Maximum Area Research Articles

Finding the largest separating rectangle among two point sets

Given a set R of n red points and a set B of m blue points, we study the problem of finding a rectangle that contains all the red points, the minimum number of blue points and has the maximum area. We call such a rectangle a maximum-area separating rectangle (MSR). We first address the planar, axis-aligned (2D) version, and present an O(mlog⁡m+n) time, O(m+n) space algorithm. The running time reduces to O(m+n) if the points are pre-sorted by one of the coordinates. We also consider the planar arbitrary orientation version, in which the MSR is allowed to have arbitrary orientation. For this arbitrary orientation version, our algorithm takes O(m3+nlog⁡n) time and O(m+n) space. Finally, we address the 3D axis-aligned version, which asks for the maximum-volume separating box (MSB), i.e., the maximum-volume axis-aligned box containing all the red points and the fewest blue points. For this version, we give an algorithm that runs in O(m2(m+n)) time and O(m+n) space.

Application value of volumetric CT value in quantifying the activity of a pulmonary tuberculoma.

The purpose of this study was to explore the auxiliary diagnostic value of volumetric CT value in quantifying the activity of a pulmonary tuberculoma. Chest CT image data of 112 patients with pulmonary tuberculomas who were diagnosed clinically between October 16, 2013 and March 21, 2023 were selected. With the shortest diameter axis>5 mm on the mediastinal window serving as the inclusion criterion, 108 active tuberculomas and 64 non-active tuberculomas were selected. The focused image was manually segmented using ITK-SNAP software, the volumetric CT value of the focus was calculated, and the ROC curve was analyzed. Using the final clinical diagnosis as the reference standard, the auxiliary diagnostic efficacy and consistency of the conventional CT film reading method and volumetric CT value in determining the activity of a pulmonary tuberculoma were compared. The volumetric CT value of 108 active pulmonary tuberculoma lesions (33.39 [28.17,36.23] HU) was significantly less than 64 inactive pulmonary tuberculoma lesions (78.91 [57.81,120.31] HU); the difference was statistically significant (Z = -10.888. P < 0.001). ROC curve analysis showed that at a maximum Yoden index value of 0.963, the optimal volumetric CT threshold value was 45.32 HU, the sensitivity and specificity of the volumetric CT value in determining the activity of a pulmonary tuberculoma were 97.2% and 100.0%, respectively, and the maximum area under the ROC curve was 0.998. Taking the final clinical diagnosis as the reference standard, the sensitivity, specificity, consistency, and kappa value of the conventional CT film reading method for determining the activity of a pulmonary tuberculoma were 72.2% (78/108), 70.3% (45/64), 71.5% (123/172), and 0.413, respectively, while the corresponding volumetric CT values were 97.2% (105/108), 100.0% (64/64), 98.3% (168/172), and 0.951, respectively. Accurately quantifying the volumetric CT value of a pulmonary tuberculoma focus determines the activity of a pulmonary tuberculoma, which has very important auxiliary diagnostic value.

Combinations of Clinical Factors, CT Signs, Radiomics for Differentiating High-density Areas After Mechanical Thrombectomy in Patients with Acute Ischemic Stroke.

