Bimodal Peaks Research Articles

Influence of boundary layer-cloud coupling on cloud microphysics based on aircraft observations in the North China plain.

Previous studies on hand, foot, and mouth disease (HFMD) have primarily addressed initial infections, with limited focus on reinfection trends and multifactorial risk interactions. Conventional methods like logistic regression often fail to capture temporal risk dynamics. This study applied a Cox proportional hazards model to analyze epidemiological traits and risk factors for HFMD reinfection in Quzhou from 2008 to 2024, to guide prevention strategies. Among 79,841 reported cases, 3945 reinfections were identified, yielding a reinfection rate of 4.94%. Most cases experienced 2 episodes (96.53%), with fewer having 3 (3.40%) or 4 (0.08%). Infections showed bimodal seasonal peaks in April–June and November–December. Median intervals between successive infections decreased from 1.38 years (1st to 2nd) to 0.82 years (3rd to 4th). Cox proportional hazards regression modeling identified age under 3 years, scattered children, urban residence, initial infection with coxsackievirus A16, and coxsackievirus A16 being the predominant circulating strain in the year of initial infection as significant risk factors for HFMD reinfection. our study identifies a significant HFMD reinfection burden (4.94%) in Quzhou. These findings highlight the need for targeted health education and sustained vigilance, especially for high-risk groups, to mitigate reinfection risks. However, only 4.16% of reinfection cases in this study were laboratory-confirmed, and the diagnostic reagents did not permit differentiation across all serotypes. Variation in detection rates among reinfection cases may have introduced bias, and the related findings should therefore be interpreted with caution.

Predicting shifts in plant-pollinator communities as a result of warming requires an accurate understanding of floral availability, insect activity, and spatio-temporal patterns of plant-insect interaction. Plant-insect visitor network studies from the High Arctic have demonstrated high generalization and rapid temporal turnover, yet comparable data are lacking for the Low Arctic. We worked in two tundra plant community types on the North Slope of Alaska in 2022 and 2023 to construct the first plant-insect visitor networks for this region of the Arctic and document temporal patterns of floral resource availability and insect visitation. We found temporal differences in floral availability between community types. Both floral density and the number of species in anthesis peaked earlier in the dry heath tundra compared to the moist acidic tundra. In addition, Hymenopteran visitation rates showed a bimodal peak (early- and late-season) while Dipteran visitation rates showed a unimodal pattern. Network complexity peaked earlier in the dry compared to the moist community. Our results suggest that temporal heterogeneity in floral resources between plant community types may increase the duration of floral availability for insects at a landscape scale. Given this region’s low species diversity and increasing vulnerability to extreme weather events, spatio-temporal heterogeneity in floral resources may play a critical role in the resiliency of this system.

Ammonia is a green zero-carbon fuel, yet its low reactivity poses challenges, including difficult ignition and slow combustion rates. Compared to diesel or biodiesel, dimethyl ether (DME) has no C-C bonds, which means it produces almost no soot and has a high cetane number that helps it ignite easily. So, using the highly reactive DME to help ignite liquid ammonia is a good way to make it burn better. This study uses computer simulations to look at how well liquid ammonia and DME work together as fuel with different injection setups. Results indicate optimal DME ignition enhancement at injector spacing L = 6 cm, injection angle 180°, and ammonia energy share 70%, outperforming cases with spacings of 7–8 cm and angles of 150°, 120°, 90°, and 60°. At the same time, having shorter spacing during DME combustion leads to smaller areas for OH but more NH₂ formation, showing that ammonia is more effective at cooling the flame and that more ammonia is being used as fuel. Additionally, when DME is not burning, both OH and NH₂ areas grow larger at shorter spacings, showing that the fuel mixes sooner, the reaction areas get bigger, and the burning process is more complete. Regarding the bimodal NH₂ peaks, the initial peak reflects partial ammonia oxidation that is flame-entrained during DME combustion, while the secondary peak indicates the onset of autoignition, which is characterized by diminished reaction rates and reduced combustion intensity.

