Long-term Changes Research Articles

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.

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 60mg/6 months for 4years. 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 4years (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 &lt; 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 &lt; 0.001 for the tibia and p = 0.004 for the femur), subchondral bone height (p &lt; 0.001 for the tibia and p = 0.014 for the femur), trabecular bone volume (p &lt; 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.

Study the Impact of the Anthropogenic Activities on the Marine Environment of Fujairah Offshore Waters of UAE Based on Baseline Surveys and Buoy Data

As Fujairah comprises extremely diverse natural landscapes which enforce us to protect and understand possible risks and challenges faced by the coastal waters of Fujairah, it is critical to mitigate, reduce, and eliminate the risks. The aim of this study is to assess and evaluate the effect of such anthropogenic activities on the offshore waters of Fujairah. Accordingly, two buoys were deployed after conducting a baseline survey for 30 locations targeting areas affected by the anthropogenic activities. Furthermore, two sites were chosen for the buoy deployment, nearshore which is across the desalination plant (Qidfa) and offshore which is across the oil and gas facility port (Skamkam). After analyzing the water quality measurements taken for 1 year from both deployed buoys and compared it with the baseline survey measurements, an indication of water quality deterioration in nearshore and offshore buoys was evinced, and the nearshore site which located in Qidfa has a higher deterioration in water quality measurements compared to the offshore site located in Skamkam. A long-term monitoring program needs to be conducted to gather additional data on water quality over several years to help identify the seasonal variations, trends, and long-term changes in water quality.

Dry and Wet Spells in Poland in the Period 1966–2023

The aim of this study is to present the spatial and temporal variability of the frequency of dry and wet days and dry and wet spells against the background of changes in precipitation and atmospheric circulation. The study is based on daily precipitation totals from 46 meteorological stations in Poland from 1966 to 2023. Additionally, seven circulation indices were used, namely GBI, NAO, AO, EA, EA/WR, SCAND, and AMO. Dry days are defined as days without precipitation. Wet days are days with at least 1 mm of precipitation. It was shown that dry spells are much more common than wet spells, are longer, and cover larger areas. Long-term changes in the annual characteristics of dry and wet days and spells are not statistically significant. Only the length of the most extended dry spell in the year increases. However, there are significant changes in their annual cycles. Spring is drier; in summer, precipitation decreases in the south and increases in the north; November and December, symbols of gloomy rainy weather, are increasingly drier; and rainy weather has shifted to January and February. The impact of circulation varies according to the season, with the NAO, AO, SCAND, and GBI indices having the greatest influence.

The distribution of self-incompatibility systems in angiosperms: the relationship between mating system diversity, life span, growth habit and latitude in a changing global environment.

There is ample theoretical and experimental evidence that angiosperms harbouring self-incompatibility (SI) systems are likely to respond to global changes in unique ways relative to taxa with other mating systems. In this paper, we present an updated database on the prevalence of SI systems across angiosperms and examine the relationship between the presence of SI and latitude, biomes, life-history traits and management conditions to evaluate the potential vulnerability of SI taxa to climate change and habitat disturbance. We performed literature searches to identify studies that employed controlled crosses, microscopic analyses and/or genetic data to classify taxa as having SI, self-compatibility (SC), partial self-compatibility (PSC) or self-sterility (SS). Where described, the site of the SI reaction and the presence of dimorphic versus monomorphic flowers were also recorded. We then combined this database on the distribution of mating systems with information about the life span, growth habit, management conditions and geographic distribution of taxa. Information about the geographic distribution of taxa was obtained from a manually curated version of the Global Biodiversity Information Facility database, and from vegetation surveys encompassing 9 biomes. We employed multinomial logit regression to assess the relationship between mating system and life-history traits, management condition, latitude and latitude-squared using self-compatible taxa as the baseline. Additionally, we employed LOESS regression to examine the relationship between the probability of SI and latitude. Finally, by summarizing information at the family level, we plotted the distribution of SI systems across angiosperms including information about the presence of SI or dioecy, the inferred reaction site of the SI system when known, as well as the proportion of taxa in a family for which information is available. We obtained information about the SI status of 5686 hermaphroditic taxa, of which 55% exhibited SC, and the remaining 45% harbour SI, self-sterility (SS), or PSC. Highlights of the multinomial logit regression include that taxa with PSC have a greater odds of being short- (OR=1.3) or long- (OR=1.57) lived perennials relative to SC ones, and that SS/SI taxa (pooled) are less likely to be annuals (OR=0.64) and more likely to be long-lived perennials (OR=1.32). SS/SI taxa had a greater odds of being succulent (OR=2.4) or a tree (OR=2.05), and were less likely to be weeds (OR=0.34). Further, we find a quadratic relationship between the probability of being SI with latitude: SI taxa were more common in the tropics, a finding that was further supported by the vegetation surveys which showed fewer species with SS/SI in temperate and northern latitudes compared to mediterranean and tropical biomes. We conclude that in the short-term habitat fragmentation, pollinator loss and temperature increases may negatively impact plants with SI systems, particularly long-lived perennial and woody species dominant in tropical forests. In the longer term, these and other global changes are likely to select for self-compatible or partially self-compatible taxa which, due to the apparent importance of SI as a driver of plant diversification across the angiosperm tree of life, may globally influence plant species richness.

