Changes In Variables Research Articles

Rising temperatures, falling fisheries: causes and consequences of crossing the tipping point in a small-pelagic community

Global change has profound effects on marine species, communities, and ecosystems. Among these impacts, small pelagics have emerged as valuable indicators for detecting regime shifts in fish stocks. They exhibit swift responses to changes in ocean variables, including decreased abundances, accelerated juvenile growth rates, early maturation, and reduced adult sizes in warm waters. However, each pelagic species occupies a unique local ecological niche, that reflects the sum of all environmental conditions. Consequently, their responses to environmental changes manifest in distinct ways. We explore here how global change affects small pelagics in the Madeira Archipelago (NE Atlantic Ocean) at (i) community level, by studying the effects of climate change over a 40-year (1980–2019) period on small pelagic landings, and (ii) population level, by studying the effects on the life-history traits of the two most abundant species, Scomber colias and Trachurus picturatus. Our study demonstrated that anomalies in the Sea Surface Temperature and the North Atlantic Oscillation caused a regime shift within the small pelagic community. Both environmental predictors explained 88.9% of the community landings oscillations. S. colias appears to exhibit a relatively more favorable adaptive response to climate change compared to T. picturatus. Understanding the species-specific ecological responses of small pelagic fish to global change is crucial for effective management and conservation efforts in the face of ongoing environmental scenarios.Graphical abstract

Effect of a Mobile Health-Based Remote Interaction Management Intervention on the Quality of Life and Self-Management Behavior of Patients With Low Anterior Resection Syndrome: Randomized Controlled Trial.

People who undergo sphincter-preserving surgery have high rates of anorectal functional disturbances, known as low anterior resection syndrome (LARS). LARS negatively affects patients' quality of life (QoL) and increases their need for self-management behaviors. Therefore, approaches to enhance self-management behavior and QoL are vital. This study aims to assess the effectiveness of a remote digital management intervention designed to enhance the QoL and self-management behavior of patients with LARS. From July 2022 to May 2023, we conducted a single-blinded randomized controlled trial and recruited 120 patients with LARS in a tertiary hospital in Hefei, China. All patients were randomly assigned to the intervention group (using the "e-bowel safety" applet and monthly motivational interviewing) or the control group (usual care and an information booklet). Our team provided a 3-month intervention and followed up with all patients for an additional 3 months. The primary outcome was patient QoL measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. The secondary outcomes were evaluated using the Bowel Symptoms Self-Management Behaviors Questionnaire, LARS score, and Perceived Social Support Scale. Data collection occurred at study enrollment, the end of the 3-month intervention, and the 3-month follow-up. Generalized estimating equations were used to analyze changes in all outcome variables. In the end, 111 patients completed the study. In the intervention group, 5 patients withdrew; 4 patients withdrew in the control group. Patients in the intervention group had significantly larger improvements in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 total score (mean difference 11.51; 95% CI 10.68-12.35; Cohen d=1.73) and Bowel Symptoms Self-Management Behaviors Questionnaire total score (mean difference 8.80; 95% CI 8.28-9.32; Cohen d=1.94) than those in the control group. This improvement effect remained stable at 3-month follow-up (mean difference 14.47; 95% CI 13.65-15.30; Cohen d=1.58 and mean difference 8.85; 95% CI 8.25-9.42; Cohen d=2.23). The LARS score total score had significantly larger decreases after intervention (mean difference -3.28; 95% CI -4.03 to -2.54; Cohen d=-0.39) and at 3-month follow-up (mean difference -6.69; 95% CI -7.45 to -5.93; Cohen d=-0.69). The Perceived Social Support Scale total score had significantly larger improvements after intervention (mean difference 0.47; 95% CI 0.22-0.71; Cohen d=1.81). Our preliminary findings suggest that the mobile health-based remote interaction management intervention significantly enhanced the self-management behaviors and QoL of patients with LARS, and the effect was sustained. Mobile health-based remote interventions become an effective method to improve health outcomes for many patients with LARS. Chinese Clinical Trial Registry ChiCTR2200061317; https://tinyurl.com/tmmvpq3.

