Likelihood Of Events Research Articles

Community Pharmacist's Awareness, Knowledge and Attitude Towards use of Vitamin Supplements in Pimpri-Chinchwad Municipal Corporation (PCMC) Area of Pune, India: A Descriptive Cross Sectional Study.

US FDA defines: dietary supplements is a product that intended to supplement a person's diet, it's generally consist of at least one or more of the following dietary ingredients, vitamin, minerals, a herb or other botanical and amino acid by increasing the daily consumptions of an extract metabolite concentration, constitute or combinations of these medication. Excessive and inappropriate use of medicines has been recognised as a public health problem resulting in increased likelihood of adverse drug event, drug interaction, and inappropriate drug prescribing and increased cost. This was the cross-sectional study conducted in year 2022 at Pimpri Chinchwad (Pune). The total 250 questionaires are distributed and from that 226 response were received. Target population consist of community pharmacists working in the drug store in this area (n=226). Data was represented in three domains of study i. e. awareness, knowledge and attitude. Correlation coefficient using Pearson's method were determined to evaluate strength of correlation between awareness-knowledge, Knowledge-attitude and awareness-attitude. Correlation coefficient were calculated by comparing most relevant and equal number of questions. The study demonstrated positive attitude among surveyed community pharmacists in Pune, India. There is lacuna in accurate and adequate awareness, knowledge and attitude of vitamin deficiency, efficiency, recommended daily allowance (RDA), toxicity and interactions among pharmacist as one of the stakeholders of healthcare in India. Few of the remedies viz. framing of guidelines, inclusion in formal education syllabus, continuous education, updation exams etc. may be of use.

On the Effects of Turbulence Modulation Driven by Suspended Sediment Stratification in Emergent Rigid Canopies

AbstractAquatic vegetation has the potential to increase suspended sediment capture while also increasing sediment resuspension and bedload transport. Suspended sediment can induce density stratification, which modulates the turbulence in the water column. We derive a Rouse‐based formulation for suspended sediment concentration (SSC) including the effect of sediment‐induced density stratification. We perform Large Eddy Simulations of vegetated and non‐vegetated channels to explicitly highlight the effect of stratification on SSC profiles. We found that the impact of stratification is dominant in the near‐bed region within the bottom boundary layer, affecting both sediment resuspension and bedload transport. Stratification reduces the likelihood of both dominant sweep and ejection events in the near the bed region which may affect sediment entrainment and bedload transport. Modifications to existing models of sediment entrainment and bedload transport are suggested to account for the effects of sediment induced stratification in vegetated and non‐vegetated channels.

Semaglutide and Tirzepatide Use and Reduction of Cardiovascular Risks in Adults with Overweight and Obesity

Background: Obesity is a prevalent, growing health concern in the United States, affecting over 42% of adults and contributing significantly to the burden of cardiovascular disease (CVD). Recently, approved anti-obesity medications (AOMs) such as semaglutide (Wegovy) and tirzepatide (Zepbound) have emerged as potential interventions to reduce weight and potentially lower cardiovascular risk among individuals with obesity. Aim: To analyze the impact of AOM on cardiovascular risk among US patients with obesity. Methods: Utilizing Kythera data, we conducted a retrospective cohort study from November 2022 to June 2024. Patients with obesity and AOM use were identified based on diagnosis claims and prescription claims for tirzepatide or semaglutide (identification period: Nov. 1, 2023–Dec. 31, 2023) with 6 months of follow-up to measure CVD risk. Exclusions included patients with pre-existing CVD and prior AOM use. Cox regression and multivariable analyses adjusted for comorbidities and sociodemographic factors were employed to assess the risk of cardiovascular events, with additional analyses comparing outcomes between tirzepatide and semaglutide users. Results: We identified 22,620 patients with obesity and AOM use and 84,427 patients with obesity without AOM use. Significant differences were observed in the proportion of patients with an Elixhauser Index Score ≥2, comprising 61.97% in the AOM cohort versus 13.50% in the non-AOM cohort (standardized difference = 1.2868). The AOM cohort demonstrated significantly lower incidence of cardiovascular events (1.77%) than non-AOM users (12.17%, p<0.0001). Adjusted analyses confirmed that AOM use was associated with a substantially reduced risk of CVD (hazard ratio=0.37, p<0.0001). Differences in specific cardiovascular outcomes between tirzepatide and semaglutide users were observed, with semaglutide users showing a higher hazard of CVD than tirzepatide users (hazard ratio=1.53, p=0.0215). Conclusions: Use of AOM was associated with a significantly lower risk-adjusted likelihood of cardiovascular events than non-use, highlighting these medications as promising interventions in obesity management.

