Long-term Changes Research Articles

"COVID-19 and the New Hidden Curriculum of Moral Injury and Compassion Fatigue".

Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.

Differential Effect of Aortic Valve Replacement for Severe Aortic Stenosis on Hyperemic and Resting Epicardial Coronary Pressure Indices.

Coronary pressure indices to assess coronary artery disease are currently underused in patients with aortic stenosis due to many potential physiological effects that might hinder their interpretation. Studies with varying sample sizes have provided us with conflicting results on the effect of transcatheter aortic valve replacement (TAVR) on these indices. The aim of this meta-analysis was to study immediate and long-term effects of TAVR on fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs). Lesion-specific coronary pressure data were extracted from 6 studies, resulting in 147 lesions for immediate change in FFR analysis and 105 for NHPR analysis. To investigate the long-term changes, 93 lesions for FFR analysis and 68 for NHPR analysis were found. Lesion data were pooled and compared with paired t tests. Immediately after TAVR, FFR decreased significantly (-0.0130±0.0406 SD, P: 0.0002) while NHPR remained stable (0.0003±0.0675, P: 0.9675). Long-term after TAVR, FFR decreased significantly (-0.0230±0.0747, P: 0.0038) while NHPR increased nonsignificantly (0.0166±0.0699, P: 0.0543). When only borderline NHPR lesions were considered, this increase became significant (0.0249±0.0441, P: 0.0015). Sensitivity analysis confirmed our results in borderline lesions. TAVR resulted in small significant, but opposite, changes in FFR and NHPR. Using the standard cut-offs in patients with severe aortic stenosis, FFR might underestimate the physiological significance of a coronary lesion while NHPRs might overestimate its significance. The described changes only play a clinically relevant role in borderline lesions. Therefore, even in patients with aortic stenosis, an overtly positive or negative physiological assessment can be trusted.

Long-term clinical observation of patients with heterozygous KIF1A variants.

KIF1A-related disorders (KRDs) encompass recessive and dominant variants with wide clinical variability. Recent genetic investigations have expanded the clinical phenotypes of heterozygous KIF1A variants. However, there have been a few long-term observational studies of patients with heterozygous KIF1A variants. A retrospective chart review of consecutive patients diagnosed with spastic paraplegia at Miyagi Children's Hospital from 2016 to 2020 identified six patients with heterozygous KIF1A variants. To understand the long-term changes in clinical symptoms, we examined these patients in terms of their characteristics, clinical symptoms, results of electrophysiological and neuroimaging studies, and genetic testing. The median follow-up period was 30 years (4-44 years). This long-term observational study showed that early developmental delay and equinus gait, or unsteady gait, are the first signs of disease onset, appearing with the commencement of independent walking. In addition, later age-related progression was observed in spastic paraplegia, and the appearance of axonal neuropathy and reduced visual acuity were characteristic features of the late disease phenotype. Brain imaging showed age-related progression of cerebellar atrophy and the appearance of hyperintensity of optic radiation on T2WI and FLAIR imaging. Long-term follow-up revealed a pattern of steady progression and a variety of clinical symptoms, including spastic paraplegia, peripheral neuropathy, reduced visual acuity, and some degree of cerebellar ataxia. Clinical variability between patients was observed to some extent, and therefore, further studies are required to determine the phenotype-genotype correlation.

A likely role for stratification in long-term changes of the global ocean tides

A likely role for stratification in long-term changes of the global ocean tides

Anaerobically mineralized nitrogen as a potential indicator of the activity and abundance of mycorrhizal fungi in Mollisols

