Emergency Scenario-Based Training Curriculum Development: Enhancement of Caregivers for the Elderly' Emergency Assistance Competency in a Rural Thai Community.

Background: Caregivers for the elderly are a critical component of the health care system, especially in rural communities. They play a crucial role, assisting older people in confronting emergency illnesses. Objective: The study describes the process of developing an emergency scenario-based training curriculum (ESBTC) for caregivers of the elderly, focusing on geriatric life-threatening surveillance and emergency assistance (GLTSEA) in rural communities. Methods: The descriptive qualitative research utilized for developing the ESBTC followed Karn's six steps of curriculum development: (1) needs assessment, (2) targeted needs assessment, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback. The research sample comprised community representatives engaged in providing care during emergency illnesses, emergency experts, and health care providers. A group discussion and focus group were conducted along with semi-structured interviews. The data were analyzed by content analysis following Creswell's six steps. Results: The results revealed problems and needs related to the care and management of emergency illnesses in rural communities. Five main themes emerged, including insufficient knowledge, difficulties in communication, mindfulness and self-confidence, Unable to assess the initial symptoms, and a need for skills development. In the development step, the curriculum focused on skill development and continued follow-up to ensure necessary skills, such as providing basic life support, using automated external defibrillators, through training scenarios. In the evaluation step, the participants indicated that their emergency assistance skills had improved. The six main themes that emerged regarding the training continuity, courses, and competencies needed to support the emergency system for caregivers were benefits and value, competence enhancements, upstreaming confidence, sustainable development, challenges in curriculum development, and effective strategies. Conclusions: The ESBTC combines community-based and realistic scenarios, involving the participation of community stakeholders. It is crucial to gather community feedback and needs assessments to formulate potential strategies as part of the curriculum.

Pre-crash scenarios for safety testing of autonomous vehicles: A clustering method for in-depth crash data.

Autonomous vehicles (AVs) provide an opportunity to enhance traffic safety. However, AVs market penetration is still restricted due to their safety concerns and dependability. For widespread adoption, it is crucial to thoroughly assess the safety response of AVs in various high-risk scenarios. To achieve this objective, a clustering method was used to construct typical testing scenarios based on the China In-depth Mobility Safety Study-Traffic Accident (CIMSS-TA) database. Initially, 222 car-to-powered two-wheelers (PTWs) crashes and 180 car-to-car crashes were reconstructed from CIMSS-TA database. Second, six variables were extracted and analyzed, including the motion of the two vehicles involved, relative movement, lighting condition, road condition, and visual obstruction. Third, these variables were clustered using the k-medoids algorithm, identifying five typical pre-crash scenarios for car-to-PTWs and seven for car-to-car. Additionally, we extracted the velocities and surrounding environmental information of the crash-involved parties to enrich the scenario description. The approach used in this study used in-depth case review and thus provided more insightful information for identifying and quantifying representative high-risk scenarios than prior studies that analyzed overall descriptive variables from Chinese crash databases. Furthermore, it is crucial to separately test car-to-car scenarios and car-to-PTWs scenarios due to their distinct motion characteristics, which significantly affect the resulting typical scenarios.

The effect of scenario-based training versus video training on nurse anesthesia students' basic life support knowledge and skill of cardiopulmonary resuscitation: a quasi-experimental comparative study.

BACKGROUND: Performing CPR (Cardiopulmonary Resuscitation) is an extremely intricate skill whose success depends largely on the level of knowledge and skill of Anesthesiology students. Therefore, this research was conducted to compare the effect of the scenario-based training method as opposed to video training method on nurse anesthesia students' BLS (Basic Life Support) knowledge and skills. METHODS: This randomized quasi-experimental study involved 45 nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in 2022-2023. The practical room of the university formed the research environment. The participants were randomly divided into three groups of scenario-based training, video training, and control. Data were collected by a knowledge questionnaire and a BLS skill assessment checklist before and after the intervention. RESULTS: There was a significant difference between the students' scores of BLS knowledge and skill before and after the educational intervention in both SG (scenario group) (p < 0.001) and VG (video group) (p = 0.008) (p < 0.001). However, no significant difference was observed in this regard in the CG (control group) (p = 0.37) (p = 0.16). Also, the mean scores of BLS knowledge and skills in the SG were higher than those in the VG (p < 0.001). CONCLUSION: Given the beneficial impact of scenario-based education on fostering active participation, critical thinking, utilization of intellectual abilities, and learner creativity, it appears that this approach holds an advantage over video training, particularly when it comes to teaching crucial subjects like Basic Life Support.

