Geographical Location Research Articles

A network method to analyze compound extreme events: Risk enhancement relationship and trigger causal relationship in high voice traffic and high data throughput events

Based on ideas from event coincidence analysis (ECA), we propose a network analysis method to study compound extreme events at different geographical locations. Integrating network modeling into statistical correlation research allows us to analyze potential risk enhancement relationship and trigger causal relationship between these events. In this approach, we consider different geographical locations as nodes and construct a directed edge from node i to node j when event A at location i occurs synchronously before event B at location j. Precursor coincidence analysis quantifies the risk enhancement relationship between two types of extreme events, while trigger coincidence analysis quantifies the trigger causal relationship between two types of extreme events. A directed weighted network can be constructed based on statistical correlations between these events at different geographical locations. Further analysis of network topology characteristics extends traditional ECA in method and application. Herein, we construct the precursor functional network and the trigger functional network of high voice traffic and high data throughput to analyze potential risk enhancement and trigger causal relationships between these events at different base stations within a communication system.

Relationship between soil structure and hydrological properties of the active layer in the permafrost region of the Qinghai–Tibet Plateau based on fractal theory

Soil structure and hydrological properties influence ecosystem stability and hydrological cycles. Fractal theory has been widely used in the quantitative analysis of soil particle-size distribution (PSD), aggregate and pore distribution, and evaluation of soil degradation, desertification, and wind erosion. However, the complex relationships between soil physiochemical properties and soil hydrological processes based on fractal theory have not been thoroughly investigated. This study focused on the correlation among soil structure, physicochemical properties, and hydrological properties in the active layers of various soil types and vegetation coverages in the permafrost region of the Qinghai–Tibet Plateau (QTP) using the principles of fractal theory. The results showed that the fractal dimension of soil PSD (DPSD) in the active layer of the QTP was predominantly within the range of 2.13–2.70, which is notably smaller than the fractal dimension of the soil water retention curve (DWRC: 2.72–2.93). With decreased vegetation coverage, the alpine soil particles exhibit gradual fineness, increasing the DPSD. Soil physicochemical properties were affected by the interactions among internal factors and the external environment, such as geographical locations, slope orientations, vegetation coverages, and soil freeze–thaw cycles. The results of correlation analysis indicated that the fractal dimension of PSD and the soil water retention curve (WRC) were significantly correlated with soil textural, physicochemical, and hydraulic properties, particularly in clay, silt, and very fine sand content. Finally, a fractal model of WRC in the permafrost region was established based on DPSD and WRC parameters of the Gardner and van Genuchten models. The study provides an improved perspective for revealing the transport process and influencing mechanism of soil water and salt in the active layer of the QTP and a more accurate prediction of soil physiochemical and hydrological properties for climate warming and wetting.

Earthquake risk assessment for Kuwait City, Kuwait

Estimating the expected losses from a seismic disaster, whether economic or human is considered one of the most important priorities for urban development in countries, especially those with continually expanding urban areas, high-rise buildings, and skyscraper construction as is the case in Kuwait City. It is necessary to conduct an earthquake risk assessment study due to Kuwait’s geographical location which makes it close to the most important global seismic belt, the Zagros Seismic Belt, and its proximity to local seismic sources. To conduct such a study, three inputs including seismic hazard, exposure, and vulnerability modules were incorporated, considering the inputs’ uncertainty. To assess the seismic hazard module, a unified earthquake catalog was compiled, a seismotectonic model of 27 seismic sources was designed, the recurrence parameters of seismicity and the strongest predictable earthquake were calculated for each source, and the unified hazard spectrums were obtained. Earthquake scenarios were generated to create a seismic hazard module. The exposure module is performed using data from the Kuwaiti Public Authority for Civil Information including coordinates of 33,066 facilities and buildings, area, height, shape, and type of buildings, the materials used in their construction, their occupancy, and replacement cost. The vulnerability module was implemented using mean damage ratio curves by choosing the most appropriate equations that describe the condition of buildings in Kuwait, the vast majority of which are modern multi-story concrete buildings. The final results including the economic losses of the exposures were calculated using probabilistic metrics (predicted annual losses, loss exceedance curve, and probable maximum loss). The results showed that the annual average loss is $12,793,319.52 and that seismic source No.27 to the north of Kuwait has a significant value to the losses, but the frequent occurrence of losses from seismic source No.15 to the east of Kuwait, in the Zagros region, gave the most danger to Kuwait. Seismic risk results can be used to create emergency response scenarios and risk mitigation strategies.

