Persistent Effects Research Articles

Early-onset peritonitis and outcomes of peritoneal dialysis: A cohort study with data from the RDPLF.

Introduction Peritonitis occurring within the first months on peritoneal dialysis (PD) has been associated with poorer PD outcomes. Whether early peritonitis is a risk factor for transfer to haemodialysis in the long term is a matter of investigation. Methods This retrospective study was conducted using data from the French Language PD Registry of incident PD patients between 2002 and 2018. Early-onset peritonitis (EOP) was defined as peritonitis occurring during the first 3 months on PD. Our hypothesis was that EOP was associated with an increased risk of transfer to haemodialysis during the first months on PD but that it was no longer associated with an increased risk of transfer to haemodialysis several months after the start of PD. The associations between EOP and the different outcomes were explored via time-dependent coefficient Cox regression and Fine and Gray regression. Results EOP was associated with an increased risk of PD cessation by transfer to haemodialysis within the first 12 months of PD and beyond (<12 months cs-HR 1.50, 95% CI 1.36-1.66 and >12 months cs-HR 1.17, 95% CI 1.06-1.28, respectively). Conclusion EOP is associated with a greater risk of PD cessation due to transfer to haemodialysis, especially within the first year after peritonitis occurrence, and with a persistent effect in the long term. Reducing or delaying EOP, notably through its systematic reporting and monitoring as a KPI to help in the implementation of QIPs, could have a favourable impact on patient-level outcomes.

Drug resistance testing at regimen failure in individuals diagnosed with HIV-1 between 2010 and 2018 in Israel.

Assess virological failures, analyze the results of resistance testing (RET), and investigate factors associated with acquired drug resistance mutations (aDRM). A retrospective longitudinal cohort study. Virological failures (viral load >50 copies/ml) from a cohort of 1130 individuals, diagnosed with HIV-1 in 2010-2018 and followed up until 2020, were included. Demographic, clinical, and virological data were collected. A piecewise exponential additive mixed model was employed to estimate the association of various factors with aDRM. Only 82 individuals had virological failure, 20/82 had multiple virological failures. The majority of virological failures (77%) were men, 48% were Israeli-born,79% were diagnosed in 2010-2014. Only 18% initiated with second-generation integrase-inhibitor (INI) based regimens. Although no baseline differences were identified between those with single and multiple virological failures, the latter had lower CD4+ levels before first virological failure. NRTI M184IV and INI N155H were identified in more than 10% of the cases. In those with additional failures, INI N155H was more prominent in cases with subtype B compared to those with non-B subtypes (P = 0.039). Diagnoses with CD4+ cell count less than 200 cells/μl and AIDS [hazard ratio = 3.46, 95% confidence interval (95% CI): 1.51-7.92, P = 0.003], second-generation INI at the first virological failure (HR = 0.32, 95% CI: 0.11-0.91, P = 0.033), and RET at baseline (hazard ratio = 0.34, 95% CI: 0.13-0.86, P = 0.022) had a significant and persistent relative effect on aDRM. The risk for aDRM is reduced in those who are treated with second-generation INI-based regimens. Diagnosis with low CD4+ cell counts and AIDS is associated with detection of aDRM.

Early adolescent second-generation antipsychotic exposure produces long-term, post-treatment increases in body weight and metabolism-associated gene expression.

The use of second-generation antipsychotic (SGA) medications in pediatric patients raises concerns about potential long-term adverse outcomes. The current study evaluated the long-term effects of treatment with risperidone or olanzapine on body weight, caloric intake, serum insulin, blood glucose, and metabolism-associated gene expression in C57Bl/6J female mice. Compared to mice treated with vehicle, female mice treated with risperidone or olanzapine gained weight at higher rates during treatment and maintained higher body weights for months following treatment cessation. High-fat diet feeding did not produce a robust difference in weight gain in previously treated vs. control groups. Finally, female mice previously treated with olanzapine also exhibited increased expression of genes associated with inflammation and lipogenesis. These findings suggest that pediatric use of SGA medications that induce excess weight gain during treatment may exert persistent effects on body weight and gene expression and such outcomes may form an important aspect of assessing risk-to-benefit ratios in prescribing decisions.