Understanding how endangered carnivores partition spatiotemporal distribution in human-dominated landscapes is pivotal for mitigating biodiversity loss in climate-sensitive boreal ecosystems. Here, we used kernel density data derived from a 16-month camera-trap survey (140 UVL7 cameras), cold single-season (November-April) occupancy models, and MaxEnt 3.4.4 to identify the effects of biotic interactions, anthropogenic disturbance, and environmental factors on the spatiotemporal distribution of the wolverine (Gulo gulo) in Beijicun National Nature Reserve, Heilongjiang Province, China. We found that wolverines exhibited crepuscular activity patterns using night-time relative abundance index (NRAI) = 50.29% with bimodal peaks (05:00-07:00, 13:00-15:00), with dawn activity predominant during the warm season (05:00-06:00) and a bimodal activity pattern in the cold season (08:00-09:00, 14:00-15:00). Temporal overlap with prey (overlap coefficient Δ = 0.84) and competitors (Δ = 0.70) was high, but overlap with human-dominated temporal patterns was low (Δ = 0.58). Wolverines avoided human settlements and major roads, preferred moving along forest trails and gentle slopes, and avoided high-altitude deciduous forests. Populations were mainly concentrated in southern Hedong and Qianshao Forest Farms, which are characterized by high habitat integrity, high prey densities, and minimal anthropogenic disturbance. These findings suggest that wolverines may influence boreal trophic networks, especially in areas with intact prey communities, competitors, and spatial refugia from human disturbances. We recommend that habitat protection and management within the natural reserve be prioritized and that sustainable management practices for prey species be implemented to ensure the long-term survival of wolverines.

Although burn injury survival has improved significantly in high-income countries (HICs) over the past 3decades, low- and middle-income countries (LMICs) continue to experience high mortality rates. Prior studies have attributed burn mortality to factors, such as total body surface area burned, inhalation injury, and under-resuscitation, primarily focusing on late deaths in HICs. This study examines the characteristics of early versus late burn deaths in LMICs. We conducted a retrospective analysis of pediatric patients admitted to the Kamuzu Central Hospital (KCH) burn unit in Lilongwe, Malawi. Bivariable analyses, followed by a multivariable logistic regression analysis, were performed to evaluate factors influencing early mortality (death within 3days of burn injury). Among the 2315 patients analyzed, 397 (17.1%) died, with 109 (27.4%) classified as early deaths. The median age was 2years (IQR 2-7), and there was a slight male preponderance in both early and late death cohorts. The estimate plot demonstrated bimodal peaks in mortality within one and 7 days postinjury. Multivariable logistic regression revealed that patients who did not receive adequate fluid resuscitation within 24 h of injury were significantly more likely to experience early death (aOR 2.96, 95% CI 1.20-7.29, and p=0.02). The predictive probabilities showed a significant decrease in mortality with increased length of stay in the burn unit. Adequate fluid resuscitation within 24 h is crucial for improving survival and may mitigate early mortality in pediatric patients with burn, emphasizing the need for targeted treatment protocols in resource-limited settings.

The increasing emergence of antifungal resistance poses potential clinical challenges, particularly among immunocompromised patients with cancer at risk of invasive mold infections, but data on antifungal susceptibility trends specific to this population are few. We evaluated distributions of minimal inhibitory concentrations (MIC), including minimal effective concentrations (MEC) for echinocandins, of 11 antifungal agents for 523 mold isolates (395 Aspergillus spp.) from cancer patients. Based on published Clinical and Laboratory Standards Institute guidelines, isavuconazole had notably high rates of non-wild-type MICs for A. fumigatus (19.6%), A. flavus/oryzae (34.8%), A. niger complex (26.1%), and A. terreus complex (8.33%). Persistent low baseline resistance of A. fumigatus to voriconazole was observed across multiple years (2.4–11.5% per year, average 8.41%) without significant trends in MIC change over time. Itraconazole and posaconazole demonstrated the lowest MIC distributions (MIC50 ≤ 0.06–0.5 µg/mL) of the azoles against Aspergillus spp. Amongst the A. niger complex, 29.4% (27/92) demonstrated non-wild-type MICs to itraconazole. While the A. nidulans group was less frequent (n = 24), bimodal peaks in MIC/MEC were noted for caspofungin (≤0.06 and 1 µg/mL). Non-Aspergillus molds of significance (Zygomycetes, Fusarium spp., Scedosporium spp., and Lomentospora prolificans) demonstrated variable but increased MICs to antifungal agents as previously described. Our results highlight increased rates of non-wild type MICs for Aspergillus spp. to isavuconazole and voriconazole, which are commonly used antifungal agents in cancer patients. Such AST trends should be closely monitored in populations with frequent antifungal use and encourage increased antifungal stewardship efforts.

