Separate Sites Research Articles

Construction of Spatially Separated Acid-Base Sites inside and outside Metal-Organic Framework Nanocrystals for Efficient Cascade Reactions.

The development of acid-base catalysts for one-pot cascade reactions remains challenging because of the inherent incompatibility of inorganic acid and base active sites. Here, we introduced an innovative approach that employs spatial separation to construct separated inorganic acid-base sites, achieving sequence control of acid-base cascade reactions. The as-prepared bifunctional catalyst applied metal-organic framework (MOF) nanocrystals as spatial separators, with the inside microcavities loaded with 1 nm inorganic polyoxometalate acid H3PMo12O40 clusters (NENU-5) and the outside crystal surface covered with basic CuCo layered double hydroxide (CuCo-LDH) nanosheets. By applying the resultant NENU-5@CuCo-LDH catalyst to cascade deacetalization-Knoevenagel condensation, over 99% of the benzaldehyde dimethyl acetal (BDMA) was transformed into the final benzylidene cyanoacetate (BCA) with a 99% yield at 80 °C and solvent-free conditions. Compared to the random NENU-5+CuCo-LDH, the NENU-5@CuCo-LDH with spatially separated acid-base sites indicated a higher reaction rate due to the designed reaction sequence and the shorter mass transfer pathway. Moreover, this hierarchical structure showed inherent shape selectivity and extraordinary stability. This study introduces spatial separation to address the incompatibility issue between inorganic acid and base active sites, offering novel perspectives for acid-base systems.

Multiple introduction events expand the range of the invasive brown alga Rugulopteryx okamurae to northern Spain.

The brown alga Rugulopteryx okamurae is one of the most recent and aggressive marine invaders known, with a non-native range that spans from the western Mediterranean to the southern Iberian Peninsula, and the European Macaronesian archipelagos. Here, we provide the first record of its presence at three disjunct sites from northern Spain, supported by morphological and molecular evidence. Rugulopteryx okamurae was discovered in the port of Bilbao in the northeastern Atlantic of Spain, more than 1200km away from the nearest invaded location previously known. It was also found at two separate sites in northwestern Spain: San Amaro, a small inlet at the entrance of the port of A Coruña, and Monteferro-Playa América, a site close to aquaculture facilities and the port of Vigo. In two locations, R. okamurae was found to cover up to 100% of the bottom, suggesting that it may behave as an aggressive invader in northern Spain. Our findings confirm the propensity of R. okamurae for long-distance dispersal and reveal that this invader is expanding its range northwards along the European Atlantic coast.

The stability of natural and man-made unsaturated slopes influenced by different rainfall patterns.

Many slope failures have been recorded in Malaysia in recent times, particularly during the rainy season. An irregular rainfall is a change in rainfall patterns that is found to affect the slope stability with the infiltration of rainfall. The objective of this research is to investigate variations in the pattern of rainfall and their effect on the stability of natural and man-made unsaturated slopes in two separate site locations. Case A is located near a student's hall in Universiti Kebangsaan Malaysia (UKM), and another is located at the main entrance of UKM. Both cases are simulated with current and projected rainfall. The behaviour of the slopes with applied rainfall is analyzed with generated pore-water pressure, displacement and factor of safety. The first case was conducted by including the rainfall records from January 2011 to January 2021 and future-oriented data in January 2050. The software package used for this case is Plaxis2D. The results indicate that the highest factor of safety captured for 2021 was 1.156, while the lowest factor of safety was 1.11. It is observed that the obtained safety factor decreased with increasing rainfall intensity. Moreover, the displacement obtained was 0.1761m. In Case B, the capillary barrier system was used consisting of two layers of soil with different hydraulic properties as slope cover. A parametric study was performed to investigate the effect of several variables, including the hydraulic conductivity of soil and the rate of infiltration. By using SEEP/W from the GeoStudio, the results obtained show that the pore-water pressure in the initial slope is higher than the slope with the capillary barrier system. In addition, the factor of safety was calculated in SLOPE/W, indicating that the slope with a capillary barrier system has a high factor of safety than the original slope. The capillary barrier system was seen to improve slope stability by reducing the rainwater infiltration. These two cases were investigated in regard to the behaviour of unsaturated slopes within the changing rainfall and the unsaturated soil conditions.

