes are taken into account. The method relies on a control-banding scheme. A work situation is described by exposure parameters such as the process or the local exhaust ventilation and by the hazard of the product. Each possible value of the parameters is associated with a "band," which is associated with an integer value. The multiplication of these values results in a score, which represents a priority for intervention. The higher the score, the more the situation warrants investigation for implementing prevention measures, such as chemical substitution and the addition of local exhaust ventilation. To simplify communication, the priority is associated with a colored priority band: red for "very high priority," orange for "high priority," and green for "moderate priority." The priority bands are computed for all work situations performed in a company. An example of the use of this method is described in a French façade insulation company. A tool named Seirich was developed to implement this method and promote good practices for helping industrial hygienists in the prioritization of interventions for reducing chemical risk in France.

In‐depth evaluation of protein domains improves classification of SORL1 variant pathogenicity in Alzheimer’s Disease patients

AbstractBackgroundRare pathogenic SORL1 gene variants have been identified as strong risk‐increasing factors in Alzheimer’s disease (AD). Recent analysis indicated that SORL1 loss‐of‐function (LoF) variants associated with a ∼40‐fold increased risk for early‐onset AD, while missense variants that were prioritized using in silico variant pathogenicity‐prediction algorithms associated only with a 2‐fold risk increase. However, current risk‐prediction strategies do not take SORL1‐specific features into account. We aimed to design a variant classification strategy that adds in‐depth knowledge of SORLA structural folding and function to the variant risk prediction.MethodWe identified coding SORL1 variants in a discovery/replication sample of whole exome sequencing data from the ADES/ADSP studies comprising 18,959 cases and 21,893 controls after quality control. We selected only the extremely rare variants (MAF<0.05%) and further divided these into LoF(n = 77) and missense variants(n = 539). With an in‐depth evaluation of protein functional domains (informed by pathogenic variants in homologous genes) combined with their predicted pathogenicity (REVEL algorithm) we prioritized missense variants into ‘high priority’, ‘moderate priority’ and ‘low priority’. We compared the age‐dependent penetrance of missense variants for each priority‐category and LoF variants, in context of APOE genotype.ResultCarriers of prioritized missense variants had a similar age‐dependent penetrance as LoF variants, with median age at AD‐onset of ∼65 years which is significantly lower compared to non‐carriers (∼72 years). In addition, carriers of prioritized SORL1 missense variants have an expedited age at onset by ∼7 years independent of their APOE genotype. If we look at a 80% penetrance level, SORL1 carriers with homozygous ε4 background had AD by age 61 (95%CI 60‐NA, n = 6) compared to age 73 (95%CI 72‐73, n = 1091) for SORL1 WT carriers. Carriers with a heterozygous background had AD by age 71 (95%CI 68‐76, n = 62) compared to 78 (95%CI 78‐78, n = 4816) for WT. For a non‐ε4 background the age at onset for carriers was 83 years (95%CI 78‐90, n = 54) compared to 85 years (95%CI 85‐85, n = 5773) for WT. The moderate and low priority group showed no significant difference compared to WT.ConclusionOur prioritization model can successfully identify likely pathogenic missense SORL1 variants, allowing for better identification of patients with possible SORL1‐associated‐AD.

Comparative Analysis of MCDA Techniques for Identifying Erosion-Prone Areas in the Burhanpur Watershed in Central India for the Purposes of Sustainable Watershed Management

The degradation of land and increasing water scarcity are existing challenges for agricultural sustainability, necessitating the implementation of improved soil-conservation practices at the watershed scale. The identification and selection of critical/prone areas based on erosion-governing criteria is essential and helps in the execution of the management process for determining priority. This study prioritizes erosion-prone sub-watersheds (alternatives) based on morphometric parameters (multiple criteria) via five Multi-Criteria Decision Analysis (MCDA) approaches, i.e., AHP: Analytical Hierarchy Process; TOPSIS: Technique for Order of Preference by Similarity to Ideal Solution; VIKOR: VIseKriterijumska Optimizacija I Kompromisno Resenje; SAW: Simple Additive Weighting; and CF: Compound Factor. Based on their priority score, 19 sub-watersheds were classified into four priority classes: low priority (0–0.25), moderate priority (0.25–0.50), high priority (0.50–0.75), and very high priority (0.75–1). The results revealed that about 8.34–30.15% area of the Burhanpur watershed is critically prone to erosion, followed by 23.38–52.05% area classed as high priority, 7.47–49.99% area classed as moderate priority, and 10.33–18.28% area classed as low priority. Additionally, four indices—percentage of changes (∆P), intensity of changes (∆I), the Spearman rank correlation coefficient test (SCCT), and the Kendall tau correlation coefficient test (KTCCT)—were employed to compare the models. This study confirms the efficacy of morphometric parameters for prioritizing sub-watersheds to preserve soil and the environment, particularly in areas for which limited information is available.

