Relative Increase Research Articles

Microstructure and property enhancement of 7075 aluminium alloy via laser metal deposition augmented by in-situ ultrasonic vibration

ABSTRACT This study employed laser directed energy deposition (DED) with in-situ ultrasonic vibration to obtain AA7075 deposits. The results showed that with ultrasonic treatment, the grain morphology of DED produced AA7075 was changed from columnar grains with an average area of 1751 µm2 to equiaxed grains of 118.2 µm2, representing a reduction of about 93%. Also, the application of ultrasonic treatment led to the increase of average hardness from 93.1 HV to 110.2 HV, and the increase of average ultimate tensile strength from 226.8 MPa to 314.7 MPa, representing relative increases of 18.36% and 38%, respectively. However, it did not result in a significant reduction of ductility. It is believed that ultrasonic vibration promotes the formation of additional nucleation sites due to cavitation and acoustic streaming, as well as the formation of secondary phase particles at grain boundaries. Both mechanisms effectively augment the mechanical properties of DED produced AA7075.

The prevalence of gestational syphilis in Malawi between 2014 and 2022: spatiotemporal modeling of population-level factors.

Mother-to-child transmission of syphilis remains high especially in the WHO AFRO region with a prevalence of 1.62%, resulting in a congenital syphilis rate of 1,119 per 100,000 live births. Elimination efforts can be supported by an understanding of the spatial and temporal changes in disease over time, which can identify priority areas for targeted interventions aimed at reducing transmission. We collated routine surveillance data from health facilities and covariate data from demographic and health surveys conducted in Malawi between 2014 and 2022. We fitted a Bayesian hierarchical mixed model with spatial and temporally structured random effects to model the district-level monthly counts of maternal syphilis notifications as a function of individual- and district-level predictors. We then generated district-level spatiotemporally explicit risk profiles to estimate the effect of individual- and district-level covariates on maternal syphilis notifications and to identify hotspot areas. Overall, the national prevalence of maternal syphilis increased from 0.28% (95% CI: 0.27-0.29%) in 2014 to peaking in 2021 at 1.92% (95% CI: 1.89-1.96%). Between 2020 and 2022, there was a decline in prevalence, with the most significant decline seen in Zomba District (1.40, 95% CI: 1.12-1.66%). In regression models, a one percentage point increase in district-level antenatal HIV prevalence was associated with increased maternal syphilis (prevalence ratio [PR]: 1.15, 95% credible interval [CrI]: 1.10-1.21). There was also an increased prevalence of maternal syphilis associated with an increased district-level mean number of sex partners (PR: 1.05, 95% CrI: 0.80-1.37). The number of districts with a high prevalence of maternal syphilis also increased between 2014 and 2022, especially in the southern region, where most had a high probability (approaching 100%) of having high maternal syphilis (defined as relative risk >1 compared to the standard population of women aged 15-49 years) in 2022. Maternal syphilis prevalence in Malawi shows an increasing upward trend, with an estimated six times relative increase between 2014 and 2022 (0.28% to 1.73%) and strong associations with higher district-level HIV prevalence. Controlling syphilis depends on reaching vulnerable populations at the sub-national level, which may be disproportionately affected. Our findings support the move to integrate the elimination of mother-to-child transmission (EMTCT) of syphilis programs with existing prevention of mother-to-child transmission (PMTCT) of HIV programs.

Effects of first-line nucleot(s)ide analogues on lipid profiles in patients with chronic hepatitis B: a network meta-analysis.

