Geographic Variation Research Articles

Content-Based Instruction in Language Education: A Bibliometric Review

The popularization of content-based foreign language programs has given rise to Content-Based Instruction (CBI) as a practical pedagogical approach to facilitating language learning through the medium of content. The growing amount of relevant research in the past decades has necessitated a systematic review of the trends in CBI research to summarize achievements and illuminate future research practices. In this article, CBI-related research articles indexed in Web of Science are reviewed bibliometrically using VOSviewer, following a rigorous selection and screening process. Certain aspects are emphasized, including publication patterns, geographic distribution, institutional contributions, contributing scholars, influential journals and articles, and frequently repeated author keywords. Among the findings, the review highlights substantial geographical variation in previous CBI research as well as the most frequently repeated keywords with corresponding clusters. This review concludes by addressing the research trends in this field and recommending future research directions, which are crucial for understanding the current situation and establishing a foundation for future studies.

Geographical variation, socioeconomic inequalities of low birth weight, and its relationship with maternal dietary diversity: Insights from the maternal infant and young child nutrition programme in Bangladesh.

Globally, every year, 20 million neonates are born with weights below 2500 g and are considered low birth weight (LBW). About 90% of these births occur in low- and middle-income countries. Information regarding the geographical variation, socioeconomic inequalities of LBW neonates, and the relationship between maternal inadequate dietary diversity and LBW is limited in rural areas of Bangladesh. We aimed to explore the geographical disparities and socioeconomic inequalities in the prevalence of LBW and its association with inadequate maternal dietary diversity. We extracted data from a large-scale evaluation programme conducted as a part of the maternal infant and young child nutrition phase two in Bangladesh, implemented by BRAC. We used the concentration index (CIX) to measure the socioeconomic inequalities of LBW. We performed a cluster-adjusted multiple logistic regression analysis to determine the association between LBW and maternal dietary diversity. A total of 4651 children aged <5 years with their mother's information were included. The overall prevalence of LBW was 13.5%. About 16% of mothers living in the poorest wealth quintile gave birth to LBW babies, whereas 10% of mothers living in the richest households gave birth to LBW babies. The CIX exhibited LBW babies were more prevalent among the socioeconomically worst-off (poorest) group (CIX = -0.08), indicating mothers of the poorest households are vulnerable to giving birth to normal-weight babies. An adjusted multiple logistic regression model indicated that mothers with inadequate dietary diversity had higher odds (adjusted odds ratio (AOR) = 1.27; 95% confidence interval (CI) = 1.04, 1.54) of giving birth to LBW babies. Notably, in the interaction of mothers' age and dietary diversity, we found that adolescent mothers (aged ≤ 19 years) with inadequate dietary diversity had 2.56 times (AOR = 2.56; 95% CI = 1.14, 5.76) higher odds of giving birth to LBW babies compared to adult mothers (aged >19 years) who consumed diversified foods. Intervention strategies for reducing LBW prevalence should target the poorest households. Also, interventions for improving the dietary diversity of adolescent pregnant mothers are expected to reduce the number of LBW babies from the rural areas of Bangladesh.

Dear Malaria: Deer Have Malaria! Prevalence ofPlasmodium odocoilei Infection in White-tailed deer in Pennsylvania

