Average Loss Research Articles

Efficacy of lifestyle weight loss interventions on regression to normoglycemia and progression to type 2 diabetes in individuals with prediabetes: a systematic review and pairwise and dose-response meta-analyses

BackgroundCurrent recommendations for weight loss in individuals with prediabetes come from individual trials and are derived from older data. ObjectivesTo elucidate the dose-dependent impacts of weight loss on participants with prediabetes to determine the optimal magnitude of weight loss required for the implementation of the most effective diabetes prevention program. MethodsWe searched PubMed, Scopus, CENTRAL, CINAHL, and gray literature sources to September 2023 for randomized trials ≥6 mo that evaluated the efficacy of a lifestyle weight loss intervention on participants with prediabetes. We conducted random-effects pairwise meta-analyses to calculate relative and absolute effects. We performed a 1-stage weighted mixed-effects meta-analysis to elucidate the dose-response curves. ResultsForty-four randomized trials with 14,742 participants with prediabetes [intervention duration range: 6–72 mo (median: 24 mo), mean weight loss range: 1%–9%] were included. Lifestyle weight loss interventions increased regression to normoglycemia by 11/100 participants (95% confidence interval [CI]: 8 more, 17 more; risk ratio: 1.51; 95% CI: 1.27, 1.80; n = 20 trials, grading of recommendations assessment, development, and evaluation = moderate], and reduced progression to type 2 diabetes by 8/100 participants (95% CI: 11 fewer, 6 fewer; risk ratio: 0.59; 95% CI: 0.51, 0.67; n = 37, grading of recommendations assessment, development, and evaluation = moderate). There were no significant or credible differences between subgroups categorized by the type and duration of intervention. Dose-response meta-analyses indicated that the risk of regression to normoglycemia increased, and the risk of progression to type 2 diabetes declined in a linear pattern within the range of weight loss from 1% to 9%. ConclusionsOver a median duration of 24 mo, with weight loss ranging from 1% to 9%, the relationship between weight loss and the progression to type 2 diabetes, as well as the regression to normoglycemia, follows a linear pattern. Any form of lifestyle weight loss intervention, including diet, exercise, or a combination of both, can have beneficial impacts on participants with prediabetes.This trial was registered at PROSPERO as CRD42023465322.

Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery

BackgroundOrthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate these side effects, vacuum-assisted tools have been developed to aid in tissue removal. These devices enable surgeons to suction tissue without discarding it, potentially improving outcomes in conditions such as osteomyelitis or tumor removal while enabling collection of the material for downstream applications. Despite limited research, vacuum-assisted devices show promise beyond bone marrow harvesting. This study assesses infection and clearance rates, estimated blood loss, and total procedure time associated with the use of vacuum-assisted tissue removal, with a goal to understand if these devices can be used for tissue removal across a variety of pathologic conditions.MethodsA retrospective cohort study was conducted on patients undergoing orthopedic procedures with the Avitus® Bone Harvester repurposed from its original design from December 1, 2021, to July 1, 2023. Procedures were categorized into oncology, and debridement for infection cases. Infection cases were further categorized into those secondary to trauma and those involving primary infections (osteomyelitis and periprosthetic joint infection). Clinical variables, including demographics, intraoperative details, complications, and follow-up, were reviewed. Statistical analysis included descriptive statistics computed with R Studio.ResultsThe study included 44 patients, with debridement for infection cases being the most common (primary infection: 45.5%; infection secondary to trauma: 18.1%), followed by oncology cases (36.4%). In all oncology cases, a definitive diagnosis was established using the device, and no post-operative infections were reported. The infection clearance rate was 85.0% for primary infection cases and 50.0% for cases of infection following trauma. Across the entire cohort, the average blood loss was 314.52 mL (sd: 486.74), and the average total procedure time was 160.93 min (sd: 91.07). The overall reoperation rate was 47.7%, with an unplanned reoperation rate of 11.4%.ConclusionThe vacuum-assisted bone harvester was effectively utilized in a wide range of debridement and curettage procedures across diverse orthopedic surgeries. In oncology cases, the device enabled effective tissue removal with comparable recurrence rates, demonstrating its potential to minimize contamination while preserving tissue for accurate diagnoses. Additionally, a high rate of osteomyelitis eradication was observed in debridement for primary infection cases (85%). Despite the relatively high reoperation rate of 47.7%, it is crucial to interpret this figure within the context of the varied reasons for reoperation. Many of these reoperations were planned as part of a staged approach to treatment or were unrelated to the device's performance. It is crucial to acknowledge that isolating the device's contribution to these results can be difficult. The utilization of the device should be guided by considerations of cost-effectiveness and patient-specific risk factors.

