High Rate Of Change Research Articles

Geospatial analysis of alarmingly increasing flood vulnerability and disaster risk within the northeast himalaya region of India

Geoenvironmetally the eastern part of the Himalaya region is highly vulnerable to flood and other natural disasters as it consists of fragmented and tectonically active geology and geomorphology, very high monsoon rainfall (>360 cm) and subsequent runoff, rugged hilly terrain with high ranges of elevation and slope, dense drainage density etc. Other hand, the unplanned developmental activities keep going and scaling up this vulnerability and risk to floods and other disasters. Addressing this burning issue, a geospatial technology-based case study of the Kohima district, Nagaland state (India), is presented here. The geospatial "technology-based" analyses employed in the study are thematic GIS mapping of flood hazard, vulnerability and risk controlling factors; and performing overlay operation using the AHP model in GIS software to generate spatio-temporal map layers of flood vulnerability and disaster risk. Results reveal that the region is under a high rate of monsoon climate change (increasing temperature, rainfall, rainy days, rainfall events and flood events with an annual rate of 0.35 %, 1.12 %, 0.36 %, 2.67 % and 4 % respectively), land use degradation (increasing built-up area with 0.60 %, annual rate decreasing forest, shrubs and water bodies with 0.80 % accumulated annual rates respectively) and demographic changes (increasing urban as well and rural population density with 0.53–2.10 % and 0.55–2.14 % respectively). Accumulated impacts of climate change, land use degradation and demographic changes causing an increase in flood hazard, vulnerability and disaster risk. Flood hazard zones and vulnerability zones extending with 0.50 % (4.89 km2) and 0.84 % (8.16 km2) annual rates respectively, subsequently the flood risk zones categorized as a moderate, high and very high potential risk, have been spreading out with a yearly rate of 0.07 % (0.65 km2), 0.13 % (1.31 km2) and 0.03 % (0.33 km2) respectively. It decreases the area under low and very low-risk zones by 0.17 % (1.63 km2) and 0.07 % (0.65 km2) annual rates respectively. Following up on these annual rates, the spatial distribution of flood hazard, vulnerability and risk zones for the next decade (2031–2040) have also been projected, revealing alarming situations, if flood disaster risk reduction (F-DRR) measures were not implemented in timely. It is strongly believed that the proposed study will be very useful for district-level planners and administrators to implement sustainable development planning, for the scientific fraternity to enhance their research work in the field of flood disaster management and for individuals for their safety in terms of life and property.

Изменения литоральных популяций рачков-балянусов Semibalanus balanoides (L.) Кольского залива и Восточного Мурмана в период потепления климата в Арктике

Methods for bioindication of early climate impacts in the marine ecosystem are unknown and being developed for the first time. The high rate of changes in the littoral barnacle Semibalanus balanoides (L.) populations is of key importance for bioindication. Mass mortality and significant decrease in the abundance over 1–3 years were observed in estuaries only and mainly associated with an increase of spring floods during the period of ongoing climate warming in the Arctic. The survival of the juveniles appeared in 2023 (up to 8000 sp/m2) fully depends on further climate changes.

Impact of 18F-FES PET/CT on Clinical Decisions in the Management of Recurrent or Metastatic Breast Cancer.

The clinical impact of 16α-18F-fluoro-17β-estradiol (18F-FES) PET/CT on patient management has not been well investigated. The aim of this study was to assess the clinical impact of 18F-FES PET/CT on the management of patients with recurrent or metastatic breast cancer. Methods: Study subjects were identified retrospectively from a database of a prospective trial for postmarketing surveillance of 18F-FES between 2021 and 2023. Patients who were suspected or known to have recurrent or metastatic estrogen receptor-positive breast cancer based on a routine standard workup were included. Planned management before and actual management after 18F-FES PET/CT were assessed by 2 experienced medical oncologists via medical chart review. A 5-point questionnaire was provided to evaluate the value of 18F-FES PET/CT for management planning. The rate of intention-to-treat and interdisciplinary changes, and the impact of 18F-FES PET/CT according to PET/CT result or clinical indication, were examined. Results: Of the 344 included patients, 120 (35%) experienced a change in management after 18F-FES PET/CT. In 139 (40%) patients,18F-FES PET/CT supported the existing management decision without a change in management. Intention-to-treat and interdisciplinary changes accounted for 64% (77/120) and 68% (82/120) of all changes, respectively. A higher rate of change was observed when lesions were 18F-FES-negative (44% [36/81]) than 18F-FES-positive (30% [51/172]) or mixed 18F-FES-positive/negative (36% [33/91]). Regarding clinical indications, the highest rate of change was shown when evaluating the origins of metastasis of double primary cancers (64% [9/14]). Conclusion: 18F-FES PET/CT modified the management of recurrent or metastatic breast cancer, serving as an impactful imaging modality in clinical practice.