Evaluating net primary productivity dynamics and their response to land-use change in the loess plateau after the 'Grain for Green' program.

Assessing net primary productivity (NPP) dynamics and the contribution of land-use change (LUC) to NPP can help guide scientific policy to better restore and control the ecological environment. Since 1999, the "Green for Grain" Program (GGP) has strongly affected the spatial and temporal pattern of NPP on the Loess Plateau (LP); however, the multifaceted impact of phased vegetation engineering measures on NPP dynamics remains unclear. In this study, the Carnegie-Ames-Stanford Approach (CASA) model was used to simulate NPP dynamics and quantify the relative contributions of LUC and climate change (CC) to NPP under two different scenarios. The results showed that the average NPP on the LP increased from 240.7 gC·m-2 to 422.5 gC·m-2 from 2001 to 2020, with 67.43% of the areas showing a significant increasing trend. LUC was the main contributor to NPP increases during the study period, and precipitation was the most important climatic factor affecting NPP dynamics. The cumulative amount of NPP change caused by LUC (ΔNPPLUC) showed a fluctuating growth trend (from 46.23 gC·m-2 to 127.25 gC·m-2), with a higher growth rate in period ΙΙ (2010-2020) than in period Ι (2001-2010), which may be related to the accumulation of vegetation biomass and the delayed effect of the GGP on NPP. The contribution rate of LUC to increased NPP in periods Ι and ΙΙ was 101.2% and 51.2%, respectively. Regarding the transformation mode, the transformation of grassland to forest had the greatest influence on ΔNPPLUC. Regarding land-use type, the increased efficiency of NPP was improved in cropland, grassland, and forest. This study provides a scientific basis for the scientific management and development of vegetation engineering measures and regional sustainable development.

Spatiotemporal evolution and driving factors of ecosystem service bundle based on multi-scenario simulation in Beibu Gulf urban agglomeration, China.

Rapid urbanization is profoundly impacting the ecological environment and landscape patterns, leading to a decline in ecosystem services (ES) and posing threats to both ecological security and human well-being. This study aimed to identify the spatial and temporal patterns of ecosystem service bundles (ESB) in the Beibu Gulf urban agglomeration from 2000 to 2030, analyze the trajectory of ESB evolution, and elucidate the drivers behind ESB formation and evolution. We utilized the Patch-generating Land Use Simulation (PLUS) model to establish baseline (BLS), carbon sequestration priority (CPS), and urbanization priority (UPS) scenarios for simulating land use patterns in 2030. Following the assessment of ecosystem service values (ESV) through the equivalent factor method, we identified the spatiotemporal distribution patterns of ESB using the K-means clustering algorithm. By employing stability mapping and landscape indices, we identified and analyzed various types of ESB evolutionary trajectories. Redundancy analysis (RDA) was employed to pinpoint the drivers of ESB formation and evolution. The results revealed that from 2000 to 2030, land use changes were primarily observed in cropland, forestland, and construction land. Between 2000 and 2020, 92.88% of the region did not experience shifts in ESB types. In UPS, the ESB pattern in the study area underwent significant changes, with only 76.68% of the region exhibiting stabilized trajectories, while the other two scenarios recorded percentages higher than 80%. Key drivers of ESB-type shifts included initial food provision services, elevation, slope, changes in the proportion of construction land, and population change. This multi-scenario simulation of ESB evolution due to land use changes aids in comprehending potential future development directions from diverse perspectives and serves as a valuable reference for formulating and changing ecological management policies and strategies.

Risk-based public health impact assessment for drinking water contamination emergencies.