Gaidropsarus mauritanicus (Gadiformes, Gaidropsaridae) a new three-bearded rockling from a deep-water coral ecosystem with a genetically verified biogeographical distribution of the genus and notes to its ecology and behavior.

Gaidropsarus mauritanicus sp. nov. is described from one specimen collected using a grab sample from the Tanoûdêrt Canyon (ca. 20° N) off Mauritania at a depth of 595 m. The new species was further observed during eight remotely operated vehicle (ROV) dives along the Mauritanian slope southwards down to the Tiguent Coral Mound Complex (~17° N) in a bathymetric range between 613 and 416 m. It can be distinguished from congeners by a combination of characteristics, including large eyes (38.1% head length [HL]), large head (25.8% standard length [SL]), elongated pelvic fins (35.7% SL), low number of vertebrae (44), and coloration (pinkish with a dorsal darker brownish hue and bright blotches along the dorsal-fin base). A species-delimitation analysis performed with available cytochrome c oxidase subunit 1 (COI) sequences affiliated to the genus Gaidropsarus additionally supported the validity of the new species. Video analyses showed a deep-water coral-associated and protection-seeking behavior, which may explain why the species has remained undescribed until now. Additional ROV footage from separate deep-water coral sites in the North Atlantic and Mediterranean Sea further highlights the ecological behavior and hidden diversity of bathyal three-bearded rocklings. Here, we additionally discuss the biogeographical distribution of all genetically verified Gaidropsarus spp. in combination with genetic data and morphological characters. G. mauritanicus sp. nov. is closely related to a species from Tasmania (43° S), a geographical point furthest among the studied samples, which may hint to an important influence of (paleo-) oceanography on the distributions of Gaidropsarus species.

Estimates of the Fugacity of CO2 in the Vridi Channel (Côte d’Ivoire)

From July to November 2023 and in April 2024, surface waters were collected at three separate sampling sites within the Vridi channel, to measure physical and chemical parameters such as salinity, temperature, pH, Dissolved Inorganic Carbon (DIC). The fCO2 and Total Alkalinity were calculated from pH and DIC. These surface waters were sampling during 4 seasons to study the variability of the carbonate system parameters. Low salinity and low temperature were observed in July -August because this period corresponded to high precipitation inducing salinity dilution and the appearance of coastal upwelling. High salinity and temperature were observed in a great dry season. In the whole, salinity and temperature have same trends of variability. Whatever the season, surface waters were oversaturated in fCO2 with respect to atmospheric equilibrium in the Vridi channel except in dry season. On average the fCO2 decreased from the great cold season to the hot season following marine season. Indeed, the high coastal upwelling appeared in July and disappeared in October. The variability of the channel fCO2 followed the upwelling events along the coastal areas. Moreover, parameters such as Total Alkalinity (TA), Dissolved Inorganic Carbon and pH undergone the influence of coastal upwelling as fCO2 in the Vridi channel.

Feasibility, safety, and efficacy of a novel external compression vascular closure device: The LockeT® study.

Hemostasis following large-bore femoral vein access remains a challenge. Manual compression has been the standard of care but requires bedside staff, prolonged bed rest, and longer length of stay. The LockeT is an external compression device that attempts to address these issues while achieving venous hemostasis. We evaluate postprocedural hemostasis and vascular closure outcomes after using LockeT following cardiac electrophysiologic procedures. We performed a single-center, observational study of patients who underwent vascular closure for electrophysiology procedures using LockeT. Postprocedural outcomes were subsequently analyzed. We studied 102 patients (N) for whom LockeT was used to close 182 separate vascular access sites (n). Common procedures were atrial fibrillation ablation (56.9%, N = 58) and left atrial appendage occlusion (28.4%, N = 29). Most often, 8-Fr [48.3% (n = 126)], 11-Fr [27.2% (n = 71)], and 8.5-Fr [16.9% (n = 44)] sheaths were used, with an average procedure time of 82.1 ± 29.4 min. Hemostasis was achieved in 97.8% (n = 187) of all LockeT cases. Time to ambulation and discharge were 3.93 ± 1.10 hand 8.1 ± 4.4 h, respectively. No major complications were noted. Postprocedurally, 52% (N = 53) of patients were discharged on the same day. There were no differences in hemostasis (p = .859) or ambulation times (p = .202) between procedure types. The LockeT can effectively close venous access sites with no major complications.

