Region Research Articles

The commensal skin microbiome of amphibian mountain populations and its association with the pathogen Batrachochytrium dendrobatidis.

Microbial assemblages naturally living on the skin are an integral part of immunity. In amphibians, this skin microbiota may hold a mitigation solution against the fungal pathogen Batrachochytrium dendrobatidis (Bd), which causes the panzootic disease chytridiomycosis. We used 16S rRNA gene metabarcoding to test the adaptive microbiome hypothesis. We compared the community composition, richness, and putative Bd-inhibitory function of the skin microbiome of three amphibian host species in the Pyrenees, as well as three species in Taiwan, in both Bd-positive and negative mountain populations. In both geographical regions, the amphibian host species played a decisive role in shaping the microbial assemblage and putative anti-Bd properties. In the Pyrenees, the species most susceptible to chytridiomycosis, Alytes obstetricans, had the lowest relative abundances of putative protective bacteria. In Bd-positive and negative sites, individuals had different skin microbiomes, with all anuran species showing increased relative abundances of potential anti-Bd bacteria, while the Taiwanese caudata Hynobius sonani showed the opposite pattern. Our results suggest that, in response to exposure to the pathogen, the skin microbiota shifted to a defensive state with increased anti-Bd function, which may contribute to promoting disease resistance, as proposed by the adaptive microbiome hypothesis.

Enhancing Learning Abilities in Students Using a Cognitive Neuroscience Model Based on Brain-Computer Interface Signal Analysis

Computational intelligence is used to create artificially intelligent systems with the ability to learn, adapt, and solve problems. Learners’ computational abilities can be improved with the help of Cognitive Neuroscience techniques. Computational intelligence refers to the ability of a learner based on the complex operations of the brain in the four relevant dimensions: Visual (V), Aural (A), Kinematic (K), and Reading/Writing (R/W). Our proposed framework consists of electroencephalogram (EEG) data acquisition, signal extraction, and EEG signal categorization to assess students’ cognitive learning abilities. Our proposed approach uses an EEG device equipped with a microprocessor, a Think Gear (TGAM) EEG sensor, and a PCB of 16 dry electrodes. The EEG device and the remote processing device are connected by Bluetooth. The EEG signal provides the students with neurofeedback on their cognitive learning capability. The feedback obtained through the learning process will be endowing to improvise computational intelligence. The statistical derivative, Pearson Co-efficient, is used to find the correlation among the derived attributes. The attributes considered are the learner’s gender, stream, age, and geographical region. The results obtained highlight that gender, stream, and age have no correlation with the detectable learning index, and the most accurate learners are kinesthetic ones. Bi-modal learners, who can maintain focus while reading and using their kinematic abilities, had the second highest learning capacity.

DEVELOPMENT OF A RAPID SNP PCR ASSAY TO DIFFERENTIATE BETWEEN EUROPEAN AND NORTH AMERICAN HAPLOTYPES OF ECHINOCOCCUS MULTILOCULARIS.

Herein we describe a single nucleotide polymorphism-specific polymerase chain reaction (PCR) assay to rapidly detect and differentiate variants belonging to the European and North American lineages of Echinococcus multilocularis in clinical samples. This is an extremely relevant and applicable test in North America because the range of E. multilocularis continues to expand across the continent and because of a rise in prevalence in wildlife, domestic animals, and humans. The endemic North American (NA) and introduced European (EU) variants are believed to have different pathogenic potentials, with the EU variants being more infective and pathogenic than the NA variants. The rise of the EU variants of E. multilocularis increases the risk of spillover from wildlife to humans because of its increased potential for infectivity. Current PCR-based diagnostics can detect E. multilocularis deoxyribonucleic acid (DNA), but DNA sequencing is required to identify the specific variant. Our assay provides a straightforward conventional PCR method to differentiate the NA and EU variants, and we suggest this same approach could be used for the diagnosis of other parasites or variants that are genetically very similar. As surveillance continues for E. multilocularis across North America, identifying the different genetic variants from different geographic regions will become essential to understanding the current epidemiological shift that the parasite is experiencing, as well as informing public health decisions in affected areas.