Moderate associations between the use of levonorgestrel-releasing intrauterine device and metabolomics profile.

Use of levonorgestrel-releasing intrauterine device (LNG-IUD) has become common irrespective of age and parity. To date, only a few studies have examined its possible metabolic changes and large-scale biomarker profiles in detail and in a longitudinal design. To apply the metabolomics technique to examine the metabolic profile associated with the use of LNG-IUD both in a cross-sectional and in a longitudinal design. The study consists of cross-sectional and longitudinal analyses of a population-based survey (Health 2000) and its 11-year follow-up (Health 2011). All participants aged 18-49 years with available information on hormonal contraceptive use and metabolomics data (n=1767) were included. Altogether 212 metabolic measures in LNG-IUD users (n=341) were compared to those in non-users of hormonal contraception (n=1426) via multivariable linear regression models. Participants with complete longitudinal information (n=240) were divided into continuers, stoppers, starters, and never-user groups, and 11-year changes in levels of each metabolite were compared. After adjustment for covariates, levels of 102 metabolites differed in LNG-IUD current users compared to non-users of hormonal contraception (median difference in biomarker concentration: -0.12 SD): lower levels of fatty acids concentrations and ratios, cholesterol, triglycerides and other lipids, as well as particle concentration, cholesterol, total lipids and phospholipids in lipoproteins. The 11-year metabolic changes did not differ in relation to changes in LNG-IUD use. The use of LNG-IUD was associated with several moderate metabolic changes, mostly suggestive of a reduced arterial cardiometabolic risk. Changes in LNG-IUD use were not related to long-term metabolic changes.

Interaction of serotonin/GLP-1 circuitry in a dual preclinical model for psychiatric disorders and metabolic dysfunction

Isolation of rodents throughout adolescence is known to induce many behavioral abnormalities which resemble neuropsychiatric disorders. Separately, this paradigm has also been shown to induce long-term metabolic changes consistent with a pre-diabetic state. Here, we investigate changes in central serotonin (5-HT) and glucagon-like peptide 1 (GLP-1) neurobiology that dually accompany behavioral and metabolic outcomes following social isolation stress throughout adolescence. We find that adolescent-isolation mice exhibit elevated blood glucose levels, impaired peripheral insulin signaling, altered pancreatic function, and fattier body composition without changes in bodyweight. These mice further exhibited disruptions in sleep and enhanced nociception. Using bulk and spatial transcriptomic techniques, we observe broad changes in neural 5-HT, GLP-1, and appetitive circuits. We find 5-HT neurons of adolescent-isolation mice to be more excitable, transcribe fewer copies of Glp1r (mRNA; GLP-1 receptor), and demonstrate resistance to the inhibitory effects of the GLP-1R agonist semaglutide on action potential thresholds. Surprisingly, we find that administration of semaglutide, commonly prescribed to treat metabolic syndrome, induced deficits in social interaction in group-housed mice and rescued social deficits in isolated mice. Overall, we find that central 5-HT circuitry may simultaneously influence mental well-being and metabolic health in this model, via interactions with GLP-1 and proopiomelanocortin circuitry.