894 Attitudes, Barriers and Difficulties to Discharge – a Qualitative Approach

Abstract Aim It is well accepted that prompt and effective discharges are crucial in order to sustain patient continuity of care, patient flow and create bed space for patients. Systematic difficulties and the health professional staffing crisis may create further barriers to satisfying the above statement. Thus, the authors have investigated the titled characteristics with a view to instigating beneficial changes. Method A curated questionnaire was designed and emailed to all health care professionals who worked within the general surgical department at the authors’ trust who completed discharge summaries. A total of 26 respondents completed the survey. Results The main obstacle in completing discharges was lack of patient knowledge (40% of respondents) followed by time pressure (28% of respondents). In addition, each discharge usually took 11 minutes or more. Discharge priority is deemed to be of variable importance, with 52% ranking it as moderate priority and 24% deeming it to be high priority. Multiple symbiotic factors were thought to be important in improving the discharge process. However, the single key factor was dedicated protected time to complete discharge paperwork (17.39% of respondents). 60% of respondents ideally favoured a typed discharge summary with 28% preferring dictation despite a lack of knowledge and understanding of the available resources. Conclusions This work has offered a valuable insight into the attitudes, barriers and difficulties surrounding discharges with scope to instigate improvements, such as the use of dictation software, protected time and subsequent possible policy changes.

Investigating the spatial clustering of drowning events in the United Kingdom: A geospatial cross-sectional study

Globally, drowning is the third leading cause of unintentional injury death, accounting for 7% of all injury-related deaths. This study aimed to examine the spatial clustering in UK drowning incidents. Data were obtained from the Water Incident Database (WAID) (1/1/2012–31/12/19). We examined spatial clustering of intentional and unintentional drownings using a density-based spatial clustering of applications with the noise method (DBSCAN). Intentional and unintentional events were delineated to establish thresholds for cluster identification for moderate, high and very high priority areas respectively, all within a 500-m radius (i.e., 5–7 min walk) of the water network. We identified 2 very high priority (minPts 8), 5 high priority (minPts 6) and 21 moderate priority (minimum points [minPts] 4) areas for unintentional drowning. This study also identified 4 very high priority (minPts 16), 16 high priority (minPts 8) and 36 moderate priority (minPts 4) areas for intentional drownings. Our findings serve to identify priority spatial locations, which provide important foundations for drowning prevention interventions. Prevention efforts should now consider the wider determinants of drowning in these areas, including accounting for the evident spatial patterns in drowning events. Our study addresses key priorities of United Nations and World Health Organisation's drowning prevention guidelines.

Initiating Evaluation of Composite Outcome Measures for Psoriatic Arthritis: 2022 Updates From the GRAPPA-OMERACT Working Group.

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) working group-comprising rheumatologists, dermatologists, methodologists, and patient research partners-provided updates at the GRAPPA 2022 annual meeting on its work to evaluate composite outcome measures for PsA. Ten composite outcome measures were considered. Initial steps were to define the population, the purpose of use, and the proposed pros and cons of the 10 candidate composite instruments for PsA. Preliminary Delphi exercises within the working group and GRAPPA stakeholders confirmed high priority for evaluating minimal disease activity (MDA); moderate priority for Disease Activity in PsA (DAPSA), American College of Rheumatology (ACR) response criteria, Psoriatic Arthritis Disease Activity Score (PASDAS), Composite Psoriatic Disease Activity Index (CPDAI), 3 visual analog scale (VAS), and 4VAS; and low priority for Disease Activity Score in 28 joints (DAS28), Psoriatic Arthritis Responder Criteria (PsARC), and Routine Assessment of Patient Index Data 3 (RAPID3). Further appraisal of candidate composite instruments is ongoing.

