Minor Factor Research Articles

Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia

AbstractInherited thrombophilia (IT) workup is commonly pursued in patients with venous thromboembolism (VTE). Recent American Society of Hematology guidelines recommend a selective approach to IT testing, nevertheless, evidence on whether thrombophilia testing can actually improve patient-important outcomes through tailored management is limited. Data from the large, prospective Registro Informatizado de Enfermedad TromboEmbólica (RIETE) registry were analyzed to compare VTE risk factors, management, and outcomes between patients who were tested for IT and untested patients, during anticoagulant treatment and after its discontinuation. Among 103 818 patients enrolled in RIETE, 21 089 (20.3%) were tested for IT, 8422 (8.1%) tested positive, and 82 729 (79.7%) were not tested. IT testing was more frequent in patients with VTE provoked by minor risk factors and less common in those with major risk factors such as surgery or active cancer. Choices of anticoagulant treatment did not differ based on IT testing results. Untested patients exhibited inferior outcomes across all VTE categories, with higher rates of VTE recurrence, major bleeding, mortality, and notably, cancer-related mortality. After treatment discontinuation, IT-negative patients with surgically provoked VTE showed lower recurrence rates. For immobilization-related VTE as well as in estrogen-related VTE, no significant differences in recurrence rates were observed between IT-negative and IT-positive patients. However, IT-negative patients with pregnancy or postpartum-related VTE had significantly lower recurrence rates. Patients with unprovoked VTE, particularly those testing positive for IT, had high recurrence rates after treatment. These findings underscore the complex role of IT testing in managing VTE, supporting personalized treatment strategies that consider VTE risk factors and comorbidities. The trial was registered at www.clinicaltrials.gov as #NCT02832245.

ASSESSMENT OF FALL RISK IN CANCER PATIENTS RECEIVING PALLIATIVE CARE

Aim: This study aims to evaluate fall risk factors in cancer patients receiving palliative care units. Method: This cross-sectional descriptive study was performed on 122 cancer patients served the palliative care unit between 01 October and 20 November 2020. The patient’s functional status was evaluated with the Katz Index of Independence in Activities of Daily Living. The data were collected using the Itaki Fall Risk Scale. Results: The mean age of patients was 57.32±12.10 years. The fall risk score of the patients was found to be 17.25±6.20. The risk of falling was higher in the elderly, those with chronic disease, diagnosed with lung cancer, and a history of falling variables. The most common minor risk factor was the presence of chronic disease, and the most common major risk factor was dizziness. Conclusions and Suggestions: Fall risk is high in cancer patients receiving palliative care. Cancer patients receiving palliative care treatment should be evaluated in terms of fall risk.

A Case Study of Ionospheric Storm‐Time Altitudinal Differences at Low Latitudes During the May 2021 Geomagnetic Storm

AbstractPrevious studies paid little attention to the ionospheric storm‐time altitudinal differences due to insufficiency of ionospheric measurements. In this work, multiple instrumental observations were used to investigate the ionospheric storm‐time response at low latitudes in the American and Asian‐Australian sectors during the May 2021 geomagnetic storm. The ground‐based Global Navigation Satellite Systems (GNSS) total electron content (TEC) and Low Earth Orbit (LEO) satellite topside TEC presented opposite (positive/negative) variations in the low‐latitude and equatorial region of both sectors during this storm. The electron density profiles from the Constellation Observing System for Meteorology, Ionosphere, and Climate‐2 (COSMIC‐2) and the Sanya Incoherent Scatter Radar showed a good agreement and well explained the opposite variations between GNSS TEC and LEO satellite topside TEC. The F2‐layer peak height (hmF2) and peak density (NmF2) displayed inverse variations, and the feature was present mostly in the regions between equatorial ionization anomaly crests. The combined modulation effects of the storm‐time zonal electric fields and the field‐aligned transports possibly resulted in the contrary variations of hmF2 and NmF2 in the low‐latitude and equatorial region, leading to the storm‐time altitudinal differences during this storm. Relatively, the storm‐time thermospheric composition disturbances might be a minor factor responsible for these differences.