Reconstruction of long-term hydrologic change and typhoon-induced flood events over the entire island of Taiwan

Study regionThe island of Taiwan. Study focusThis study presents long-term and high-resolution modeling of flood occurrence, interdecadal patterns of river-floodplain dynamics, and analysis of flooding during two typhoon events—Nari and Morakot over Taiwan. The modeling system combines a hydrological model (HiGW-MAT) and a river hydrodynamics model (CaMa-Flood), simulating hydrologic-hydrodynamic processes at ∼ 5 km resolution with flood occurrences downscaled to ∼ 90 m. New hydrological insights for the regionAs the first investigation to conduct spatially comprehensive and temporally continuous modeling in Taiwan, this study presents important advances on the application of large-scale hydrological-hydrodynamic models in settings like that of Taiwan with important implications on flood prediction under climate change. The assessment of interdecadal changes in streamflow indicates no consistent trends over the past four decades; however, the variabilities in monthly-scale streamflow are significant and regionally diverse across Taiwan. Decadal changes in flood occurrence are also minimal at the island-scale, but the changes vary substantially across different regions and exhibit an increased variability over time. Furthermore, the simulated flood patterns in response to Typhoons Nari and Morakot suggest that the modeling framework can be used to reproduce the spatial dynamics and temporal progression of flooding under extreme events in relatively small regions like Taiwan.

Deciphering multi-temporal scale dynamics in the concentration, sources and processes of near surface ozone over different climatic regions of India.

This study aims to investigate the factors influencing seasonal and long-term (2003-2021) changes in the near surface ozone (850 hpa) concentrations over different climatic sub-regions of India. Detailed comparison of daily (2019-2021) near surface ozone values of ERA-5 and CAAQMS (Continuous Ambient Air Quality Monitoring Stations) ground-based measurements revealed that ERA-5 is temporally in phase with CAAQMS measurements falling indifferent climatic sub-regions of India. ERA-5 near surface ozone shows statistically significant long-term (2003-2021) positive trends [2-4 percent per decade (ppd)] over most of the climatic sub-regions, over Indo-Gangetic Planes (IGPs), Southern and Central India trends are particularly strong. Trends were also estimated for each season separately, which were largely positive (2-6 ppd) over Central and Southern India in the Autumn and Winter seasons. Extensive climatological analysis reveals that the reversal of winds in the Indian monsoonal system plays a vital role in such trend patterns across the Indian subcontinent. South-westerly winds from June through September presumably bring ozone deficit air of marine origin, thus causing a dilution effect while the North-easterly winds during late Autumn and early Winters plausibly bring ozone-rich air from the stratospheric-tropospheric efflux dominated Himalayan region. It allows near surface ozone enhancement over Central and Southern India. Seasonal Principal component analysis (PCA) revealed that precursor gases (CH4 and NO2) and climatic variables especially specific humidity (SH) are the primary drivers of near surface ozone variability in the Winter season, while in Spring, climatic variables like boundary layer height (BLH), temperature (T) and SH have a significant role. Principal component regression (PCR) reveals a long-term increase in near surface ozone levels mostly dominated by precursor concentration over IGPs and Southern sub-regions. Whereas, BLH, T and SH significantly explain near surface ozone trends over North-eastern and Coastal India.