Financial Well-Being Among US Adults with Vascular Conditions: Differential Impacts Among Blacks and Hispanics.

The ability to meet current and ongoing financial obligations, known as financial well-being (FWB), is not only associated with the likelihood of adverse health events but is also affected by unexpected health care expenditures. However, the relationship between FWB and common health outcomes is not well understood. Using data available in the Financial Well-Being Scale from the Consumer Financial Protection Bureau, we evaluated the impact of four vascular conditions-cardiovascular disease (CVD), stroke, high blood pressure (BP), and high cholesterol-on FWB and how these impacts varied between racial and ethnic groups. Using the Understanding America Survey-a nationally representative, longitudinal panel-we identified adults with self-reported diagnoses between 2014 and 2020 of high cholesterol, high BP, stroke, and CVD. We used stratified, longitudinal mixed regression models to assess the association between these diagnoses and FWB. Each condition was modeled separately and included sex, age, marital status, household size, income, education, race/ethnicity, insurance, body mass index, and an indicator of the condition. Racial and ethnic differentials were captured using group-condition interactions. On average, Whites had the highest FWB Scale score (69.0, SD=21.8), followed by other races (66.7, SD=21.0), Hispanics (59.3, SD=21.6), and Blacks (56.2, SD=21.4). In general, FWB of individuals with vascular conditions was lower than that of those without, but the impact varied between racial and ethnic groups. Compared with Whites (the reference group), Blacks with CVD (-7.4, SD=1.0), stroke (-8.1, SD=1.5), high cholesterol (-5.7, SD=0.7), and high BP (6.1, SD=0.7) had lower FWB. Similarly, Hispanics with high BP (-3.0, SD=0.6) and CVD (-6.3, SD=1.3) had lower FWB. Income, education, insurance, and marital status were also correlated with FWB. These results indicated differences in the financial ramifications of vascular conditions among racial and ethnic groups. Findings suggest the need for interventions targeting FWB of individuals with vascular conditions, particularly those from minority groups.

Understanding sea wave height conditions in sumatra waters

Ocean waves play a crucial role in influencing a wide range of marine and fisheries activities. In this research study, we aim to analyze the climatological conditions of sea wave heights in Sumatran waters over a span of 83 years (1940-2022). We utilize three-dimensional Copernicus numerical model simulations to examine seasonal patterns of sea wave heights and assess the likelihood of extreme wave events. Our findings reveal that high waves, reaching heights of 4-5 meters, are predominantly observed in the western and southern zones off the coast of Sumatra, particularly in the vicinity of smaller islands. Conversely, in enclosed or semi-enclosed waters, such as the lee side of Sumatra and the Malacca Strait, sea wave heights tend to be relatively lower. Seasonally, our study indicates that extreme wave heights are more likely to occur during the west season as opposed to the east season. This research provides valuable insights into the dynamic ocean wave conditions in Sumatran waters, which can have significant implications for various sectors reliant on the ocean environment.

Efficacy of anti-obesity agents: a systematic review and network meta-analysis of randomized controlled trials