Wayside Wifi-Repeater as a Railway Operation Facility for Optimizing Traffic Density Detection Cameras at Level Crossings

Wireless technology uses repeater mode as a medium for sending data to railway operation facility equipment and railway crossing density detection cameras. To cover a 225-meter track, three access points are needed, one as a server and two as repeaters. Testing includes coverage area with signal strength (RSSI), jitter, access point transfer, and data transmission. The test results show that the railway crossing area can be covered by a wireless repeater with an RSSI of 53.103 dBi. The jitter of the two access points, namely 28.65ms and 32.54ms, is included in the good category. When the access point is moved, there is an average packet loss of 2.6%. Data transmission at four points of the crossing track has a delay/latency of 38.49ms at point one, 66.03ms at point two, 45.33ms at point three, and 39.18ms at point four

Effect of Tillage, Crops Residues and Crops Management Practices on Runoff Erosion, Soil Loss and Soil Properties in Ethiopa: Review

The conducted investigations showed that tillage practices with crop residue and proper cropping systems protect loss of soil from runoff erosion which depletes soil nutrients and affects soil physical and chemical properties. The review was conducted with aim of reviewing the effect of tillage, crops residues and crops management practices on runoff, soil loss and soil properties in Ethiopia. The three years study conducted in the Upper Blue Nile basin of Northwestern Ethiopia showed that reduced tillage reduced soil loss over conventional tillage, row planting reduced soil loss over broadcast planting, without trampling reduced soil loss over with trampling planting, and the sediment concentration was ranged from 0.01 to 5.37g/L and total soil loss was 0.20 to 0.50t/ha. The study conducted in the humid highlands of Ethiopia showed that the lower average soil loss was 16 t/ha.yr under zero tillage with crop residue and maximum was 30 t/ha.yr in conventional tillage without crop residue. The investigation indicated that zero tillage with maize soya bean intercrop, maize rotation, continuous maize and continuous soya bean improved soil properties than conventional tillage system. The investigation which was carried out to evaluate the effects of tillage and cropping system on soil properties showed that enrichment ratio ≤1 under no tillage with intercropping and no tillage with mulch reduce nutrient losses and enrichment ratio. The study conducted at Derashe and Arba Minch Zuriya in Ethiopia showed that some selected properties were statistically significant (P<0.05) and conservation tillage is favored for soil management relative to conventional tillage. Therefore, tillage practices like zero tillage and minimum tillage with crop residue management like mulching and crop management such as intercropping and crop rotation reduce surface runoff erosion, soil loss and soil fertility depletion, but additional continual research is needed to reveal trends in tillage, crops residues and crops management.

Evaluation of soil erosion rate using geospatial techniques for enhancing soil conservation efforts

According to reports, Ethiopia is one of the countries in sub-Saharan Africa with the worst affected by soil erosion. It has both on-site and off-site consequences on biophysical and socioeconomic settings in an area. The study area is heavily affected by soil erosion forming diverse erosion structures, particularly in the upper course of the watershed. Hence, this work seeks to estimate the geographically distributed annual soil loss rate and mapping of soil erosion hazard hotspot areas in the watershed using the Revised Universal Soil Loss Equation (RUSLE) adapted to Ethiopian conditions. The RUSLE parameters, such as rainfall erosion factor (R-factor), soil erodibility factor (K-factor), slope steepness and slope length factor (LS-factor), land cover factor (C-factor), and conservation practice factor (P-factor) were considered as data input for the analysis to quantify the soil loss rate in the study area. A digital elevation model (DEM) with a 12.5 × 12.5-meter resolution was employed for catchment delineation and determination of the LS factor.The mean yearly rainfall data from the surrounding rain gauge stations was used to analyze the R-factor. The results of the current conditions showed that the average typical soil loss rate from the entire watershed is 23.8 t ha-1 yr-1, and the quantity of soil loss from the study area ranged from 0 to 776.71tan /ha-1 yr-1. Nonetheless, Tiro Afeta experiences mean soil erosion at a rate of roughly 50.2 t ha-1 yr-1, exceeding the acceptable threshold of 11 t ha-1 yr-1. Determining the sustainability of soil production requires assessment, particularly in cases where significant yearly soil erosion occurs. Due to intensive agricultural activities in the Xiro Afeta watershed, significant soil erosion is predominantly occurring in thissteep upper region. Consequently, this area urgently requires appropriate soil protection measures.