Clinical symptoms and psychosocial functioning in patients with schizophrenia spectrum disorders testing seropositive for anti-NMDAR antibodies: a case–control comparison with patients testing negative

Antibodies against the N-methyl-D-aspartate receptor (NMDAR) have been described in the serum of people with schizophrenia spectrum disorders (schizophrenia). However, the prevalence and clinical relevance of these antibodies in schizophrenia is unclear. This knowledge gap includes the possibility of such antibodies being associated with a distinct clinical profile, which in turn might warrant a distinct treatment approach. We aimed to assess the seroprevalence of anti-NMDAR antibodies in schizophrenia, and compare symptoms and psychosocial functioning between patients with schizophrenia who were seropositive and seronegative for these antibodies. In this case-control comparison, by combining new and existing studies, we included patients diagnosed with schizophrenia from four independent cohorts for whom anti-NMDAR serostatus had been assessed (or could be assessed by us) with live cell-based assays. Included cohorts were from the EULAST study (a trial conducted across 15 European countries and Israel), the OPTiMiSE study (an interventional study in Europe), and the PPiP1 and PPiP2 studies (conducted in the UK). Patients from these cohorts were analysed if they had complete Positive and Negative Syndrome Scale (PANSS) data. No participant had been diagnosed with autoimmune encephalitis or received treatment for this condition. After calculating the prevalence of serum anti-NMDAR antibodies, we examined possible differences in PANSS scores (negative, positive, and general symptom subscales, and total score) between anti-NMDAR-seropositive and anti-NMDAR-seronegative patients. Psychosocial functioning as measured by Personal Social Performance (PSP) score was also compared. All analyses were exploratory and no adjustment was done for multiple testing. People with lived experience were not involved in the conduct of this study. We collected individual patient data from 1114 patients with schizophrenia across the four cohorts. The study population had a mean age of 28·6 years (SD 7·6) and comprised 382 (34·3%) women and 732 (65·7%) men, including patients of White (929 [83·4%]), Asian (54 [4·8%]), Black (68 [6·1%]), and other (62 [5·6%]) ethnicities. Overall, 41 (3·7%) participants (range 3·1-4·0% across cohorts) tested positive for serum anti-NMDAR antibodies. Lower symptom severity on the negative symptoms PANSS subscale was observed for anti-NMDAR-seropositive patients (mean score 15·8 [SD 6·4]) than for anti-NMDAR-seronegative patients (18·2 [6·8]; Cohen's d=0·36; p=0·026), as well as on the general symptoms PANSS subscale (32·9 [8·9] vs 36·1 [10·1]; d=0·33; p=0·029) and total PANSS score (65·5 [18·5] vs 72·6 [19·3]; d=0·37; p=0·013). Mean PSP score was better in anti-NMDAR-positive patients (62·0 [17·0]) than in anti-NMDAR-negative patients (53·5 [16·3]; d=0·52; p=0·014). Serum NMDAR antibodies are present in 3-4% of patients with schizophrenia and are associated with relatively low severity of negative symptoms and relatively good psychosocial functioning. Thus, although the findings await replication in cohorts from other geographical regions, serum anti-NMDAR antibodies might be associated with a different form of psychotic illness. These findings could inform future prognostic and interventional studies examining whether anti-NMDAR antibodies are associated with a specific course of illness or with treatment response. None.

Participation in Non-small Cell Lung Cancer Clinical Trials in the United States by Race/Ethnicity

IntroductionDespite efforts by Cancer Centers and community organizations to increase diversity in clinical trials, significant racial/ethnic disparities remain. Given the high mortality rates in non-small cell lung cancer (NSCLC), it is important to increase diversity in NSCLC trials, ensuring all patients benefit from advances in new treatment modalities. Materials and MethodsWe evaluated the distribution of racial/ethnic minority enrollment in NSCLC clinical trials using data from ClinicalTrials.gov. We extracted trial characteristics, including start year, study phase, tumor stage, sample size, sponsor, geographic region, and masking. The number of participants by race/ethnicity was obtained from ClinicalTrials.gov or linked publications. Using annual NSCLC incidence data from SEER*Stat for each racial/ethnic group from 2010 to 2019, we applied a 2-sample test for equality of proportions with continuity correction to assess differences between incidence and trial participation. ResultsA total of 147 unique studies were included in the final analysis. Of the 28,540 participants, 79.6% were White, with 3% Black, 10.4% Asian or Pacific Islander and 3.4% Hispanic/Latino. Most participants were enrolled in phase III trials (63.8%), industry-sponsored (93.9%), and open-label (67.7%). Black patients were more commonly enrolled in academic sponsored trials and less commonly enrolled in masked (i.e., blinded) studies. When comparing trial participation to annual incidence data, we observed underrepresentation among Black participants (Difference: −7.9%) and Hispanic/Latino participants (Difference: −3.2%). ConclusionPersistent underrepresentation exists in NSCLC clinical trials among Black and Hispanic/Latino patients. We urge further investigation of these findings through well-designed clinical trials among diverse patient populations.

