Minimal Increase Research Articles

Is oviposition time and oviposition interval associated with the deposition of cuticle on the hen’s egg?

ABSTRACT 1. The cuticle acts as a barrier to prevent microbial penetration of the eggshell. The reduction in the oviposition interval with selection for egg production and the activity of clock genes in the oviduct led to testing the hypothesis that the interval between successive oviposition of eggs would be related to the deposition of the cuticle. 2. There was oviposition interval and cuticle deposition data from 2140 eggs from 5 White Leghorn pure lines for over 7 d. The association between oviposition interval and cuticle deposition was assessed using a random slopes model for each hen. 3. The time of oviposition was 05:37 h:m, about 2.5 h after lights on. Differences in oviposition time between lines were significant (P=0.025). Oviposition interval was slightly greater than 24 h at 24:06 h:min with significant differences between lines (P = 0.003). The variance was low and the maximum difference between lines for oviposition interval was only 11 min. Cuticle deposition was 28.87ΔE*ab with no differences between lines. 4. The number of eggs a hen laid had an effect on the oviposition interval (P = 0.004), being shortest in hens laying seven eggs (24:01 h:m) than those laying six (24:08) or five eggs (24:14). 5. There was a significant positive association between cuticle deposition and oviposition interval (P = 0.007) with a minimal increase of 0.79 ΔE*ab in cuticle deposition for each additional hour of oviposition interval. Heritability for cuticle deposition in this study was 0.48 but heritability was not measurable for oviposition interval and was not different from zero for oviposition time. 6. Combined with a difference between the top and tail of the distribution for cuticle deposition, there was evidence for a significant but relatively small relationship between oviposition interval and deposition of cuticle on the egg. This may have contributed to some reduction in cuticle coverage as the oviposition interval approached 24 h, but it seems unlikely that it was a major component.

Parametric design workflow for solar, context-adaptive and reusable facades in changing urban environments

This study proposes a concept and workflow for solar, context-adaptive and reusable facades. Integrating solar control with parametric facade design, the workflow uses solar radiation to inform facade modules with variable openness or properties (e.g. frit cover), enabling envelopes to adapt to urban context changes while promoting circularity. The method was tested through simulations, assessing daylight, glare, energy and circularity in changing urban scenarios. A Solar Circularity Indicator (SCI) was introduced to track façade alterations and reuse. In the 100m new obstruction scenario, 79% of facade modules were maintained, while 29% of altered modules were reused, yielding an 85% SCI. Sunlight Autonomy metrics aligned well with SCI. Re-design improved Spatial Daylight Autonomy by up to 4% with minimal energy increase (<1%). Our solution provided 2% more useful daylight (100–3000lux) than glazed facades and 11% less glare. The workflow provides a framework for circular, performance-based designs that preserve aesthetics and adaptability.

A US payer budget impact analysis of Flurpiridaz-PET-MPI compared to SPECT-MPI in the diagnosis of coronary artery disease

Aims This economic model was developed to assess the budget impact of a novel radiotracer, Flurpiridaz (F18-PET-MPI), compared to SPECT-MPI from a US payer perspective. Materials and Methods The model was developed comparing F18-PET-MPI and SPECT-MPI, with F18-PET-MPI modality share increasing from 0.5% to 2.5% of the total MPI modality share, over a 5-year time horizon. The model estimates the impact of diagnostic performance on downstream healthcare resource utilization (HCRU) including invasive coronary angiography (ICA), revascularization, pharmacological treatment, and cardiac outcomes (CO) such as cardiac mortality (CM) and myocardial infarction (MI). Four suspected CAD populations, including general and difficult-to-image subgroups, were analyzed. Clinical inputs used to support the parameterization of the model were sourced from a systematic literature search and included claims-based real-world evidence, observational, and multicenter registry studies to inform the rates of HCRU and CO, and head-to-head comparative clinical trial data advised diagnostic performance inputs. Reimbursement codes informed MPI modality costs. Results are reported as per-member per-month (PMPM) based on a hypothetical health plan. Results In all suspected CAD populations analyzed, there was a nominal cost increase in the world with F18-PET-MPI. The 5-year average PMPM incremental budget impact ranged from $0.02 to $0.05 across all suspected CAD subgroups. Cost-savings were associated with decreased downstream CO such as CM, MI, and ICA. Limitations and Conclusion The available literature to source all parameters in the model was limited; therefore, assumptions and additional calculations were made based on published evidence to inform the model. A one-way sensitivity analysis was performed to confirm and address uncertainty in key parameters. This comprehensive analysis illustrates that the superior diagnostic performance of F18-PET-MPI may result in reduced adverse CO events and associated costs, increased appropriate identification and treatment of CAD, and a minimal increase in overall costs among general and difficult-to-image patient subgroups.