A 14-year longitudinal study of neurofilament light chain dynamics in premanifest and transitional Huntington's disease.

Growing evidence supports the value of neurofilament light (NfL) as a prognostic biomarker in premanifest Huntington's disease (HD). To date, however, there has been no longitudinal study exceeding 3years examining either its serial dynamics or predictive power in HD. We aimed to conduct the first such study. Serum NfL was sampled using ultrasensitive immunoassay at four timepoints across a 14-year period in a cohort of HD gene carriers (n = 21) and controls (n = 14). Gene carriers were premanifest at baseline. Clinical features of HD were evaluated by Unified Huntington's Disease Rating Scale (UHDRS TMS), Montreal Cognitive Assessment (MoCA), Trail A/B task, Symbol Digit Modalities Task and semantic/phonemic fluency tasks. 14/21 HD gene carriers converted to prodromal or manifest disease by the final timepoint ("converters"). At baseline and each subsequent timepoint, NfL levels were higher in converters than in non-converters and controls (p = < 0.001-0.03, ηp2 = 0.25-0.66). The estimated rate of change in NfL was higher in converters than in non-converters (p = 0.03) and controls (p = 0.001). Baseline NfL was able to discriminate converters from non-converters (area under curve = 1.000, p = 0.003). A higher rate of change in NfL was predictive of more severe motor (UHDRS-TMS p = 0.007, β = 0.711, R2 = 0.468) and cognitive deficits (MoCA p = 0.007, β = -0.798, R2 = 0.604; Trail B, p = 0.007, β = 0.772, R2 = 0.567; phonemic fluency p = 0.035, β = -0.632, R2 = 0.345). Our data suggest that (1) NfL longitudinal dynamics in premanifest/transitional HD are non-constant; rising faster in those closer to disease onset, and (2) NfL can identify individuals at risk of conversion to manifest disease and predict clinical trajectory, > 10years from disease onset.

Predictive Modelling and Functional Group of Clay Soil Treated with Steel Slag and Calcium Carbide Residue

Swell-shrink subgrade soils like clay are rich in sulphate and exhibit a high rate of volume change by swelling and shrinking during wet and dry cycles, respectively, leading to heaves, cracks, and differential settlement of pavement layers. The aim of this study was to establish predictive simulation models and functional group of clay soil treated with steel slag and calcium carbide residue. Physical and geotechnical tests (such as California bearing ratio (CBR), compaction characteristics, and consistency parameters) were carried out on the unstabilised and stabilised clay soil. Using SPSS statistical software (version 23), multiple linear regression analysis was applied to the experimental data that relate CBR to compaction parameters and additive contents (steel slag and calcium carbide residues). The generated models gave a reliable coefficient of determination, R2 , of 0.990, and 0.998, which can be used to successfully predict both unsoaked and soaked CBR of the stabilised clay soil, respectively. Fourier transform infrared spectroscopy (FTIR) analysis was examined on the clay soil, the additives, and the stabilised clay soils. The FTIR analysis showed weak peaks at 1115 and 1103 cm-1 for all the stabilised clay soils, and this revealed that both additives drastically reduced the sulphate content in the clay soil, which consequently reduced the expansion, cracking, and disintegration rates. As a result, the clay soil's chemical bonding was enhanced through physico- chemical mechanisms.

Sturnidae sensu lato Mitogenomics: Novel Insights into Codon Aversion, Selection, and Phylogeny.