Ultra‐Wideband Terahertz Integrated Polarization Multiplexer

AbstractPolarization‐division multiplexing is crucial for increasing channel capacity and spectral efficiency in communications. A key component is the polarization multiplexer, which combines or separates signals with orthogonal polarizations. Existing planar multiplexers lack an ultrawide band for terahertz communications. While microwave‐inspired orthomode transducers (OMTs) provide broadband operation, they suffer from high ohmic loss and bulkiness at terahertz frequencies. Optical integrated polarization beam splitters (PBSs) offer low loss and good integrability but have narrow bandwidths. This work presents a substrateless all‐silicon polarization multiplexer based on tapered directional couplers and air‐silicon effective mediums, integrated monolithically on a compact footprint. The device demonstrates a 37.8% fractional bandwidth, an average insertion loss of 1 dB, and a polarization extinction ratio above 20 dB over 225–330 GHz. This superior performance is enabled by the anisotropy of the effective medium claddings, affecting the two orthogonal guided modes differently. The multiplexer enables simultaneous two‐channel terahertz fiber communications with polarization diversity. It supports aggregated data rates up to 155 and 190 Gbit with bit error rates below hard‐ and soft‐decision forward‐error‐correction limits, respectively. This advancement holds promise for 6G terahertz integrated systems with enhanced channel capacities.

Non-destructive health monitoring of glass fibre epoxy composites under fatigue loading using electrical resistance change method

ABSTRACT This study investigates the effect of stress amplitude on the damage sensing characteristic of glass fibre reinforced (GFRP) composites under fatigue loading using the electrical resistance change (ERC) method. The electrical conductivity of GFRP composites was achieved by incorporating 0.3 wt.% multi-walled carbon nanotubes (MWCNTs) into epoxy resin by ultrasonication method. In-situ electrical resistance measurements during fatigue tests of MWCNT-filled GFRP (MWNCT/GFRP) composites were conducted at two different stress amplitudes, S = 0.6 and S = 0.5. The average stiffness losses at failure were observed as 28% and 25% for S = 0.6 and S = 0.5 respectively. The corresponding ERC ratios at failure were found as 153% and 59% for S = 0.6 and S = 0.5, respectively. A two-parameter Weibull analysis, based on the ERC ratios corresponding to 40%, 60%, 80%, and 100% (failure) fatigue life, was implemented to establish reliability curves at the two stress amplitudes. The ERC ratios at failure with a 95% reliability for S = 0.6 and S = 0.5 were determined as 64% and 23%, respectively. Finally, the remaining fatigue life and the stiffness loss of composite specimens at the ERC ratios corresponding to various Weibull reliability were found for both stress amplitudes.

Sustainable Land Management for Mitigating Soil Erosion at the Catchment Scale

This study addresses this challenge by focusing on the Revised Universal Soil Loss Equation (RUSLE) to combat excessive soil erosion rates within the Kayacık Dam Basin, located in the semi-arid region of the Tigris-Euphrates Basin in Türkiye. The primary objective is to maintain an average annual soil loss of no more than 10 tons per hectare. To achieve this, the RUSLE model is employed to evaluate sustainable land management (SLM) strategies. These strategies encompass agronomic, vegetative, and structural measures, all of which are intricately linked to RUSLE's C and P factors. Spatial analysis reveals that severe erosion (10-20 t ha-1 y-1) is predominantly concentrated in agricultural areas, spanning 2536.37 hectares. In contrast, very severe erosion (>20 t ha-1 y-1) affects 834.13 hectares of grassland. Statistical analyses underscore the significant contributions of various model factors to predicted soil losses (A). LS, C, K, and R factors account for 80.24%, 44.68%, 0.97%, and 0.27% of the effect, respectively. Remarkably, topography exerts the most substantial influence on agriculture, pasture, and forest/other land uses, contributing 84.46%, 57.29%, and 39.27% to the variation, respectively. These findings highlight the pivotal role of effective agronomic and vegetative practices in ecosystems management, especially within steep-slope landscapes encompassing agriculture, grassland, and forest. Furthermore, the semi-arid regions under investigation contend with the intricate interplay of heightened drought risk and the ramifications of intensive irrigated agriculture on soil erosion. This complex dynamic presents distinct challenges for implementing SLM strategies in the face of evolving climatic conditions and underscores the need for climate-resilient solutions.

