Effects analysis and probability forecast (EAPF) of real-time management on urban flooding: A novel bidirectional verification framework

Government departments usually prepare and implement contingency plans to address frequent urban flooding caused by short-term heavy rainfall. Previous studies focused on the evaluation of the static impact of the policies on urban floods, while there is a lack of research on the effect of off-design conditions, real-time feedback and treatments of the flood events on urban flood mitigation, which is detrimental to the optimization of management strategies of the cities. To quantify the effects of real-time management on flood mitigation in Fuzhou City, China, this study proposed a framework (EAPF) for evaluation and risk prediction. First, we collected data on the locations, rainfall intensity, inundation time, and the triggers of the waterlogging events from 2017 to 2021. Second, based on the vigilance analyses, a structural equation model (SEM) was constructed to quantitatively evaluate the mitigation effects of management on waterlogging. Finally, a probability prediction model of dynamic drainage capacity was proposed for flood simulation caused by the rainwater grate blockage. The results indicate that the environmental factors were the decisive triggers affecting the severity of waterlogging, and increasing the frequency of management events effectively reduced the probability of blocking. The correlation between the number of management events and blocking flood events was -0.42, while a decrease in vigilance increased the possibility of flooding caused by overdue treatment. The proposed hydrological waterlogging model, which considered blockages, exhibited a Nash-Sutcliffe efficiency (NSE) coefficient exceeding 0.9 under deterministic conditions. The probability prediction model verified the mitigating effect of management on the blockages and urban flooding, and its results were consistent with those of the SEM. Our study contributes to improving the reliability of waterlogging prediction and optimizing the management flow in the developing cities.

Management Strategy for Prostate Imaging Reporting and Data System Category 3 Lesions

PURPOSE OF REVIEW

Prostate Imaging Reporting and Data System (PI-RADS) category 3 lesions present a clinical dilemma due to their uncertain nature, which complicates the development of a definitive management strategy. These lesions have an incidence rate of approximately 22-32%, with clinically significant prostate cancer (csPCa) accounting for about 10-30%. Therefore, a thorough evaluation is warranted.

RECENT FINDINGS

This review highlights the need for radiology peer review, including the confirmation of dynamic contrast-enhanced (DCE) compliance, as the initial step. Additional MRI models such as VERDICT or Tofts need to be verified. Current evidence shows that imaging and clinical indicators can be used for risk stratification of PI-RADS 3 lesions. For low-risk lesions, a safety net monitoring approach involving annual repeat MRI can be employed. In contrast, lesions deemed potentially risky based on prostate-specific antigen density (PSAD), 68 Ga-PSMA PET/CT, MPS, Proclarix, or AI/machine learning models should undergo biopsy. It is recommended to establish a multidisciplinary team that takes into account factors such as age, PSAD, prostate, and lesion size, as well as previous biopsy pathological findings. Combining expert opinions, clinical-imaging indicators, and emerging methods will contribute to the development of management strategies for PI-RADS 3 lesions.

Severe Symptomatic Epidural Hematoma Following Percutaneous Endoscopic Unilateral Laminectomy for Bilateral Decompression (Endo-ULBD)-Series Report and Management Strategies

OBJECTIVES

Severe symptomatic epidural hematoma (SSEH) is one of the most severe complications following percutaneous endoscopic unilateral laminectomy for bilateral decompression (Endo-ULBD). Considering that this technique has been performed for a short time, no detailed reports have been recently published. Thus, it is critical to gain a better understanding of SSEH occurring in its postoperative period with regard to its incidence, possible causes, outcome, etc., in order to identify relevant management strategies.

METHODS

Patients with spinal stenosis who had undergone Endo-ULBD in our department from May 2019 to May 2022 were retrospectively analyzed. Of which, patients with postoperative epidural hematoma were followed-up. The preoperative and postoperative physical conditions of each patient were recorded, and the information related to hematoma removal surgery was recorded in detail. Clinical outcomes were assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI), and the results were classified into "excellent," "good," "fair," or "poor" based on the modified MacNab criteria. The incidence of hematoma with different factors was calculated, and a bar graph was used to compare the difference of the indexes related to hematoma removal between cases, and a line graph was used to reflect the trend of the outcome of each patient within 6 months to evaluate the effect of the treatment.

