Reference Year Research Articles

Dynamics of legume Cropping and Agro-ecological Transition in the Cotton Savannah Zones of West Africa: the Case of Koumbia District of Burkina Faso

Aims: This paper shows the contribution of participatory research to upgrade the integration of legumes into cropping systems. Place and Duration of Study: The investigation is based on survey data collected in 2008 and 2011 (two reference years) and 2021 and 2022 (current situation) in the village of Koumbia in western Burkina Faso. Methodology: Data was collected through surveys and field measurements. The surveys were conducted with a sample of fifty (50) volunteer farmers. In 2008, 2011 and 2022, the same questionnaire was administered to all 50 farmers. Field measurements with GPS (Global Positioning System) were conducted on crop area. Results: The results show that the proportion of area under legumes crops increased by 77,38% after 15 years. Other legumes crops (Glycine max and Mucuna sp.) were introduced in addition to those previously grown (groundnuts and cowpeas) by farmers. Surface cropped in sorghum (35.36%) and millet (82.79%) declined while cotton and maize remain the main crops in the zone. The results on farmers’ perception show that they prefer single cropping of legume crops as their insertion modality in the existing farming systems compared to their association with cereals. Conclusion: The study shows that the role of legumes is increasing in the cropping system, and represents an opportunity to succeed in the agro-ecological transition, even though the intercropping of cereal/legume, which is put forward by the theoretical models of the agro-ecological transition, is still little practiced. The structuration of the legume sector can be a condition for achieving it.

Comparative Techno-Economic Analysis of Parabolic Trough and Linear Fresnel Collectors with Evacuated and Non-Evacuated Receiver Tubes in Different Geographical Regions

In the context of Concentrated Solar Power (CSP) technology, this paper presents a comparison between the Parabolic Trough Collector (PTC) and the Linear Fresnel Collector (LFC), considering both evacuated and non-evacuated receiver tubes. The comparison was carried out in terms of the Levelized Cost of Electricity (LCOE) considering a reference year and four locations in the world, characterized by different levels of direct normal irradiation (DNI) from 2183 kWh/m2/year to 3409 kWh/m2/year. The LCOE depends on economic parameters and on the net energy generated by a plant on an annual basis. The latter was determined by a steady-state 1D model that solved the energy balance along the receiver axis. This model required computing the incident solar power and heat losses. While the solar power was calculated by an optical ray-tracing model, heat losses were computed by a lumped-parameter model developed along the radial direction of the tube. Since the LFC adopted a secondary concentrator, no conventional correlation was applicable for the convective heat transfer from the glass cover to the environment. Therefore, a 2D steady-state CFD model was also developed to investigate this phenomenon. The results showed that the PTC could generate a higher net annual energy compared to the LFC due to a better optical performance ensured by the parabolic solar collector. Nevertheless, the difference between the PTC and the LFC was lower in the non-evacuated tubes because of lower heat losses from the LFC receiver tube. The economic analysis revealed that the PTC with the evacuated tube also achieved the lowest LCOE, since the higher cost with respect to both the LFC system and the non-evacuated PTC was compensated by the higher net energy yield. However, the non-evacuated LFC demonstrated a slightly lower LCOE compared to the non-evacuated PTC since the lower capital cost of the non-evacuated LFC outweighed its lower net annual energy yield. Finally, a sensitivity analysis was conducted to assess the impact on the LCOE of the annual optical efficiency and of the economic parameters. This study introduces key technical parameters in LFC technology requiring improvement to achieve the level of productivity of the PTC from a techno-economic viewpoint, and consequently, to fill the gap between the two technologies.

Investigating uncertainties in air quality models used in GMAP/SIJAQ 2021 field campaign: General performance of different models and ensemble results