Annual and lunar-cycle-related breeding rhythmicity in the acorn barnacle Tetraclita kuroshioensis Chan, Tsang & Chu, 2007 (Cirripedia: Balanomorpha: Tetraclitidae) in Okinawa, Japan

Abstract We investigated the reproduction of the barnacle Tetraclita kuroshioensisChan, Tsang & Chu, 2007 (Cirripedia: Thoracica: Tetraclitidae) at different heights in the intertidal zone in Okinawa, Japan with a focus on gonadal development, the brooding of eggs, and unhatched larvae, as well as the role of environmental factors in breeding rhythmicity. Histological observations collected around each full moon from September 2019 to October 2020 showed various stages of oocyte development in September and October 2019 and from March to September 2020, whereas mature testes were observed from April to October 2020. The breeding season of this species thus lasts for at least seven months under long-day conditions at a water temperature above 21 °C. Barnacles collected from three tidal levels on multiple occasions during April, August, and October 2020 displayed little vertical variation in their stage of ovarian development, but there was a noticeable difference in the percentage of brooding individuals in August and October, as well as an increased prevalence of brooding during the new-moon phase at the upper and middle tidal heights. Our findings indicate that larval release by T. kuroshioensis undergoes seasonal variation, apparently influenced by the cycles of lunar (major factor) and tide (minor factor) in their habitat.

Structural Analysis of 3,5-Bistrifluoromethylhydrocinnamic Acid

The crystal structure of 3,5-bistrifluoromethylhydrocinnamic acid [systematic name: 3-[3,5-bis(trifluoromethyl)phenyl]propanoic acid], C11H8F6O2, has been determined and described. The structure was subject to the Hirshfeld surface-analysis and CE-B3LYP interaction-energies calculations. The title compound crystallises in the monoclinic P21/c space group with one molecule in the asymmetric unit. The propanoic acid side chain of the studied molecule has a bent conformation. The key supramolecular motif in the crystal structure is a centrosymmetric O–H∙∙∙O hydrogen-bonded dimer (R22(8) in the graph set notation). According to CE-B3LYP, the molecules involved in this motif exhibit the strongest pairwise interaction total energy (Etot = −67.9 kJ/mol). On the other hand, there are seven other interacting molecular pairs with significant Etot values in the range of −17 to −28 kJ/mol. In these, the energy is dominated by the dispersive contribution. A survey of the Cambridge Structural Database revealed that in other 3-phenylpropanoic acid structures, the middle dihedral angle of the propanoic acid side chain is always in the trans conformation. This contrasts the current structure where this dihedral angle is in the gauche conformation. According to the Density Functional Theory calculations in the gas phase (at the B3LYP/aug-cc-pvDZ level), the presence of the two CF3 groups (strong electron-withdrawing character) increases the population of the gauche conformers by a substituent electronic effect, and this may be a minor factor contributing to the appearance of this conformation observed in the solid state.

Evaluation of Chinese traditional military settlements’ defensive capabilities via principal component analysis (PCA): a case study of coastal Wei forts in the Ming dynasty

Defensive capability is one of the essential attributes of traditional military settlements. In the Ming dynasty, coastal Wei fort was the one of the most functionally complex and wide-ranging fortifications in the military defense system of China. Because many factors affect their defensive capacities, including three dimensions: individual construction, synergistic links, and regional jurisdiction, it is not easy to compare different settlements’ defensive capacities or to judge the degrees of different factors’ influences. Through principal component analysis, this study determines the weights of each minor factor. It constructs a model for evaluating traditional Chinese military settlements’ defensive capabilities, to quantify the defensive capability. The results show that the synergistic relationship between the settlements, especially settlement accessibility, has the most significant impact on defensive capability, much higher than a single castle's defensive construction. The defensive capability index of the Wei forts in Guangdong is the highest, consistent with the highest rate of victory in the wars fought on the coast during the Ming dynasty. The defensive capacity is directly proportional to the rate of victory, which validates this evaluation model’s soundness. This study not only comprehensively evaluates the coastal Wei forts’ defensive capacity in the Ming Dynasty, but also provides new methods for the quantitative or comparative analysis of military settlements at other temporal and spatial scales.