Peripubertal antagonism of corticotropin-releasing factor receptor 1 results in sustained changes in behavioral plasticity and the transcriptomic profile of the amygdala.

Peripuberty is a significant period of neurodevelopment with long-lasting effects on the brain and behavior. Blocking type 1 corticotropin-releasing factor receptors (CRFR1) in neonatal and peripubertal rats attenuates detrimental effects of early-life stress on neural plasticity, behavior, and stress hormone action, long after exposure to the drug has ended. CRFR1 antagonism can also impact neural and behavioral development in the absence of stressful stimuli, suggesting sustained alterations under baseline conditions. To investigate this further, we administered the CRFR1 antagonist (CRFR1a) R121919 to young adolescent male and female rats across 4 days. Following each treatment, rats were tested for locomotion, social behavior, mechanical allodynia, or prepulse inhibition (PPI). Acute CRFR1 blockade immediately reduced PPI in peripubertal males, but not females. In adulthood, each assay was repeated without CRFR1a exposure to test for persistent effects of the adolescent treatment. Males continued to experience deficits in PPI while females displayed altered locomotion, PPI, and social behavior. The amygdala was collected to measure long-term effects on gene expression. In the adult amygdala, peripubertal CRFR1a induced alterations in pathways related to neural plasticity and stress in males. In females, pathways related to central nervous system myelination, cell junction organization, and glutamatergic regulation of synaptic transmission were affected. Understanding how acute exposure to neuropharmacological agents can have sustained impacts on brain and behavior, in the absence of further exposures, has important clinical implications for developing adolescents.

Exploring the Themes of Otherness in the Movie Avatar (2009)

This article will explore the concept of "otherness," as articulated by Edward Said in James Cameron’s work Avatar (2009). Through the interaction between the native Na'vi of Pandora and the human colonists, the research explores how the movie depicts the dynamics of power, identity, and cultural representation. The study looks at how the "Other" is constructed and how it affects colonial and exploitative narratives by keeping in view the idea of Edward Said on cultural identification. Using a qualitative methodology encompassing literary analysis, the study examines the film's linguistic and visual components under the lens of postcolonial theory and interrogates power dynamics that sustain marginalization. Situated within the context of contemporary literary discourse and orientalist critiques, the study contributes to a deeper understanding of Cameron's work and its implications for understanding identity clashes and cultural representation. The findings show that by emphasizing the exploitation of Pandora's resources and the dehumanization of the Na'vi, Avatar criticizes colonialism. By critically examining the persistent effects of colonialism in modern media, this study advances our knowledge of how Said's theory of otherness is still applicable to the analysis of contemporary narratives of power and identity.

The Effects of Resigning GPs on Patient Healthcare Utilization and Some Implications for Health.

We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization and diagnoses in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.1 quarters after the old resigns, on average, the persistent effects must be explained through the new GP. Indeed, the new GP serves more patients but performs less diagnostic testing. Our results reveal a substantial decrease in diagnoses of many relevant chronic conditions (such as congestive heart failure and diabetes), suggesting that disruptions may have adverse consequences for the efficiency of the healthcare system. This indicates that continuity in primary care is pivotal and shows that the GP has an essential role in healthcare delivery, particularly in healthcare systems such as Germany, where GPs often have a high workload and little consultation time.

Crops, Culture and Complexity

ABSTRACTThis study shows that traditional farming practices have a persistent effect on shaping cultural traits that influence modern‐day economic complexity. Societies with a legacy of growing more labour‐intensive crops tend to develop interdependence, creating a culture of collectivism. Conversely, societies with a history of farming less labour‐intensive crops tend to develop independent traits, leading to a culture of individualism. The dichotomy in these farming legacies gives rise to the individualism–collectivism cleavage, which may explain variation in the level of economic complexity. Using information on land suitability to construct measures of individualism‐ and collectivism‐enhancing environments, this paper finds that societies with a more individualist orientation tend to develop stronger innovative capabilities. This enables them to produce and export a wide range of sophisticated products, resulting in a high level of economic complexity. However, societies imbued with collectivistic cultures tend to have a less complex economic structure.