Clinically, hemorrhagic transformation (HT) after mechanical thrombectomy (MT) is a common complication. This study is aim to investigate the value of clinical factors, CT signs, and radiomics in the differential diagnosis of high-density areas (HDAs) in the brain after MT in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO). A total of 156 eligible patients with AIS-LVO in Center Ⅰ from December 2015 to June 2023 were retrospectively enrolled and randomly divided into training (n=109) and internal validation (n=47) sets at a ratio of 7:3. The data of 63 patients in Center Ⅱ were collected as an external validation set. According to the diagnostic criteria, the patients in the three datasets were divided into a HT group and a non-HT group. The clinical and imaging data from Centers Ⅰ and Ⅱ were used to construct a clinical factor and CT-sign model, a radiomic model and a combined model by logistic regression (LR). Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of each model in the three datasets. Clinical blood glucose (Glu) and the maximum cross-sectional area (Areamax) on CT were associated with the nature of the HDA according to multivariate LR analyses (P < 0.05). Among the three models, the combined model had the highest diagnostic efficiency, with area under the curve (AUC) values of 0.895, 0.882, and 0.820 in the three datasets, which were significantly greater than the AUC values of the radiomic model (0.887, 0.898, 0.798) and clinical factor and CT sign model (0.831, 0.744, 0.684). The combined model based on radiomics had the best performance, indicating that radiomic features can be used as imaging biomarkers to aid in the clinical judgment of the nature of HDA after MT. HDA =high-density area; HT =hemorrhagic transformation; MT =mechanical thrombectomy; AIS-LVO =acute ischemic stroke with large vessel occlusion; LR =logistic regression; AUC =area under the curve; ICE =iodine contrast extravasation; DECT =dual energy CT; IOM =iodine overlay map; VNC =virtual noncontrast; Glu =glucose; LASSO =least absolute shrinkage and selection operator; ICC =intraclass correlation coefficient; ROC =receiver operating characteristic; DCA =decision curve analysis.

Minimum environmental flow assessment: a fuzzy TOPSIS decision-making system for selecting the best approach

The literature has explored various methods for assessing minimum environmental flow. Implementing holistic approaches proves to be prohibitively expensive and impractical for many small and medium projects. Hence, desktop and cost-effective methods are commonly employed without an integrated decision-making system to justify the assessed values. This study introduces a systematic decision-making framework aimed at selecting the most suitable method for assessing the actual needs of river habitats. Employing a fuzzy technique known as the Order Preference Similarity to the Ideal Solution (FTOPSIS), the study considers factors such as physical, thermal, and dissolved oxygen habitat suitability, maximum habitat area, and water demand loss function to determine the most appropriate method among established ones, including the Tennant method, flow duration curve analysis method, wetted perimeter method, and physical habitat simulation method. The results prioritize physical habitat simulation, wetted perimeter by slope method, and flow indices of 70%, 75%, and 80% by flow duration curve analysis method as the optimal approaches for assessing minimum environmental flow. This proposed decision-making system offers a viable platform to explore the applicability of existing cost-effective methods for assessing minimum environmental flow. It also serves as an effective mechanism for reducing negotiations among stakeholders by comprehensively considering all relevant aspects in the environmental management of river ecosystem requirements.

Recent Trends in the Study of Springs in Nepal: A Review

Springs, a component of groundwater systems, are a vital source of fresh water for fulfilling people's demand for drinking water, household uses, and irrigation, especially in the Middle Hill region of Nepal. Springs provide water for base flows and lifelines for many rivers originating from the Middle Hill regions. The present study reviews a recent trend of spring studies and investigations in Nepal through a systematic search of published and unpublished works related to springs, which are freely available. The results show 47 publications, out of 30 are published, and 17 are unpublished. The origin of published work is mainly related to project-related works, whereas unpublished works come from the academic sector for fulfilling academic criteria for thesis research. According to the physiographical division of Nepal, the study area falls in the Middle Hills of Nepal, with the maximum area located in Bagmati Province. Most of the studies that qualitative rather than quantitative information of springs. Studies are not linked with spring source and their seasonal dynamics. However, clearly available data, attributes and information about springs from 47 reviewed documents are noted. Systematic data generation and a standard framework for data collection are also missing. Nevertheless, out of 47 studies, including 11 published and 4 unpublished, the total number of springs per sq. km. in the Middle Hill region of Nepal is estimated as 2.57, which can be integrated after more research on future springs–related work.