Pretreatment of microneedles enhances passive transdermal administration of pilocarpine and pilocarpine-induced sweat production in humans

The development of an effective transdermal drug delivery protocol to eccrine sweat glands is important for the advancement of research on the human sweating response. We investigated whether microneedle treatment prior to the application of pilocarpine, a hydrophilic and sudorific agent that does not induce sweating due to a limited percutaneous passive diffusion by skin application alone, augments sweat production. We applied three microneedle arrays to forearm skin sites simultaneously (n = 20). Upon removal of the microneedles, 1 % pilocarpine was applied to each site for 5-, 15-, and 30-min for the assessment of sweat gland function. In parallel, pilocarpine was administered by transdermal iontophoresis (5-min) at a separate site. Sweat rate was assessed continuously via the ventilated capsule technique. Pilocarpine augmented sweat rate at the 15- and 30-min periods as compared to the application at 5-min. The sweating responses induced by the 15- and 30-min application of pilocarpine were equivalent to ∼ 80 % of that measured at the iontophoretically treated sites. Notably, we observed a correlation in sweat rate between these two transdermal drug delivery methods. Altogether, our findings show that pre-treatment of microneedle arrays can enhance transdermal delivery efficiency of pilocarpine to human eccrine sweat glands.

A Comprehensive Review of Surface Ozone Variations in Several Indian Hotspots

Ozone at ground level (O3) is an air pollutant that is formed from primary precursor gases like nitrogen oxides (NOx) and volatile organic compounds (VOCs). It plays a significant role as a precursor to highly reactive hydroxyl (OH) radicals, which ultimately influence the lifespan of various gases in the atmosphere. The elevated surface O3 levels resulting from anthropogenic activities have detrimental effects on both human health and agricultural productivity. This paper provides a comprehensive analysis of the variations in surface O3 levels across various regions in the Indian subcontinent, focusing on both spatial and temporal changes. The study is based on an in-depth review of literature spanning the last thirty years in India. Based on the findings of the latest study, the spatial distribution of surface O3 indicates a rise of approximately 50–70 ppbv during the summer and pre-monsoon periods in the northern region and Indo-Gangetic Plain. Moreover, elevated levels of surface O3 (40–70 ppbv) are observed during the pre-monsoon/summer season in the western, southern, and peninsular Indian regions. The investigation also underscores the ground-based observations of diurnal and seasonal alterations in surface O3 levels at two separate sites (rural and urban) in Kannur district, located in southern India, over a duration of nine years starting from January 2016. The O3 concentration exhibits an increasing trend of 7.91% (rural site) and 5.41% (urban site), ascribed to the rise in vehicular and industrial operations. This review also presents a succinct summary of O3 fluctuations during solar eclipses and nocturnal firework displays in the subcontinent.

Integrating in-situ data and spatial decision support systems (SDSS) to identify groundwater potential sites in the Esan plateau, Nigeria

Establishing suitable groundwater resource areas is a challenging endeavour across the globe. However, novel spatial technologies have emerged as valuable tools for the effective strategy, management, and assessment of groundwater resources, especially in data-scarce emerging economies. The current study used spatial decision support systems (SDSS) for evaluating and defining groundwater potential sites (GPSs) in Nigeria's Edo central region to promote sustainable governance of groundwater. By merging multiple groundwater contributing theme layers, a leading-edge information-based multiparametric analytical hierarchy process (AHP) was applied to define the groundwater prospective areas. By systematically assigning weights to every subject-specific layer and feature, the subject matter layers of geology, geomorphology, drainage density, slope, soil properties, landuse/landcover, rainfall distribution, hydraulic conductivity, transmissivity, curvature, proximity to surface water bodies, and elevation were generated and used for groundwater potential map generation. Each thematic layer's weights were allocated and adjusted depending on their qualities and relevance to groundwater recharge. The multicollinearity (MC) analysis was used to evaluate the model's predictive capacity. Finally, groundwater potential sites were created by integrating the theme-specific maps with the weighted total overlay computation tool. The study area contained three separate groundwater potential sites: low, moderate, and high. According to the regional geographic distribution, the largest portion of the area (65%) fell within the moderately significant groundwater potential geographical area. The high and low GPSs, which both have a low curvature and a valley plain characteristic, account for 25% and 10%, respectively, of the entire area. The outcomes were contrasted with the yield of groundwater from boreholes gathered in the study region. The validation analysis found an acceptable 88.89% similarity. This highlights the potential for the groundwater map's significant prediction. Therefore, the applied approach is a viable choice for the advancement of groundwater in the central Edo region and with comparable geology all over the globe.