Anaerobically mineralized nitrogen (AN) is a suitable soil health indicator. The AN is sensitive to soil use changes and is related to soil and particulate organic carbon and aggregate stability. This work aims to evaluate the relationship between AN and 1) easily extractable glomalin-related soil proteins; 2) abundance of arbuscular mycorrhizal fungi measured by the number of arbuscular mycorrhizal fungi spores, and 3) arbuscular mycorrhizal fungi activity (root colonization). Soil samples were taken at depths of 0-5 and 5-20 cm from cultivated and uncultivated plots throughout the southeastern province of Buenos Aires. Anaerobically mineralized nitrogen, soil organic carbon, particulate organic carbon, aggregate stability, easily extracted glomalin-related soil proteins and the logarithm of the number of arbuscular mycorrhizal fungi spores (log spores) at 0-5, 5-20 and 0-20 cm depths were determined. In wheat roots, the percentages of total infection and arbuscules at 0-20 cm were measured. At all depths, AN was positively correlated to easily extractable glomalin-related soil proteins (r=0.34-0.65), which is an indicator of arbuscular mycorrhizal fungi activity and abundance. Likewise, AN was positively related to log-spores (r=0.58-0.78), which is an indicator of arbuscular mycorrhizal fungi abundance. However, AN was not related to root colonization (the percentages of total infection and arbuscules) that manifests the activity of arbuscular mycorrhizal fungi at a specific moment. Thus, anaerobically mineralized nitrogen would be an indicator of mid- to long-term changes in arbuscular mycorrhizal fungi abundance and activity (easily extractable glomalin-related soil proteins and log-spores) resulting from soil use. Consequently, the AN would allow monitoring an important aspect of soil microbiological health associated with arbuscular mycorrhizal fungi. However, it is necessary to evaluate the relationships studied in this work in a wider range of soil situations.

A large-scale high-resolution numerical model for sea-ice fragmentation dynamics

Abstract. Forecasts of sea-ice motion and fragmentation are of vital importance for all human interactions with sea ice, ranging from those involving indigenous hunters to shipping in polar regions. Sea-ice models are also important for simulating long-term changes in a warming climate. Here, we apply the Helsinki Discrete Element Model (HiDEM), originally developed for glacier calving, to sea-ice breakup and dynamics. The code is highly optimized to utilize high-end supercomputers to achieve an extreme time and space resolution. Simulated fracture patterns and ice motion are compared with satellite images of the Kvarken region of the Baltic Sea from March 2018. A second application of HiDEM involves ice ridge formation in the Gulf of Riga. With a few tens of graphics processing units (GPUs), the code is capable of reproducing observed ice patterns that in nature may take a few days to form; this is done over an area of ∼100km×100km, with an 8 m resolution, in computations lasting ∼10 h. The simulations largely reproduce observed fracture patterns, ice motion, fast-ice regions, floe size distributions, and ridge patterns. The similarities and differences between observed and computed ice dynamics and their relation to initial conditions, boundary conditions, and applied driving forces are discussed in detail. The results reported here indicate that the HiDEM has the potential to be developed into a detailed high-resolution model for sea-ice dynamics at short timescales, which, when combined with large-scale and long-term continuum models, may form an efficient framework for forecasts of sea-ice dynamics.

Climate Change Risks for the Mediterranean Agri-Food Sector: The Case of Greece

The study assesses the direct effects of climate change by 2060, including extreme events, on the productivity of regional crop farming and livestock in Greece, and the broader socio-economic effects on the agri-food and other sectors. Different approaches (i.e., agronomic models, statistical regression models, and equations linking thermal stress to livestock output) were combined to estimate the effects on productivity from changes in the average values of climatic parameters, and subsequently the direct economic effects from this long-term climate change. Recorded damages from extreme events together with climatic thresholds per event and crop were combined to estimate the direct economic effects of these extremes. The broader socio-economic effects were then estimated through input–output analysis. Under average levels of future extreme events, the total direct economic losses for Greek agriculture due to climate change will be significant, from EUR 437 million/year to EUR 1 billion/year. These losses approximately double when indirect effects on other sectors using agricultural products as inputs (e.g., food and beverage, hotels, and restaurants) are considered, and escalate further under a tenfold impact of extreme events. Losses in the GDP and employment are moderate at the national level, but significant in regions where the contribution of agriculture is high.