Effect of plastic deformation of particle and substrate on metallurgical bonding during cold spraying

The metallurgical bonding of cold spraying is investigated from the perspective of plastic deformation. The individual Al particle was deposited on the surface of Ni substrate by low-pressure cold spraying technology. Direct observation of the Al/Ni interface from the cross-sectional morphology shows that metallurgical bonding occurs only at the partial Al/Ni interface. The finite element simulation considering the presence of oxide layer confirms that the metallurgical bonding is located in front of the maximum plastic deformation area. In the maximum plastic deformation area, the relative displacement between Al particle and Ni substrate exists from the beginning of contact to the end of deposition, which makes the metallurgical bonding discontinuous and gradually disappear.

Enzymatically and chemically starch nanoparticles preparation using ultrasonication, precipitation and lyophilization post-treatments: Screening and characterization

Starch nanoparticles (SNPs) have been used in food emulsions as natural stabilizer and emulsifier. SNPs in colloidal form were produced using enzymatically, acidic and alkaline hydrolyses in combination to ultrasonication and precipitation methods. X-Ray diffraction test for produced SNPs indicated that enzymatically and acidic prepared SNPs had amorphous structure while, the resulted SNPs using alkaline hydrolysis had lower relatively crystallinity. Results indicated that, enzymatically prepared SNPs, had minimum particle size (225 ± 10 nm) and polydispersity index (0.472 ± 0.05), and maximum zeta potential (−26.3 ± 1 mV), antioxidant activity (3.36 ± 0.05 %) and specific surface area (1.8 ± 0.1 m2g−1). Transmission electron microscopy revealed that prepared SNPs had spherical shape and enzymatically prepared SNPs had mean particle size of <100 nm. SNPs in powder form were prepared using freeze drying (pressure and temperature of 100 Pa and − 70 °C). Atomic force microscopy results demonstrated that starch granules had smooth surface, with polyhedral shape and particle size ranging 5 to 25 μm, and after hydrolysis, SNPs had particle size in nanometer scale. Emulsion ability test indicated that oil separation time from the prepared emulsions containing 10 % (W/V) starch, and enzymatically, acidic and alkaline prepared SNPs powder were 41, 70, 82 and 101 s, respectively.

Coproporphyrin-I as a Selective OATP1B Biomarker Can Be Used to Delineate the Mechanisms of Complex Drug-Drug Interactions: Cedirogant Case Study.

Cedirogant is an inverse agonist of retinoic acid-related orphan receptor gamma thymus developed for the treatment of chronic plaque psoriasis. Cedirogant induces cytochrome P450 (CYP) 3A4 while inhibiting P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), organic anion transporting polypeptide (OATP) 1B1, and OATP1B3 in vitro. Static drug-drug interactions (DDIs) predictions suggested possible clinical induction of CYP3A4, and inhibition of P-gp, BCRP, and OATP1B1, leading to challenges in interpreting DDI studies between cedirogant and substrates of CYP3A, P-gp, BCRP, and OATP1B1/3. Here the effects of cedirogant on the pharmacokinetics of two statin drugs were investigated in healthy participants. Coproporphyrin-I (CP-I), a selective endogenous OATP1B biomarker, was used to assess the impact of cedirogant on OATP1B. Cedirogant (375 mg once daily) increased rosuvastatin maximum plasma concentration (Cmax) and area under the plasma concentration curve (AUCtau) by 141% and 55%, respectively when co-administered, whereas atorvastatin Cmax increased by 40% with no effect on its AUCtau compared with administration of rosuvastatin/atorvastatin alone. Cedirogant did not increase CP-I exposures, indicating no clinical OATP1B inhibition. The increased rosuvastatin exposure and minimal change in atorvastatin exposure with co-administration of cedirogant is attributed to BCRP inhibition and interplay between P-gp/BCRP inhibition and CYP3A induction, respectively. Correlation analysis with data from two investigational drugs (glecaprevir and flubentylosin) demonstrated that OATP1B1 R-value of > 1.5 and [Cmax,u]/[OATP1B1 IC50] of > 0.1 are associated with > 1.25-fold increase in CP-I Cmax ratio. This demonstrates the utility of CP-I in disentangling mechanisms underlying a complex DDI involving multiple transporters and enzymes and proposes refined criteria for static OATP1B inhibition predictions.