P09 Attitudes, barriers and difficulties to discharge – a qualitative approach

Abstract Introduction It is well accepted that prompt and effective discharges are crucial in order to sustain patient continuity of care, patient flow and create bed space for patients. Systematic difficulties and the health professional staffing crisis may create further barriers to satisfying the above statement. Thus, the authors have investigated the titled characteristics with a view to instigating beneficial changes. Methods A curated questionnaire was designed and emailed to all health care professionals who worked within the general surgical department at the authors’ trust who completed discharge summaries. A total of 26 respondents completed the survey. Results The main obstacle in completing discharges was lack of patient knowledge (40% of respondents) followed by time pressure (28% of respondents). In addition, each discharge usually took 11 minutes or more. Discharge priority is deemed to be of variable importance, with 52% ranking it as moderate priority and 24% deeming it to be high priority. Multiple symbiotic factors were thought to be important in improving the discharge process. However, the single key factor was dedicated protected time to complete discharge paperwork (17.39% of respondents). 60% of respondents ideally favoured a typed discharge summary with 28% preferring dictation despite a lack of knowledge and understanding of the available resources. Conclusion This work has offered a valuable insight into the attitudes, barriers and difficulties surrounding discharges with scope to instigate improvements, such as the use of dictation software, protected time and subsequent possible policy changes.

Prioritization of Potential Native Plants from Arabian Peninsula Based on Economic and Ecological Values: Implication for Restoration

Land degradation is one of the most important environmental problems worldwide, including in the Arabian Peninsula. In arid climatic conditions (i.e., high temperature, high evaporation, scanty rainfall and high salinity), anthropogenic factors (i.e., grazing, camping, infrastructure development, etc.) are the major causes of land degradation. Therefore, restoration of degraded lands is urgently needed to achieve sustainable development goals. Moreover, countries in the Arabian Peninsula are suffering from a lack of natural freshwater resources. Therefore, using halophytes could be an environmentally and economically viable option to overcome limited availability of fresh water by substituting the demand of portable water for irrigation as well as restoring salt-affected lands. Saline soils are common in the Arabian Peninsula, therefore, exploring the ecological and economic potential of halophytes and incorporating them in restoration projects could be a sustainable option. In this study, an attempt was made to document the uses of Arabian halophytes through a survey of the literature and prioritizing them based on their use value. Out of the 107 species studied, 4 species, namely Arthrocnemum macrostachyum (Moric.) K.Koch., Alhagi graecorum Boiss., Bassia muricata (L.) Asch. and Phragmites australis (Cav.) Trin. Ex Steud., were categorized as high priority followed by 36 species under moderate priority. However, when the priority and life form of species was considered for prioritization, three species, namely Alhagi graecorum, Arundo donax L. and Phragmites australis, ranked at the top in the priority list among perennials and Bassia muricata ranked at the top among annuals. This information could be useful for land restoration specialists to use appropriate halophyte species to achieve for different restoration objectives in salt-affected lands. However, there is a need to develop an active monitoring system that strictly concentrates on the recycling of plants that are used in phytoremediation.

Multicriteria Decision Analysis of Steel and Mass Timber Prototype Buildings in the Pacific Northwest

This study used multicriteria decision analysis to quantitatively compare two prototype buildings, both designed using equivalent mass timber and steel structural systems across four decision criteria of seismic resiliency, global warming potential, superstructure cost, and durability. The 5-story and 12-story prototype buildings were both located at an arbitrary site in Seattle, WA. The first three decision criteria were quantitatively measured for each prototype building and durability was assumed to be equivalent between the alternatives. Seismic resiliency was measured using the median expected annual loss calculated using as a percentage of predicted building replacement cost using a procedure in line with FEMA P-58. The global warming potential was measured over the production, construction, and end-of-life stages using the life-cycle analysis program Athena Impact Estimator for Buildings (IE4B). The superstructure cost was calculated as the average cost per square meter using 10 estimating variations that attempt to account for uncertainty in market rates of material, labor, and mass timber design efficiency. Five decision-maker scenarios were analyzed that span the practical range of decision-maker priorities, as informed by discussions with architects and engineers active in the Pacific Northwest. Results from this study showed that for decision-maker cases where the global warming priority was low, steel buildings were the preferred choice. For cases with moderate to high global warming priority and low priority on cost, mass timber buildings were the preferred choice. However, for decision-maker scenarios with moderate priority on both global warming potential and cost, the steel and mass timber buildings were approximately equivalent. Finally, a hybrid steel–timber alternative was presented as a possible sweet-spot solution that merged the benefits of each building material and minimized their drawbacks, making it the most-preferred solution for the case of moderate priority on both cost and global warming potential. The hybrid case was also close second in ranked choice for all other scenarios examined.

