Recovery Phase Research Articles

Hysteresis phenomena in the response of geomagnetic activity and cosmic ray parameters to variations in the interplanetary medium during a magnetic storm

The dynamics of the intensity of cosmic rays is known to be different on the ascending and descending branches of the 11-year solar cycle, i.e., hysteresis phenomena are observed. Recently, it has been obtained that at shorter intervals on the scale of magnetic storms there are also signs of hysteresis in dependences of cosmic ray cutoff rigidities R (geomagnetic thresholds) on heliosphere and geosphere parameters. R is the rigidity below which a particle flux is cut off due to geomagnetic shielding. In this paper, we have analyzed the dependence of the geomagnetic storm index Dst and the variation of the ΔR thresholds on interplanetary magnetic field (IMF) and solar wind (SW) parameters during the two-step magnetic storm on September 7–8, 2017. We have found hysteresis phenomena in the following paired series: (1) dependences of Dst on SW and IMF parameters, and (2) dependences of ΔR on SW and IMF parameters. We have established that the dependence curves in the storm descending phase (main phase) and ascending phase (recovery phase) do not coincide — hysteresis loops are formed. A specific feature of the storm under study is the second lowering of Dst in the recovery phase. The hysteresis pattern reflects this specific storm dynamics, forming two hysteresis loops in response to the two Dst drops.

Effect of intravenous different drugs on the prevention of restlessness during recovery period of pediatric laparoscopic surgery: a randomized control trial.

To explored the impact of dexmedetomidine and esketamine in mitigating restlessness during the postoperative recovery phase following laparoscopic surgery in children. 102 individuals aged 1 to 7years experiencing laparoscopic surgery were randomly allocated into three groups, each accepting 1μg/kg of dexmedetomidine, 0.3mg/kg of esketamine, or saline immediately at the end of carbon dioxide pneumoperitoneum. Emergence agitation(EA) occurrence was assessed by PAED scale and 5-point agitation scale. Pain was judged using Face, Legs, Activity, Cry, and Consolability (FLACC) scale. The recovery time, extubation time, and post-anesthesia care unit (PACU) stay time were recorded for all three groups. Patients administered 1μg/kg of dexmedetomidine (8.8%) and individuals given 0.3mg/kg of esketamine (11.8%) showed lower incidences of emergence agitation compared to those receiving saline (35.5%; P = 0.009). There was no statistically significant difference in the time to discharge from the PACU among the three groups of patients (P > 0.05). The recovery time and extubation time were notably extended in the dexmedetomidine group (40.88 ± 12.95min, 42.50 ± 13.38min) when compared to the saline group (32.56 ± 13.05min, 33.29 ± 11.30min; P = 0.009, P = 0.010). Following CO2 pneumoperitoneum in pediatric laparoscopic surgeries, the intravenous administration of 1μg/kg dexmedetomidine or 0.3mg/kg esketamine effectively lowers EA occurrence without extending PACU time.

The April 2023 SYM‐H = −233 nT Geomagnetic Storm: A Classical Event

AbstractThe 23–24 April 2023 double‐peak (SYM‐H intensities of −179 and −233 nT) intense geomagnetic storm was caused by interplanetary magnetic field southward component Bs associated with an interplanetary fast‐forward shock‐preceded sheath (Bs of 25 nT), followed by a magnetic cloud (MC) (Bs of 33 nT), respectively. These interplanetary structures were led by a coronal mass ejection erupted from the Sun in association with an M1.7 X‐ray flare. At the center of the MC, the plasma density exhibited an order of magnitude decrease, leading to a sub‐Alfvénic solar wind interval for ∼2.1 hr. Ionospheric Joule heating accounted for a significant part (∼81%) of the magnetospheric energy dissipation during the storm main phase. Equal amount of Joule heating in the dayside and nightside ionosphere is consistent with the observed intense and global‐scale DP2 (disturbance polar) currents during the storm main phase. The sub‐Alfvénic solar wind is associated with disappearance of substorms, a sharp decrease in Joule heating dissipation, and reduction in electromagnetic ion cyclotron wave amplitude. The shock/sheath compression of the magnetosphere led to relativistic electron flux losses in the outer radiation belt between L* = 3.5 and 5.5. Relativistic electron flux enhancements were detected in the lower L* ≤ 3.5 region during the storm main and recovery phases. Equatorial ionospheric plasma anomaly structures are found to be modulated by the prompt penetration electric fields. Around the anomaly crests, plasma density at ∼470 km altitude and altitude‐integrated ionospheric total electron content are found to increase by ∼60% and ∼80%, with ∼33% and ∼67% increases in their latitudinal extents compared to their quiet‐time values, respectively.

