Northern Asia Research Articles

The becoming of worker mothers: The untold narratives of an identity transition

AbstractWorker mothers still struggle to find a good balance between their care and work identities. Most research on motherhood at work focuses on how organizational structures can enable professional women to find a balance between caring and work identities neglecting their personal experiences and how they understand themselves in relation to both motherhood and work. We propose to use a liminal identity work perspective to explore the identity tensions that professional women experience during their transition into motherhood and how they manage it. To explore this question, we conducted a qualitative study over 2 years with worker mothers in Latin and North America, Europe, Asia Pacific, and Africa. The thematic and narrative analysis of 80 individual narrative interviews shows the emergence of two coexisting identity narratives. The first narrative understands motherhood as a linear process, where women experience liminality, uncertainty, and identity loss but eventually return to work after having aggregated their new worker mother identities during maternity leaves. The second coexisting narrative challenges this linear and finite view by highlighting the transition to motherhood as a continuous, liminoid, and never‐ending process. The two narratives are contextualized and managed differently according to the different cultural, historical, and social contexts where they are developed; the overall results present motherhood as a ‘liminoid’ experience that requires constant identity work to navigate the tensions emerging between potentially new and customary identities and behaviors in work contexts.

First records of two mackerel shark species (Carcharodon planus comb. nov. and Carcharodon hubbelli; Lamnidae) from New Zealand

ABSTRACT The fossil record of the genus Carcharodon (Lamniformes: Lamnidae) dates to the late Oligocene and has a near global distribution. Today the genus is represented by a single species, the white shark Carcharodon carcharias. However, multiple extinct species are recognised in the Cenozoic including Carcharodon hastalis, Carcharodon hubbelli and Carcharodon planus comb. nov. Here we present the first occurrences of Carcharodon hubbelli and Carcharodon planus from New Zealand/Aotearoa, from the South Island/Te Waipounamu. Carcharodon hubbelli is previously reported from late Miocene deposits in the Pacific basin of North and South America, Asia, and Australia. Whereas Carcharodon planus has been reported from the Miocene of North America and Asia. One tooth from Carcharodon hubbelli is reported from the presumed late Miocene of Motunau Beach, North Canterbury, while one upper early Miocene tooth recovered from the Kakahu River, South Canterbury and an earliest Miocene tooth from the Big River mouth, Tasman District are referred to Carcharodon planus. In addition to being the first reported occurrences of these two species in New Zealand, the teeth of Carcharodon planus represent some of the earliest occurrences of the taxon as well as its southernmost occurrence.

Incidence and Prevalence of Primary Sclerosing Cholangitis: A Meta-analysis of Population-based Studies.

Primary sclerosing cholangitis is a chronic liver disease associated with significant morbidity, mortality, and healthcare utilization. We conducted a systematic review and meta-analysis of population-based studies of the incidence and prevalence of primary sclerosing cholangitis. Medline and Embase were systematically searched to identify population-based studies of a defined geographic area and reported the incidence or prevalence of primary sclerosing cholangitis in the general population. Meta-analyses, using random-effects, were performed to calculate overall and country-specific incidence (per 100 000 persons/year) and prevalence rates (per 100 000 persons) with 95% confidence intervals. The 14 studies on incidence and the 12 for prevalence originated from North America, Asia, Europe, and Oceania. Incidence and prevalence rates of primary sclerosing cholangitis were 0.87 (95% confidence interval, 0.59-1.29) and 13.53 (95% confidence interval, 10.20-17.94) per 100 000 persons, respectively. Both the prevalence and incidence of primary sclerosing cholangitis is low in the general population. Future studies on the incidence and prevalence of primary sclerosing cholangitis in the general population should be directed at Asia, Africa, and Latin America to allow for a more robust assessment of the global epidemiology of primary sclerosing cholangitis.

Sources, variability, long-term trends, and radiative forcing of aerosols in the Arctic: implications for Arctic amplification.