Evaluating the effectiveness of minimum chlorate technologies employed by manufacturers of skim milk powder from both microbiological quality and chemical residue perspectives

Dairy processors in the Republic of Ireland have adopted chlorine-free chemicals for cleaning and chlorine gas for water disinfection as a means of minimizing chlorate residue in dairy products. For these 'minimum chlorate technologies' to be satisfactory, they must be able to deliver product with acceptable levels of bacteria as well as minimum levels of chlorate and other chlorine based residues. To establish the effectiveness of these technologies, sampling was conducted across the skim milk powder (SMP) manufacturing chain in 3 separate milk processing sites. Across the 3 sites a total of 11 different batches of SMP were sampled in duplicate from the whole milk silo through the manufacturing process to the powder product; yielding a total of 137 samples. Samples were tested for chlorate, perchlorate and trichloromethane alongside a suite of microbiological plate count tests including total bacteria, thermophilic bacteria, thermoduric bacteria and both mesophilic and thermophilic spore-forming bacteria. Chlorate was detected at reportable levels (≥0.01 mg/kg) in 9 of 22 SMP samples analyzed; resulting in a mean chlorate concentration 0.0183 mg/kg. Bacteria were ubiquitous across all samples analyzed with spore-forming bacteria counts ranging from 1.30 to 2.33 log cfu/ g in SMP.

Efficiency evaluation of ordinary and nanoscale extracts of Agaricus bisporus. on inhibition mycelial growth and aflatoxin production of Aspergillus flavus in maize grain

This study aimed to protect maize crops from infection and production of Aspergillus flavus (A. flavus) aflatoxin B1(AFB1), using the ordinary and nanoscale extracts of Agaricus spp. HPLC technology showed that the isolate taken from Musayyib district which coded with (AFA5) was a highest toxin producer. AFB1 at a concentration of 77.02 ppb. PCR product showed that the amplification of the ITS4- region was successful ITS1 according to the primers used, where a single bundle with a size of 744 bp (base pair) appeared. The isolated and diagnostic results of maize samples collected from separate sites showed the presence of A. flavus and different genera of fungi, namely Aspergillus spp., Fusarium spp., Penicillium spp., and Rhizopus spp., issued by the genus Aspergillus spp. with frequency rates of 18.33, 38.87, 20.19, 15.92, and 6.69 % respectively. On Potato Dextrose Agar (PDA), inhibitory effect results of Agaricus bisporus (A. bisporus) extract in inhibiting A. flavus growth, with inhibition percentages for the ordinary extract of 43.95, 34.59, and 10.90%, respectively, and for the nano extract 18.74, 43.71, and 76.56 % at 250,500 and 100 ppm respectively. AFB1 production was reduced by adding A. bisporus extracts (ordinary and nano) to Yeast Extract Sucrose Broth (YES) medium by 66% and 72.14%, respectively. Overall, our study presented a new insight for future scientific researches possibility of biocompands production using nanotechnology from natural resources that have the ability to safely environmentally control on mycotoxins production that present in agricultural production especially maize grains and encourage to widespread commercially use.

Radon in water and soil cover in the coastal zone of Issyk-Kul

The article summarizes the results of the study of the Issyk-Kul coastal zone - exposure dose, total alpha- and beta-activity, radon in the lake water, and soil cover. Our studies have established that radionuclide contamination is mainly natural in some coastal areas (thorium sands of Zhenish and Ak-Terek) and of natural-technogenic nature in the area of Kadzhi-Sai tailing dump. The nature of contamination is spotty, where rocks are enriched and located closer to the soil cover. Gamma-radiation exposure dose rates of the coastal zone of Lake Issyk-Kul by soil types showed that in general at the background level (from 19 ± 3 to 34 ± 6 µR/h) and below the accepted norm. On separate natural-technogenic sites (Kadzhi-Sai tailing dump, thorium sands Zhenish and Ak-Terek) gamma radiation exposure dose rate, total alpha-activity, and isotopic composition are increased from 2 to 8 times compared to background sites.

A Modified Switching Procedure from Temporary to Tunneled Central Venous Dialysis Catheters.