Immune-mediated liver injury (IMLI) is a critical adverse event in patients treated with PD-1/PD-L1 inhibitors. The study aims to characterize the clinical heterogeneity, temporal dynamics, and immunological drivers of PD-1/PD-L1 inhibitor-associated IMLI and optimize surveillance and management strategies. We retrospectively recruited 373 IMLI patients. We evaluated clinical data, including liver injury patterns, severity, temporal trends, and immune cell subsets. Statistical analyses identified risk factors for severe IMLI and temporal dynamics. Among 373 patients (median age: 65 years; male: 74.8%), IMLI severity was graded as G1 (53.9%), G2 (25.2%), G3 (17.9%), and G4 (2.7%), with hepatocellular (17.2%), mixed (42.6%), and cholestatic (40.2%) patterns observed. The median time to onset was 106-115 days across severity groups. In contrast, recovery time was significantly prolonged (G1/2: 14 days vs. G3/4: 23 days, P<0.05), and recovery-phase CD8+ T cells (524.9 vs. 270.68 cells/μL, P=0.026) were higher in severe cases. Bimodal onset peaks occurred at 1-2 months and 3-4 months, with 88% recovering within 100 days. No tumor-type differences existed in patterns (P=0.427) or severity (P=0.054). Elevated baseline NK cells (OR=1.004, P=0.036) predicted severe IMLI. IMLI demonstrates bimodal onset and pan-cancer uniformity, driven by systemic immune dysregulation. Baseline NK cells are potential predictors of severity. Risk-adapted monitoring within 4 months post-ICI and standardized protocols are recommended.

Understanding the spatiotemporal dynamics of vegetation net primary productivity (NPP) and its drivers is critical to sustainable land -carbon management, carbon-neutral development, and ecological restoration in fragile karst landscapes. This study proposes a Pearson Correlation—Deep Transformer (PCADT) model that integrates attention mechanisms and geospatial covariates to enhance NPP estimation accuracy in Guangxi, China—a global karst hotspot. Leveraging multisource remote sensing data (2015–2020), PCADT achieves 10.7% higher predictive accuracy (R2 = 0.83 vs. conventional models) at 500 m resolution, thereby capturing the fine-scale heterogeneity essential for sustainability planning. The results reveal a significant annual NPP increase (4.14 gC·m−2·a−1, p &lt; 0.05), with eastern areas exhibiting higher baseline productivity (1129 gC·m−2 in Wuzhou) but western regions showing steeper growth rates (5.2% vs. 2.1%). Vegetation carbon sequestration capacity, validated against MOD17A3HGF data (R2 = 0.998), demonstrates spatial consistency (east &gt; west), with forest-dominated Wuzhou contributing 6.5 TgC annually. Mechanistic analyses identify precipitation as the dominant climatic driver (partial r = 0.62, p &lt; 0.01), surpassing temperature sensitivity, while bimodal NPP-altitude peaks (300 m and 900 m) and land -use transitions (e.g., forest-to-cropland conversions) explain 18.5% of NPP variability and reduce regional carbon stocks by 4593 tC. The PCADT framework offers a scalable solution for precision carbon management by emphasizing the role of anthropogenic interventions—such as afforestation—in alleviating climatic constraints. It advocates for spatially adaptive strategies to optimize water resource utilization, enhance forest conservation, and promote sustainable land -use transitions. By identifying areas where water -scarcity relief and targeted afforestation would yield the highest carbon returns, the PCADT framework directly supports SDG 13 (Climate Action) and SDG 15 (Life on Land), providing a strategic blueprint for sustainable development in water-limited karst regions globally.