Atmospheric pollution in the Arctic has been an important driver for the ongoing climate change there. Increase in the Arctic aerosols causes the phenomena of Arctic haze and Arctic amplification. Our analysis of aerosol optical depth (AOD), black carbon (BC), and dust using ground-based, satellite, and reanalysis data in the Arctic for the period 2003-2019 shows that the lowest amount of all these is found in Greenland and Central Arctic. There is high AOD, BC, and dust in the northern Eurasia and parts of North America. All aerosols show their highest values in spring. Significant positive trends in AOD (> 0.003year-1) and BC (0.0002-0.0003year-1) are found in the northwestern America and northern Asia. Significant negative trends are observed for dust (- 0.0001year-1) around Central Arctic. Seasonal analysis of AOD, BC, and dust reveals an increasing trend in summer and decreasing trend in spring in the Arctic. The major sources of aerosols are the nearby Europe, Russia, and North America regions, as assessed using the potential source contribution function (PSCF). Anthropogenic emissions from the transport, energy, and household sectors along with natural sources such as wildfires contribute to the positive trends of aerosols in the Arctic. These increasing aerosols in the Arctic influence Arctic amplification through radiative effects. Here, we find that the net aerosol radiative forcing is high in Central Arctic, Greenland, Siberia, and Canadian Arctic, about 2-4 W/m2, which can influence the regional temperature. Therefore, our study can assist policy decisions for the mitigation of Arctic haze and Arctic amplification in this environmental fragile region of the Earth.

FIRST RECORD OF <i>CRYPTOPS HORTENSIS</i> (DONOVAN 1810) (SCOLOPENDROMORPHA, CRYPTOPIDAE) IN THE CIS-URALS

The species Cryptops hortensis (Donovan 1810), as well as the family Cryptopidae and the order Scolopendromorpha to which it belongs, were first discovered in the Urals. All records of this species in the Cis-Urals and in the Asian part of Russia were made in greenhouses. Distribution notes are given, and all records of Cryptops hortensis in Russia are mapped.

Relationships between the Levels of Dopamine, Thyroid, and Antispermal Antibodies in Populations of the European and Asian North

Relationships between the Levels of Dopamine, Thyroid, and Antispermal Antibodies in Populations of the European and Asian North

Genetic Diversity and Genome-Wide Association Study for the Phenology Response of Winter Wheats of North America, Western Asia, and Europe

Wheat is a staple food in many areas around the World. In the 20th century, breeders and scientists were able to boost wheat yield considerably. However, a yield plateau has become a concern and is threatening food security. Investments in cutting-edge technologies, including genomics and precision phenology measurements, can provide valuable tools to drive crop improvement. The objectives of this study were to (i) investigate the genetic diversity in a set of winter wheat lines, (ii) characterize their phenological response under different vernalization and photoperiod conditions, and (iii) identify effective markers associated with the phenological traits. A total of 249 adapted genotypes of different geographical origin were genotyped using the 35K Axiom® Wheat Breeder’s Array. A total of 11,476 SNPs were used for genetic analysis. The set showed an average polymorphism information content of 0.37 and a genetic diversity of 0.43. A population structure analysis revealed three distinct subpopulations mainly related to their geographical origin (Europe, North America, and Western Asia). The lines of CGIAR origin showed the largest diversity and the lowest genetic distance to all other subpopulations. The phenology of the set was studied under controlled conditions using four combinations of long (19 h light) and short photoperiod (13 h light) and long vernalization (49 days at 5 °C) and no vernalization. With this, phenological traits such as earliness per se (Eps), relative response to vernalization (RRV), and relative response to photoperiod (RRP) were calculated. The phenotypic variation of growing degree days was significant in all phenology combinations. RRV ranged from 0 to 0.56, while RRP was higher with an overall average of 0.25. The GWAS analysis detected 30 marker-trait associations linked to five phenological traits. The highest significant marker was detected on chromosome 2D with a value of −log10(p) = 11.69. Only four loci known to regulate flowering exceeded the Bonferroni correction threshold of −log10(p) > 5.1. These results outline a solid foundation to address global food security and offer tremendous opportunities for advancing crop improvement strategies.

Inflation as Talk, Economy as Feel

Abstract Whether with central bankers or strolling passers-by, inflation is a recurring term, one that encapsulates contemporary life in Tunisia. How does a concept of economics become everyday talk? Through three stories, I show how what I call ‘inflation-talk’—a mode of small talk that operates as critique and affect—circulates across discursive spaces, ultimately becoming a medium to question economic transformations and reveal political disillusions in post-revolutionary Tunisia. I consider how inflation has become a ‘feel’ of the economy, meaning a measurement not solely for economists but for people to make sense of their everyday. Ultimately, I ask how in times of global inflation, anthropologists, especially ones working in North Africa and West Asia, can theorise a critical anthropology of inflation.