Seismocardiography and echocardiography: the correlation in the systolic complex

Aim. This study aimed to investigate the correlation between seismocardiographic and echocardiographic systolic variables and whether a decrease in preload could be detected by the seismocardiography (SCG). Methods. This study included a total of 34 subjects. SCG and electrocardiography were recorded simultaneously followed by echocardiography (echo) in both supine and 30◦ head-up tilted position. The SCG signals was segmented into individual heartbeats and systolic fiducial points were defined using a detection algorithm. Statistical analysis included correlation coefficient calculations and paired sample tests. Results. SCG was able to measure a decrease in preload by almost all of the examined systolic SCG variables. It was possible to correlate certain echo variables to SCG time intervals, amplitudes, and peak to peak intervals. Also, changes between supineand tilted position of some SCG variables were possible to correlate to changes in echo variables. LVET, IVCT, S’, strain, SR, SV, and LVEF were significantly correlated to relevant SCG variables. Conclusion. This study showed a moderate correlation, between systolic echo and systolic SCG variables. Additionally, systolic SCG variables were able to detect a decrease in preload.

Spiritual Connectivity Intervention for Individuals with Depressive Symptoms: A Randomized Control Trial.

Depression is one of the most prevalent mental disorders worldwide. This study examined the effect of a spiritual connectivity intervention on individuals with depression in a randomized waitlist-controlled trial. Fifty-seven participants with mild or moderate depressive symptoms were randomly assigned to either the intervention group (n = 28) or the waitlist control group (n = 29). The intervention comprised eight weekly sessions focusing on divine connection, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. The outcome measures included depressive symptoms, anxiety, hope, meaning in life, self-esteem, and social support. Participants completed self-administered questionnaires at baseline (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Repeated-measures ANOVA and one-way ANCOVA were used to compare the within-group and between-group differences in the changes in outcome variables. Participants in the intervention group showed significant improvements in depression, anxiety, spiritual experience, hope, self-esteem, and perceived social support after the intervention. Effect size statistics showed small to large differences (Cohen's d, 0.308 to -1.452). Moreover, 85.71% of participants in the intervention group also experienced clinically significant reductions in PHQ-9 scores from baseline to immediate post-intervention. This study highlights the effectiveness of a low-cost, accessible intervention suitable for community implementation by clergy and faith-based organizations.

The pulse of Yarlung Tsangpo River: Ultra-high-resolution insights into the flow and sediment

Traditional monitoring techniques of flow and sediment are inadequate for the sparsely populated, the rivers in the Qinghai-Tibetan Plateau region which are experiencing amplified climate change. Inspired by the Euchiloglanis fish, this study developed a unique self-contained hydrodynamic observation platform to withstand the high velocities of mountain rivers typically encountered in mountain rivers. The platform, equipped with sensors, was successfully deployed in the Yarlung Tsangpo River, collecting ultra-high-resolution data on flow and sediment over a period of nearly two months. Performance assessments showed that the median value of discharge per unit width measured and suspended sediment concentration by this system were basically consistent with those daily measurements from the hydrological station. Meanwhile, the superiority of the system was reflected in the more significant daily average change, especially at the flooding period. The data unveiled significant minute-level hydrological fluctuations and a complex interplay of factors affecting the river’s flow and sediment transport. A wavelet coherence analysis revealed asynchrony changes in short-period flow and sediment variables. Persistent short-period and coherent long-period signals are significantly displayed during flood events. The platform promises future applications, such as automated benthic observations and replacing traditional ’lead-line’ methods. Despite acknowledging system limitations of underwater attitude, burying tendency, and real-time data transmission capabilities, the study highlighted the crucial role of this system in understanding and managing river dynamics, particularly amid escalating environmental threats.

Training approaches for the dissemination of clinical guidelines for NSSI: a quasi-experimental trial

BackgroundNon-suicidal self-injury (NSSI) is of high clinical relevance due to its high prevalence and negative long-term implications. In 2016, the German consensus-based clinical guidelines for diagnostic, assessment and treatment of NSSI in childhood and adolescence were published. However, research indicates that clinical guidelines are often poorly implemented in clinical practice. One crucial part of this process is the training of healthcare professionals to transfer knowledge and capacities to bring guideline recommendations into clinical practice.MethodsThe effect of three different dissemination strategies (printed educational material, e-learning, and blended-learning) on the NSSI guidelines´ recommendations was examined among 671 physicians and psychotherapists via an online-survey. The quasi-experimental study included three measurement points (before the training, after the training, 3-month follow-up) and mixed effects models were used to test for changes in knowledge, competences and attitudes toward NSSI and treatment. Moreover, the transfer of gained competences to practical work and user satisfaction were reviewed.ResultsWith all three training formats, the intended changes of the outcome variables could be observed. Hereby, the printed educational material condition showed the lowest improvement in the scores for the ‘negative attitudes toward NSSI and those who self-injure’. The training effect remained stable throughout the follow-up measurement. The highest application rate of acquired intervention techniques in clinical practice was reported for the blended-learning condition. For all three training strategies, user satisfaction was high and evaluation of training quality was positive, with printed educational material receiving the lowest and blended-learning the highest evaluations.ConclusionsIn summary, all three training formats were perceived to be of high quality and seem to be suited to cover the needs of a heterogeneous group of physicians and psychotherapists. The choice of training method could be driven by considering which training goals are desired to be achieved and by the benefit-cost ratio allowing for tailored training approaches.