BackgroundDespite therapeutic advances, acute leukemia (AL) continues to impose a substantial global health burden, with persistently high incidence and mortality rates. Notably, the prediction is that the number of incidence and mortality of acute myeloid leukemia (AML) cases will continue to increase to 184,287.88 and 165,537.59, respectively, by 2040. Using Global Burden of Disease Study (GBD) 2021 data, we assessed the worldwide AL burden from 1990 to 2021, analyzing trends by sex to inform public health strategies. MethodsTo delineate the burden of AL, we reported incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates at global, regional, and national levels, with these estimates including age-standardized rates (ASRs) per 100,000 population and average annual percentage changes (AAPCs) from 1990 to 2021 which were stratified by age, sex, and socio-demographic index (SDI), and computed ASRs and AAPCs using linear regression. Temporal trends were analyzed using an age-period-cohort (APC) model with intrinsic estimation (principal component regression). Risk factor attribution quantified contributions of 21 behavioral, environmental, and metabolic exposures to AL-related DALYs. For inequality assessment, we applied the Slope Index of Inequality and Concentration Index to evaluate absolute and relative disparities in AL burden across regions and countries. Future projections (2040) were modeled via a Bayesian APC framework with Integrated Nested Laplace Approximation. All statistical analyses were performed using R software (version R 4.4.1). The GATHER (Guidelines for Accurate and Transparent Health Estimates Reporting) statement provides a framework to ensure the transparency, reproducibility, and quality of health estimates reporting. ResultsBetween 1990 and 2021, global ASRs of AL declined, except for acute lymphoblastic leukemia (ALL) age-standardized prevalence rates (ASPR) (AAPC 0.84, 95% CI 0.59-1.10). Case numbers rose overall, though ALL mortality and DALYs decreased. AML burden correlated positively with SDI (ρ > 0, P < 0.001), with the highest number of incident and mortality cases in Western Europe. For ALL, SDI showed positive associations with ASIR and ASPR (ρ > 0, P < 0.001) but negative correlations with ASMR and ASDALR (ρ < 0, P < 0.001), with East Asia being the most severely affected region. High body mass index (BMI), smoking, and benzene/formaldehyde exposure were key AL DALY risk factors. High BMI and smoking predominate in developed countries, and the proportion of DALYs decreases progressively as SDI decreases. Occupational exposures prevailed in developing countries. Population growth drove most absolute increases. Males bore a greater AL burden. AML risk rose with age, whereas ALL displayed bimodal peaks (< 5 and > 40 years). Notably, while ASRs in AL are projected to decline slightly and the number of ALL to decrease by 2040, the number of AML is expected to increase, with the number of incidence and mortality cases increasing by 41.56% and 27.16%, respectively.ConclusionAs a major public health concern, despite declining ALL-related mortality and DALYs (1990–2021), AL remains a growing global health challenge, with AML cases projected to rise significantly by 2040. Region-specific intervention strategies are required: high-SDI nations should prioritize smoking cessation and metabolic control to address smoking and high BMI-related AML risks while preparing for aging populations, whereas low/middle-SDI countries urgently need enhanced pediatric ALL diagnosis, treatment capacity, and occupational safety measures. Effective mitigation demands evidence-based health planning, including resource allocation guided by projected AL burden trends and targeted policy interventions to reduce healthcare disparities.

Craniopharyngiomas are rare intracranial tumors originating from the Rathke's pouch, affecting the sellar and parasellar regions. Despite their benign nature, they cause significant morbidity and mortality due to their proximity to vital structures such as the optic pathways and the hypothalamic-pituitary axis, resulting in endocrine, visual, neurological impairment, and hypothalamic syndrome. Classified into adamantinomatous (ACP) and papillary (PCP), these tumors differ in epidemiology, histology, and pathophysiology. ACP, the most common type, presents a bimodal peak incidence between 5 and 15 years of age and 45 and 60 years of age, while PCP is more restricted to adults. Traditional treatments such as surgery and radiotherapy face significant challenges, including high recurrence rates. Intracystic chemotherapy is used in monocystic ACP but with limited efficacy and adverse effects related to toxicity. Recent advances in molecular biology have introduced targeted therapies, such as BRAF and MEK inhibitors, which show potential benefits in craniopharyngioma patients, particularly in the PCP. For ACP, however, therapeutic outcomes remain limited despite advances in molecular understanding, including mutations in the CTNNB1 gene and growth factors. Increasing investigation into the inflammatory microenvironment and immune response of these tumors presents new therapeutic possibilities and promising alternatives for tumor control, such as the use of anti-IL-6R, anti-VEGF agents and immune checkpoints inhibitors. This review aims to synthesize advancements in the pathophysiology of craniopharyngiomas and explore emerging therapeutic implications, focusing on precision medicine approaches for the management of this challenging disease.