Optimization of Islamic Law in its Role to Prevent Covid-19

This article aims to explain the importance of maintaining religious moderation amid the COVID-19 pandemic. The approach used is socio-religious by looking at news facts that happen to residents. result of sharing understanding that moderate priority on religion during the covid 19 pandemic is a must. For this reason, the public is trying to understand more about maintaining their own safety and participating in protecting and assisting the government in dealing with the Covid-19 virus. The main focus of the war that occurred during the Covid-19 Pandemic for Muslims was the maintenance of religion, meaning that worship activities under any circumstances must be carried out. So Islamic law is always present in every situation, so that Muslims remain calm in carrying out their religious activities. with various kinds of health references about the dangers of Covid-19 and maintaining the security and stability of the country.

Diabetes-related research priorities of people with type 1 and type 2 diabetes: a cross-sectional study in Germany

To investigate (i) the importance and priorities of research objectives for people with type 1 (T1DM) and type 2 diabetes (T2DM); (ii) subgroups with specific research priorities; (iii) associated factors (e.g., sociodemographic characteristics) of the subgroups. The cross-sectional survey was conducted in 2018 using data from 869 respondents (29.0% response, 31.2% female, mean age 61.3 years, 62.7% T2DM) from a German statutory health insurance population. Diabetes-related research priorities were assessed with a questionnaire. Subgroups and associated factors were identified using latent class analysis. Three subgroups were found in T1DM: (1) high priority for the research topic ‘healing diabetes’ and moderate priority for the research topic ‘prevention of long-term complications’, (2) priorities for simplifying handling (high) and stress reduction (moderate), (3) priorities for healing diabetes (high) and simplifying handling (high). Three subgroups were found in T2DM: (1) priorities for simplifying handling (moderate), diabetes prevention (moderate) and prevention of long-term complications (moderate), (2) priorities for stress reduction (high) and diabetes prevention (moderate), (3) priorities for simplifying handling (high) and stress reduction (high). Classes differed in age and HbA1c. Knowledge about research priorities enables researchers to align their work with the needs of people with diabetes.

Sub-watershed prioritization of Koyna river basin in India using multi criteria analytical hierarchical process, remote sensing and GIS techniques

Watershed characterization and prioritization have become essential for proper natural resources management and sustainable development. This paper introduces an empirical hierarchical method based on the multi-criteria analytical hierarchical process (AHP). This method has been applied for sub-watershed or watershed prioritization and land and water development of sensitive areas in the Koyna River Basin. The study area was delineated and classified into nineteen sub-watersheds, which referred as SW1 to SW19. Remote sensing (RS) and Geographic Information System (GIS) methods are highly developed that help planners and policymakers create reliable and timely plans and decisions. The geomorphologic parameters are used in the watershed prioritization analysis covering the linear/areal aspects viz. the bifurcation ratio, stream density, stream frequency, drainage intensity, texture ratio, overland flow with profile factors. Drainage intensity is identified as the most important of morphometric characteristics to identify the prioritization of the watershed. We have found that SW1 to SW5, SW9, SW10, SW16, and SW19 very high priority sub-watersheds, SW6, SW7, SW8, SW11, SW13, SW15, SW17, and SW18 moderate priority sub-watersheds and SW12 and SW14 low priority sub-watersheds in the basin area using RS and GIS methods. These sub-watershed wise planning and management would be beneficial important for the maintaining the ecosystem, and recharging groundwater. The results can be helpful to the development and planning of groundwater resources.