Bayesian calibration and uncertainty quantification of a rate-dependent cohesive zone model for polymer interfaces

This study presents a rate-dependent cohesive zone model for the fracture of polymeric interfaces and performs a Bayesian calibration, an uncertainty quantification, and a sensitivity analysis for the model. The proposed cohesive zone model accounts for both reversible elastic and irreversible rate-dependent separation sliding deformation at the interface. The viscous dissipation due to the irreversible opening at the interface is modeled using elastic-viscoplastic kinematics that incorporates the effects of strain rate. Inverse calibration of parameters for such complex models through trial and error is challenging due to the large number of parameters of the model. Moreover, the calibrated parameter values are often non-unique and uncertain when the available experimental data is limited. To tackle this challenge, we employ a Bayesian calibration approach to identify parameters from experimental data, the resulting parameters significantly enhance the accuracy of the model. To quantify the uncertainty associated with the inverse parameter estimation, a modular Bayesian approach is employed to calibrate the unknown model parameters, accounting for the parameter uncertainty of the cohesive zone model. The advantages of the Bayesian calibration over a deterministic parameter fit are demonstrated. Further, to quantify the model uncertainties, such as incorrect assumptions or missing physics, a discrepancy function is introduced, which significantly improves the model’s prediction. Finally, the total uncertainty of the model is quantified in a predictive setting. A sensitivity analysis is performed to assess how changes in the input variables of the model affect the peak load, facilitating the identification of a concise set of highly influential parameters. The present approach can be used for calibration and uncertainty quantification for other complex computational mechanics models. It should also facilitate the designing of interface materials under uncertainty.

In-situ valve opening response of eastern oysters to estuarine conditions

High-frequency recordings of valve opening behavior (VOB) in bivalves are often used to detect changes in environmental conditions. However, generally a single variable such as temperature or the presence of toxicants in the water is the focus. A description of routine VOB under non-stressful conditions is also important for interpreting responses to environmental changes. Here we present the first detailed quantitative investigation of the in-situ VOB of eastern oysters (Crassostrea virginica) to environmental variables typically not considered stressful. The VOB of eight individuals was monitored for seven weeks in a Louisiana estuary. We examined the relationships between VOB metrics (variance in mean % max opening among oysters, the probability of an oyster being closed, and the rate of valve closure), and temperature, salinity, chlorophyll-a (chl-a) concentration, the rate of change in those environmental variables, and the rate of change in water depth. Relationships were analyzed through statistical models including rates of change over 0, 0.25, 1-, 6-, 12-, and 24-hours. All the responses were best explained by the 12-hour time step model. The interaction effect between salinity and the rate of change of salinity had the greatest impact on variance in oysters’ behavior. Oysters closed faster at higher salinities and were more likely to be closed at lower chl-a concentrations. Significant interactions were found between many environmental variables, indicating a high level of complexity of oyster behavior in the natural environment. This study contributes to a better understanding of the impact of environmental conditions on oyster behavior and can help inform predictive tools for restoration initiatives and fisheries practices.

