Entire Time Frame Research Articles

TTV and CMV viral load dynamics: Which emerges first during immunosuppression?

Novel biomarkers reflecting the degree of immunosuppression in transplant patients are required to ensure eventual personalized equilibrium between rejection and infection risks.With the above aim, Torque Teno Virus(TTV) viremia was precisely examined in a large cohort of transplanted immunocompromised patients (192 hematological and 60 solid organ transplant recipients) being monitored for Cytomegalovirus reactivation.TTV load was measured in 2612 plasma samples from 448 patients. The results revealed a significant increase in TTV viral load approximately 14 days following CMV reactivation/infection in solid organ transplant(SOT) patients. No recognizable difference in TTV load was noted among hematological patients during the entire timeframe analyzed. Furthermore, a temporal gap of approximately 30 days was noted between the viral load peaks reached by the two viruses, with Cytomegalovirus(CMV) preceding TTV.It was not possible to establish a correlation between CMV reactivation/infection and TTV viremia in hematological patients. On the other hand, the SOT patient cohort allowed us to analyze viral kinetics and draw intriguing conclusions. Taken together, the data suggest, to our knowledge for the first time, that CMV infection itself could potentially cause an increase in TTV load in the peripheral blood of patients undergoing immunosuppressive therapy.

Electrochemotherapy in Kaposi's Sarcoma Patients: From the Gold Standard Strategy to Locally Advanced Cutaneous and Subcutaneous Lesions.

Electrochemotherapy (ECT) is one of the newest therapeutic strategies employed as a medical procedure for skin neoplasms' treatment, especially for classic Kaposi's sarcoma (CKS). The aim of this study was to demonstrate ECT clinical response and the local control of CKS disease. The primary endpoint was to value the worth and efficacy of this local therapy in CKS skin lesions' treatment. In total, 19 CKS patients were enrolled, 14 males and 5 females with median age at diagnosis of 72. Complete response (CR) has been gained in 12 patients after first ECT attempt; meanwhile, 3 and 4 out of 19 patients obtained a partial response (PR), so they underwent a second and third ECT treatment, respectively. Clinical response was evaluated during the entire timeframe of the follow-up, which ranged between 3 months and 4 years with a median of 18 months. The control of CKS skin lesions still represents a challenge for surgeons and oncologists. Nevertheless, according to this and other authors' recent experiences, ECT could be considered the gold standard strategy for early-stage patients, but at the same time it could be considered as a valid option in controlling Kaposi's sarcoma locally advanced lesions.

Utilization of cannulated screw fixation of Jail and TiRobot-assisted percutaneous indirect reduction technique for AO/OTA type 41B2 tibial plateau fracture treatment

PurposeThe present study was designed to investigate the precise procedure and effectiveness of percutaneous minimally invasive fixation assisted by TiRobot in managing AO/OTA type 41B2 tibial plateau fracture to provide an alternative solution for clinical application. MethodsIn total, 10 participants with AO/OTA type 41B2 tibial plateau fractures diagnosed by preoperative imaging examinations were enrolled in this study between May 2019 and May 2022. They were 5 males and 5 females, with an average age of 45.6 ± 11.3 years old (range 27–62 years old). All of them had closed fractures, including 6 cases with anterior cruciate ligament (ACL) tibial insertion avulsion fractures, 1 case with medial collateral ligament (MCL) tear, and 4 cases with a lateral meniscus tear. From injury through surgery, the entire time frame was 4.0 ± 1.5 days (range, 2–7 days). Following indirect percutaneous reduction assisted by TiRobot, the Jail method was used to treat all patients with minimally invasive internal fixation. Patients with ligament or meniscus injurieswere treated with arthroscopic surgery in one stage. The standardized functional exercise was performed postoperatively. The knee function was measured using the Hospital for Special Surgery (HSS) score, and the fracture reduction was assessed through the Rasmussen radiology score. ResultsAll patients were followed up for 12.7 ± 6.8 months (6–24 months).The fracture healing time was 11.8 ± 0.8 weeks (10–13 weeks), and the X-rays revealed satisfactory fracture reduction.The knee joint's Rasmussen score was 17.8 ± 0.4 (in the range of 17–18) a year after the procedure, with 8 patients receiving outstanding ratings and 2 cases receiving satisfactory scores. The HSS score was 93.8 ± 2.3 (range, 89 to 96), of which 10 cases were excellent. The motion range of the kneewas 138.7°±2.7° (range, −5° to 0° to 135°). No adverse effects or serious complications, such as internal fixation failure, postoperative infection, popliteal vascular injury, and common peroneal nerve injury, were observed during the last follow-up visit. ConclusionsThe intelligent assistance and accurate guidance of TiRobot can simplify and standardize procedures of percutaneous minimally invasive fixation in theSchatzker type Ⅲ tibial plateau fracture treatment. This technique increases the precision of indirect percutaneous reduction and screw fixation while minimizing bone grafting.