Ecometrics demonstrates that the functional dental traits of carnivoran communities are filtered by climate.

Terrestrial carnivorans, with their diverse diets and unique adaptations such as the carnassial tooth, offer insights into the connections between functional traits and the climatic and environmental conditions they inhabit. They shed light on functional trait-environment relationships at the highest trophic levels across a broad range of environmental conditions. In this study, we evaluate the relationship between relative blade length (RBL) of the lower carnassial tooth, a key dietary adaptation among terrestrial carnivorans for slicing and grinding food items, and climate. We propose RBL as an ecometric trait and test the hypothesis that community-level RBL is correlated with climate and mediated by environmental effects on food availability. Our findings show that communities with higher mean and broader variance of RBL are typically located in warmer and wetter climates, suggesting a relationship between carnivoran dietary diversity and climate. Conversely, communities with a lower mean and narrower variance of RBL predominantly occupy cooler, drier places. This indicates that community-level carnivoran dietary traits have the potential to serve as indicators of environmental conditions. Given the robust fossil record associated with carnivorans, we also show how RBL can be used as a proxy for reconstructing paleoclimates by examining trait change at seven sites in North America to estimate changes in temperature and precipitation over time in relation to changes in carnivoran community assembly. Understanding the nature of trait-environment relationships can help us anticipate biological impacts of ongoing environmental change and the geographic regions at the greatest risk of ecological disruption.

Preterm Infant Enteral Feeding Practices in Saudi Arabia: A Scoping Review

Abstract Background: Preterm infants are at risk of developing nutritional deficiencies, which is further compounded by the fact that providing them with adequate nutrition is often challenging. Enteral feeding (EF) practices vary across neonatal units and can be impacted by the setting and geographical region. There is also a lack of evidence on best practices. Objective: To investigate EF practices and related nutrition factors, patterns, and outcomes in preterm infants in Saudi Arabia by examining studies published in this area. Methods: A search was conducted for articles on EF practices among preterm infants in Saudi Arabia that were published between January 2010 and May 2024. Searches were carried out across five electronic databases and through searching inward and backward citation and reference lists of relevant papers. Studies that described or assessed EF practices used in preterm infants from any region of Saudi Arabia and were published in English or Arabic were included. Results: The database and manual search resulted in 1905 articles. After removing duplicates and applying the inclusion/exclusion criteria, 14 publications were included: 12 were observational studies, 1 was a conference abstract (with retrospective analysis), and 1 was a commentary. Of these, 7 studies were conducted in the Central Province, 6 in the Western Province, and 1 in the Eastern Province. More than half of the publications (8 of 14) were published between 2021 and 2023. The studies included were categorized to three themes based on their aim: studies describing practices on mother–infant bond to encourage breastfeeding, assessing nutritional status and EF, and assessing EF as a risk factor for developing prematurity complications. Conclusion: While research activity on EF practices in Saudi Arabia has increased very recently, yet there is a paucity of studies, particularly experimental studies that focus on both short- and long-term health outcomes.

Geographical Differences in the Safety and Efficacy of Tofacitinib Versus TNFi: APost Hoc Analysis of ORAL Surveillance.