RESULTS

A total of 461 patients with spinal stenosis who underwent Endo-ULBD were enrolled in the study. SSEH occurred in four cases, with an incidence rate of 0.87% (4/461). All these four patients underwent decompression of multiple segments, and three of them had a history of hypertension comorbid with diabetes. Notably, one patient had a past history of hypertension and coronary artery disease and was on postoperative low molecular heparin due to lower extremity venous thrombosis. According to the conditions of the four patients, three types of treatment were used. And with timely treatment, all patients recovered well.

CONCLUSION

Despite being a minimally invasive technique, postoperative epidural hematoma remains a severe complication of Endo-ULBD. Therefore, during percutaneous endoscopic surgery, it is essential to enhance the comprehensive perioperative management of patients with Endo-ULBD. Signs related to postoperative hematoma must be recognized and promptly managed. If necessary, satisfactory results can be achieved by using percutaneous endoscopy along the original surgical channel to remove the hematoma.

Agricultural management strategies for balancing yield increase, carbon sequestration, and emission reduction after straw return for three major grain crops in China: A meta-analysis

Straw return can improve crop yield as well as soil organic carbon (SOC) but may raise the possibility of N₂O and CH₄ emissions. However, few studies have compared the effects of straw return on the yield, SOC, and N₂O emissions of various crops. Which management strategies are the best for balancing yield, SOC, and emission reduction for various crops needs to be clarified. A meta-analysis containing 2269 datasets collected from 369 studies was conducted to investigate the influence of agricultural management strategies on yield increase, soil carbon sequestration, and emission reduction in various crops after the straw return. Analytical results indicated that, on average, straw return increased the yield of rice, wheat, and maize by 5.04%, 8.09%, and 8.71%, respectively. Straw return increased maize N₂O emissions by 14.69% but did not significantly affect wheat N₂O emissions. Interestingly, straw return reduced the rice N₂O emissions by 11.43% but increased the CH₄ emissions by 72.01%. The recommended nitrogen application amounts for balancing yield, SOC, and emission reduction varied among the three crops, while the recommended straw return amounts were more than 9000 kg/ha. The optimal tillage and straw return strategies for rice, wheat, and maize were plow tillage combined with incorporation, rotary tillage combined with incorporation, and no-tillage combined with mulching, respectively. A straw return duration of 5-10 years for rice and maize and ≤5 years for wheat was recommended. These findings provide optimal agricultural management strategies after straw return to balance the crop yield, SOC, and emission reduction for China's three major grain crops.

Value conflicts in grassroots environmental management from a network perspective: a case study of crop residue management in Harbin, China

Open burning of crop residue is a hot issue in Asia and has attracted widespread attention. However, this attention rarely extends to the complex interactions between multi-stakeholders in the governance process, which is precisely the focus of today's environmental governance dilemma. Harbin is a major grain-producing area in China, the annual air pollution caused by the open burning of crop straw is more prominent than in other parts of China, and the conflicting relationships among multi-stakeholders are also typical. Taking Harbin as a case, this study quantifies the complex relationships among stakeholders through value demands conflicts and constructs a value conflict network in the context of straw governance. Through the analysis of the network nodes and relationships, we found that grassroots governments and farmers are the core of the conflict, while public and higher-level governments, as supervisory subjects, are marginalized. The multiple identities and value demands of the grassroots government, as well as cost and technology constraints, are the main reasons for the governance dilemma. In addition, the grassroots government in different scenario dimensions has different conflict resolution strategies, and it has a strong self-adaptation ability in the embedded value conflict network and can influence and reshape other stakeholders. These findings highlight the critical role of the grassroots government in crop residue governance, add to the research paradigm on grassroots environmental management from a multiple-stakeholder participation perspective, and provide a theoretical and methodological basis to formulate effective strategies.

Emergent interactions in the management of multiple threats to the conservation of harbour porpoises