Modeling and Performance Study of Vehicle-to-Infrastructure Visible Light Communication System for Mountain Roads.

Visible light communication (VLC) is considered to be a promising technology for realizing intelligent transportation systems (ITSs) and solving traffic safety problems. Due to the complex and changing environment and the influence of weather and other aspects, there are many problems in channel modeling and performance analysis of vehicular VLC. Unlike existing studies, this study proposes a practical vehicle-to-infrastructure (V2I) VLC propagation model for a typical mountain road. The model consists of both line-of-sight (LOS) and non-line-of-sight (NLOS) links. In the proposed model, the effects of vehicle mobility and weather conditions are considered. To analyze the impact of the considered propagation characteristics on the system, closed-form expressions for several performance metrics were derived, including average path loss, received power, channel capacity, and outage probability. Furthermore, to verify the accuracy of the derived theoretical expressions, simulation results were presented and analyzed in detail. The results indicate that, considering the LOS link and when the vehicle is 50 m away from the infrastructure, the difference in channel gain between moderate fog and dense fog versus clear weather conditions is 1.8 dB and 3 dB, respectively. In addition, the maximum difference in total received optical power between dense fog conditions and clear weather conditions can reach 76.2%. Moreover, under clear weather conditions, the channel capacity when vehicles are 40 m away from infrastructure is about 98.9% lower than when they are 10 m away. Additionally, the outage probability shows a high correlation with the threshold data transmission rate. Therefore, the considered propagation characteristics have a significant impact on the performance of V2I-VLC.

High-Linearity Ta2O5 Memristor and Its Application in Gaussian Convolution Image Denoising.

In the image Gaussian filtering process, convolving with a Gaussian matrix is essential due to the numerous arithmetic computations involved, predominantly multiplications and additions. This can heavily tax the system's memory, particularly with frequent use. To address this issue, a W/Ta2O5/Ag memristor was employed to substantially mitigate the computational overhead associated with convolution operations. Additionally, an interlayer of ZnO was subsequently introduced into the memristor. The resulting Ta2O5/ZnO heterostructure layer exhibited improved linearity in the pulse response, which enhanced linearity facilitates easy adjustment of the conductance magnitude through a linear mapping of the number of pulses and the conductance. Subsequently, the conductance of the W/Ta2O5/ZnO/Ag bilayer memristor was employed as the weights for the convolution kernel in convolution operations. Gaussian noise removal in image processing was achieved by assembling a 5 × 5 memristor array as the kernel. When denoising was performed using memristor arrays, compared to denoising achieved through Gaussian matrix convolution, an average loss of less than 5% was observed. The provided memristors demonstrate significant potential in convolutional computations, particularly for subsequent applications in convolutional neural networks (CNNs).

Improving the mechanical and wear properties of AZ91 magnesium alloy via laser cladded (AlCu)3.5CoCrNiSnx (x = 0 and 1) high entropy alloy coatings

(AlCu)3.5CoCrNiSnx (x = 0 and 1) high entropy alloy (HEA) coatings were prepared on AZ91 magnesium alloy substrate by laser cladding technology. Both the HEA coatings consisted of FCC phase and BCC phase. The addition of Sn could lead to an increase in the relative proportion of the BCC phase and the formation of coarse dendritic structure in the HEA coating. The average microhardness and average wear weight loss of the (AlCu)3.5CoCrNi coating (612.2 HV and 2.9 mg) and (AlCu)3.5CoCrNiSn coating (562.1 HV and 3.9 mg) were both higher and lower than those of the AZ91 substrate (70.5 HV and 5.5 mg), indicating that the prepared HEA coatings could significantly improve the properties of the substrate. The (AlCu)3.5CoCrNi coating showed better performance than the (AlCu)3.5CoCrNiSn coating due to the grain refinement effect.