Kretschmann configuration as a method to enhance optical absorption in two-dimensional graphene-like semiconductors

Objectives. The optical properties of two-dimensional semiconductor materials, specifically monolayered transition metal dichalcogenides, present new horizons in the field of nano- and optoelectronics. However, their practical application is hindered by the issue of low light absorption. When working with such thin structures, it is essential to consider numerous complex factors, such as resonance and plasmonic effects which can influence absorption efficiency. The aim of this study is the optimization of light absorption in a two-dimensional semiconductor in the Kretschmann configuration for future use in optoelectronic devices, considering the aforementioned phenomena. Methods. A numerical modeling method was applied using the finite element method for solving Maxwell’s equations. A parametric analysis was conducted focusing on three parameters: angle of light incidence, metallic layer thickness, and semiconductor layer thickness.Results. Parameters were identified at which the maximum area of absorption peak was observed, including the metallic layer thickness and angle of light incidence. Based on the resulting graphs, optimal parameters were determined, in order to achieve the highest absorption percentages in the two-dimensional semiconductor film.Conclusions. Based on numerical studies, it can be asserted that the optimal parameters for maximum absorption in the monolayer film are: Ag thickness &lt;20 nm and angle of light incidence between 55° and 85°. The maximum absorption in the two-dimensional film was found only to account for a portion of the total absorption of the entire structure. Thus, a customized approach to parameter selection is necessary, in order to achieve maximum efficiency in certain optoelectronic applications.

Safety, Tolerability, and Pharmacokinetics of Nebulized GB05-Human IFNα1b Inhalation Solution: A Randomized, Placebo-Controlled, Dose-Escalation PhaseI Study in Healthy Chinese Adult Volunteers.

Human respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection, especially in children and older people. However, no effective treatment is currently available. TypeI interferons (IFNs) are a group of cytokines that help regulate the activity of the immune system. GB05, human IFNα1b inhalation solution, was developed under US Food and Drug Administration (FDA) standard guidelines to combat RSV infection. This randomized, double-blind, placebo-controlled, dose-escalation phaseI trial evaluated the safety, tolerability, and pharmacokinetics of nebulized GB05. A total of 35 eligible healthy Chinese adult volunteers were enrolled in this study. In the single ascending dose (SAD) study, volunteers were randomized into 0.2, 0.6, 1.2, and 1.8million IU of GB05 or placebo. In the multiple ascending dose (MAD) study, volunteers received 1.2 or 1.8million IU of GB05 or placebo for four consecutive days. Safety, tolerability, immunogenicity, and plasma pharmacokinetics were assessed for all groups. All adverse events were mild or moderate and resolved spontaneously. The most common adverse event was decreased white blood cell count (8.6% in SAD and 10% in MAD). No serious adverse events, deaths, or adverse events that reached the termination criteria occurred during the study. In SAD, the maximum concentration and area under the curve increased across the dose range of 1.2-1.8million IU in a non-linear relationship. The maximum plasma concentration after GB05 nebulization (1.06IU/ml in the 1.8million IU group) reflected a low concentration in the blood, suggesting a better lung uptake of GB05 and reduced incidence or risks of adverse events. In MAD, a steady state was reached after continuous administrations of twice daily for 3days. Overall, nebulized GB05 exhibited satisfactory safety, tolerability, and favorable pharmacokinetic (PK) profiles in healthy adult volunteers, supporting further clinical investigation in patients infected with respiratory syncytial virus. ClinicalTrials.gov Identifier NCT06277167.