Bibliometric analysis of transforaminal lumbar interbody fusion: research status, trends, and future directions.

Transforaminal lumbar interbody fusion (TLIF) is a classic surgical procedure for posterior lumbar fusion. This study aims to analyze the TLIF field by bibliometric method and comprehensively summarize the research status and trends. All TLIF-related articles were retrieved from the Web of Science. The data were analyzed using R software and SPSS to calculate corresponding indicators. Visualizations were drawn using VOSviewer and Scimago Graphica, including country, institution, journal, author, and keywords. A total of 919 articles were included. The annual publication volume of TLIF-related articles presented an exponential growth. North America, Europe, and Asia were the main sources of articles, with the USA and China being the main contributors and the USA being the global research center for TLIF. The level of the national economy was an important factor affecting TLIF-related research. The highest number of contributions in this field was made by Kern Singh among authors and by Rush University among institutions. The European Spine Journal was the most influential journal. The research focus has gradually shifted from perfecting the TLIF technique toward emphasizing the patient level. The improvement of minimally invasive techniques and how to improve clinical outcomes as well as accelerate postoperative rehabilitation of patients may be the hot spot of future research. With the advancement of medical technology and the popularization of minimally invasive concepts in recent years, TLIF and its derivative technologies have attracted increasing attention. Patient-centered minimally invasive surgery is a hot research topic in the field of TLIF currently and will continue to be so into the future.

Cross-Regional Data Initiative for the Assessment and Development of Treatment for Neurological and Mental Disorders.

To describe and categorize detailed components of databases in the Neurological and Mental Health Global Epidemiology Network (NeuroGEN). An online 132-item questionnaire was sent to key researchers and data custodians of NeuroGEN in North America, Europe, Asia and Oceania. From the responses, we assessed data characteristics including population coverage, data follow-up, clinical information, validity of diagnoses, medication use and data latency. We also evaluated the possibility of conversion into a common data model (CDM) to implement a federated network approach. Moreover, we used radar charts to visualize the data capacity assessments, based on different perspectives. The results indicated that the 15 databases covered approximately 320 million individuals, included in 7 nationwide claims databases from Australia, Finland, South Korea, Taiwan and the US, 6 population-based electronic health record databases from Hong Kong, Scotland, Taiwan, the Netherlands and the UK, and 2 biomedical databases from Taiwan and the UK. The 15 databases showed good potential for a federated network approach using a common data model. Our study provided publicly accessible information on these databases for those seeking to employ real-world data to facilitate current assessment and future development of treatments for neurological and mental disorders.

Advancing guideline quality through country-wide and regional quality assessment of CPGs using AGREE: a scoping review

Background and objectiveClinical practice guidelines (CPGs) are evaluated for quality with the Appraisal of Guidelines for Research and Evaluation (AGREE) tool, and this is increasingly done for different countries and regional groupings. This scoping review aimed to describe, map, and compare these geographical synthesis studies, that assessed CPG quality using the AGREE tool. This allowed a global interpretation of the current landscape of these country-wide or regional synthesis studies, and a closer look at its methodology and results.Study design and methodsA scoping review was conducted searching databases Medline, Embase, Epistemonikos, and grey literature on 5 October 2021 for synthesis studies using the later versions of AGREE (AGREE II, AGREE-REX and AGREE GRS) to evaluate country-wide or regional CPG quality. Country-wide or regional synthesis studies were the units of analysis, and simple descriptive statistics was used to conduct the analysis. AGREE scores were analysed across subgroups into one of the seven Sustainable Development Goal regions, to allow for meaningful interpretation.ResultsFifty-seven studies fulfilled our eligibility criteria, which had included a total of 2918 CPGs. Regions of the Global North, and Eastern and South-Eastern Asia were most represented. Studies were consistent in reporting and presenting their AGREE domain and overall results, but only 18% (n = 10) reported development methods, and 19% (n = 11) reported use of Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Overall scores for domains Rigor of development and Editorial independence were low, notably in middle-income countries. Editorial Independence scores, especially, were low across all regions with a maximum domain score of 46%. There were no studies from low-income countries.ConclusionThere is an increasing tendency to appraise country-wide and regionally grouped CPGs, using quality appraisal tools. The AGREE tool, evaluated in this scoping review, was used well and consistently across studies. Findings of low report rates of development of CPGs and of use of GRADE is concerning, as is low domain scores globally for Editorial Independence. Transparent reporting of funding and competing interests, as well as highlighting evidence-to-decision processes, should assist in further improving CPG quality as clinicians are in dire need of high-quality guidelines.