In ORAL Surveillance, incidence rates (IRs) of major adverse cardiovascular events (MACE) and malignancies (excluding non-melanoma skin cancer [NMSC]) in cardiovascular (CV)-risk-enriched patients with rheumatoid arthritis (RA) were numerically greater with tofacitinib in North America versus the rest of the world, due to underlying risk factors. Here, we evaluated the safety and efficacy of tofacitinib versus tumor necrosis factor inhibitors (TNFi) among patients with RA across geographical regions. Patients with RA in ORAL Surveillance (NCT02092467), who were aged ≥ 50years with ≥ 1additional CV risk factor, received tofacitinib 5 or 10mg twice daily or TNFi; 45.9% were from either Poland or North America. This post hoc analysis stratified patients by region (Poland, North America, Other countries). Efficacy endpoints included Clinical Disease Activity Index, Disease Activity Score in 28 joints, with C-reactive protein (DAS28-4[CRP]), and Health Assessment Questionnaire-Disability Index (HAQ-DI). IRs and hazard ratios for adverse events were reported. Of 4362 patients (Poland, N = 759; North America, N = 1243; Other countries, N = 2360), more patients from North America versus Poland/Other countries had CV risk factors such as body mass index ≥ 30kg/m2 and history of diabetes/hypertension; however, more patients from Poland versus other regions were ever smokers and more patients from Poland/North America versus Other countries had history of coronary artery disease. MACE IRs were similar in North America and Poland, and numerically higher versus Other countries. IRs for malignancies (excluding NMSC) were numerically higher in NorthAmerica versus Poland/Other countries with tofacitinib. Serious infections IRs werenumerically higher in North America versus Poland across treatments. Venousthromboembolism/all-cause mortality IRs were generally comparable across regions. DAS28-4(CRP)/HAQ-DI improvements were generally lowest in North America. Differences in safety outcomes were driven by the presence of baseline risk factors; North America and Poland demonstrated a higher proportion of patients with some baseline CV risk factors/comorbidities versus Other countries. NCT02092467 (ClinicalTrials.gov).

Diagnostic evaluation for abnormal uterine bleeding at emergency departments in the United States.

269 Background: Uterine cancer is the most common gynecologic malignancy in the U.S. with well-documented racial disparity in stage at diagnosis (more advanced stage among Black women). As there is no routine screening for uterine cancer, timely and proper evaluation of relevant symptoms is important for early diagnosis. Abnormal uterine bleeding (AUB) is a prominent symptom of uterine cancer, yet data on the quality of care around AUB evaluation are sparse, especially among patients presenting to the emergency departments (ED) who are particularly at risk for delayed diagnosis due to lack of access to primary care. This study aimed to examine the pattern of diagnostic evaluation for AUB in a national sample of women seeking care at EDs and potential racial and ethnic differences. Methods: Using the 2014-2021 National Hospital Ambulatory Medical Care Survey (NHAMCS) data, we identified 7,900,653 (weighted) women without previous cancer diagnosis who visited ED for non-pregnancy related AUB. The primary outcomes were whether an ultrasound was performed/ordered at the ED visit and whether a referral/return to a physician or clinic for follow-up consultation was recommended. Multivariable logistic regressions were fit to assess the association of race and ethnicity with these diagnostic evaluations, while accounting for other characteristics of the ED visit (e.g. patient age, comorbidities, involvement of a consulting physician, type of insurance, geographic region, and metropolitan area location). All analyses accounted for the NHAMCS complex sample design and sampling weight to generate nationally representative estimates. Results: Non-Hispanic Black women were less likely than non-Hispanic White women to receive or have an ultrasound ordered (34.9% vs 42.5%, P = 0.004), which remained statistically significant after adjusting for other characteristics of the visit in multivariable analysis (adjusted OR = 0.58, 95% CI 0.36-0.92). Multivariable analysis also showed a lower likelihood of non-Hispanic Black women receiving referral or recommendation for follow-up consultation, compared to non-Hispanic White women (adjusted OR = 0.54, 95% CI 0.31-0.94). Hispanic women did not differ significantly from non-Hispanic White women in these measures. Perimenopausal age (45-54 years) and location in a non-metropolitan area were associated with a lower likelihood of having an ultrasound performed/ordered or a referral/follow-up consultation recommended. Involvement of a consulting physician at the ED visit increased the likelihood of having an ultrasound performed/ordered while reducing the likelihood of referral/recommendation for follow-up consultation. Conclusions: There is racial disparity in the diagnostic evaluation of AUB among women seeking care at EDs. Future efforts to improve care quality and equity in this area may help reduce disparities in early diagnosis of uterine cancer.

Coinfection of human adenovirus and recombinant human astrovirus in a case of acute gastroenteritis: A report from China.