Response to ‘Risky conclusions regarding shrinking rhino horns’: Clarification on a statistically determined reduction of relative horn length in five species of rhinoceros since 1885

Abstract In their response to Wilson, Pashkevich, Rookmaaker, et al. (2022), Ferreira et al. argue that our conclusions regarding shrinking rhino horns were risky, given the low sample size used for this assessment, the variation in rhino horn length related to non‐heritable factors (including age, sex, environment and behaviour) and the low impact that current selective trophy hunting has on rhino numbers. We agree that our sample size was low and that many factors can influence horn length and therefore we discussed these points as important caveats in Wilson, Pashkevich, Rookmaaker, et al. (2022). However, we argue that although many factors can lead to variation in horn length, they do not explain the decline in relative horn length over time that we observed, and we note that the response does not offer an alternative explanation for this temporal shift. Although selective hunting is currently a minor factor in rhino mortality, this may have been relatively more important and to have had a potentially greater selective influence in the past. Our dataset does not allow identification of factors driving this change, and in Wilson, Pashkevich, Rookmaaker, et al. (2022), we offered selective hunting as one possible explanation for the relative decline, calling for more work to investigate this further. We highlight that the focus of Wilson, Pashkevich, Rookmaaker, et al. (2022) was far more than an assessment of changing relative horn length and instead aimed to demonstrate that a wide range of data can be extracted effectively from image repositories for use in a conservation context. We hope that the results in Wilson, Pashkevich, Rookmaaker, et al. (2022) will provide a useful starting point for future research, including addressing the questions raised by Ferreira et al. Ultimately, we feel that the attention given to Wilson, Pashkevich, Rookmaaker, et al. (2022) reveals the enduring interest people have in rhinos, a topic addressed in other parts of our original paper, which we encourage readers to read in its entirety. Read the free Plain Language Summary for this article on the Journal blog.

Prevalence of Hepatitis B and C Infection and its Associated Risk factors in Pregnant Women Visiting Hospitals of Southern Punjab

Background: Hepatitis B and C infections remain formidable challenges to global health, with significant morbidity and mortality rates, especially among pregnant women. These infections pose substantial risks not only to the infected individuals but also to their unborn children, due to the potential for vertical transmission. In Pakistan, particularly in the Southern Punjab region, the prevalence and impact of these infections demand rigorous investigation to inform public health strategies. Objective: This study aimed to assess the prevalence of Hepatitis B and C infections among pregnant women visiting selected hospitals in Southern Punjab, Pakistan, and to identify associated risk factors, thereby contributing to the formulation of targeted intervention strategies. Methods: Employing an analytical cross-sectional design, this study involved 422 pregnant women from the outpatient departments of Gynecology at Nishtar Hospital, Shahbaz Sharif Hospital in Multan, and Bismillah Medical Complex in Kahror Pacca, between December 1, 2023, and March 5, 2024. Participants were selected using a convenience sampling technique. Data on demographic characteristics and potential risk factors were collected through a structured questionnaire. Hepatitis B and C seropositivity was determined through specific serological tests. The analysis was performed using SPSS version 25, focusing on the prevalence rates and the identification of major and minor risk factors for the transmission of Hepatitis B and C. Results: The study found an 8.3% prevalence rate for Anti-HCV and a 5.2% prevalence rate for HBsAg among the participants. Notable risk factors included ear or nose piercings, history of blood transfusions, and previous cesarean sections. Socio-demographic analysis revealed higher rates of infection among participants with lower educational levels, those residing in rural areas, and among certain age groups and parity statuses. Conclusion: The observed prevalence rates of Hepatitis B and C infections among pregnant women in Southern Punjab highlight the critical need for enhanced screening programs, targeted vaccination initiatives, and comprehensive education campaigns to mitigate the risk of vertical transmission and reduce the burden of these infections.

Sheep Rearing in Yadgir, Karnataka: A Comprehensive Study on Factors Affecting Sheep Rearing and Reasons for Liquidation of Kenguri Sheep

The important aspects of liquidation of Kenguri sheep and purpose of its rearing were studied during the experiment. Total forty sheep farms, 20 each in intensive and extensive rearing systems were selected randomly based on their accessibility in study area Yadgir district of Karnataka, India. The main factors of liquidation and purpose of sheep raising were tabulated by calculating frequency and percentage values. Reasons like agriculture purpose (100.00%) and domestic expenses (90.00%) were having sometimes and occasional frequencies under liquidation of sheep in intensive rearing system majorly. Likewise, domestic expenses (80.00%) and repay loan (80.00%) were having equal weightage of sometimes and occasional frequencies in extensive rearing system regarding sheep selling. Income generation (100.00%) and hereditary acquisition (95.00%) were the major and minor intrinsic factors and high demand for mutton production was major extrinsic factor in intensive rearing system. Employment (70.00%) and investment and growth (75.00%) were the major and minor intrinsic factors and more lucrative (90.00%) was the major extrinsic factor in extensive rearing system. The findings of this evaluation will pave the path for profitable selling and systematic rearing of sheep to the farming community in further days.