The Sturnidae family comprises 123 recognized species in 35 genera. The taxa Mimidae and Buphagidae were formerly treated as subfamilies within Sturnidae. The phylogenetic relationships among the Sturnidae and related taxa (Sturnidae sensu lato) remain unresolved due to high rates of morphological change and concomitant morphological homoplasy. This study presents five new mitogenomes of Sturnidae sensu lato and comprehensive mitogenomic analyses. The investigated mitogenomes exhibit an identical gene composition of 37 genes-including 13 protein-coding genes (PCGs), 2 rRNA genes, and 22 tRNA genes-and one control region (CR). The most important finding of this study is drawn from CAM analyses. The surprisingly unique motifs for each species provide a new direction for the molecular species identification of avian. Furthermore, the pervasiveness of the natural selection of PCGs is found in all examined species when analyzing their nucleotide composition and codon usage. We also determine the structures of mt-tRNA, mt-rRNA, and CR structures of Sturnidae sensu lato. Lastly, our phylogenetic analyses not only well support the monophyly of Sturnidae, Mimidae, and Buphagidae, but also define nine stable subclades. Taken together, our findings will enable the further elucidation of the evolutionary relationships within Sturnidae sensu lato.

Prognostic Importance of PTEN, p53, and MDM2 Expressions in Endometrioid and Serous-Type Endometrial Carcinomas

Aim: Endometrial carcinomas (ECs) are neoplasms with the highest rate of change in the phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) pathway. In this study, the relationship among PTEN, MDM2, and p53 protein expression in the PI3K/AKT/mTOR pathway with clinicopathological data in endometrioid endometrial carcinomas (EECs) and serous-type endometrial carcinomas (SECs) was evaluated. Material and Method: A hundred and twenty cases of patients who underwent hysterectomy for EC between 2009 and 2021 were included in the study. Thirty cases of SEC and 90 cases of EEC were evaluated. EEC cases consist of grades 1-3 tumors, and each group includes 30 patients. p53 was examined in two groups as normal/wild type and abnormal/mutant type. PTEN and MDM2 were examined in two groups: positive and negative. The relationship among p53, PTEN, and MDM2 immunohistochemical expression status with histological grade, myometrial invasion, cervical invasion, lymphovascular invasion (LVI), metastatic lymph nodes, presence of tumor in peritoneal fluid, tumor stage, and overall and progression-free survival was evaluated. Results: Loss of PTEN was associated with EEC compared to SEC (p

High-Contrast Thermochromism in Room-Temperature Transparent Layered Perovskite PEA2PbBr4 with a High Temperature-Induced Bandgap Change Rate of 0.8 meV/K.

Two-dimensional organic-inorganic hybrid layered perovskites have emerged as a new generation of optoelectronic materials. However, the thermochromism in organic-inorganic hybrid layered perovskites has been rarely explored in depth. A further understanding of the mechanism is necessary and favorable for the application. Here, transparent centimeter-sized single crystals of the organic-inorganic hybrid layered perovskite (C6H5C2H4NH3)2PbBr4 (PEA2PbBr4) were synthesized using an improved evaporation method. As a typical organic-inorganic hybrid layered perovskite, the PEA2PbBr4 single crystal shows high-contrast and progressive thermochromism exhibiting a change from colorlessness and transparency to lemon yellow in a wide temperature range of 200-450 K. Based on the calculation through the Varshni equation, the temperature-induced bandgap change rate directly associated with the high-contrast thermochromism of PEA2PbBr4 reaching 0.8 meV/K. This value is higher than that of many three-dimensional perovskites and traditional IV-III semiconductors. Furthermore, the temperature-dependent 193 nm photoluminescence spectra suggest that this high temperature-induced bandgap change rate of PEA2PbBr4 is a result of the competitive interaction between lattice thermal expansion and electron-phonon coupling (Fröhlich coupling coefficient ΓLO = 2.215). Based on the characteristics introduced above, PEA2PbBr4 as an organic-inorganic hybrid layered perovskite has a better performance in achieving the balance between high-contrast and high room-temperature transmittance. Therefore, PEA2PbBr4 is a material with great potential in applications like temperature-indicating labels. This work provides valuable insights into the thermochromism of layered perovskites, offering a new material system and approach for developing thermochromic materials with higher sensitivity and efficiency.

The highly dynamic satellitomes of cultivated wheat species.