Assessing visual comfort for active building enclosures: a novel simulation workflow for environmentally active top lighting cells

This study examines the impact of top lighting cells in a low-latitude city. It hypothesizes that an environmentally active control system enhances indoor illuminance without causing glare. It proposes a parametric procedure based on three simulation stages using UDI/UDIavg, Image-based, and Imageless DGP. The first stage is a simplified approach for evaluating image-based simulations considering representative dates. The second stage uses the image-based results for selecting the most contributing motion parameters through a One-way Variance-based Sensibility Analysis. The third expands the system's complexity for grid-based year-round simulations. Results indicate tilt motion as the most contributing factor for daylight control. Furthermore, the cells supplement daylight indoors, rendering a minimal increase of approximately 30% of the hours within the adequate illuminance range compared to the base case with no zenithal opening. The system ultimately achieve 100% of the hours in compliance with the selected daylight thresholds without significantly increasing glare.

Finite Element Analysis of 3D Transient Linear Temperature Changes in the Periodontal Ligament During Thermoplasticized Gutta-Percha Obturation Techniques

ABSTRACT Objective: This study used finite element analysis to evaluate temperature changes in the periodontal ligament due to various thermoplasticized gutta-percha obturation techniques. Methods: Mandibular premolar models were created in SolidWorks software, simulating carrier-based obturation (CBO) and continuous wave of condensation with backfill obturation (CWC+BFO). Results: Upon analyzing seven models, the study revealed that the CWC+BFO models with the highest temperature settings (Models 4 and 7) recorded the highest maximum temperatures, nearing 127°C. In contrast, the CBO model (Model 1) exhibited the lowest maximum temperature at 47.835°C. These temperatures were primarily measured at the apical region. The duration exceeding 10°C above body temperature was highest in Models 4 and 7. CBO caused a brief 10.835°C rise for 0.43 s, deemed safe, while all CWC+BFO techniques exceeded 10°C above body temperature, lasting up to 14.40 s. Lower temperature settings, particularly during CWC, are recommended for safer CWC+BFO application. Conclusion: The CBO technique caused minimal temperature increase and appears safe. However, the CWC technique with BFO resulted in significantly higher temperatures, potentially harming the periodontal ligament. The authors recommend using lower temperatures with both techniques, especially with the CWC technique, and applying the BFO technique in multiple layers to minimize risks.

E-Fuel: An EV-Friendly Urgent Electrical Charge-Sharing Model with Preference-Based Off-Grid Services

Electric-powered vehicles (EVs) allow for an environmentally friendly and economic alternative to fuel-running ones. However, such an alternative is expected to impose further usage hikes and periods of instability on cities’ power systems. From their perspective, cities need to scale their infrastructure grids to allow for adequate power resources to feed such new power-hungry consumers. Indeed, for such a green alternative to proceed, our power grids need to be ready to cope with any unexpected hikes in the power consumption rates without compromising the stability of the services provided to our homes and workplaces. Operators’ steps in this path are still modest, and the coverage of EV charging stations is still insufficient as they are trying to avoid any further costs for upgrading their infrastructures. The lack of price consideration for the charging services offered at charging stations may result in EV drivers paying higher costs compared to traditional fuel vehicles to charge their EVs’ batteries, hindering the economic incentive of owning such sorts of vehicles. Hence, it may take a while for sufficient coverage to exist. Although for drivers the adoption of EVs represents a city-friendly alternative with affordable expenses, it usually comes with range anxiety and battery charging concerns. In this work, we are presenting e-Fuel, a charge-sharing model that allows for preference-based mobile EV charging services. In e-Fuel, we are proposing a stable weight-based vehicle-to-vehicle matching algorithm, through which drivers of EVs will be capable of requesting instant mobile charge-sharing service for their EVs. In addition to being mobile, such charging services are customized, as they are chosen based on the drivers’ preferences of price-per-unit, charging speed, and time of delivery. The developed e-Fuel matching algorithm has been tested in various environments and settings. Compared to the benchmark price-based matching algorithm, the resulting matching decisions of e-Fuel come with balanced matching attributes that mostly allow for 6- to 7-fold shorter service delivery times for a minimal increase in service charges that vary between 9% and 65%.