Abstract Background: To conduct a network meta-analysis comparing the safety and efficacy of five anti-obesity drugs approved by the United States Food and Drug Administration (US FDA)-Bupropion/Naltrexone combination (BUP/NLX), Liraglutide (LIRA), Orlistat (ORLI), Phentiramine/Topiramate combination (PHEN/TPM) and Simaglutide (SGT) vs placebo. Methods: The study's eligibility criteria include randomized controlled trials (RCTs) with a focus on obese patients receiving BUP/NLX or LIRA or ORLI or PHEN/TPM or SGT versus placebo. We conducted a comprehensive search of electronic databases (PubMed, Embase, Cochrane Library, and Scopus) to identify relevant randomized controlled trials published, with no restrictions on the publication language or year. Three reviewers independently screened the studies, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. Bucher's and Bayesian Meta-regression Simulation Method were used for indirect head-to-head comparison between various active drugs. RevMan Version 5.4® along with A Network Meta- Analysis Toolkit by Cochrane Methods were used. p-value less than 0.05 was considered significant. Results: Total 28 studies were included in this meta-analysis. PHEN/TPM combination exhibited (odds ratio :0.568, p value <0.001, cl 95%) ORLI (odds ratio: 0.889, p value <0.001, cl 95%), SGT (odds ratio: 0.922, p value <0.001, cl 95%). BUP/NLX combination exhibited a high (odds ratio: 4.61, p value <0.001, cl 95%) LIRA displayed the lowest (odds ratio: 1.109, p value <0.001, cl 95%). Network meta-analysis revealed. BUP/NLX combination exhibited highest Efficacy. ORLI found as safest among the evaluated drugs. SGT had significant likelihood of adverse events (odds ratio = 1.328, p-value<0.0001, Cl 95%) compared to ORLI (odds ratio = 0.138, p-value<0.0001, Cl 95%), BUP/NLX (odds ratio = 0.197, p-value<0.0001, cl 95%), and LIRA (odds ratio = 0.456, p-value < 0.001, Cl 95%), PHEN/TPM (odds ratio = 0.456, p-value<0.0001, Cl 95%). Discussion: These findings have important clinical implications for the management of obesity. The BUP/NLX , LIRA , and SGT can be considered as effective treatment options for weight reduction. However, healthcare providers need to carefully consider the safety profiles and potential side-effects of these medications when making treatment decisions. The study relied on aggregated data, which might introduce bias. High attrition rates and heterogeneity among studies limit the findings. It only compared common gastrointestinal side effects and didn't use the GRADE approach for evidence quality. Conclusion: Study provides evidence supporting the efficacy of anti-obesity medications compared to placebo. BUP/NLX combination, LIRA, and SGT emerged as the most effective agents, considering safety profile. Findings can guide clinicians about options for obesity management. Study Registration: The study is registered with PROSPERO (CRD42023465989).

Refusal of prescribed drug therapy (absolute non-adherence) after acute myocardial infarction/unstable angina: data from prospective observation in the LIS-3 registry

Aim. Within the LIS-3 register of acute coronary syndrome (ACS), to evaluate the phenomenon of complete refusal of treatment (absolute non-adherence) after discharge from the hospital of patients diagnosed with acute myocardial infarction (AMI)/unstable angina (UA): to study the characteristics of absolutely nonadherent patients, disease outcomes after 2.5 years after first contact.Material and methods. The study was conducted within the framework of the LIS-3 register. This part of the study included patients who survived ACS and were discharged from the hospital in the first 9 months of 2014 (104 people) and patients who survived ACS and were discharged from the hospital in the first 9 months of 2018 (223 people). Of the 327 patients who survived after AMI/UA, 226 patients remained alive by the time of the first survey (on average 3 years after discharge). The created questionnaire was used, which includes questions about possible long-term outcomes, adherence to visits to medical and preventive institutions (health facilities) and adherence to drug therapy. 221 people answered questions about treatment, 11 (5%) of them did not take any drug therapy (absolutely non-adherent). On average, 29 months (2.5 years) after the initial survey, a repeat survey of completely non-adherent patients or their relatives was carried out, information was collected on the vital status of these patients, repeated cardiovascular events and on the use of recommended drug therapy, about visiting a health facility.Results. When comparing the clinical and demographic characteristics of patients who were adherent and completely non-adherent to the prescribed therapy, no significant differences were noted. By the time of the repeat survey, 4 patients from among those who were completely non-adherent had died, 2 had suffered ACS. Of the 6 patients who survived, at the time of re-contact, 2 had not started taking medications, explaining that they were feeling well, 2 had resumed taking medications in full, 2 — partially, contact with 1 patient was lost.Conclusion. A certain proportion of patients who have suffered AMI/UA completely refuse the prescribed treatment, mainly because they feel well. The likelihood of death and recurrent cardiovascular events in such patients is extremely high.

Coronary artery calcium and the risk of cardiovascular events and mortality in younger adults: a meta-analysis.