Mapping interdisciplinary collaboration in music education: analysis of models in higher education across North America, Europe, Oceania, and Asia

Interdisciplinary collaboration is an emerging imperative in music education, but current understanding of global practices remains limited. Prior studies have focused narrowly on specific programs within limited geographic areas. However, there is minimal quantitative mapping of initiatives across institutions and regions. Contextual insights explaining regional variations are also scarce. Hence, this study aims to address these gaps by conducting a comprehensive analysis of interdisciplinary programs, partnerships, events, and publications across leading global music institutions using a mixed methods approach. The analysis reveals significant diversity in models and determinants of productivity across regions. For instance, while Europe leads in formal integration and research output, North America prioritizes technology-enabled innovation through media and emerging tools. Partnerships are ubiquitous but focus areas and curricular integration vary. The findings reveal significant diversity in interdisciplinary education practices and formats worldwide, implying a need for contextualized implementation aligned to institutional strengths rather than a one-size-fits-all approach. Therefore, as music education evolves, tailored interdisciplinary strategies that blend local priorities with global best practices are recommended to creatively nurture multifaceted skills and maximize potential for innovation. Thus, this research contributes an invaluable knowledge base to inform evidence-based, nimble policies and frameworks for cultivating cutting-edge, socially engaged musicians and ventures worldwide.

First description and conservation implications of a unique stand of the Caucasian wingnut in Lapankuri (Georgia)

AbstractMany north‐temperate tree species survived glacial periods in small, low‐density populations in refugia. These refugia are located in eastern and western North America, South Europe, East Asia, and western Asia. As a part of western Asia, Georgia harbors two main refugia: the Colchis in western Georgia and the eastern Great Caucasus, where many Cenozoic relict plants still exist. In this article, we report a new population of Pterocarya fraxinifolia (the Caucasian wingnut) which was discovered in the eastern Great Caucasus, near the village Lapankuri. The Lapankuri P. fraxinifolia stand is unique because the species grows not only in a narrow strip of riparian vegetation, but is also occurring in a broad band up to 100 m away from the river. Pterocarya fraxinifolia is dominant in the stand and is represented by large and old trees. Many other relict trees such as Diospyros lotus and Juglans regia are also present in the Lapankuri stand. Although some Cenozoic relict species are widely cultivated and naturalized in Central and Western Europe, natural stands of these plants provide the only evidence of their past growing conditions; therefore, conservation of this place is strongly advocated.

EPCORE FL-1: Phase 3 Trial of Subcutaneous Epcoritamab with Rituximab and Lenalidomide (R 2) Vs R 2 Alone in Patients with Relapsed or Refractory Follicular Lymphoma