Diarrhea is one of the major public health issues worldwide. Although the infections of individual enteric virus have been extensively studied, elucidation of the coinfection involving multiple viruses is still limited. In this study, we identified the coinfection of human adenovirus (HAdV) and human astrovirus (HAstV) in a child with acute gastroenteritis, analyzed their genotypes and molecular evolution characteristics. The sample was collected and identified using RT-PCR and subjected to whole-genome sequencing on the NovaSeq (Illumina) platform. Obtained sequences were assembled into the complete genome of HAdV and the ORF1 of HAstV. We conducted phylogenetic analysis using IQ-TREE software and conducted recombination analysis with the Recombination Detection Program. The sequenced HAdV was confirmed to be genotype 41, and was genetically close to some European strains. Phylogenetic analysis revealed that the HAstV was genetically close to both HAstV-2 and HAstV-4 and was different from the genotype prevalent in Shenzhen before. The recombination analysis confirmed that the sequenced HAstV strain is a recombinant of HAstV-2 and HAstV-4. Our analysis has shown that the strains in this coinfection are both uncommon variants in this geographical region, instead of dominant subtypes that have prevailed for years. This study presents a coinfection of HAdV and HAstV and conducts an evolutionary analysis on involved viruses, which reveals the genetic diversity of epidemic strains in Southern China and offers valuable insights into vaccine and medical research.

Application of Community Detection Methods to Identify Emergency General Surgery–Specific Regional Networks

There is growing interest in developing coordinated regional systems for nontraumatic surgical emergencies; however, our understanding of existing emergency general surgery (EGS) care communities is limited. To apply network analysis methods to delineate EGS care regions and compare the performance of this method with the Dartmouth Health Referral Regions (HRRs). This cross-sectional study was conducted using the 2019 California and New York state emergency department and inpatient databases. Eligible participants included all adult patients with a nonelective admission for common EGS conditions. Interhospital transfers (IHTs) were identified by transfer indicators or temporally adjacent hospitalizations at 2 different facilities. Data analysis was conducted from January to May 2024. Admission for primary EGS diagnosis. Regional EGS networks (RENs) were delineated by modularity optimization (MO), a community detection method, and compared with the plurality-based Dartmouth HRRs. Geographic boundaries were compared through visualization of patient flows and associated health care regions. Spatial accuracy of the 2 methods was compared using 6 common network analysis measures: localization index (LI), market share index (MSI), net patient flow, connectivity, compactness, and modularity. A total of 1 244 868 participants (median [IQR] age, 55 [37-70 years]; 776 725 male [62.40%]) were admitted with a primary EGS diagnosis. In New York, there were 405 493 EGS encounters with 3212 IHTs (0.79%), and 9 RENs were detected using MO compared with 10 Dartmouth HRRs. In California, there were 839 375 encounters with 10 037 IHTs (1.20%), and 14 RENs were detected compared with 24 HRRs. The greatest discrepancy between REN and HRR boundaries was in rural regions where one REN often encompassed multiple HRRs. The MO method was significantly better than HRRs in identifying care networks that accurately captured patients living within the geographic region as indicated by the LI and MSI for New York (mean [SD] LI, 0.86 [1.00] for REN vs 0.74 [1.00] for HRR; mean [SD] MSI, 0.16 [0.13] for REN vs 0.32 [0.21] for HRR) and California (mean [SD] LI, 0.83 [1.00] for REN vs 0.74 [1.00] for HRR; mean [SD] MSI, 0.19 [0.14] for REN vs 0.39 [0.43] for HRR). Nearly 27% of New York hospitals (37 of 139 hospitals [26.62%]) and 15% of California hospitals (48 of 336 hospitals [14.29%]) were reclassified into a different community with the MO method. Development of optimal health delivery systems for EGS patients will require knowledge of care patterns specific to this population. The findings of this cross-sectional study suggest that network science methods, such as MO, offer opportunities to identify empirical EGS care regions that outperform HRRs and can be applied in the development of coordinated regional systems of care.

Long‐term and landscape impacts of buffel grass on arid plant communities: Ecosystem shifts and acceleration by fire