The availability of suitable preclinical models is critical for developing novel therapeutic interventions. Ovine models are particularly useful for studying spinal diseases due to their similarity in size and weight to humans. However, evaluation of the ovine spinal cord and canal anatomy is necessary for such translational application. To date, no studies have quantified the entire ovine spine using advanced imaging. In this work, we used MR and CT imaging to obtain the quantitative anatomic information necessary for the appropriate preclinical investigations of the spinal cord and spine using sheep. Six mixed-breed, female sheep were scanned in dorsal recumbency for MR T1- and T2-weighted images, as well as sternal and dorsal recumbency for CT images. Interactive multiplanar reformation and a series of automatic measurements, followed by computation of various distances within the spinal cord and canal, were completed for each animal. This led to the quantification of the MR-derived images: spinal cord and canal width and height, cord circumference, dorsal CSF distance, and ventral-dorsal/left-right vertebral displacements. The CT-derived, computed measurements were for aminal circumference, vertebral height, and disk height index. CT and MR imaging were performed on all animals, although some measurements were excluded due to image quality. Spinal cord circumference peaked at C6 (27.41 mm) and L6 (24.93 mm), with notable ventral-dorsal displacement at L7 (2.65 mm). Neural foramina circumference showed bimodal peaks at C8 and L7, while vertebral height declined from L7 to T9, peaking at C4 (40.42 mm), highlighting structural variability along the spine. This study will be beneficial in the modeling and development of precision neurosurgical treatments by providing a comprehensive quantitative dataset for veterinary research on spinal disease and the development of therapeutic interventions.

BackgroundPrimary hypertrophic osteoarthropathy (PHO) is a rare genetic disorder classified into clinical subtypes and genetic subtypes. Previous clinical studies have primarily focused on case reports and family analyses, largely characterizing the genetic subtypes. However, there remains a long-standing gap in understanding the characteristics of the different clinical subtypes of PHO. This study aimed to determine the distribution of the three clinical subtypes of PHO and compare their clinical characteristics using a large global sample.MethodsA systematic literature search was conducted in multiple databases to categorize cases into complete form (CO), incomplete form (IN), and fruste form (FR). Statistical analyses were performed to assess clinical differences in a retrospective study design.ResultsMales predominated across all subtypes, whereas females were most prevalent in IN patients (51.1%). IN patients had the highest family history rate (62.1%). Age at onset peaked in adolescence for CO and FR patients, while IN patients exhibited bimodal peaks in early childhood and adolescence. Congenital diseases were more frequent in IN patients (7.8%, P = 0.021), while CO patients had a higher prevalence of digestive system diseases (12.2%, P = 0.007). Urinary prostaglandin E2 (PGE2) and PGE Metabolite (PGEM) were consistently elevated in CO and FR patients. In IN patients, urinary PGE2 levels were also increased, but the urinary PGEM levels showed equal proportions of elevation and reduction. Genetic analysis revealed that solute carrier organic anion transporter family member 2A1 (SLCO2A1) mutations were predominant in CO (95 cases, 73.1%) and FR (22 cases, 57.9%) patients, whereas hydroxyprostaglandin dehydrogenase (HPGD) mutations were most frequently associated with IN (25 cases, 73.5%).ConclusionsThe three clinical subtypes of PHO exhibited distinct characteristics with no clear correlation between clinical and genetic subtypes. These findings highlighted the clinical significance of PHO typing and provided valuable insights for diagnosis, differential diagnosis and subtype-specific management strategies.