Study on correlation between Chinese medicine syndromes in stroke and neurological deficits during recovery phase: Perspective.

Stroke is a leading cause of long-term disability and mortality worldwide, necessitating effective rehabilitation strategies for successful recovery. Traditional Chinese medicine (TCM) has gained recognition as a complementary and alternative approach in stroke rehabilitation, owing to its unique syndromes that offer valuable insights for personalized treatment plans. This study aims to elucidate the correlation between TCM syndromes observed during the recovery phase of stroke and the associated neurological deficits. Syndromes such as Blood stasis, Phlegm-dampness, Qi deficiency, and Yin deficiency were systematically examined, while standardized neurological assessments, encompassing motor function, sensory perception, and cognitive abilities, were employed to evaluate the extent of neurological impairment. Rigorous statistical analyses were conducted to discern potential correlations between TCM syndromes and the severity of neurological deficits. The results revealed statistically significant positive associations between certain TCM syndromes, particularly Blood stasis and Phlegm-dampness, and heightened neurological deficits during the recovery phase post-stroke. These findings suggest that these syndromes may serve as indicators of more severe brain injury post-stroke, thereby guiding the development of tailored rehabilitation strategies. By establishing robust connections between TCM syndromes and neurological deficits, this study contributes to advancing our understanding of stroke recovery through an integrated approach that incorporates TCM principles. Moreover, it underscores the potential benefits of integrating TCM into conventional rehabilitation protocols, offering valuable insights for healthcare professionals and potentially improving patient outcomes.

Personal relationships during and after an initial psychotic episode. First-person experiences

Background Psychosis is often associated with loneliness, the absence of a confidant and a perceived lack of social support. In addition, the social isolation and solitude experienced can aggravate internalised stigma, depressive symptoms and/or suicidal tendencies, and worsen the course of the disorder. Aim This study explores the experiences and perceptions of persons with psychosis concerning how their interpersonal relationships have evolved from the earliest symptoms of the disorder to its subsequent clinical stabilisation. Method A qualitative content analysis was performed of the findings from five focus groups and six in-depth interviews (36 participants). Results In the prodrome and initial symptoms stage, five themes were coded: social withdrawal, loss of friends, loss of personal skills, communication difficulties and breakdown of life project. During the recovery phase, four themes were coded: family support, partner support, loneliness and the desire for more close relationships. Finally, during the clinical stabilisation phase, three themes were coded: the recovery of interpersonal relationships, including with peers; reconstruction of the life project and increased interpersonal sensitivity. Conclusions These findings highlight the impact that psychosis can have on social life and show that recovery is also related to the development of maeningful interpersonal relationships.

ECONOMIC ACTIVITY OF THE UKRAINIAN PEOPLE AS A CONTINUOUS PROCESS OF DEVELOPMENT OF ENTREPRENEURIAL COMPETENCE IN THE HISTORICAL AND PEDAGOGICAL CONTEXT

In the scientific research the analysis of the economic activity of Ukrainians and their motivation for entrepreneurial activity in the historical and pedagogical contexts has been conducted. The authors have identified the factors influencing the formation of entrepreneurial initiative of modern Ukrainians, determined the reasons for their demotivation in engaging in entrepreneurship, highlighted the historical factor, which has a significant impact on the economic behavior, motivation, and self-motivation of Ukrainians. The article emphasizes the importance of incorporating an economic component into the training programs of future professional (vocational) education teachers, the necessity of developing their entrepreneurial competence, the need to enhance motivation and self-motivation for entrepreneurship.The study concludes that the entrepreneurial activity of the Ukrainians represents a continuous process of developing entrepreneurial competence. The authors propose considering the historical factor when designing national strategic programs, both during the current wartime period and in the post-war recovery phase for maintaining business activity within small and medium-sized enterprises. They substantiate the need to include an economic component and implement a motivation system in the training programs for future professional education teachers, who initially serve as recipients and later as providers of educational services. The necessity of integrating a motivation system and entrepreneurial practice into these programs has also been demonstrated for fostering the development of entrepreneurial competence, increasing motivation and self-motivation for entrepreneurship, enabling these future teachers to implement entrepreneurial competence in their subsequent work.