Chemical spills in surface waters pose a significant threat to public health and the environment. This study investigates the public health impacts associated with organic chemical spill emergencies and explores timely countermeasures deployable by drinking water facilities. Using a dynamic model of a typical multi-sourced New England drinking water treatment facility and its distribution network, this study assesses the impacts of various countermeasure deployment scenarios, including source switching, enhanced coagulation via poly­aluminum chloride (PACl), addition of powdered activated carbon (PAC), and temporary system shutdown. This study reveals that the deployment of multiple countermeasures yields the most significant reduction in total public health impacts, regardless of the demand and supply availability. With the combination PAC deployed first with other countermeasures proving to be the most effective strategies, followed by the combination of facility shutdowns. By understanding the potential public health impacts and evaluating the effectiveness of countermeasures, authorities can develop proactive plans, secure additional funding, and enhance their capacity to mitigate the consequences of such events. These insights contribute to safeguarding public health and improving the resilience of drinking water systems in the face of the ever-growing threat of chemical spills.

Historical development, impact mechanism and future trends of nitrogen footprint in Wuxi City, China.

Human activities have changed the biogeochemical cycle of nitrogen, leading to a large amount of reactive nitrogen (Nr) into the environment, aggravating a series of environmental problems, affecting human and ecosystem health. Cities are the core areas driving nitrogen cycling in terrestrial ecosystems, however, there are numerous influencing factors and their contributions are unclear. The nitrogen footprint is an important index to understand the impact of human activities on the environment, however, the calculation of urban nitrogen footprint needs a simplified and accurate system method. Here we use a nitrogen footprint calculation model at the urban system level based on system nitrogen balance, and a multi-factor extended STIRPAT (stochastic impact by regression on population, affluence, and technology) model suitable for analyzing the impact mechanism of nitrogen footprint to estimate nitrogen footprint of Wuxi City during 1990-2050. We find that: (1) from 1990 to 2020, the total nitrogen footprint of Wuxi City was in an increasing trend, but the per capita nitrogen footprint was in a decreasing trend. The per capita nitrogen footprint of 22.36 kg capita-1 in 2020 was at a lower level globally. (2) Nr discharge from fossil fuel combustion and Haber-Bosch nitrogen fixation accounted for the main proportion of nitrogen footprint. (3) Dietary choice (Ad), GDP per capita (Ag), urbanization rate (Au), population (P), and fossil energy productivity (Te) were the key factors contributing to the increase of the nitrogen footprint, which resulted in an annual increase of 1.39 %. While nitrogen footprint productivity (Tn), nitrogen use efficiency in crop farming (Tc), and nitrogen use efficiency in animal breeding (Ta) were the key inhibit factors that inhibit the increase of nitrogen footprint, and these factors slow down the annual growth rate of nitrogen footprint by 0.39 %. (4) The continuous growth of nitrogen footprint in the baseline and population growth scenarios will bring more environmental problems and greater environmental governance pressure to Wuxi City, while the sustainable scenario that includes comprehensive means such as economic adaptation and technological improvement is more in line with the requirements of high-quality development in China. Several mitigation measures are then proposed by considering Wuxi's realities from both key impact factors and potential for nitrogen footprint reduction in different scenarios, which can provide valuable policy insights to other cities, especially lakeside cities to mitigate nitrogen footprint.

Key factors in the future of oral and dental health in Iran using scenario writing approach.

BACKGROUND: Oral and dental health can significantly impact individuals' quality of life. The World Health Organization introduces oral health as one of the essential priorities of public health worldwide. Given the lack of studies on the future of oral and dental health in Iran, this study used a futures studies approach to identify the factors in oral and dental health in Iran through scenario writing. METHODS: This study was conducted in three stages including the scenario writing approach, qualitative methods, and exploratory future research. First, potential variables affecting future oral and dental health systems were extracted through interviews. The focus group discussion determined the uncertainty and importance of the variables. Then, the cross-impact balance matrix was imported into the Scenario Wizard software to identify the different states of the scenario generator variables and compatible scenarios were extracted. RESULTS: Seventy variables were extracted as key variables affecting the future of oral and dental health. Regarding the importance and uncertainty, seventeen variables scored higher and fell into policy and governance, economy and financing, social, service delivery, and technology, serving as five categories of scenario generators. Fifteen scenarios with weak consistency and three with strong consistency were obtained using the Cross-Impact Balance matrix in Scenario Wizard software. CONCLUSION: The probability of a pessimistic scenario where all five categories of the scenarios were in the worst possible state was higher due to its consistency. The government's support policies and commitment to oral and dental health were two key factors in the future. Achieving an optimistic and favorable scenario for the future of the country's oral and dental health system depends on the government and policymakers in the health sector adopting a positive attitude towards the role of oral and dental health services in improving societal health. In this scenario, the five categories of the scenario generators were in the best condition.