Reflection of prenatal exposure to wildfire smoke on reduced birth weight in 2015-2019

Wildfire smoke contains many different types of air pollutants which are cause for concern. Studies on epidemiology have identified correlations between PM2.5 exposure to wildfire smoke and mortality, respiratory and cardiovascular morbidities, and may result in a reduction in birth weight. However, evidence from Indonesia is limited. For this study, a retrospective cohort epidemiological study was undertaken to quantify the Indonesian population’s exposure to wildfire-PM2.5. We present 9652 (88%) records of newborns to identify an association between fire-sourced PM2.5 and birth weight in Palangka Raya, Indonesia from 2015 to 2019. On an annual basis, geospatial, and season variations in wildfire-PM2.5 concentrations were observed using a satellite-based dataset from CAMS and used for gestational exposure to wildfire smoke. Applying a general linear model with birth weight (yi) as a continuous outcome, the relationship between PM2.5 exposure and low birth weight was examined. In addition, the binary outcome of low birth weight was analysed. A statistically significant difference in the birth weight reduction between infants delivered to mothers exposed to high levels of wildfire smoke and those exposed to low levels of wildfire smoke was observed over the entire time frame (2015-2019) (ρ-value < 0.001). In comparison to infants born to mothers exposed to lower concentrations, the birth weight of infants delivered to mothers exposed to high concentrations of PM2.5 in the third trimester decreased by 19.96%. A 1.9% reduction in birth weight could be caused by exposure during the fire-prevalent in the first trimester of pregnancy (ρ-value < 0.001). Since an estimation model predicted a 10 g/m3 increase in PM2.5 exposure between the first and last trimesters of pregnancy, variations in the second trimester did not significantly affect the association (ρ-value = 0.761). This emphasizes the significance of foetal development during these two trimesters. Exposure to pollution from wildfires contributes significantly to the global burden of newborns’ birth weight.

Drivers of land use land cover change and intensity analysis of land transformation in the moist semi-deciduous forest zone of Ghana: Case of Bobiri Forest Reserve and its environs

Understanding land cover transformation over time and space is crucial for comprehending ecological challenges, particularly in environmentally vulnerable areas. In Sub-Saharan Africa, the demand for fuel, food, and fibre is expected to significantly expand croplands, resulting in the degradation of natural ecosystems. This research presents a spatiotemporal analysis of land-cover change in the Bobiri forest and its surrounding areas in Ghana's moist semi-deciduous forest zone. The study’s main objectives were to identify the drivers of land-cover change, and to analyse the intensity of land transformation from 1986 to 2022 in the study area. The methodology used measured land-cover changes at different levels, including intervals, categories, and transitions. The findings indicate that the annual rate of land change was higher from 1986 to 2007 (1.64%) compared to the period from 2007 to 2022 (1.04%). Additionally, the analysis at the category level reveals that the increase in cropland and non-vegetated areas during both time intervals was higher than the uniform intensity. The analysis at the transition level suggests that most of the cropland gains originated from non-vegetated areas during both periods. There is also evidence of localized increases in closed forests, likely due to afforestation policies implemented by the Ghanaian government. However, overall, there has been a decline in closed forests over the entire timeframe, with an annual rate of change of -1.25%. This study contributes valuable data for enhancing our understanding of the scale and direction of land-cover change, which is essential for developing policies aimed at mitigating the impact on local livelihoods and the environment at national and sub-national levels.

Match Rates Among Underrepresented Minority and Female Applicants to Orthopaedic Surgery Residency Programs from 2011 to 2021: How Are We Doing?