P-251. Assessing the Persistent Effects of an Extensive Hospital Cleaning Initiative on Healthcare-Associated Infections and Multidrug-Resistant Microorganism Colonization in Patients: A Longitudinal Study

Abstract Background Healthcare-associated infections (HAI) pose a significant global threat to patient safety. The hospital environment's role in infection prevention and control has gained renewed importance. Objective: to assess the impact of hospital environmental interventions on improving healthcare environmental hygiene and ultimately reducing patient colonization with multidrug-resistant microorganisms (MDROs) and other epidemiologically significant pathogens. Secular time trend of monthly incidence density per 1,000 patient-days for nine MDROs, 2021-2022 Secular time trend of monthly incidence density per 1,000 patient-days for nine MDROs, 2021-2022 Methods In 2019, a multidisciplinary environmental organization committee was formed, including representatives from the hospital board, hospitality, occupational health and safety, and pharmacy. This committee launched a dedicated weekly task force to focus on cleaning and integrated surface disinfection throughout the hospital, encompassing all units, including the intensive care units. Regular rounds were conducted by the task force to ensure comprehensive environmental hygiene. The study was conducted at a public institution in Belo Horizonte, Brazil, which has a capacity of 420 beds. The incidence density per 1,000 patient-days was calculated to assess the time trend of nine MDROs across the entire hospital. The MDROs included in the analysis were MRSA, carbapenem-resistant Acinetobacter sp, carbapenem-resistant Enterobacteriaceae, VRE, ESBL-producing Gram-negative bacilli, KPC-producing Gram-negative bacilli, Pseudomonas aeruginosa, Serratia sp, and NDM-producing Gram-negative bacilli. Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for MRSA, 2021-2022 Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for MRSA, 2021-2022 Results Over the course of four years (2019-2022) of implementing the weekly cleaning task force, we observed a sustained downward trend in the monthly and six-month moving average incidence rates of seven out of the nine MDROs assessed. Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for carbapenem-resistant Acinetobacter sp, 2021-2022 Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for carbapenem-resistant Acinetobacter sp, 2021-2022 Conclusion Long-term implementation of a dedicated and extensive hospital cleaning task force has resulted in a consistent reduction in MDRO occurrences, demonstrating the effectiveness of this approach. Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for carbapenem-resistant Acinetobacter sp, 2021-2022 Monthly incidence density per 1,000 patient-days, and six-month moving average incidence for carbapenem-resistant Acinetobacter sp, 2021-2022 Disclosures All Authors: No reported disclosures

Two-dimensional BiTeX crystals with persistent luminescence induced by photochemical reactions.

Two-dimensional (2D) materials are highly valued for their unique properties and potential applications, as they can display exotic behaviors differing from those of their bulk forms. Research on elementary and binary solids has been making great progress recently, while synthesizing multi-component 2D materials experimentally remains a challenge, despite the possibility of greatly extending the number of members of the 2D realm. In this study, we synthesized ternary BiTeX (X = Cl, Br, I) nanosheets with high crystallinity through an electrochemical exfoliation method. Structural analysis confirmed the retention of bulk composition in these nanosheets. Interestingly, the BiTeX nanosheets display a persistent luminescence effect, where the photogenerated carriers exhibit lifetimes of over 100 seconds. Furthermore, the recovery time increased at lower temperatures. The persistent luminescence in 2D BiTeX, which can be ascribed to reversible bond cleavage and recovery under photoexcitation, exhibits potential for applications in fluorescence and photo-responsive systems.

Umbilical Cord-derived Mesenchymal Stem Cells (CLV-100) Infusion in Healthy Subjects: a 5-Year Follow-up Study on Safety and Immunomodulatory Effect