Abstract Background To combat antimalarial treatment resistance, better understanding of malaria pathogenesis is needed, but existing animal model have various limitations. Notably, prevailing murine models require laboratory infection of non-natural host species. In 2016, the parasite Plasmodium odocoilei was identified in white-tailed deer (Odocoileus virginianus). This was the first non-human mammalian malaria parasite identified in North America, representing a novel naturally occurring model system that allows for integrated examination of host, vector, and systems parasite biology. In addition, sickle hemoglobinopathy is exceptionally common among white-tailed deer, occurring in up to 60% of apparently healthy animals. In humans, the prevalence of sickle hemoglobinopathy in individuals with ancestry from malaria-endemic regions is due to the protective effects of sickle trait against severe malaria. Thus, the white-tailed deer-P. odocoilei system represents the only known naturally occurring model of the association between malaria parasite biology and sickle cell disease. Pennsylvania white-tailed deer have not previously been surveyed for infection. In this study, we determined P. odocoilei prevalence in a sample of 170 Pennsylvania white-tailed deer. Methods We amplified the CytB gene of P. odocoilei by nested PCR from DNA extracted from homogenized white-tailed deer tongue tissue obtained from the PennVet Wildlife Futures Program. We confirmed samples screening positive on gel electrophoresis via unprimed sequencing (Plasmidsaurus, USA) and NCBI-BLAST analysis. Results We estimate the prevalence of P. odocoilei infection in Pennsylvania white-tailed deer to be 0.6% (1 of 170 samples). Sequencing of the positive sample revealed a 621-bp sequence with close sequence identity to previous North American isolates of P. odocoilei (query cover 91-100%, percent identity 99.34-100.00%). Biobank metadata showed the positive sample originated from a roadkilled yearling male picked up at GPS coordinates (40.8423, -79.0409) on August 15, 2022. Conclusion P. odocoilei is endemic to Pennsylvania white-tailed deer. Our future directions include screening of additional samples, determination of host hemoglobin allele frequencies, detailed parasite genetic studies, and entomologic studies to elucidate vector biology. In addition, granular sample metadata collected by the PennVet Wildlife Futures Program will allow us to analyze the effects of geographic, demographic, and temporal variables on epidemiology. In sum, our survey data empowers future Pennsylvania-based studies to take advantage of the only known naturally occurring animal model of sickling and its association with protozoan infection.

Geographical Variation in the Sand Cat, Felis margarita (Carnivora: Felidae)

Sand cats, Felis margarita, range from northern Africa and the Arabian Peninsula to Central Asia. Their apparently discontinuous distribution is recognized as comprising four subspecies. Recent genetic research found little differentiation between subspecies except for the North African form. In this study, 90 skins and 88 skulls were analyzed from the four subspecies. A discriminant function analysis of the scores, ranging from 1 to 4, of four pelage characteristics revealed differentiation between putative subspecies, except between Turkmenian and Pakistani sand cats. Northern African and Arabian sand cats tend to be spotted and striped, while Turkmenian and Pakistani sand cats are less spotted and have a dorsal crest of fur. Nonmetric multidimensional scaling (NMDS) models generated from 21 skull measurements revealed an overlap in morphospace between all subspecies, except for larger Turkmenian sand cats; northern African sand cats were smallest. Therefore, both pelage characteristics and skull morphometrics support up to three subspecies. However, considering recent genetic research, it is likely that two subspecies should be recognized, F. m. margarita from northern Africa and F. m. thinobia from the Arabian Peninsula, and Southwest and Central Asia. Widening of the dataset and nuclear DNA evidence are required to increase our understanding of geographical variation in this little studied species.

Vegetative traits, floral biology, and mutualistic interactions in the tropical mountain shrub Ribes ciliatum (Grossulariaceae)

Plant species in tropical mountain ecosystems experience significant environmental variation across short spatial distances. These systems offer an opportunity to assess geographic variation in plant traits in relation to biotic and abiotic environments. We examined plant vegetative and reproductive traits in the shrub R. ciliatum across two native conifer forests in central Mexico. We measured plant height, number of branches, leaf size, flower production, floral morphology, floral longevity, and plant reproductive success in R. ciliatum populations found in fir forests (3100 m) and Hartweg's pine forests (subalpine habitat, 3700 m). We also quantified the level of pollinator dependence, pollinator visitation rates, and fruit consumption rates by frugivorous birds in both populations. Plants were shorter and had smaller leaves in the subalpine forest than in the fir forest. Floral longevity decreased in the subalpine forest, but flower production, flower size, and fruit weight remained similar across populations. Fruit set and pollinator visitation rates were higher in the subalpine forest; however, seed weight and fruit consumption rates did not differ between sites. Hummingbirds and bumblebees were the primary pollinators of R. ciliatum, and the bird Ptiliogonys cinereus was the most important fruit consumer at both sites. Fruit set was entirely dependent on pollinators. Reduced plant size in the subalpine forest coincides with a general pattern associated with high mountain environments. In contrast, reproductive characters had a closer relationship to the pollination environment. The absence of variation in flower size and shape was consistent with the similarity in the composition of the pollinator community. Meanwhile, compared to lower-elevation forests, the subalpine forest exhibited shorter-lived flowers and increased fruit set, associated with higher pollinator visitation rates. Ribes ciliatum is a key resource for pollinators and frugivores at a time of year when few other floral resources are available in these high-elevation mountain forests.