Exploring Geometric Properties and Cycle Design in Packed Bed and Monolith Contactors Using Temperature-Vacuum Swing Adsorption Modeling for Direct Air Capture.

This study presents a comprehensive comparison between the packed bed and monolith contactor configurations for direct air capture (DAC) via process modeling of a temperature-vacuum swing adsorption (TVSA) process. We investigate various design parameters to optimize performance across different contactor geometries, including pellet size, monolith wall thickness, active sorbent content in monoliths, and packed bed structure configurations, considering both a traditional long column (PB40) and multiple shorter columns configured in parallel (PB5). Our parametric analysis assesses specific exergy consumption, sorbent, and volume requirements across different operating conditions of a five-step TVSA cycle. For minimizing sorbent requirements, PB5 and monoliths with over 80% sorbent loading were the best-performing contactor designs with overlapping performance in the low-exergy region. Beyond this region, PB5 faced limitations in reducing sorbent requirements further and was constrained by a maximum velocity at which it is sensible to operate without substantially increasing the exergy demand. In contrast, monoliths decreased sorbent requirements with minimal exergy increase due to reduced mass transfer resistances and lower pressure drop associated with their thin walls. The analysis of volume requirement-specific exergy Pareto fronts revealed that PB5 was less competitive with this metric due to the requirements for additional void space in the contactor configuration. The study also revealed that optimal sorbent loading for reducing volume requirements in monoliths differed from those minimizing sorbent usage, with the most effective loading being below 100%. Thus, the optimal contactor design varies depending on the goals of minimizing sorbent and volume requirements, and the choice and design of the contactor will depend on the relative costs of these factors. Lastly, our findings challenge the assumption that higher velocities are always preferable for direct air capture, suggesting instead that the operating velocity depends on the contactor configuration.

Loss-less passive polarization rectifier design with minimal etendue and size increase

We describe an approach allowing the passive rectification of the polarization of light with approximately the same beam size, minimal increase of the etendue of the beam and with negligible reduction of its power. This is done for arbitrary (including chaotic) input polarization states and without their prior identification. The tradeoff is the partial increase of the angular spectrum of light. Theoretical estimations are provided along with some preliminary experimental results describing the possible use of this approach with large diameter beams as well as in optical fibers.

Hispanic Faculty Trends in U.S. Medical Schools: A 50-Year Perspective

The U.S. Hispanic population has grown substantially over the past 50 years, and simultaneously, the number of U.S. medical schools and medical school faculty has increased. This study examines the trends for Hispanic faculty in clinical and basic science departments at U.S. medical schools. Method This retrospective, cross-sectional observational study analyzed data from the Association of American Medical Colleges Faculty Roster for faculty at all LCME-accredited medical schools from 1973 to 2022. Proportions of faculty were compared according to department, sex, rank, and Hispanic status using a 2-independent-sample t-test and simple linear regressions. Results The percentage of Hispanic medical school faculty increased from 1.7% in 1973 to 5.4% in 2022, with similar rates of increase in basic science and clinical departments. In 2022, departments with the highest representation of Hispanic faculty included family medicine and obstetrics and gynecology. The departments with the lowest representation of Hispanic faculty were orthopedic surgery and otolaryngology. In 2022, only 1.5% and 3.1% of all full professors were Hispanic females and males, respectively. Conclusion There was a minimal increase in the percentage of Hispanic faculty in medical schools over the last 50 years, and the rank was disproportionally higher at the Assistant Professor level, particularly for females. The combination of a rapid increase in the U.S. Hispanic population and a slow increase in Hispanic faculty has resulted in Hispanic medical school faculty being more underrepresented in academic medicine in 2022 than in 1973.