Abstract Purpose Umbilical cord-derived mesenchymal stem cells (UCMSCs) have garnered significant attention in the field of regenerative medicine, specifically in inflammation-related diseases. Our team has previously demonstrated that a single infusion of allogeneic UCMSCs by Cytopeutics® (CLV-100), at both low dose (65 million cells) and high dose (130 million cells), in 11 healthy volunteers was safe up to 6 months with a dose-dependent immunomodulatory effect. In this present follow-up study, we investigated the medium-term safety and efficacy of intravenous administration of CLV-100 in the same healthy subjects. Methods All 11 subjects were enrolled in this 5-year follow-up, and none dropped out (NMRR-13–1152-17400, 28/09/2016). Clinicians conducted consultations to assess overall health indicators. Blood samples and serum were collected for laboratory testing and biomarker analysis, respectively. Results Five years after the CLV-100 infusion, all subjects remained healthy, with no reported side effects or major health conditions. Levels of cancer markers also remained within normal ranges. The anti-inflammatory effect of CLV-100 remained statistically significant in the high-dose group. Notably, major organ health parameters, including those subjects aged over 60 years, remained stable even after 5 years. Conclusion The findings demonstrated the medium-term safety of a single CLV-100 infusion and persistent dose-dependent immunomodulatory effects. CLV-100 may also confer protection against age- and inflammation-related frailty. Lay Summary The current follow-up study provides insight into the safety and immunomodulatory effects of a single infusion of allogeneic umbilical cord-derived mesenchymal stem cells (CLV-100) for up to 5 years in healthy subjects. The effects on the inflammatory cytokines CLV-100 were more pronounced in the high-dose group. In addition, other biomarker levels were comparable between the older and younger age groups. CLV-100 is therefore safe over the medium-term with sustained anti-inflammatory effect in a dose-dependent manner.

Persistent effect of salt reduction in schoolchildren and their families: 1-year follow-up after an application-based cluster randomized controlled trial

BackgroundA 12-month cluster randomized controlled trial (RCT) demonstrated the effectiveness of an application-based education program in reducing the salt intake and systolic blood pressure (SBP) of schoolchildren’s adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.MethodsFifty-four schools were randomly assigned to either the intervention or control group. All participants (594 children in grade 3 and 1188 of their adult family members) who completed the baseline survey were contacted again 12 months after the trial. The primary outcome was the difference in salt intake change between the intervention and control groups at 24 months versus baseline and 12 months, measured by the mean two consecutive 24-h urinary sodium excretions. The secondary outcome was the difference in the change of blood pressure and salt-related Knowledge, Attitude, Practice (KAP) score.ResultsThe difference in salt intake change in adults between the intervention and control groups after adjusting for confounding factors was − 0.38 g/day at 24 months versus baseline (95% CI − 0.81 to 0.05, p = 0.09), following the − 0.83 g/day (95% CI − 1.25 to − 0.41, p < 0.001) at 12 months. The adjusted difference in SBP change was − 2.19 mm Hg (95% CI − 3.63 to − 0.76, p = 0.003) at 24 months versus baseline, following the − 1.80 mm Hg (95% CI − 3.19 to − 0.40, p = 0.01) at 12 months. The intervention group had a higher KAP score than the control group both at 12 months and at 24 months versus baseline. No significant changes were found in children.ConclusionsThe effect of the education program on adults’ salt intake faded, but the SBP lowering effect and the improvement of KAP score remained 12 months after the completion of the RCT. Continuous efforts are needed to maintain the salt reduction effects in real-world settings.Trial registrationChiCTR1800017553. Registered on August 3, 2018.

Historical redlining and survival among children, adolescents, and young adults with cancer diagnosed between 2000-2019 in Seattle and Tacoma, Washington.

Historical redlining has been associated with inferior survival in adult-onset cancers. However, its relationship with pediatric, adolescent, and young-adult-onset cancer outcomes is unknown. This study identified incident cancer among individuals <40 years of age living in Seattle and Tacoma between 2000-2019 via the population-based Cancer Surveillance System. The authors determined case redlining status using Home Owners' Loans Corporation data overlaid with 2000 and 2010 census tracts. Kaplan-Meier methods and multivariable Cox proportional hazards models were used to determine 5- and 10-year overall survival and hazard ratio (HR) of death according to redlined status. Cox models adjusted for patient and tumor characteristics and area-level poverty; interaction between redlining and area-level poverty was also assessed. Among 4355 cases (median age at diagnosis 32 years), overall survival at 5 years was lower (85.1%; 95% confidence interval [CI], 83.5%-86.5%) among individuals residing in redlined neighborhoods compared with those in unexposed neighborhoods (90.3%; 95% CI, 89.0%-91.5%). Survival differences persisted at 10 years. The unadjusted hazard of death for redlined exposed individuals with cancer was higher than redlined unexposed (hazard ratio [HR], 1.62; 95% CI, 1.39-1.89). In the fully adjusted model, mortality remained higher for redlined cases (HR, 1.32; 95% CI, 1.12-1.56). There did not appear to be effect modification from area-level poverty in the relationship between redlining and death (p=.49). Among young individuals with cancer, residence at diagnosis in previously redlined neighborhoods was associated with lower survival compared with those residing in nonredlined neighborhoods, supporting the hypothesis that structural racism exerts persistent effects on contemporary health outcomes.