CGS-21680 defers cisplatin-induced AKI-CKD transition in C57/BL6 mice

Acute kidney injury (AKI), with a high mortality and morbidity, is known as a risk factor for developing progressive chronic kidney disease (CKD). Targeting transition of AKI to CKD displays an excellent therapeutic potential. This study aims at investigating the role of CGS-21680, selective A2AR agonist, in deferring Cis-induced AKI-CKD transition. The AKI-CKD transition model was induced in C57/BL6 mice by repeated low doses of Cis (2.5 mg/kg i.p for 5 consecutive days in two cycles with a recovery phase of 16 days between two cycles). CGS-21680 was administered daily for 6 weeks (0.1 mg/kg, i.p). Urine, blood, and kidney were collected at three different time points to track the disease progression. CGS-21680 administration preserved kidney function and attenuated tubular damage as evidenced by hematoxylin-eosin (H&E) histopathology. CGS-21680 significantly restored oxidative status as reflected by reduced malondialdehyde (MDA) content and increased total antioxidant capacity (TAC). CGS-21680 showed anti-inflammatory effect as indicated by decreased TNF-α and iNOS. Additionally, CGS-21680 ameliorated endothelial dysfunction and enhanced renal vasodilation as evidenced by upregulation of endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) expression and down regulation of endothelin-1 (ET-1) and its receptor endothelin-A (ET-A) receptor expression. CGS-21680 also attenuated renal fibrosis as reflected by the reduction of percentage of fibrosis in Masson's trichome-stained renal sections and down regulation of transforming growth factor beta1 (TGF-β1) protein expression in IHC-stained renal sections. In conclusion, CGS-21680 could defer Cis-induced AKI-CKD transition via its vasodilatory, antioxidant, anti-inflammatory, and anti-fibrotic effects.

Dynamic phase measurement based on two-step phase-shifting interferometry with geometric phase grating

Abstract This paper proposes a novel dynamic 2-step phase-shifting interferometry method with a geometric phase grating and direct aberration-free object phase recovery algorithm. By exploring the amplitude-phase modulation property of the geometric phase grating, two-step phase-shifting interferograms with π / 2 phase shift can be obtained in a single shot through two kinds of spatial-multiplexing arrangements. Then the restriction on the background uniformity of the 2-step phase-shifting algorithms and the system aberration can be avoided simultaneously, based on the presented direct and fast object phase demodulation strategy with an object-free state recorded in advance, so an accurate object measurement result can be guaranteed. Accordingly, a detailed analysis of the theoretical model of error sources is conducted by taking the depolarization error of geometric phase grating and phase measurement model error into consideration, with a Least Squares Iteration optimization strategy established to further improve the measurement accuracy. Experiments on various types of phase objects, such as a photo-etched quartz substrate, the spatial light modulator, and a silicon chip, validate the effectiveness and accuracy of our method when compared with the reference phase obtained from 4-step temporal phase-shifting method. The dynamic phase measurement capability is demonstrated by exhibiting the evaporation process of alcohol droplet.

Ultra-Wideband Common-Mode Rejection Structure with Autonomous Phase Balancing for Ultra-High-Speed Digital Transmission.

For ultra-high-speed digital transmission, required by 5G/6G communications, ultra-wideband common-mode rejection (CMR) structures with autonomous phase-balancing capability are proposed. Common-mode noise, caused by phase and amplitude unbalances, is one of the most undesired disturbances affecting modern digital circuits. According to the circuit design guides with a typically used differential line (DL) for high-speed digital transmission, common-mode rejection is achieved using CMR filters, and the unbalanced phase, caused by a length difference between the two signal lines of a DL, is compensated by inserting an additional delay line. However, due to nonlinear phase interactions between the two DLs and unbalanced electromagnetic (EM) interferences, the conventional compensation method is frequency-limited at around 10 GHz. To significantly enhance the common-mode rejection level and extend the phase recovery bandwidth, the proposed CMR structure utilizes a planar balanced line (BL), such as a coplanar stripline (CPS) or a parallel stripline (PSL), along with additional conductor strips arranged laterally near the BL. To demonstrate the performance of the proposed BL-based CMR structures, various types of CMR structures are fabricated, and the measurement results are compared with the 3D EM simulation results. As a result, it is proven that the proposed BL-based CMR structures have the capability to reject the common-mode noise with suppression levels of more than 10 dB and to simultaneously recover the phase balance from near DC to over 40 GHz.