Lignosulfonate-derived porous carbon via self-activation for supercapacitor electrodes

This research aims to contribute to promoting a circular economy for technical lignin derived from the pulp and paper industry and developing sustainable and environmentally friendly energy storage solutions. Lignosulfonate was used as a precursor, and a three-stage carbonization method was employed to produce the electrode material. Porous carbon was successfully prepared through a self-activation process without the use of any activating agents. The resulting porous carbon was subjected to plasma treatment and screen printing, and assembled into a supercapacitor with a PVA/H2SO4 gel electrolyte. The results showed that carbonizing temperature at 1000°C boasts the highest specific surface area of 531.158 m2/g, a maximum area capacitance of 308.21 mF/cm2, the highest energy density of 27.39 μWh/cm2, and the power density of 0.0665 mW/cm2. These impressive results demonstrate the successful development of a lignosulfonate-based supercapacitor using a clean manufacturing process. This achievement can promote the high-value applications of technical lignin.

Enhanced Analysis of Ice Accretion on Rotating Blades of Horizontal-Axis Wind Turbines Using Advanced 3D Scanning Technology

This study investigated the meteorological conditions leading to ice formation on wind turbines in a coastal mountainous area. An enhanced ice formation similarity criterion was developed for the experimental design, utilizing a scaled-down model of a 1.5 MW horizontal-axis wind turbine in icing wind tunnel tests. Three-dimensional ice shapes on the rotating blades were obtained and scanned using advanced 3D laser measurement technology. Post-processing of the scanned data facilitated the construction of solid models of the ice-covered blades. This study analyzed the maximum ice thickness, ice-covered area, and dimensionless parameters such as the maximum dimensionless ice thickness and dimensionless ice-covered area along the blade. Under the experimental conditions, the maximum ice thickness reached 0.5102 m, and the ice-covered area extended up to 0.5549 m2. The dimensionless maximum ice thickness and dimensionless ice-covered area consistently increased along the blade direction. Our analysis of 3D ice shape characteristics and the ice volume under different test conditions demonstrated that wind speed and the liquid water content (LWC) are critical factors affecting ice formation on blade surfaces. For a constant tip speed ratio, higher wind speeds and a greater LWC resulted in increased ice volumes on the blade surfaces. Specifically, increasing the wind speed can augment the ice volume by up to 57.2%, while increasing the LWC can enhance the ice volume by up to 149.2% under the experimental conditions selected in this study.

State of polar climate in 2023

The year 2023 has become the warmest year on global record. As the Antarctic and Arctic are sensitive regions to global warming, the climate changes in 2023 in these regions have attracted widespread attention. In this study, using observations, reanalysis and remote sensing data, we reported detailed polar climate changes in 2023, including warming, sea ice, atmospheric composition and extreme events. Antarctic exhibited large east‒west regional differences and the coexistence of extreme warm and cold events. In Coats Land, Queen Maud Land and the Antarctic Peninsula, three and seven stations recorded the second and third highest autumn air temperatures in history, respectively. The Amundsen–Scott station experienced extreme warming event in July, with the temperature increasing by 40 °C in one day. Abnormal cooling was evident in the Ross Sea and neighboring regions which were predominantly winter (June–August) cold anomalies, with Marylin Station reaching the lowest winter temperature in history. The Arctic experienced the warmest summer after 1979, with an overall distribution of ‘warm land‒cold sea’ on annual average. Compared with the 1991–2020 average, the annual air temperature anomalies reached more than 2 °C in northern Canada and the Barents Sea–Kara Sea coast. Abnormal high summer temperature caused most severe wildfires in Canada on record and second largest daily cumulative melt area over the Greenland ice Sheet daily post-1979. Polar sea ice continued to decrease rapidly, with minimum sea ice extent in Antarctic and Arctic ranking the first and sixth lowest post-1979. For melt season, Arctic Ocean sea ice began to melt later in 2023 than the 2011–2023 average, and freeze onset was delayed due to high temperatures in summer and autumn. Additionally, the status of polar atmospheric greenhouse gases remains bleak, and major greenhouse gas concentrations continue to increase. The Antarctic ozone hole in 2023 formed approximately 10 d earlier and lasted longer than the 1979–2023 average, with a maximum daily area of 2.6 × 107 km2 on 21 September. This summary of polar climate changes in 2023 will help people better understand global climate change and draw attention to polar regions.