Unveiling Priority Emerging PFAS in Taihu Lake Using Integrated Nontarget Screening, Target Analysis, and Risk Characterization.

Amidst tightening regulations, the proliferation of next-generation per- and polyfluoroalkyl substances (PFAS) necessitates a deeper understanding of their environmental fate and potential risks. Here, we conducted a comprehensive assessment of PFAS in the water and sediment of Taihu Lake, incorporating both nontarget and target screening, seasonal and geographical variation analysis, and risk prioritization. A total of 58 PFAS from 13 classes were identified, revealing complex PFAS contamination. In addition to short-chain perfluoroalkyl carboxylates (PFCAs) and sulfonates (PFSAs), bis(trifluoromethanesulfonyl)imide (Ntf2) and perfluoro-2,5-dimethyl-3,6-dioxo-heptanoic acid (C7 HFPO-TA) exhibited relatively high concentrations in water, with median values of 21.7 and 5.72 ng/L, respectively. Seasonal and geographical variation analysis revealed elevated levels of C7 HFPO-TA, Ntf2, and perfluorohexanoic acid (PFHxA) in the northeastern areas, suggesting transport via water diversion project. Multicriteria risk prioritization identified four high priority PFAS (Ntf2, C7 HFPO-TA, PFHxA, and perfluorooctanoic acid (PFOA)) in water and two high priority PFAS (hexafluoropropylene oxide dimer acid (HFPO-DA) and PFHxA) in sediment. Overall, this study revealed Ntf2 and C7 HFPO-TA as priority PFAS in Taihu Lake, underscoring the urgent necessity of evaluating risks associated with these emerging PFAS.

Literature Review on Stochastic Modeling of Wet and Dry Spells

With increasing concerns about climate change and its profound implications for water resources, stochastic modeling of wet and dry spells has emerged as a critical domain within hydrology and climatology, providing insight into the temporal patterns of precipitation and drought occurrences. This review of the literature synthesizes recent advances in the modeling of wet and dry spells using stochastic methods, focusing on publications from 2000 to 2024. The review examines various modeling approaches, including Markov chain models, mixed probability models, non-homogeneous models, and time series approaches. Key findings indicate that Markov chain models are effective in simulating the sequential occurrence of wet and dry spells, with higher-order variants addressing issues of overdispersion. Mixed probability models excel at representing heterogeneity and extremes in precipitation data, especially in regions with distinct wet and dry seasons. Non-homogeneous models are valuable for understanding the temporal dynamics and irregularities of dry spells, revealing significant shifts in their frequency and duration over time. These can be complemented by time-series methods to highlight long-term trends and seasonal variations. The review underscores the importance of regional specificity in modeling approaches to accurately capture local climatic and geographical variability. Recommendations for future research include the integration of hybrid models that combine the strengths of various approaches to improve predictive precision, focusing on the impacts of climate change, and conducting cross-regional comparisons to generalize findings and enhance the robustness of the models.

Liver Cancer Etiology: Old Issues and New Perspectives.