A study on the reliability and validity of the Japanese version of the Scenario Test for people with chronic stroke-induced aphasia: A cross-sectional study.

BACKGROUND: The Scenario Test is recognised for its effectiveness in assessing the interactive aspects of functional communication in people with post-stroke aphasia (PWA). AIMS: To develop a Japanese version of the Scenario Test (Scenario Test-JP) and assess its reliability and validity. METHODS & PROCEDURES: Among 66 participants, we selected 61 individuals: 34 PWA and 27 healthy controls (HCs). We modified the Scenario Test-JP based on the UK version and subsequently evaluated its reliability (internal consistency, test-retest and intra-rater and inter-rater reliabilities) and validity (convergent and discriminant) by comparing PWA and HCs. OUTCOMES & RESULTS: The Scenario Test-JP showed strong reliability with a Cronbach's α of 0.93, test-retest reliability with an intraclass correlation coefficient (ICC) of 0.97, intra-rater reliability with an ICC of 0.95-1.00, and inter-rater reliability with an ICC of 0.96. The validity of the test was confirmed with concurrent scores ranging from ρ = 0.37 to 0.76 (p < 0.05) and known-groups validity (p < 0.001, r = -0.56). CONCLUSIONS & IMPLICATIONS: The reliability and validity of the Scenario Test-JP align with those of the original Dutch version and the UK and Greek versions. Additionally, the assessment can now include extended alternative communication methods, such as digital devices, indicating the potential of the Scenario Test-JP for modern Japanese speech-language therapy. WHAT THIS PAPER ADDS: What is already known on the subject Interactive communication is a facet of functional communication and is crucial for evaluating engagement and participation of people with aphasia (PWA) in speech-language therapy. The Scenario Test provides valuable information for planning speech-language treatment strategies by assessing dialogic communication. What this study adds This study describes the development of the Scenario Test-JP for use with Japanese speakers and Japanese PWA, which is adapted from the Scenario Test UK version. This study evaluated the reliability and validity of this assessment tool and provided supporting evidence. What are the clinical implications of this work? The reliability and validity of the Scenario Test-JP were consistent with those of the Dutch, UK and Greek versions. The Scenario Test-JP contributes to speech-language therapy in Japan, where high-quality support for the activities and participation of PWA is required. PRACTITIONER POINTS: Insights from the Scenario Test The Scenario Test plays a crucial role in evaluating the functional communication skills of people with post-stroke aphasia (PWA). Enhancing functional communication has been linked to improved social engagement among PWA, which in turn influences their overall quality of life (QOL). Issues addressed by the Scenario Test The Scenario Test aids in delineating rehabilitation objectives for activities and participation among PWA, particularly concerning functional communication. The test facilitates tailored support for PWAs' interactive communication and forms the foundation for appropriate speech-language therapy interventions. Transformation of speech-language therapy (SLT) in Japan through the introduction of the Scenario Test-JP The integration of the Scenario Test-JP could enhance the SLT services provided to PWA in Japan. With Japan experiencing an unprecedented ageing population, the prevalence of social isolation and diminished QOL resulting from communication disorders like stroke-induced aphasia is expected to rise. Consequently, the SLT rehabilitation sector in Japan is actively seeking effective interventions to support functional communication among PWA. Hence, the adoption of the Scenario Test-JP is anticipated to streamline the evaluation of functional communication, facilitating the judicious selection and timely provision of assistance to PWA in SLT, including guidance on communication partner support and communication skill training.

Scenario-based assessment of emergency management of urban infectious disease outbreaks.

Infectious diseases pose a severe threat to human health and are accompanied by significant economic losses. Studies of urban outbreaks of infectious diseases are diverse. However, previous studies have neglected the identification of critical events and the evaluation of scenario-based modeling of urban infectious disease outbreak emergency management mechanisms. In this paper, we aim to conduct an empirical analysis and scenario extrapolation using a questionnaire survey of 18 experts, based on the CIA-ISM method and scenario theory, to identify the key factors influencing urban infectious disease outbreaks. Subsequently, we evaluate the effectiveness of urban infectious disease outbreak emergency management mechanisms. Finally, we compare and verify the actual situation of COVID-19 in China, drawing the following conclusions and recommendations. (1) The scenario-based urban infectious disease emergency management model can effectively replicate the development of urban infectious diseases. (2) The establishment of an emergency command center and the isolation and observation of individuals exposed to infectious diseases are crucial factors in the emergency management of urban outbreaks of infectious disease.