Background: Tunneled central venous catheters are commonly used for dialysis in patients without a functional permanent vascular access. In an emergent setting, a non-tunneled, temporary central venous catheter is often placed for immediate dialysis. The most critical step in the catheter insertion is venipuncture, which is often a major cause for longer intervention times and procedure-related adverse events. To avoid this critical step when placing a more permanent tunneled catheter, an exchange over a previously placed temporary one can be considered. In this paper, we present a modified switching approach with a separate access site. Methods: In this retrospective analysis of a prospective database, we examined whether this modified technique is non-inferior to a de novo application. Therefore, we included all 396 patients who received their first tunneled dialysis catheter at our site from March 2018 to March 2023. Out of these, 143 patients received the modified approach and 253 the standard de novo ultrasound-guided puncture and insertion. Then, the outcomes of the two groups, including adverse events and infections, were compared by nonparametric tests and multivariable logistic regression. Results: In both groups, the implantations were 100% successful. Catheter explantation due to infection according to CDC criteria was necessary in 18 cases, with no difference between the groups (5.0% vs. 4.4% p = 0.80). The infection rate per 100 days was 0.113 vs. 0.106 in the control group, with a comparable spectrum of bacteria. A total of 12 catheters (3 vs. 9) had to be removed due to a periinterventional complication. An early-onset infection was the reason in two cases (1.3%) in the study group and five in the control group (1.9%). A total misplacement of the catheter occurred in two cases only in the control group. After adjustment for potential confounders via multivariable logistic regression there was not a significant difference in the complication rate (adjusted odds ratio, aOR = 0.53, 95% CI = 0.14-2.03, p = 0.351) but an estimated decreased risk overall based on the average treatment effect of -1.7% in favor of the study group. Conclusions: The present study shows that a catheter exchange leads to no more infections than a de novo placement; hence, it is a feasible method. Moreover, misplacements and control chest X-rays to exclude pneumothorax after venipuncture were completely avoided by exchanging. This approach yields a much lower infection rate than previous reports: 1.3% compared to 2.7% in all existing aggregated studies. The presented approach seems to be superior to existing switching methods. Overall, an exchange can also help to preserve veins for future access, since the same jugular vein is used.

Bidirectional heterojunctions photocatalyst engineered with separated dual reduction sites for hydrogen evolution

Photocatalytic technology is identified as one of the most clean and sustainable routes for hydrogen generation. Nonetheless, inadequate photoinduced carrier separation limits photocatalytic performance. Rationally designing bidirectional heterojunctions that leverage single/two-photon co-excitation pathways and dual reduction sites, thereby inhibiting recombination of the photoinduced carriers and exposing active sites to increase photocatalytic activity. This study proposes bidirectional heterojunctions consisting of 0D carbon dots (CDs) and nickel phthalocyanines co-modified sulfur-doped multivesicular carbon nitride tubes (denoted as 7CDs/SMVCTs/Ni0.5 %). The as-prepared photocatalyst displays a remarkable yield of 16,363.62 μmol g−1 h−1, with a rate 23.2 times that of pristine carbon nitride (denoted as PCN, 704.23 μmol g−1 h−1). The improvement of photocatalytic performance is attributed to the efficient separation and transportation of photoexcited electron-hole pairs induced by the coexistence of single/two-photon excitation pathways and dual reduction sites. The efficient combination of lateral and vertical heterostructures plays an essential role in the photocatalytic process and is exhaustively studied using catalyst rational design and modification technology.

Effectiveness of topical hyaluronic acid of different molecular weights in xerosis cutis treatment in elderly: a double-blind, randomized controlled trial.