Human activities at sea are intensifying and diversifying. This is leading to more complex interactions of anthropogenic impacts requiring adaptable management interventions to mitigate their cumulative effects on biodiversity conservation and restoration objectives. Bycatch remains the dominant conservation threat for coastal cetaceans. Additionally, the indirect impact of repeated exposure to disturbances, particularly acoustic disturbances, can affect cetacean population growth and therefore conservation objectives. Pingers are used to ensonify nets to provide an effective mitigation of bycatch risk. As those become more prevalent across fisheries at risk to catch for example harbour porpoises, pingers become contributors to the anthropogenic noise landscape which may affect the vital rates of this species as well. Currently, we do not know how to best balance pinger prevalence to minimise both bycatch rate and the population consequences of acoustic disturbance (PCoD). Here we use an agent-based model to determine how pinger prevalence in nets can be adjusted to minimise bycatch rate and noise disturbance propagating to affect population growth for harbour porpoises. We show that counter-intuitively bycatch rate can increase at lower pinger prevalence. When ecological conditions are such that PCOD can emerge, higher prevalence of pingers can lead to indirect effects on population growth. This would result from condition-mediated decreased reproductive potential. Displacing fishing effort, via time-area closure, can be an effective mitigation strategy in these circumstances. These findings have important implications for current management plans which, for practical consideration, may lead to lower overall pinger prevalence at sea. This study also shows that estimating the reproductive potential of the species should be incorporated in bycatch monitoring programmes. We now need to better understand how physiological condition affect reproductive decisions and behavioural responses to noise in cetaceans to better appraise and estimate the cumulative impacts of bycatch and its mitigations.

Spatio-temporal variation of net anthropogenic nitrogen inputs (NANI) from 1991 to 2019 and its impacts analysis from parameters in Northwest China

At present, excessive nutrient inputs caused by human activities have resulted in environmental problems such as agricultural non-point source pollution and water eutrophication. The Net Anthropogenic Nitrogen Inputs (NANI) model can be used to estimate the nitrogen (N) inputs to a region that are related to human activities. To explore the net nitrogen input of human activities in the main grain-producing areas of Northwestern China, the county-level statistical data for the Ningxia province and NANI model parameters were collected, the spatio-temporal distribution characteristics of NANI were analyzed and the uncertainty and sensitivity of the parameters for each component of NANI were quantitatively studied. The results showed that: (1) The average value of NANI in Ningxia from 1991 to 2019 was 7752 kg N km^-2 yr^-1. Over the study period, the inputs first showed an overall increase, followed by a decrease, and then tended to stabilize. Fertilizer N application was the main contributing factor, accounting for 55.6%. The high value of NANI in Ningxia was mainly concentrated in the Yellow River Diversion Irrigation Area. (2) The 95% confidence interval of NANI obtained by the Monte Carlo approach was compared with the results from common parameters in existing literature. The simulation results varied from -6.4% to 27.4% under the influence of the changing parameters. Net food and animal feed imports were the most uncertain input components affected by parameters, the variation range was -20.7%-77%. (3) The parameters of inputs that accounted for higher proportions of the NANI were more sensitive than the inputs with lower contributions. The sensitivity indexes of the parameters contained in the fertilizer N applications were higher than those of net food and animal feed imports and agricultural N-fixation. This study quantified the uncertainty and sensitivity of parameters in the process of NANI simulation and provides a reference for global peers in the application and selection of parameters to obtain more accurate simulation results.

Progress in the management of acute colchicine poisoning in adults

Colchicine is a tricyclic, lipid-soluble alkaloid which has long been used to treat gout and many immunological diseases. Due to its narrow therapeutic window and long half-life of elimination, colchicine overdose occurs occasionally. Unfortunately, some patients lost their lives because of colchicine overdose or suicide. Acute colchicine poisoning can lead to original gastrointestinal disorders, shock, progressive multiple organ failure, and myelosuppression. Although many researchers in the world performed lots of research, there are currently no specific antidotes for colchicine poisoning. Meanwhile, there are no management guidelines to treat patients with acute colchicine poisoning until now. Herein, we systematically elaborate on the clinical features and progress in the management of acute colchicine poisoning in adults according to the previous literature. This paper will provide some valuable and available information for clinicians.

The noteworthy chloride ions in reclaimed water: Harmful effects, concentration levels and control strategies

Chloride ions (Cl^-), which are omnipresent in reclaimed water, can cause various problems in water reuse systems, especially during water transmission and at end use sites. Although reverse osmosis (RO) is considered as an effective technology to reduce chloride, its high investment and complex maintenance requirements hinder its application in many water reclamation plants (WRPs). Recently, several technologies bringing new options to better deal with chloride have gained increased attention. This review provides detailed information on the harmful effects, concentration levels, and sources of chloride in reclaimed water and summarizes and discusses various chloride removal technologies, including non-selective methods (e.g., membrane filtration, adsorption and ion exchange, oxidation, and electrochemical methods) and selective methods (e.g. precipitation and specially designed electrochemical methods). Among these, Friedel's salt precipitation and capacitive deionization showed attractive development potential. This review also proposes a holistic framework for chloride control from aspects of "Fit-for-Purpose" planning, technical system development, and whole process optimization, which could facilitate the planning and operation of long-term sustainable water reuse practices.