Recent studies have found that lipid levels in patients with chronic hepatitis B (CHB) may change during antiviral therapy. To assess the effects of first-line nucleot(s)ide analogues (NAs) on lipid profiles in patients with CHB using network meta-analysis. Seven electronic databases (PubMed, Embase, Cochrane Library, and four Chinese databases) were searched for cohort studies on the effect of NA on lipids in patients with CHB up to August 1, 2023. The changes of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were taken as outcomes. The mean difference (MD) of continuous variables and 95% confidence intervals (CI) were calculated using RevMan 5.4 and Stata 16.0 software, and network meta-analysis was based on a frequentist framework. A total of 4194 patients were included in the study, including patients with CHB treated with entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), as well as patients not receiving antiviral therapy [patients with inactive CHB who were not receiving antiviral therapy (referred as inactive CHB patients) and non-HBV-infected patients]. TDF reduced TC levels compared to the non-antiviral group (TDF vs. inactive CHB patients: MD = - 17.27, 95% CI (- 30.03, - 4.47); TDF vs. non-HBV-infected individuals: MD = - 17.10, 95% CI (- 20.13, - 14.07)). TC changes in the TAF and ETV groups were not statistically different from the non-antiviral group (TAF vs. inactive CHB patients: MD = - 2.69, 95% CI (- 14.42, 9.04); TAF vs. non-HBV-infected individuals: MD = - 2.52, 95% CI (- 8.47, 3.43); ETV vs. inactive CHB patients: MD = - 4.24, 95% CI (- 17.12, 8.64); ETV vs. non-HBV-infected individuals: MD = - 4.07, 95% CI (- 9.90, 1.75)). The ranking of the effects for lowering TC is as follows: CHB patients treated with nucleotide analogues [with varying efficacy: TDF (SUCRA = 99.9) > ETV (SUCRA = 59.3) > TAF (SUCRA = 43.6)] > inactive CHB patients (SUCRA = 27.3) > non-HBV-infected individuals (SUCRA = 19.9). As for secondary outcomes, among the three antiviral drugs, TDF had the most significant effect on lowering TG, LDL-C, and HDL-C, but none of the three drugs was statistically different from the non-antiviral group. Subgroup analysis showed that the lipid-lowering effect of TDF was more pronounced in the elderly (≥ 50years). TDF was effective in lipid reduction, particularly pronounced in the older population. TAF and ETV had a neutral effect to TC, TG, LDL-C, and HDL-C. Despite a relative increase in lipids observed in patients transitioning from TDF to TAF or ETV, these changes remained within acceptable limits.

Quantitative EEG Spectral and Connectivity Analysis for Cognitive Decline in Amnestic Mild Cognitive Impairment.

Mild cognitive impairment (MCI) is considered to be the borderline of cognitive changes associated with aging and very early dementia. Cognitive functions in MCI can improve, remain stable or progress to clinically probable AD. Quantitative electroencephalography (qEEG) can become a useful tool for using the analytical techniques to quantify EEG patterns indicating cognitive impairment. The aim of our study was to assess spectral and connectivity analysis of the EEG resting state activity in amnestic MCI (aMCI) patients in comparison with healthy control group (CogN). 30 aMCI patients and 23 CogN group, matched by age and education, underwent equal neuropsychological assessment and EEG recording, according to the same protocol. qEEG spectral analysis revealed decrease of global relative beta band power and increase of global relative theta and delta power in aMCI patients. Whereas, decreased coherence in centroparietal right area considered to be an early qEEG biomarker of functional disconnection of the brain network in aMCI patients. In conclusion, the demonstrated changes in qEEG, especially, the coherence patterns are specific biomarkers of cognitive impairment in aMCI. Therefore, qEEG measurements appears to be a useful tool that complements neuropsychological diagnostics, assessing the risk of progression and provides a basis for possible interventions designed to improve cognitive functions or even inhibit the progression of the disease.

EU’S SOUTHERN NEIGHBOURHOOD POLICY TOWARDS LIBYA AND SYRIA

The EU is actively involved in the dynamics of the states in its immediate vicinity to make them more stable. This involvement requires a high financial effort. In this paper I will analyse how the European Union (EU) implemented and intends to continue the neighbourhood policy with two states that went through the “Arab Spring” and became conflict zones. For the states in question, namely Libya and Syria, EU provides humanitarian aid and wishes them to recover from their failed state. The main objectives pursued by the EU within the European Neighbourhood Policy (ENP) are stabilization of neighbouring countries, promotion of EU key interests and facilitation of regional cooperation. In addition to the neighbourhood policy instrument, between the EU and the two states there is a significant increase in trade relations from year to year. This increase in economic exchanges also leads to a deepening of bilateral relations. This rapprochement can transpose models of good governance from the EU to these failed states, and over time can create an environment conducive to state reconstruction, where the citizen is at the centre of attention and the rulers’ own interests are no longer at the forefront. The purpose of the paper is to analyse the EU southern neighbourhood policy, with an emphasis on Libya and Syria. The starting hypothesis of the research is that the EU’s ENP aid to Libya and Syria ensures minimal stability for the two countries and a better neighbourhood for it. As a working methodology, I will use the qualitative analysis of documentary materials.