Residual renal volume as a long-term independent predictive factor of developing chronic kidney disease after donor nephrectomy

To assess the long-term association between the residual renal volume and the progression of chronic kidney disease (CKD) in kidney donors following open or laparoscopic donor nephrectomy. A retrospective observational study involving 452 individuals who underwent open or laparoscopic donor nephrectomy at Ramathibodi Hospital, Bangkok, Thailand. The study spanned over a comprehensive 60-month monitoring period. Residual renal volume was determined through Computer Tomography. Patient characteristics, surgical techniques, donated kidney side, and estimated glomerular filtration rate (eGFR) were collected and analysed. In a multivariate analysis, a residual renal volume exceeding 50% of original volume is associated with an increased likelihood of developing CKD, with a hazard ratio (HR) of 1.675 (P < 0.05), and male gender has a hazard ratio (HR) of 4.013 (P < 0.001). Additionally, age is identified as a minor risk factor for developing CKD, with hazard ratio (HR) of 1.107 (P < 0.001). Higher residual renal volume, male gender, and older age were identified as independent risk factors for the development of CKD following open or laparoscopic donor nephrectomy during long-term follow-up.

Assessment of factors causing landslides using the Analytical Hierarchy Process (AHP) method

Landslides are Indonesia's second most common disaster in the last ten years. Landslides cause losses, reaching hundreds of billions and threatening human safety. For this reason, it is necessary to take action to reduce the negative impact of landslides. Physical and non-physical mitigation can occur before, during, and after a disaster. The most essential thing in disaster mitigation is knowing the major factors that cause landslides. This research aims to analyze the major and minor factors that cause landslides using the Analytical Hierarchy Process (AHP) and the Likert scale. Respondents in this research are experts in disasters, especially landslides—respondents from universities in Indonesia, practitioners, and people involved in disaster mitigation. Validity and reliability tests were carried out on each question used in the questionnaire. The research results show that the landslide disaster was caused by a disruption in balance that occurred due to internal and external disturbance factors. The major external factors that cause slope failures are the cutting of hills and changes in land use to built-up areas. In contrast, the major internal factors that trigger landslides are heavy rainfall and steep topographic conditions. The results of this research in the form of weight and scoring values for each factor causing landslides can be used as a reference for mapping landslide areas to identify areas with the potential for landslides.

Morphometric traits, carcass characteristics and biochemical composition of meat between local and synthetic Algerian rabbit genotypes

The aim of this research was to study the genetic and sex effects on morphometric traits, carcass characteristics and biochemical composition of rabbit meat of two Algerian breeds, local population and synthetic line (ITELV2006). For this purpose, 60 animals (30 per group) from 90 d of age were used. The body weight and the morphometric traits recorded were determined using a digital weighing scale and flexible tape. At slaughter, carcass traits, and biochemical meat quality characteristics such us protein, fat, ash, moisture content and fatty acids composition were measured. The results obtained revealed that the synthetic line has higher values of morphometric measurements than the local breed. The sex factor and the interaction genotype X sex had a significant effect only on chest circumference (P &lt; 0.05). It is also observed, that the majority of carcass characteristics were more affected by genetic than by genetics. Which body weight at slaughter of males and females derived from synthetic lines were 41% and 22% higher than local rabbits respectively. Furthermore, the new line displayed a good meat yield (60%) with a higher mean value (+ 5%) of dressing out % rather than the local one. Regarding, the proximate biochemical composition of meat, the synthetic line has shown also the highest content of protein and fat (P &lt; 0.05). Concerning with fatty acids profile; the local breed exhibited the highest content of n3 and n6 polyunsaturated fatty acids (n3 and n6 PUFAs), consequently, the lower value of n-6: n-3 ratio (9.82) and the highest value of polyunsaturated fatty acids to saturated fatty acids (PUFAs/SFAs: 0.73). Finally, it should be emphasized that the relevant differences recorded in this experiment are assumed to be primarily genetic, thus, sex might be regarded as a minor factor. The synthetic showed better characteristics due to its genetic potential. Therefore, it is recommended to be used for Algerian meat production.