Linking Suspended Sediment Conditions to Hyporheic Dissolved Oxygen and Fine Sediment Deposition in Salmonid Spawning Habitat Below an Irrigation Dam, Park County, Wyoming

ABSTRACTDams are essential for water resources management but impose notable effects on fluvial sediment transport and downstream river morphology by reducing or altering the timing of sediment loads. We explored the relationship between dam sediment management and downstream sediment dynamics in the context of riverine fisheries management. We quantified the effects of dam sediment management operations on downstream salmonid spawning habitat during two differing water‐level drawdown events: (1) an experimental drawdown leading to various high concentration sediment releases, and (2) a typical slower drawdown intended to minimize release of sediment. The experimental drawdown increased deposited fine sediment and decreased hyporheic dissolved oxygen levels. However, the typical drawdown did not increase fine sediment deposition or decrease hyporheic dissolved oxygen. We quantify the immediate impacts of dam operations using a number of water column and substrate metrics, and demonstrate the potential for sediment flushing operations to have short‐term seasonally persistent effects on salmonid spawning habitat. Common surrogates of suspended sediment concentration (i.e., turbidity) were poor indicators of salmonid spawning habitat, especially when sand was the dominant grain size. Instead, other measures of suspended sediment concentration such as acoustic backscatter and depth‐integrated samples, combined with discharge, appear to be better suited for monitoring and inferring the impacts of sediment releases on salmonid spawning habitat. We demonstrate the importance of understanding sediment particle sizes, monitoring relevant water column conditions in real‐time, and provide options for effectively monitoring the downstream impact of dam operations. This work can help managers balance dam sediment management operations with ecological priorities.

Unraveling vacant land concerns in the social and economic dimensions of sustainability in Chicago neighborhoods

ABSTRACT Scholars often describe vacant land as both a symptom of and a contributing factor to neighborhood decline. Not only does vacant land signal neighborhood distress and unsustainable development, but it also acts as a feedback mechanism that accelerates and perpetuates the decline in social and economic sustainability. However, our knowledge of the mutual relationship between vacant land and the decline in neighborhood social and economic sustainability remains limited due to a lack of empirical evidence. This study employed cross-lagged modeling to explore the bidirectional associations of vacant land with critical social and economic sustainability measures at the neighborhood level in Chicago, Illinois. The findings reveal that vacant land has a complex relationship with neighborhood social and economic sustainability, notably featuring mutually reinforcing associations of vacant land with crime and poverty. This study also highlights that vacant land exhibits both persistent and self-perpetuating effects over time, thereby contributing to the long-term decline in social and economic sustainability.

Studying the interplay of context and semantic content in the interpretation of adversative conjunctions with eye-tracking

The French adversative connective mais, much like its English counterpart but, takes two conjuncts and indicates that they stand in some kind of opposition. The nature of this opposition is often discussed in the existing literature of adversatives. Using an eyetracking experiment, we look at where and when this opposition appears to be manifested in a sentence reading task, using superiority comparatives sentences that appear degraded without a supportive context, as well as inferiority comparatives that do not seem to require such specific contextual information. We presented participants (n = 28) with four types of sentences, differing in the form of comparative, and in the information provided by the context. Some contexts contained a pivot property to help readers access the opposition of the two conjuncts, while others were neutral in that regard. Eye movements were recorded with a 250Hz Tobii Pro Fusion eyetracker, and mixed effect models were used to analyze the following eyetracking metrics : total fixation time and regression probability for the whole sentences, as well as first-fixation duration, first-gaze duration, regression-path duration, regressions-out and regressions-in for each individual words. Even if the helping context is shown to lower negative acceptability judgment on sentences with mais plus (Winterstein et al. 2014), we found no context effect in online reading processing, finding instead a persisting effect of the less/more dichotomy in all chosen measures, sometimes before fixation of those words, pointing towards a parafoveal effect of the aforementioned dichotomy, which merits closer look in future work.

