Similar Extent Research Articles

Effect of Intensive Blood Pressure Control on Cardiovascular Outcomes in Cancer Survivors.

To evaluate whether cancer modifies the effect of intensive blood pressure control on major cardiovascular outcomes. Using data of the SPRINT (Systolic Blood Pressure Intervention Trial), we compared the risk of the composite outcomes of myocardial infarction, other acute coronary syndromes, stroke, heart failure, and cardiovascular death in patients with and without a history of cancer. Using Cox proportional hazards regression, we tested interactions between history of cancer and intensive blood pressure control on major cardiovascular outcomes. The study included a total of 9336 patients, with a mean age of 67.9±9.4 years, among whom 2066 (22.2%) were cancer survivors. Over a median follow-up of 3.2 years, 561 primary cardiovascular outcomes were observed. Cancer survivors had a similar risk of experiencing the primary outcome compared with patients without cancer after multivariable adjustment (adjusted hazard ratio, 0.94 [95% CI, 0.77-1.15]). Intensive blood pressure control reduced risk of the primary cardiovascular outcome similarly for cancer survivors (hazard ratio, 0.70 [95% CI, 0.51-0.97]) and patients without cancer (HR, 0.76 [95% CI, 0.63-0.93]; P for interaction 0.74). In SPRINT study, intensive blood pressure treatment reduced the risk of major cardiovascular events in cancer survivors to a similar extent to that of patients without cancer. Cancer history not requiring active treatment in last 2 years should not be an obstacle to intensive treatment of hypertension. This post hoc analysis should be considered as hypothesis-generating and merit further clinical trial. URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062.

Fractal analysis of the medical insurance market: Theoretical and practical aspects

The latest experience obviously reflects that social-economic systems increasingly demonstrate an unforecastable behaviour. Financial markets are characterised by extremely guick change and crisis phenomena. Use of traditional modelling methods (in particular, the effective market hypothesis) provides no opportunity to obtain efficient forecasts about state and development of financial markets. One of promising methods in researching and modelling financial markets is the fractal analysis. Various natural and social phenomena posess fractality properties, namely there are similar structures on different scales. Generality of the fractal analysis methods allows their applying to study systems of any nature – from physical to economic and social ones. Fractality attributes of time series provide its dynamics pre-forecast and assess the time series predictability. The fractal analysis consists in establishing the extent of time series similarity to the fractal ones and defining a relation between the trend line and fractal dimension. The Hurst exponent assessment (persistence or anti-persistence of time series) predicts the further process development on the preliminary data basis. The fractal analysis efficiency during the unstable market periods is applicable for studying different social-economic systems (in particular, the Ukrainian medical insurance market). The research object is time series of gross insurance rewards on the Ukrainian medical insurance market. The research topic is the time series fractal analysis. The paper deals with peculiarities of the time series fractal analysis, the R/S analysis for time series of gross insurance rewards on the Ukrainian medical insurance market (via the MS Excel software). The Statistica 10.0.228.2 application generated the ARIMA model to predict dynamics of the gross insurance rewards on the Ukrainian medical insurance market. The obtained results may be used to conduct the R/S analysis of financial time series. In particular, that concerns those time series that describe the insurance market. Also, dynamics of the financial time series may be forecasted via these results as well.

Assessment of surface roughness and compressive strength of resin-based composite using different types of bleaching protocols.

Background and objective: This study aimed to evaluate the effect of three types of bleaching protocols on the surface roughness and compressive strength of composite resin. Methods: Eighty composite resin samples were prepared using metal molds; forty samples (2 mm in height and 8 mm in diameter) for surface roughness evaluation and the other forty samples (6 mm in height and 4 mm in diameter) for compressive strength. Every forty samples were divided into four groups; Group 1 (n = 10) The samples were stored in deionized water at 37°C for two weeks as control, group 2 (n =10) The samples were subjected to bleaching with 22% Carbamide Peroxide (CP) Home bleaching, group 3 (n =10) The samples were subjected to bleaching with 14% Hydrogen Peroxide (HP) Home bleaching and group 4 (n =10) The samples were subjected to bleaching with 25% Hydrogen Peroxide (HP in-Office) in a dental clinic. After bleaching, groups 2, 3, and 4 were evaluated for surface roughness and compressive strength. Results: The enamel surface roughness of all specimens were increased after bleaching protocols to a very similar extent with no statistically significant difference between the means of enamel roughness of the control group and the other three groups and the highest value was recorded in the Carbamide Peroxide group (CP), while compressive strength of the composite was decreased after using bleaching protocols in all groups in comparison with the control group and the least compressive strength was recorded in (HP) group followed by (HP in-Office) group and (CP) group respectively. Conclusions: Within the limitation of this study, the following conclusions can be drawn: There was a decrease in surface roughness using different types of bleaching protocols (22% CP and 14% HP) at-Home bleaching technique and (25%) in-Office HP bleaching. Although there was no significant difference between them. The compressive strength of the composite resin was reduced after bleaching with no significant difference. Keywords: Bleaching protocol, Hydrogen peroxide, Carbamide peroxide

Understanding Barriers Impacting upon Patient Wellbeing: A Nationwide Italian Survey and Expert Opinion of Dermatologists Treating Patients with Moderate-to-Severe Psoriasis.