Balancing Cost and Environmental Impact: A Linear Programming Approach to Sustainable Shopping

A linear programming model is devised for consumer purchasing decisions minimizing weighted cost and environmental impact using real-world data. Minor shifts towards environmental preferences can greatly reduce impact with minimal cost increase. Spending slightly more on the bundle than the cheapest option can cut environmental impact by a third. Conversely, less than 10% compromise in impact yields over 15% cost savings. Consumers can find efficient midpoints—cost-effective and environmentally sustainable options—through strategic decisions. Additionally, a synthetic dataset, modeling different societal dispositions through Beta distributions of cost-environment orientation parameters, simulates societal attitudes, showing that a 10% reduction in environmental impact is possible with a 23% higher economic burden, while 60% of this reduction can be achieved with only 3.1% increase in cost when maintaining a balanced societal disposition. This demonstrates the potential of optimization-based strategic purchasing decisions to achieve significant economic and environmental efficiencies when accompanied by increased environmental awareness.

Differential impact of clinic BP target on the prevalence and predictors of the masked uncontrolled hypertension and white-coat uncontrolled hypertension

Abstract Background Although intensive blood pressure (BP) control have been advocated, major clinical practices guidelines still recommend clinic BP (cBP) &amp;lt; 149/90 mmHg as the target for antihypertensive therapy. But, cBP targets could influence the prevalence and predictors of any hypertension phenotype. We investigated how different cBP targets impacted on the prevalence and predictors of masked uncontrolled hypertension (MUCH) and white-coat uncontrolled hypertension (WUCH) using the Korean Ambulatory Blood Pressure (KorABP) registry. Methods A multicenter prospective longitudinal cohort study was performed in outpatients with hypertension. Among 5,965 patients enrolled in the KorABP registry, 1,601 patients on antihypertensive medications with a valid ambulatory BP monitoring record were included in this study. Two different cBP targets, &amp;lt;130/80mmHg (intensive) and &amp;lt;140/90 mmHg (conventional) were investigated. Results Controlled ambulatory BP (aBP; &amp;lt;130/80 mmHg) was observed in 472 patients (29.5%). Controlled cBP was shown in 348 patients (21.7%) with the intensive cBP target and in 697 patients (43.5%) with the conventional cBP target. Controlled hypertension, WUCH, MUCH and uncontrolled hypertension were found in 294, 174, 54, and 1,075 patients with the intensive target and in 378, 94, 319 and 810 patients with the conventional target, respectively. Among the patients with controlled cBP, the prevalence of MUCH markedly decreased with the intensive target (15.5%), compared to the conventional target (45.8%). In contrast, among the patients with uncontrolled cBP, the prevalence of WUCH had only 3.8% increase with the intensive target (10.4%), compared to the conventional target (14.2%) (Figure 1). With the conventional target, 75.9% of patients with MUCH had cBP between 130/80 mmHg and 139/89 mmHg. The concordance between the controlled aBP and controlled cBP was higher with the intensive target than with the conventional target (Cohen’s κ 0.62 [0.58-0.67] vs. 0.46 [0.41-0.50]). The logistic models for MUCH included the left ventricular mass index and underuse of antihypertensive drugs (&amp;lt;2 types of drugs) as the common predictors of the both targets. With the conventional target, clinic systolic BP and diastolic BP were the strongest predictors of MUCH, but the cBP was not a predictor of MUCH with the intensive target. The logistic models for WUCH included beta-blocker use, increased heart rate and lower waist circumference and clinic systolic BP as the common predictors of WUCH with the both target. The logistic model for MUCH performed better with the conventional target, whereas the logistic model for WUCH performed better with the intensive target (Figure 2). Conclusion The use of the intensive cBP target (&amp;lt;130/80 mmHg) could reduce the prevalence of MUCH with minimal increase in the prevalence of WUCH and would provide the better assessment for the BP control status than the use of the conventional cBP target (&amp;lt;140/90 mmHg).Figure 1Figure 2