Health System Inquiry: Is Health Sector Reforms in Bangladesh Imperative?

In Bangladesh, Government is trying to find a perfect health system that best serves its population. Here, we present the results of our study with aim to assess the opinion of various stakeholders about: what are the 1) high-priority areas, 2) moderate priority areas, and 3) low-priority areas to reform the health sectors for Bangladesh. We conducted a cross-sectional, exploratory and anonymous population-based e-survey from February to June, 2021 among individuals aged above 26 years. A semi-structured questionnaire was designed and incorporated into the Google survey tool (Google Forms) and a shareable link was generated and disseminated to physicians, Academicians/ Clinicians of Medical Colleges/ Universities, Health System administrators etc. Respondents were also given space to comment on each topic. Comments & reactions of all respondents were categorized into three main headings. These were 1) high-priority areas, 2) moderate priority areas, and 3) low-priority areas to reform the health sectors for Bangladesh. Out of 483 respondents, 476 respondents (80.5% males and 19.5% female) completed the entire survey. The mean age of respondents is 44.70 SD± 10.07 with age range 26-86 years. About 27% of the respondents were from faculties from medical colleges /medical universities and 1.7% were health system administrators. The high prioritized areas where the majority (>60%) of our respondents strongly agreed upon, for instance, good governance, structural referral system should be establishment, and reformation of existing health care procurement & purchasing policy. The moderate prioritized areas where 50 - 60% of our respondents strongly agreed upon, such as securing sustainable financing for health care, further development of existing health infrastructure, and establishment of Health Academy of planning and development (HAPD). The low prioritized areas where less than 50% of our respondents strongly agreed upon, such as decentralization and autonomous health system, public health-oriented infection prevention and control (IPC) program, and implement the national health insurance system (NHIS) under a separate authority etc. Good governance in health departments & health care provider organizations are essential elements for health sector reform. Health sector reform should be sustained, purposeful, planned and evidence-based and fundamental change addressing significant, strategic dimensions of health systems. J Bangladesh Coll Phys Surg 2022; 40: 84-94

Assessment of oil and gas fields in California as potential CO2 storage sites

California's total annual greenhouse gas (GHG) emissions (425.3 MtCO2e) in 2018 were about 6.4% of the US total (6,677 MtCO2e) and around 1% of global emissions. About 39% of 2018 GHG emissions in California were from the industrial and electrical sectors. Many of these emissions were from large stationary point sources and were suitable for carbon capture retrofit with subsequent storage of the captured carbon dioxide (CO2) in geological formations. Previous studies of California found suitable geology and CO2 storage resource. This study refines and furthers prior work using a three-stage screening process of oil fields, gas fields, and underground natural gas storage (UGS) sites by combining criteria from previous studies while excluding sites that pose technical risk or are located in regions with surface restrictions including sensitive habitats and dense populations. In the first stage, 129 CO2 storage sites in California were identified using qualification criteria based upon formation properties including geological conditions and pore pressure. The second stage identified sensitive sites by applying conservative screens including seismic activity, faulting, population density, restricted lands, and sensitive habitats. During the third stage, 61 CO2 potential storage sites were identified by subtraction of stage 2 areas from stage 1. The potential storage volume in the third stage ranged from 1.0 to 2.0 GtCO2. Finally, we applied a scoring system with seven parameters to rank the 61 potential sites based on subsurface technical criteria. The scored sites are classified as high priority, medium priority, and sites for future study. Prospective CO2 storage sites with high and moderate priority were selected and linked to CO2 sources. There are 14 prospective sites (above 20 MtCO2 storage resource per site) with a total storage resource of 1024 MtCO2 distributed in Northern and Southern California. Of these sites, there are 9 potential CO2-EOR sites and 1 depleted oil field with a total estimated CO2 storage volume of ∼800 MtCO2 in the Southern San Joaquin and Ventura Basin. These 10 prospective sites with a storage resource greater than 20 MtCO2 could potentially deliver more than 20 years of storage with an average injection rate of 40 MtCO2/year. The remaining 4 highly prospective sites are in Northern California. Study results also suggest that saline formations should be re-evaluated in concert with storage in oil, gas, and natural gas storage reservoirs.