A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists' perspectives on the impact of psoriasis and its treatment on patients' daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.2 years) completed a 31-question survey and workshop sessions were undertaken in order to identify the best management approach to achieve patient wellbeing. Social (4.2 ± 0.1), physical (4.26 ± 0.2) and mental components (4.1 ± 0.3) were rated by dermatologists as contributing to patient wellbeing to similar extents. While a high proportion (85.4%; rating of 4.3 out of 5) of dermatologists felt that they considered the QoL of patients, a lower proportion (69.6%; rating of 3.7 out of 5) felt that patients were satisfied in this regard. The psoriasis area and severity index and body surface area were the instruments most frequently used to assess the physical domain, while interviews/questions and the dermatology life quality index were used to assess social and mental domains, with only 60% of dermatologists following up on these aspects. The importance of investigating the presence of comorbidities was recognized but not always carried out by many dermatologists, (>70%), particularly for obesity and anxiety/depression. This survey identified key components contributing to barriers impacting on the QoL of patients with moderate-to-severe psoriasis from the perspective of the dermatologist.

Solvent-Driven Degradation of Ni-Rich Cathodes Probed by Operando Gas Analysis

High-capacity Ni-rich layered metal oxide cathodes are highly desirable to increase the energy density of lithium-ion batteries. However, these materials suffer from poor cycling stability, which is exacerbated by increased cell voltage due to higher interfacial reactivity than their lower Ni-content analogues. Here, we study the pivotal role of electrolyte solvents in determining the interfacial reactivity at charged LiNi0.33Mn0.33Co0.33O2 (NMC111) and LiNi0.8Mn0.1Co0.1O2 (NMC811) cathodes by using both single-solvent model electrolytes and the mixed solvents used in commercial cells (1, 2). Operando gas analysis reveals that the solvent-dependent reactivity for Ni-rich cathodes is related to the extent of lattice oxygen release and accompanying electrolyte oxidation. We demonstrate here the detrimental effect of ethylene carbonate (EC), a core component in conventional electrolytes, when NMC811 is charged above 4.3 V vs Li/Li+ - the observed onset potential for lattice oxygen release. Oxygen loss is enhanced by EC-containing electrolytes and correlates with more electrolyte oxidation/breakdown and cathode surface degradation, which increase concurrently above 4.4 V. The gas analysis also reveals the crosstalk effect caused by the products of the nascent oxygen from the NMC811 lattice and the electrolyte solvent, showing anodic reactivity. In contrast, NMC111, which does not release oxygen up to 4.6 V, shows a similar extent of degradation irrespective of the electrolyte. Higher lattice oxygen release with EC-containing electrolytes is coupled with higher interfacial impedance, a thicker oxygen-deficient rock-salt surface reconstruction layer, more electrolyte solvent and salt breakdown. Oxygen loss is suppressed in the EC-free electrolyte, highlighting the incompatibility between Ni-rich cathodes and conventional electrolyte solvents. W. M. Dose et al., Onset Potential for Electrolyte Oxidation and Ni-Rich Cathode Degradation in Lithium-Ion Batteries. ACS Energy Letters 7, 3524-3530 (2022).W. M. Dose et al., Electrolyte Reactivity at the Charged Ni-Rich Cathode Interface and Degradation in Li-Ion Batteries. ACS Applied Materials & Interfaces 14, 13206-13222 (2022). Figure 1

No murder without a clue: An intersemiotic translation of murders in And Then There Were None

The aim of this study is to analyze the detective novel titled And Then There Were None by Agatha Christie to find out the implicit or explicit clues in the conflict part of the plot to allow the readers to be able to draw inferences or anticipations on the resolution. Following the identification of the relevant contexts in the source text, the TV mini series adaptation of the novel is also analyzed in comparison to the source contexts to find out the extent of preservation or omission of the meaning in intersemiotic translation. The contexts with implicit or explicit clues are discussed in relation to discursive techniques in a narration, particularly anticipation and amorce techniques. The relevant contexts in the source text are mostly found to be preserved in the target text. However, this preservation does not come directly copying or transferring the content to the target text, rather the dynamics different between a literary text and audiovisual text could impel the intersemiotic translator to employ the compensation technique in the adaptation process. A text of visual and cognitive nature is translated to another semiotic system incorporating the auditory aspect to TV adaptations, resulting in translation decisions different from interlingual translations. As a result of the analysis, it is recommended that compensation technique could allow the target viewers to gather anticipations as regards the resolution as is the case with source readers in intersemiotic translation. Therefore, what counts in novel-to-TV adaptations turns out to be the extent of similarity rather than a quest for sameness.