Determinants of Salary Variation and the Gender Pay Gap: A Survey of the American Association of Hip and Knee Surgeons (AAHKS) Surgeon Member Workforce

BackgroundThe increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives. MethodsAn online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023. Surgeon demographic data, experience, practice geography and type, and annual case volume were solicited. Univariate and multivariate analyses were performed to describe the association of respondent characteristics with reported salary directly from patient care, as well as indirect revenue streams. ResultsA total of 730 AAHKS members responded to the survey. The largest proportion of surgeons performed 251-400 cases annually (36%); 81% (n = 592) and 93% (n = 679) of respondents identified as white and male, respectively. Case volume was the primary determinant for surgeon salary, followed by practice type, years in practice, and gender. After controlling for confounding variables, multivariate analyses revealed the direct salary of women surgeons was 14.4% less than men [95% confidence interval, 0.4%-28.3%]. When considering indirect revenue, the gender pay gap widened. Salary was not associated with reported hours worked per week, geographic location, or ethnicity. ConclusionsSalary is an important but underdiscussed subject that reflects the realities of our culture and value system in medicine. A direct relationship between salary and modifiable variables like case volume is clear. However, after controlling for confounders, women arthroplasty surgeons still earn 86 cents on the dollar compared to their male colleagues from direct surgical revenue.

Exploring the Impact of High-Temperature Stress on Physiological, Anatomical, Molecular, Productive, and Quality Parameters in Diverse Olive Cultivars

Olive (Olea europaea L.) is one of the most important horticultural crops in Saudi Arabia. High temperatures are typical in most regions during the summer season. This study explored the effect of high temperatures on diverse olive cultivars (Manzanillo, Chemlali, and Picual) grown in three different geographical locations in Saudi Arabia (Sakaka, Basita, and Al-Qurayyat). Sakaka region was classified as a hot region, while the Basita and Al-Qurayyat regions were characterized by relatively mild or low temperatures. Genotypic components were assessed by studying Amplified Fragment Length Polymorphism (AFLP) molecular markers and physiological, anatomical, productive, and oil quality parameters. The evaluated genotypes displayed considerable variation across the three studied locations. Picual exhibited more heat tolerance, followed by Chemlali and Manzanillo. The high temperature in Sakaka negatively impacted critical characteristics related to olive growth, production, and quality. Results revealed that linoleic acid, oil acidity, total phenols, upper epidermis, palisade tissue, vascular bundle area, and mesophyll were the most appropriate parameters for predicting the impact of high temperatures. These traits were highly correlated with Sakaka and were highly and significantly associated with all the studied markers. Also, significant interactions between locations and genotypes showed that the means for most of the studied traits were the highest in Basita region.

The Influence of Phytoconstituents for the Management of Antipsoriatic Activity in Various Animal Models.

It is possible for psoriasis to manifest at any point in a person's life, regardless of their age, gender, or geographic location. It is a chronic immune-linked inflammatory skin ill-ness that affects individuals of various racial and ethnic origins. It is recognized to be a long-lasting condition. Because of the significant contribution that natural products have made, there has been a significant advancement in the treatment of skin illnesses such as psoriasis. The biggest number of phytochemicals derived from a wide range of plants and herbs are now being used in a variety of applications throughout the whole world. Additionally, a number of phyto-chemicals, including aloe-emodin, psoralen, curcumin, and others, have been effectively ex-tracted in pure or clear form, and they have shown a great deal of efficacy in the treatment of psoriasis illness. There is evidence that a few herbal remedies are effective, and the occurrence of these phytochemicals provides more proof. When synthetic medications are used for chronic therapy, they may cause a variety of adverse consequences; hence, the exploration of natural pharmaceuticals can give a successful natural treatment with a minimal amount of adverse ef-fects. Within the scope of this concise review, a number of plant sources that possess anti-pso-riatic activity are investigated, and the antipsoriatic effects of these plant sources are shown on a number of animal models using particular pathways.