High magnetoelectric coupling in piezoelectric modified BNT and magnetic NZFO particulate composite

Lead-free magnetoelectric (ME) particulate composite comprising piezoelectric 72.5Bi0·5Na0·5TiO3-22.5Bi0·5K0·5TiO3–5BiMg0·5Ti0·5O3 (MBNT) and piezomagnetic Ni0·7Zn0·3Fe2O4 (NZFO) in varying phase fraction, i.e., (1-x)MBNT-xNZFO (x = 0.05–0.30; Δx = 0.05) was prepared by solid state reaction route. Their structural, electrical, magnetic and ME properties were investigated. The high temperature sustainability up to 390 °C and the relaxor behavior was confirmed by their dielectric study. The room temperature dielectric constant (∼1081 at 1 kHz), saturation polarization (∼37.12 μC/cm2) and electro-strain (∼0.22 %) was observed maximum for pure MBNT, which decreases in composites with the induction of non-ferroelectric NZFO content. All composites exhibited magnetic hysteresis behavior where net increase in magnetization was associated with the relative increase in NZFO that possessed a saturation magnetization of 74.52 emu/g. At the optimum phase fraction of composite (i.e., 0.80MBNT-0.20NZFO), giant ME coefficient (∼58.12 mV/cm.Oe at 800 Oe) was observed at low frequency of 10 Hz, which suggest its credibility for energy harvester.

Pathways from adolescent close friendship struggles to adult negative affectivity.

This 19-year prospective study applied a social development lens to the challenge of identifying long-term predictors of adult negative affectivity. A diverse community sample of 169 individuals was repeatedly assessed from age 13 to age 32 using self-, parent-, and peer-reports. As hypothesized, lack of competence establishing and maintaining close friendships in adolescence had a substantial long-term predictive relation to negative affectivity at ages 27-32, even after accounting for prior depressive, anxious, and externalizing symptoms. Predictions also remained robust after accounting for concurrent levels of depressive symptoms, indicating that findings were not simply an artifact of previously established links between relationship quality and depressive symptoms. Predictions also emerged from poor peer relationships within young adulthood to future relative increases in negative affectivity by ages 27-32. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Pediatric Medical Subspecialist Use in Outpatient Settings

A first step toward understanding whether pediatric medical subspecialists are meeting the needs of the nation's children is describing rates of use and trends over time. To quantify rates of outpatient pediatric medical subspecialty use. This repeated cross-sectional study of annual subspecialist use examined 3 complementary data sources: electronic health records from PEDSnet (8 large academic medical centers [January 1, 2010, to December 31, 2021]); administrative data from the Healthcare Integrated Research Database (HIRD) (14 commercial health plans [January 1, 2011, to December 31, 2021]); and administrative data from the Transformed Medicaid Statistical Information System (T-MSIS) (44 state Medicaid programs [January 1, 2016, to December 31, 2019]). Annual denominators included 493 628 to 858 551 patients younger than 21 years with a general pediatric visit in PEDSnet; 5 million beneficiaries younger than 21 years enrolled for at least 6 months in HIRD; and 35 million Medicaid or Children's Health Insurance Program beneficiaries younger than 19 years enrolled for any amount of time in T-MSIS. Calendar year and type of medical subspecialty. Annual number of children with at least 1 completed visit to any pediatric medical subspecialist in an outpatient setting per population. Use rates excluded visits in emergency department or inpatient settings. Among the study population, the proportion of girls was 51.0% for PEDSnet, 51.1% for HIRD, and 49.3% for T-MSIS; the proportion of boys was 49.0% for PEDSnet, 48.9% for HIRD, and 50.7% for T-MSIS. The proportion of visits among children younger than 5 years was 37.4% for PEDSnet, 20.9% for HIRD, and 26.2% for T-MSIS; most patients were non-Hispanic Black (29.7% for PEDSnet and 26.1% for T-MSIS) or non-Hispanic White (44.9% for PEDSnet and 43.2% for T-MSIS). Annual rates for PEDSnet ranged from 18.0% to 21.3%, which were higher than rates for HIRD (range, 7.9%-10.4%) and T-MSIS (range, 7.6%-8.6%). Subspecialist use increased in the HIRD commercial health plans (annual relative increase of 2.4% [95% CI, 1.6%-3.1%]), but rates were essentially flat in the other data sources (PEDSnet, -0.2% [95% CI, -1.1% to 0.7%]; T-MSIS, -0.7% [95% CI, -6.5% to 5.5%]). The flat PEDSnet growth reflects a balance between annual use increases among those with commercial insurance (1.2% [95% CI, 0.3%-2.1%]) and decreases in use among those with Medicaid (-0.9% [95% CI, -1.6% to -0.2%]). The findings of this cross-sectional study suggest that among children, 8.6% of Medicaid beneficiaries, 10.4% of those with commercial insurance, and 21.3% of those whose primary care is received in academic health systems use pediatric medical subspecialty care each year. There was a small increase in rates of subspecialty use among children with commercial but not Medicaid insurance. These data may help launch innovations in the primary-specialty care interface.