Durum wheat, Triticum turgidum, and bread wheat, Triticum aestivum, are two allopolyploid species of very recent origin that have been subjected to intense selection programs during the thousands of years they have been cultivated. In this paper, we study the durum wheat satellitome and establish a comparative analysis with the previously published bread wheat satellitome. We revealed the durum wheat satellitome using the satMiner protocol which is based on consecutive rounds of clustering of Illumina reads by RepeatExplorer2, and estimated abundance and variation for each identified satDNA with RepeatMasker v4.0.5. We have also performed a deep satDNA families characterization including chromosomal location by Fluorescence In Situ Hybridization (FISH) in durum wheat and its comparison with FISH patterns in bread wheat. Basic Local Alignment Search Tool (BLAST®) was used for trailing each satDNA in the assembly of durum wheat genome through NCBI's Genome Data Viewer (GDW) and the genome assemblies of both species were compared. Sequence divergence and consensus turnover rate (CTR) between homologous satDNA families of durum and bread wheat were estimated using MEGA11. This study reveals that in an exceedingly short period, significant qualitative and quantitative changes have occurred in the set of satellite DNAs (satDNAs) of both species, with expansions/contractions of the number of repeats and the loci per satellite, different in each species, and a high rate of sequence change for most of these satellites, in addition to the emergence/loss of satDNAs not shared between the two species analysed. These evolutionary changes in satDNA are common between species but what is truly remarkable and novel about this study is that these processes have taken place in less than the last ~8000 years separating the two species, indicating an accelerated evolution of their satDNAs. These results, together with the relationship of many of these satellites with transposable elements and the polymorphisms they generate at the level of centromeres and subtelomeric regions of their chromosomes, are analysed and discussed in the context of the evolutionary origin of these species and the selection pressure exerted by man throughout the history of their cultivation.

The patterns of potential evapotranspiration and seasonal aridity under the change in climate in the upper Blue Nile basin, Ethiopia

Evapotranspiration is one of the determinant components of the hydrological process, highly influenced by climate change due to the increase in atmospheric temperature at global and regional scales. This study was designed to evaluate the extent to which climate change affects the Potential Evapotranspiration (PET) and the consequent Aridity Index (AI) in the high-emission scenario of Representative Concentration Pathways (RCPs) in the Gilgel Abay, Ribb, Gumara, and Megech watersheds using six Global Climate Models in the 2011–2040, 2041–2070, and 2071–2100 relative to the 1971–2000 (baseline period). The average PET is simulated using the Soil Water Assessment Tool (SWAT) model. Penman-Monteith and Hargreaves methods were used in the computation of PET using the water balance technique, and the Hargreaves method was found more efficient in calibration and validation processes. The Aridity Index (AI) of watersheds is calculated using the ratio of precipitation and potential evapotranspiration. The study revealed that the change in annual average PET is showing an increasing pattern in the three time periods, and the highest rate of changes in Megech, Gilgel Abay, Ribb, and Gumara, watersheds are 16.66%, 15.53%, 14.68%, and 13.46%, respectively in the 2071–2100 time period. Seasonally, the highest rate of change in PET is 20.37% (September), 19.29% (April), 17.46% (March), and 17.02% (March) in the Megech, Gilgel Abay, Ribb, and Gumara, respectively. Similarly, the seasonal highest change in Aridity Index (AI) is also likely to be observed in the 2071–2100 in which in the dry season, it accounts –0.303 (March), –0.299 (March), –0.285 (April), and –0.276 (April) in the Ribb, Gumara, Gilgel Abay, and Megech, respectively, whereas in the rainy season, the change is 0.263, 0.258, 0.238, and 0.211 in the Gilgel Abay, Gumara, Ribb, and Megech, respectively. In general, due to the rising atmospheric temperature, the amount of moisture during dry seasons in the headwater catchments of the upper Blue Nile basin is expected to deplete in the 21st century. Therefore, it is highly recommended to use different climate change adaptation mechanisms including adopting suitable physical and biological water conservation techniques to enhance the amount of water stored in the subsurface and joining the groundwater during the rainy season.

Stimulated Vocal Fold Immobility After Vagal Nerve Stimulator Placement: A Case Series.