Enhancing microgrid performance: Optimal proactive reactive power dispatch using photovoltaic active power forecasts

AbstractMicrogrids with substantial incorporation of distributed renewable energy sources face challenges such as magnitude voltage rise, frequency variations, and power quality issues. A novel method is proposed to managing and controlling reactive power within microgrids with high integration of photovoltaic panels. The proactive dispatch is carried out for a few minutes in advance, using power forecast and the inverters of the photovoltaic installations as reactive energy providers. The goal is to stabilise voltage levels and reduce overall energy losses. Optimising reactive power poses a non‐convex problem. The presented method tackles this challenge by employing Conic approximations and Wirtinger calculus techniques to convert and frame the issue within a convex framework, simplifying its resolution. It primarily concentrates on fine‐tuning reactive power output from photovoltaic inverters to minimise overall losses and maintain stable magnitude voltage levels. To enable the reactive power dispatch, a Markov switching forecasting model that uses on‐site data, including sky imagery and other external variables, predicting active power generation every 6 minutes. The proposed technique is evaluated in a CIGRE test network, showing an average loss reduction between 14% and 66% for sunny and cloudy conditions with different levels of PV penetration, this while maintaining the steady state voltages in range.

Screening for undernutrition in gastric bypass: a case study of four patients in the Marrakech Tensift Al Haouz region, Morocco

Undernutrition presents a major risk to patients’ health and well-being following gastric bypass surgery. After undergoing this surgery, the nutritional status of three women and one man was examined in this study. Follow-up visits were used to measure weight, body composition, and biological and biochemical data. After 3 months of follow-up after gastric bypass surgery, our findings revealed a reduction in muscle mass. The average loss of muscle mass was 4.375±1.470 kg. Their initial body mass index, which was 45.01 kg/m2, on average, dropped to 28.38 kg/m2. Significant drops were observed in the mean levels of albumin and pre-albumin (albumin: 38.6 g/L to 24.8 g/L, pre-albumin: 195 mg/L to 113 mg/L). In our study, patients with micronutritional deficiencies and gastric bypass demonstrated a significant and adaptive reduction in daily caloric intake. Early identification of undernutrition makes it possible to assess its severity and, as part of the patient’s overall follow-up, to implement appropriate nutritional management.

Mechanical thrombectomy with the InThrill device for thrombosed hemodialysis access: A single center experience.

To assess the effectiveness and safety of the InThrill Thrombectomy System in treating thrombosed arteriovenous fistulas (AVFs) and grafts (AVGs) via mechanical thrombectomy. Institutional database was retrospectively searched to identify all thrombectomy procedures performed using the study device at our hospital for thrombosis of AVFs or AVGs. Inclusion criteria encompassed patients aged 18 and above who underwent AV access thrombectomy using the study device. Intraprocedural metrics, including procedure time, device time, blood loss, and adjunctive procedures were collected. Technical success was defined as restoration of flow combined with <30% residual diameter stenosis of the treated vascular segment. Clinical success was defined as the resumption of normal hemodialysis for a minimum of at least one session following intervention. Through 3-month follow-up, patency, and adverse events were evaluated. A total of 20 thrombectomies were performed on 2 AVFs and 18 AVGs in 13 patients. Median procedure and device times were 45 and 10 min, respectively. Balloon angioplasty was performed in all cases with additional stenting in 40% (8/20) of cases to address stenosis following thrombus removal. No other mechanical thrombectomy devices were utilized. Intraprocedural thrombolytics were not administered in any case. Average blood loss was 10 mL. The technical success and clinical success rates were 100% (20/20) and 95% (19/20), respectively. There were no intraoperative adverse events. One patient developed a post-operative minor hematoma, and one patient developed a post-operative pseudoaneurysm at the access site. The primary patency rate was 77% (10/13) at 1 month. Both assisted primary and secondary patency rates were 100% at 1 and 3 months. These preliminary results suggest that the InThrill Thrombectomy System is rapid, safe, and effective for thrombolytic-free treatment of AV access thrombosis in hemodialysis patients.

Survival rate and aesthetic outcomes of two-piece zirconia dental implants: A one-year single clinical trial of partially edentulous patients.