Knowledge Families Hold: Co-Production and Co-Research With Mental Health Family Carers in Understanding Experiences During the COVID-19 Pandemic.

Through an in-depth exploration of mental health family carers' experiences during the COVID-19 pandemic in Australia, this co-produced study identified recommendations for advocacy, practice and policy implications to uphold family carer wellbeing. Government-enforced restrictions, changed service availability and difficulties accessing hospitals, led to additional anxiety, depression and elevated distress, especially for people experiencing mental health challenges before the pandemic. The National Mental Health Consumer and Carer Forum alongside two academic researchers aimed to discern the impact of care provision, levels of distress, unmet needs, challenges and benefits of providing support, across geographic locations and diverse communities. This article reports on the survey component of a co-designed mixed-methods exploratory study of family carer experiences. A project steering group worked with two academic researchers, members of SWITCH Research Group, Monash University, to develop the 71-question online survey across 9-domains. Family carers were relied upon to provide support and care when mental health services changed or closed. Carers support more than one person and typically people with daily and high-level needs. Caring levels increased from 26-h to an average of 40-h a week of support provision, with changed roles and increased complexity. Heightened demands became stress-inducing to the point of mental ill health and suicidality for some family carers. Government policy and pandemic responses failed to address the financial, practical or emotional resources needed to fulfil the role of care provision and support to unwell and extremely distressed people with new or ongoing mental and psychological ill-health. From its inception, this project was co-produced and co-designed with mental health family carers and service users based on their expertise in understanding their experiences and ways to best explore these to the benefit and wellbeing of families in distress. The academic research partners both have active experience of supporting people with mental health challenges. Through each of the identified phases, lived experience expertise (family carers and service users) co-designed and co-facilitated the process. At times leading the process, such as in recruitment strategies, and at other times acting as guides. Guidance was provided by lived experience expertise in reflecting upon the literature review to understand what had been researched internationally and what would be important to understand in Australia. The academic partners advised on the possible processes for data collection, and the lived experience experts decided on the methodology based on that advice. Both the focus group and survey questions were developed and scrutinised from the perspective of the service users and carers in the project team. Difficult conversations were handled with respect, service users within the project team gently addressed areas of enquiry that may suggest stigma or feed into societal stereotypes of people with mental health challenges. Carers were able to consider the wording of questions to still be able to address areas of concern including domestic violence within the family unit and suicide. Dissemination strategies were planned together with the carer and service user representatives being co-presenters at conferences. The report for submission to the National Mental Health Commission (Australia) was written and reviewed with all partners. A committee of service users and carers, alongside the academic partners, planned the launch of the report in August 2023. The co-authorship of peer-reviewed articles has included family carers and service users from the National Mental Health Consumer and Carer Forum.

Chemical composition and antioxidant activity of 'Nufar' basil (Ocimum basilicum L.) essential oil from three municipalities of Tolima, Colombia

Essential oils are natural compounds with great potential to be used as products with high antioxidant activity. The aim of this research was to determine the chemical composition and antioxidant activity of the Nufar variety basil essential oil from three municipalities in Tolima, Colombia. The essential oil extracted from the leaves of this basil variety using microwave-assisted extraction predominantly comprises linalool (37.9–41.1%), estragole (24.5–33.6%), and 1,8-cineole (5.2–7.6%). The quantities of these compounds are influenced by the plant's place of origin. Regarding antioxidant activity, the basil essential oil cultivated in the municipality of Honda shows higher antioxidant activity in the DPPH and ABTS·+ tests (29.89 ± 4.03 and 9.60 ± 1.74 mg/mL, respectively), compared to the values from the municipalities of Mariquita and Espinal. The Principal Component Analysis applied to the data generated biplots that explain 99.8% of the total variation. These indicate that the essential oils from basil grown in the municipality of Espinal are characterized by having a high IC50 (mg/mL) in the DPPH test. On the other hand, the essential oils of basil cultivated in the municipalities of Honda and Mariquita are distinguished by their high content of monoterpenes and total terpenes. The study concludes that the geographical location significantly impacts the chemical composition and antioxidant activity of basil plants.