AbstractPlant invasions drive biodiversity loss, transform ecosystems, and promote positive‐feedback cycles between invasion and fire. However, the long‐term impacts of invasive grasses across landscapes with diverse plant communities and interactions with fire are poorly known. Our objectives were to examine whether buffel grass (Cenchrus ciliaris), a globally significant plant invader, altered the abundance of understory and overstory plants, homogenized plant composition, and shifted ecosystems from woodlands to grassland and to explore interrelationships between invasion and fire. We combined two methodological approaches to assess invasion spread and impacts of buffel grass in the Aṉangu Pitjantjatjara Yankunytjatjara (APY) Lands of arid central Australia: a before‐after‐control‐impact (BACI) experiment over 25 years at 15 sites and a paired‐plot (randomized‐block) experiment at 18 sites. Both experiments spanned two geographic regions and multiple vegetation communities situated on flat plains and rocky hills. We used generalized linear mixed models to analyze predictions about plant abundance and permutational multivariate ANOVA (PERMANOVA) and permutational multivariate analysis of dispersion (PERMDISP) to examine changes in community composition. Fire and invasion interactions were explored using fire history or the relative fire tolerance of plant species as covariates, predictors, or responses. Fire interacted with the invasion process in multiple ways. Invaded sites had burnt more frequently and recently than native sites in one region, and where propagules were present in 1995, buffel grass abundance increased most when fires ensued. Abundance of understory plant functional groups (native grasses, ferns, and vines) decreased with invasion, and understory shrubs decreased due to frequent fires in invaded sites. Overstory composition shifted from fire‐sensitive species toward fire‐tolerant species, but this was not directly attributable to invasion. Partial evidence for ecosystem regime shifts included homogenization of understory communities in invaded rocky hills, and an increase in woody shrub cover at native but not invaded sites over 25 years, resulting in a 5% cover difference by 2019. Impacts were detected across heterogeneous ecological communities at a scale not previously tested amongst high background community variability. Although invasion is not dependent on fire, the acceleration of invasion spread and impacts with fire is a critical consideration for future research and management of grass invaders.

Revisiting factors influencing premature closure of small-scale miners: A case study of quarry mines

This study accentuates the significant contribution of small-scale mining (SM) to stimulating economic development, providing employment, and developing infrastructure. Nevertheless, the continuing premature shutdown of SM bodes ill for economic recovery. To get an idea of these underlying reasons, a systematic review of all articles published in the scientific literature was calculated using Web of Science, Scopus, and Google Scholar. The application of Boolean operators guided the collection of key insights utilising the PRISMA protocol. Tools like ggplot2 (for graphs) and word clouds in RStudio helped us recognise patterns. Analysis was facilitated with ggplot2, showing boxplots and bar charts of quantitative variables between quarry types and geographical regions. At the same time, word clouds also gave us insights into the most common expressions and, thus, the main reasons behind quarry closures. Further, the research revealed a lack of subsurface geological data, which is needed to estimate mineral resources in SM accurately. It also identified a relation with under-exploration leading to early abandonment which in turn increases the chance of misclassification of mineral reserves. Consequently, the study advocates for further research to devise practical strategies for managing mineral resources effectively in small-scale mining operations.

“Why Should We Care?”: Motivations of Public Librarians in the American South to Expand Civic Engagement for Racial Justice

ABSTRACTAn important aspect of human information behavior research is to understand the motivations of people as they interact with information and technologies to make a difference. This paper presents exploratory findings of a qualitative study of public librarians' motivations to expand civic engagement for racial justice in the American South. The geographical region is stereotypically characterized historically as being solely racially intolerant in public perceptions, scholarly discourse, political networks, and news media. This research challenges such limited notions, highlighting public librarian's logic‐based motivations to further civic engagement for racial justice in context of the nation's historical/contemporary racialized political climate. In the process, the authors acknowledge the voices/perspectives of public librarians, an often‐underrepresented group in privileged academic information behavior research. Thematic narrative analysis is explored as a strategic mode of presenting the findings.

Digital economy and green transformation of regional industries: New insights from sustainability.

Studying the impact of the digital economy on carbon emissions in the distribution industry is of great significance for realizing sustainable development goals and coping with climate change. This study finds that increasing the level of digital economy development can reduce the carbon emission intensity of the circulation industry through fixed-effects modeling. Moreover, the effect is different in different geographic regions, and the improvement of the digital economy development level in the east and central regions can significantly reduce the carbon emission intensity of the distribution industry. The digital economy can simultaneously reduce the carbon emission intensity of the circulation industry by reducing the degree of labor factor mismatch in the circulation industry and improving the regional green innovation capacity. Therefore, in order to promote the green development of the distribution industry, it is also necessary to make efforts to improve the construction of network infrastructure, accelerate the process of research and development and cultivation of green technology, and break down the barriers of cross-regional mobility of talents.

Meta-Analysis of the Relationship Between Occupational/Environmental Exposure to Wood Dust and Laryngeal Cancer.