Risk factors and management strategies for cerebrospinal fluid leakage following lumbar posterior surgery

OBJECTIVE

To analyze the risk factors of cerebrospinal fluid leakage (CSFL) following lumbar posterior surgery and summarize the related management strategies.

METHODS

A retrospective analysis was performed on 3179 patients with CSFL strategies lumbar posterior surgery in our hospital from January 2019 to December 2020. There were 807 cases of lumbar disc hemiation (LDH), 1143 cases of lumbar spinal stenosi (LSS), 1122 cases of lumbar spondylolisthesis(LS), 93 cases of lumbar degenerative scoliosis(LDS),14 cases of lumbar spinal benign tumor (LST). Data of gender, age, body mass index(BMI), duration of disease, diabete, smoking history, preoperative epidural steroid injection, number of surgical levels, surgical methods (total laminar decompression, fenestration decompression), revision surgery, drainage tube removal time, suture removal time, and complications were recorded.

RESULTS

The incidence of 115 cases with cerebrospinal fluid leakage, was 3.6% (115/3179).One-way ANOVA showed that gender, body mass index (BMI), smoking history, combined with type 2 diabetes and surgical method had no significant effect on CSFL (P > 0.05). Age, type of disease, duration of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery had effects on CSFL (P < 0.05). Multivariate Logistic regression analysis showed that type of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery were significantly affected CSFL (P < 0.05).Drainage tube removal time of CSFL patients ranged from 7 to 11 days, with an average of 7.1 ± 0.5 days, drainage tube removal time of patients without CSFL was 1-3 days, with an average of 2.0 ± 0.1 days, and there was a statistical difference between the two groups (P < 0.05).The removal time of CSFL patients was 12-14 days, with an average of 13.1 ± 2.7 days, and the removal time of patients without CSFL was 10-14 days, with an average of 12.9 ± 2.2 days, there was no statistically significant difference between the two groups (P > 0.05).

CONCLUSION

Type of disease, preoperative epidural steroid injection, number of surgical levels and revision surgery were the risk factors for CSFL. Effective prevention were the key to CSFL in lumbar surgery. Once appear, CSFL can also be effectively dealt without obvious adverse reactions after intraoperative effectively repair dural, head down, adequate drainage after operation, the high position, rehydration treatment, and other treatments.

Clinical analysis of second-trimester pregnancy termination after previous caesarean delivery in 51 patients with placenta previa and placenta accreta spectrum: a retrospective study

BACKGROUNDS

Pregnancy termination during the second trimester in patients with placenta previa and placenta accreta spectrum (PAS) is a complex and challenging clinical problem. Based on our literature review, there has been a relative increase in the number of such cases being treated by hysterotomy and/or local uterine lesion resection and repair. In the present study, a retrospective analysis was conducted to compare the clinical outcomes when different management strategies were used to terminate pregnancy in the patients with placenta previa and PAS.

METHODS

A total of 51 patients who underwent pregnancy termination in the second trimester in Beijing Obstetrics and Gynecology Hospital between June 2013 and December 2018 were retrospectively analyzed in this study. All patients having previous caesarean delivery (CD) were diagnosed with placenta previa status and PAS.

RESULTS

① Among the 51 patients, 16 cases received mifepristone and misoprostol medical termination, 15 cases received mifepristone and Rivanol medical termination, but 1 of them was transferred to hysterotomy due to failed labor induction, another 20 cases were performed planned hysterotomy. There was no placenta percreta cases and uterine artery embolization (UAE) was all performed before surgery.② There were 31 cases who underwent medical termination and 30 cases were vaginal delivery. Dilation and evacuation (D&E) were used in 20 cases of medical abortion failure and in all 30 cases of difficult manual removal of placental tissue. ③ A statistically significant difference was found among the three different strategies in terms of gestational weeks, the type of placenta previa status, main operative success rate and β-HCG regression time (P < 0.05). ④ There were 4(7.8%) cases who were taken up for hysterectomy because of life-threatening bleeding or severe bacteremia during or after delivery and hysterotomy. The uterus was preserved with the implanted placenta partly or completely left in situ in 47(92.2%) cases. Combined medical and/or surgical management were used for the residual placenta and the time of menstrual recovery was 52(range: 33 to 86) days after pregnancy termination.