American College of Cardiology/American Heart Association 2019 prevention guidelines recommend utilizing coronary artery calcium (CAC) to stratify cardiovascular risk in selected cases. However, data regarding CAC and risk in younger adults are less robust due to the lower prevalence of CAC and lower incidence of events. The objective of this meta-analysis is to determine the ability of CAC to predict the risk of cardiovascular events and mortality in adults <50. PubMed and Cochrane CENTRAL databases were electronically searched through May 2022 for studies with a primary prevention cohort under age 55 who underwent CAC scoring. Six observational studies with a total of 45 919 individuals with an average age of 43.1 and mean follow-up of 12.1 years were included. The presence of CAC was associated with an increased risk of adverse events [pooled hazard ratio (HR) = 1.80, 95% confidence interval (CI) 1.26-2.56, P = 0.012, I2 = 65.5]. Compared with a CAC of 0, a CAC of 1-100 did carry an increased risk of cardiovascular events (pooled HR = 1.85, 95% CI 1.08-3.16, P = 0.0248, I2 = 50.3), but not mortality (pooled HR = 1.20, 95% CI 0.85-1.69, P = 0.2917), while a CAC > 100 did carry an increased risk of cardiovascular events (pooled HR = 6.57, 95% CI 3.23-13.36, P < 0.0001, I2 = 72.6) and mortality (pooled HR = 2.91, 95% CI 2.23-3.80, P < 0.0001). In a meta-analysis of younger adults undergoing CAC scoring, a CAC of 1-100 was associated with a higher likelihood of cardiovascular events, while a CAC > 100 was associated with a higher likelihood of cardiovascular events and mortality.

ENVIRONMENTAL-ORIENTED SYSTEM&#x0D; OF MANAGEMENT COST ACCOUNTING FORESTRY PRODUCTION

In modern conditions, characterized by increasing instability of the state of the natural environment, exacerbation&#x0D; of climate problems, and an increase in the likelihood of adverse events in forestry production, it becomes advisable to&#x0D; organize an environmentally oriented management accounting system as a system for managing environmental costs and&#x0D; environmental risks. Environmental costs are forestry costs of a commercial nature, control over the accounting and&#x0D; distribution of which can be ensured in the management accounting system.&#x0D; The article substantiates the feasibility of organizing an environmentally-oriented system of management accounting&#x0D; for environmental costs and environmental risks; It is proposed to allocate an independent position as part of current&#x0D; environmental expenses: “The probable amount of costs associated with the implementation of environmental risk (environmental&#x0D; risk costs)”; correspondence of accounts for accounting for environmental costs, as well as preparation of&#x0D; management reporting to reflect the environmental indicators of the sustainable development of the organization.

Molecular Mechanisms of Cationic Fusogenic Liposome Interactions with Bacterial Envelopes.

Although fusogenic liposomes offer a promising approach for the delivery of antibiotic payloads across the cell envelope of Gram-negative bacteria, there is still a limited understanding of the individual nanocarrier interactions with the bacterial target. Using super-resolution microscopy, we characterize the interaction dynamics of positively charged fusogenic liposomes with Gram-negative (Escherichia coli) and Gram-positive (Bacillus subtilis) bacteria. The liposomes merge with the outer membrane (OM) of Gram-negative bacteria, while attachment or lipid internalization is observed in Gram-positive cells. Employing total internal reflection fluorescence microscopy, we demonstrated liposome fusion with model supported lipid bilayers. For whole E. coli cells, however, we observed heterogeneous membrane integrations, primarily involving liposome attachment and hemifusion events. With increasing lipopolysaccharide length, the likelihood of full-fusion events was reduced. The integration of artificial lipids into the OM of Gram-negative cells led to membrane destabilization, resulting in decreased bacterial vitality, membrane detachment, and improved codelivery of vancomycin─an effective antibiotic against Gram-positive cells. These findings provide significant insights into the interactions of individual nanocarriers with bacterial envelopes at the single-cell level, uncovering effects that would be missed in bulk measurements. This highlights the importance of conducting single-particle and single-cell investigations to assess the performance of next-generation drug delivery platforms.

Guidelines for Establishing Safety in Ayahuasca and Ibogaine Administration in Clinical Settings

As the research field with psychedelic substances grows, it is expected to encompass a more extensive cohort of individuals presenting a spectrum of medical conditions, comorbidities, and unique physiological traits, thereby increasing the likelihood of potential adverse events. Furthermore, it is worth noting that there is a scarcity of the specialized literature regarding procedures to ensure the safe management of clinical trials involving psychedelics. Acknowledging this, our research team designed a series of protocols to standardize the care and management of adverse scenarios, ensuring the safety and well-being of research volunteers included in clinical trials conducted by the LEAPS (Laboratory for Studies with Hallucinogens and Psychedelics in Mental Health, linked to the University of São Paulo). These guidelines have been meticulously crafted based on the established guideline philosophy of Hospital das Clínicas de Ribeirão Preto (the university hospital of Universidade de São Paulo), consultation with specialists in the field, and a thorough review of the existing literature. The process resulted in protocols that have been tailored to specifically address the unique requirements and particularities of clinical research with psychedelic substances (in this case, ayahuasca and ibogaine). As a result, these guidelines aim to cover a range of potential issues, encompassing both psychiatric manifestations (e.g., panic attacks, suicidal behavior, and psychotic episodes) and clinical manifestations (e.g., hypertensive crisis and hypoglycemia).