Wood dust is a human carcinogen. However, studies examining the relationship between wood dust exposure and laryngeal cancer have yielded inconsistent findings. Therefore, we systematically reviewed relevant studies examining the relationship between wood dust exposure and laryngeal cancer development, followed by a meta-analysis. Publications in the following databases were searched: PubMed, Medline, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI). The Newcastle-Ottawa scale was used to evaluate the study quality. A random-effects model was used for the meta-analysis. Eighteen case-control studies and one cohort study, involving a total of 4426 patients with laryngeal cancer and 319,129 control participants, were identified. The association between occupational/environmental exposure to wood dust and laryngeal cancer, if any, was unclear (adjusted combined OR: 1.11; 95% CI: 0.94-1.31). However, subgroup analyses according to the number of cases, geographic region, publication year, and follow-up duration revealed correlations between wood dust exposure correlated and laryngeal cancer, as follows: number of cases > 200 (OR: 1.14; 95% CI: 1.01-1.25 [n = 10]); studies conducted in the US (OR: 1.21; 95% CI: 1.07-1.37 [n = 5]); follow-up time > 5 years (OR: 1.19; 95% CI: 1.07-1.32 [n = 10]); and publication after the year 2000 (OR: 1.15; 95% CI: 1.04-1.28 [n = 8]). A high heterogeneity in the results was observed (I2 = 42.5%, p = 0.024). The results were stable, and no publication bias existed, according to sensitivity analysis. This meta-analysis suggests that wood dust exposure is associated with laryngeal cancer. Additional large-scale studies are warranted to clarify the relationship between wood dust exposure and laryngeal cancer.

Scale-dependence in elk habitat selection for a reintroduced population in Wisconsin, USA.

Habitat selection is a critical aspect of a species' ecology, requiring complex decision-making that is both hierarchical and scale-dependent, since factors that influence selection may be nested or unequal across scales. Elk (Cervus canadensis) ranged widely across diverse ecoregions in North America prior to European settlement and subsequent eastern extirpation. Most habitat selection studies have occurred within their contemporary western range, even after eastern reintroductions began. As habitat selection can vary by geographic location, available cover, season, and diel period, it is important to understand how a non-migratory, reintroduced population in northern Wisconsin, USA, is limited by the lack of variation in topography, elevation, and vegetation. We tested scale-dependent habitat selection on 79 adult elk from 2017 to 2020 using resource selection functions across temporal (i.e., seasonal) and spatial scales (i.e., landscape and home range). We found that selection varied both spatially and temporally, and elk selected areas with the greatest potential to influence fitness at larger scales, meaning elk selected areas closer to escape cover and further from "risky" features (e.g., annual wolf territory centers, county roads, and highways). We found stronger avoidance of annual wolf territory centers during spring, suggesting elk were selecting safer habitats during calving season. Elk selected habitats with less canopy cover across both spatial scales and all seasons, suggesting that elk selected areas with better access to forage as early seral stage stands have greater forage biomass than closed-canopy forests and direct solar radiation to provide warmth in the cooler seasons. This study provides insight into the complexity of hierarchical decision-making, such as how risky habitat features and land cover type influence habitat selection differently across seasons and spatial scales, influencing the decision-making of elk. Scale-dependent behavior is crucial to understand within specific geographic regions, as these decisions scale up to influence population dynamics.

Global, regional, and national burden of upper respiratory infections, 1990–2021: findings from the global burden of disease study 2021

BackgroundUpper respiratory infections (URIs) are common infectious diseases worldwide. Accurate and timely assessment of the disease burden of URIs is crucial for governments to develop comprehensive prevention and control strategies, and to allocate and utilize healthcare resources more efficiently. MethodsFor URIs in Global Burden of Disease (GBD) 2021 database, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), age-standardized mortality rates (ASMR), disability-adjusted life-years (DALYs), and case numbers for incidence, prevalence, deaths, and DALYs across the globe, five socio-demographic Index (SDI) regions, 21 geographical regions, and 204 countries and territories were provided and analyzed. Trends from 1990 to 2021 were described using the average annual percentage change (AAPC), and future URIs burden was projected with a Bayesian age-period-cohort (BAPC) model. ResultsFrom 1990 to 2021, there was a significant decline in global ASIR (APCC = −289.86, 95% confidence interval [CI]: −298.59 – −281.12), ASPR (AAPC = −4.04, 95% CI: −4.16 – −3.92), ASMR (AAPC = −0.02, 95% CI: −0.02 – −0.03) and age-standardized DALY rate (AAPC = −0.75, 95% CI: −0.76 – −0.74). The ASIR, ASPR, ASMR, and age-standardized DALY rate were high in elderly for both males and females, and both genders. Similarly, the number of incident cases, prevalence cases, deaths, and DALY cases for URIs was highest in children under five years. The ASMR and age-standardized DALY rate exhibited a negative correlation with SDI across 204 countries and territories in 2021. The ASIR and ASPR for URIs will show an upward trend from 2022 to 2050, while ASMR and age-standardized DALY rate are expected to decline. Low birth weight for gestation remains the leading contributor to deaths related to URIs. ConclusionDespite the global decline in URIs burden, significant challenges remain among the elderly population. These findings support the optimization and implementation of public health policies, including targeted vaccination and integrated One Health approaches to reduce the burden in high-risk populations.