Learning to Holistically Detect Bridges From Large-Size VHR Remote Sensing Imagery.

Bridge detection in remote sensing images (RSIs) plays a crucial role in various applications, but it poses unique challenges compared to the detection of other objects. In RSIs, bridges exhibit considerable variations in terms of their spatial scales and aspect ratios. Therefore, to ensure the visibility and integrity of bridges, it is essential to perform holistic bridge detection in large-size very-high-resolution (VHR) RSIs. However, the lack of datasets with large-size VHR RSIs limits the deep learning algorithms' performance on bridge detection. Due to the limitation of GPU memory in tackling large-size images, deep learning-based object detection methods commonly adopt the cropping strategy, which inevitably results in label fragmentation and discontinuous prediction. To ameliorate the scarcity of datasets, this paper proposes a large-scale dataset named GLH-Bridge comprising 6,000 VHR RSIs sampled from diverse geographic locations across the globe. These images encompass a wide range of sizes, varying from 2,048 × 2,048 to 16,384 × 16,384 pixels, and collectively feature 59,737 bridges. These bridges span diverse backgrounds, and each of them has been manually annotated, using both an oriented bounding box (OBB) and a horizontal bounding box (HBB). Furthermore, we present an efficient network for holistic bridge detection (HBD-Net) in large-size RSIs. The HBD-Net presents a separate detector-based feature fusion (SDFF) architecture and is optimized via a shape-sensitive sample re-weighting (SSRW) strategy. The SDFF architecture performs inter-layer feature fusion (IFF) to incorporate multi-scale context in the dynamic image pyramid (DIP) of the large-size image, and the SSRW strategy is employed to ensure an equitable balance in the regression weight of bridges with various aspect ratios. Based on the proposed GLH-Bridge dataset, we establish a bridge detection benchmark including the OBB and HBB tasks, and validate the effectiveness of the proposed HBD-Net. Additionally, cross-dataset generalization experiments on two publicly available datasets illustrate the strong generalization capability of the GLH-Bridge dataset.

Telehealth visit type and patient-reported outcomes among patients with cancer

BackgroundRelaxed licensing restrictions on telehealth use during the COVID-19 pandemic allowed broad use irrespective of visit type. As these telehealth waivers expire, optimal uses of telehealth must be assessed to inform policy and clinical care. We evaluated patient experience associated with telehealth and in-person new or established visits. MethodsPatients seen in-person and via telehealth for urologic cancer care from August 2019 to June 2022 received a survey on satisfaction with care, perceptions of communication during their visit, travel time, travel costs, and days of work missed. We assessed survey responses with descriptive statistics. ResultsSurveys were completed for 1,031 patient visits (N = 494 new visits, N = 537 established visits). Satisfaction rates were high for all visit modalities among new and established patients (mean score range 59.9–60.7 [maximum 63], P > 0.05). Patient-rated quality of the encounter did not differ by visit type and modality (P > 0.05, for nearly all comparisons). New in-person patient visits were associated with significantly higher travel costs (mean $496.10, SD $1021) compared with new telehealth visits (mean $26.60, SD $141; P < 0.001); 27% of new in-person patients required plane travel and 41% required a hotel stay (P < 0.001 vs. 0.8% and 3.2% of new telehealth patients, respectively). ConclusionsSatisfaction outcomes among patients with urologic cancer receiving new patient telehealth care equaled those of new patients cared for in-person while costs were significantly lower. Offering telehealth exemption beyond COVID-19 licensing waivers to include new patient visits would allow for ongoing delivery of high-quality urologic cancer care irrespective of geographic location.