Titanium dental implants, traditionally used for tooth replacement, face certain biological and aesthetic limitations. Recently, zirconia has become a notable alternative, valued for its aesthetics and biocompatibility. This study evaluated the efficacy of two-piece zirconia dental implants, particularly their impact on inflammatory cytokines and their survival rate over one year. This study was a single-center, prospective trial and included adults aged 18 and above. 2021-2022, nine two-piece tissue-level zirconia implants were placed in eight patients. Following a three-month osseointegration phase, crowns were cemented. Over a year, we assessed Plaque and Gingival indices, Pocket Depth, and tissue color and texture. Peri-apical radiographs measured bone levels, and IL-1β in peri-implant crevicular fluid (PICF) was quantified using ELISA. Eight subjects (ages 31-63) participated. One implant failed after six months, resulting in a one-year survival rate of 88.8%. Plaque and Gingival indices rose, but peri-implant soft tissue remained stable in color and texture. At 12 months, average bone loss was minimal and insignificant compared to the baseline. IL-1β levels were similar to those at contralateral teeth, with no correlation between IL-1β, Pocket Depth, and Bleeding on Probing. Two-piece zirconia implants emerged as a viable tooth replacement option, with an 88.8% one-year survival rate. They maintained stable soft tissue and bone levels, indicating their potential as effective dental restoratives.

Opportunities to optimize lifestyle interventions in combination with glucagon-like peptide-1-based therapy.

Obesity is a chronic multi-system disease and major driver of type 2 diabetes and cardiometabolic disease. Nutritional interventions form the cornerstone of obesity and type 2 diabetes management. Some interventions such as Mediterranean diet can reduce incident cardiovascular disease, probably independently of weight loss. Weight loss of 5% or greater can improve many adiposity-related comorbidities. Although this can be achieved with lifestyle intervention, it is often difficult to sustain in the longer term due to adaptive endocrine changes. In recent years glucagon-like-peptide-1 receptor agonists (GLP-1RAs) have emerged as effective treatments for both type 2 diabetes and obesity. Newer GLP-1RAs can achieve average weight loss of 15% or greater and improve cardiometabolic health. There is heterogeneity in the weight loss response to GLP-1RAs, with a substantial number of patients unable to achieve 5% or greater weight. Weight loss, on average, is lower in older adults, male patients and people with type 2 diabetes. Mechanistic studies are needed to understand the aetiology of this variable response. Gastrointestinal side effects leading to medication discontinuation are a concern with GLP-1RA treatment, based on real-world data. With weight loss of 20% or higher with newer GLP-1RAs, nutritional deficiency and sarcopenia are also potential concerns. Lifestyle interventions that may potentially mitigate the side effects of GLP-1RA treatment and enhance weight loss are discussed here. The efficacy of such interventions awaits confirmation with well-designed randomized controlled trials.

Morphogenic Modeling of Corrosion Reveals Complex Effects of Intermetallic Particles.

Corrosion processes are often discussed as stochastic events. Here, it is shown that some of these seemingly random processes are not driven by nanoscopic fluctuations but rather by the spatial distribution of micrometer-scale heterogeneities that trigger fast reactions associated with corrosion. Using a novel excitable reaction-diffusion model, corrosion waves traveling over the metal surface and the associated material loss are described. This resulting nonuniform corrosion penetration, seen as a height loss in modeling, exposes buried intermetallic particles, which depending on the local electrochemical state of the surface trigger or block new waves. Informed by quantitative experimental data for the Mg-Al-Zn alloy AZ31B, wave speeds, wave widths, and average material loss are accurately captured. Morphogenic mitigation based on wave-breaking microparticles is also simulated. While AZ31B corrosion is identified as a process driven by rare-wave events, this study predicts several other corrosion regimes that proceed via spots or patchy patterns, opening the door for new protection, design, and prediction strategies.