The international field campaign, GMAP/SIJAQ 2021, was conducted in Korea from October 18th to November 25th to enhance the performance and validation of the Geostationary Environment Monitoring Spectrometer (GEMS) products algorithm and obtain a better understanding of the current air pollution status of the Korean Peninsula. Five chemical transport models (CTMs), including CMAQ, CMAQ-GIST, CAMx, WRF-Chem, and WRF GEOS-Chem, were utilized during the campaign to assist in organizing the observation plan and identifying changes in pollutant concentrations and their spatiotemporal distribution in Korea following the Korea–United States Air Quality (KORUS-AQ) 2016. In this study, we evaluated the forecasting performance, strengths, and limitations of these five CTMs and their ensemble in simulating air quality. Intensive measurement data and intercomparisons were employed to explain discrepancies between observed and simulated results. A comparison of the CTM ensemble results for PM2.5 and various gaseous pollutants between the current GMAP/SIJAQ 2021 and previous KORUS-AQ 2016 campaigns showed the R-value for the total mass PM2.5 concentration increased from 0.88 to 0.94. This improvement is related to CTM updates, including the emission inventory and better reproductions of the concentrations of gaseous species. However, the models consistently underestimated carbon monoxide (CO) concentrations, similar to the results from KORUS-AQ. This finding still suggests a further challenge that requires consideration of missing anthropogenic sources. The results of the ensemble model agreed well with the chemical composition of PM2.5 observed at the intensive monitoring station. However, for NO3− and NH4+, discrepancies were primarily due to inaccuracies in the meteorological inputs, such as precipitation, relative humidity (RH), and nighttime planetary boundary layer height (PBLH) in the CTMs. Hence, all models overestimated the concentration of elemental carbon (EC), therefore, it is necessary to revise EC emissions in the SIJAQv2 inventory, as these apply to unusual levels recorded in Seoul during the reference year of 2018.

The intensity of regional food trade among the Western Balkan countries during periods of crisis

This study explores the intensity of food trade among the Western Balkan (WB) countries (Albania, Bosnia and Herzegovina, Montenegro, North Macedonia, and Serbia) during periods of crisis, emphasizing the impact of COVID-19 and the Ukrainian-Russian conflict on regional trade dynamics. The impact of this crisis was measured over three analyzed years: 2018, representing a reference year for comparison, then 2020 as the year affected by COVID-19, and 2022, being affected by the pandemic as well as the Ukrainian-Russian crisis. All data collected are from the “Trade Statistics for International Business Development Database”. Conclusions about the intensity of exchange of agricultural and food products within the WB region were obtained by calculating Regional Intensity of Trade of Export (RITE) and Regional Intensity of Trade of Import (RITI). Higher values than 1 indicate intensity in trade or dominance of trade in specific products with a particular region compared with the trade with the world. In the case of trade among the WB countries, the COVID-19 crisis did not affect the increase in trade volume. However, there was an increase in intra-regional trade by about 50% when compared with 2020 and 2022. The RITE coefficients for all countries except Albania were greater than 1, indicating intensified export of agricultural and food products to the WB region compared with their global export. The RITI index is very important in crisis, as it somewhat answers the question of who "feeds" the country during crises. All WB countries had the RITI indices greater than 1, indicating a higher intensity of food imports from the region compared with the world. According to this research, the RIT coefficients measured generally declined in the years of crises, meaning that the countries shifted their export focus to other regions but still the most significant foreign and intense trade partners in agricultural and food products were countries from the region.

Tree-ring anomalies as time markers for ice-core chronologies, with special reference to 5281 BCE as the possible date of the Kikai volcanic event

The synchronization of Greenland and Antarctica ice core data with tree-ring data, other proxies, and direct observations of natural processes and events is important to understand past climatic variation and environmental change. One of the methods that is used to correct the dating of ice layers is to match volcanic eruption footprints in ice cores with tree rings, manifested as sulphate spikes and anomalous rings, respectively. In this study, we inventoried the occurrence of tree-ring anatomical anomalies and extremes in ring width during three 200-year periods. These periods included three of the eight largest Holocene volcanic eruptions, each with a Volcanic Explosivity Index (VEI) of 7. The initial period spanned from 6560 to 6360 BCE and included the eruption of Ilyinsky Volcano in Kamchatka. The second period was from 5780 to 5580 BCE, during which Mount Mazama Volcano in North America erupted. The third period was from 5380 to 5180 BCE when the Kikai Volcano in the Japanese Islands erupted. Throughout the first two periods, no substantial tree-ring anomalies were observed suggesting the absence of any significant climate consequences of a major volcanic eruption. However, in the 5380–5180 BCE period, a clear sharp decline in tree growth and an exceptionally high frequency of tree-ring anomalies were identified in 5281 BCE and the subsequent 5 years. We propose that the exceptionally narrow light rings in these 6 years are indicative of the climatic impact resulting from the Kikai volcanic eruption. We suggest utilising the year 5281 BCE as the reference year for synchronising the Greenland and Antarctica ice core chronologies. In the case that our assumption is correct, this would imply the necessity to adjust the time of the event to an earlier date compared to the dates indicated by the existing ice core chronologies of the GICC05 (Greenland Ice Core Chronology 2005), adjusted according to Kobashi (2017), and WD2014 used for creating HolVol 1.0 (Holocene ice-core volcanic eruption catalogue from 9500 BCE - 1900 CE) by 67 and 54 years, respectively, for the period around 5300 BCE. A verification of our assumption could be conducted by examining the nearby Miyake event, a spike in cosmogenic radiocarbon, of 5258 BCE. Ice core layers displaying potential signs of this event should be approximately 25 years later than the markers of the Kikai volcanic eruption.