Background: Follicular lymphoma (FL) is the most common form of indolent non-Hodgkin lymphoma (NHL). Several treatment options are approved by the US Food and Drug Administration for second- or later-line FL therapy, including rituximab + lenalidomide (R 2). However, advanced-stage FL remains incurable and new treatment options for relapsed or refractory (R/R) disease are needed. Epcoritamab, a subcutaneously administered, bispecific antibody that binds CD3 on T lymphocytes and CD20 on B cells, induces potent and selective T-cell-mediated killing of malignant CD20 + B cells (van der Horst et al, Blood Cancer J 2021). In the first-in-human, phase 1/2 EPCORE NHL-1 trial (NCT03625037) in heavily pretreated patients with B-cell NHL (N=68), epcoritamab showed manageable safety and promising single-agent anti-tumor activity (Hutchings et al, Lancet 2021). Among 10 patients with R/R FL, objective response rate (ORR) was 90% (95% CI: 55-100) and complete response (CR) rate was 50%. In the ongoing phase 1b/2 trial evaluating epcoritamab + R 2 for R/R FL (EPCORE NHL-2 arms 2a and 2b; NCT04663347), ORR was 98% among 104 efficacy-evaluable patients, with a complete metabolic response in 87%. Most cytokine release syndrome (CRS) events were low grade (n=111; grade 1-2, 46%; grade 3, 2%) and occurred in cycle 1; all CRS events resolved with routine management. These encouraging data, and the distinct mechanisms of action of epcoritamab and R 2, support ongoing evaluation of this combination for its potential to improve clinical outcomes in patients with R/R FL. The phase 3 EPCORE FL-1 trial was designed to evaluate epcoritamab in combination with R 2 vs R 2 alone in patients with R/R FL with ≥1 prior line of anti-lymphoma therapy. We present an updated protocol, reflecting recent developments and revisions implemented in this study. Study Design and Methods: EPCORE FL-1 (NCT05409066) is a global, randomized, open-label, multicenter phase 3 trial designed to evaluate efficacy and safety of epcoritamab in combination with R 2 vs R 2 alone in patients with R/R FL. Adult patients must have histologically confirmed classic FL (previously grades 1 to 3a FL) stage II, III, or IV with a CD20 + tumor on a representative biopsy based on local pathology report and no evidence of histologic transformation. Patients must have R/R disease after ≥1 prior anti-lymphoma regimen that contained an anti-CD20 monoclonal antibody in combination with chemotherapy; patients receiving only prior anti-CD20 monoclonal antibody monotherapy and/or radiation are not eligible. Other key eligibility criteria include Eastern Cooperative Oncology Group performance status 0 to 2, fluorodeoxyglucose positron emission tomography-avid disease, and ≥1 measurable disease site per Lugano 2014 criteria. Lenalidomide-refractory FL (best response to lenalidomide of stable or progressive disease or progressive disease within 6 months of completion of lenalidomide) is excluded. Approximately 520 patients will be enrolled and randomized 1:1 to receive a full dose of epcoritamab in combination with R 2 or R 2 alone ( Figure); the trial is currently enrolling in 2 arms, Arms A & C. Based on emerging safety and efficacy data, Arm B has been closed to enrollment and the recommended dose of epcoritamab in combination with R 2 is 48 mg. Epcoritamab will be subcutaneously administered using a step-up dosing regimen to full dose in cycle 1 (28 days/cycle). Full dose of epcoritamab will be administered weekly in cycles 2-3 and monthly from cycle 4 onward for up to 12 cycles of treatment. Patients will be serially assessed for disease progression at prespecified intervals. The primary endpoint is progression-free survival assessed by independent review committee (IRC) per Lugano criteria. Key secondary efficacy endpoints include CR rate (by IRC per Lugano criteria), overall survival, and minimal residual disease negativity. Other efficacy endpoints include best overall response, duration of response, duration of complete response, time to progression, event-free survival, time to next anti-lymphoma treatment, and patient-reported outcomes. Safety endpoints include incidence and severity of treatment-emergent adverse events and adverse events of special interest. Exploratory endpoints include assessments of pharmacodynamic and pharmacokinetic data. The study opened for enrollment in 2022 in North America, South America, Europe, Africa, Asia, and Australia.

Acrue: A Phase 2, Open-Label Study of Acalabrutinib in Combination with Rituximab in Elderly and/or Frail Patients with Treatment-Naive Diffuse Large B-Cell Lymphoma