The effects of land use changes on site occupancy and breeding success of the barn owl (Tyto alba) from 1993 to 2020

Land use changes, driven by human activities such as agricultural intensification and urban expansion, have drastic effects on biodiversity. As these changes are anticipated to continue, understanding species’ adaptations to their evolving habitats is essential to find solutions for effective conservation efforts and sustainable management. In this study, we investigated how long-term changes in the agricultural landscape influence the breeding performance of a population of barn owls (Tyto alba) residing in nest boxes using data collected from 1993 until 2020. Specifically, we assessed how agricultural intensification, urbanization, and site availability affected barn owls' site occupancy and breeding success. Our results reveal that nest boxes surrounded by more agricultural fields are more likely to be occupied and have higher fledging success. Additionally, nest boxes installed higher on the barn were more likely to be occupied. Owls laid more eggs in nest boxes facing North than South or East. Clutches laid in nest boxes installed at higher altitudes were smaller. Finally, nest boxes with a higher density of surrounding nest boxes were less likely to be occupied and had smaller clutches. These insights show barn owls high reliance on the agricultural landscape surrounding their nesting sites, but also the importance of nest box characteristics to optimize their breeding success.

Changes in epiphytic lichen diversity along the urban-rural gradient before, during, and after the acid rain period

AbstractSpatial variations in epiphytic macrolichen richness in the city of Oslo were assessed annually 1973–2019. These observations were contrasted with earlier published data from 1930 to examine how long-term changes in species richness of functional groups track different stages of air pollution regimes. From 1930 to the 1970’s, representing the early surge and late peak of S-deposition, the lichen-deficient urban area remained largely unaltered. Epiphytic macrolichen richness in the surrounding zone declined and changed from a mix of nitrophytes and acidophytes in 1930 when agriculture was still present to a dominance of acidophytes in the 1970’s shortly after the acid rain peak. The subsequent 1980-2019-period marked by significantly lower S-emissions, and weakly decreasing N-deposition, experienced a shift from acidophytes to nitrophytes, following the successful control of acid rain. This underscores the role of pH as a contributing determinant of the strong nitrophyte recolonization. While successive pollution regimes shaped functional group-specific changes in lichen richness over the past 90 years, continuous rain in autumn 2000 led to sudden temporal lichen dieback across the urban-to-rural gradient, delaying lichen recovery after the acid rain period by approximately 5 years for nitrophytes and over 15 years for acidophytes. Epiphytic lichen richness never returned to the high levels seen in 1930, even in the outer parts of the urban-rural gradient and despite the reduction in S-deposition. Excess N impedes effective establishment of acidophytic lichens and prevents full recovery of the former diversity.

Assessment of immediate and five-year earthquake impacts on river systems in sabah, Malaysia using multi-temporal satellite imageries

BackgroundEarthquake is one of the most destructive natural disasters, which cause immediate and long-term changes to the river systems. This research aimed to examine the immediate and five-year impacts of the 2015 Ranau Earthquake (6.0 Mw) on river systems in Malaysian state of Sabah, a region of low earthquake hazard.MethodsWe used object-based classification on Landsat 8 (2014 and 2015) and Sentinel-2A (2020) satellite imageries to derive land cover time series for investigating the impacts on the riparian areas.ResultsThe earthquake removed vegetation in the riparian zones of four rivers, the highest being the Penataran River (69.21 ha). During the immediate impact period (2014–2015), river bar formation occurred in all rivers, with the largest increase occurring in the Kadamaian River (56.97 ha), followed by the Panataran River (54.36 ha), which had no river bar before the earthquake. The river bar of the Kadamaian River continued to increase, whereas the river bar of the Panataran River decreased five years after the earthquake. Land cover transition analysis revealed that 78.39 ha of vegetation, barren land, and river water areas changed to river bars in the Kadamaian riparian area during the immediate impact period. Except for 26.87% of river bars in the Kadamaian riparian area in 2015, most river bars transitioned to other land cover types five years later. During the period of immediate impact, 22.05 ha of vegetation and 10.71 ha of river water were transformed into river bars along the Penataran River. Five years later, except for 16.2 ha, all river bar areas had transitioned to other cover types. Additionally, 17.7 ha of new river bars were formed. This study provides crucial data on post-earthquake land cover changes, particularly river bar formation and changes, for assessing the earthquake impacts on the river systems and supporting impact mitigation.