This review aims to synthesize the old issues and current understandings of the etiology of liver cancer, focusing on the diverse causative factors influenced by geographical, socioeconomic, and lifestyle variations across different regions. We highlight significant geographic disparities in liver cancer risk factors. While hepatitis B and C viruses, aflatoxin exposure, and alcohol consumption remain globally established contributors; metabolic dysfunction-associated steatotic liver disease and metabolic syndromes are increasingly prominent in the West. Chronic HBV and aflatoxin continue to dominate as risk factors in Asia and Africa. Dietary factors, metabolic diseases like diabetes and obesity, genetic predispositions, environmental risk factors and lifestyle choices such as smoking and alcohol use play substantial roles in specific populations. Protective factors like coffee and tea consumption, along with aspirin use, vegetables and fruits have shown potential in reducing HCC risk, although findings vary by population and dietary habits. Liver cancer etiology is influenced by various factors that differ by region. Established risk factors include hepatitis B and C, aflatoxin, and alcohol. Emerging risks, such as metabolic dysfunction-associated steatotic liver disease, are more prevalent in Western countries, while aflatoxin and HBV remains significant in Asia and Africa. Diet, metabolic conditions like diabetes and obesity, genetic predispositions, and lifestyle choices also play crucial roles. Coffee, tea, aspirin, vegetables, and fruits may reduce HCC risk, but effectiveness varies. Future research should integrate epidemiology, genetics, and nutrition, with global cooperation and data sharing essential for effective cancer control strategies.

Increasing Utilization of Intratympanic Injections among Medicare Fee-for-Service Providers.

To characterize national practice patterns and geographic variations in intratympanic injections among Medicare providers. Retrospective cross-sectional analysis of intratympanic injections performed in the Medicare fee-for-service population from 2013 to 2021. Center for Medicare & Medicaid Services Physician and Other Practitioners database. Providers performing outpatient intratympanic injections, documented by Current Procedural Terminology code 69801. Intratympanic injections. The number of intratympanic injections performed by individual providers, states, and geographic regions, as well as reimbursements, was analyzed annually. A total of 159,236 in-office intratympanic injections were performed. The Center for Medicare & Medicaid Services reimbursed $25,407,086; out-of-pocket patient costs were $6,591,514. The mean Medicare reimbursement rate and out-of-pocket cost per injection were $159.56 and $41.38, respectively. From 2013 to 2021, the number of intratympanic injections increased from 13,117 to 20,711 injections, representing a 57.9% increase. On linear regression, an additional 989.9 injections were performed each year (95% CI 766.4-1,213.4, p < 0.001). The number of providers performing injections also increased from 1,828 to 2,834 from 2013 to 2021 (b = 125.6 [95% CI 111.3-140.0], p < 0.001). The population-controlled annual mean number of injections varied substantially across the United States, ranging from 12.0 injections per 100,000 beneficiaries in Oklahoma to 255.2 injections per 100,000 beneficiaries in Alabama. The number of intratympanic injections administered in the Medicare population has increased from 2013 to 2021. There is variability in practice patterns and utilization of intratympanic injections among otolaryngologists in the United States.

Phage communities in household-related biofilms correlate with bacterial hosts

The average American spends 93% of their time in built environments, almost 70% of that is in their place of residence. Human health and well-being are intrinsically tied to the quality of our personal environments and the microbiomes that populate them. Conversely, the built environment microbiome is seeded, formed, and re-shaped by occupant behavior, cleaning, personal hygiene and food choices, as well as geographic location and variability in infrastructure. Here, we focus on the presence of viruses in household biofilms, specifically in showerheads and on toothbrushes. Bacteriophage, viruses that infect bacteria with high host specificity, have been shown to drive microbial community structure and function through host infection and horizontal gene transfer in environmental systems. Due to the dynamic environment, with extreme temperature changes, periods of wetting/drying and exposure to hygiene/cleaning products, in addition to low biomass and transient nature of indoor microbiomes, we hypothesize that phage host infection in these unique built environments are different from environmental biofilm interactions. We approach the hypothesis using metagenomics, querying 34 toothbrush and 92 showerhead metagenomes. Representative of biofilms in the built environment, these interfaces demonstrate distinct levels of occupant interaction. We identified 22 complete, 232 high quality, and 362 medium quality viral OTUs. Viral community richness correlated with bacterial richness but not Shannon or Simpson indices. Of quality viral OTUs with sufficient coverage (614), 532 were connected with 32 bacterial families, of which only Sphingomonadaceae, Burkholderiaceae, and Caulobacteraceae are found in both toothbrushes and showerheads. Low average nucleotide identity to reference sequences and a high proportion of open reading frames annotated as hypothetical or unknown indicate that these environments harbor many novel and uncharacterized phage. The results of this study reveal the paucity of information available on bacteriophage in indoor environments and indicate a need for more virus-focused methods for DNA extraction and specific sequencing aimed at understanding viral impact on the microbiome in the built environment.