Vagal nerve stimulator (VNS) implantation is a vital therapy for epilepsy refractory to other treatments; however, it is associated with a very high rate of voice changes. Relatively few of these patients are evaluated for vocal fold motion impairments. In this series, we evaluate 5 such patients with a novel phenotype of forced abduction with VNS stimulation. Retrospective case series. Five patients with a VNS implant who underwent operative direct or in-office rigid laryngoscopy and had vocal fold motion impairment associated with VNS activation are included. All 5 patients had vocal fold mobility with VNS off and a fixed with activation. All patients exhibited vocal fold abduction with VNS activation. Patient 2 has since undergone laryngeal reinnervation, which helped her intermittent dysphonia but left a small glottic gap. A type 1 thyroplasty corrected this gap and improved her voice further. Patient 3 has undergone laryngeal reinnervation for which early results show improvement in perceptual and patient reported outcomes. Patients 4 and 5 have both undergone laryngeal reinnervation with improvement in voice. Previous reported cases of stimulated immobility associated with VNS use describe only adduction of the vocal fold. This series expands the previous work showing the VNS activation can also cause stimulated immobility in an abducted position, for which reinnervation and other medialization procedures offer promising treatment.

Geospatial AI solution to monitor and mitigate increasing adverse ecological and hydrological impacts of climate change in Uttarakhand Himalaya (India).

Though climate change and its adverse ecological and geohydrological impacts are being experienced across the world in all types of ecosystems but as far as the Himalaya mountain ecosystem is concerned, the rate of climate change and subsequent impacts have reached an alarming stage due to anthropogenic and technogenic intervention on natural process and now need most effective and less time taking management strategy. Addressing this burning environmental problem, a geospatial artificial intelligence (GeoAI) technique-based case study is presented here from one of the most densely populated and urbanized regions of Himalaya mountain, viz Uttarakhand Himalaya, which is also called central Himalaya. The results of the study suggest that due to quite a high rate of climate change, the climatic zones shifting towards higher altitudes at the average rate of 5.6 2m/year, causing several adverse ecological impacts in terms of decreasing quality dense temperate forest cover (0.05%/year), snow cover (0.02%/year), water bodies (0.01%/year), agricultural land (0.31%/year), and horticultural land (0.01%/year). Conversion of these eco-friendly land use land cover into barren land, fallow land, and built-up land causes geohydrological consequences of climate change in terms of decreasing rainy days (1%/year), drying perennial springs (0.20%/year), perennial streams (0.11%/year), decreasing spring and stream discharge during non-monsoon season, increased extreme rainfall events (6-8%/year), and subsequent surface runoff during monsoon season. Further, the study advocates that the degraded geohydrological process has resulted in an increased frequency of disaster events (floods, cloudbursts, landslides. etc.) with a 3% (12 events) annual rate, causing great loss of environment, infrastructure, lives, and economy each year. Therefore, it has been very urgent to mitigate climate change and increase geohydrological disaster events through an integrated approach. Keep in view this, the present study proposed an integrated watershed management plan which is equally useful to be implemented across the Himalaya region and other similar ecosystems across the world.

Numerical investigation of annular expansion-deflection nozzle flow under varying backpressure changing rate

The characteristics of flow and thrust evolution of an annular Expansion-Deflection (ED) nozzle are numerically investigated under varying backpressure changing rates during ascending and descending trajectories. The objective is to test the sensitivity of unsteady behaviors of shock waves in the ED nozzle to backpressure changing rate, and to further elucidate the thrust evolution mechanism and mode transition hysteresis. The movement of shock reflection points on the nozzle wall follows two flow mechanisms, namely, shock self-excited oscillations and rapid backpressure changes. A low backpressure changing rate enables shock self-excited oscillations, leading to a reciprocating motion of the shock waves accompanied by thrust oscillations, while a high backpressure changing rate suppresses the shock self-excited oscillations, leading to a unidirectional motion of the wave system on the nozzle shroud wall. A criterion for distinguishing ED nozzle operation modes is proposed, which relies on the loading inflection points of the nozzle pintle base and exhibits a fast and user-friendly feature. A dual-wake mode hysteresis region is defined to quantify the hysteresis in nozzle mode transition, with the span of the region decreasing as the backpressure changing rate slows down. The present work helps in understanding the unsteady flow mechanism and thrust evolution in ED nozzles.