P0013 Protein-Energy Malnutrition Induces Microbiome-Dependent Long-Lasting Changes in Intestinal Epithelial Composition

Abstract Background Protein-energy malnutrition (PEM) in childhood is associated with increased susceptibility to infections, endocrine disorders, metabolic syndrome and organ dysfunction later in life1-4. However, the mechanisms behind these long-term effects are poorly understood. While the gut microbiome plays an important role in the aetiology of PEM, little is known about the long-term epithelial changes caused by the microbiome5-7. The aim of this project was to analyse the effects of PEM on the intestinal epithelium in the presence and absence of the microbiome. Methods Conventionally maintained (CONV-R) and germ-free (GF) mice were exposed to isocaloric PEM (0.7% protein) for 4 weeks, followed by a 6-week recovery period (20% protein). Multi-omics was used to analyse the effects of PEM. Changes in the composition of the intestinal epithelium were validated by immunostaining. An organoid differentiation model was used to analyse the hypotheses formulated under ex vivo PEM conditions. Results PEM caused a long-lasting reduction in body weight in CONV-R mice and extensive changes in the intestinal epithelium, including a significant depletion of Paneth cells, compared to GF mice. Furthermore, PEM disrupted microbiota composition and function, particularly affecting amino acid and lipid metabolism. Using a multi-omics approach, we identified the microbiota-derived PPAR-GDF15 axis as a critical mediator of PEM-induced Paneth cell dysfunction. These findings were validated using an ex vivo intestinal organoid model of PEM, which revealed that Paneth cell depletion requires not only the stress-induced cytokine GDF15 as a mediator of PEM, but also a secondary microbiota-dependent hit including lipid metabolites such as 9-HODE and 12,13-diHOME, which act as PPAR agonists. Conclusion PEM induces long-term microbiome-dependent changes in the intestinal epithelium. This malnutrition-microbiome-host axis may be a promising target for therapeutic intervention to counteract the persistent effects of malnutrition.

Transcriptomic response of an algal species (raphidocelis subcapitata) exposed to 22 per- and polyfluoroalkyl substances.

Per- and polyfluoroalkyl substances (PFAS) are a large class of chemicals of concern for both human and environmental health because of their ubiquitous presence in the environment, persistence, and potential toxicological effects. Despite this, ecological hazard data are limited to a small number of PFAS even though there are over 4000 identified PFAS. Traditional toxicity testing will likely be inadequate to generate necessary hazard information for risk assessment. Therefore, the present study investigated the utility of using transcriptomic points of departure (tPODs) for informing PFAS algal toxicity. Raphidocelis subcapitata, a freshwater green algal species, were exposed for 24 hours in 96 well microplates to multiple concentrations of 22 different PFAS. Following exposure, RNA was extracted, and the transcriptome was evaluated by RNA sequencing followed by concentration response modeling to determine a tPOD for each PFAS. PFAS tPODs, based upon measured concentrations, ranged from 0.9 µg/L for perfluorotridecanoic acid to 1 mg/L for perfluorononanoic acid. These values derived from R. subcapitata exposures were compared to published hazard benchmarks from other taxa (larval fathead minnow and Daphnia magna) and in vitro data. While R. subcapitata was generally more sensitive to the tested PFAS than previously tested taxa and in vitro assays, the algal tPODs were, on average, three orders magnitude greater than the maximum concentrations of PFAS detected in Great Lakes tributaries. This high throughput transcriptomics assay with algae is a promising new approach method for an ecologically relevant, tiered hazard evaluation strategy.