Background and Significance: Patients aged ≥80 years with diffuse large B-cell lymphoma (DLBCL) account for approximately 18% of DLBCL cases in the United States (Morrison et al. Future Oncol. 2018). Standard-of-care chemoimmunotherapy (CIT) regimens such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), including reduced doses of CHOP (R-miniCHOP), are not well tolerated in elderly and/or frail patients, leading to high treatment-related mortality rates (Boslooper et al. Leuk Lymphoma. 2014; Freudenberger et al. Ann Hematol. 2021; Peyrade et al. Lancet Oncol. 2011). Therefore, safe, effective, and convenient treatment alternatives to CIT are needed. Acalabrutinib is a highly selective, second-generation Bruton tyrosine kinase inhibitor approved for the treatment of patients with relapsed/refractory mantle cell lymphoma and in patients with chronic lymphocytic leukemia. Acalabrutinib monotherapy has demonstrated encouraging activity in patients with DLBCL in phase 1b (NCT02112526) and phase 2 (NCT04002947) studies (Strati et al. Haematologica. 2021; Roschewski et al. Blood. 2021). However, neither of these studies were conducted specifically in a population of elderly and/or frail patients. Study Design and Methods: ACRUE (NCT05952024) is a phase 2, open-label, single-arm, global, multicenter study of acalabrutinib plus rituximab in elderly and/or frail patients with treatment-naive (TN) DLBCL who are unable to tolerate standard CIT ( Figure). Eligible patients are aged ≥80 years or aged 65-79 years with impairment in ≥1 activity of daily living (ADL) or instrumental ADL (IADL), or with cardiac/renal/liver function impairment or other comorbidities that render them unable to tolerate CIT. Furthermore, patients must have histologically confirmed CD20-positiveDLBCL (not otherwise specified), according to WHO 2016 classification, an Ann Arbor classification of stage II, III, or IV disease, an Eastern Cooperative Oncology Group performance status of 0-2, and ≥1 measurable lesion. Patients with active central nervous system involvement by lymphoma, leptomeningeal disease, or spinal cord compression, or significant cardiovascular disease within 6 months of screening are excluded. Target enrollment is 80 patients. Patients will receive acalabrutinib plus rituximab combination for 8 cycles (acalabrutinib 100 mg orally twice daily beginning on day 1 of cycles 1-8; rituximab 375 mg/m 2 intravenously on C1D15, then 1400 mg subcutaneously, on day 1 of cycles 2-8; cycles 1-8 are 21 days/cycle), followed by acalabrutinib monotherapy until disease progression, unacceptable toxicity, or 24 months (cycles 9-28 are 28 days/cycle). The primary endpoint is the percentage of patients with grade 3-4 treatment-emergent adverse events. The key secondary endpoint is investigator-assessed objective response rate per Lugano 2014 criteria. Other secondary endpoints include progression-free survival, event-free survival, overall survival, duration of response, and Timed Up and Go test. Exploratory biomarker analyses may include genomic characterization of baseline samples to evaluate predictors of survival, and of progression samples to evaluate genomic resistance mechanisms. Descriptive safety and efficacy data will be summarized. If patients discontinue treatment prior to completing 28 cycles of therapy, they will be followed every 12 weeks after their last treatment dose for up to 2 years. Patients who are still on treatment at the end of the study and are deriving clinical benefit may receive continued treatment, with assessments reverting to standard of care. Enrollment is planned to begin Q4 of 2023 in approximately 40 sites from North and South America and Asia. Summary: This study will help determine if acalabrutinib plus rituximab combination therapy is tolerable and effective in elderly and/or frail patients with TN DLBCL who are unable to tolerate CIT.

2163. Prevalence and geographic distribution of mutations in TonB-dependent receptors in the Prospective Observational Pseudomonas aeruginosa (PA) Study

Abstract Background Cefiderocol (FDC) is a last line treatment for carbapenem-resistant Pseudomonas aeruginosa (CR-PA). FDC retains activity against CR-PA by inhibition of penicillin-binding proteins facilitated by active uptake of drug via TonB-dependent receptors (TBDR). Prior, we have shown an association between mutations in TBDR genes and loss of FDC susceptibility, particularly in association with changes at the PA-derived cephalosporinase (PDC/AmpC) active site. Here, we outline geographic variation and prevalence of TBDR mutations in the Prospective Observational Pseudomonas (POP) study.Figure 1.SNP frequency in the pirR, pirS, pirA, and piuA/piuD genes across geographic location.Figure 2.Genotypic variation of PirRS and PiuA/D genes in the 972 P. aeruginosa isolates of the POP cohort. Black versus gray differentiates presence of either PiuA versus PiuD homologous proteins. Color legend corresponds to presence of TBDR gene variants/SNPs per gene pirR, pirS, pirA, piuA/piuD, and ampC. Methods The genomes of 972 CR-PA isolates collected across 10 countries in North America, South America, Asia, and Oceania were screened for single nucleotide polymorphisms (SNP) resulting in missense, insertion/deletion (indel), frameshift, and early stop codon mutations in the TBDR genes pirR, pirS, pirA, piuA/piuD, and ampC using PAO1 as a reference. SNPs were defined as variant mutations occurring in ≤10% of isolates. A core genome maximum likelihood phylogenetic tree was used to assess distribution and prevalence of genotypic variants. Neighbor-joining trees of the variants in each gene were used to analyze clusters across lineages. Results Across all regions except Oceania, SNPs were most frequently seen in pirS and pirA (Fig 1). Gene variants comprised from 8% up to 50% of each geographic population. On phylogenetic mapping, isolates within the same lineage tended to have clustering of shared mutations across the TBDR genes pirS, pirR, and pirA, and the majority of piuA/piuD mutations clustered within two distinct lineages (Fig 2). Major mutations, including indel, frameshift, and early stop codon mutations occurred in 16 isolates (1.6%), predominantly in isolates from the United States (n=14). Variations in PDC were frequently observed, with 57 different variants across 35.8% of the population. Seven of the PDC variants (n=10 isolates) have been associated with decreased susceptibility to ceftolozane/tazobactam, but these variants did not co-occur with major TBDR mutations. Conclusion TBDR mutations occur in PA isolates worldwide. Mutations previously associated with reduced susceptibility to FDC occurred most frequently in isolates from the United States. Disclosures Michael J. Satlin, MD, AbbVie: IDMC member|Biomerieux: Grant/Research Support|Merck: Grant/Research Support|Shionogi: Advisor/Consultant|SNIPRBiome: Grant/Research Support William R. Miller, M.D., Merck: Grant/Research Support|UpToDate: Honoraria