Appropriate Water and Nitrogen Regulation Promotes Soybean Yield Formation and Improves Water–Nitrogen Use Efficiency

To address water scarcity and soil damage in the Hexi Oasis irrigation area of China, a study was conducted on regulating water and nitrogen levels for soybean growth under film drip irrigation over two growing seasons (2020 and 2021). Two irrigation levels were tested: mild deficit (W1, 60–70% of field water capacity, FC) and full irrigation (W2, 70–80% of FC), along with three nitrogen levels: low (N1, 60 kg·ha−1), medium (N2, 120 kg·ha−1), and high (N3, 180 kg·ha−1). The control treatment was no nitrogen with full irrigation (W2N0), totaling seven treatments. Results showed that during both growing seasons, soybean plant height reached its peak at the tympanic ripening stage, while the leaf area index (LAI), net photosynthesis rate (Pn), and transpiration rate (Tr) decreased at the tympanic ripening stage. The highest values for the plant height, LAI, Pn, Tr, yield, and the cost–benefit ratio were observed under the W2N2 treatment, significantly outperforming the W2N0 in all aspects (p &lt; 0.05). Over the two-year period, the plant height and LAI were notably higher by 22.86% and 7.09%, respectively, in the W2N2 treatment compared to the W1N1. Full irrigation under N1 and N2 conditions resulted in an enhanced soybean Pn and Tr. However, under N3 conditions, a deficit-tuned irrigation treatment led to a 15.71% increase in the Pn and a 13.34% increase in the Tr on a two-year average. The W2N2 treatment had the highest yield, with a significant 4.93% increase over the W1N3 treatment on a two-year average. The highest rate of change in yield was observed in W1. The two-year cost–benefit ratio and unilateral water benefit reached their peak values in W2N2 and W1N2, respectively. Water use efficiency (WUE) was lower in N1 but significantly increased by 21.83% on a two-year average in W1N3 compared to W1N2. Additionally, W1 had a 14.21% higher WUE than W2 over two years. N3 had the lowest partial factor productivity of nitrogen, which increased by 17.78% on a two-year average in W2N1 compared to W1N1. All nine indicators related to yield formation and water–nitrogen use efficiency showed a positive correlation (p &lt; 0.05) in this study. The highest composite scores were achieved with the W2N2 treatment in both years using the entropy weight and TOPSIS method. Overall, the W2N2 treatment provides a water and nitrogen combination that enhances soybean water and fertilizer efficiency, making it a promising option for high-yield soybean cultivation with water and nitrogen conservation in the Hexi Oasis irrigation area of China. This study offers valuable insights for achieving efficient soybean production while saving water and reducing nitrogen use.

What Is the Epidemiology of Cervical and Thoracic Spine Fractures?

Vertebral fractures are associated with enduring back pain, diminished quality of life, as well as increased morbidity and mortality. Existing epidemiological data for cervical and thoracic vertebral fractures are limited by insufficiently powered studies and a failure to evaluate the mechanism of injury. What are the temporal trends in incidence, patient characteristics, and injury mechanisms of cervical and thoracic vertebral fractures in the United States from 2003 to 2021? The United States National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) database collects data on all nonfatal injuries treated in US hospital emergency departments and is well suited to capture epidemiological trends in vertebral fractures. As such, the NEISS-AIP was queried from 2003 to 2021 for cervical and thoracic fractures. The initial search by upper trunk fractures yielded 156,669 injuries; 6% (9900) of injuries, with a weighted frequency of 638,999 patients, met the inclusion criteria. The mean age was 62 ± 25 years and 52% (334,746 of 638,999) of patients were females. Descriptive statistics were obtained. Segmented regression analysis, accounting for the year before or after 2019 when the NEISS sampling methodology was changed, was performed to assess yearly injury trends. Multivariable logistic regression models with age and sex as covariates were performed to predict injury location, mechanism, and disposition. The incidence of cervical and thoracic fractures increased from 2.0 (95% CI 1.4 to 2.7) and 3.6 (95% CI 2.4 to 4.7) per 10,000 person-years in 2003 to 14.5 (95% CI 10.9 to 18.2) and 19.9 (95% CI 14.5 to 25.3) in 2021, respectively. Incidence rates of cervical and thoracic fractures increased for all age groups from 2003 to 2021, with peak incidence and the highest rate of change in individuals 80 years or older. Most injuries occurred at home (median 69%), which were more likely to impact older individuals (median [range] age 75 [2 to 106] years) and females (median 61% of home injuries); injuries at recreation/sports facilities impacted younger individuals (median 32 [3 to 96] years) and male patients (median 76% of sports facility injuries). Falls were the most common injury mechanism across all years, with females more likely to be impacted than males. The proportion of admissions increased from 33% in 2003 to 50% in 2021, while the proportion of treated and released patients decreased from 53% to 35% in the same period. This epidemiological study identified a disproportionate increase in cervical and thoracic fracture incidence rates in patients older than 50 years from 2003 to 2021. Furthermore, high hospital admission rates were also noted resulting from these fractures. These findings indicate that current osteoporosis screening guidelines may be insufficient to capture the true population at risk of osteoporotic fractures, and they highlight the need to initiate screening at an earlier age. Level III, prognostic study.