Orthopaedic surgery residency programs have traditionally had less representation of underrepresented minority (URM) and female trainees compared with other medical specialties. Widespread efforts have been implemented to increase the diversity of orthopaedic surgery residency programs; however, it is not known whether URM and female applicants are increasingly likely to match as a result. Thus, we aimed to study the independent association between URM and female applicants and matching into orthopaedic surgery over the past decade. Applicant-level data from the Electronic Residency Application Service were reviewed from 2011 to 2021 with variables including demographic variables, URM status, and matriculation to an orthopaedic surgery residency program. Multivariate logistic regression was used to identify the likelihood of matriculating into orthopaedic surgery when controlling for number of applications, top 40 medical school status, AOA status, and MD/other degree. Twelve thousand one hundred eleven applicants were identified from 2011 to 2021 with a match rate of 70% overall. Two thousand fifty-six applicants (17%) were female and 1,926 (16%) classified as URM. The total number of applications increased from 1,074 in 2011 to 1,229 in 2021. The adjusted odds ratio (OR) associated with matching among all applicants decreased from 0.75 in 2011 to 0.64 in 2021, p < 0.001, and the OR of non-URM male and female applicants also decreased (female: 0.79-0.69, p < 0.001; male: 0.78-0.65, p < 0.001). The OR of URM male applicants did not change significantly (0.57-0.55, p = 0.60). The OR for URM female applicants, however, increased significantly from 0.46 to 0.61, p < 0.001. Over the entire time frame, the odds of matching were significantly lower for URM applicants compared with non-URM applicants (both male and female). Overall, the adjusted odds ratio of matching into orthopaedic surgery among female URM applicants has increased over the past decade, indicating successful efforts to improve the diversity of orthopaedic surgery training programs. The odds of URM male applicants have remained relatively constant, and the odds of URM male and female applicants were significantly lower than all non-URM applicants. III.

Referral, Genetic Counselling, and BRCA Testing in the Manitoba High-Grade Serous Ovarian Cancer Population, 2004–2019

(1) Background: The primary objective of this study was to examine the rate of genetic referral, BRCA testing, and BRCA positivity amongst all patients with high-grade serous ovarian cancers (HGSOC) from 2004-2019. The secondary objective was to analyze secondary factors that may affect the rates of referral and testing. (2) Methods: This population-based cohort study included all women diagnosed with HGSOC using the Manitoba Cancer Registry, CervixCheck registry, Medical Claims database at Manitoba Health, the Hospital Discharge abstract, the Population Registry, and Winnipeg Regional Health Authority genetics data. Data were examined for three different time cohorts (2004-2013, 2014-2016; 2017-2019) correlating to practice pattern changes. (3) Results: A total of 944 patients were diagnosed with HGSOC. The rate of genetic referrals changed over the three timeframes (20.0% → 56.7% → 36.6%) and rate of genetic testing increased over the entire timeframe. Factors found to increase rates of referral and testing included age, histology, history of oral contraceptive use, and family history of ovarian cancer. Prior health care utilization indicators did not affect genetic referral or testing. (4) Conclusion: The rate of genetic referral (2004-2016) and BRCA1/2 testing (2004-2019) for patients with a diagnosis of HGSOC increased over time. A minority of patients received a consultation for genetics counselling, and even fewer received testing for a BRCA1/2. Without a genetic result, it is difficult for clinicians to inform treatment decisions. Additional efforts are needed to increase genetics consultation and testing for Manitoban patients with HGSOC. Effects of routine tumour testing on rates of genetic referral will have to be examined in future studies.

Regional-scale burned area mapping in Mediterranean regions based on the multitemporal composite integration of Sentinel-1 and Sentinel-2 data