Modern Concepts of Restructured Meat Production and Market Opportunities.

Restructured meat (RM) products are gaining importance as an essential component of the meat industry due to consumers' interest in health benefits. RM products imply the binding or holding of meat, meat by-products, and vegetable proteins together to form a meat product with meat's sensory and textural properties. RM products provide consumers with diversified preferences like the intake of low salt, low fat, antioxidants, and high dietary fiber in meat products. From the point of environmental sustainability, RM may aid in combining underutilized products and low-valued meat by adequately utilizing them instead of dumping them as waste material. RM processing technique might also help develop diversified and new hybrid meat products. It is crucial to have more knowledge on the quality issues, selection of binding agents, their optimum proportion, and finally, the ideal processing techniques. It is observed in this study that the most crucial feature of RM could be its healthy products with reduced fat content, which aligns with the preferences of health-conscious consumers who seek low-fat, low-salt, high-fiber options with minimal synthetic additives. This review briefly overviews RM and the factors affecting the quality and shelf life. Moreover, it discusses the recent studies on binding agents in processing RM products. Nonetheless, the recent advancements in processing and market scenarios have been summarized to better understand future research needs. The purpose of this review was to bring light to the ways of sustainable and economical food production.

How to effectively achieve air pollutant reduction and carbon mitigation in China's industrial sector? A study based on decomposition analysis and scenario simulation.

Reducing air pollutant and carbon emissions in the industrial sector is crucial for the ecological civilization construction in China. In this study, we first employ the generalized Divisia index method to analyze the driving factors of industrial CO2 and SO2 emissions, incorporating fixed asset investment and R&D input. The key sub-sectors that exert significant impact on emissions of the whole industrial sector are identified. And then, scenario analysis and Monte Carlo simulation are utilized to predict future trends and potential for reducing CO2 and SO2 emissions. Furthermore, the carbon peaking time of the industrial sub-sectors is investigated. The results indicate that fixed asset investment and R&D input both have played positive roles in CO2 and SO2 emissions. Emission reduction is mainly driven by investment emission intensity, output emission intensity, and R&D emission intensity. Sub-sectors S09, S10, S11, S12, and S18 present substantial potential for reducing air pollutant and carbon emissions. Although SO2 emissions from the industrial sector are projected to decrease in the future, the peak of CO2 emissions have not been reached. The carbon peak time for the whole industrial sector is predicted in 2025, with the peak of 7892.33 Mt. The five key sub-sectors are anticipated to reach the respective carbon emission peaks at different times. Therefore, to effectively implement industrial air pollutant and carbon reduction, the role of fixed asset investment and R&D input should be fully utilized, and high-energy consumption and high-emission sub-sectors should be prioritized for action.

Spatial and temporal changes in shorebird habitats under different land use scenarios along the Yellow and Bohai Sea coasts in China.

The effect of coastal wetland loss on shorebird habitat in recent years has been widely reported in previous studies. Various coastal wetland conservation and restoration measures have been implemented or will soon be implemented in China. The extent to which these measures will affect the area and structure of coastal wetland habitat in the future remains unclear. Here, we predicted changes in habitat area and structure for 39 common shorebird species along the coasts of the Yellow and Bohai Seas using a cellular automata-Markov (CA-Markov) land use scenario model and a maximum entropy species distribution model, along with terrain factors (slope, aspect, and digital evaluation model) and climate factors (temperature and precipitation) from the Data Centre for Resources and Environmental Sciences at the Chinese Academy of Sciences, land cover maps interpreted using the human-computer interactive method, and citizen science data of shorebird occurrences derived from eBird, Global Biodiversity Information Facility, and Bird Report. We found that shorebird habitat was most abundant along the coasts of Bohai Bay, Laizhou Bay, and Yancheng. The area of habitat decreased and became increasingly fragmented between 2000 and 2020 for more than half of the 39 species. Under the future business-as-usual scenario, the area of shorebird habitat decreased from 2020 to 2050, and the remaining habitat became increasingly fragmented. Under the ecological protection (EP) scenario, habitat loss was mitigated, and habitat connectivity was improved. The area of habitat was lower in 2050 under the EP scenario than in 2000 for most species, especially threatened species, suggesting that the area of habitat will not return to year-2000 levels under the EP scenario. These results emphasize the need to protect remaining shorebird habitats and implement ecological conservation measures to ensure the long-term preservation of coastal wetlands.