Atmospheric black carbon aerosol: Long-term characteristics, source apportionment, and trends

Black carbon (BC) aerosols play a very significant role in influencing air quality, climate, and human health. Large uncertainties still exist in BC emissions due to limited observations on the relative source contributions of fossil fuel (ff) combustion and biomass (wood fuel, wf) burning. Our understanding of long-term changes in BC emissions, especially their source apportionment, is sparse and limited. For the first time, BC characteristics, its source apportionment into ff and wf components, and their trends measured using a multi-wavelength aethalometer over an urban location (Ahmedabad) in India covering a 14 year period (2006–2019) are comprehensively investigated. The average contributions of eBCff and eBCwf concentrations to total eBC are 80 % and 20 %, respectively, which highlights the dominance of emissions from fossil fuel combustion processes. A statistically significant increasing trend in eBC and eBCff mass concentrations at the rate of 11 % and 29%yr−1, respectively, and a decreasing trend in eBCwf concentration at the rate of 36%yr−1 are detected. The study reveals a significant decrease in biomass (wood fuel) burning emissions over the past decade and an increase in emissions from fossil fuel combustion. However, the rates of increase and decrease in eBCff and eBCwf are different, which indicate that rapid urbanization led to an increase in anthropogenic emissions, whereas an increase in usage of non-polluting fuel led to a decreasing trend in wood burning contribution. During weekdays and weekends, eBC and eBCff mass concentrations did not exhibit any statistically significant trends. However, eBCwf concentration shows a statistically significant decreasing trend during weekdays 34%yr−1 and weekends 38%yr−1. Globally, several countries are adopting various strategies and mitigation policies to improve air quality; however, significant gaps exist in their implementation towards achieving cleaner air and less polluted environment. This comprehensive study is relevant for understanding the impact of urbanization and devising better BC emission control policies.

The Implication of Political Risk and Specific Macroeconomic Variables on Total Revenue in Tourism Industry

The Implication of Political Risk and Specific Macroeconomic Variables on Total Revenue in Tourism Industry

Maintenance Pulmonary Rehabilitation: An Update and Future Directions.

The Global Initiative for Chronic Obstructive Lung Disease guidelines recommend pulmonary rehabilitation (PR) for individuals with COPD to improve exercise capacity and health-related quality of life (HRQOL) and reduce symptoms of dyspnea. For cost-effectiveness in COPD care, PR is second only to smoking cessation. However, PR programs typically last 9-12 weeks. The benefits of PR in terms of exercise capacity and HRQOL often decrease toward pre-PR levels as early as 3-6 months after completing PR if patients do not continue to engage in exercise. This review will (1) briefly summarize the efficacy data that informed the 2023 American Thoracic Society (ATS) clinical practice guidelines for maintenance PR, (2) discuss exercise components of maintenance PR studied since 2020 when the last papers were included in the ATS guidelines, (3) explore future directions for delivery of maintenance PR using technology-mediated models, and (4) examine the need for behavior change techniques informed by theoretical models that underpin long-term behavior change. This review will focus on persons with COPD who have completed an out-patient core initial PR program as most of the data on maintenance PR have been published in this patient population. Core PR typically implies a facility-based initial intensive structured program. All patients who complete a core initial PR program should be counseled by PR staff at the discharge visit to engage in ongoing exercise. This usual care is equally as important as referral to a formal PR maintenance program. It is critical to emphasize that usual care after core initial PR means all patients should be supported to participate in regular ongoing exercise, regardless of whether supervised maintenance PR is available. Currently, the optimal frequency, exercise and/or physical activity content, and delivery mode for maintenance PR in persons with COPD and other chronic respiratory diseases remain unknown. Patient safety and degree of in-person supervision required due to the severity of the underlying lung disease need to be considered. Future research of maintenance PR should be underpinned by behavior change techniques. Finally, in the setting of finite resources, balancing the competing priorities of core initial programs with those of maintenance PR programs needs to be achieved.