ABSTRACT Wildland fires are among the main factors affecting the surrounding territory in terms of ecological and socioeconomic changes at different temporal and spatial scales. In the Mediterranean environment, although fire can positively influence some bio-physical dynamics of habitats, it acts as a pressing disturbance on ecosystems when the severity, spatial scale, and/or frequency are high, thereby determining their degradation. Therefore, knowing and mapping the accurate quantitative spatial distribution of all areas affected by fire during an entire high-frequency fire season and on a relatively large scale (regional/national scale) is an essential step to initialize the numerous subsequent effect monitoring analyses that can be carried out. This work proposes a reliable and open-access workflow to map burned areas on regional and national scales during the entire fire season. To achieve this, we integrated optical (Sentinel-2, S2) and Synthetic Aperture Radar (SAR; Sentinel-1, S1) free high spatial and temporal resolution data into a multitemporal composite criterion. Open-source software and Python-based libraries were used to develop the workflow. In particular, the second-lowest near infra-red (NIR) image composite (secMinNIR) criterion, based on the retrieval of the second minimum values that the NIR values reached in each pixel during the entire time frame considered, was applied to cloud-free S2 imagery to optimize the separability between burned and unburned areas. Subsequently, a second temporal composite criterion was developed and applied to the S1 time series, relying on the SAR capacity to detect vegetation fire-induced structural and humidity changes. It was based on retrieving the S1 pixel value of the first next (or the same) date to the corresponding date of the pixel value previously found by secMinNIR. The burned area map was created using an object-based geographic analysis (GEOBIA) process, using two optical and SAR composite images as input layers. The large-scale mean-shift (LSMS) algorithm was employed to segment the image, while the random forest (RF) classifier was the machine-learning model used to perform supervised classification. GEOBIA-based burned area classification was also performed using only the optical composite. The resulting accuracy values were compared using the precision (p), recall (r), and F-score accuracy metrics. The classification achieved high accuracy levels (F-score value greater than 0.9) in both cases (S1+ S2, 0.956; S2, 0.914), highlighting the increased effectiveness of this approach in detecting burned areas, heterogeneous in terms of amplitude, and affected site-specific characteristics that occurred during the fire season. Although the use of only optical data is sufficient to map the fire-affected areas early, some commission errors, represented by small regions scattered over the entire study area, remain, proving that the integration of SAR data improves the quality of the obtained results.

Short-term paleogeographic reorganizations and climate events shaped diversification of North American freshwater gastropods over deep time

What controls species diversity and diversification is one of the major questions in evolutionary biology and paleontology. Previous studies have addressed this issue based on various plant and animal groups, geographic regions, and time intervals. However, as most previous research focused on terrestrial or marine ecosystems, our understanding of the controls on diversification of biota (and particularly invertebrates) in freshwater environments in deep time is still limited. Here, we infer diversification rates of North American freshwater gastropods from the Late Triassic to the Pleistocene and explore potential links between shifts in speciation and extinction and major changes in paleogeography, climate, and biotic interactions. We found that variation in the speciation rate is best explained by changes in continental fragmentation, with rate shifts coinciding with major paleogeographic reorganizations in the Mesozoic, in particular the retreat of the Sundance Sea and subsequent development of the Bighorn wetland and the advance of the Western Interior Seaway. Climatic events in the Cenozoic (Middle Eocene Climate Optimum, Miocene Climate Optimum) variably coincide with shifts in speciation and extinction as well, but no significant long-term association could be detected. Similarly, no influence of diversity dependence was found across the entire time frame of ~ 214 Myr. Our results indicate that short-term climatic events and paleogeographic changes are relevant to the diversification of continental freshwater biota, while long-term trends have limited effect.

Assessment of Bankline Shifting and Erosion-Deposition dynamics of Kangsabati River in Downstream of Mukutmanipur Dam, Rarh Bengal

Bank erosion and channel shifting is an inherent natural process of river dynamics. This paper attempts to investigate the changes in the nature and extent of bank line shift and erosion-deposition dynamics along both the banks of Kansabati river in downstream of Mukutmanipur dam during the period 1921-2018. The shift of bank lines and amount of erosion-deposition along both the banks have been measured, analysed and mapped using Districts maps, Topographical Sheets of Survey of India and various multi-temporal Landsat imageries using various GIS techniques and tools as well as field investigation. Entire stretch of channel under investigation has been divided into 3 reaches and 25 GIS transects have been taken into consideration to assess the bank line shift. The result of the study reveals the differential shifting pattern of both left bank and right bank of Kangsabati river during the entire observation periods. The maximum shift of 519.81m (51.98m/year) along left bank at cross section-12 and 329.65m (32.97m/year) along the right bank at cross section – 18 were noted from second phase of observation 1978-1988. During the entire time frame of 1921-2018, net eroded area of 6.55 sq. km. and net accreted area of 32.16 sq. km were measured along the left and right banks respectively. As the middle and lower reach of the study area are severely prone to riverbank erosion and channel shifting during the annual peak monsoon. So, such a study is very much necessary to understand the regime of regional river dynamics.

