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Atmospheric heat has become a major public concern in a rapidly warming world. Evapotranspiration, however, provides effective land surface cooling during the vegetation period. Adversely, modern cultural landscapes - due to both water and potential evapotranspiration pathways lacking - are increasingly incapable of offering this important benefit. We hypothesised that concerted measures for a revived landscape water retention can fuel plant transpiration, especially during dry periods, and thus contribute to climate change adaptation by stabilising the regional climate. Seeking nature-based ways to an improved landscape water retention, we used the land surface temperature (LST) as a proxy for landscape mesoclimate. For our drought-prone rural study area, we identified potential candidate environmental predictors for which we established statistical relationships to LST. We then, from a set of potential climate change adaptation measures, mapped selected items to potential locations of implementation. Building on that, we evaluated a certain measures' probable cooling effect using (i) the fitted model and (ii) the expected expression of predictors before and after a hypothetical measure implementation. In the modelling, we took into account the spatial and temporal autocorrelation of the LST data and thus achieved realistic parameter estimates. Using the candidate predictor set and the model, we were able to establish a ranking of the effectiveness of climate adaptation measures. However, due to the spatial variability of the predictors, the modelled LST is site-specific. This results in a spatial differentiation of a measure's benefit. Furthermore, seasonal variations occur, such as those caused by plant growth. On average, the afforestation of arable land or urban brownfields, and the rewetting of former wet meadows have the largest cooling capacities of up to 3.5 K. We conclude that heat countermeasures based on fostering both evapotranspiration and landscape water retention, even in rural regions, offer promising adaptation ways to atmospheric warming.
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Cambio Climático , TemperaturaRESUMEN
Against the backdrop of slowing economic growth and increasing environmental pressure, the Yangtze River Delta city cluster, as one of the largest city clusters in the world, has become more driven in its pursuit of high-quality development. We constructed a system of 24 evaluation indexes and used entropy-weighted TOPSIS to calculate and study the high-quality development index of urban agglomerations in the region. First, the level of high quality development (HQD) of the Yangtze River Delta city cluster generally improved from 2010 to 2021, with 2017 was the best year, while 2010 was the worst year. Second, in the multidimensional evaluation of HQD, Jiangsu excels in innovation and people's livelihood with 0.524 and 0.534, respectively; Shanghai (0.531) excels in coordinated development; Zhejiang excels in green and economic development with 0.557 and 0.484, respectively; and Anhui lags behind in all aspects. Third, the development process of HQD in the Yangtze River Delta region is uneven, and the level of HQD development varies greatly among the city clusters in the province. The measurement results show that Shanghai (0.511) has the highest score, followed by Zhejiang (0.484), Jiangsu (0.440) and Anhui (0.435). Fourth, spatial correlation analysis shows that Shanghai and Jiangsu are mainly distributed in the double-high region, Zhejiang is distributed in the high-low region, while Anhui is concentrated in the low-low region. The results of this study help us understand more deeply the characteristics and challenges of high-quality development in the Yangtze River Delta urban agglomerations and provide a scientific basis for more precise urban development policies.
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OBJECTIVES: This study aimed to develop a new patient-reported outcome measure (PROM) to systematically and scientifically evaluate patients' subjective feelings after orthognathic surgery. METHODS: A literature review and semi-structured interviews were conducted to construct a conceptual framework and an item pool, followed by expert and patient surveys for measure construction. We conducted a clinical investigation to test the feasibility, reliability, and content validity of this measure. RESULTS: The conceptual framework included four domains: psychological health, physiological health, social function, and satisfaction, and 33 items were included in the survey. Following the expert analysis, 31 items remained in the draft. The clinical investigation showed a 100% recovery and completion rate and good reliability, with Cronman-Brown formula coefficients of 0.893 and 0.944, respectively. CONCLUSIONS: A new outcome measure to evaluate patients' subjective feelings after orthognathic surgery was successfully developed, and the clinical investigation demonstrated that the PROM had satisfactory feasibility, reliability, and validity. Further studies are possible based on our PROM, and data on a larger scale may reveal more information on patients' subjective feelings about orthognathic surgery. CLINICAL SIGNIFICANCE: The novel PROM provides a systematic and scientific way to evaluate the patient's subjective feelings to help surgeons obtain complete patient-reported information after orthognathic surgery. Additionally, standardised multicentre research on patients' subjective feelings using our PROM is possible and could improve the effectiveness of the evaluation and help maintain treatment quality.
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Cirugía Ortognática , Humanos , Reproducibilidad de los Resultados , Medición de Resultados Informados por el Paciente , Encuestas y Cuestionarios , Satisfacción Personal , Calidad de Vida/psicologíaRESUMEN
BACKGROUND: To achieve national and international strategic goals, countries are advised to assess the maturity status of their health information systems (HIS), including business continuity and interoperability. This work aims to determine the existing maturity status of the Ethiopian HIS, set HIS improvement goals, and inform a path towards an improved national HIS by the end of 2024. METHODS: This assessment was a collaborative and transparent process that was carried out with the engagement of all key stakeholders through consultation. We used the Stages of Continuous Improvement (SOCI) tool to guide the assessment to measure the maturity level of the Ethiopian HIS in five core domains, 13 components and 39 subcomponents and to guide future plans. RESULTS: The overall average score of the national HIS maturity was 2.68/5, which is categorized between repeatable (stage 2) and defined (stage 3) maturity levels. The assessment findings revealed that three out of the five HIS maturity domains were at a repeatable stage. Only the leadership and governance and the data quality and use domains were at the defined maturity level. A majority (7/13) of the subcomponents were at the repeatable level of maturity, while four were at the defined level. Policy, legal and regulatory framework and compliance from the leadership and governance domain and interoperability from the data quality and use domain were categorized as having an emerging status. Considering the current HIS maturity status, gaps and strengths identified, ongoing HIS initiatives, existing platforms, and the interest and level of engagement of senior government leadership, this assessment put forward an improvement roadmap for achieving the desired managed stage (4.37) of maturity by the end of 2024. CONCLUSIONS: The findings show that the overall maturity level of the Ethiopian HIS is 2.68, which is between the repeatable and defined maturity stages. Enforcement of policies and legislation, data exchange among systems, and information and communication technology infrastructure business continuity planning are the main challenges of Ethiopian HIS requiring further investment. Strengthened and collaborative effort is critical to reaching the desired goal of "managed" HIS (stage 4) in the country by 2024.