Alcohol for seizure induction in the epilepsy monitoring unit

Rationale: Seizure induction techniques are used in the epilepsy monitoring unit (EMU) to increase diagnostic yield and reduce length of stay. There are insufficient data on the efficacy of alcohol as an induction technique. MethodsWe performed a retrospective cohort study using six years of EMU data at our institution. We compared cases who received alcohol for seizure induction to matched controls who did not. The groups were matched on the following variables: age, reason for admission, length of stay, number of antiseizure medications (ASM) at admission, whether ASMs were tapered during admission, and presence of interictal epileptiform discharges. We used both propensity score and exact matching strategies. We compared the likelihood of epileptic seizures and nonepileptic events in cases versus controls using Kaplan-Meier time-to-event analysis, as well as odds ratios for these outcomes occurring at any time during the admission. ResultsWe analyzed 256 cases who received alcohol (median dose 2.5 standard drinks) and 256 propensity score-matched controls. Cases who received alcohol were no more likely than controls to have an epileptic seizure (X2(1) = 0.01, p = 0.93) or nonepileptic event (X2(1) = 2.1, p = 0.14) in the first 48 h after alcohol administration. For the admission overall, cases were no more likely to have an epileptic seizure (OR 0.89, 95 % CI 0.61–1.28, p = 0.58), nonepileptic event (OR 0.97, CI 0.62–1.53, p = 1.00), nor require rescue benzodiazepine (OR 0.63, CI 0.35–1.12, p = 0.15). Stratified analyses revealed no increased risk of epileptic seizure in any subgroups. Sensitivity analysis using exact matching showed that results were robust to matching strategy. ConclusionsAlcohol was not an effective induction technique in the EMU. This finding has implications for counseling patients with epilepsy about the risks of drinking alcohol in moderation in their daily lives.

Sudden wave flooding on steep rock shores: a clear but hidden danger

It is shown that very steep coastal profiles can give rise to unexpectedly large wave events at the coast. We conduct a statistical analysis of runs from a nearshore Boussinesq-type model to demonstrate that under certain wave conditions, which a casual observer would perceive as calm, the likelihood of large run-up events is uncharacteristically high. The data computed by the Boussinesq-type model show that sea states with lower overall wave steepness favor higher run-up. Under these wave conditions, more of the available wave energy reaches the shore, since less wave breaking occurs, which can create a false sense of security for beach-goers.

Association of change in fat and lean mass with incident cardiovascular events for women in midlife and beyond: A prospective study using dual-energy x-ray absorptiometry (DXA).

To determine whether changes in fat and lean mass over time, quantified using dual-energy x-ray absorptiometry (DXA), are related to incident cardiovascular events. Previous studies using surrogate anthropometric methods have had inconsistent findings. Prospective, longitudinal observational study of women aged 40 to 80 randomly selected from the electoral roll and stratified into decades: 40-49, 50-59, 60-69 and 70-79years. Changes in anthropometric measurements (body mass index and waist-to-hip ratio) and DXA-quantified fat mass and lean mass between the first and fifth years of the study. Incident cardiovascular events recorded from the sixth to the 12th year. In total 449 participants (87.9%) were analyzed. A 10% or greater decrease in total fat mass index was associated with a 67% lower likelihood of any cardiovascular event (OR=0.33, 95%CI 0.15-0.71); no association was observed for an increase. A 10% or greater decrease in abdominal fat mass index was associated with a 62% lower likelihood of incident stroke (OR=0.38, 95%CI 0.16-0.91); no association was observed for an increase. A 10% or greater decrease in appendicular lean mass index resulted in increased odds ratio of 2.91 for incident peripheral artery events (OR=2.91, 95%CI 1.18-7.20). Reducing fat mass for women in midlife and beyond may decrease the risk of cardiovascular events. An increase in fat mass may not contribute to additional cardiovascular events. A reduction in limb muscle mass may provide an independent marker for cardiometabolic risk and peripheral artery disease. No independent association was found using anthropometric measurements and incident cardiovascular events.