Fit for 2030? Possible scenarios of road transport demand, energy consumption and greenhouse gas emissions for Italy

Decarbonizing the transportation sector is one of the key challenges to reduce greenhouse gas (GHG) emissions and meet EU Green deal 2030 targets. Road transport decarbonization requires a holistic approach encompassing various strategies and interventions aimed at fostering the sustainable transition of this sector. This challenge is crucial given that road is responsible for over 90% of the overall transport GHG emissions.Within this framework, this study aims, for the Italian case, to: a) estimate the national passenger and freight road travel demand with respect to three different time periods: 2005 (reference year for EU “fit for 55” target); 2019 (last consolidated pre-covid year); 2022 (base-line year); b) define possible road transport scenarios to 2030 following the Avoid-Shift-Improve (ASI) approach; c) estimate the GHG and energy consumption inventory related to national road transport for the 2005, 2019; 2022 and 2030 scenarios. Due to the current “deep uncertainty” regarding key economic and social variables in this period, two forecasting scenarios – named “moderate decarbo” and “high decarbo” – were designed and based on different and somewhat opposite hypotheses on exogenous variables (e.g., GDP) and penetration rates of measures and policies promoting sustainable transportation (e.g., subsidies for electric vehicles) already in place. Although the current European legislation refers only to Tank-to-Wheel (TtW) objectives, this study included also the Well-to-Wheel (WtW) evaluation, which is more accurate in assessing the GHG impact of different policies, energy carriers, and technologies. As for the past, results suggest that GHG reductions over the period 2005–2022 are mostly due to crises and stagnation of the Italian economy. “Moderate decarbo” forecasts for 2030 lead to a 12% reduction of TtW (and 15% for WtW) GHG emissions compared to 2005 levels, with ASI policies compensating for the assumed economic growth. In any case these values are far from the EU “Fit for 55” goal setting a 43.7% reduction of TtW emissions. Even under very favourable hypotheses (“high decarbo” scenario), GHG emissions might be reduced by only 28% for TtW and 33% for WtW, still well below EU objectives. Furthermore, passengers and freight show very different behaviour, with the latter contributing to emissions more than proportionally, and “shift-to-rail” policies, although very useful in some market segments, contribute moderately at the overall national level. The main conclusion of this study is that the pathway towards road transport decarbonization in Italy (and possibly in other EU Countries) is very uncertain, and the ambitious 2030 target is unlikely to be met with currently planned policies alone. The transportation system needs to be constantly monitored, and new policies have to be implemented to reach higher emissions reduction goals.

Chutes and Ladders? Job Opportunities for Generation Covid

Focusing on jobs for youth, this study analyzes the development of job postings in Norway during the first and second waves of the COVID-19 pandemic in 2020. Jobs for youth are defined by the top 20 three-digit occupations for young workers, and postings for these occupations took a heavier hit than other jobs during the pandemic. We also identify the top 20 occupations for entrants immediately after completing their highest education to reveal that, during the pandemic, entry jobs for young people with lower education declined the most. Using 2018 and 2019 as reference years, we show that the decline started before ‘lockdown’ policies were in place but worsened during the lockdown. As the economy reopened, job posting rates improved but did not reach the 2018 and 2019 levels.