On the Transformation of the Organization of Scientific Activity in Russia

Rapid changes in the world order, digital transformation of human activity, and increased competition for a favorable future have formed a new focus of competition for digital innovation. The nature of development is changing – it is becoming socio-technological. Digitalization is fundamentally changing the field of science and technology and the requirements for the knowledge and skills of researchers. Changes in science act as a catalyst for further changes, the speed of which is increasing. Strengthening the role of artificial intelligence in the context of existing restrictions on its use leads to an increase in the role of humans as a task setter, a main partner participant, a beneficiary and even a sensor. Increasing competition for the future and aggravation of the geopolitical situation are leading to an increase in the importance of science, technology and innovation. This fundamentally changes the requirements for the organization of science, which requires the addition of the existing system of organizations with network communications of creative teams and researchers, the formation of hybrid intelligence through the joint training of humans and artificial intelligence. Science is becoming networked, going beyond the boundaries of organizations, acquiring regional and local components. In the context of a sharp increase in the diversity of digital innovations, scientific interaction between researchers with recognition (rating) in local fields of knowledge becomes a necessary condition. The high rate of change requires the inclusion of evaluation of the results of scientific activity in the research process. Effective results require the creation of processes for intelligent management of knowledge convergence and digital innovations of socio-technological development based on scientific knowledge.

Does a peer review group consensus process for MR-Linac patients affect clinical care? Evaluation of impact and feasibility

Background and purposePeer review is an important component of quality assurance in radiotherapy. To our knowledge, there are no studies reporting on the feasibility and outcomes of the peer review process for magnetic resonance (MR) guided radiotherapy (MRgRT) on the MR linear accelerator (MR-Linac) despite the planning complexity involved and its evolving clinical indications. This study aimed to quantify the rate of change in treatment plans post-peer review and the time and resources required. Materials and methodsFifty-five cases presented at weekly MR-Linac peer review meetings across two centres from 8 June to 21September 2023 were prospectively collected. Cases were analysed to determine the rate and extent of plan changes based on the Peer Review Audit Tool for radiation oncology (PRAT) developed by the Royal Australian and New Zealand College of Radiologists (RANZCR). ResultsPeer review resulted in changes to 36.4 % of treatment plans (n = 20), with 3.6 % (n = 2) having major changes requiring deferment of treatment. The most frequent changes were to organs at risk (OAR) volumes involving both delineation and increased OAR sparing (16.4 %, n = 9), total dose and fractionation (10.9 %, n = 6) and target volume dose coverage (5.5 %, n = 3). Patients with SBRT plans (39.1 % cf 22.2 %), oligometastatic/oligoprogressive sites (38.1 % cf 30.7 %) and reirradiation cases (41.2 % cf 34.2 %) had higher rates of change. Cases took a mean of 7 min (range 2–15 minutes) to discuss. ConclusionThe high rates of plan changes support the value of peer review in MRgRT. We recommend, where possible that all MRgRT cases, particularly those involving SBRT plans, oligometastatic/oligoprogressive sites, and/or reirradiation, be subject to peer review.