Impact of Lp(a) on lipid control in patients with acute coronary syndrome

Abstract Background The lipoprotein(a) (Lp[a]) is a genetically determined low-density lipoprotein (LDL)-like particle. Lp(a) levels above 50mg/dl have been correlated to an increased risk of atherosclerosis and major adverse cardiovascular events. Thus, treatments designed to reduce Lp(a) levels are currently under investigation. However, it is unknown how high Lp(a) concentrations affect the control of lipid profile. Purpose The purpose of this project is to investigate how Lp(a) impacts lipid profile control in individuals with acute coronary syndromes (ACS). Methods We designed a single-center prospective registry including consecutive patients admitted for ACS. Lp(a) levels were obtained from all enrolled patients during hospitalization; lipid profile (total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, triglycerides) was obtained at admission and at the 6-month follow-up (6MFU). Patients were stratified according Lp(a) concentration (low-Lp(a): Lp(a) &amp;lt; 50 mg/dL; high-Lp(a): Lp(a) ≥ 50 mg/dL). LDL-cholesterol (LDLcorr) levels corrected for concentration of Lp(a) were calculated as LDLcorr= LDLmeasured – 30%Lp(a). At discharge cholesterol lowering drugs were introduced or titrated as standard of care. The primary endpoint was the percentage of patients reaching target LDL and LDLcorr (&amp;lt;55 mg/dL) at 6MFU. The secondary endpoints were the correlations between Lp(a) levels and lipid profile, both at baseline and at 6MFU, as well as the correlation between Lp(a) levels and the total number of traditional cardiovascular risk factors in the study population. Results From February 2020 through September 2023, a total of 409 patients were included: 305 (74.6%) with Lp(a) &amp;lt; 50 mg/dL; 104 (25.4%) with Lp(a) ≥ 50 mg/dL (Table 1). High-Lp(a) patients showed a lower prevalence of diabetes (14.2% vs 27.87%, P = 0.0055), an overall lower number of traditional cardiovascular risk factors (&amp;gt;2 in 25.9% vs 38.1%, P=0.0244). High-Lp(a) patients showed higher level of LDL-cholesterol compared to the low-Lp(a) population both at baseline (124±52 mg/dL vs 110.4±44 mg/dL, P= 0.0263) and at 6MFU (70.5±21 vs 63.8±29, P= 0.0208) with fewer patients achieving the target LDL cholesterol levels (21.57% vs 40.13%, P=0.0184). Estimating the true LDL concentration (LDLcorr) the percentage of patients reaching target LDL cholesterol levels at FU significantly increased in the high-Lp(a) group (from 21.57% to 76.5%), with a minimal increase noticeable in the low-Lp(a) population (from 40.13% to 48.41%, p 0,1870). Conclusions In ACS population, patients with high Lp(a) concentrations have fewer traditional CV risk factors and a lower prevalence of diabetes. High-Lp(a) patients, furthermore, seem more challenging to meet LDL target at 6 month follow up, but not when the LDL values are adjusted for Lp(a).

Artificial Intelligence-Assisted Colonoscopy for Polyp Detection : A Systematic Review and Meta-analysis.

Randomized clinical trials (RCTs) of computer-aided detection (CADe) system-enhanced colonoscopy compared with conventional colonoscopy suggest increased adenoma detection rate (ADR) and decreased adenoma miss rate (AMR), but the effect on detection of advanced colorectal neoplasia (ACN) is unclear. To conduct a systematic review to compare performance of CADe-enhanced and conventional colonoscopy. Cochrane Library, Google Scholar, Ovid EMBASE, Ovid MEDLINE, PubMed, Scopus, and Web of Science Core Collection databases were searched through February 2024. Published RCTs comparing CADe-enhanced and conventional colonoscopy. Average adenoma per colonoscopy (APC) and ACN per colonoscopy were primary outcomes. Adenoma detection rate, AMR, and ACN detection rate (ACN DR) were secondary outcomes. Balancing outcomes included withdrawal time and resection of nonneoplastic polyps (NNPs). Subgroup analyses were done by neural network architecture. Forty-four RCTs with 36 201 cases were included. Computer-aided detection-enhanced colonoscopies have higher average APC (12 090 of 12 279 [0.98] vs. 9690 of 12 292 [0.78], incidence rate difference [IRD] = 0.22 [95% CI, 0.16 to 0.28]) and higher ADR (7098 of 16 253 [44.7%] vs. 5825 of 15 855 [36.7%], rate ratio [RR] = 1.21 [CI, 1.15 to 1.28]). Average ACN per colonoscopy was similar (1512 of 9296 [0.16] vs. 1392 of 9121 [0.15], IRD = 0.01 [CI, -0.01 to 0.02]), but ACN DR was higher with CADe system use (1260 of 9899 [12.7%] vs. 1119 of 9746 [11.5%], RR = 1.16 [CI, 1.02 to 1.32]). Using CADe systems resulted in resection of almost 2 extra NNPs per 10 colonoscopies and longer total withdrawal time (0.53 minutes [CI, 0.30 to 0.77]). Statistically significant heterogeneity in quality and sample size and inability to blind endoscopists to the intervention in included studies may affect the performance estimates. Computer-aided detection-enhanced colonoscopies have increased APC and detection rate but no difference in ACN per colonoscopy and a small increase in ACN DR. There is minimal increase in procedure time and no difference in performance across neural network architectures. None. (PROSPERO: CRD42023422835).