Indian Ocean Intermediate Water Masses and Their Simulations by CMIP6 Models

Abstract Water masses are carriers of anthropogenic fingerprints in the ocean interior, with their property changes manifesting oceanic thermodynamic responses to climate change. Yet, delimiting ocean water masses remains challenging in either observational atlas or climate models. This study analyzes the distribution of Indian Ocean seawater in the density–spicity space and uses volumetric maxima and minima between σ = 27.1 and 27.4 kg m−3 to track the cores and boundaries of intermediate water masses, respectively. In addition to the well-known Antarctic Intermediate Water (AAIW) and Red Sea–Persian Gulf Intermediate Water (RS-PGIW), two other water masses are identified by the new approach. One is the Indian-AAIW (I-AAIW), as a mixture of the AAIW and the Indonesian Throughflow water, existing in the South Equatorial Current and the Agulhas Current system. The other [equatorial Indian Intermediate Water (EIIW)] exits in the equatorial Indian Ocean and Bay of Bengal, sourced from the RS-PGIW and overlying fresh waters. These waters are corroborated by nutrient and dissolved oxygen data. Around half (26 out of 51) of phase 6 of the Coupled Model Intercomparison Project (CMIP6) models can reasonably simulate these intermediate water masses. Compared with the observed water masses, the intermediate water masses in models are of a smaller thickness and the RS-PGIW is colder and fresher. The former arises from a warm bias in the thermocline, whereas the latter is likely linked to insufficient ventilation in the Red Sea and Persian Gulf in models owing to coarse grid resolution and a surface cold bias. Significance Statement Oceanic water masses are important for understanding climate change. Yet, the definition of water masses is controversial. Here, we use volumetric minima in the density–spicity space to track the boundaries of intermediate (27.1–27.4 kg m−3) water masses in the Indian Ocean. We identify four water masses: AAIW, I-AAIW, EIIW, and RS-PGIW. We delineate the geographical location of each water mass, including two newly identified water masses (I-AAIW and EIIW). We also examined the performance of 51 CMIP6 models in simulating these water masses and found that 26 models can reasonably simulate the distribution of these water masses. There are two systematic model biases emerging from these models. The intermediate water masses in models are of a thinner thickness arising from a warm bias in the thermocline, and the RS-PGIW is colder and fresher owing to insufficient ventilation in the Red Sea and Persian Gulf. These results provide a useful benchmark for understanding water masses in a changing climate and constraining climate models.

Fishing or farming? Isotopic evidence of human subsistence strategies at the Dashuitian site during the middle Neolithic in the Three Gorges of the Yangtze River, China

The Three Gorges of the Yangtze River, with its deep canyons, abundant freshwater resources, and unique geographic location at the crossroads in the spread of rice-millet agriculture in the Middle Neolithic, is of great significance for understanding the interaction between fishing-hunting-gathering and farming in inland freshwater environments. However, few direct evidence for human subsistence strategies had been published in this region. This study presents results of carbon and nitrogen stable isotope analyses on human bones, animal and millet remains from the Dashuitian site (c. 6000–5500 BP) in the Three Gorges of the Yangtze River, China, to investigate the diet and subsistence and intrapopulation dietary variations in this region. The results indicate that the humans at the site consumed mostly freshwater fish foods and supplemented by terrestrial animals, with no discernable input from millets. They had consistently relied on a fishing, hunting, and gathering economy during the occupation of the site in the Middle Neolithic (c. 6000–5500 BP), differing from humans in other areas especially along the rivers and coasts of the lower Yangtze River valley for the roughly same period, further showing the extensive utilization of and adaptation to the available environmental resources. In addition, intrapopulation dietary variations based on burial style and sex provide evidence that differentiation and inequality, at least regarding to food consumption, existed at the Three Gorges region during the Middle Neolithic. Here, our findings provide isotopic evidence about the Middle Neolithic human subsistence strategies in the Three Gorges of the Yangtze River, providing a glimpse into the complexity related to inequality in food access among fisher-hunter-gatherers in inland areas, and new insights into understanding past human-environment interactions.