Unusual patterns of codeswitching in an unbalanced bilingual person with aphasia: effects of language and executive functions impairment

ABSTRACT Background Bilingual individuals with aphasia may exhibit unique patterns of language impairment and recovery. While code-switching (CS) is a common feature of bilingual speech, pathological CS following brain damage can provide insights into the neural mechanisms controlling bilingual language processing. Aims This study aimed to examine language impairment and recovery patterns in IZ, an unbalanced Hebrew-English bilingual with non-fluent aphasia, focusing on the unusual CS behavior observed during his subacute phase of recovery. Methods and procedures IZ underwent language and narrative assessments in both languages during the subacute and chronic phases of recovery. Ten cognitive tests were administered to assess various domains of cognitive function. Language performance was evaluated through naming and syntactic processing tasks in L1-Hebrew and L2-English. The frequency and type of CS were analyzed using the matrix language frame model. Outcomes and results During the subacute phase, IZ displayed significant language deficits in both L1-Hebrew and L2-English, with more severe impairment in L1-Hebrew naming and L2-English syntactic processing. He exhibited frequent involuntary CS, primarily using L1-Hebrew as the matrix language while embedding L2-English content words. Cognitive testing revealed reduced performance across multiple domains. In the chronic phase, IZ showed parallel improvements in both languages, particularly in L1-Hebrew naming and L2-English syntactic processing, along with a marked reduction in CS frequency. Conclusions IZ’s case demonstrates a double dissociation between lexical and syntactic processing across L1 and L2. The results suggest that matrix language selection in bilinguals may be governed by distinct neural mechanisms for each language, with specific brain regions responsible for activating lexical representations. Damage to these regions may lead to pathological CS, as observed in this case. This study underscores the importance of understanding bilingual language control mechanisms in aphasia rehabilitation.

Zona Incerta GABAergic Neurons Facilitate Emergence from Isoflurane Anesthesia in Mice.

The zona incerta (ZI) predominantly consists of gamma-aminobutyric acid (GABAergic) neurons, located adjacent to the lateral hypothalamus. GABA, acting on GABAA receptors, serves as a crucial neuromodulator in the initiation and maintenance of general anesthesia. In this study, we aimed to investigate the involvement of ZI GABAergic neurons in the general anesthesia process. Utilizing in-vivo calcium signal optical fiber recording, we observed a decrease in the activity of ZI GABAergic neurons during isoflurane anesthesia, followed by a significant increase during the recovery phase. Subsequently, we selectively ablated ZI GABAergic neurons to explore their role in general anesthesia, revealing no impact on the induction of isoflurane anesthesia but a prolonged recovery time, accompanied by a reduction in delta-band power in mice under isoflurane anesthesia. Finally, through optogenetic activation/inhibition of ZI GABAergic neurons during isoflurane anesthesia, we discovered that activation of these neurons facilitated emergence without affecting the induction process, while inhibition delayed emergence, leading to fluctuations in delta band activity. In summary, these findings highlight the involvement of ZI GABAergic neurons in modulating the emergence of isoflurane anesthesia.

Response of bacterial communities and soil chemistry to flood durations and recovery phases

Response of bacterial communities and soil chemistry to flood durations and recovery phases

Recovery control of autonomous underwater vehicles based on modified delay-product-type functional

This paper focuses on the recovery process of autonomous underwater vehicles, emphasizing a hierarchical framework in which autonomous underwater vehicles are categorized into a mothership and sub-vessels. In the recovery phase, following the completion of an underwater mission, sub-vessels navigate towards a location designated by the mothership. The crux of the recovery hinges on the design of the controller for adapting communication delays induced by environmental in underwater communication transmissions. The mothership and sub-vessels constitute a collaborative multi-autonomous underwater vehicles network equipped with these controllers, making them operate through the synchronized adjustment of their states represented in error terms. A delay-dependent controller condition criterion is proposed based on the modified delay-product-type Lyapunov-Krasovskii functional. The controller with the gain obtained from the criterion manages the system effectively and ensures successful recovery. The effectiveness of the proposed approach is demonstrated through a case study involving a network comprising one leading and four following autonomous underwater vehicles.