Effect of propofol infusion vs ketamine plus dexmedetomidine infusion on the amplitude of motor evoked potential in pediatric patients undergoing tethered spinal cord surgeries; a randomized, double blind controlled study

Background & objective: The use of intraoperative neurophysiologic monitoring (IOM) has increased over the past two decades for the detection and prevention of iatrogenic neurologic injuries. Motor evoked potentials (MEP) are extremely sensitive to changes in physiological variables and inhalational agents reduce MEPs in a dose dependent manner. So IV anesthetics (propofol or ketamine) and opioids (fentanyl or remifentanil), are frequently used in spinal surgeries under MEPs monitoring. We compared the effects of propofol and fentanyl to those of ketamine, dexmedetomidine, and fentanyl in terms of minimizing their effects on MEP amplitude and hemodynamic stability during surgery Methodology: This double blind, randomized, prospective study was conducted on 46 children, who were randomly allocated into 2 groups Ketamine–dexmedetomidine group: (n = 23) Maintenance throughout the procedure, by infusing Dexmedetomidine (0.4 -0.6 μg/.kg /.hr) ketamine, (1 -2m/.kg/.hr.) and giving bolus of fentanyl, (1-2μg/.kg/ ). Propofol-group:(n = 23) Maintenance throughout the procedure, By infusing propofol (100 ug L/kg/min) and giving bolus of fentanyl, (1-2μg/.kg/ ), with keeping mean arterial blood pressure changes within 25% of the baseline in both groups. Results: Right and left quadriceps muscle measurements were insignificantly different between both groups at base line and were significantly higher in Group KD than Group P at skin incision, surgical manipulation and surgical closure. Right and left adductor hallucis muscle measurements were insignificantly different between both groups at base line and were significantly higher in Group KD than Group P at 5 mins, 10 mins, 15 mins, skin incision, surgical manipulation and surgical closure (P value <0.001). Intraoperative fentanyl consumption was significantly lower in Group KD than Group P. Conclusion: The combination of dexmedetomidine and ketamine infusion is efficacious, safe, and has minimal effect on evoked potentials compared with the propofol-based TIVA group during spine pediatrics surgery. In addition, this combination increases the reliability and accuracy of MEP monitoring with hemodynamic stability and adequate post-operative pain relief. Using dexmedetomidine and ketamine infusions during pediatric spine surgery might successfully replace the typical propofol-based TIVA, although more studies are required . Registration: ClinicalTrials.gov registration number NCT05591001. Keywords: Motor evoked potential, dexmedetomidine, ketamine, propofol. Citation: Saleh AH, Hammad SH, Hassan PF. Effect of propofol infusion vs ketamine plus dexmedetomidine infusion on the amplitude of motor evoked potential in pediatric patients undergoing tethered spinal cord surgeries; a randomized, double blind controlled study. Anaesth. pain intensive care 2024;28(4):692−699; DOI: 10.35975/apic.v28i4.2218 Received: May 08, 2023; Reviewed: February 02, 2024; Accepted: July 03, 2924

Holocene ecosystem and temperature development inferred from invertebrate remains in Zminje Jezero (Dinaric Alps, Montenegro)

AbstractLake Zminje Jezero (1535 m a.s.l.) in Montenegro was studied for chironomid and other aquatic invertebrate remains in a sediment sequence dating back to 12,000 calibrated 14C years before present (cal yr BP), providing, to our knowledge, the first lake-sediment record studied for chironomids and other associated chitinous aquatic invertebrate remains in the Dinaric Alps. Changes in chironomid and other invertebrate remains along the record make it possible to constrain changes of relevant environmental variables for aquatic invertebrates in the lake including temperature, oxygen availability, trophic status and water depth. The results suggest moderate changes in trophic conditions with chironomid assemblages indicating meso- to eutrophic conditions during the analysed interval. Invertebrate assemblages were typical for lakes with relatively high oxygen availability with a minor trend during the middle to late Holocene to conditions observed in lakes that are more hypoxic. A change in temperature is suggested in the earlier part of the record when the share of chironomid taxa adapted to warmer conditions increased, at the Younger Dryas to Holocene transition, whereas later no particularly pronounced shifts in temperature-sensitive taxa were observed. July air temperatures were estimated based on chironomid assemblages using a transfer function based on calibration data consisting of 117 lakes sampled in the Swiss Alps and northern Switzerland. The results suggest that temperatures rapidly increased by 5 °C at the onset of the Holocene (11,500 cal yr BP) leading to a relatively warm early to mid-Holocene and thereafter slightly decreased during the late Holocene. Reconstructed temperatures are discussed together with a previously published pollen record for our study site and are broadly consistent with other chironomid-based temperature reconstructions from Central, Eastern and Southern Europe. From ca. 3000 cal yr BP sedimentation rates increased and from ca. 500 cal yr BP onwards pollen data suggest that the vegetation and lake catchment were affected by human activities, possibly influencing chironomid and other invertebrate assemblages in the lake and thereby also reconstructed temperatures. Overall, our results show that combining analyses of chironomid and other invertebrate assemblages can provide valuable insights into long-term environmental changes and can provide temperature reconstructions for small mountain lakes in the Balkans, such as Zminje Jezero.