Dry skin is a common dermatological condition that frequently affects the elderly. A contributing cause to dry skin is a reduced concentration of hyaluronic acid (HA) in both the epidermis and dermis. The effectiveness of moisturizer containing HA as a therapy for dry skin is impacted by its specific molecular weight. Low molecular weight HA (LMWHA) is believed to be more effective in replenishing skin hydration in aging skin compared to High Molecular Weight HA (HMWHA) due to its ability to penetrate the stratum corneum. However, there is a lack of clinical research supporting this claim. A double-blind, randomized controlled trial was conducted on 36 residents of a nursing home in Jakarta. The participants, aged between 60 and 80 years, had been diagnosed with dry skin. Each test subject was administered three distinct, randomized moisturizing lotions (LMWHA, HMWHA, or vehicle), to be topically applied to three separate sites on the leg. Skin capacitance (SCap), transepidermal water loss (TEWL), and specified symptom sum score (SRRC) were measured at weeks 0, 2, and 4. After four weeks of therapy, area that was treated with LMWHA showed greater SCap values compared to the area treated with HMWHA (56.37 AU vs. 52.37 AU, p = 0.004) and vehicle (56.37 AU vs. 49.01 AU, p < 0.001). All groups did not show any significant differences in TEWL and SRRC scores. No side effects were found in all groups. The application of a moisturizer containing LMWHA to the dry skin of elderly resulted in significant improvements in skin hydration compared to moisturizers containing HMWHA and vehicle. Furthermore, these moisturizers demonstrated similar safety in treating dry skin in the elderly. ClinicalTrials.gov Identifier NCT06178367, https://clinicaltrials.gov/study/NCT06178367 .

Ocean circulation contributes to genetic connectivity of limpet populations at deep-sea hydrothermal vents in a back-arc basin.

For endemic benthos inhabiting hydrothermal vent fields, larval recruitment is critical for population maintenance and colonization via migration among separated sites. The vent-endemic limpet, Lepetodrilus nux, is abundant at deep-sea hydrothermal vents in the Okinawa Trough, a back-arc basin in the northwestern Pacific; nonetheless, it is endangered due to deep-sea mining. This species is associated with many other vent species and is an important successor in these vent ecosystems. However, limpet genetic diversity and connectivity among local populations have not yet been examined. We conducted a population genetics study of L. nux at five hydrothermal vent fields (maximum geographic distance, ~545 km; depths ~700 m to ~1650 m) using 14 polymorphic microsatellite loci previously developed. Genetic diversity has been maintained among these populations. Meanwhile, fine population genetic structure was detected between distant populations, even within this back-arc basin, reflecting geographic distances between vent fields. There was a significant, positive correlation between genetic differentiation and geographic distance, but no correlation with depth. Contrary to dispersal patterns predicted by an ocean circulation model, genetic migration is not necessarily unidirectional, based on relative migration rates. While ocean circulation contributes to dispersal of L. nux among vent fields in the Okinawa Trough, genetic connectivity may be maintained by complex, bidirectional dispersal processes over multiple generations.

Evaluating the impact of socioeconomic status on patient satisfaction in radiation oncology.

e23166 Background: Patient satisfaction (PS) is a critical indicator in evaluating healthcare quality. While the impact of socioeconomic status (SES), on healthcare outcomes is well-documented, its specific connection to PS in the context of radiation oncology remains unclear. This study aims to delineate the correlation between SES, as determined by the Area Deprivation Index (ADI), and PS within our healthcare system. Methods: In this single institution study, National Research Council (NRC) PS survey questionnaires were prospectively collected from patients who visited 4 separate outpatient academic radiation oncology sites between May 2021 and November 2023. Area Deprivation Index (ADI) data for these patients was sourced from the Neighborhood Atlas, encompassing both national percentiles and state deciles, with higher values indicating a greater level of SES disadvantage. To assess the data, univariate (UVA) and multivariable (MVA) logistic regression analyses were performed on the survey's recommendation scores, which ranged from 0 to 10, with scores of 9 or higher suggesting a greater propensity to recommend the facility or provider. Results: Our analysis included 7,501 survey responses with a cohort that was majority female (55.3%), curative intent (81.5%), and had a breast cancer diagnosis (30.4%). Most survey responses were follow-up visits (69.0%). Mean state and national ADI scores were 3.94 and 50.75, respectively. The UVA revealed curative intent (OR 1.68, p &lt; 0.001), follow-up visits (OR 1.69, p &lt; 0.001), and breast cancer diagnosis (OR 1.42, p = 0.018) as predictors of higher likelihood to recommend the facility or the provider. Patients with a national ADI above the mean were less likely to recommend the facility (OR 0.81, p = 0.050) or the provider (OR 0.71, p = 0.002). The MVA, outlined in Table 1, showed the influence of national ADI on provider recommendations remained significant (OR 0.730, p = 0.005) but not for facility recommendations (OR 0.832, p = 0.089). All other variables remained significant on the MVA. Conclusions: Respondents experiencing greater SES disadvantage were significantly less likely to recommend their provider. These findings underscore the necessity of incorporating SES as a factor when evaluating PS. Further research is necessary to determine the root cause of the impact of SES on PS and to explore the complex dynamics of patient-provider interactions. [Table: see text]