Comparative Study on the Effect of External Magnetic Field on Aluminum Alloy 6061 and 7075 Resistance Spot-Welding Joints

This study investigates the effects of the external magnetic field on the microstructure and mechanical property aluminum alloy 6061-T6 and 7075-T651 resistance spot welding joints. The melting behavior of 6061 and 7075 was analyzed via the calculation of the phase diagram (CALPHAD) technique. The CALPHAD results indicate that, for the 6061 aluminum alloy, the liquid fraction shows a minimal increase at the beginning stage during the solid–liquid phase transition process but with a sharp rise at the ending stage (near the liquidus). In contrast, for the 7075 aluminum alloy, the liquid fraction gradually increases throughout the entire solid–liquid phase transition process. The differences in melting behavior between the 6061 and 7075 alloys lead to different liquation crack morphologies in their spot-welded joints. In the 6061 alloy, the cracks tend to be “eyebrow-shaped”, allowing the liquid metal in the nugget to feed the gaps, and this does not significantly compromise the mechanical properties of the joint. In contrast, the 7075 alloy develops slender cracks that extend through the partially melted zone (PMZ), making it difficult for the liquid metal to feed these gaps, thereby significantly deteriorating the joint’s mechanical strength. Compared to conventional resistance spot-welding joints, the heat exchange between the nugget and the workpiece is enhanced under the external magnetic field, leading to a wider PMZ. This exacerbates the detrimental effects of liquation cracks on the mechanical properties of the 7075 joints. Lap-shear tests indicate that the mechanical properties of the 6061 aluminum alloy joints are improved under electromagnetic stirring. For 7075 aluminum alloy joints, the mechanical properties improve when the welding current is below 34 kA. However, when the welding current exceeds 34 kA, because the widening of the PMZ increases the tendency for liquation cracks, the joint’s mechanical property is deteriorated.

Divergent Syntheses of Near-Infrared Light-Activated Molecular Jackhammers for Cancer Cell Eradication.

Aminocyanines incorporating Cy7 and Cy7.5 moieties function as molecular jackhammers (MJH) through vibronic-driven action (VDA). This mechanism, which couples molecular vibrational and electronic modes, results in picosecond-scale concerted stretching of the entire molecule. When cell-associated and activated by near-infrared light, MJH mechanically disrupts cell membranes, causing rapid necrotic cell death. Unlike photodynamic and photothermal therapies, the ultrafast vibrational action of MJH is unhindered by high concentrations of reactive oxygen species scavengers and induces only a minimal temperature increase. Here, the efficient synthesis of a library of MJH is described using a practical approach to access a key intermediate and facilitating the preparation of various Cy7 and Cy7.5 MJH with diverse side chains in moderate to high yields. Photophysical characterization reveals that structural modifications significantly affect molar extinction coefficients and quantum yields while maintaining desirable absorption and emission wavelengths. The most promising compounds, featuring dimethylaminoethyl and dimethylcarbamoyl substitutions, demonstrate up to sevenfold improvement in phototherapeutic index compared to Cy7.5 amine across multiple cancer cell lines. This synthetic strategy provides a valuable platform for developing potent, light-activated therapeutic agents for cancer treatment, with potentially broad applicability across various cancer types.