Troubleshooting in an IVF Laboratory

In the realm of assisted reproductive technology, troubleshooting within an in vitro fertilization (IVF) laboratory is of paramount importance to ensure successful outcomes. FMEA is a proactive methodology used to identify potential failure modes in laboratory processes, assess their possible effects, and prioritize interventions to prevent or mitigate them. In the context of IVF, FMEA aids in recognizing critical steps prone to errors, such as sample mishandling or equipment malfunctions. By quantifying the probability and severity of failures, FMEA allows laboratories to allocate resources judiciously and implement corrective measures that reduce the likelihood of adverse events. Root cause analysis (RCA) is a retrospective technique employed to delve into the underlying causes of anomalies or failures that have already occurred. In the IVF laboratory, RCA helps uncover the root reasons for unsuccessful procedures, like embryo implantation failure. This analysis aids in identifying both immediate triggers and underlying systemic issues, paving the way for targeted improvements to enhance overall success rates. By plotting key performance indicators over time, IVF laboratories can detect deviations from established norms. This enables swift corrective actions before deviations result in compromised outcomes. Control Charts thus offer a dynamic tool for monitoring laboratory processes, maintaining consistency, and swiftly addressing unexpected fluctuations. By systematically preventing potential failures, investigating root causes, and dynamically monitoring processes, IVF laboratories can improve their success rates, enhance patient experiences, and contribute to the advancement of assisted reproductive technologies.

Evaluation of cardiotoxicity of anthracycline-containing chemotherapy regimens in patients with bone and soft tissue sarcomas: A study of the FDA adverse event reporting system joint single-center real-world experience.

To assess the occurrence of cardiotoxicity in patients with tumors receiving anthracycline-based chemotherapy, especially for sarcomas. This study summarized the types and frequency of adverse events (AEs) for three anthracyclines from the FDA adverse event reporting system (FAERS) database. FAERS data from January 2004 to June 2022 were collected and analyzed. Disproportionality analyses, logistic regression, and descriptive analysis were used to compare the differences in cardiac disorders. A retrospective cohort study was conducted in a single center between December 2008 and May 2022. Our hospital-treated patients with bone and soft tissue sarcomas (BSTSs) with anthracycline-containing chemotherapy were analyzed. Serum markers, echocardiography, and electrocardiography have been used to evaluate cardiotoxic events. One hundred thousand and seventy-five AE reports were obtained for doxorubicin (ADM), epirubicin (EPI), and liposome doxorubicin (L-ADM) from the FAERS database. ADM (OR = 3.1, p < 0.001), EPI (OR = 1.5, p < 0.001), and sarcomas (OR = 1.8, p < 0.001) may increase the probability of cardiac disorders. Cardiac failure, cardiotoxicity, and cardiomyopathy were anthracyclines' top 3 frequent AEs. Among patients receiving ADM-containing therapy, those with ADM applied at doses ≥75 mg/m2 /cycle were more likely to develop cardiac disorders than the other subgroups (OR = 3.5, p < 0.001). Patients younger than 18 are more likely to benefit from dexrazoxane prevention of cardiac failure. Six hundred and eighty-three patients with BSTSs receiving anthracycline-based chemotherapy were analyzed in our center. Patients receiving ADM-containing chemotherapy were likelier to experience abnormalities in serum troponin-T and left ventricular ejection fraction (p < 0.05). 2.0% (6/300) of patients receiving ADM-containing chemotherapy required adjustment of the chemotherapy regimen because of cardiotoxicity, whereas none were in the EPI or L-ADM groups. Among patients receiving anthracycline-containing therapy, patients with BSTSs were more likely to develop cardiac disorders than other tumors. In addition, patients with BSTSs receiving ADM chemotherapy had a higher likelihood of cardiotoxic events than those receiving EPI or L-ADM.

Assessing the Influence of HGT on the Evolution of Stress Responses in Microbial Communities from Shark Bay, Western Australia.

Pustular microbial mats in Shark Bay, Western Australia, are modern analogs of microbial systems that colonized peritidal environments before the evolution of complex life. To understand how these microbial communities evolved to grow and metabolize in the presence of various environmental stresses, the horizontal gene transfer (HGT) detection tool, MetaCHIP, was used to identify the horizontal transfer of genes related to stress response in 83 metagenome-assembled genomes from a Shark Bay pustular mat. Subsequently, maximum-likelihood phylogenies were constructed using these genes and their most closely related homologs from other environments in order to determine the likelihood of these HGT events occurring within the pustular mat. Phylogenies of several stress-related genes-including those involved in response to osmotic stress, oxidative stress and arsenic toxicity-indicate a potentially long history of HGT events and are consistent with these transfers occurring outside of modern pustular mats. The phylogeny of a particular osmoprotectant transport gene reveals relatively recent adaptations and suggests interactions between Planctomycetota and Myxococcota within these pustular mats. Overall, HGT phylogenies support a potentially broad distribution in the relative timing of the HGT events of stress-related genes and demonstrate ongoing microbial adaptations and evolution in these pustular mat communities.