Human activity drives establishment, but not invasion, of non‐native plants on islands

Island ecosystems are particularly susceptible to the impacts of invasive species. Many rare and endangered species that are endemic to islands are negatively affected by invasions. Past studies have shown that the establishment of non‐native species on islands is related to native plant richness, habitat heterogeneity, island age, human activity, and climate. However, it is unclear whether the factors promoting establishment (i.e. the formation of self‐sustaining populations) also promote subsequent invasion (i.e. spread and negative impacts). Using data from 4308 non‐native plant species across 46 islands and archipelagos globally, we examined which biogeographic characteristics influence established and invasive plant richness using generalized linear models nested within piecewise structural equation models. Our results indicate that anthropogenic land use (i.e. human modification) is strongly associated with establishment but not invasion, that climate (maximum monthly temperature) is strongly associated with invasion but not establishment, and that habitat heterogeneity (represented by maximum elevation and island area) is strongly associated with both establishment and invasion. Island isolation explains native plant richness well, but is not associated with established and invasive plant richness, likely due to anthropogenic introductions. We conclude that anthropogenic land use on islands is likely to be a proxy for the number of introductions (i.e. propagule pressure), which is more important for establishment than invasion. Conversely, islands with more diverse habitats and favorable (warm) climate conditions are likely to contain more available niche space (i.e. ‘vacant niches') which create opportunities for both establishment and invasion. By evaluating multiple stages of the invasion process, we differentiate between the biogeographic characteristics that influence plant establishment (which does not necessarily lead to ecological impacts) versus those that influence subsequent plant invasion (which does lead to negative impacts).

Favipiravir pharmacokinetics in COVID-19 patients with moderate to severe kidney dysfunction: Lessons learned.

There is limited information on favipiravir pharmacokinetics in critically ill patients and no studies on pharmacokinetics in patients with moderate and severe kidney dysfunction. The aim was to determine favipiravir pharmacokinetics (oral, 1,600 mg, q12h on day 1, then 600 mg, q12h for 4 days) in critically ill COVID-19 patients with kidney dysfunction and to compare those with observations reported in healthy adults. In a descriptive study, blood samples taken from patients meeting the relevant criteria (estimated glomerular filtration rate <60mL/min) were collected and analyzed. Analysis of blood samples was done by high performance liquid chromatography (HPLC), and the maximal concentration (Cmax), the time of maximal concentration (tmax), half-life (T1/2) and area under the curve (AUC0-12h) of favipiravir were calculated (WinNonlin) and compared to reported data in healthy subjects after first administration. Based on analysis of samples collected in 7 patients, the Cmax (29.99 vs. 64.5 µg/mL) of favipiravir was decreased, T1/2 (5.8 vs. 4.8 hours) longer, tmax delayed, while total exposure was lower (AUC0-12: 192.53 vs. 446.09 μg/mL) compared to reported data in healthy subjects after first administration. Exposure remained lower up to day 5. In patients with kidney dysfunction related to COVID-19, favipiravir did not reach the expected exposure. This may be due to poorer and delayed absorption, and subsequent altered disposition. Population pharmacokinetic and mechanistic studies are needed to better explore the relevant covariates and to determine the optimal dose in these patients, as this drug is likely of relevance for other indications.