Glacial interglacial variations in the natural iron fertilization during the low sea ice periods along the eastern continental margin of Antarctica

The Southern Ocean sequesters atmospheric CO2 through biological pumps, though its driving factors are debated. Modern productivity is regulated by natural iron fertilization from micronutrient influx through dust, regeneration, and Antarctic glaciers and sea ice melting (ice melt). The productivity along the eastern Antarctic continental margin was low during the last glacial period and gradually increased through the deglacial to Late Holocene, marked by distinct productivity peaks. The micronutrients also varied similarly, with reduced glacial influx and an increase in the Holocene, which may cause productivity peaks. Therefore, the coherence of enhanced productivity and micronutrient influx is considered as enhanced iron fertilization period. The productivity peaks declined within ∼1.5 kyr, mostly due to the Ekman transport and sea ice formation. Along with ice melt, the independent weathering pattern that responds with glacial- interglacial ice volume changes suggest the source of micronutrients is not terrigenous. Shelf interaction of oceanic currents can influence the water column nutrient stock significantly, while its utilization occurs during reduced ice periods (low sea ice and high glacier melting) for productivity. Therefore, enhanced natural iron fertilization periods are considered as ice low periods that occurred in a periodicity of 2 kyrs, at ∼7.5 kyr BP, ∼5.5 kyr BP, ∼4 kyr BP, ∼ 2.5 kyr BP, and ∼0.5 kyr BP, likely due to the combined effects of atmospheric and oceanographic factors driven by the high amplitude regional temperature variability during the mid to late Holocene.

8751 Radiofrequency Thermal Ablation in 32 Patients with Toxic Adenomas with Resolution of Hyperthyroidism in All Cases

Abstract Disclosure: L.G. Amato: None. E.M. Volpi: None. L.D. Volpi: None. P.M. Carani: None. A. Rahal: None. Introduction: In the general population, thyroid nodules are found in 3-7% of individuals on physical examination and in 20-76% on ultrasound. Around 8-10% of benign nodules may present autonomous behavior, being called hot nodules, causing symptoms of hyperthyroidism and being called toxic adenomas (TA). In TAs, autonomous hormone production can be caused by somatic activating mutations of genes regulating thyroid growth and hormone synthesis caused by somatic activating mutations of genes regulating thyroid growth and hormone synthesis. Classically, the proposed treatment for autonomous nodules was surgical resection or radioiodine ablation (RAI). In this context, the prevalence of hypothyroidism after the procedure varies from 2% to 3% following lobectomy, and lower after isthmusectomy in the unique circumstance in which the TA is confined to the thyroid isthmus. A study following 684 patients with TA treated with RAI reported a progressive increase in overt and sub-clinical hypothyroidism. Potential complications following near-total/total thyroidectomy include the risk of permanent hypoparathyroidism (&amp;lt; 2.0%) or recurrent laryngeal nerve injury (RLN) (&amp;lt; 2.0%). A small risk of permanent RLN injury exists with surgery for TA. Following RAI therapy, there have been reports of new-onset Graves Disease (up to 4% prevalence) as well as concern for thyroid malignancy and a very minimal increase in late non thyroid malignancy. Radiofrequency ablation (RFA) has been a precise and effective alternative for the treatment of many benign thyroid nodules over the past ten years, including hot nodules. RFA could preserves normal thyroid function compared to surgery or RAI. Clinical case: We evaluated the effectiveness of a single session of RFA in 32 patients with TA, through hormonal status, achieving normalization of thyroid and volumetric reduction of the nodule. Among the 32 patients included in this study, aged between 25 and 88 years, of these, 31 were women and 1 was a man, all of whom underwent a single RFA procedure (“moving shot” technique associated with hydrodissection). We had a single case of a reversible complication: a patient who had transient vocal cord paralysis, with total reversal. There was a reduction in the volume of all nodules as well as all patients progressed to a state of euthyroidism within 60 days of follow-up. Conclusion: A single session of RFA was effective in treating autonomous nodules, restoring euthyroidism in all patients. Presentation: 6/3/2024

Analisis Faktor Penghambat Usaha Mikro dan Kecil pada Industri Fashion Hijab di Kota Bandung

The fashion creative industry is the 2nd largest business unit in Indonesia, especially the fashion business category in clothing including hijab, which experienced a minimal increase in 2019-2021. Business competition can have an impact on business bankruptcy. So, it is important to create a long-term business strategy for businesses to minimize obstacles when running a business in order to avoid business bankruptcy. The purpose of this study is to determine what are the most dominant or frequent inhibiting factors in the development of micro and small businesses in the hijab fashion industry in Bandung City. This research method utilizes quantitative methods. The data collection technique used a questionnaire given to 105 respondents in Bandung City. The results of this study resulted in five factors inhibiting the development of micro and small businesses in the hijab fashion industry in Bandung City, namely Capital Limitations, Internet Mastery, Management Quality, Human Resource Limitations, and Marketing Difficulties. Limited human resources is the dominant or frequent inhibiting factor in business development. So it is recommended to involve training and continuing education to improve HR skills in the hijab fashion industry, through workshops, partnerships with educational institutions, and joining communities or business associations.