Geospatial analysis of diarrhoea determinants among children under five in Pakistan using Multiscale Geographically Weighted Regression (MGWR)

Diarrhoea is the second most common cause of death among children under five worldwide. About 90 percent of diarrhoeal diseases occur in South Asia and sub-Saharan countries. In Pakistan, it causes almost 53,000 children to die every year. Against this background, this study aimed to analyze the geographical variations in the socio-economic and climatic determinants of under-five diarrhoea cases in districts of Pakistan. We used Generalized Linear Regression (GLR) and Multiscale Geographically Weighted Regression (MGWR) to explore the spatial variation of diarrhoea and its associated determinants. The MGWR model with 10 independent variables outperforms the GLR model (R2 = 0.72) with an adjusted R2 of 0.86. The local accuracy of the MGWR model increases from southwest to northeast. Furthermore among ten selected regressors, significant geographic diversity was found in the determinants of diarrhoea, including altitude, temperature, fever, ARI, and sanitation practices. These insights demand the need for targeted public health interventions, such as immunization campaigns, improved sanitation, and access to clean water and nutritional supplements, poverty eradication, especially in rural and high-risk regions. Future research should employ longitudinal designs and advanced spatial modeling to evaluate the impact of strategies and inform evidence-based policies to reduce the burden of childhood diarrhoea in Pakistan.

Распределение очагов инвазии литоральных моллюсков партенитами и личинками трематод в губах и заливах Мурманского побережья в мае–июне 2021 года

Species composition and geographical variation in the distribution of digenean parthenite and larvae in intertidal snails in the littoral zones along the Murmansk coast were examined. Four species of littoral gastropods (Littorina saxatilis, L. obtusata, L. littorea and Nucella lapillus) were investigated. We found 10 species of digeneans, of which 9 have marine birds as a final host. The exception was Podocotyle atomon which uses fish as a definitive host. Larvae of trematode Microphallus pygmaeus, M. piriformes and Podocotyle atomon are found everywhere on the Murmansk coast. The richest helminth fauna were recorded in the Kola Bay and in Ivanovskaya Bay, the poorest helminth fauna were recorded in Dvorovaya Bay. No pronounced trends in distribution of infection foci were noted. Trematode prevalence appears to be predominantly determined by local site condition favoring or hindering final host (birds and fishes) abundance.

Spatial variation of soil carbon, nitrogen, and phosphorus in the Caatinga dry forest

Soil nutrients are crucial for understanding the impact of global changes on terrestrial ecosystems. Carbon (C), nitrogen (N), and phosphorus (P) are required in specific quantities by plants and are related to soil fertility. In the Caatinga, one of the world’s largest and most diverse tropical dry forests, there have been limited studies investigating the factors that contribute to the spatial distribution of organic carbon (OC), N, and P in the soil and, even fewer, those that explored the use of Machine learning (ML) modeling. In this research, we aim to predict the spatial distribution of these properties at depths ranging from 0 to 20 cm in the Caatinga biome and assess the predictive capability of environmental and geographic variables. We used the Random Forest model in Google Earth Engine to forecast maps with a spatial resolution of 30 m. The best result was obtained for predicting P [Lin's concordance correlation coefficient (LCCC) of 0.32 and R2 of 0.25], followed by OC (LCCC of 0.25 and R2 of 0.17), N (LCCC of 0.21 and R2 of 0.12) and C/N ratio (LCCC of 0.14 and R2 of 0.10). The final maps exhibited a consistent spatial pattern, with OC, N, and C/N ratio showing correlation with climatic covariates (air and soil temperature in the first 15 cm deep), topographic data (altitude), and geographic regions (longitude and latitude). The variation in P content was primarily influenced by parent material. We highlight the relevance of ecotones, which recorded the highest average levels of C and N and C/N, demonstrating the importance of these areas for the maintenance and dynamics of these ecosystems.