Impacts on Biogenic Carbon Dioxide Emission Fluxes Driven by Generated Numerical-Downscaled Climate Scenarios

The aim of this research is to analyze the local impacts (high spatial resolution) of tier 1 CMIP6 climate scenarios (SSP126, SSP245, SSP370 and SSP585) on CO2 biogenic emission fluxes after downscaled climate data over five European regions (national, regional and urban scale) for the period: 2015-2050 using numerical simulations with the WRF/Chem-VPRM tool. VPRM is the Vegetation Photosynthesis and Respiration Model which is coupled with the Weather Research and Forecasting (WRF) model and Chem (Transport). Satellite data is used to derive vegetation indexes used by the VPRM model. The effect of climate is isolated using 2018 (reference year) emissions and land use over the entire simulation period and it is calculated as results of the future simulations minus present (2018). The research is part of the European DISTENDER project, who develops a methodological framework to bring together adaptation and mitigation strategies against the risks of climate change. The increase in temperature leads to higher CO2 emissions from vegetation, as the increase in temperature favors the respiration process of plants. The impacts are spatially and temporally varied and therefore each case study and scenario has its own pattern, with a strong influence on the existing vegetation and local climate Keywords: Climate change, CO2, biogenic emissions, scenarios, downscaling

Cost-Effectiveness of 9-Valent HPV Vaccination for Patients Treated for High-Grade Cervical Intraepithelial Neoplasia in the UK

Patients who have been treated for high-grade cervical intraepithelial neoplasia (CIN grade ≥2) are at a high risk for subsequent CIN and other cancers and diseases related to human papillomavirus (HPV). HPV vaccination can reduce the risk of subsequent disease in patients surgically treated for grade 2 or greater CIN; however, there is no formal recommendation for prophylactic HPV vaccination in this high-risk population, and the cost-effectiveness is unknown. To assess the incremental lifetime outcomes, costs, and cost-effectiveness of integrating peritreatment 9-valent HPV (9vHPV) vaccination in combination with posttreatment surveillance for the prevention of cervical cancer and other HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN vs posttreatment surveillance alone from a UK payer perspective. This economic evaluation used 3 independent Markov model structures. Model inputs for vaccine efficacy, utilities, and costs were obtained from published sources, and cervical cancer screening data were obtained from the National Health Service Cervical Screening Program. Costs were adjusted to 2022 to 2023 reference years. Data were analyzed from October 2022 to September 2023. Peritreatment vaccination with 9vHPV in combination with posttreatment surveillance compared with posttreatment surveillance alone. Clinical outcomes included grade 1, 2, or 3 CIN; cervical cancer; vaginal cancer; vulvar cancer; anal cancer; head and neck cancer; genital warts; and recurrent respiratory papillomatosis. Incremental cost-effectiveness ratios (ICERs) using a willingness-to-pay threshold (WTP) of £20 000 (US $26 200) per quality-adjusted life-year (QALY) were estimated. Deterministic sensitivity analysis and probabilistic sensitivity analysis were performed. Vaccination with 9vHPV in conjunction with posttreatment surveillance was cost-effective, with a favorable ICER of £13 789.07 (US $18 064.68) per QALY gained (ie, below the WTP of £20 000 per QALY) vs posttreatment surveillance alone. The resulting ICER was £52 358.01 (US $68 588.99) per HPV-related cancer averted and £64 090 (US $83 958.18) per HPV-related cancer death averted. The ICER was most sensitive to discount rate, incidence of HPV infection, vaccine price, and age at initial treatment for grade 2 or greater CIN. Results of the probabilistic sensitivity analysis showed peritreatment 9vHPV vaccination was cost-effective at the WTP recommended by the UK's Joint Committee on Vaccination and Immunisation (90% of iterations <£30 000 [US $39 300] per QALY) in 100% of iterations. These findings suggest that peritreatment prophylactic 9vHPV vaccination is a cost-effective option for preventing subsequent HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN.

Declining Trends in Septic Revision Following Total Knee Arthroplasty From 2010 to 2019: A National Cohort Analysis