Response of the performance and succession of denitrification consortium under the variation of nutritional conditions: Mechanisms and characteristics

In the process of wastewater treatment, biomass was typically subjected to variation of nutrient condition. This study investigated the effects of different nutrient condition on denitrification performance and bacterial communities. The results showed that under carbon-to-nitrogen ratio (C/N) was 4, denitrifying sludge (DS) exhibited excellent denitrification performance with influent nitrate (NO3--N) concentration in the range of 88.8 ± 9.04–297.5 ± 6.63 mg L−1, maintained total nitrogen removal efficiency (TNRE) of 98.1 ± 1.75 %. While, as influent NO3--N concentration reached 408.9 ± 9.56 mg L−1, the denitrification performance was inhibited, and this inhibition was reversible. Under appropriate substrate level (215.0 ± 13.01 mg L−1), the specific denitrification activity (SDA) elevated to 300 % of its original value. Additionally, under starvation stress, although the relative abundance of some starvation-resistant bacteria (such as Actinobacteriota and Lentimicrobium) increased, the TNRE decreased by 7.3 %. During the recovery phase, despite extracellular polymeric substances (EPS) promoted, the TNRE decreased to 78.3 ± 4.7 %. Starvation stress was less favorable to DS for activity recovery than that of feast condition. These findings contribute to elucidating the mechanisms for DS to respond of different nutrient condition.

ĐẶC ĐIỂM DỊCH TỄ LÂM SÀNG, CẬN LÂM SÀNG BỆNH SỐT XUẤT HUYẾT DENGUE Ở TRẺ EM TẠI BỆNH VIỆN SẢN NHI NGHỆ AN

Dengue hemorrhagic fever is rising in many localities nationwide, including Nghe An. The movement of people carrying the Dengue virus increases the risk of an outbreak. The study aimed to describe dengue's epidemiological, clinical and paraclinical characteristics in children. The results show that children living in rural areas have a higher infection rate than those in urban areas; the disease frequency is mainly in the rainy season from August to December. There are 50% of children hospitalized in the early stages of the disease. The danger of the disease is that common clinical symptoms are joint pain and muscle fatigue; tired, abdominal pain in the liver area, and enlarged liver; Hemorrhagic manifestations, of which subcutaneous bleeding is the most common; 4.7% had symptoms of shock due to dengue fever; 31.3% had a platelet count reduced below 50.109/l. Subclinical liver enzymes (GOT, GPT) increased mainly at mild and moderate levels. Dengue IgM and Dengue NS1Ag tests appeared in 3 stages of the disease; Dengue IgG only appeared in the later stages, in which the recovery phase accounts for the highest rate. Dengue hemorrhagic fever can have clinical manifestations ranging from mild to severe, with complications of hypovolemic shock that can potentially lead to cardiovascular collapse, severe organ failure shock or severe bleeding. If not detected and treated promptly, it can lead to death, especially in children. Keywords: Dengue hemorrhagic fever; children; Nghe An Obstetrics and Pediatrics Hospital.

Kinetics of Viral Shedding for Outbreak Surveillance of Emerging Infectious Diseases: Modeling Approach to SARS-CoV-2 Alpha and Omicron Infection.