Exploring Economic Growth and Clean Fuel Technology: a Dumitrescu-Hurlin Approach

Objective: This research aims at exploring the relationship between economic growth and sustainable technology in 19 countries of G20 members. Theoretical Framework: In the Porter Hypothesis explained that in a regulations of environment will encourage innovation and improve economic performance. According to Porter, well-designed environmental standard can stimulate innovation and bring economic benefits such as increased competitiveness and efficiency Method: The research takes the data sourced from the World Bank and uses Pairwise Dumitrescu-Hurlin Panel Causality as the analytic tool. Results and Discussion: The results of research indicate that there is a causal relationship from ABB to GDP, but not vice versa. This means that the changes in ABB variable can be used to predict the changes in GDP variable, but not vice versa. Research Implications: The application of clean technology will increase the production efficiency and then will increase the economic output. This research contributes to the development of global policies that drive the balanced and environmentally-friendly growth in the whole world. Originality/Value: This research marks a novelty by applying the Pairwise Dumitrescu-Hurlin Panel Causality analysis tool, which allows for a deeper understanding of the causal relationship between economic growth and technological development in G20 countries. While most previous research limit themselves to simple causality analysis, this research details the dynamics of interactions among these factors.

Changes in Accelerometer-Measured Physical Activity and Sedentary Time Across Retirement Transition as a Predictor of Self-Rated Health.

Retirement transition has been shown to associate with changes in physical activity (PA) and self-rated health (SRH), but their interrelationship is less studied. The aim was to investigate changes in accelerometer-measured total PA, moderate to vigorous PA (MVPA), and sedentary time across retirement transition as a predictor of SRH. Data from the Swedish Retirement Study and the Finnish Retirement and Aging study were harmonized and pooled. Data from 3 waves (about 12mo apart) were included: 1 preretirement (wave 1) and 2 postretirement follow-ups (wave 2-3). A totally of 245 participants (27% men) were included. Thigh-worn accelerometers were used to collect data for PA variables (wave 1-2), and SRH was obtained from the questionnaire (wave 1-3). Between wave 1 and 2, total PA decreased with 11 (CI, -22 to -1)minutes per day, MVPA was stable (0 [CI, -3 to 3]min), and sedentary time decreased nonsignificantly with 9 (CI, -20 to 1)minutes. SRH changed between all 3 waves (all P < .001). At preretirement, 10 more minutes of MVPA was associated with greater odds of better SRH when adjusting for accelerometer wear-time, cohort, sex, age, and occupational status (odds ratio: 1.11 [95% CI, 1.02-1.22]). This association was no longer statistically significant when additionally adjusting for marital status, body mass index, and smoking. No significant associations were observed between changes in the PA variables during retirement transition and SRH at postretirement follow-ups. This study showed a cross-sectional association between MVPA and greater odds of reporting better SRH before retirement. No longitudinal associations were observed between changes in the PA variables from before to after retirement and later changes in SRH.

Longitudinal associations of internalized weight stigma with physical activity and weight loss.

Cross-sectional research has demonstrated that internalized weight stigma (IWS) is associated with less engagement in weight management behaviors, including physical activity. However, limited research has explored longitudinal relationships among IWS, physical activity, and weight loss. This study examined longitudinal associations of changes in IWS, physical activity, and weight and tested whether physical activity mediated the relationship between IWS and weight change. Individuals with obesity and high IWS (N=105) participated in a 72-week behavioral weight loss intervention, with or without a weight stigma intervention. Measures of IWS (Weight Self-Stigma Questionnaire), physical activity (accelerometry and self-report), and weight were collected at baseline and weeks 20, 46 and 72. Correlations examined relationships among changes in variables from baseline to all timepoints, controlling for treatment condition. Mediation, controlling for treatment condition, tested whether IWS reductions during the first 20weeks predicted greater weight loss at weeks 46 and 72 via increased physical activity between weeks 20 and 46 or 72. Decreases in IWS at week 20 were associated with greater week-20 weight loss (r=0.265, p=0.012). Physical activity was not a significant mediator, but greater reductions in IWS at week 20 predicted greater week-46 weight loss with or without controlling for physical activity (WSSQ: b=0.30, confidence interval: 0.12, 0.54). Significant associations were not found at week 72. Initial reductions in IWS were associated with greater week-46 weight loss. Further research should investigate whether reducing IWS early in obesity treatment enhances long-term outcomes. ClinicalTrials.gov (NCT03704064).