Long-Term Volumetric Evaluation of Stent-Assisted Balloon-Induced Intimal Disruption and Relamination of Aortic Dissection (STABILISE) in Acute Type B Aortic Dissection

ObjectiveTo quantify the volumetric aortic remodeling of patients with acute type B aortic dissection (ATBAD) treated with the stent-assisted balloon-induced intimal disruption and relamination (STABILISE) technique. MethodsAll patients with ATBAD operated with the STABILISE technique between 2014 and 2017 with pre-operative (PreOp), post-operative (PostOp) and >12 months (follow-up) computed tomography scans were included in this study. True lumen and total aortic volume were accurately assessed in the thoracic and abdominal portions with a semi-automatic 3D tool. Associations with long-term adverse events were estimated. ResultsSeventeen patients were measured at PreOp, PostOp and a mean follow-up of 19±8 months. The false lumen to total volume ratio decreased on average from 63% to 18% after STABILISE (p<0.001) and remained around 12% at follow-up. These remodeling was more pronounced in the thoracic aorta (7%) than in the abdominal aorta (28%). The trend in aortic size growth was stronger for volumes than for maximum areas or diameters (p<0.001, p<0.05 and p<0.05, respectively). Adverse events were identified in 4 patients during a long-term follow-up of 76±18 months. The only aortic size variable assessed preoperatively that was associated with undesirable events was the total volume of the abdominal aorta (p<0.05). ConclusionsA volumetric analysis of dissected aortic size after the STABILISE procedure allowed accurate quantification of mid-term aortic remodeling and helped to identify the abdominal aortic volume as a preoperative variable associated with undesirable long-term events.

Assessing climate-driven impacts on Karakoram glacier surge: A geospatial analysis highlighting Shishper Glacial Lake outburst flood events (2019–2022) as prime example

The Northern Areas of Pakistan encompass the Hindukush, Karakoram, and Himalayan mountain ranges witnessing glacier surging, exacerbated by climate warming. As glaciers rapidly melt, ravines experience heightened blockage and migration, obstructing stream discharges and forming expansive ice-dammed lakes. The rupture of these natural dams triggers Glacial Lake Outburst Floods downstream in the primary glacier's ravine. The catastrophic Glacial Lake Outburst Floods in 2022 across the Karakoram ranges in Northern Pakistan prompted this study. It focuses on Shishper Glacier Lake. The aim is to provide complete flood observations and their devastating effects on downstream communities. Analysis of Landsat 08 Imagery reveals the evolution of Shishper Glacier Lake from its initiation in November 2018 to the catastrophic GLOF in May 2022. The lake reached a maximum area of 0.32 km2 in 2019 and its successive breaches on June 22, 2019, and May 29, 2020, reduced it to 0.018 km2. Draining continued until July 2021, shrinking the lake area to 0.009 km2. A noteworthy 2.73 °C temperature increase in 2022 correlated with an expansion of the lake area to 0.33 km2, culminating in the GLOF on May 7th, 2022. The study emphasizes the critical need for mapping, assessing, and monitoring surging glaciers and glacier-formed lakes in the Karakoram ranges to safeguard downstream communities from potential hazards.

Benefits Over Five Years of Ixekizumab Treatment in Patients With Psoriasis Involving Challenging Body Areas.

Psoriasis involving challenging body areas, such as the scalp, face, palmoplantar surfaces, or nails, can be challenging to treat and negatively affects patient outcomes. To assess clear responses and cumulative clinical benefits over 5 years of ixekizumab treatment of moderate-to-severe plaque psoriasis in patients with and without baseline involvement of challenging body areas. This post hoc analysis included patients treated with ixekizumab in the UNCOVER-3 trial. We assessed PASI100 responses through the week (W) 264 and cumulative clinical benefits at W264 (calculated as least-squares mean of the percentage of maximum area under the curve for PASI100 and PASI% improvement and expressed as cumulative clearance days). Statistical differences were calculated via ANCOVA. A total of 385 patients were analyzed: 349 with scalp involvement, 152 with facial involvement, 96 with palmoplantar involvement, and 229 with nail involvement. Proportions of patients achieving PASI100 were numerically similar between patients with and without scalp and nail involvement. More patients without facial and palmoplantar involvement achieved PASI100 at W60 (only palmoplantar), W108, W156, W204, and W264 (only palmoplantar). At W264, cumulative clinical benefits for PASI100 and PASI% improvement were high and similar in both patient groups, with and without challenging body areas. A significant difference (P=0.006) was only observed for PASI% improvement between patients with and without nail involvement. For most efficacy measures, patients treated with ixekizumab over 5 years achieved similar clear responses and cumulative clinical benefits regardless of baseline involvement of challenging body areas. J Drugs Dermatol. 2024;23(8):619-625.&nbsp; doi:10.36849/JDD.8160.