Digitalizing corporate whistleblowing systems: the role of country peers in the adoption of substantive CSR initiatives

Purpose This study aims to examine whether companies adopt digital platforms for corporate whistleblowing systems (CWSs), as more substantive corporate social responsibility (CSR) initiatives, by following the existing practices of their industry peers (competitive pressure) and/or geographical location peers (legitimacy pressure). Design/methodology/approach This study identifies 446 focal companies in the European Economic Area that introduced new CWSs during 2017–2021. Then, the peers are defined as companies with existing CWS practices that are similar in size to each focal company. Using a quantitative approach, this study uses a logistic regression model. Findings This study finds that companies are more likely to adopt digital CWS if their country peers (not, industry peers) have done so, especially the ones operated in countries where governments build CSR partnerships with companies through cooperative consensus. However, the role of country peers is less prominent when companies have CSR committees. Practical implications This study shows the importance of country norms over competitive pressure in CSR. Nevertheless, the results offer additional insights for policy-makers by showing that country regulations mandating CWSs are not significant in promoting the adoption of digital CWS nor reducing the role of country peers. Social implications Providing CWSs with digital platforms may show corporate commitment to better preventing social misconduct and improving social responsibility. Originality/value While most literature focuses on the role of industry peers and/or community peers in a single-country setting, this study examines the role of country peers specifically on digitalization regarding CSR and governance.

Global disparities in cancer care: Bridging the gap in affordability and access to medications between high and low‐income countries

AbstractBackgroundCancer remains a significant challenge for health care systems, despite notable progress in the field. These advancements have significant financial implications that disproportionately affect low‐income countries. This review article aims to explore the present state of drug development, assessing the availability of drugs in different income countries, and proposing potential solutions to address the inequality in access to new cancer treatments.MethodsA search was conducted on MEDLINE and PubMed on October 2, 2023 and updated on December 14, 2023, limited to English language articles.ResultsThere is a projected rise in cancer cases worldwide, particularly in low‐income countries where most cancer‐related deaths are expected. Although the approval rate of cancer treatments has risen, their excessive cost and lack of affordability pose significant barriers to widespread access. Disparities in the costs of crucial cancer medications are influenced by geographic location and procurement connections. Potential solutions to address the inequity in drug distribution include sharing production secrets, implementing price discrimination, international funding, improved primary health care measures, and the implementation of cost‐effective screening methods.ConclusionPreventing, screening for, and treating cancer should be a global priority with minimal differences in access to therapy among various countries.

Usable Privacy and Security in Mobile Applications: Perception of Mobile End Users in Saudi Arabia

Privacy and security is very critical for mobile users and in-depth research into the area highlights a need for more scientific literature on the perception and challenges of end users to better align the design of privacy and security controls with user expectations. In this paper, we have explored the perceptions of the usability of privacy and security settings in mobile applications from mobile users in Saudi Arabia. The findings highlight that gender, age, and education level of users do not have any positive correlation with the privacy and security usability perceptions of mobile users. On the other hand, user concerns about privacy and security and the trustworthiness levels of end users regarding mobile phone privacy and security have a positive impact on end users’ perception of privacy and security usability. Furthermore, privacy usability perception has a positive impact on users’ feelings about their control over the privacy and security of their mobile phones. Based on the results of this empirical study, we propose that user-centric design of privacy and security controls, transparent data handling policies, periodic data management status preview and validation by end users, user education guidelines, strict governmental policies, and automated security settings recommendations can enhance the usability of the privacy and security of mobile phone applications. Our study did not take the geographical location of respondents into account, nor were the respondents balanced based on age and gender. In future work, these weaknesses need to be taken into account, and more qualitative studies can help to extract design guidelines for usable and secure mobile applications.