Peer support as a potential tool to promote pharmacists’ wellbeing

Discussion regarding burnout in health professionals, including community pharmacists, has grown substantially since the arrival of the COVID-19 pandemic. Rapid legislative and societal behavioural changes led to significant global disruption of physical and emotional wellbeing during the pandemic as pharmacists continued to provide care while under unprecedented levels of stress. Community pharmacists have had an essential role in maintaining face-to-face care as the number of COVID-19 diagnoses and deaths rose. Communications emerged from the World Health Organization which implored long-term changes to healthcare workplaces, including increased access to psychosocial support for employees. Peer support is a unique initiative, and it is low-cost and accessible across many platforms. Its main purpose is to bring people together with shared experiences and can often include people in the same career field or workplace. The feasibility and efficacy of peer support programs have been studied in other professional groups such as nurses and physicians, and also in undergraduate medical students. The conclusions drawn from these studies suggest that involvement in peer support reduced the risk of burnout and increased workplace engagement. In contrast to many other healthcare professionals, community pharmacists often work in relative isolation. Research has shown that younger pharmacists, and those in the earlier stages of their careers, reported feeling stressed, undervalued, and supported. They also mentioned a desire for access to a mentoring or coaching program. Following the success of peer support in other cohorts, research is needed to verify if this intervention will similarly benefit early career community pharmacists.

Long-Term Bone Mineral Density Changes in Kidney Transplant Recipients Treated with Denosumab: A Retrospective Study with Nonequivalent Control Group

Data on the effectiveness of denosumab on osteoporosis after kidney transplantation are limited. We investigated the long-term bone mineral density (BMD) changes in kidney transplant recipients (KTRs) treated with denosumab compared to untreated KTRs. We enrolled KTRs treated with denosumab 60 mg/6 months for 4 years. An untreated group of sex and age-matched KTRs with a 1:1 ratio was included. The primary outcome was BMD changes assessed by Dual-energy X-ray Absorptiometry over 4 years. Data on serum creatinine, alkaline phosphatase (ALP), parathyroid hormone, and 25-hydroxyvitamin D were collected. All patients received oral cholecalciferol and calcium supplementation. 23 denosumab-treated KTRs were enrolled, and 23 untreated KTRs. The median time from transplant to the start of denosumab was 4 years (range 0:24). The denosumab group showed a significant increase from baseline in BMD at the lumbar spine (LS) (9.0 ± 10.7%, p < 0.001), and total hip (TH) (3.8 ± 7.9%, p = 0.041). The untreated group showed a significant decrease at all sites (− 3.0 ± 7%, p = 0.041 at the LS; − 6.3 ± 9.2%, p = 0.003 at the TH; − 6.7 ± 9.3%, p = 0.003 at the FN). The between-group differences in percent BMD changes were statistically significant at all sites. Similar results were found for the respective Z-scores. The ALP serum levels significantly decreased from baseline only in the denosumab group, with a significant between-group difference (p = 0.032). No significant differences in serum creatinine, hypocalcaemic events or acute graft rejection rates were observed. Four years of denosumab therapy were associated with increased BMD in KTRs, while untreated KTRs showed significant BMD losses at all sites.