Previous studies have highlighted the importance of viral shedding using cycle threshold (Ct) values obtained via reverse transcription polymerase chain reaction to understand the epidemic trajectories of SARS-CoV-2 infections. However, it is rare to elucidate the transition kinetics of Ct values from the asymptomatic or presymptomatic phase to the symptomatic phase before recovery using individual repeated Ct values. This study proposes a novel Ct-enshrined compartment model to provide a series of quantitative measures for delineating the full trajectories of the dynamics of viral load from infection until recovery. This Ct-enshrined compartment model was constructed by leveraging Ct-classified states within and between presymptomatic and symptomatic compartments before recovery or death among people with infections. A series of recovery indices were developed to assess the net kinetic movement of Ct-up toward and Ct-down off recovery. The model was applied to (1) a small-scale community-acquired Alpha variant outbreak under the "zero-COVID-19" policy without vaccines in May 2021 and (2) a large-scale community-acquired Omicron variant outbreak with high booster vaccination rates following the lifting of the "zero-COVID-19" policy in April 2022 in Taiwan. The model used Bayesian Markov chain Monte Carlo methods with the Metropolis-Hastings algorithm for parameter estimation. Sensitivity analyses were conducted by varying Ct cutoff values to assess the robustness of the model. The kinetic indicators revealed a marked difference in viral shedding dynamics between the Alpha and Omicron variants. The Alpha variant exhibited slower viral shedding and lower recovery rates, but the Omicron variant demonstrated swifter viral shedding and higher recovery rates. Specifically, the Alpha variant showed gradual Ct-up transitions and moderate recovery rates, yielding a presymptomatic recovery index slightly higher than 1 (1.10), whereas the Omicron variant had remarkable Ct-up transitions and significantly higher asymptomatic recovery rates, resulting in a presymptomatic recovery index much higher than 1 (152.5). Sensitivity analysis confirmed the robustness of the chosen Ct values of 18 and 25 across different recovery phases. Regarding the impact of vaccination, individuals without booster vaccination had a 19% higher presymptomatic incidence rate compared to those with booster vaccination. Breakthrough infections in boosted individuals initially showed similar Ct-up transition rates but higher rates in later stages compared to nonboosted individuals. Overall, booster vaccination improved recovery rates, particularly during the symptomatic phase, although recovery rates for persistent asymptomatic infection were similar regardless of vaccination status once the Ct level exceeded 25. The study provides new insights into dynamic Ct transitions, with the notable finding that Ct-up transitions toward recovery outpaced Ct-down and symptom-surfacing transitions during the presymptomatic phase. The Ct-up against Ct-down transition varies with variants and vaccination status. The proposed Ct-enshrined compartment model is useful for the surveillance of emerging infectious diseases in the future to prevent community-acquired outbreaks.

STATE AND PROSPECTS OF THE DEVELOPMENT OF UKRAINE'S BUILDING INDUSTRY IN THE CONDITIONS OF THE ECONOMIC CRISIS CAUSED BY THE FULL-SCALE AGGRESSION OF THE RUSSIA, FROM THE POINT OF VIEW OF ECONOMIC CYCLICITY

The article is dedicated to examining the specific manifestations of economic cyclicality in Ukraine's building materials industry under martial law conditions. The analysis reveals that the full-scale war has led to the destruction of approximately 20% of enterprises, while others have experienced significant declines in production volumes, market access, raw material sources, and human resources. The features of war-induced economic crises are compared with cyclical overproduction crises, showing that military actions immediately push the economy into a recession phase. However, recovery may commence even before the end of hostilities due to the economy reaching the trough of the economic cycle.The article explores various approaches to defining and understanding the concept of "economic crisis," highlighting the importance of identifying its causes and characteristics. Key factors influencing the transition between different phases of economic cycles—recession, depression, recovery, and expansion—are identified. It is noted that the moments of phase transition are critical to economic development, as they represent the shift from quantitative changes in one phase to qualitative changes in the next.The dynamics of real estate prices are analyzed as one of the key indicators signaling the onset of the recovery phase. Additionally, the article formulates the components of a development strategy for Ukraine’s construction sector during the recovery period, taking into account the consequences of the war. These components include the localization of building materials production, improving housing comfort, ensuring the environmental sustainability of building materials, conserving resources in their production (particularly energy), involving foreign aid in the reconstruction process, and recycling demolition waste into building materials. It is determined that the future development of the construction industry must also address the issue of effectively insulating protective structures and bomb shelters with eco-friendly materials, necessitating further development of domestic building materials that meet the urgent demands of wartime. The article concludes with the prospect of utilizing hemp-lime building materials in the reconstruction process, as they fully align with the proposed development strategy

A data science-based analysis of socioeconomic determinants impacting pediatric diagnostic radiology utilization during the COVID-19 pandemic.