CONCLUSIONS

Terminating a pregnancy by vaginal delivery through medical induction of labor may be feasible if clinicians have an overall understanding of gestational age, the type of placenta previa status, the type of placenta accreta, and patients concerns about preserving fertility. A collaborative team effort in tertiary medical centers with a very experience MDT and combined application of multiple methods is required to optimize patient outcomes.

Net anthropogenic nitrogen and phosphorus inputs in Pearl River Delta region (2008-2016)

Excess inputs of nitrogen (N) and phosphorus (P) are the main contributors of aquatic environmental deterioration. Due to the agricultural and industrial activities in the rapidly urbanized basin, the anthropogenic N and P cycle are significantly different from other regions. In this study, we took the Pearl River Delta as an example and introduced the budget list of N and P in the five survey years, including the net anthropogenic N inputs (NANI) and net anthropogenic P inputs (NAPI). The results revealed that the intensities of NANI and NAPI in this area increased from 2008 to 2010 and then decreased after 2010. The peak values were 21001 kg N km^-2yr^-1 and 4515 kg P km^-2yr^-1 for the intensities of NNAI and NAPI, respectively, while the lowest values decreased to 19186 kg N km^-2yr^-1 and 4103 kg P km^-2yr^-1 in 2016. The most important contribution of NANI and NAPI sources in this area were net N and P inputs for human food and animal feed with an average contribution of 61.41% and 76.83%, which indicated that large amounts of N and P were introduced into the environment through the food system. This study expanded the knowledge on regional environmental management from human dietary consumption, human life consumption, animal consumption and fertilizer consumption. Its reuse will be put into practice by understanding the driving factors of N and P inputs in each region of the basin, combining the urbanization characteristics.

Impacts of key factors on heavy metal accumulation in urban road-deposited sediments (RDS): Implications for RDS management

Understanding of the impacts of key influential factors on RDS related heavy metal (HM) contamination is crucial for developing effective RDS management strategies to support the stormwater pollution mitigation. In this paper, three factors (i.e. traffic condition, slope of road and antecedent dry period) were considered to investigate their influences on the accumulation of RDS and adsorbed HMs. Positive correlations between truck and Zn/Ni content in RDS, car and Cu/Pb content in fine RDS, as well as bus and Cu content in coarse RDS were observed. Relative to sloping stretches, RDS from level stretches generally presented finer size distributions and aggravated HM contamination in fine fractions. Moreover, the fine RDS and adsorbed HMs increased significantly with the accumulation of RDS. Based on these findings, optimized RDS management strategies were proposed to enhance the removal of washable RDS in pollution hotspots. For example, tandem sweeping technologies, performing high efficiency in capturing fine particles, are suggested to be employed during the steady period of RDS accumulation, in order to reduce fine RDS effectively. The outcomes of this study provide useful reference for the source control of stormwater runoff pollution.

Perioperative management strategy of severe traumatic brain injury during the outbreak of COVID-19

Since December 2019, a pneumonia caused by a new coronavirus, i.e. COVID-19 occurred in Wuhan, Hubei Province, China. Although the epidemic in China has been bought under control, the global COVID-19 situation is still grim. Severe traumatic brain injury (TBI), as one of critical conditions in the department of neurosurgery, requires an early and effective treatment, especially surgery. There were currently no reliable guidelines on how to perform perioperative protection in TBI patients with suspected or confirmed coronavirus infection. According to the corresponding treatment regulations and guidelines issued by the authorities, we summarized the management strategy of TBI patients in perioperative period during the COVID-19 outbreak based on medical and nursing practice, in order to provide a reference for clinicians.

Impacts of climate change on geographical distributions of invasive ascidians

Ocean warming associated with global climate change renders marine ecosystems susceptible to biological invasions. Here, we used species distribution models to project habitat suitability for eight invasive ascidians under present-day and future climate scenarios. Distance to shore and maximum sea surface temperature were identified as the most important variables affecting species distributions. Results showed that eight ascidians might respond differently to future climate change. Alarmingly, currently colonized areas are much smaller than predicted, suggesting ascidians may expand their invasive ranges. Areas such as Americas, Europe and Western Pacific have high risks of receiving new invasions. In contrast, African coasts, excluding the Mediterranean side, are not prone to new invasions, likely due to the high sea surface temperature there. Our results highlight the importance of climate change impacts on future invasions and the need for accurate modelling of invasion risks, which can be used as guides to develop management strategies.