Heritability of floral traits in Allium cepa L. populations from biparental crosses

AbstractOnions (Allium cepa L.) are one of the main vegetable crops worldwide. As an allogamous species with entomophilous pollination, floral traits play a critical role in seed production. Improving seed yield, especially for hybrid seed production, is very important. In this work, we obtained genetic information for floral traits using segregating populations from three male‐sterile lines and one open‐pollinated variety. Data on 16 floral traits, including perianth, gynoecium, stamens, and receptacle structures, were collected from the parental cultivars, their hybrids, and from segregating populations in the F2 and F3 generations. This dataset underpinned a comprehensive analysis of genetic variability, broad‐ and narrow‐sense heritability estimation, genetic gain predictions, and trait correlations. The evaluated traits exhibited high broad‐sense heritability values (0.08–0.85), but moderate narrow‐sense heritability values (0.01–0.68), implying that the observed phenotypic variance is mainly explained by genetic factors, with a minor additive genetic factors contribution. Consequently, the study revealed effective genetic gain for the analyzed traits. The phenotypic correlations observed in the parental cultivars were not always maintained in the segregating populations, suggesting random correlations. Meanwhile, genetic correlations were moderate to low, suggesting that the analyzed traits can be independently selected without affecting the expression of other floral traits. Notably, correlations among floral traits were significant in stable cultivars but weak in segregating populations, excluding pleiotropic effects. This work has successfully demonstrated the heritability of onion floral traits and provided a sound basis for selecting individuals with desirable attributes, with valuable practical implications for onion breeding and seed production.

Mortalité maternelle par thromboembolie veineuse en France 2016–2018

Pregnancy and the post-partum period represent a thromboembolic risk situation, with pulmonary embolism (PE) remaining one of the leading causes of direct maternal deaths in developed countries. Between 2016 and 2018 in France, twenty maternal deaths were caused by venous thromboembolic complications (VTE), yielding a Maternal Mortality Ratio (MMR) of 0.9 per 100,000 live births (95%CI 0.6–1.3), with no change compared to the periods 2013–2015 or 2010–2012. Among these 20 deaths, 1 death was related to cerebral thrombophlebitis, and the remaining 19 were due to PE. Regarding the timing of death, 2 deaths occurred after an early termination of pregnancy, 40% (8/20) during an ongoing pregnancy, and 50% (10/20) in the post-partum period. Among the 20 VTE deaths, 20% (4/20) occurred outside of a healthcare facility (at home or in a public place). Among the nineteen cases with documented BMI, seven women had obesity (37%), three times more than in the population of parturients in France (11.8%, ENP 2016). Among the nineteen PE deaths and the case of cerebral thrombophlebitis, eleven were considered preventable, six possibly preventable (35%), two probably preventable (12%), and three preventability undetermined. The identified preventability factors were inadequate care and the patient's failure to interact with the healthcare system. From the case analysis, areas for improvement were identified, including insufficient consideration of major and minor risk factors, the early initiation of appropriate prophylactic treatment, and the absence of fibrinolysis in cases of s refractory cardiac arrest due to suspected PE.

Rotation Local Solutions in Multidimensional Item Response Theory Models.

We conducted an extensive Monte Carlo study of factor-rotation local solutions (LS) in multidimensional, two-parameter logistic (M2PL) item response models. In this study, we simulated more than 19,200 data sets that were drawn from 96 model conditions and performed more than 7.6 million rotations to examine the influence of (a) slope parameter sizes, (b) number of indicators per factor (trait), (c) probabilities of cross-loadings, (d) factor correlation sizes, (e) model approximation error, and (f) sample sizes on the local solution rates of the oblimin and (oblique) geomin rotation algorithms. To accommodate these design variables, we extended the standard M2PL model to include correlated major factors and uncorrelated minor factors (to represent model error). Our results showed that both rotation methods converged to LS under some conditions with geomin producing the highest local solution rates across many models. Our results also showed that, for identical item response patterns, rotation LS can produce different latent trait estimates with different levels of measurement precision (as indexed by the conditional standard error of measurement). Follow-up analyses revealed that when rotation algorithms converged to multiple solutions, quantitative indices of structural fit, such as numerical measures of simple structure, will often misidentify the rotation that is closest in mean-squared error to the factor pattern (or item-slope pattern) of the data-generating model.