Research on healthcare disparities in pediatric radiology is limited, leading to the persistence of missed care opportunities (MCO). We hypothesize that the COVID-19 pandemic exacerbated existing health disparities in access to pediatric radiology services. Evaluate the social determinants of health and sociodemographic factors related to pediatric radiology MCO before, during, and after the COVID-19 pandemic. The study examined all outpatient pediatric radiology exams at a pediatric medical center and its affiliate centers from 03/08/19 to 06/07/21 to identify missed care opportunities. Logistic regression with the least absolute shrinkage and selection operator (LASSO) method and classification and regression tree (CART) analysis were used to explore factors and visualize relationships between social determinants and missed care opportunities. A total of 62,009 orders were analyzed: 30,567 pre-pandemic, 3,205 pandemic, and 28,237 initial recovery phase. Median age was 11.34years (IQR 5.24-15.02), with 50.8% females (31,513/62,009). MCO increased during the pandemic (1,075/3,205; 33.5%) compared to pre-pandemic (5,235/30,567; 17.1%) and initial recovery phase (4,664/28,237; 16.5%). The CART analysis identified changing predictors of missed care opportunities across different periods. Pre-pandemic, these were driven by exam-specific factors and patient age. During the pandemic, social determinants like income, distance, and ethnicity became key. In the initial recovery phase, the focus returned to exam-specific factors and age, but ethnicity continued to influence missed care, particularly in neurological exams for Hispanic patients. Logistic regression revealed similar results: during the pandemic, increased distance from the examination site (OR 1.1), residing outside the state (OR 1.57), Hispanic (OR 1.45), lower household income ($25,000-50,000 (OR 3.660) and $50,000-75,000 (OR 1.866)), orders for infants (OR 1.43), and fluoroscopy (OR 2.3) had higher odds. In the initial recovery phase, factors such as living outside the state (OR 1.19), orders for children (OR 0.79), and being Hispanic (OR 1.15) correlate with higher odds of MCO. The application of basic data science techniques is a valuable tool in uncovering complex relationships between sociodemographic factors and disparities in pediatric radiology, offering crucial insights into addressing inequalities in care.

Can acclimation of freshwater rotifers to silver nanoparticles or 5-fluorouracil influence their multi- and transgenerational effects?

Emerging chemical contaminants (ECCs) are among the major environmental threats in present century. A variety of ECCs is released into aquatic environments with little knowledge about their long-term impacts to organisms. We examined the role of acclimation of the freshwater rotifer Brachionus calyciflorus to silver nanoparticles (Ag-NPs) and 5-fluorouracil (5-FU) for determining their ability to deal with these ECCs individually and in mixtures along multiple generations. Additionally, transgenerational effects were also assessed during the recovery phase. Rotifers acclimated at EC10 of Ag-NPs along generations showed a higher ability to deal with higher concentrations of these nanoparticles or 5-FU along generations. Rotifers acclimated to EC10 of 5-FU showed varied responses, as their population growth rates were affected at the initial generations once exposed to higher concentration (EC50) of the same or a new contaminant; however, the rotifers acquired resistance in later generations. The exposure of generational Ag-NP-acclimated rotifers to the mixture of Ag-NPs and 5-FU at EC50 led to a shift from no effects to negative effects along successive generations, suggesting a decrease in resistance, which remained even in the post-exposure recovery phase. Similar transgenerational adverse effects were also observed for the generational Ag-NP-acclimated rotifers released from 5-FU. Rotifers acclimated to 5-FU showed a decrease in population growth rate at the first generation of recovery phase, possibly shifting their optimal environmental conditions when released from contaminants. Overall, our results suggest that rotifers had a high level of plasticity to ECC exposure in freshwaters; however, acclimation can be generic or contaminant dependent.

Steering through the storm: Environmental uncertainty and delivery performance

AbstractWe investigate the impact of Typhoon Lekima, a source of environmental uncertainty, on delivery performance, utilizing data from RiRiShun Logistics. We apply a staggered difference‐in‐differences model across low‐complexity and high‐complexity supply chains. The analysis uncovers distinct dynamics throughout the typhoon's forecast, active, and recovery phases. Notably, the active phase experiences less disruption in delivery performance compared to the forecast phase, owing to RiRiShun's wait‐and‐see policy. This approach leads to order accumulation but subsequently enables more effective resource allocation. In the recovery phase, high‐complexity supply chains demonstrate significant improvements, surpassing pre‐disaster performance levels. The study further emphasizes the critical role of two response mechanisms in managing high‐complexity supply chains. Increasing throughput efficiencies at destination centers and implementing transfer centers prove effective in enhancing delivery performance during both the forecast and active phases. However, the simultaneous application of these response mechanisms during the forecast phase unexpectedly reduces performance.