Exploring the contribution of nature-based solutions for environmental challenges in the Netherlands.

Nature-based solutions (NbS) offer a promising and sustainable approach to addressing multiple environmental challenges, including climate change, pollution, and biodiversity loss. Despite the potential of NbS, their actual effectiveness in solving these challenges remains uncertain. Therefore, this study evaluates the contribution of NbS implemented in a nature-inclusive scenario for six environmental challenges and associated policy targets in the Netherlands. Fifteen different NbS were applied in the scenario in urban, agricultural, aquatic, and protected nature areas, with measures like flower field margins, green roofs, groundwater level management, and river restoration. The spatially-explicit Natural Capital Model was used to quantify the effectiveness of all applied NbS at a national-scale. Results show NbS significantly contribute to simultaneously solving all six assessed environmental challenges. The most significant impact was seen in improving the quality of water bodies (+34 %), making agriculture more sustainable (+24 %), and protecting and restoring biodiversity (+22 %). The contribution of NbS to address the quality of the living environment (+13 %), climate change (+10 %), and the energy transition was less effective (+2 %). Furthermore, NbS can help to achieve sectoral policy targets at the global, EU, and national levels, including those related to the Birds Habitats Directives, carbon emission, and pesticide reduction targets. This study highlights the potential of NbS to effectively address multiple environmental challenges, although they do not provide a complete solution, and suggests that future research could focus on identifying even more effective ways to implement NbS, and to mainstream their use in policy and practice.

GIS-based spatial analysis for lightning scenario in Bangladesh.

Bangladesh has witnessed alarmingly rising lightning frequency, particularly during pre-monsoon and monsoon seasons. This has resulted in significant annual death tolls from lightning strikes over the past decade. Recognizing this crisis, the country officially declared lightning casualties a natural disaster in 2016. This study delves deeper into the landscape of lightning fatalities and causalities in Bangladesh. Utilizing secondary data sources, this research introduces a unique approach by integrating Bangladesh Meteorological Department (BMD) data and NASA's Lightning Imaging Sensor (LIS) data from the International Space Station's (ISS) Near-real Time (NRT) mission. This combined dataset allows for a more comprehensive analysis. Furthermore, Geographic Information Systems (GIS) was employed to analyze spatial distributions and generate maps. The Inverse Distance Weighted (IDW) interpolation tool was used to create detailed spatial distribution maps of lightning fatalities, thunderstorm days (TSDs), and lightning flash frequency (LFF) across Bangladesh. The analysis revealed that farmers and fishermen were the most vulnerable populations, with the northeastern regions experiencing the highest impact. Sylhet division emerged as the area with the most fatalities, highlighting the northeastern zone's susceptibility. The study also identified monsoons as the period with the highest occurrences of lightning deaths and injuries. By combining innovative data integration and spatial analysis, this study offers valuable insights into the alarming trend of lightning fatalities in Bangladesh. These findings can inform targeted prevention strategies and interventions to safeguard vulnerable populations and communities.

Enhancing seasonal influenza projections: A mechanistic metapopulation model for long-term scenario planning.