Evidence of overfishing of geoduck clam Panopea globosa from a length-based stock assessment approach

Stock assessment of the geoduck clam Panopea globosa in Mexico has been based on data-poor without consideration of the biological traits of the species, promoting a passive management strategy without biological reference points for its harvest and conservation, which results in limited advice regarding the sustainability of the fishery. The stock assessment was supported on an integrated catch-at-size assessment model. The model described the population changes, including recruitment, selectivity, fishing mortality, individual growth patterns and survival over time, providing management quantities for the geoduck clam fishery, such as biomass-at-length (total and vulnerable) and harvest rate-at-length. The results indicated overfishing of the geoduck clam population; the harvest rate exceeded the management tactics established for this fishery, even the individuals smaller than the minimum legal size (130 mm) were harvested. Thus, declines in the total biomass (from 3,262 to 1,130 t) and recruitment (representing an 86% decrease) were observed from 2010 to 2012. Although the results showed a recovery trend in recruitment and total biomass from 2014 to 2016, this trend may have been due to the spatial relocation of fishing mortality.

Neck management in patients with olfactory neuroblastoma

OBJECTIVE

Optimal neck management in patients with olfactory neuroblastoma (ONB), a rare malignancy, remains uncertain. This study aimed to analyse patterns of cervical lymph node metastases and corresponding clinical outcomes and to investigate the value of elective neck irradiation (ENI) in this population.

METHODS AND MATERIALS

This study retrospectively reviewed clinical records, imaging findings, nodal metastasis features and treatment data of 217 patients with ONB treated at our hospital during 1991-2019. Univariate and multivariate analyses were used to assess the influence of cervical lymph node involvement on treatment outcomes. Survival and regional failure rates were compared between patients with or without ENI.

RESULTS

Thirty-two patients (14.7%) presented initially with cervical lymph node metastases, most frequently at levels II (10.6%, 23/217) and VIIa (5.5%, 12/217). Patients with and without cervical node metastasis differed significantly in overall (OS) (41.9% vs. 86.1%, p < 0.001), progression-free (PFS) (41.9% vs. 84.8%, p < 0.001), regional failure-free (45.9% vs. 89%, p < 0.001) and distant metastasis-free survival (41.5% vs. 86.1%, p < 0.001). Cervical lymph involvement was an independent factor affecting poor OS (hazard ratio, 0.184, 95% confidence interval, 0.078-0.436, p < 0.001) and PFS (hazard ratio, 0.198, 95% confidence interval, 0.088-0.445, p < 0.001). Moreover, 43.8% patients (95/217) underwent ENI, which significantly reduced the incidence of regional recurrence from 10.7% to 3.2% (χ² = 4.396, p = 0.036) but did not significantly affect other survival outcomes. Regional failures could be resolved using salvage treatment.

CONCLUSIONS

Our findings indicate the importance of systematic therapy for patients with initial cervical lymph node metastases. ENI is not recommended for N0 disease.

Detecting crucial dispersal pathways using a virtual ecology approach: A case study of the mirid bug Stenotus rubrovittatus

Detecting dispersal pathways is important both for understanding species range expansion and for managing nuisance species. However, direct detection is difficult. Here, we propose detecting these crucial pathways using a virtual ecology approach, simulating species dynamics using models, and virtual observations. As a case study, we developed a dispersal model based on cellular automata for the pest insect Stenotus rubrovittatus and simulated its expansion. We tested models for species expansion based on four landscape parameters as candidate pathways; these are river density, road density, area of paddy fields, and area of abandoned farmland, and validated their accuracy. We found that both road density and abandoned area models had prediction accuracy. The simulation requires simple data only to have predictive power, allowing for fast modeling and swift establishment of management plans.

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km² representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups (p-values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development.

An integrative review on conflict management styles among nursing students: Implications for nurse education

OBJECTIVES

Nurse education plays a critical role in the achievement of conflict management skills in nursing students. However, a wider perspective on this concept has not been explored. This paper is a report of a review appraising and synthesizing existing empirical studies describing conflict management styles among nursing students.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five (5) bibliographic databases (CINAHL, Medline, Psych Info, Embase and SCOPUS) were searched to locate relevant articles.