Periprosthetic joint infections (PJI) following total knee arthroplasty (TKA) are associated with high patient morbidity, mortality, and healthcare costs. Methods to reduce the burden of PJI have been shown to be efficacious on a small scale. On a national scale, it is unknown whether these methods have reduced PJI rates. A retrospective trend analysis was conducted using a national database. The incidence of 2-year septic revision was observed for the entire cohort and patients who had high-risk co-morbidities from 2010 to 2019. A multivariable logistic regression was performed to compare the odds ratios of 2-year septic revision rates from 2011 to 2019 to the reference year of 2010. Linear regression was used to compare the change throughout this period in the overall and high-risk sub-analysis groups. Among the 860,185 patients, 5,589 underwent septic revision within 2 years. The 2-year septic revision rate decreased from 0.75% in 2010 to 0.69% in 2019 (compounded annual growth rate [CAGR] = -0.94%, P = 0.049). Multivariable logistic regressions demonstrated that the odds of septic revision in 2019 were significantly lower than those in 2010 (OR [odds ratio]: 0.83, 95% CI [confidence interval]: [0.70 to 0.96], P = 0.017). In high-risk patients, the septic revision rate decreased from 1.04 to 0.80% (CAGR = -2.80%, P = 0.004), specifically in those who had a history of psychoses, Medicaid insurance, anemia, heart failure, obesity, liver disease, tobacco use, and drug abuse (P < 0.05 for all). This study demonstrates a national reduction in the 2-year septic revision rate in all TKA patients, including patients considered at high risk for PJI. This suggests current preventative methods may be efficacious on a national scale in TKA. Further research is needed to identify more modalities to reduce the national incidence of this morbid and costly complication.

EXAMINING THE EFFICIENCY OF NATIONAL AND INTERNATIONAL RAILWAY FREIGHT TRANSPORTATION DURING A SPECIFIC TIME PERIOD

The aim of this study is to determine the efficiency values of the Republic of Turkey State Railways (TCDD) in national and international freight transportation between 2010 and 2019. Additionally, the study aims to identify the years in which the company operated more efficiently, process this information, and provide reference years and recommendations to relevant institutions.Since railway investment costs are very high, the efficient use of resources is of great importance. This study is significant in terms of guiding the efficient use of railway resources. Moreover, the use of different input and output variables over a specific time period distinguishes this study from other scientific research, as it incorporates both national and international data. For efficiency measurement, output (tonne-kilometres) and input variables (amount of freight transported, main line length, and number of freight wagons) were used, following the relevant literature. The data used in the research were obtained from the activity reports of TCDD and the Turkish Statistical Institute. DEAP (Data Envelopment Analysis Program) software, based on Productivity Time Analysis, was used to analyze the research data. As a result, the average efficiency in national railway freight transport decreased by 1.8%, while the average efficiency in international railway freight transport decreased by 22.4%. The reference year for both types of transport was 2010. Although efficiency in international railway freight transport showed partial improvement in certain years, it generally exhibited a continuous downward trend.

Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022.

Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic's impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method. Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented. The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with "endocrine, nutritional, and metabolic diseases" and "symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified." Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.

Economic burden and health-related quality of life in patients with epidermolysis bullosa in Spain

Background. Epidermolysis bullosa (EB) is a rare genetic skin disorder characterized by fragility of skin with appearance of acute and chronic wounds. The aim of this study was to determine the economic burden and the health-related quality of life (HRQoL) of patients with epidermolysis bullosa (EB) in Spain from a societal perspective.Methods. We conducted a cross-sectional, retrospective study including 62 patients with EB (62% dystrophic, 9.6% junctional, 3.2% Kindler syndrome, and 26% with simplex EB). Data were collected from questionnaires completed by patients or their caregivers. The costs were estimated, including not only direct healthcare costs but also direct non-healthcare costs and productivity losses. We compared severe EB (Dystrophic, Junctional EB and Kindler syndrome) to non-severe EB (simplex EB) using as reference year 2022. HRQoL was measured by generic (EQ-5D) and specific (QoLEB) questionnaires.ResultsThe average annual cost for an EB patient was €31,352. Direct healthcare costs represented 17.2% of the total cost, direct non-healthcare costs (mainly informal care costs) 71.3% and productivity losses 11.5% of the total cost. Participants in the severe EB group had a slightly higher average cost than participants in the non-severe EB group (€31,706 vs. €30,337). Direct healthcare costs and non-healthcare costs were higher in the severe EB group (€6,205 vs. €3,024 and €23,148 vs. €20,113) while productivity losses were higher in the non-severe EB group (€7,200 vs. €2,353). The mean utility index score, where the maximum value possible is one, was 0.45 for patients with severe EB (0.76 for their caregivers) and 0.62 for those with non-severe EB (0.77 for their caregivers).Conclusions. The social economic burden of EB, resulting from the high direct non-healthcare cost of informal care, and from the loss of productivity, accentuates the importance of not restricting cost analysis to direct healthcare costs. This substantiates that EB, particularly severe EB represents a significant hidden cost that should be revealed to society and should be considered in the support programmes for people who suffer from this disease, and in the economic evaluation of new treatments.