Pharmacological and Psychological Treatment Have Common and Specific Effects on Brain Activity in Obsessive-Compulsive Disorder

Initial treatment for obsessive-compulsive disorder (OCD) consists of pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) and/or psychological treatment with cognitive behavioral therapy (CBT). The assumption is that both treatments have different neural working mechanisms, but empirical evidence is lacking. We investigated whether these treatments induce similar or different functional neural changes in OCD. We conducted a longitudinal nonrandomized controlled trial in which thirty-four OCD patients were treated with sixteen weeks of CBT or SSRIs. Functional magnetic resonance imaging was performed before and after treatment during emotional processing (emotional face matching and symptom provocation tasks) and response inhibition (stop signal task). Twenty matched healthy controls were scanned twice with a similar time interval. Both CBT and SSRIs were successful in reducing OCD symptoms. Compared to healthy controls, treatment led to a reduction of insula activity in OCD patients during symptom provocation. The comparison between treatment groups revealed widespread divergent brain changes in the cerebellum, posterior insula, caudate nucleus, hippocampus, and occipital and prefrontal cortex during all tasks, explained by relative increases of activity following CBT compared to relative decreases of activity following SSRIs. Pharmacological and psychological treatment primarily lead to opposite changes in brain function, with a common reduction of insula activity during symptom provocation. These findings provide insight into common and specific neural mechanisms underlying treatment response, suggesting that CBT and SSRIs support recovery from OCD along partly distinct pathways. This trial is registered with NTR6575.

Genetic ancestry and diagnostic yield of exome sequencing in a diverse population

It has been suggested that diagnostic yield (DY) from Exome Sequencing (ES) may be lower among patients with non-European ancestries than those with European ancestry. We examined the association of DY with estimated continental/subcontinental genetic ancestry in a racially/ethnically diverse pediatric and prenatal clinical cohort. Cases (N = 845) with suspected genetic disorders underwent ES for diagnosis. Continental/subcontinental genetic ancestry proportions were estimated from the ES data. We compared the distribution of genetic ancestries in positive, negative, and inconclusive cases by Kolmogorov–Smirnov tests and linear associations of ancestry with DY by Cochran-Armitage trend tests. We observed no reduction in overall DY associated with any genetic ancestry (African, Native American, East Asian, European, Middle Eastern, South Asian). However, we observed a relative increase in proportion of autosomal recessive homozygous inheritance versus other inheritance patterns associated with Middle Eastern and South Asian ancestry, due to consanguinity. In this empirical study of ES for undiagnosed pediatric and prenatal genetic conditions, genetic ancestry was not associated with the likelihood of a positive diagnosis, supporting the equitable use of ES in diagnosis of previously undiagnosed but potentially Mendelian disorders across all ancestral populations.