The Local Welfare State and Differences in Racialized Poverty

ABSTRACT Researchers concerned with the U.S. welfare state have documented that more localized administration allows for greater geographic variation in public policies as well as the greater potential for racial discrimination to influence policy outcomes. I explore whether key attributes of the local welfare state, capacity and spending, are associated with differences in racialized poverty across localities. I develop a conceptual framework drawing on two sociological traditions: spatial inequality framework and local welfare state theory. Spatial inequality scholarship provides a framework for interrogating why poverty varies across localities and racialized groups. Local welfare scholarship conceptualizes the processes by which local governments impact poverty and how those processes may be highly racialized. Drawing on data from the Census of Governments, I examine all local governments’ capacity and spending across counties in the U.S. and their association with poverty rates among white, Black, and Hispanic populations. I find that local governments’ capacity and spending do matter to understanding differences in racialized poverty. Specifically, racialized groups perceived as more deserving are likely to be the beneficiaries of local government interventions and policies. This study calls for greater attention to the local welfare state as a possible mechanism maintaining racial stratification.

Clinical characterization, prognostic, and predictive values of HER2-low in patients with early breast cancer in the PALLAS trial (ABCSG-42/AFT-05/BIG-14–13/PrE0109)

BackgroundBidirectional crosstalk between HER2 and estrogen receptor (ER) pathways may influence outcomes and the efficacy of endocrine therapy (ET). Low HER2 expression levels (HER2-low) have emerged as a predictive biomarker in patients with breast cancer (BC).MethodsPALLAS is an open, international, phase 3 study evaluating the addition of palbociclib for 2 years to adjuvant ET in patients with stage II-III ER-positive/HER2-negative BC. To assess the impact of HER2 expression on patient outcomes in the phase III PALLAS trial, we analyzed (1) the association between rate of HER2-low with demographic and clinicopathological parameters, (2) the prognostic value of HER2-low status on invasive disease-free survival (iDFS), distant relapse-free survival (DRFS), and overall survival (OS) and (3) HER2 expression’s value as a predictive biomarker of response to palbociclib. HER2-low was defined as HER2 immunohistochemistry (IHC) 1 + or IHC 2 + with negative in situ hybridization (ISH). All pathologic evaluation was performed locally. Prognostic and predictive power of HER2 were assessed with Cox models.ResultsFrom the original PALLAS intention-to-treat population (N = 5753), 5304 patients (92.2%) were included in this analysis. Among these, 2254 patients (42.5%) were classified as having HER2 IHC 0 (HER2-0), and 3050 (57.5%) as having HER2-low disease (1838 with IHC 1 + and 1212 with IHC 2 +). Median follow-up was 59.8 months. HER2-low prevalence varied significantly across 21 participating countries (range 16.7% to 75.6%; p < 0.001) and was more frequent in patients enrolled in North America (63.1%) than in Europe (53.4%) or other regions (53.4%) (p < 0.001). HER2 status was not significantly associated with iDFS in a multivariable Cox model (hazard ratio 0.93, 95% confidence interval 0.81 – 1.06). No significant interaction was observed between treatment arm and HER2 status for iDFS (p = 0.43). Similar results were obtained for DRFS and OS.ConclusionsIn this large, prospective, global patient cohort, no differences were observed in clinical parameters, prognosis, or differential benefit from palbociclib between HER2-0 and HER2-low tumors. Significant geographic variability was observed in the prevalence of HER2-low status, suggesting a high degree of variation in pathologic assessment of HER2 expression without impact on outcomes.