REVIEW METHODS

An electronic database search was performed in December 2016 to locate studies published from 2007 onwards. The search words included: 'conflict', 'management resolution', 'management style', 'management strategy', 'nursing', 'student'. Thirteen (13) articles met the inclusion criteria.

RESULTS

Nursing students preferred 'constructive/positive conflict management styles' when handling conflicts. However, more studies are needed to identify factors that may affect their choice of styles. Further, this review emphasizes the need for empirical studies to identify appropriate interventions that would effectively enhance nursing students' skills in managing conflicts using rigorous methods.

CONCLUSIONS

Nursing faculty play a critical role in teaching, training, and modeling constructive conflict resolution styles in nursing students. Simulation scenarios, reflective exercises, and role playing may be useful to facilitate such learning in choosing constructive conflict management styles. Structured training programme on conflict management will assist nursing students develop positive conflict management styles.

Phylogeographic Identification of Tench Tinca tinca (L., 1758) (Actinopterygii: Cyprinidae) from the Northern Balkans and Adjacent Regions and its Implications for Conservation

Jelena Lujić, Klaus Kohlmann, Petra Kersten, Zoran Marinović, Miroslav Ćirković, and Vladica Simić (2017) The tench, Tinca tinca, is an endangered freshwater fish species in the Balkans. However, there are no management and conservation strategies developed for this species so far. In order to be able to develop such strategies, we first determined the phylogeographic identity of 70 tench individuals from four countries (Serbia, FYRO Macedonia, Hungary and Croatia) by PCR-RFLP analyses of two nuclear markers (Act and RpS7) and one mitochondrial marker (Cytb). All makers enabled the identification of two major geographic clades of tench (Western and Eastern), while nuclear markers additionally enabled the identification of hybrids between the two clades. Based on the mitochondrial marker Cytb, tench populations can be separated into two distinct areas: areas north of the Danube River with the dominant Western origin, and areas south of the Danube River with the dominant Eastern origin. Data obtained for the Act gene demonstrated Eastern origin for most individuals (88.23%) while data obtained for the RpS7 gene demonstrated mixed origin with a high percentage of hybrids. The presence of high numbers of individuals with Western alleles for the RpS7 gene in areas south of the Danube may indicate a natural invasion of this phylogroup. According to these results, areas north and south of the Danube are identified as two main management units. Additionally, we identified the rare western haplotype W2 based on the Cytb marker which clearly indicated human-aided dispersals of tench in the investigated region and since some individuals with W2 origin were cultured, attention must be given to the genetic structure and identity of the introduced individuals, whether during introduction or reintroduction since biological and ecological consequences of the hybridization between the two major clades are still unknown. Finally, we propose and discuss management and conservation strategies for tench of both management areas.

Factors associated with remission of primary nocturnal enuresis and changes of parental perception towards management strategies: A follow-up study

OBJECTIVE

To understand the remission rates, shifts in treatment methods used by parents, and parents' attitudes towards their children with primary nocturnal enuresis (NE).

STUDY DESIGN

A total of 408 children aged 6-12 years and diagnosed with primary nocturnal enuresis from a 2004 epidemiological study in Taiwan were enrolled. After a 5.5-year follow-up period, the remission rates of the children of each age group were evaluated, and the corresponding treatment methods were employed daily. Furthermore, the major risk factors that influenced the remission rates in these children were investigated.

RESULTS

The overall remission rate was 93.1% among all age groups, and the median age of remission was 9.9 years (95% CI 9.5-10.2 years). Comparing the previous and after results of this study, the treatment methods utilized by the parents in response to enuresis were significantly different. More parents chose combination therapy and sought medical attention as the children grew older, particularly the parents of children with severe NE. Few parents still continued to use punishment method. A Cox proportional hazards regression model revealed that girls, young children, those with low enuresis frequency, and light sleepers had higher remission rates than did their counterparts.

CONCLUSION

Parents' attitudes towards enuresis influence their choice of therapy for their children. In most cases, parents chose a combination of therapies, particularly combining limited fluid intake and regular voiding. Only 37 (9.1%) children received medicine. The older the enuretic child, the more likely the parents were to seek medical treatment for their children. Enuresis might disappear spontaneously but not always. A small proportion of children will continue to wet till adulthood. The treatment of NE at this age would be challenging. Children who were deep sleepers or affected by severe enuresis had a low probability of achieving dryness. However, girls and young children had a higher probability of achieving remission than did their counterparts.