ABSTRACT Background: Hodgkin’s lymphoma is a malignant tumor of the lymph nodes that causes painless lymphadenopathy. Diagnosing it can be challenging, especially in the early stages, due to often nonspecific symptoms. This study addresses our center’s increased Hodgkin’s lymphoma (HL) incidence. Given the limited literature on this subject, we aim to enhance our understanding of HL’s incidence and clinicopathological features in our environment. Methods: This retrospective study analyzed HL cases from 2010 to 2022 at Lagos University Teaching Hospital and two private laboratories. Clinical data were gathered from case files and laboratory requests, and both hematoxylin-eosin-stained sections and immunohistochemical slides were reviewed to classify the diseases morphologically. Results: A total of 50 HL cases were identified, primarily in the cervical region, with 5 and 4 cases in the inguinal and axillary regions, respectively. Among the 34 with clinical information, there were 35% in Ann Arbor stage I, 15% in stage II, none in stage III, and 9% in stage IV, while 41% had unspecified stages. The cohort comprised 40 males and 10 females, with a male-to-female ratio of 4:1. Ages ranged from 2 to 72 (mean 32.8), and most cases (68%) involved individuals in their third to fifth decades. Histologically, the breakdown was 44% nodular sclerosis, 30% mixed cellularity, 8% lymphocyte-rich, 4% lymphocyte-depleted, and four unclassified cases. Conclusions: HL is common at our center. It typically presents at a late stage, predominantly nodal, and is more frequent in young adult males. The nodular sclerosis (NS) subtype is the most common, and a bimodal peak is not observed. The increased frequency among young people and late presentations indicates a need for improved access to clinical and diagnostic services.

Current epidemiology of infectious encephalitis: a narrative review.

In this study, a solution system of KCl-NH4Cl-NH3-H2O with different mass fractions was prepared at room temperature using x-ray scattering, Raman spectroscopy, and molecular dynamics simulations. From x-ray scattering, it was obtained that the peak near Q = 2.50Å-1 in the F(Q) function changed from a flat-topped blunt peak to a bimodal peak as the concentration of ammonia increased. This change indicated that increased ammonia altered the hydrogen bonding network within the mixed solution. In the G(r) function, the peak near 3.25Å enhances with the increase in ammonia concentration, suggesting a higher occurrence of N(NH4+)-N(NH3) interactions. Raman spectroscopy findings demonstrated that in the KCl-NH4Cl aqueous mixture, the area of DDAA-type hydrogen bonds increased as KCl concentration decreased and NH4Cl concentration increased. This suggests that KCl disrupts DDAA-type hydrogen bonds more significantly than NH4Cl. The situation was reversed when ammonia was added to the system, implying that KCl damages the DDAA-type hydrogen bonding structure less than NH4Cl when NH3 is present in the solution. Molecular dynamics simulations indicated that the coordination number of K-Cl increases with ammonia concentration, as ammonia's lone pair of electrons can bind to NH4+ to stabilize the [NH4(H2O)m-n(NH3)n]+ complex. This study elucidates the underlying microscopic mechanisms behind the decrease in KCl solubility and the increase in NH4Cl solubility upon increased ammonia.

AimThe epidemiology of hemorrhoids is challenging because of variability in sampling methodologies and diagnostic criteria across different studies. This study indirectly clarified the epidemiology of hemorrhoids by investigating the number of invasive treatments for hemorrhoids (ITH) using a nationwide healthcare claims database.MethodsThe annual number and rate of ITH procedures per 100 000 people during 2018–2022 were examined. ITH covered by the Japanese healthcare insurance includes sclerotherapy, rubber band ligation, infrared coagulation, thrombectomy, hemorrhoidectomy, and stapled hemorrhoidopexy. The demographic peak patterns in the sex‐ and age‐stratified data were analyzed. Annual trends were evaluated using the Jonckheere–Terpstra trend test or Poisson regression model.ResultsOver the 5‐year period, the total number of ITH was 697 838, with a rate of 110.5 per 100 000 person‐years. The male‐to‐female ratio was 1.2:1, indicating slight male predominance. Demographic peak analysis revealed bimodal peaks in males aged 40–44 and 75–79 years, and in females aged 35–39 and 75–79 years. No significant changes were observed in all ITH procedures. The age‐adjusted number across all age groups per 100 000 person‐years demonstrated annual decreasing trends for males but increasing trends for females (p < 0.0167). Subgroup analysis indicated a decrease among older cohorts in both males and females, in contrast to an increase among young and middle‐aged females (p < 0.00088).ConclusionDistinct bimodal ITH peaks were observed in males and females in their 30s–40s and 70s. These findings provide valuable insights into the epidemiology of hemorrhoids.