The increasing number of surgically excised chalazion during the COVID-19 pandemic

Abstract Purpose: Our goal is to determine the number of excised chalazion over the last 16 years to see if there is an increase in the last 36 months, particularly during the COVID-19 pandemic. Methods: In this retrospective study, 1772 surgically excised cases of chalazion were reviewed. The date range was between 2007 and 2021, and cases were grouped in intervals of 36 months. Information regarding age, sex, and location of the chalazion was also obtained. Results: Of all cases, 54% of the patients (n = 952) were male and 46% (n = 820) were female. The mean age was 46.26 years, ranging from 44.65 to 47.28 in the different groups. There was a relative increase in the number of excised chalazion over the last 36 months. From 2019 to 2021, 506 cases were diagnosed. There were fewer cases in the other groups, as follows: 2016–2018-455 cases; 2013–2015-283 cases; 2010–2012-302 cases; and 2007–2009-226 cases. Regarding location of the excised lesion, 1098 (62%) were in the upper eyelid and 674 (38%) were in the lower eyelid. Conclusion: In the onset of the COVID-19 pandemic, fewer patients sought medical care for nonurgent conditions, such as chalazion. However, our data showed that despite that decrease, there was an increased number in chalazion excisions. Among several possible explanations, we suggest that the use of oral protection, such as masks, could have an impact in the increased incidence of chalazion, particularly the ones that end up being surgically removed.

Exploring the impact of CYP2D6 and UGT2B7 gene-drug interactions, and CYP-mediated DDI on oxycodone and oxymorphone pharmacokinetics using physiologically-based pharmacokinetic modeling and simulation

Oxycodone is one of the most commonly used opioids to treat moderate to severe pain. It is metabolized mainly by CYP3A4 and CYP2D6, while only a small fraction of the dose is excreted unchanged into the urine. Oxymorphone, the metabolite primarily formed by CYP2D6, has a 40- to 60-fold higher mu-opioid receptor affinity than the parent compound. While CYP2D6-mediated gene-drug-interactions (GDIs) and drug-drug interactions (DDIs) are well-studied, they only account for a portion of the variability in oxycodone and oxymorphone exposure. The combined impact of CYP2D6-mediated GDIs and DDIs, CYP3A4-mediated DDIs, and UGT2B7 GDIs is not fully understood yet and hard to study in head-to-head clinical trials given the relatively large number of scenarios. Instead, we propose the use of a physiologically-based pharmacokinetic model that integrates available information on oxycodone's metabolism to characterize and predict the impact of DDIs and GDIs on the exposure of oxycodone and its major, pharmacologically-active metabolite oxymorphone. To this end, we first developed and verified a PBPK model for oxycodone and its metabolites using published clinical data. The verified model was then applied to determine the dose-exposure relationship of oxycodone and oxymorphone stratified by CYP2D6 and UGT2B7 phenotypes respectively, and administered perpetrators of CYP-based drug interactions. Our simulations demonstrate that the combination of CYP2D6 UM and a UGT2B7Y (268) mutation may lead to a 2.3-fold increase in oxymorphone exposure compared to individuals who are phenotyped as CYP2D6 NM / UGT2B7 NM. The extent of oxymorphone exposure increases up to 3.2-fold in individuals concurrently taking CYP3A4 inhibitors, such as ketoconazole. Inhibition of the CYP3A4 pathway results in a relative increase in the partial metabolic clearance of oxycodone to oxymorphone. Oxymorphone is impacted to a higher extent by GDIs and DDIs than oxycodone. We predict oxymorphone exposure to be highest in CYP2D6 UMs/UGT2B7 PMs in the presence of ketoconazole (strong CYP3A4 index inhibitor) and lowest in CYP2D6 PMs/UGT2B7 NMs in the presence of rifampicin (strong CYP3A4 index inducer) covering a 55-fold exposure range.