Washed away: industrial capital, labor, and floods

Abstract This study quantifies the dynamic impacts of floods on industrial capital and labor in India using a novel dataset combining geocoded flood events with firm facility-level data from 2000 to 2021. Employing a stacked difference-in-differences approach with carefully matched controls, we uncover persistent negative effects of floods on firms’ assets and employment, with striking heterogeneity across sectors and regions. In the post-flood period, we estimate declines from mean values in total assets of 46.1% (16.68 billion INR ≈ 225 million USD), employment of 49.0% (8.20 thousand workers), and the wage bill of 74.5% (5.52 billion INR ≈ 74 million USD). The sectoral impacts are highly varied: the information technology and communication, manufacturing, and utilities sectors experience significant declines in assets, while the financial services sector exhibits growth. Mapping the spatial distribution of flood events and industrial facilities reveals pronounced regional heterogeneity in flood exposure and economic impacts. Adding nuance to the empirical investigation of the “creative destruction” hypothesis, we find limited evidence of systematic capital reallocation toward better-performing sectors, suggesting instead that floods generate sector-specific impacts with varying recovery patterns. These findings challenge assumptions of rapid post-disaster equilibration and have important implications for policymakers and firm managers in developing sector-specific strategies to mitigate the adverse impacts of floods in an increasingly climate-uncertain world.

Legacies from early-season hot drought: how growth cessation alters tree water dynamics and modifies stress responses in Scots pine.

Tree responses to drought are well studied, but the interacting effects of drought timing on growth, water use, and stress legacy are less understood. We investigated how a widespread conifer, Scots pine, responded to hot droughts early or late in the growing season, or to both. We measured sap flux, stem growth, needle elongation, and leaf water potential (Ψleaf) to assess the impacts of stress timing on drought resilience in Scots pine saplings. The early summer hot drought had peak temperatures of 36.5 °C, while the late summer hot drought peaked at 38.2 °C. Soil water content during both periods declined to ca. 50% of control values. The early-season hot drought caused growth cessation already at Ψleaf - 1.1 MPa, visible as an almost 30 days earlier end to needle elongation, resulting in needles 2.7 cm shorter, on average. This reduction in leaf area decreased productivity, resulting in a reduction of 50% in seasonal transpiration. However, the reduced water use of early-stressed saplings appeared to enhance resistance to a late-season drought, as reflected in a smaller decline in Ψleaf and lower tree water deficit compared to saplings that did not experience early-season stress. In summary, we observed persistant drought legacy effects from early-season hot-drought stress, as evident in a 35% reduction of leaf area, which impacted tree water use, stress resistance, and productivity. These structural adjustments of leaf development and reduced bud mass from early-season stress could be critical in evergreen conifers, whose long-lived foliage influences future water use and growth potential.

The impact of kidney disease on peri-operative outcomes of novel BPH surgeries across the board: a propensity score matched analysis using the ACS-NSQIP database.

Pre-operative kidney disease was shown to impact peri-operative outcomes of endoscopic BPH surgeries. We aim to assess the effect of novel surgical techniques (Laser Enucleation of the Prostate (LEP) and Laser Vaporization of the Prostate (LVP)) compared to Transurethral Resection of Prostate (TURP), on post-operative outcomes stratified based on kidney function. The ACS-NSQIP database was reviewed from 2008 to 2021 for 83,020 patients that underwent TURP, LEP, and LVP. Pre-operative variables were compared across kidney function groups: G1(normal/high function); G2-G3(mild/moderate kidney disease); and G4-G5(severe kidney disease). Multivariate logistic regression was performed on 30-day peri-operative complications adjusting for pre-operative variables. Propensity score matching was done between LEP and LVP to TURP. LEP showed a protective effect against UTIs (p < 0.05) in the G1 and G2-G3 categories but lost that protective effect in the G4-G5 category when compared to TURP. It had longer operative time (p < 0.05) across all kidney function groups, and demonstrated shorter hospital stay (p < 0.05) in the G1 and G2-G3 categories compared to TURP. LVP had a persistent protective effect against bleeding (p < 0.05) across all kidney function groups and shorter hospital stay (p < 0.05) when compared to TURP. LVP had a protective effect against return to OR (p < 0.05) in the G1 and G2-G3 kidney function group but lost that protective effect in the G4-G5 category. LVP had significant protective effect against thromboembolic events (p < 0.05) in the G2-G3 category and against cardiac complications (p < 0.05) in the G4-G5 category. LEP and LVP are superior to TURP in terms of post-operative complications. The type of endoscopic surgery technique should be tailored according to patient's pre-operative kidney status and risk.