Spatio-Temporal Trends in Precipitation, Temperature, and Extremes: A Study of Malawi and Zambia (1981–2021)

Analyzing long-term climate changes is a prerequisite for identifying hotspot areas and developing site-specific adaptation measures. The current study focuses on assessing changes in precipitation, maximum and minimum temperatures, and potential evapotranspiration in Zambia and Malawi from 1981 to 2021. High-resolution precipitation and temperature datasets are used, namely, Climate Hazards Group InfraRed Precipitation with Station data (0.05°) and Multi-Source Weather (0.1°). The Mann–Kendall trend test and Sen’s Slope methods are employed to assess the changes. The trend analysis shows a non-significant increase in annual precipitation in many parts of Zambia and Central Malawi. In Zambia and Malawi, the average annual and seasonal maximum and minimum temperatures show a statistically significant increasing trend (up to 0.6 °C/decade). The change in precipitation during the major rainy seasons (December–April) shows a non-significant increasing trend (up to 3 mm/year) in a large part of Zambia and Central Malawi. However, Malawi and Northern Zambia show a non-significant decreasing trend (up to −5 mm/year). The change in December–April precipitation significantly correlates with El Niño–Southern Oscillation (Indian Ocean Dipole) in Southern (Northern) Zambia and Malawi. To minimize the impact of the observed changes, it is imperative to develop adaptation measures to foster sustainability in the region.

Pulmonary Function, Computed Tomography Lung Abnormalities, and Small Airway Disease after COVID-19: 3-, 6-, and 9-Month Follow-Up

Background/Objectives: Coronavirus disease 2019 (COVID-19) course may differ among individuals—in particular, those with comorbidities may have severe pneumonia, requiring oxygen supplementation or mechanical ventilation. Post-COVID-19 long-term structural changes in imaging studies can contribute to persistent respiratory disturbance. This study aimed to investigate COVID-19 sequels affecting the possibility of persistent structural lung tissue abnormalities and their influence on the respiratory function of peripheral airways and gas transfer. Methods: Patients were divided into two groups according to severity grades described by the World Health Organization. Among the 176 hospitalized patients were 154 patients with mask oxygen supplementation and 22 patients with high-flow nasal cannula (HFNC) or mechanical ventilation. All tests were performed at 3, 6, and 9 months post-hospitalization. Results: Patients in the severe/critical group had lower lung volumes in FVC, FVC%, FEV1, FEV1%, LC, TLC%, and DLCO% at three months post-hospitalization. At 6 and 9 months, neither group had significant FVC and FEV1 value improvements. The MEF 25–75 values were not significantly higher in the mild/moderate group than in the severe/critical group at three months. There were weak significant correlations between FVC and FEV1, MEF50, MEF 75, plethysmography TLC, disturbances in DLCO, and total CT abnormalities in the severe/critical group at three months. In a mild/moderate group, there was a significant negative correlation between the spirometry, plethysmography parameters, and CT lesions in all periods. Conclusions: Persistent respiratory symptoms post-COVID-19 can result from fibrotic lung parenchyma and post-infectious stenotic small airway changes not visible in CT, probably due to persistent inflammation.

Long-term gene expression changes in the rat thyroid by neonatal irradiation - a possible mechanism related to thyroid carcinogenesis by childhood radiation

Long-term gene expression changes in the rat thyroid by neonatal irradiation - a possible mechanism related to thyroid carcinogenesis by childhood radiation

“Recovery activities are needed every step of the way”—exploring the process of long-term recovery in people previously diagnosed with exhaustion disorder

BackgroundSick-leave rates are high due to stress-related illnesses, but little is still known about the process of recovery from these conditions. The aim of this study was to explore the experiences of the recovery process, 6 to 10 years after treatment in people previously diagnosed with exhaustion disorder (ED), focusing on facilitators and barriers for the process of recovery from ED, and recovery activities experienced as helpful during the recovery process.MethodThirty-eight participants (average age: 52 years, 32 females) previously diagnosed with ED were interviewed with semi-structured interviews 6–10 years after undergoing treatment. The interviews were analyzed with thematic analysis.ResultsThree themes resulted from the analysis. The first theme, “A long and rocky road”, summarizes the fluctuating path to feeling better and emphasizes barriers and facilitators that affected the process of recovery, with a focus on external life events and the participants’ own behaviors. Facilitators were changing workplace, receiving support, a reduction in stressors, and changed behaviors. Barriers were a poor work environment, caregiver responsibilities, negative life events and lack of support. The second theme “Recovery activities are needed every step of the way” describes how both the need for recovery activities and the types of activities experienced as helpful changed during the recovery process, from low-effort recovery activities for long periods of time to shorter and more active recovery activities. Recovery activities were described as important for self-care but hard to prioritize in everyday life. The last theme, “Reorienting to a new place”, captures the struggle to cope with the remaining impact of ED, and how internal facilitators in terms of understanding and acceptance were important to reorient and adjust to a new way of functioning.ConclusionsRecovering from ED is a long and ongoing process where recovery activities are needed every step of the way. Our results highlight the importance of supporting personal recovery and long-term behavioral change, addressing individual stressors that may perpetuate the condition, and adjusting recovery activities according to where the person is in the recovery process.Trial registrationClinicalTrials.gov: NCT0073772. Registered on March 8, 2017. This study was pre-registered on Open Science Framework (osf.io).