Using machine learning or deep learning models in a hospital setting to detect inappropriate prescriptions: a systematic review

ObjectivesThe emergence of artificial intelligence (AI) is catching the interest of hospital pharmacists. A massive collection of health data is now available to train AI models and hold the promise...

Overcoming the constraints of landlocked-ness through sustainable connectivity in North and Central Asia

Overcoming the constraints of landlocked-ness through sustainable connectivity in North and Central Asia

Anthropogenic influence has significantly affected snowfall changes in Eurasia

It has been widely reported that anthropogenic influences are detectable with high confidence in global warming. However, whether human activities have an impact on snowfall changes is still unclear. Here we based on phase 6 of the Coupled Model Intercomparison Project (CMIP6) multi-forcing dataset and the regularized optimal fingerprint method, the detection and attribution of various grades of snowfall (including annual snowfall (>0.1 mm/day), light snowfall (<2.5 mm/day), intense snowfall (>5 mm/day), and their corresponding days) changes in Eurasia (20°-90°N, 10°W-180°E) were carried out. Results show that anthropogenic activity forcing (ANT) and greenhouse gas forcing (GHG) well reproduced the spatial-temporal characteristics of snowfall indices. The ANT influence is robustly detected in the decreased trend of snowfall days (snowday), light snowfall, and light snowfall days (light_day) at the 90% confidence interval, clearly separated from the natural forcing. Moreover, the GHG signals are detectable for decreases in the three snowfall indices, which only could be distinguished from the natural and aerosol forcings for snowday and light snowfall. Thus, anthropogenic activities may considerably account for the decreases in snowday, light snowfall, and light_day across Eurasia, wherein the changes in the first two indices dominated by GHG emissions. However, human influence detections fail for intense snowfall, and it is hard to detect on regional scales, except for North Asia. Finally, by the end of this century (2081–2100), the observation-constrained projections based on the detection and attribution analysis under two SSPs (new Shared Socioeconomic Pathway) scenarios exhibit that the scaled snowday, light snowfall, and light_day are expected to decrease by approximately 13.9 days (28.3 days), 24.8% (48.7%), and 4.3 days (8.8 days) under the SSP2–4.5 (SSP5–8.5) scenario with reference to the current climate (1995–2014). Our study highlights the need to improve climate model performance in simulating extreme snowfall to clear whether and to what extent human influence impacts it.

Developments and challenges of foresight evaluation: Review of the past 30 years of research

As a particular subfield of futures studies, foresight evaluation has not yet been thoroughly studied. This paper investigates research on foresight evaluation, reviewing authors, articles, journals, topics, evaluative elements, and foresight frames. We analyzed 186 academic papers published over the past 30 years. The analysis shows that foresight evaluation, which originated in Europe and partly diffused to North America and Asia, is still an emerging discipline. Research on the evaluation of foresight has covered four topics: 1) Project for Policy, 2) Future Methodology, 3) Technology, and 4) Future Impact; studies in these areas show that there is currently no active research on topics other than technology. Each of these four topics encompasses traditional evaluative elements, such as impact and quality, but few studies reflect the hopeful element of learning. Also, the results of our analysis show that the predictive and planning frames are in high demand, while less predictable frames are not. This study elucidates the reasons behind the inactive state of foresight evaluation research. This paper argues that both researchers and decision-makers have an important role in overcoming this inertia and finding new paths for continuing the development of foresight evaluation.