Total-Body Dynamic Imaging and Kinetic Modeling of [18F]F-AraG in Healthy Individuals and a Non-Small Cell Lung Cancer Patient Undergoing Anti-PD-1 Immunotherapy.

Immunotherapies, especially checkpoint inhibitors such as anti-programmed cell death protein 1 (anti-PD-1) antibodies, have transformed cancer treatment by enhancing the immune system's capability to target and kill cancer cells. However, predicting immunotherapy response remains challenging. 18F-arabinosyl guanine ([18F]F-AraG) is a molecular imaging tracer targeting activated T cells, which may facilitate therapy response assessment by noninvasive quantification of immune cell activity within the tumor microenvironment and elsewhere in the body. The aim of this study was to obtain preliminary data on total-body pharmacokinetics of [18F]F-AraG as a potential quantitative biomarker for immune response evaluation. Methods: The study consisted of 90-min total-body dynamic scans of 4 healthy subjects and 1 non-small cell lung cancer patient who was scanned before and after anti-PD-1 immunotherapy. Compartmental modeling with Akaike information criterion model selection was used to analyze tracer kinetics in various organs. Additionally, 7 subregions of the primary lung tumor and 4 mediastinal lymph nodes were analyzed. Practical identifiability analysis was performed to assess the reliability of kinetic parameter estimation. Correlations of the SUVmean, the tissue-to-blood SUV ratio (SUVR), and the Logan plot slope (K Logan) with the total volume of distribution (V T) were calculated to identify potential surrogates for kinetic modeling. Results: Strong correlations were observed between K Logan and SUVR with V T, suggesting that they can be used as promising surrogates for V T, especially in organs with a low blood-volume fraction. Moreover, practical identifiability analysis suggested that dynamic [18F]F-AraG PET scans could potentially be shortened to 60 min, while maintaining quantification accuracy for all organs of interest. The study suggests that although [18F]F-AraG SUV images can provide insights on immune cell distribution, kinetic modeling or graphical analysis methods may be required for accurate quantification of immune response after therapy. Although SUVmean showed variable changes in different subregions of the tumor after therapy, the SUVR, K Logan, and V T showed consistent increasing trends in all analyzed subregions of the tumor with high practical identifiability. Conclusion: Our findings highlight the promise of [18F]F-AraG dynamic imaging as a noninvasive biomarker for quantifying the immune response to immunotherapy in cancer patients. Promising total-body kinetic modeling results also suggest potentially wider applications of the tracer in investigating the role of T cells in the immunopathogenesis of diseases.

Triad of temporomandibular joint ankylosis, micrognathia, and obstructive sleep apnoea: a systematic review of surgical management

Complex functional issues arising from temporomandibular joint (TMJ) ankylosis are associated with abnormal mandibular growth secondary to the condylar-glenoid fossa and its surrounding structures. These include severe limited mouth opening, micrognathia, mandibular asymmetry, and obstructive sleep apnoea (OSA), which necessitate effective treatment to allow optimum functional rehabilitation. This article aims to present a comprehensive systematic review of the surgical strategy for patients who present with a triad of TMJ ankylosis, micrognathia and OSA via a literature search of PubMed, Google Scholar, and Scopus following PRISMA guidelines. The outcomes of interest were difference in maximum mouth opening, incidence of reankylosis, amount of mandibular advancement, posterior airway space, preoperative and postoperative apnoea/hypopnoea index, and arterial oxygen saturation, as well as changes in other cephalometric or polysomnographic variables. Thirty four studies involving 360 patients were included. Surgical interventions included distraction osteogenesis (DO), release of TMJ ankylosis and mandibular advancement, simultaneous arthroplasty and DO, pre-athroplasty DO, and post-arthroplasty DO. Most studies reported functional post-intervention mouth opening, with reankylosis reported in four. Mandibular advancement was between 6 mm and 34 mm. All studies reported improvement in the various polysomnographic variables measured. In conclusion, the systematic review was conducted based on a low level of literature evidence. Even though various surgical strategies were reported, effective case-specific management of TMJ ankylosis with micrognathia and OSA requires comprehensive assessment and careful consideration of surgical options that promote mandibular advancement and airway improvement.