Generating an agricultural risk map based on limited ecological information: A case study using Sicyos angulatus

In this study, we propose a method for estimating the risk of agricultural damage caused by an invasive species when species-specific information is lacking. We defined the "risk" as the product of the invasion probability and the area of potentially damaged crop for production. As a case study, we estimated the risk imposed by an invasive weed, Sicyos angulatus, based on simple cellular simulations and governmental data on the area of crop that could potentially be damaged in Miyagi Prefecture, Japan. Simulation results revealed that the current distribution range was sufficiently accurate for practical purposes. Using these results and records of crop areas, we present risk maps for S. angulatus in agricultural fields. Managers will be able to use these maps to rapidly establish a management plan with minimal cost. Our approach will be valuable for establishing a management plan before or during the early stages of invasion.

Early Lung Computed Tomography Scan after Allogeneic Hematopoietic Stem Cell Transplantation

A lung computed tomography (CT) scan is essential for diagnosing lung diseases in hematopoietic stem cell transplantation (HSCT) recipients. As a result, lung CT scans are increasingly prescribed in the early phase after allogeneic HSCT, with no assessment of the added value for global patient management. Among 250 patients who underwent allogeneic HSCT in our center over a 2-year period, we evaluated 68 patients who had at least 1 lung CT scan within the first 30 days post-transplantation. The median interval between allogeneic HSCT and lung CT scan was 8.5 days. Patients who underwent an early lung CT scan were more immunocompromised and had a more severe course. Fever was the main indication for the CT scan (78%). The lung CT scan was abnormal in 52 patients, including 17 patients who had an abnormal pre-HSCT CT scan. A therapeutic change was noted in 37 patients (54%) within 24 hours after the lung CT scan. The main changes included the introduction of corticosteroids (n = 23; 62%), especially in patients with a normal CT scan (89%). In univariate models, we found that a normal pretransplantation CT scan (P = .002), the absence of either dyspnea (P = .029) or hypoxemia (P = .015), and a serum C-reactive protein level <10 mg/L (P = .004) were associated with a normal post-HSCT lung CT scan. We found that the association of these variables could predict the normality of early post-HSCT lung CT scans. Pretransplantation lung CT scans are useful for the interpretation of subsequent lung CT scans following allogeneic HSCT, which are frequently abnormal. Early post-HSCT lung CT scans are helpful in patient management, but prescriptions could be more targeted.

Current perspectives on pancreatic serous cystic neoplasms: Diagnosis, management and beyond

Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.

Vegetation effects on floating treatment wetland nutrient removal and harvesting strategies in urban stormwater ponds

Floating treatment wetlands (FTWs) consist of emergent macrophytes that are placed on a floating mat in a pond for water treatment and aesthetic purposes. FTWs may have unique advantages with respect to treating urban runoff within existing retention ponds for excess nutrients. However, research is lacking in providing guidance on performance of specific species for treating urban runoff, and on timing of harvest. Harvesting is needed to remove nutrients permanently from the retention pond. We investigated vegetation effects on FTWs on nitrogen (N) and phosphorus (P) removal performance and storage in above-ground FTW macrophyte tissues. The study evaluated pickerelweed (PW, Pontederia cordata L.) and softstem bulrush (SB, Schoenoplectus tabernaemontani) over time in microcosms flushed with water obtained from a nearby urban retention pond in northern Virginia near Washington, DC. While the literature exhibits a wide range of experimental sizes, using the term mesocosm, we have chosen the term microcosm to reflect the small size of our vessel; and do not include effects of sediment. The experiment demonstrated PW outperformed SB for P and N removal. Based upon analysis of the accumulated nutrient removal over time, a harvest of the whole PW and SB plants in September or October is recommended. However, when harvesting only the aerial parts, we recommend harvesting above-ground PW tissues in July or August to maximize nutrient removal. This is because PW translocates most of its nutrients to below-ground storage organs in the fall, resulting in less nutrient mass in the above-ground tissue compared to the case in the summer (vegetative stage). Further research is suggested to investigate whether vegetation can be overly damaged from multiple harvests on an annual basis in temperate regions.