Post-operative venous thromboembolism in patients after extracranial otologic surgery: A case series

ObjectiveThis study aimed to report 9 venous thromboembolism (VTE) cases after extracranial otologic surgery and analyze the potential risk factors. Study designCase series. SettingSingle tertiary-level academic center. MethodsTotally, 9 cases of VTE were identified among adults who underwent extracranial otologic surgery at our hospital from January 2018 to December 2020. Caprini risk scores were calculated, and comprehensive preoperative, operative, and postoperative clinical data within 14 days were collected to assess the evidence of VTE. ResultsThe median age of 9 patients was 64 years old. Among them, 7 (77.8%) patients presented with intramuscular vein thrombosis, 1 (11.1%) patient had deep vein thrombosis, and 1 (11.1%) patient experienced pulmonary embolism. Preoperatively, 8 (88.9%) patients had low or middle Caprini risk scores (≤4) with an average of 2.67 ± 0.47 points. The average Caprini scores for all patients were 4.44 ± 0.35 on postoperative day (POD)1 and 5.67 ± 0.64 on POD14. D-dimer levels were collected, indicating an average of 0.55 ± 0.17 mg/FEU preoperatively, 8.53 ± 3.94 mg/FEU at day 1, and 3.76 ± 0.45 mg/FEU at POD14. In postoperative period, 7 (77.8%) patients experienced vertigo/dizziness and/or head immobility/bed rest. ConclusionThe present study highlighted that patients with low- and middle-risk of VTE undergoing otologic surgery should be also vigilant about postoperative VTE. Vertigo/dizziness and/or head immobility/bed rest in postoperative period should be considered as minor risk factors for developing VTE in patients undergoing extracranial otologic surgery. Conducting perioperative assessments, including Caprini risk score evaluation, D-dimer testing, and venous ultrasound of lower extremities, is recommended to ensure patients’ safety.

The Philosophy of Medicine: On the Ethical Discussion about the Life and the Death

The purpose of the article is to highlight the key philosophical cases in the medical and ethical debate on life and death - ontological, axiological and anthropological. For the philosophy of medicine, the concepts of life and health are fundamental dimensions, as they combine elements of nature and human existence. The aim of the article is to differentiate the existential, value and human contexts of philosophy in the medical space. The methodology used in the study is focused mainly on the analytical cluster of general scientific knowledge. The analysis of the literature on the problem of life and death in medical and ethical discourse allowed us to separately group the medical, philosophical and scientific and worldview clusters of this problem. Through generalising and comparative analysis, an attempt is made to unify the problem of life and death in the context of a single philosophical and scientific paradigm. To achieve these objectives, it is advisable to use the principles of interdisciplinarity, which help to bring to a common understanding the various ideas and views on the ethical component of the dichotomy of life and death in medicine. The results of the study indicate that the human-dimensional philosophical component dominates the ontological and axiological components in the modern worldview of human existence. This is the result of the policy of anthropocentrism in its global manifestation and the consequence of the use of a pragmatic approach in the system of human sciences. However, the COVID-19 pandemic, a minor factor by civilisational standards, has managed (albeit for a short period) to reorient the philosophical issues of life and death to existential dimensions. A promising area of research is modelling the situation of a socio-cultural crisis of a global scale in the healthcare system and the readiness of society to re-position the problem of life and death. Thus, the philosophy of medicine clearly structures the problem of life and death in three fundamental cases: ontological, axiological and anthropological, which change their priority in the scientific and philosophical discourse depending on the socio-cultural trends in the development of society and civilisation.