The role of hydropower in decarbonisation scenarios

An increased penetration of renewable energy sources is essential for the energy transition. A major role will be played by wind and solar, as they are widely available. Hydropower is another crucial resource, currently covering large shares of power generation (e.g., Norway, Italy, Brazil). Despite little expected growth, in a context of increasing electrification, improved integration of hydropower can play a critical role thanks to programmable operation. This work addresses the modelling of hydropower flexibility in energy system models and analyses the impact of hydropower operation on CO2 emission-constrained scenarios. To implement the study, a detailed dataset of the Italian programmable hydroelectric plants is created, using open-source information, covering location, rated power, and storage capacity. Inflow timeseries are derived from historical operational data. These new sets of data are employed in OMNI-ES (a multi-node, multi-sector, and multi-vector energy system model) to study optimal configurations and operation of the Italian energy system in decarbonisation scenarios, such as net-zero-CO2 and Fit-for-55 targets. Considering different operational strategies and multiple historical reference years (impacting the inflow), results demonstrate significant changes in hydropower behaviour and highlight its relevance as zero-carbon resource in terms of both power and energy output, influencing the installation of other technologies.

Catalog of the Ulidiidae (Diptera: Tephritoidea) of Chile

A catalog of Ulidiidae, picture-winged flies, from Chile is provided. Included are all valid names and synonyms for the 16 species and nine genera known from Chile, including information about name, author, year of publication, page number, type species, type locality, and references. Euxesta Loew is the more species richness genus in Chile, with five species, followed by Ceroxys Macquart, with two species. Besides, the lectotype and three paralectotypes of Ortalis fasciata Wiedemann, 1830, now in Pterotaenia, are here designated. A discussion about the distribution and biology of the picture-winged flies’ species in Chile is presented.

Performance and clinical outcomes in telestroke remain robust during the COVID-pandemic: insight into the NEVAS network.

The COVID-19 pandemic had significant impact on global healthcare, including stroke management. Telemedical stroke networks have emerged with positive results for patient outcome in rural areas without stroke expertise. However, telestroke faced enormous on-site challenges during the pandemic. So far, data on performance and clinical outcomes in telestroke settings during the COVID-pandemic are scarce. We retrospectively analyzed data from stroke patients treated in four spoke hospitals of the Bavarian telestroke network NEVAS in 2020-2021 and 2019 as reference year and compared the 3years for various parameters. Primary outcome was functional outcome according to the modified Rankin scale (mRS). Secondary outcome parameters included time intervals, periprocedural intracranial hemorrhage rates, and mortality. In 2019-2021, 2820 patients were treated for acute ischemic stroke with an admission decrease of 10% during the pandemic. Of those, 241 received only IVT and 204 were transferred to our center for MT. Door-to-imaging, door-to-needle, and symptom-onset-to-groin times remained comparable in the 3years. Complication rates remained at a low level. Good clinical outcome rates (mRS 0-2) at discharge remained stable for all stroke patients (82-84%) and for those treated with IVT (64-77%). Good clinical outcome rates at 3month follow-up for MT patients declined in 2020 (23% vs. 35% in 2019) but recovered again in 2021 (42%). Mortality rates did not increase for all patient groups analyzed. Stroke care remained robust during the COVID-pandemic within our network, indicating that well-established telestroke networks can overcome unexpected critical challenges such as a pandemic, guaranteeing best practice stroke care in rural areas.

An Estimation of Water Deficits considering the Hwanggang Dams on the Imjin River, North Korea

Water resources are essential for sustaining economic activities; therefore, water conflicts between nations and regions are common. The Imjin and Bukhan rivers, which are shared by South and North Korea, have been the sources of several disputes related to water usage and management between both nations. This study is intended to investigate such water deficits and provide elementary data for future responses by quantifying the water deficit in the Imjin River according to current water usage criteria. The researchers collected records on river water usage and flow rates in the Imjin River Basin from 2001 to 2023 and estimated the river maintenance flow. They analyzed eight runoff stations to assess the river maintenance flow and hydrological phenomena to determine the presence of a water deficit. Through a comparative analysis of the flow rates of the Imjin and Hantan rivers, using 2008 as the reference year, they determined the cause of the water deficit to be a North Korean dam. At the ten-year return-period drought, the total water deficit in the Imjin River Basin amounted to 114.5 million cubic meters, with 92.8% of the deficit occurring in the middle reaches of the Imjin River and the remaining 7.2% in the Hantan River.