Pan-omics-based characterization and prediction of highly multidrug-adapted strains from an outbreak fungal species complex

Strains from the Cryptococcus gattii species complex (CGSC) have caused the Pacific Northwest cryptococcosis outbreak, the largest cluster of life-threatening fungal infections in otherwise healthy human hosts known to date. In this study, we utilized a pan-phenome-based method to assess the fitness outcomes of CGSC strains under 31 stress conditions, providing a comprehensive overview of 2,821 phenotype-strain associations within this pathogenic clade. Phenotypic clustering analysis revealed a strong correlation between distinct types of stress phenotypes in a subset of CGSC strains, suggesting that shared determinants coordinate their adaptations to various stresses. Notably, a specific group of strains, including the outbreak isolates, exhibited a remarkable ability to adapt to all three of the most commonly used antifungal drugs for treating cryptococcosis (amphotericin B, 5-fluorocytosine, and fluconazole). By integrating pan-genomic and pan-transcriptomic analyses, we identified previously unrecognized genes that play crucial roles in conferring multidrug resistance in an outbreak strain with high multidrug adaptation. From these genes, we identified biomarkers that enable the accurate prediction of highly multidrug-adapted CGSC strains, achieving maximum accuracy and area under the curve (AUC) of 0.79 and 0.86, respectively, using machine learning algorithms. Overall, we developed a pan-omic approach to identify cryptococcal multidrug resistance determinants and predict highly multidrug-adapted CGSC strains that may pose significant clinical concern.

Outcomes and Spinopelvic Changes After Anterior Lumbar Interbody Fusion With a Novel Interbody Fusion Device: A Retrospective Study.

Interbody devices in anterior lumbar interbody fusion (ALIF) are currently a focus of innovation due to their potential to improve clinical outcomes. The purpose of the present study was to analyze complications and changes in spinopelvic parameters after ALIF with the novel Medacta MectaLIF interbody fusion device. Patients aged 18 to 80 years who underwent multilevel ALIF using this novel implant were identified. Demographic and surgical data were collected. Patients were divided into short- and long-fusion cohorts. A comparison of outcomes between the short- and long-fusion groups was performed using the Student t test for continuous variables and Fisher's exact test and the χ2 test for categorical variables. Analysis of the pre- vs postoperative radiographic data for the entire cohort was performed using the 2-tailed Student t test. One hundred and eight patients met the inclusion criteria. No significant postoperative change was observed in L1-4 lumbar lordosis (LL). L1-S1 LL increased to a mean of 55.1 ± 12.8 (a mean change of 10.7 ± 14.5), and L4-S1 LL increased to a mean of 38.4 ± 8.7 (a mean increase of 7.5 ± 8.2), with pelvic incidence LL mismatch changing from 8.9 ± 15.1 to 1.1 ± 13.5 (n = 102). Related changes in sacral slope and pelvic tilt were also observed (33.0 ± 11.0 to 37.6 ± 10.9 and 19.6 ± 9.5 to 18.2 ± 9.1 [n = 103], respectively). Five patients (4.6%) experienced implant subsidence, 1 (0.9%) had implant migration, and 6 (5.6%) experienced a nonunion. There was no difference in the rates of complications associated with the novel implant in the short- and long-fusion cohorts. This novel implant achieves correction of spinopelvic parameters with minimal complications. The ability to modify the implant intraoperatively based on the patient's anatomy can help achieve maximal contact area and therefore help reduce the risk of subsidence. This modular implant can achieve correction of spinopelvic parameters with minimal medical and surgical complications.