In vitro cytotoxicity evaluation of green synthesized alumina nanoscales on different mammalian cell lines

Nanoscale research is gaining interest in the biomedical, engineering, and environmental fields. Current expensive traditional chemical methods for synthesizing nanoparticles (NPs) inevitably lead to the synthesis of NPs with potentially less or no toxic effects on living cells. To overcome these challenges, in this study, we use a simple, inexpensive, and less toxic one-pot green chemistry approach instead of a chemical method to synthesize alumina nanoparticles (AlNPs) from Carica papaya extract. Nano-alumina has been widely studied due to its remarkable biological and physiochemical properties at nanoscale. However, to date, its biomedical application is limited due to the lack of sufficient data on cytotoxicity in living cells. The physicochemical properties of nano-alumina were determined by FT-IR, DLS, SEM and HRTEM. The cytotoxic effects of the synthesized nano-alumina were studied in cell lines LT and VERO at concentrations of 10–480 µg/mL in vitro. The cell viability of nano-alumina was evaluated using the MTT assay and the AO /EB double staining technique. Our results based on DLS and HRTEM analyzes confirmed spherical AlNPs with a zeta potential and average particle size of − 25 to 5 mV and 52 nm, respectively. The nano-alumina tested showed low toxicity to both cell lines after 28- and 48-h exposure. Furthermore, cell viability statistically decreased with increasing incubation time and concentration of AlNPs up to 480 μg/mL (p < 0.001). However, a minimal increase in cytotoxicity was observed at threshold levels in the range of 120–480 µg/mL. The half-maximal inhibitory concentration (IC50) of AlNPs in the VERO and LT cell lines were 153.3, 252.0 µg/mL and 186.6, 395.3 µg/mL, respectively, after 24- and 48-h exposure to AlNPs. Thus, we conclude that the cytotoxic effect of AlNPs depends on the concentration, exposure time and cell type. The result suggests that the concentration used in this study may be useful for biomedical applications.

Optimizing Decision Support Alerts to Reduce Telemetry Duration: A Multicenter Evaluation.

Telemetry monitoring is crucial for high-risk patients but excessive use beyond practice standards increases costs. Prior studies have shown that electronic health record (EHR) alerts reduce low-value telemetry monitoring. However, specific components of these alerts that contribute to effectiveness are unknown. We aimed to revise previously implemented EHR Best Practice Advisories (BPAs) to optimize their effectiveness in reducing telemetry duration. The secondary objective was to assess the impact on clinicians' alert burden. A multicenter retrospective study was conducted at Johns Hopkins Hospital (JHH), Johns Hopkins Bayview Medical Center (JHBMC), and Howard County General Hospital (HCGH). An EHR alert in the form of a BPA was previously implemented at JHH/JHBMC, firing at 24, 48, or 72 hours based on order indication. HCGH used an alert firing every 24 hours. A revised BPA was implemented at all hospitals optimizing the prior JHH/JHBMC alert by including patient-specific telemetry indications, restricting alerts to daytime hours (8:00 a.m.-6:00 p.m.), and embedding the discontinuation order within the BPA alert. A retrospective analysis from October 2018 to December 2021 was performed. The primary outcome was telemetry duration. The secondary outcome was the mean monthly BPA alerts per patient-day. Compared with the original BPA, the revised BPA reduced telemetry duration by a mean of 6.7 hours (95% CI: 5.2-9.1 hours, p < 0.001) at JHH/JHBMC, with a minimal increase of 0.06 mean monthly BPA alerts per patient-day (p < 0.001). The BPA acceptance rate increased from 7.8 to 31.3% postintervention at JHH/JHBMC (p < 0.0001). At HCGH, the intervention led to a mean monthly reduction of 20.2 hours in telemetry duration per hospitalization (95% CI: 19.1-22.8 hours, p < 0.0001). Optimizing EHR BPAs reduces unnecessary telemetry duration without substantially increasing clinician alert burden. This study highlights the importance of tailoring EHR alerts to enhance effectiveness and promote value-based care.