In silico and in vitro study of Mycobacterium tuberculosisH37Rv uncharacterized protein (RipD): an insight on tuberculosis therapeutics.

Tuberculosis caused byMycobacterium tuberculosis(Mtb)is responsible forthe highest global health problem, with the deaths of millions of people. With prevalence of multiple drug resistance (MDR) strains and extended therapeutic times, it is important to discover small molecule inhibitors against novel hypothetical proteins of the pathogen. In this study, a virtual screening protocol was carried out against MtbH37Rv hypothetical protein RipD (Rv1566c) for the identification of potential small molecule inhibitors. The 3D model of the protein structure binding site was used for virtual screening (VS) of inhibitors from the Pathogen Box, followed by its validation through a molecular docking study. The stability of the protein-ligand complex was assessed using a 150ns molecular dynamics simulation. MM-PBSA and MM-GBSA are the two approaches that were used to perform the trajectory analysis and determine the binding free energies, respectively. The ligand binding was observed to be stable across the entire time frame with an approximate binding free energy of -22.9916kcal/mol. The drug-likeness of the inhibitors along with a potential anti-tuberculosis compound was validated by ADMET prediction software. Furthermore, a CFU inhibition assay was used to validate the best hit compound's in vitro inhibitory efficacy against a non-pathogenic Mycobacterium smegmatis MC2155 under low nutrient culture conditions. The study reported that the compound proposed in our study (Pathogen Box ID: MMV687700) will be useful for the identification of potential inhibitors against Mtb in future.

Assessment of success in university–industry cooperation literature: A bibliographic coupling analysis

AbstractUniversity–industry relationships have been central in technology and management innovation literature for decades. Success has been one of the most relevant topics in this field, driving a high proportion of this research. Our objective is to analyze this literature. Based on a framework of the motivations and expected benefits of the partners, classifying them into six categories (technological, strategic, financial, educational, political and epistemological), we have carried out a bibliographic coupling analysis to determine the topic’s knowledge structure. We show how these themes have evolved, with some remaining central during the entire timeframe and others gaining academics’ attention in recent years. We offer a research schedule and a dynamic, interpretative model that classifies and organizes the motivations of success for university–industry collaboration. This analysis can help in the formulation and implementation of public and private programs that aim to promote cooperation between firms and universities.

Excess all-cause mortality during COVID-19 outbreak: potential role of untreated cardiovascular disease.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has rapidly spread globally. Due to different testing strategies, under-detection of positive subjects and COVID-19-related-deaths remains common. Aim of this analysis was to assess the real impact of COVID-19 through the analysis of 2020 Italian all-cause mortality data compared to historical series. We performed a retrospective analysis of 2020 and 2015-2019 all-cause mortality data released by the Italian National Institute for Statistics (ISTAT) for the time period January 1st-March 21st. This preliminary sample included 1084 Italian municipalities showing at least 10 deaths during the above-mentioned timeframe and an increase in mortality of more than 20% as compared to the previous five years (2015-2019), with a resulting coverage of 21% of Italian population. The difference between 2020 observed and expected deaths (mean of weekly deaths in 2015-2019) was computed, together with mortality rate ratio (MRR) for each of the four weeks following detection of the first autochthonous COVID-19 case in Italy (February 23rd, 2020 - March 21st, 2020), as well as for this entire timeframe. Subgroup analysis by age groups was also performed. Overall MRR was 1.79 [1.75-1.84], with an observed excess mortality of 8750 individuals in the investigated sample, which in itself outweighs Italian Civil Protection report of only 4,825 COVID-19-related deaths across Italy, as of March 21. Subgroup analysis did not show any difference in mortality rate in '0-14 years' age group, while MRRs were significantly increased in older age groups, in particular in patients >75 years (MRR 1.84 [1.79-1.89]). In addition, week-by-week analysis showed a progressive increase in MRR during this period, peaking in the last week (March 15th, 2020 - March 21st, 2020) with an estimated value of 2.65 [2.53-2.78]. The analysis of all-cause mortality data in Italy indicates that reported COVID-19-related deaths are an underestimate of the actual death toll. All-cause death should be seen as the epidemiological indicator of choice to assess the real mortality impact exerted by SARS-CoV-2, given that it also best reflects the toll on frail patient subsets (e.g. the elderly or those with cardiovascular disease).