The Influence of Artificial Light Exposure on Indigenous Populations: Exploring Its Impact on Menarcheal Age and Reproductive Function

The impact of artificial light exposure on human health has garnered significant attention in recent years. In particular, its effects on reproductive health have raised concerns. Given that the onset of menarche serves as a crucial indicator of reproductive maturity, understanding the implications of artificial light exposure becomes paramount. Age of menarche onset occurs relatively earlier in urban females than females raised in rural areas. Besides the decline in age of menarche onset, exposure to artificial light may contribute to impairment in reproductive hormones, particularly gonadotropins, by disrupting rhythms of reproductive hormones, modulating stress hormones and kisspeptin productions, and causing body weight changes. This drastic environmentally induced change may increase the proportion of teenage pregnancies, unfulfilled childhood dreams, depression, and ill-prepared marriages, thus creating a potential need for public health intervention. Due to limited studies and often lack of longitudinal data, a significant knowledge gap exists in unraveling the potential mechanism involved in alteration of these physiologic processes. The purpose of the current review was to elucidate the intricate interplay between environmental factors, cultural practices, and biological processes within indigenous communities. By meticulously examining the multifaceted influences of artificial light, including its prevalence and varying intensity based on geographical locations and light pollution levels, this study aimed to provide scholarly insights in-to the pathophysiologic mechanisms underlying the observed changes. The findings of this inquiry will also inform evidence-based strategies and interventions aimed at safeguarding the reproductive well-being of indigenous populations amidst the escalating challenges posed by artificial light exposure.

Clonal and horizontal transmission of carbapenem-resistant Enterobacterales strains and genes via flies.

Antimicrobial resistance (AMR) is one of the most pressing global public health challenges; in particular, the rapid dissemination of carbapenem-resistant Enterobacterales (CRE) is emerging as a significant concern worldwide. Flies, serving as carriers of pathogens, pose a potential threat in the transmission of antibiotic-resistant bacteria (ARB) between animals and humans. The aim of this study was to evaluate and reveal the potential risk of AMR spread by flies. A total of 450 flies were collected from four farms, four rural areas, and four urban areas in Dengfeng, Henan, China. To select CRE strains on the surface of flies, three flies sampled from the same geographical location were arbitrarily selected and placed into one tube of brain heart infusion broth (BHI), and the supernatant was screened using CHROMagar™ mSuperCARBA culture medium. Different colors and shapes of colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. Antimicrobial susceptibility testing for CRE strains was performed using broth microdilution. All CRE strains were whole-genome sequenced. Short-read sequencing was performed using MGISEQ-2000 and long-read sequencing was conducted using GridION. Totally, 150 BHI tubes were screened for CRE strains, and 33 strains were identified as CRE positive. In 24 mSuperCARBA plates, only one species of CRE strain was isolated from each plate. In three plates, two different species of CRE strains were identified in each plate. In one plate, three different species of CRE strains were simultaneously isolated. Carbapenem resistance genes were detected in 81.8% of CRE strains, and blaNDM-1 was predominant (66.7%). No significant correlations between carbapenem-resistant phenotypes and carbapenem resistance genes were observed. The complete genomes of all 33 strains were obtained. Genome analysis revealed that clonal transmission events may have occurred among different farms and rural areas. Phylogenetic analysis revealed that blaNDM-1 IncFII plasmids could break bacterial species barrier for cross-host transmission in diverse areas. To understand and control the transmission of AMR from the perspective of One Health, it is imperative to enhance surveillance of ARB, antibiotic resistance genes, and antibiotic-resistant plasmids in flies.

Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.

High maternal mortality rates in sub-Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region. This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub-Saharan Africa and identify gaps in priority conditions or geographical locations. We identified references through a Medline (PubMed) search covering September 2012 to June 2022. We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub-Saharan Africa, and published in English or French. Screening and data extraction were done in duplicate using EPPI-reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders. We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub-Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders. Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub-Saharan Africa.

Three-year survival follow-up of patients with gastrointestinal cancer treated during the COVID-19 pandemic in Spain: data from the PANDORA-TTD20 study.