Dedicated OAM Oncology Navigation program to improve access to medication education, ePRO enrollment, and physician treatment plan completion adherence.

234 Background: Effective coordination of oncology care is essential for optimizing patient outcomes and ensuring adherence to treatment plans. When an Oncology Navigation program is implemented specifically related to patients on Oral Anticancer Medications (OAMs), it directly improves patient access to medication education and treatment adherence through enrollment in ePRO (electronic patient reported outcomes) tracking systems. Currently, there is limited evidence published related to the quantitative impact of dedicated OAM Navigation programs on patient treatment review and coordination visits, and provider completion adherence to treatment plans. Methods: This quality improvement initiative aimed to evaluate the impact of implementing an OAM Navigation program. Data were collected over a 90-day pilot period from a single geographic region within a community oncology practice. The patients’ medical records were reviewed to assess completion of treatment review and coordination visits by an APP or Physician, ePRO enrollment, and provider adherence to completion of treatment plans. Results: Analysis of the data revealed a significant increase in completed treatment review and coordination visits following the implementation of the OAM Navigation program, with a 28% increase observed compared to pre-implementation levels. Enrollment to ePRO system increased from 46 patients’ pre-pilot to 272 patients within the pilot period, a 491% increase in enrollment. Additionally, provider adherence to completion of treatment plans showed a marked improvement, increasing by 50% post-implementation. These findings suggest that the OAM Navigation program effectively facilitated enhanced quality and safety of care provided. Conclusions: Dedicated OAM Navigation programs play a crucial role in improving patient outcomes and optimizing oncology care delivery. Our findings demonstrate the significant positive impact of an OAM Navigation program on increasing patient education, ePRO enrollment, and improving provider adherence to completion of treatment plans. Incorporating OAM Navigation programs into ambulatory oncology practices can lead to more efficient and effective care coordination, ultimately enhancing the quality and safety of care. As we continue to expand and refine this program, we look forward to sharing our research findings and insights with the broader oncology healthcare community.

The Geometry of Flow: Advancing Predictions of River Geometry With Multi‐Model Machine Learning

AbstractHydraulic geometry parameters describing river hydrogeomorphic relationships are critical for determining a channel's capacity to convey water and sediment which is important for flood forecasting. Although well‐established, power‐law hydraulic geometry curves have been widely used to understand riverine systems and mapping flooding inundation worldwide for the past 70 years, we have become increasingly aware of their limitations. In the present study, we have moved beyond these traditional power‐law relationships, testing the ability of machine‐learning models to provide improved predictions of river width and depth. For this work, we have used an unprecedentedly large river measurement data set (HYDRoSWOT) as well as a suite of watershed predictor data to develop novel data‐driven approaches to better estimate river geometries over the contiguous United States (CONUS). Our Random Forest, XGBoost, and neural network models out‐performed the traditional, regionalized power law‐based hydraulic geometry equations for both width and depth, providing R‐squared values of as high as 0.75 for width and as high as 0.67 for depth, compared with R‐squared values of 0.45 for width and 0.18 for depth from the regional hydraulic geometry equations. Our results also show diverse performance outcomes across stream orders and geographical regions for the different machine‐learning models, demonstrating the value of using multi‐model approaches to maximize the predictability of river geometry. The developed models have been used to create the newly publicly available STREAM‐geo data set, which provides river width, depth, width/depth ratio, and river and stream surface area (%RSSA) for nearly 2.7 million NHDPlus stream reaches across the contiguous US.