Compulsive buying gradually increased during the first six months of the Covid-19 outbreak.

Background and aimsThe current Covid-19 situation offers a natural experiment to explore the effect of a chronic stressor on compulsive buying tendencies over an extended period of time.DesignSurvey method of sampling every three days a new cohort during the first six months of the Covid-19 pandemic (March-October 2020) in the United States.ParticipantsTotal (clean) sample of N = 1,430 (39.3% female, mean age = 36.4 years).MeasurementsOnline and offline compulsive buying separately, distress, economic position, income and age were assessed.FindingsBoth online and offline compulsive buying increased during the data collection period ( = 0.24, = 0.22, respectively, both P < 0.001). Individuals with self-reported high economic position (EP) reported the highest tendency for compulsive buying throughout the entire time frame, although the increase in compulsive buying tendencies over time was the most pronounced among the economically less privileged. Online compulsive buying increased after the CARES Act (first stimulus package) by an effect size of d = 0.33. When entered into a regression model, EP had the strongest effect on compulsive buying after accounting for the effect of distress, income and age. The high-EP group reported the strongest correlation between distress and compulsive buying (r = 0.67, P < 0.001, 95% CI: 0.57–0.76).ConclusionsCompulsive buying tendency gradually increased during the first six months of the Covid-19 pandemic especially after the CARES Act.

Reducing Psychosocial Risk Factors and Improving Employee Well-Being in Emergency Departments: A Realist Evaluation.

This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.

Drivers of diversification in freshwater gastropods vary over deep time.

Unravelling the drivers of species diversification through geological time is of crucial importance for our understanding of long-term evolutionary processes. Numerous studies have proposed different sets of biotic and abiotic controls of speciation and extinction rates, but typically they were inferred for a single, long geological time frame. However, whether the impact of biotic and abiotic controls on diversification changes over time is poorly understood. Here, we use a large fossil dataset, a multivariate birth–death model and a comprehensive set of biotic and abiotic predictors, including a new index to quantify tectonic complexity, to estimate the drivers of diversification for European freshwater gastropods over the past 100 Myr. The effects of these factors on origination and extinction are estimated across the entire time frame as well as within sequential time windows of 20 Myr each. Our results find support for temporal heterogeneity in the factors associated with changes in diversification rates. While the factors impacting speciation and extinction rates vary considerably over time, diversity-dependence and topography are consistently important. Our study highlights that a high level of heterogeneity in diversification rates is best captured by incorporating time-varying effects of biotic and abiotic factors.

Rainfall Variability and Trends over the African Continent Using TAMSAT Data (1983–2020): Towards Climate Change Resilience and Adaptation

This study reveals rainfall variability and trends in the African continent using TAMSAT data from 1983 to 2020. In the study, a Mann–Kendall (MK) test and Sen’s slope estimator were used to analyze rainfall trends and their magnitude, respectively, under monthly, seasonal, and annual timeframes as an indication of climate change using different natural and geographical contexts (i.e., sub-regions, climate zones, major river basins, and countries). The study finds that the highest annual rainfall trends were recorded in Rwanda (11.97 mm/year), the Gulf of Guinea (river basin 8.71 mm/year), the tropical rainforest climate zone (8.21 mm/year), and the Central African region (6.84 mm/year), while Mozambique (−0.437 mm/year), the subtropical northern desert (0.80 mm/year), the west coast river basin of South Africa (−0.360 mm/year), and the Northern Africa region (1.07 mm/year) show the lowest annual rainfall trends. There is a statistically significant increase in the rainfall in the countries of Africa’s northern and central regions, while there is no statistically significant change in the countries of the southern and eastern regions. In terms of climate zones, in the tropical northern desert climates, tropical northern peninsulas, and tropical grasslands, there is a significant increase in rainfall over the entire timeframe of the month, season, and year. This implies that increased rainfall will have a positive effect on the food security of the countries in those climatic zones. Since a large percentage of Africa’s agriculture is based only on rainfall (i.e., rain-fed agriculture), increasing trends in rainfall can assist climate resilience and adaptation, while declining rainfall trends can badly affect it. This information can be crucial for decision-makers concerned with effective crop planning and water resource management. The rainfall variability and trend analysis of this study provide important information to decision-makers that need to effectively mitigate drought and flood risk.