Impact assessment of future fleet compositions in vehicle emissions in urban areas: A methodological framework and a case study

This study explores the impact of emerging vehicle technologies on direct urban traffic emissions. It investigates emission reduction potential from shifts in fleet compositions and modal choices, especially considering climate change. To achieve this, three key research areas are explored for historical, current, and future scenarios (up to 2050): mode choice, emission factors for different vehicle categories, and diverse vehicle propulsion technologies. The estimation of the modal split is pivotal, developing a methodology utilizing Stated Preference survey data, discrete choice modeling, Monte Carlo simulations, and macroscopic traffic simulations. Future scenarios derive from the reference year’s modal split, and emission factors and fleet compositions are predetermined via an extensive literature review, aiding the assessment of their respective emissions. A subsequent sensitivity analysis identifies the impact of specific parameters on emissions, guiding future research focus. Study results underscore differences in greenhouse gas emissions and primary air pollutants between base and future scenarios.

Stroke but no hospital admission: Lost opportunity for whom?

To counter the spread of COVID-19, the French government imposed several stringent social and political measures across its entire population. We hereto assess the impact of these political decisions on healthcare access in 2020, focusing on patients who suffered from an ischemic stroke. We divide our analysis into four distinct periods: the pre-COVID-19 pandemic period, the lockdown period, the "in-between" or transitional period, and the shutdown period. Our methodology involves utilizing a retrospective dataset spanning 2019-2020, an exhaustive French national hospital discharge diagnosis database for stroke inpatients, integrated with income information from the reference year of 2019. The results reveal that the most affluent were more likely to forgo medical care, particularly in heavily affected areas. Moreover, the most disadvantaged exhibited even greater reluctance to seek care, especially in the most severely impacted regions. The data suggest a loss of opportunity for less severely affected patients to benefit from healthcares during this lockdown period, regardless of demographic, location, and socioeconomic determinants. Furthermore, our analysis reveals a notable discrepancy in healthcare-seeking behavior, with less affluent patients and seniors (over 75 years old) experiencing slower rates of return to healthcare access compared to pre-pandemic levels. This highlights a persistent gap in healthcare accessibility, particularly among socioeconomically disadvantaged groups, despite the easing of COVID-19 restrictions.

The quality of routine data for measuring facility-based maternal mortality in public and private health facilities in Kampala City, Uganda

BackgroundRoutine health facility data are an important source of health information in resource-limited settings. Regular quality assessments are necessary to improve the reliability of routine data for different purposes, including estimating facility-based maternal mortality. This study aimed to assess the quality of routine data on deliveries, livebirths and maternal deaths in Kampala City, Uganda.MethodsWe reviewed routine health facility data from the district health information system (DHIS2) for 2016 to 2021. This time period included an upgrade of DHIS2, resulting in two datasets (2016–2019 and 2020–2021) that were managed separately. We analysed data for all facilities that reported at least one delivery in any of the six years, and for a subset of facilities designated to provide emergency obstetric care (EmOC). We adapted the World Health Organization data quality review framework to assess completeness and internal consistency of the three data elements, using 2019 and 2021 as reference years. Primary data were collected to verify reporting accuracy in four purposively selected EmOC facilities. Data were disaggregated by facility level and ownership.ResultsWe included 255 facilities from 2016 to 2019 and 247 from 2020 to 2021; of which 30% were EmOC facilities. The overall completeness of data for deliveries and livebirths ranged between 53% and 55%, while it was < 2% for maternal deaths (98% of monthly values were zero). Among EmOC facilities, completeness was higher for deliveries and livebirths at 80%; and was < 6% for maternal deaths. For the whole sample, the prevalence of outliers for all three data elements was < 2%. Inconsistencies over time were mostly observed for maternal deaths, with the highest difference of 96% occurring in 2021.ConclusionsRoutine data from childbirth facilities in Kampala were generally suboptimal, but the quality was better in EmOC facilities. Given likely underreporting of maternal deaths, further efforts to verify and count all facility-related maternal deaths are essential to accurately estimate facility-based maternal mortality. Data reliability could be enhanced by improving reporting practices in EmOC facilities and streamlining reporting processes in private-for-profit facilities. Further qualitative studies should identify critical points where data are compromised, and data quality assessments should consider service delivery standards.