Long‐term snowfall trends and variability in the Alps

AbstractSnow is particularly impacted by climate change and therefore there is an urgent need to understand the temporal and spatial variability of depth of snowfall (HN) trends. However, the analysis of historical HN observations on large‐scale areas is often impeded by lack of continuous long‐term time series availability. This study investigates HN trends using observed time series spanning the period 1920–2020 from 46 sites in the Alps at different elevations. To discern patterns and variations in HN over the years, our analysis focuses also on key parameters such as precipitation (P), mean air temperature (TMEAN), and large‐scale synoptic descriptors, that is, the North Atlantic Oscillation (NAO), Arctic Oscillation (AO) and Atlantic Multidecadal Oscillation (AMO) indices. Our findings reveal that in the last 100 years and below 2000 m a.s.l., despite a slight increase in winter precipitation, there was a decrease in HN over the Alps, especially for southern and low‐elevation sites. The South‐West and South‐East regions experienced an average loss of 4.9 and 3.8%/decade, respectively. A smaller relative loss was found in the Northern region (2.3%/decade). The negative HN trends can be mainly explained by an increase of TMEAN by 0.15°C/decade. Most of the decrease in HN occurred mainly between 1980 and 2020, as a result of a more pronounced increase in TMEAN. This is also confirmed by the change of the running correlation between HN and TMEAN, NAO, AO over time, which until 1980 were not correlated at all, while the correlation increased in later years. This suggests that in more recent years favourable combinations of temperature, precipitation, and atmospheric pattern have become more crucial for snowfall to occur. On the other hand, no correlation was found with the AMO index.

Dissemination of the 2022 ASMBS and IFSO Guidelines for Bariatric Surgery: What Has Reached Primary Care Providers?

BackgroundOnly 1% of Americans eligible for metabolic and bariatric surgery (MBS) receive MBS. Prior studies have analyzed primary care provider (PCP) referral patterns and perceptions of MBS as a potential barrier to increasing MBS. However, less data exists regarding PCP knowledge of MBS indications and outcomes. Following the 2022 update to the indications for MBS by the ASMBS and IFSO, the number of eligible patients is only expected to increase. We evaluated PCP knowledge regarding the existence of the 2022 ASMBS and IFSO updated guidelines, MBS indications, and MBS outcomes.MethodsAn 11-question survey was emailed to primary care residents, advanced practice providers, and faculty at a single institution.ResultsOf 151 surveys distributed, 39.7% responded (n = 60). 95% were unaware of the 2022 updated guidelines. On multiple choice questions, 16.3% correctly identified the average weight loss from MBS, and 46.8% correctly answered the diabetes remission rate following MBS. Trainee answers were not statistically significant from practicing PCPs. Fifteen respondents had referred a patient for MBS, but this subgroup did not perform significantly better on the assessment. A total of 72.3% of respondents reported inadequate MBS education during their training, and 85.1% were interested in additional education.ConclusionsWe present the first assessment of PCP MBS knowledge since the release of the 2022 updated ASMBS and IFSO guidelines. This study indicates a gap in PCPs’ knowledge regarding the updated guidelines and represents an opportunity for collaboration with our primary care colleagues to provide further MBS education.

Co-pyrolysis characteristics and pyrolysis oil analysis of Chlorella vulgaris and marine waste plastics with multi-metal MOFs-derived additive

In this study, MOFs-derived additives with microwave absorption and catalytic characteristics were employed in the microwave co-pyrolysis of Chlorella vulgaris (CV) and marine waste plastics (MW) to produce high-quality pyrolysis oil. The effects of additives (Ni-Cu@C, Ni-Co@C, Cu-Co@C and Ni-Cu-Co@C) under different addition amounts (10%, 20%, 30%) on co-pyrolysis characteristics, product yield and pyrolysis oil composition were investigated. Furthermore, the pyrolysis mechanism was analyzed. The results showed that the MOFs-derived additives improved the co-pyrolysis characteristics, especially at 30% addition amount. The maximum average weight loss rate (0.0273 wt.%/s) and pyrolysis oil yield (14.33%) obtained at 30% Ni-Cu-Co@C group. Moreover, the aromatic content (30.07%), deoxygenation efficiency (27.70%) and denitrogenation efficiency (80.03%) in pyrolysis oil were maximum at adding 30% Ni-Cu-Co@C. Ni-Cu-Co@C promoted the nitrogen transformation into gaseous products, while reduced the nitrogen contents in char and pyrolysis oil. Meanwhile, the nitrogen in char was dominated by pyridine-N and quaternary-N. Importantly, the activity of the Ni-Cu-Co@C remained 0.66 times of the initial activity after 5 cycles, demonstrating the excellent regenerative usability.