Analytical transient analysis of temporal boundary value problems using the d'Alembert formula.

Temporal boundary value problems (TBVPs) provide the foundation for analyzing electromagnetic wave propagation in time-varying media. In this paper, we point out that TBVPs fall into the category of unbounded initial value problems, which have traveling wave solutions. By dividing the entire time frame into several subdomains and applying the d'Alembert formula, the transient expressions for waves propagating through temporal boundaries can be evaluated analytically. Moreover, unlike their spatial analogs, TBVPs are subject to causality. Therefore, the resulting analytical transient solutions resulting from the d'Alembert formula are unique to temporal systems.

Changes in the use patterns of bDMARDs in patients with rheumatic diseases over the past 13\xa0years

The better understanding of the safety of biologic DMARDs (bDMARDs), as well as the emergence of new bDMARDs against different therapeutic targets and biosimilars have likely influenced the use patterns of these compounds over time. The aim of this study is to assess changes in demographic characteristics, disease activity and treatment patterns in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) who started a first- or second-line biologic between 2007 and mid-2020. Patients diagnosed with RA, PsA or AS included in the BIOBADASER registry from January 2007 to July 2020 were included. According to the start date of a first- or second-line biologic therapy, patients were stratified into four time periods: 2007–2009; 2010–2013; 2014–2017; 2018–2020 and analyzed cross-sectionally in each period. Demographic and clinical variables, as well as the type of biologic used, were assessed. Generalized linear models were applied to study the evolution of the variables of interest over time periods, the diagnosis, and the interactions between them. A total of 4543 patients initiated a first biologic during the entire time frame of the study. Over the four time periods, disease evolution at the time of biologic initiation (p < 0.001), disease activity (p < 0.001), retention rate (p < 0.001) and the use of tumor necrosis factor inhibitors as a first-line treatment (p < 0.001) showed a significant tendency to decrease. Conversely, comorbidities, as assessed by the Charlson index (p < 0.001), and the percentage of patients using bDMARDs in monotherapy (p < 0.001), and corticosteroids (p < 0.001) tended to increase over time. Over the entire period of the study's analysis, 3289 patients started a second biologic. The following trends were observed: decreased DAS28 at switching (p < 0.001), lower retention rates (p = 0.004), and incremental changes to the therapeutic target between the first and second biologic (p < 0.001). From 2007 until now rheumatic patients who started a biologic were older, exhibited less clinical activity, presented more comorbidities, and switched to a different biologic more frequently and earlier.

Time- and depth-resolved mechanistic assessment of water stress in Australian ecosystems under the CMIP6 scenarios

This work provides a comprehensive analysis of soil water dynamics in Australia for the climate projections of the Coupled Model Intercomparison Project 6 (CMIP6). We modelled the historical soil water dynamics from 1981 to 2018 at various depths within and below the root zone using the BRTSim computational solver to generate the "current conditions". We then investigated how the CMIP6 scenario can affect water accessibility by plants, and hence their potential impact on croplands and native ecosystems. We found that surface soil moisture can decline by 7% across Australia between 2020 and 2050, with the 2030 decade projected to experience the greatest soil water loss. Above-average precipitation during the 2040s will still lead to 2% soil moisture decline relative to current conditions, with about 1 million km2 projected to recover from this deficit later on. Seasonally, our results inferred drier summers and winters with 13% and 5% loss in soil water, respectively. Shrublands and savannas were the most affected native ecosystems with a moisture decline between 16% and 7% within the root zone, respectively. More importantly, 36% to 52% of croplands were found to undergo a 7% decline in soil moisture within the root zone, which was spatially and temporally heterogeneous across crop types. Within the crop calendar, wheat-growing regions were affected by soil moisture deficiencies from sowing to harvest in almost the entire time frame of our assessment.