Role of anthropogenic forcing and atmospheric circulation in a low-temperature event in February 2022 in eastern China

In February 2022, eastern China experienced prolonged low temperatures, with significant impacts on agriculture, transportation, and power supply. The regional average temperature anomaly for February 2022 was −0.65 °C, making it the third coldest February from 2000 to 2022. Understanding the influence of anthropogenic forcing and atmospheric circulation on low-temperature events is important for climate change adaptation and mitigation in the region. This study used observational and model data from the Coupled Model Intercomparison Project Phase 6 to conduct an extreme event attribution study. The results showed that anthropogenic forcing led to a 1.5-fold decrease in the probability of 2022-like events, with anthropogenic greenhouse gases being the primary contributors to this reduction. Conversely, aerosols slightly increased the likelihood of such events. To evaluate the role of atmospheric circulation in this event, we chose Siberian High as the key circulation system and employed circulation similarity, intensity classification, and regression methods to estimate the impacts of circulation patterns, circulation intensity, and human-induced circulation change. The results demonstrated that under the influence of the same anthropogenic forcing, the presence of an anomalous Siberian High and anomalously enhanced intensity of the Siberian High both increased the likelihood of such a cold event occurrence. However, anthropogenic forcing exerts a negligible effect on such cold events via anomalous circulation.

Increased Environmental Temperature Is an Emerging Health Risk That Correlates with Rates of Acute Lymphoblastic Leukemia in Europe

Background: The World Meteorological Organization (WMO) has calculated that European temperatures have increased at more than double the global average over the last 30 years 1. Besides research in radiation, little research has focused on how this might connect to the mechanisms initiating mutations in ALL. Both latitude and solar irradiance are potential risk factors in the development of ALL 2,3. Latitude covaries with the intensity of solar irradiance and ambient temperature, and both could therefore influence the risk of ALL. Furthermore, high ambient temperature during pregnancy was found to be associated with increased likelihood of childhood ALL 4. Global increases in temperature escalate the likelihood of extreme heat events, which in mammals increases reactive oxygen species, increases DNA damage, and suppresses the immune system 5. Few studies have evaluated changes in ambient temperature as a risk factor for ALL in Europe. We also included chronic lymphocytic leukemia (CLL) for comparison. Objective:To investigate the relationship between population-weighted country centroids (location of greatest population density), average country yearly temperature, solar irradiance and ALL and CLL rates in 40 European countries between the years 2010 and 2019. Design/Method:Incidence and prevalence rates for ALL and CLL (Age-standardized data with males and females) were obtained from the Global Health Data Exchange (GHDx) database. Population-weighted latitude/longitude centroids for Europe 6 were obtained from Baylor University and input into the Global Solar Atlas to obtain the average yearly global horizontal irradiance values. European temperature data was obtained from the Climatic Research Unit at the University of East Anglia (Copernicus Climate Data Store) 7. ALL and CLL incidence and prevalence rates per 100,000 people for 40 European countries were compared by linear regression to each country's temperature or solar irradiance at the population centroids. Statistical analyses were performed using GraphPad Prism and Excel. Results:After2010, we detected a significant positive correlation between ALL incidence and prevalence rates with mean annual temperature across countries for each year of analysis (for example in 2014 the ALL prevalence p-value = 0.01 and R= 0.4, see Figure 1). There was also an increase in the significance of this relationship over time between 2010 and 2019 (Figure 1B). We also detected a significant positive correlation between the increase in mean annual temperature across Europe and an increase in ALL over the past decade (Figure 1B). However, no relationship was established in this study for solar irradiance or population-weighted latitude and CLL prevalence and incidence rates. Conclusions:Increasing mean annual temperatures may increase the risk of developing ALL. We speculate this may be connected through increases in extreme weather events impacting oxidative stress, DNA damage, and/or suppression of the immune system. Considering the global climate crisis, the WMO finding of higher European temperature increases and our finding of significance between temperature and ALL rates, these relationships should be functionally studied. Finally, these studies should be expanded to countries outside of Europe. References 1 World Meteorological Organization. Temperatures in Europe increase more than twice global average. (2022). 2 Pordanjani, S. R., Kavousi, A., Mirbagheri, B., Shahsavani, A. &amp; Etemad, K. Temporal trend and spatial distribution of ALL in Iranian children during 2006-2014: a mixed ecological study. Epidemiol. Health42, (2020). 3 Coste, A. et al. Residential exposure to UV light and risk of precursor B-cell ALL: assessing the role of individual risk factors, the ESCALE and ESTELLE studies. Cancer Causes Control28, 1075-1083 (2017). 4 Rogne, T. et al. High Ambient Temperature in Pregnancy and Risk of Childhood ALL. medRxiv (2023) 5 Chauhan, S. S., Rashamol, V. P., Bagath, M., Sejian, V. &amp; Dunshea, F. R. Impacts of heat stress on immune responses and oxidative stress in farm animals and nutritional strategies for amelioration. Int. J. Biometeorol.65, 1231-1244 (2021). 6 Hamerly, G. Population-weighted European state centers. (2006). 7 Climatic Research Unit, U. of E. A. Temperature and precipitation gridded data for global and regional domains derived from in-situ and satellite observations. (2023).