Biogeochemical lichen indication study of formation and temporal changes of Oleksandriia Arboretum atmospheric pollution

Using the method of biogeochemical lichen indication the levels of the average long-term content of K, Ca, Al, Fe, Mg, Na, Mn, Zn, Sr, Ti, Ba Cu, B, Pb, Ni, V, Cr, Co, Cd, Se, Sb in surface air were measured on the territory of Olexandriia Arboretum and adjacent territories (Bila Tserkva, Kyiv Region, Ukraine). The purpose of the study is to determine the state and dynamics of the atmospheric geochemical field on the territory of Olexandriia Arboretum and its surroundings. The method of biogeochemical lichen indication based on the values of micro- and macroelements content in epiphytic lichens was used as a research tool. Application of the ICP-OES spectroscopy method allowed the analysis for chemical elements content of the samples of epiphytic deciduous Parmelia sulcata, Xanthoria parietina and bushy Evernia prunastri lichens collected in 2009 (20 points) and 2021 (23 points).&#x0D; In order to identify possible sources of entering of certain elements into lichens the researchers used the factor analysis method, i.e. a method of principal components with Varimax factors rotation. Six obtained factors represent: the impact of land cover (the most significant factors F1–F3) and man-made components (minor polygenetic, factors F4–F6). As a factor's number decreases, its partial explanatory variance decreases too. Factor F1 represents a common dust loading on the atmosphere with a predominance of the terrigenous component (mostly coarse-dispersed particles). Factor F1 is responsible for the dust-aerosol loading that is largely caused by the microclimatic circulation of the city breeze type thus forming a peculiar atmospheric and geochemical association that consists of chemical elements related to the building industry and building materials production. Powerful, however, local (impactful) atmospheric man-made influences manifest themselves through factor F3. Minor factors' discrimination ability reduces if a source of atmospheric pollution is less significant. Both division of factors into subfactors and noticeable temporal dynamics are observed more often. For instance, factor F4 has two geochemical sub-associations affected by the impact on the Olexandriia's landscapes of the 1990s' ecological disaster (fall-out of oil products, geochemical marker – V) and galvanic waste causing soil pollution (Zn, Mg, Cr, Ni and Ti), as well as discharges of agricultural enterprises (K). One of the peculiarities of F4 is a gradual decrease in its intensity over time. Factor F5 should be interpreted as the only load on the environment associated with galvanic pollution with cobalt being replaced by copper as a leading pollution marker. We suggest considering Factor F6 as a factor associated with oil pollution only.

Role of greener default options on consumer preferences for renewable energy procurement

As options for renewable procurement have proliferated to meet consumer demand, it is more complicated for consumers to navigate the available choices. In addition to installing distributed energy resources (e.g., solar PV), consumers can subscribe to green tariffs. Depending on the electricity supplier, the default amount of renewable content will vary (e.g., Community Choice Aggregation vs. investor-owned utilities). There are also options to purchase greener electricity, up to 100%. It is unclear how this context influences household-level decisions to install solar and vice versa. This study uses a discrete choice experiment to estimate the influence of renewable content, solar PV installation, change in electricity costs, engagement level, and procurement duration on household-level decisions. Data were collected from 600 participants randomly assigned to either a 15% or 30% renewable default option. The results suggest that (1) effort is a relatively minor factor in renewable procurement decisions even when comparing PV adoption versus green electricity, (2) relative perceptions of renewable procurement options change as the default renewable content increases, and (3) some consumers are more sensitive to the default level and will shift their behavior accordingly. This research may improve program design to encourage adoption of multiple kinds of renewable energy.

Provoked vs minimally provoked vs unprovoked VTE: does it matter?

Venous thromboembolism (VTE) is a multifactorial disease, and its risk depends on exposure to risk factors and predisposing conditions. Based on their strength of association with a VTE episode, risk factors are classified as major or minor and determined using a temporal pattern to be transient or persistent. All patients with VTE should receive anticoagulant treatment for at least 3 months in the absence of an absolute contraindication. Beyond this period, selected patients may be candidates for an extended phase of anticoagulation aimed at secondary VTE prevention. The risk of recurrent VTE if anticoagulation is discontinued is probably the main driver of decision-making regarding extended treatment. The risk of recurrence after VTE associated with major risk factors is low if the risk factor is no longer present. In this case, treatment can be discontinued. If the major risk factor is persistent, anticoagulation should be continued. After VTE occurring in the absence of risk factors, anticoagulation should probably be continued indefinitely if the risk for bleeding is low and preferably with minimal effective doses of anticoagulants. VTE occurring after exposure to minor risk factors is probably the most challenging situation, especially if the clinical manifestation was acute pulmonary embolism. Understanding the actual role of minor risk factors in the occurrence of VTE helps in estimating the risk of recurrence and avoiding the dangers associated with unnecessary anticoagulation. The availability of safer strategies for anticoagulation could allow personalized strategies for secondary prevention of VTE.