Deep serum lipidomics identifies evaluative and predictive biomarkers for individualized glycemic responses following low-energy diet-induced weight loss: a PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) substudy

BackgroundWeight loss through lifestyle interventions, notably low-energy diets, offers glycemic benefits in populations with overweight-associated prediabetes. However, >50% of these individuals fail to achieve normoglycemia after weight loss. Circulating lipids hold potential for evaluating dietary impacts and predicting diabetes risk. ObjectivesThis study sought to identify serum lipids that could serve as evaluative or predictive biomarkers for individual glycemic changes following diet-induced weight loss. MethodsWe studied 104 participants with overweight-associated prediabetes, who lost ≥8% weight via a low-energy diet over 8 wk. High-coverage lipidomics was conducted in serum samples before and after the dietary intervention. The lipidomic recalibration was assessed using differential lipid abundance comparisons and partial least squares discriminant analyses. Associations between lipid changes and clinical characteristics were determined by Spearman correlation and Bootstrap Forest of ensemble machine learning model. Baseline lipids, predictive of glycemic parameters changes postweight loss, were assessed using Bootstrap Forest analyses. ResultsWe quantified 439 serum lipid species and 9 related organic acids. Dietary intervention significantly reduced diacylglycerols, ceramides, lysophospholipids, and ether-linked phosphatidylethanolamine. In contrast, acylcarnitines, short-chain fatty acids, organic acids, and ether-linked phosphatidylcholine increased significantly. Changes in certain lipid species (e.g., saturated and monounsaturated fatty acid-containing glycerolipids, sphingadienine-based very long-chain sphingolipids, and organic acids) were closely associated with clinical glycemic parameters. Six baseline bioactive sphingolipids primarily predicted changes in fasting plasma glucose. In addition, a number of baseline lipid species, mainly diacylglycerols and triglycerides, were predictive of clinical changes in hemoglobin A1c, insulin and homeostasis model assessment of insulin resistance. ConclusionsNewly discovered serum lipidomic alterations and the associated changes in lipid-clinical variables suggest broad metabolic reprogramming related to diet-mediated glycemic control. Novel lipid predictors of glycemic outcomes could facilitate early stratification of individuals with prediabetes who are metabolically less responsive to weight loss, enabling more tailored intervention strategies beyond 1-size-fits-all lifestyle modification advice.The PREVIEW lifestyle intervention study was registered at clinicaltrials.gov as NCT01777893 (https://clinicaltrials.gov/study/NCT01777893).

Quantitative 99mTc-pyrophosphate myocardial uptake: Changes on transthyretin stabilization therapy

BackgroundQuantitative technetium-99m-pyrophosphate cardiac single-photon emission computed tomography (99mTc-PYP SPECT/CT) is an emerging method for estimating myocardial burden of transthyretin cardiac amyloidosis (ATTR-CA), but its efficacy in monitoring longitudinal changes remains uncertain. We aimed to investigate longitudinal changes in cardiac ATTR amyloid burden following transthyretin stabilization therapy using visual and quantitative 99mTc-PYP SPECT/CT and to relate these with changes in cardiac biomarkers and function. MethodsThis prospective longitudinal cohort study investigated changes in 99mTc-PYP SPECT/CT in 23 participants with ATTR-CA on transthyretin stabilization therapy (median: 2.6 years). Quantitative analysis included left ventricular (LV) standardized uptake values (SUVs) (SUVmax, SUVmean), cardiac amyloid activity (CAA; SUVmean∗LV activity volume), and percent injected dose (%ID) (mean activity concentration∗LV activity volume/injected activity), calculated using a threshold of >1.5 times left atrial blood pool activity concentration on SPECT/CT. Longitudinal changes of paired continuous and ordinal variables were analyzed using Wilcoxon signed-rank test. ResultsFollowing therapy, visual grade decreased significantly (P = 0.003). Several quantitative 99mTc-PYP metrics also decreased significantly: SUVmax (median −0.75, P = 0.011), CAA (median: −406.6, P < 0.001), and %ID (median: −0.45, P < 0.001). Serum transthyretin levels improved (median: +6.5 mg/dL, P = 0.008). Echocardiographic parameters (global longitudinal strain, LV mass index, and LV wall thickness), N-terminal pro-B-type natriuretic peptide, and estimated glomerular filtration rate remained stable. ConclusionsFavorable changes in 99mTc-PYP myocardial uptake were observed in participants on transthyretin stabilization therapy, whereas echocardiographic parameters and biomarkers remained stable. These results likely signify myocardial ATTR amyloid stabilization rather than amyloid burden regression. Further investigation is needed to understand the implications of these findings.