Potential impact of blood cholesterol guidelines on statin treatment in the U.S. population using interrupted time series analysis

BackgroundThe 2013 ACC/AHA Guideline was a paradigm shift in lipid management and identified the four statin-benefit groups. Many have studied the guideline’s potential impact, but few have investigated its potential long-term impact on MACE. Furthermore, most studies also ignored the confounding effect from the earlier release of generic atorvastatin in Dec 2011.MethodsTo evaluate the potential (long-term) impact of the 2013 ACC/AHA Guideline release in Nov 2013 in the U.S., we investigated the association of the 2013 ACC/AHA Guideline with the trend changes in 5-Year MACE survival and three other statin-related outcomes (statin use, optimal statin use, and statin adherence) while controlling for generic atorvastatin availability using interrupted time series analysis, called the Chow’s test. Specifically, we conducted a retrospective study using U.S. nationwide de-identified claims and electronic health records from Optum Labs Database Warehouse (OLDW) to follow the trends of 5-Year MACE survival and statin-related outcomes among four statin-benefit groups that were identified in the 2013 ACC/AHA Guideline. Then, Chow’s test was used to discern trend changes between generic atorvastatin availability and guideline potential impact.Results197,021 patients were included (ASCVD: 19,060; High-LDL: 33,907; Diabetes: 138,159; High-ASCVD-Risk: 5,895). After the guideline release, the long-term trend (slope) of 5-Year MACE Survival for the Diabetes group improved significantly (P = 0.002). Optimal statin use for the ASCVD group also showed immediate improvement (intercept) and long-term positive changes (slope) after the release (P < 0.001). Statin uses did not have significant trend changes and statin adherence remained unchanged in all statin-benefit groups. Although no other statistically significant trend changes were found, overall positive trend change or no changes were observed after the 2013 ACC/AHA Guideline release.ConclusionsThe 2013 ACA/AHA Guideline release is associated with trend improvements in the long-term MACE Survival for Diabetes group and optimal statin use for ASCVD group. These significant associations might indicate a potential positive long-term impact of the 2013 ACA/AHA Guideline on better health outcomes for primary prevention groups and an immediate potential impact on statin prescribing behaviors in higher-at-risk groups. However, further investigation is required to confirm the causal effect of the 2013 ACA/AHA Guideline.

Heritage Building Information Modelling (HBIM): A Review of Published Case Studies

Abstract. This paper presents a systematic review of published case studies on Heritage Building Information Modelling (HBIM) since 2018, and identifies research gaps in the subject matter. Building upon the foundational work of Ewart and Zuecco (2019), this research aims to reveal the latest trends in HBIM implementation, identify recent developments of HBIM technologies, changes in the purpose of HBIM programs and stakeholder roles and responsibilities, and uncover knowledge gaps that provide avenues for future research. Utilizing the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) approach, two major academic databases, Scopus and Web of Science (WOS), were searched, resulting in a rich and diverse dataset for analysis. The paper reports findings on the status of reality capture techniques used to acquire data for HBIM development, focusing on terrestrial laser scanning (TLS) technology. The review highlights the benefits and limitations of TLS for data acquisition in HBIM, as well as the integration of TLS with other reality capture technologies, such as Structure from Motion (SfM) and photogrammetry. The paper further outlines the typical workflow for processing TLS scan data and explores the integration of multiple point clouds for comprehensive heritage site modeling. In addition to the state of the art, this systematic review also uncovers several research gaps in the field of HBIM that offer opportunities for future research and innovation, including the lack of guidelines for data acquisition in HBIM programs, the predominantly manual development process of HBIM from TLS point cloud data, and the under-utilized capacity of TLS for long-term monitoring and change detection. This comprehensive review provides valuable insights into the current landscape of HBIM, offering guidance for future research and development in the heritage sector and highlighting areas in need of further investigation to advance the field.

Long-Term Structural Changes in the Osteochondral Unit in Patients with Osteoarthritis Undergoing Corrective Osteotomy with Platelet-Rich Plasma or Stromal Vascular Fraction Post-Treatment.