In temperate regions, annual preparation by public health officials for seasonal influenza requires early-season long-term projections. These projections are different from short-term (e.g., 1-4 weeks ahead) forecasts that are typically updated weekly. Whereas short-term forecasts estimate what "will" likely happen in the near term, the goal of scenario projections is to guide long-term decision-making using "what if" scenarios. We developed a mechanistic metapopulation model and used it to provide long-term influenza projections to the Flu Scenario Modeling Hub. The scenarios differed in their assumptions about influenza vaccine effectiveness and prior immunity. The parameters of the model were inferred from early season hospitalization data and then simulated forward in time until June 3, 2023. We submitted two rounds of projections (mid-November and early December), with the second round being a repeat of the first with three more weeks of data (and consequently different model parameters). In this study, we describe the model, its calibration, and projections targets. The scenario projection outcomes for two rounds are compared with each other at state and national level reported daily hospitalizations. We show that although Rounds 2 and 3 were identical in definition, the addition of three weeks of data produced an improvement to model fits. These changes resulted in earlier projections for peak incidence, lower projections for peak magnitude and relatively small changes to cumulative projections. In both rounds, all four scenarios presented conceivable outcomes, with some scenarios agreeing well with observations. We discuss how to interpret this agreement, emphasizing that this does not imply that one scenario or another provides the ground truth. Our model's performance suggests that its underlying assumptions provided plausible bounds for what could happen during an influenza season following two seasons of low circulation. We suggest that such projections would provide actionable estimates for public health officials.

Hospital capacities and response to COVID-19 pandemic surges in Iran: A quantitative model-based study.

The coronavirus 2019 (COVID-19) pandemic resulted in serious limitations for healthcare systems, and this study aimed to investigate the impact of COVID-19 surges on in-patient care capacities in Iran employing the Adaptt tool. Using a cross-sectional study design, our study was carried out in the year 2022 using 1-year epidemiologic (polymerase chain reaction-positive COVID-19 cases) and hospital capacity (beds and human resource) data from the official declaration of the pandemic in Iran in February 2020. We populated several scenarios, and in each scenario, a proportion of hospital capacity is assumed to be allocated to the COVID-19 patients. In most of the scenarios, no significant shortage was found in terms of bed and human resources. However, considering the need for treatment of non- COVID-19 cases, in one of the scenarios, it can be observed that during the peak period, the number of required and available specialists is exactly equal, which was a challenge during surge periods and resulted in extra hours of working and workforce burnout in hospitals. The shortage of intensive care unit beds and doctors specializing in internal medicine, infectious diseases, and anesthesiology also requires more attention for planning during the peak days of COVID-19.

Change of spermatophyte family diversity in distribution patterns with climate change in China.

The global climate is undergoing extraordinary changes, profoundly influencing a variety of ecological processes. Understanding the distribution patterns and predicting the future of plant diversity is crucial for biodiversity conservation in the context of climate change. However, current studies on predictive geographic patterns of plant diversity often fail to separate the effects of global climate change from other influencing factors. In this study, we developed a spatial simulation model of spermatophyte family diversity (SSMSFD) based on data collected from 200 nature reserves covering approximately 1,500,000 km2, where direct anthropogenic disturbances to plant diversity and the surrounding environment are absent. We predicted the spermatophyte family diversity for all provinces in China in 2020, 2040, and 2080, considering the impacts of global climate change. On average, China currently exhibits 118 plant families per 25 km2, with a decreasing trend from southeast to northwest. When considering only the effects of global climate change, excluding direct anthropogenic disturbances, our results indicate that under the Shared Socioeconomic Path Scenarios (SSPs) 245 and 585, spermatophyte family diversity is projected to slowly increase in most Chinese provinces from 2021 to 2080. Notably, the increase is more pronounced under SSPs585 compared to SSPs245. Global climate change has a positive effect on plant diversity, in contrast to the negative impact of anthropogenic disturbances that often lead to declines in plant diversity. This research highlights the contrasting outcomes of future plant diversity under the sole influence of global climate change and the significant negative effects of anthropogenic disturbances on diversity.

Trajectories of socio-ecological systems: A case study in the tropical Andes.

Scenario and policy assessments in socioeconomic and environmental studies face significant challenges in socio-ecological systems (SES). There are a limited number of studies that have looked at the impact of different scenarios within integrated approaches, and many have used a static approach with a single driver of change. The present work analyzes the SES dynamics for a strategic basin in the Colombian Andes when implementing and analyzing scenarios and policies related to land cover and land use change using a system dynamics simulation model. The model includes natural, ecosystem services, sociocultural, and economic components. Scenarios and policy options are analyzed both individually and jointly to identify synergies or trade-off effects between the different SES components. The results showed the different trajectories of the socio-ecological system according to the cases studied, and its impact on different variables in the analyzed components. Some counterintuitive effects were also identified, such as the importance of intrinsic motivations in decision-making processes, and determinants in land management and policy design.