Analysing the drivers of stunting reduction in twelve sub-saharan African countries using the RIF decomposition approach

BackgroundThis study examines how significant is the changes in child stunting in Sub-Saharan African countries (SSA). Then, it investigates factors that contributed to the reduction in child stunting in those countries. For each country, we distinguish the contribution of compositional effects and structural effect.MethodsThis paper uses data from Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2000 and 2020. The z-test to compare two independent proportions was used to assess changes in child stunting and explanatory variables over the period. Recentred influence function (RIF) decomposition method was used to decompose changes in stunting over the year in each country, and to determine the contribution of each variable to the changes.ResultsThe prevalence of child stunting declines significantly in 11 countries over the year. The decline varies from 6.8% in Cameroun to 19% in Mali. The average year of education of the child’s mother and father, and the proportion of households with access to an improved drinking water source have contributed to the reduction in child stunting. This result was found in all the countries. Improvements in living standards, child vaccination, antenatal care attendance, delivery to health care centres, maternal education, improved drinking water sources, and improved sanitation make the largest contribution to the composition component, hence reducing child stunting.ConclusionsThis study sheds light on what has contributed to the achieved improvement in child nutritional status and suggests how to possibly accelerate the reduction in undernutrition in countries that lag.

Deadline-constrained security-aware workflow scheduling in hybrid cloud architecture

A hybrid cloud is an efficient solution to deal with the problem of insufficient resources of a private cloud when computing demands increase beyond its resource capacities. Cost-efficient workflow scheduling, considering security requirements and data dependency among tasks, is a prominent issue in the hybrid cloud. To address this problem, we propose a mathematical model that minimizes the monetary cost of executing a workflow and satisfies the security requirements of tasks under a deadline. The proposed model fulfills data dependency among tasks, and data transmission time is formulated with exact mathematical expressions. The derived model is a Mixed-integer linear programming problem. We evaluate the proposed model with real-world workflows over changes in the input variables of the model, such as the deadline and security requirements. This paper also presents a post-optimality analysis that investigates the stability of the assignment problem. The experimental results show that the proposed model minimizes the cost by decreasing inter-cloud communications for dependent tasks. However, the optimal solutions are affected by the limitations that are imposed by the problem constraints.

Improving motorcyclist safety through hearing in all directions: survey results concerning a novel protective helmet with earpieces.

Every year over 200,000 motorcyclists are killed globally. One poorly understood risk factor for motorcycle crashes is the role of motorcyclists' ability to hear traffic and other sounds around them in all directions. Most motorcycle helmets protect the head and permit vision in the forward direction, but they impair the wearer's ability to hear. This study evaluated user perceptions of Protective Helmet with Earpieces Equipped, a novel system that affixes technology onto existing motorcycle helmets to allow motorcyclists to better hear the surrounding environment in all directions. 59 Colombian traffic police agents who rode motorcycles daily completed self-report surveys about their traditional motorcycle helmet, used a Protective Helmet with Earpieces Equipped helmet for two months, and then completed a follow-up survey. We tested two hypotheses: (a) at follow-up compared to baseline, motorcyclists would report decreases in perceived safety, comfort, and ability to detect sounds with their traditional helmet, as well as increased fatigue and stress from motorcycling with their traditional helmet, and (b) at follow-up, motorcyclists would report high perceived safety and perceived importance of hearing traffic sounds in all directions while motorcycling. Wilcoxon signed-rank test evaluated hypotheses. Participants rated perceived safety while using their traditional helmet to be significantly lower after using the Protective Helmet with Earpieces Equipped compared to before using it (Z=-3.5, p less than .001). There were no changes in other variables assessed. Following use of the new helmet, participants reported greatly improved safety (M=4.56, SD=0.54, where 4=safer and 5=substantially safer) and perceived the importance of hearing traffic sounds in all directions as high. Improved auditory perception could increase motorcyclist safety. Participating traffic agents felt the Protective Helmet with the Earpieces Equipped greatly improved their ability to hear and improved their motorcycling safety. Perceived safety while using their traditional helmet decreased following use of the alternative.