Highly biased agonism for GPCR ligands via nanobody tethering

Ligand-induced activation of G protein-coupled receptors (GPCRs) can initiate signaling through multiple distinct pathways with differing biological and physiological outcomes. There is intense interest in understanding how variation in GPCR ligand structure can be used to promote pathway selective signaling (“biased agonism”) with the goal of promoting desirable responses and avoiding deleterious side effects. Here we present an approach in which a conventional peptide ligand for the type 1 parathyroid hormone receptor (PTHR1) is converted from an agonist which induces signaling through all relevant pathways to a compound that is highly selective for a single pathway. This is achieved not through variation in the core structure of the agonist, but rather by linking it to a nanobody tethering agent that binds with high affinity to a separate site on the receptor not involved in signal transduction. The resulting conjugate represents the most biased agonist of PTHR1 reported to date. This approach holds promise for facile generation of pathway selective ligands for other GPCRs.

Separation of source, attenuation and site parameters of 2 moderate earthquakes in France: an elastic radiative transfer approach

Summary An accurate magnitude estimation is necessary to properly evaluate seismic hazard, especially in low to moderate seismicity areas such as Metropolitan France. However, magnitudes of small earthquakes are subject to large uncertainties caused by major high-frequency propagation effects which are generally not properly considered. To address this issue, we developed a method to separate source, attenuation and site parameters from the elastic radiative transfer modeling of the full energy envelopes of seismograms. The key feature of our approach is the treatment of attenuation -both scattering and absorption- in a simple but realistic velocity model of the Earth’s lithosphere, including a velocity discontinuity at the Moho. To reach this goal, we developed a 2-step inversion procedure, allowing first to extract attenuation parameters for each source-station path from the whole observed energy envelope using the Levenberg-Marquardt and grid-search algorithms, then to determine site amplification and the source displacement spectrum from which the moment magnitude Mw is extracted. In the first step, we use the forward modeling procedure of Heller et al. (2022) in order to simulate energy envelopes by taking into account the full treatment of wave polarization, the focal mechanism of the source and the scattering anisotropy. The inversion procedure is then applied to the 2019 ML 5.2 Le Teil and 2014 ML 4.5 Lourdes earthquakes which both occurred in southern France. Data from 6 stations are selected for each event. The inversion results confirm a significant variability in the attenuation parameters (scattering and absorption) at regional scale and a strong frequency dependence. Scattering appears to be stronger towards the French Alps and Western Pyrenees. Absorption is stronger as frequency increases. Although not very resolvable, the mechanism of scattering appears to be forward or very forward. By inverting the source spectrum, we determine moment magnitudes Mw of 5.02 ± 0.17 for the Le Teil earthquake and 4.17 ± 0.15 for the Lourdes earthquake.

Evaluating a Novel AI Tool for Automated Measurement of the Aortic Root and Valve in Cardiac Magnetic Resonance Imaging.

Objective Evaluating an artificial intelligence (AI) tool (AIATELLA, version 1.0; AIATELLA Oy, Helsinki, Finland) in interpreting cardiac magnetic resonance (CMR) imaging to produce measurements of the aortic root and valveby comparison ofaccuracy and efficiencywith that of three National Health Service (NHS) cardiologists. Methods AI-derived aortic root and valve measurements were recorded alongside manual measurements from three experienced NHS consultant cardiologists (CCs) over three separate sites in the northeast part of the United Kingdom. The study utilised a comprehensive dataset of CMR images, with the intraclass correlation coefficient (ICC) being the primary measure of concordance between the AI and the cardiologist assessments. Patient imaging was anonymised and blinded at the point of transfer to a secure data server. Results The study demonstrates a high level of concordance between AI assessment of the aortic root and valve with NHS cardiologists (ICC of 0.98). Notably, the AI delivered results in 2.6 seconds (+/- 0.532) compared to a mean of 334.5 seconds (+/- 61.9) by the cardiologists, a statistically significant improvement in efficiency without compromising accuracy. Conclusion AI's accuracy and speed of analysis suggest that it could be a valuable tool in cardiac diagnostics, addressing the challenges of time-consuming and variable clinician-based assessments. This research reinforces AI's role in optimising the patient journey and improving the efficiency of the diagnostic pathway.