A first insight into seropositivity and risk factors for Brucella spp. and Coxiella burnetii in free-roaming dogs in Ecuador

Brucellosis and Q fever are two bacterial zoonoses caused by Brucella spp. and Coxiella burnetii, respectively. Dogs are reservoirs of these pathogens and play an important role in their spread. In this research, we determined the seroprevalence of antibodies against Brucella spp. and C. burnetii in free-roaming dogs from Ecuador and conducted a statistical analysis based on geographical variables. Serum samples were collected from 397 free-roaming dogs between November 2018 and May 2019 and analyzed with commercial ELISA tests for Brucella spp. and Q fever. An overall seroprevalence of 2.8 % (CI: 95 %, 0.0–6.2 %) and 1.8 % (CI: 95 %, 0.0–5.6 %) was found for Brucella spp. and C. burnetii, respectively. No statistical differences in seroprevalence values were found between geographical regions in Ecuador or between dogs from rural or urban settings, except for the association of C. burnetii infection with the Coastal Region. This is the first study of this kind in Ecuador and points out the need for a One Health approach for control and surveillance of zoonotic diseases like brucellosis and Q fever including feral and stray dogs as reservoirs to spread those pathogens to cattle, humans, or wildlife.

Success and opportunities of the American Academy of Pediatrics Marshall Klaus research grant program in neonatal-perinatal medicine.

Physician-scientists are a crucial link between clinical practice and research. The American Academy of Pediatrics (AAP) initiated the Marshall Klaus Perinatal Research Award to enhance the development of research skills among physicians training in Neonatal-Perinatal Medicine. In this study, we sought to identify trends in funding along with geographical and demographic variables of the applicants and mentees and assess the applicants' scholarly productivity and funding from the National Institutes of Health (NIH). We reviewed the data of applicants and awardees from 2015-2024. We found that basic science applications had a higher funding likelihood than clinical/translational applications. The geographical distribution of awardees is skewed. There was a significant association between awardee status and K08 or K23 funding attainment. Future efforts should support more equitable award distribution and a diverse research landscape in neonatal-perinatal medicine.

12268 Hypercalcemia Alert: Exploring The Link To Isolated Bone Marrow Sarcoidosis

Abstract Disclosure: M. Renzu: None. C.M. Hubers: None. V. mehta: None. A. Qazi: None. D.K. Yerasuri: None. Introduction: Sarcoidosis, a complex disorder marked by granuloma formation in diverse organs, often affects the lungs, but can involve various systems as well. Rare cases of bone marrow involvement may mimic conditions like multiple myeloma, emphasizing the need to consider sarcoidosis in patients with bone marrow abnormalities, especially those without typical myeloma features. Case Presentation: A 79-year-old white male with a medical history of hypertension, hyperlipidemia, deep venous thrombosis, prostate cancer in remission, chronic knee pain, and basal cell carcinoma presented for pre-operative evaluation, as he was scheduled for an elective orthopedic procedure. On routine lab work, he was found to have acute hypercalcemia and normocytic anemia. This finding raised suspicion for an underlying systemic pathology. He reported that he did not take any calcium or vitamin D supplements at home. Subsequent endocrine assessment, including evaluation of parathyroid hormone and vitamin D levels, revealed a non-PTH-mediated hypercalcemia. The persistence of hypercalcemia prompted further investigations, including assessments for multiple myeloma by oncology. The workup was negative for multiple myeloma but significant for granulomas on bone marrow biopsy, a finding consistent with sarcoidosis. Additionally, angiotensin converting enzyme levels were elevated at the time of diagnosis. Interventions led to the resolution of hypercalcemia following steroid therapy of prednisone 20 mg daily and close follow up with endocrinology. As part of his follow up, ACE levels are being regularly monitored, with the patient going for lab work every other month. Discussion: Bone marrow biopsies rarely reveal granulomas and sarcoidosis accounts for only a very small percentage of these findings. The standard workup for sarcoidosis typically does not include bone marrow biopsies. By integrating biopsies into the standard diagnostic protocol researchers may gain insights into the etiology and mechanisms driving this manifestation of sarcoidosis, ultimately improving diagnostic accuracy and patient care. Distinguishing sarcoidosis from multiple myeloma also poses diagnostic challenges, necessitating thorough evaluation in patients with bone marrow abnormalities. Despite its rarity, clinical suspicion for sarcoidosis should be considered in patients with underlying hematologic disorders or malignancies. Additionally, sarcoidosis exhibits geographical variation, being less common in Japanese men and more prevalent in African American women. This highlights the importance of considering demographic factors when evaluating patients for sarcoidosis and its extrapulmonary manifestations. Long-term outcomes in isolated bone marrow sarcoidosis remain unclear, warranting surveillance for progression to multiple myeloma or other lymphoproliferative disorders. Presentation: 6/2/2024