The initial SARS-CoV-2 pandemic wave in Spain in 2020 precipitated significant paradigm shifts in gastrointestinal oncology patient management. This study captures the "Zeitgeist" of this period by analyzing adaptive strategies, treatment modifications, and survival outcomes, leveraging a 3-year follow-up perspective to extract insights from this unprecedented experience. We conducted a multicenter, retrospective cohort study utilizing the RETUD-TTD registry, encompassing 703 patients across 19 Spanish centers in April 2020. We evaluated alterations in clinical practice, therapeutic approaches, coronavirus disease 2019 (COVID-19)-related impacts, and patient survival. A Bayesian hierarchical model was employed to identify potential regional-specific frailties. The peak of the pandemic in April 2020 catalyzed substantial shifts in oncological care delivery. Outpatient consultations decreased by 13%, with a notable selection bias toward cases with more favorable prognostic indicators. Multidisciplinary tumor board discussions were significantly curtailed (eg, mean monthly colorectal cancer cases discussed was reduced from 40 to 23), compromising qualitative care measures. This occurred concurrently with an average of over 3 oncologists per center on medical leave. Contrary to initial concerns, the healthcare system demonstrated remarkable resilience. The majority of patients received standard-of-care therapies with regulatory approval, albeit with regimen modifications in 15% of cases. These adaptations included extended dosing intervals, dose intensity modulations, and transitions to oral formulations while maintaining unexpectedly stable long-term survival outcomes. The Bayesian frailty model detected minimal unmeasured prognostic factors related to geographic location, and the type of pandemic-induced adaptation did not significantly impact survival. The model revealed that coronavirus disease 2019's impact was less pronounced than other core prognostic variables. The decentralized Spanish healthcare system exhibited substantial robustness in managing pre-pandemic diagnosed gastrointestinal malignancies, despite asymmetrical, and occasionally severe organizational disruptions. The insights gleaned from this experience could inform future crisis preparedness strategies and optimize care provision during subsequent public health emergencies.

Economic Burden of Haemophilia from a Societal Perspective: A Scoping Review.

Haemophilia is a rare genetic bleeding disorder that leads to musculoskeletal complications. The high cost of haemophilia treatment necessitates a thorough evaluation of its economic burden. However, due to the difficulty of estimating direct non-medical, indirect, and intangible costs, studies often underestimate the actual economic burden of haemophilia. This scoping review aims to summarise economic studies in haemophilia conducted from a societal perspective. A systematic search across eight scholarly databases, grey literature, and reference lists until the5th of July 2023 was conducted to identify relevant studies. The inclusion criteria encompassed full-text, English-language publications of economic analyses in congenital haemophilia from a societal perspective. Model-based studies and those adopting a payer perspective were excluded. Costs were adjusted to international dollars (I$) and US dollars (US$) in 2022 for comparability. Out of 2993 potential sources identified, 25 studies met the inclusion criteria, covering 7226 persons with haemophilia across 22 countries. All studies reported direct medical costs, with four excluding the cost of haemostatic therapy. Fifteen studies reported direct formal non-medical costs, while eight reported direct informal non-medical costs. All but one study reported the indirect costs. The average annual costs of haemophilia varied widely based on treatment modality, disease severity, geographical location, and included cost categories. When including the cost of clotting factor replacement therapy (CFRT), the total cost for severe haemophilia without inhibitors ranged from 1566 I$ to 700,070 I$ per person per year (lowest value reported in India and highest in the United States). CFRT represented up to 99.9% of the total cost for those receiving prophylaxis and up to 95.1% for episodic treatment. Haemostatic therapies accounted for 82% of the total cost in patients with inhibitors. There is a significant heterogeneity in defining cost categories required for a comprehensive economic analysis from a societal perspective. While haemostatic therapies constitute a substantial portion of the overall cost, direct non-medical and indirect costs are crucial as they are often paid out-of-pocket and may impede access to treatment. It is essential for haematologists and economists to establish a standardised costing framework for future studies, particularly in the era of novel therapies.