Introduction: Spondylodiscitis is a global term that includes vertebral osteomyelitis, spondylitis and discitis, representing approximately 3 to 5% of all cases of osteomyelitis. It occurs in around 0.5 to 2.5 cases per 100,000 inhabitants/year, with men being more affected. It has a bimodal peak incidence, the first peak up to 20 years and the second between 50 and 70 years. Most cases have an indication for non-surgical treatment, so surgery is reserved for specific cases. Objective: To analyze the epidemiology of the population affected by spondylodiscitis and assess the response to surgical treatment. Methods: We conducted a prospective cohort study in a tertiary center in Pernambuco, Recife, Brazil, investigating spondylodiscitis in all patients with back pain without a history of trauma or neurological deficit without a diagnosis of degenerative spine disease. The diagnosis of spondylodiscitis was confirmed in all cases with magnetic resonance imaging. The study period was two years. Results: During the study period, we diagnosed 31 patients with spondylodiscitis, 58% were male, the mean age was 64.9 years, the main comorbidities were systemic arterial hypertension, dialysis renal failure and diabetes, previous non-neurological surgeries (Caesarean births, permanent vascular catheter for dialysis, cardiac surgery on the iac etc.) were identified as a risk factor, 58% of patients have motor weakness and L4-L5 were the most frequent level affected. Antibiotic therapy was used in accordance with current guidelines. Conclusion: The clinical profile of our patients was 6 decades of life, male patients with neurological disabilities, clinical management has favorable results.

The combustion characteristics and gas emissions behavior of Low-calorie Indonesian coal (LC), Shaanxi coal (SC), and Datong coal (TC) were analyzed by a thermogravimetric-Fourier transform infrared spectrometer (TG-FTIR). The results showed that LC was the easiest coal to burn, followed by SC and TC. The main components of LC ash were alkali metals and alkaline earth metals (AAEMS), while SC and TC were clay minerals. The catalytic activity of LC ash was higher than that of SC and TC ash. FTIR results indicated that the main functional groups of three coals were CO2, CO, H2O, phenols, C = O, and C-H during combustion. The absorbance peaks of CO2, CO, SO2, and HCN against temperature showed single peak characteristics, while NOx was the bimodal peak. The total CO2 emission of LC was 1.04 and 1.25 times that of SC and TC. Compared to LC and SC, TC had the highest total CO and SO2 emissions. The total NOx emission of LC, SC, and TC was 0.21, 0.21, and 0.16. The study results provide the guidance for selection of coals and control the emission of gas products in the thermal power plant.

Observed alterations in seasonal patterns of common pediatric respiratory viruses during and immediately after the COVID-19 pandemic had far-reaching implications for the care of ill children. Here, we quantify the effects of the pandemic and related nonpharmaceutical interventions on the prevalence and seasonality of common pediatric respiratory illnesses. We performed a retrospective chart review within a large health network to identify incidence rates of common respiratory viruses and compared them to historical trends. Time series analyses using seasonal autoregressive integrated moving average models were utilized to identify seasonal patterns for the different virus types and quantify deviations from expected incidence rates. Overall, we noted a steep decline in non-COVID viral infection rates at the onset of the COVID pandemic in March 2020, largely coincident with the institution of mask mandates and lockdown measures. This trend continued until the Spring of 2021, at which time non-COVID infections resurged to rates higher than pre-COVID levels. In addition, the historically observed seasonality of these viruses was significantly disrupted by the pandemic. In particular, the historical peaks for influenza A and human metapneumovirus shifted from February and March, respectively, to bimodal peaks in December 2021 and May 2022; respiratory syncytial virus demonstrated an unprecedented Spring/Summer season in 2021; parainfluenza type 1 was unusually active in 2022, an even-numbered year; and influenza B virtually disappeared during and immediately after the pandemic. Our observations add to the growing body of literature supporting the hypothesis that human interactions are one of the key drivers of pediatric respiratory viral seasonality in addition to climate. Understanding the effect of human interactions on disease spread is crucial for the development of effective mitigation measures for future pandemics while avoiding dangerous spikes of other illnesses once those interventions are lifted.