SOCIAL NETWORKS: BUILDING RESOURCES FOR DIVERSE AGING FAMILIES

Abstract Social networks provide tangible resources for older adults and their families. Yet, their formation and characteristics may vary across diverse aging contexts. Friedman and colleagues examine multiple dimensions of caregivers’ networks using a nationally representative sample (N=2,176). Latent profile analysis identified three classes of caregiving networks: (1) Large, sparse networks with relatively few kin and only some people who assist with caregiving tasks for care recipients; (2) Moderately-sized, somewhat dense, kin-based networks; (3) Small, very dense family networks where caregiving is shared across network members, all of which uniquely influence caregiver well-being. Hu and colleagues evaluate measurement invariance of objective and subjective social isolation between US-born and foreign-born older adults using a regionally representative sample (N=611). Findings show indicators of social network structure and perceived relationship quality may be useful for examining social isolation among older immigrants. Ajrouch and colleagues show distinct dimensions of networks differentially influence older adult’s cognitive function. Larger networks and higher proportion of family are positively related while higher contact frequency is negatively related to cognitive function. Using data from the Detroit-based Social Relations Study, Webster and Chin show the extent of similarity in health-related behaviors between older adults and their closest social network members. Analysis of 247 dyads illustrate associations between multiple social network factors (homophily, structure, and relationship quality) and similarity in these behaviors. Together, these papers advance theoretical and methodological approaches to the ways in which social networks serve as a resource across diverse aging contexts.

SOCIAL NETWORKS AND COGNITIVE HEALTH IN RACIAL/ETHNIC CONTEXT

Abstract Social networks provide tangible resources for older adults and their families. Yet, their formation and characteristics may vary across diverse aging contexts. Friedman and colleagues examine multiple dimensions of caregivers’ networks using a nationally representative sample (N=2,176). Latent profile analysis identified three classes of caregiving networks: (1) Large, sparse networks with relatively few kin and only some people who assist with caregiving tasks for care recipients; (2) Moderately-sized, somewhat dense, kin-based networks; (3) Small, very dense family networks where caregiving is shared across network members, all of which uniquely influence caregiver well-being. Hu and colleagues evaluate measurement invariance of objective and subjective social isolation between US-born and foreign-born older adults using a regionally representative sample (N=611). Findings show indicators of social network structure and perceived relationship quality may be useful for examining social isolation among older immigrants. Ajrouch and colleagues show distinct dimensions of networks differentially influence older adult’s cognitive function. Larger networks and higher proportion of family are positively related while higher contact frequency is negatively related to cognitive function. Using data from the Detroit-based Social Relations Study, Webster and Chin show the extent of similarity in health-related behaviors between older adults and their closest social network members. Analysis of 247 dyads illustrate associations between multiple social network factors (homophily, structure, and relationship quality) and similarity in these behaviors. Together, these papers advance theoretical and methodological approaches to the ways in which social networks serve as a resource across diverse aging contexts.

Profession-based manual therapy nomenclature: exploring history, limitations, and opportunities

ABSTRACT Objective The International Consortium on Manual Therapies (ICMT) is a grassroots interprofessional association open to any formally trained practitioner of manual therapy (MT) and basic scientists promoting research related to the practice of MT. Currently, MT research is impeded by professions’ lack of communication with other MT professions, biases, and vernacular. Current ICMT goals are to minimize these barriers, compare MT techniques, and establish an interprofessional MT glossary. Methods Practitioners from all professions with training in manual therapies were encouraged by e-mail and website to participate (www.ICMTConferene.org). Video conferences were conducted at least bimonthly for 2.5 years by profession-specific and interprofessional focus groups (FGs). Members summarized scopes of practice, technique descriptions, associated mechanisms of action (MOA), and glossary terms. Each profession presented their work to the interprofessional FG to promote dialogue, understanding and consensus. Outcomes were reported and refined at numerous public events. Results Focus groups with representatives from 5 MT professions, chiropractic, massage therapy, osteopathic, physical therapy and structural integration identified 17 targeting osseous structures and 49 targeting nonosseous structures. Thirty-two techniques appeared distinct to a specific profession, and 13 were used by more than 1. Comparing descriptions identified additional commonalities. All professions agreed on 4 MOA categories for MT. A glossary of 280 terms and definitions was consolidated, representing key concepts in MT. Twenty-one terms were used by all MT professions and basic scientists. Five terms were used by MT professions exclusive of basic scientists. Conclusion Outcomes suggested a third to a half of techniques used in MT are similar across professions. Additional research is needed to better define the extent of similarity and how to consistently identify those approaches. Ongoing expansion and refinement of the glossary is necessary to promote descriptive clarity and facilitate communication between practitioners and basic scientists.