Antimicrobial Stewardship Practice Changes Following a Statewide Educational Conference in Nebraska

Background: In 2023, Nebraska held its 4th state antimicrobial stewardship (AS) educational conference, an annual one-day in-person event with continuing education offered for nurses, pharmacists, microbiology lab technicians, and physicians. One challenge of educational events is determining if content has been translated into practice. We sought to assess AS-related practice changes implemented by conference attendees. Methods: Conference attendees were sent 2 surveys by email following the conference. Survey 1 questions were integrated into the continuing education credit evaluation immediately following the conference. Survey 2 was sent three months later to all registered attendees. Qualitative responses were grouped by theme and descriptive statistics were used to evaluate Results: There were 203 attendees from across the state including a diverse group of learners (Table 1) representing metropolitan and rural areas of Nebraska (Figure 1) from acute care hospitals, critical access hospitals, long-term care settings, and public health. A total of 148 attendees (73%) answered questions in Survey 1 (Table 2), and 79 (39%) attendees responded to Survey 2. On Survey 1, 94% of respondents indicated that they intended to make practice changes, though 60% anticipated barriers including further staff training needs and lack of resources and health system support. On Survey 2, 83% of respondents indicated successful implementation of practice changes at three months after the conference. The most common practice changes included enhanced communication strategies, improved antibiotic tracking, monitoring, and review, policy and procedure updates, and AS tool implementation. On Survey 1, 26% (35/131) strongly agreed that their ability to treat patients was adequate prior to the conference; this increased to 55% (72/131) post-conference. On Survey 2, 56% (22/39) of respondents reported improvement in patient outcomes because of implemented practice changes following conference attendance. However, some also mentioned a short follow-up survey timeline as a limitation in assessing patient outcome improvements. Reported outcomes included improved receptiveness from providers, patients, and families to antibiotic use recommendations, shorter prescribed durations, and more appropriate initial antibiotic selection. Improved team performance was noted by 73% (27/37) of respondents. Themes included improved communication with internal and external stakeholders, more collaborative team discussions, increased confidence in recommendations, expanded provider and staff engagement, and increased leadership involvement. Conclusions: In addition to improved knowledge and understanding for a variety of AS-related areas, attendees of the conference also reported a high rate of practice changes that led to perceived improvements in patient outcomes and team function.

High Rate of Change of the Foot in Ecuadorian Children: The Need for Proper Shoe Design.

Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys and girls during childhood and adolescence. A total of 1678 Ecuadorian children aged 8 to 17 years participated in the study. The length, width, and height of the foot were analyzed using a 3D scanner to obtain the arch height ratio for the diagnosis of pediatric flat foot. Statistical differences were observed for lengths, widths, and perimeters of the foot in boys aged 5 to 15-16 years and girls aged 5 to 12-13 years. Differences in the height of the navicular bone were found in all age groups, with changes from 2.8 to 4.1% in boys and from 1.3 to 1.5% in girls. The greatest differences between boys and girls of the same age were found at 14 years old onwards. The highest prevalence of flat foot was found in 8-year-old girls (64.9%) and in 12-year-old boys (82.5%). The feet of Ecuadorian children develop progressively during childhood and adolescence. Boys presented with longer and wider feet than girls of the same age. The highest prevalence of flat foot was found in 12-year-old boys and 8-year-old girls.

Temporal-spatial change of China's coastal ecosystem resilience and driving factors analysis

Coastal regions, with both marine and terrestrial characteristics, play an important role in the global ecosystem and their ecological and environmental conditions are of global concern. A better understanding of regional differences in coastal resilience and its drivers facilitates ecosystem management and restoration. In this study, the level of ecological resilience of China's coastal regions from 2000 to 2020 was assessed using a three-pronged resilience assessment framework of resistance, adaptability and resilience, and the key drivers of ecological resilience were identified using geographic probes and geographically weighted regression analyses. The results of the study indicate that: (1) the ecological resilience of China's coastal region is spatially distributed as high resilience in the southern part of the study area and low resilience in the northern part of the study area; (2) the areas with higher rates of change are distributed in the Bohai Bay, Yangtze River estuary and Pearl River estuary; (3) in terms of drivers, economic development factors and environmental protection measures have a relatively large impact on changes in resilience and vary from region to region. The case study provides a systematic and quantitative framework for assessing the resilience of integrated coastal management and sustainable development.