Relative increases in CH4 and CO2 emissions from wetlands under global warming dependent on soil carbon substrates

Relative increases in CH4 and CO2 emissions from wetlands under global warming dependent on soil carbon substrates

PERCOLATION CHARACTERISTICS OF POWER-LAW FLUID IN THE FRACTAL TREE-LIKE BIFURCATION NETWORKS WITH ROUGH SURFACES

In order to study the seepage characteristics of power-law fluids in the fractal tree-like bifurcation networks with rough surfaces based on fractal theory, the shape factor of rough surfaces is treated as the randomly distributed cones. According to the generalized Darcy's law and the constitutive equation of power-law fluids, the fully-developed laminar and incompressible flow of power-law fluids in rough pipelines is explored, and the velocity graduation and flow rate expressions of fluids in rough pipelines are obtained. Then, the fractal model for the permeability of power-law fluid in the tree-like bifurcation network with rough surfaces is proposed, and the total flow rate, total pressure drop, and permeability of power-law fluid in the tree bifurcation network with rough surfaces are derived. The relative increase in pressure and the relative decrease in permeability are also obtained. Finally, the analytical expression for the permeability of power-law fluids is analyzed. It can be seen that the permeability of a rough tree-like bifurcation network is inversely proportional to relative roughness, length ratio, bifurcation angle, etc., and directly proportional to the power-law index and diameter ratio. At the same time, the predicted values of the model are compared with existing models, proving the correctness and rationality of the model.

МНОГОФАКТОРНАЯ МОДЕЛЬ ОЦЕНКИ ЭКОЛОГИЧНОСТИ РАЗВИТИЯ ЭКОНОМИКИ РЕГИОНА

One of the most important problems in the socio-economic development of regions is ensuring the proper quality of growth. As a rule, economic growth implies an increase in the intensity of resource consumption, which contributes to increased anthropogenic impact on the environment, deterioration of living conditions, threats to public health and a decrease in social security. Using the example of subjects of the Volga Federal District, the article examines the impact of economic growth on environmental factors, assessing, among other things, the relationship between the state of the environment and the incidence of disease in the population. Various approaches are used for cross-regional comparisons of environmental conditions. The index of environmental well-being, built on the basis of a three-factor model, is considered as the main characteristic. On the basis of this index, an index of environmental efficiency of the regional economy is formed, which is defined as the level of environmental well-being for a single output of the regional economy. The multifactor model showed that if environmental efficiency is maintained in a growing economy, then the level of environmental well-being will decline at a faster rate than the rate of economic growth. To maintain environmental well-being in conditions of economic growth, it is necessary that the average increase in environmental well-being for each factor is not lower than the rate of economic growth. For single-factor models, the relative increase in environmental efficiency actually corresponds to the decoupling index, but for multi-factor models this relationship weakens with economic growth, especially as the model dimension increases. In general, as the ecological efficiency of the economy increases, a positive decoupling effect is observed. A study of the Volga Federal District regions showed that the greatest environmental efficiency in recent years has been observed in the Republic of Mordovia and the Perm Territory. And in the Chuvash Republic and the Saratov region, environmental efficiency remains significantly below the base period of 2010-2014.