Enhanced recovery after bariatric surgery: a comprehensive survey-based analysis of ERABS actual clinical implementation in Italian bariatric centers.

The escalating global prevalence of bariatric procedures necessitates an enhanced focus on optimizing perioperative care for improved patient outcomes. This study focuses on the implementation of Enhanced Recovery After Bariatric Surgery (ERABS) protocols in Italian bariatric centers to optimize perioperative care. An online survey comprising 19 items was conducted in October 2023, targeting managing surgeons in 139 registered bariatric centers. This survey explored geographic and center-type variations, knowledge, and application of ERABS protocols, along with perioperative, intraoperative, and postoperative practices. Statistical analysis employed included one-way ANOVA and Tukey post hoc tests. Responses from 72 centers (51.8%) revealed a strong awareness of ERABS protocols among managing surgeons. Adherence rates varied geographically (46.3-63%) and among center types (60.8-56.3%). Perioperative practices, including the abandonment of antibiotics for perioperative prophylaxis by 77.5% of surgeons and the adoption of the TAP block technique in 69% of centers, aligned well with ERABS recommendations. However, inconsistencies were noted in abdominal drain usage (61.5% after SG; 70.5% after RYGB/OAGB), with a substantial percentage not adhering to ERABS guidelines. Intraoperative habits generally adhered to ERABS protocols, yet preferences for certain tests, particularly the methylene blue test (70.4%), deviated. Postoperative practices displayed positive trends, with early reintroduction of oral feeding (71.8%) and opioid-free pain management (71.8%). Variations existed in discharge timing and patient monitoring, indicating areas for further improvement. This study offers a comprehensive snapshot of ERABS protocol adherence in Italy, emphasizing the positive trend toward optimizing recovery and reducing patient stress. Despite variations, a majority of centers demonstrated commitment to ERABS principles. Ongoing education, interdisciplinary collaboration, and nationwide dialogue are essential for standardizing ERABS protocols and advancing bariatric-metabolic surgery outcomes in Italy.

Habitat specificity modulates the bacterial biogeographic patterns in the Southern Ocean.

Conceptual biogeographic frameworks have proposed that the relative contribution of environmental and geographical factors on microbial distribution depends on several characteristics of the habitat (e.g. environmental heterogeneity, species diversity, proportion of specialist/generalist taxa), all of them defining the degree of habitat specificity, but few experimental demonstrations exist. Here, we aimed to determine the effect of habitat specificity on bacterial biogeographic patterns and assembly processes in benthic coastal ecosystems of the Southern Ocean (Patagonia, Falkland/Malvinas, Kerguelen, South Georgia and King George Islands), using 16S rRNA gene metabarcoding. The gradient of habitat specificity resulted from a 'natural experimental design' provided by the Abatus sea urchin model, from the sediment (least specific habitat) to the intestinal tissue (most specific habitat). The phylogenetic composition of the bacterial communities showed a clear differentiation by site, driven by a similar contribution of geographic and environmental distances. However, the strength of this biogeographic pattern decreased with increasing habitat specificity: sediment communities showed stronger geographic and environmental divergence compared to gut tissue. The proportion of stochastic and deterministic processes contributing to bacterial assembly varied according to the geographic scale and the habitat specificity level. For instance, an increased contribution of dispersal limitation was observed in gut tissue habitat. Our results underscore the importance of considering different habitats with contrasting levels of specificity to better understand bacterial biogeography and assembly processes over oceanographic scales.