This pilot study examined the long-term structural changes in the osteochondral unit of 20 patients with knee osteoarthritis (KOA) who underwent high tibial osteotomy (HTO) and received post-treatment with either platelet-rich plasma (PRP) or stromal vascular fraction (SVF). Ten patients were injected with autologous PRP (PRP subgroup), while another ten patients received autologous SVF (SVF subgroup) six weeks after surgery and were monitored for 18 months. Histological samples of bone and cartilage (2 mm in diameter and 2 cm long) were taken from tibial and femoral sites during surgery and 18-month post-HTO, and morphometric analyses were conducted using Mega-Morf12 software. Both post-treatment resulted in an increase in articular cartilage height at both sites (p < 0.001 in the tibia and femur), indicating positive outcomes. Significant improvements in subchondral and trabecular bone architecture were also observed, with SVF injection showing higher reparative capacity in terms of bone volume (p < 0.001 for the tibia and p = 0.004 for the femur), subchondral bone height (p < 0.001 for the tibia and p = 0.014 for the femur), trabecular bone volume (p < 0.001 for the femur), and intertrabecular space (p = 0.009 for the tibia and p = 0.007 for the femur). This pilot study, for the first time, demonstrates that HTO surgery combined with PRP and SVF post-treatments can lead to significant enhancements in knee articular cartilage and bone architecture in KOA patients, with SVF showing higher regenerative potential. These findings may contribute to improving treatment strategies for better clinical outcomes in HTO therapy for patients with KOA.

Ventromedial frontoinsular connectivity is associated with long-term smoking behavior change in aging

Abstract A central question in the field of cognitive aging and behavioral neuroscience is what enables some individuals to successfully change their behavior more than others? Smoking is a significant risk factor for cognitive decline, particularly in vulnerable populations, including those who are at an elevated risk for Alzheimer’s disease (AD). Developing effective smoking reduction strategies is therefore a public health priority. The goal of the current study is to better understand the brain mechanisms underlying long-term smoking behavior change in cognitively normal, but at-risk, older adults. Neuroimaging and human lesion studies have implicated the insula and its functional network in subjective interoceptive awareness of cigarette craving and smoking-cue reactivity. We sought to characterize the extent to which anterior insular resting-state functional connectivity (RSFC) MRI predicted long-term smoking reduction (mean: 2.7 years, range 8 months–4 years) using a seed-to-voxel approach. Twenty-three (18 women; 26% APOE4 carriers; 61.5 years, SD = 3.7) cognitively unimpaired older individuals who smoked cigarettes at their baseline visit and have a first-degree family history of AD (at least one parent or multiple siblings affected) were included from a prospective longitudinal cohort, Pre-symptomatic Evaluation of Experimental or Novel Treatments for Alzheimer Disease (PREVENT-AD) in the current study. We found that reduced long-term smoking behavior was associated with enhanced antagonistic RSFC between bilateral anterior insula (aINS) and ventromedial prefrontal cortex (vmPFC). In a second pre-registered replication study within a larger, independent sample of 118 cognitively normal older adults who smoked cigarettes at baseline from the UK Biobank (73 women; 27.9% APOE4 carriers; 60.3 years, SD = 2.7), we found that baseline enhanced antagonistic RSFC between anterior insula and vmPFC predicted long-term smoking reduction (mean 5.2 years; ranging from 3 years to 7 years). To our knowledge, this is the largest study to examine the neural substrates of long-term smoking cessation in human aging. Our results suggest that antagonistic RSFC between aINS and vmPFC is a brain marker of future smoking reduction and disease prevention in older adults at risk for AD.

Unraveling the dynamics of atmospheric methane: the impact of anthropogenic and natural emissions

The reduction in methane concentration is crucial for achieving the goals of the Paris agreement. However, its annual growth rate is unstable, and understanding the reasons for changes in methane growth is essential for climate policy-making. Currently, there is considerable uncertainty regarding its attribution. Here, we utilize multi-source data and optimal fingerprinting methods to detect the contributions of several key drivers to the methane trend and interannual variability. We find that the methane growth trend is primarily influenced by anthropogenic emissions, while interannual variability is predominantly determined by wetland and biomass burning emissions. This result underscores the central role of anthropogenic emissions in methane dynamics, providing confidence in the effectiveness of human efforts to control methane atmospheric concentrations through emission reductions. It also helps alleviate concerns about the recent surge in atmospheric methane concentration, as it may be a short-term peak caused by increased wetland emissions rather than a long-term change.