SDUST2020MGCR: a global marine gravity change rate model determined from multi-satellite altimeter data

Abstract. Investigating the global time-varying gravity field mainly depends on GRACE/GRACE-FO gravity data. However, satellite gravity data exhibit low spatial resolution and signal distortion. Satellite altimetry is an important technique for observing the global ocean and provides many consecutive years of data, which enables the study of high-resolution marine gravity variations. This study aims to construct a high-resolution marine gravity change rate (MGCR) model using multi-satellite altimetry data. Initially, multi-satellite altimetry data and ocean temperature–salinity data from 1993 to 2019 are utilized to estimate the altimetry sea level change rate (SLCR) and steric SLCR, respectively. Subsequently, the mass-term SLCR is calculated. Finally, based on the mass-term SLCR, the global MGCR model on 5′ × 5′ grids (SDUST2020MGCR) is constructed by applying the spherical harmonic function method and mass load theory. Comparisons and analyses are conducted between SDUST2020MGCR and GRACE2020MGCR resolved from GRACE/GRACE-FO gravity data. The spatial distribution characteristics of SDUST2020MGCR and GRACE2020MGCR are similar in the sea areas where gravity changes significantly, such as the eastern seas of Japan, the western seas of the Nicobar Islands, and the southern seas of Greenland. The statistical mean values of SDUST2020MGCR and GRACE2020MGCR in global and local oceans are all positive, indicating that MGCR is rising. Nonetheless, differences in spatial distribution and statistical results exist between SDUST2020MGCR and GRACE2020MGCR, primarily attributable to spatial resolution disparities among altimetry data, ocean temperature–salinity data, and GRACE/GRACE-FO data. Compared with GRACE2020MGCR, SDUST2020MGCR has higher spatial resolution and excludes stripe noise and leakage errors. The high-resolution MGCR model constructed using altimetry data can reflect the long-term marine gravity change in more detail, which is helpful in studying seawater mass migration and its associated geophysical processes. The SDUST2020MGCR model data are available at https://doi.org/10.5281/zenodo.10701641 (Zhu et al., 2024).

Unveiling asymmetry impacts of economic policy uncertainty on climate change: fresh insights into African Countries.

This study investigates the influence of economic policy uncertainty on climate change in selected African countries within asymmetric settings. Although previous research has examined the impact of various economic factors on climate change, the asymmetric effects of economic policy uncertainty have not been thoroughly explored, particularly in African countries. We analyze annual data spanning from 1980 to 2017 by utilizing three models: Panel Pooled Mean Group-Autoregressive distributed lag model (ARDL-PMG), Panel Pooled Mean Group-non-linear autoregressive distributed lag model (NARDL-PMG), and Dumitrescu-Hurlin asymmetric causality tests. According to the results of ARDL-PMG estimation, economic policy uncertainty has a detrimental impact on climate change in the long run. However, the NARDL-PMG estimation suggests that a positive shock in economic policy uncertainty negatively affects long-term climate change mitigation. However, a negative shock has a beneficial effect on climate change in the long term. In African nations, positive and negative changes in economic policy uncertainty failed to generate any significant climate change effects in the short run. The results also reveal that both positive and negative shocks in economic policy may cause climate change in a one-way direction. Based on the findings of our study, we recommend that African policymakers implement programs aimed at reducing economic policy uncertainties to help mitigate the effects of climate change.