Sex-Related Differences in Fetal Hemoglobin Levels in Sickle Cell Patients

Sickle cell disease (SCD) continues to be the most common inherited blood disorder in the United States, characterized by a mutated HBB gene in hemoglobin subunit β (Kato 2018; Sedrak 2023). Currently, hydroxyurea is the gold standard treatment for SCD due to its mechanism of raising fetal hemoglobin (HbF) levels, ultimately lessening pain crises and need for blood transfusions (Acharya 2023). Prior to widespread usage of hydroxyurea, significant differences were found regarding HbF levels between males and females. In many cases, females were found to have, on average, higher HbF levels (El-Hazmi 1994; Ceglie 2019; Solovieff 2010; Sutnick 1968). The aim of this study is to determine whether sex-related differences presently exist in HbF levels in patients with SCD after Hydroxyurea use. This is a cross-sectional study conducted at the Center for Blood Disorders in Augusta, Georgia, consisting of a total of 496 patients diagnosed with SCD. Variables analyzed from this database included sex (male v. female), levels of HbF, and common complications of SCD: pulmonary hypertension, retinopathy, avascular necrosis, and thrombosis. Levels of HbF were calculated based on percentage and averaged. Two-sided t-test was used to identify differences between male and female HbF levels. Correlation of common complications of SCD with sex was observed using Pearson's coefficient and Fisher's z-test using R version 4.2.3. P value &amp;lt;0.05 was taken as significant. To control for confounding factors, HbF levels and age were included as covariates in the logistic regression when exploring the relationship between sex and complications of SCD. The 496 SCD patients consist of 233 males and 263 females. The males had a mean HbF of 8.71 (SD 9.84), and the females had a mean HbF of 9.83 (SD 10.4). A two-sided t-test resulted in a p-value of 0.21. 85 patients (45 female) had a history of pulmonary hypertension. The correlation between female sex on likelihood of developing pulmonary hypertension controlling for age and HbF was -0.24 (SE 0.22).121 patients (66 female) had a history of retinopathy. The correlation between female sex and the likelihood of developing pulmonary hypertension controlling for age and HbF retinopathy was -0.0066 (SE 0.21).177 patients (86 female) had a history of avascular necrosis. The correlation between female sex and likelihood of AVN controlling for age and HbF was -0.43 (SE 0.19).131 patients (72 female) had a prior thrombotic event. The correlation between female sex and likelihood of thrombotic event controlling for age and HbF was -0.12 (SE 0.19). The findings reveal no significant relationship between sex and HbF levels. We posit that this may likely be due to the effect of hydroxyurea treatment for SCD, as prior to treatment, there were significantly higher HbF levels in females (El-Hazmi 1994; Ceglie 2019; Solovieff 2010; Sutnick 1968). Adjusting for age and HbF levels, we found that there were no significant differences between the sexes in terms of risk for developing complications of pulmonary hypertension, sickle cell retinopathy, and thrombotic events. We did find that there was a significant difference between the sexes in terms of risk for developing avascular necrosis, where females were shown to have a decreased risk compared to males. Due to our limitation with sample size, next steps would entail analyzing these relationships with a larger database. With a more extensive data set of patients with SCD, further relationships may be elucidated regarding sex differences in the progression of disease that could aid in informed treatment decisions.