Investigation of Hydrostatic Imbalance with Field Observations

Abstract The hydrostatic equilibrium addresses the approximate balance between the positive force of the vertical pressure gradient and the negative gravity force and has been widely assumed for atmospheric applications. The hydrostatic imbalance of the mean atmospheric state for the acceleration of vertical motions in the vertical momentum balance is investigated using tower, the global positioning system radiosonde, and Doppler lidar and radar observations throughout the diurnally varying atmospheric boundary layer (ABL) under clear-sky conditions. Because of the negligibly small mean vertical velocity, the acceleration of vertical motions is dominated by vertical variations of vertical turbulent velocity variances. The imbalance is found to be mainly due to the vertical turbulent transport of changing air density as a result of thermal expansion/contraction in response to air temperature changes following surface temperature changes. In contrast, any pressure change associated with air temperature changes is small, and the positive vertical pressure-gradient force is strongly influenced by its background value. The vertical variation of the turbulent velocity variance from its vertical increase in the lower convective boundary layer (CBL) to its vertical decrease in the upper CBL is observed to be associated with the sign change of the imbalance from positive to negative due to the vertical decrease of the positive vertical pressure-gradient force and the relative increase of the negative gravity force as a result of the decreasing upward transport of the low-density air. The imbalance is reduced significantly at night but does not steadily approach zero. Understanding the development of hydrostatic imbalance has important implications for understanding large-scale atmosphere, especially for cloud development. Significance Statement It is well known that the hydrostatic imbalance between the positive pressure-gradient force due to the vertical decrease of atmospheric pressure and the negative gravity forces in the vertical momentum balance equation has important impacts on the vertical acceleration of atmospheric vertical motions. Vertical motions for mass, momentum, and energy transfers contribute significantly to changing atmospheric dynamics and thermodynamics. This study investigates the often-assumed hydrostatic equilibrium and investigate how the hydrostatic imbalance is developed using field observations in the atmospheric boundary layer under clear-sky conditions. The results reveal that hydrostatic imbalance can develop from the large-eddy turbulent transfer of changing air density in response to the surface diabatic heating/cooling. The overwhelming turbulence in response to large-scale thermal forcing and mechanical work of the vast Earth surface contributes to the hydrostatic imbalance on large spatial and temporal scales in numerical weather forecast and climate models.

Outcome of BMI2+: Motivational Interviewing to Reduce BMI Through Primary Care AAP PROS Practices.

Pediatric obesity rates in the United States remain at an all-time high. Pediatric primary care clinicians and registered dietitians can help treat childhood obesity, and motivational interviewing (MI) has shown promising effects in prior trials. We randomized 18 pediatric primary care practices to receive the Brief Motivational Interviewing to Reduce BMI or BMI2+ intervention or continue with usual care (UC). Practices were recruited through the American Academy of Pediatrics Pediatric Research in Office Settings network. The intervention comprised 4 components1: in-person and telehealth MI counseling by pediatric clinicians; 4 recommended sessions,2 6 telephone MI counseling sessions from a registered dietitian,3 text message reminders and tailored motivational messages, and4 parent educational materials. The main outcome was the change in the percentage of the 95th percentile of BMI. The study was conducted 2017 through 2021. There was a significant treatment x time interaction (b = 0.017, 95% confidence interval: [0.0066-0.027]) for the main outcome, favoring the UC group, with youth in the intervention arm showing a greater relative increase in their percent of the 95th percentile. There was no overall benefit of the intervention and, contrary to expectations, youth in the intervention arm gained more weight, based on percent of the distance from the 95th percentile than matched youth from UC practices. The absolute excess weight gain among intervention relative to UC youth was small, approximately 0.5 BMI units and 1 kg over 2 years. We offer several potential explanations for these unexpected findings.

In silico modelling of the effect of pyloric intervention procedures on gastric flow and emptying in a stomach with gastroparesis.

Pyloric interventions are surgical procedures employed to increase the gastric emptying rate in gastroparesis patients. In this study, we use an in silico model to investigate the consequences of pyloric intervention on gastric flow and emptying for two phenotypes of gastroparesis: antral hypomotility and decreased gastric tone. The transpyloric pressure gradient predicted by the in silico model, based on viscous fluid flow equations, is compared against in vivo measurements. Both phenotypes exhibit a similar pre-procedural emptying rate reduction, but after pyloric surgery, antral hypomotility case with preserved gastric tone shows significant improvements in emptying rates, up to 131%, accompanied by bile reflux from the duodenum into the stomach. Conversely, severely reduced gastric tone cases exhibited a post-procedural reduction in the net emptying rate due to the relatively larger bile reflux. In cases with a combination of antral hypomotility and reduced gastric tone, post-procedural improvements were observed only when both conditions were mild. Our findings highlight the pivotal role of the relative increase in pyloric orifice diameter in determining post-operative emptying rates. The study suggests a possible explanation for the selective response of patients toward these procedures and underscores the potential of in silico modelling to generate valuable insights to inform gastric surgery.

Update of the risk assessment of inorganic arsenic in food.

The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.

Trends in COPD mortality from 1983 to 2018: protocol for a population-based cohort study in Denmark

IntroductionChronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide, which is partly contributed to the increasing prevalence of COPD owning to a demographic shift towards...