COMPARISON OF LONELINESS AND SOCIAL NETWORK BETWEEN OLDER ADULT CAREGIVERS AND NONCAREGIVERS

Abstract In ageing societies, more older adults are taking up informal caregiving roles. Caregivers, compared to non-caregivers, are found to have poorer psychosocial outcomes such as loneliness and social isolation in various studies. However, most of this research is not specific to older adult caregivers and does not account for selection bias into caregiving. We compare loneliness and social network between older adult caregivers and older adult non-caregivers in Singapore, applying inverse probability weighted regression adjustment (IPWRA), to address selection bias into caregiving, on data from a nationally representative longitudinal study of older adults. Those providing unpaid assistance to any person because of their health condition were considered as caregivers. Loneliness (score: 0-12; higher score=lonelier) and social network (0-60; higher score=greater network) were measured using validated scales. The relationship of caregiving status with loneliness and social network was estimated using IPWRA, controlling for multiple demographic and health characteristics. Of the 2639 respondents, 7.2% were caregivers. Older adult caregivers, versus non-caregivers, were more likely to experience loneliness (average treatment effect [ATE] β-coefficient for loneliness score: 0.328 (95% confidence interval: 0.011-0.645; p-value: 0.042); and odds ratio for being lonely: 1.080 (1.001-1.165); p-value: 0.047). However, they did not differ in terms of their social network (ATE β-coefficient for social network score: 1.456 (-0.405-3.316); p-value: 0.125). Our findings suggest that even with a similar extent of social network, older adult caregivers are at a higher risk of loneliness, i.e., perceived social isolation or relational deficits, compared to non-caregivers.

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later.

The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology. In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40-70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline. Postmenopausal females showed higher levels of baseline blood lipids (HDL = 0.14, p < 0.001, LDL = 0.20, p < 0.001, triglycerides = 0.12, p < 0.001) and HbA1c ( = 0.24, p < 0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group ( = -0.08, p < 0.001), while WHR increased to a similar extent in both groups ( = -0.03, p = 0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes ( range = 0.03-0.13, p ≤ 0.002). HDL showed a significant inverse relationship with WMH volume ( = -0.27, p < 0.001). Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.

New insights into vermiremediation of sewage sludge: The effect of earthworms on micropollutants and vice versa

Vermicomposting represents an environmentally friendly method for the treatment of various types of biowastes, including sewage sludge (SS), as documented in numerous studies. However, there are few papers providing insights into the mechanisms and toxicity effects involved in SS vermicomposting to present a comprehensive overview of the process. In this work, the vermiremediation of SS containing various micropollutants, including pharmaceuticals, personal care products, endocrine disruptors, and per/polyfluoroalkyl substances, was studied. Two SSs originating from different wastewater treatment plants (WWTP1 and WWTP2) were mixed with a bulking agent, moistened straw, at ratios of 0, 25, 50, and 75% SS. Eisenia andrei earthworms were introduced into the mixtures, and after six weeks, the resulting materials were subjected to various types of chemical and toxicological analyses, including conventional assays (mortality, weight) as well as tissue- and cell-level assays, such as malondialdehyde production, cytotoxicity tests and gene expression assays. Through the vermiremediation process significant removal of diclofenac (90%), metoprolol (88%), telmisartan (62%), and triclosan (81%) was achieved. Although the concentrations of micropollutants were substantially different in the original SS samples, the micropollutants vermiaccumulated to a similar extent over the incubation period. The earthworms substantially eliminated the present bacterial populations, especially in the 75% SS treatments, in which the average declines were 90 and 79% for WWTP1 and WWTP2, respectively. To the best of our knowledge, this is the first study to investigate the vermiremediation of such a large group of micropollutants in real SS samples and provide a thorough evaluation of the effect of SS on earthworms at tissue and cellular level.

Stress Pathways Induced by Volatile Anesthetics and Failure of Preconditioning in a Mitochondrial Complex I Mutant.

Carriers of mutations in the mitochondrial electron transport chain are at increased risk of anesthetic-induced neurotoxicity. To investigate the neurotoxicity mechanism and to test preconditioning as a protective strategy, this study used a Drosophila melanogaster model of Leigh syndrome. Model flies carried a mutation in ND23 (ND2360114) that encodes a mitochondrial electron transport chain complex I subunit. This study investigated why ND2360114 mutants become susceptible to lethal, oxygen-modulated neurotoxicity within 24 h of exposure to isoflurane but not sevoflurane. This study used transcriptomics and quantitative real-time reverse transcription polymerase chain reaction to identify genes that are differentially expressed in ND2360114 but not wild-type fly heads at 30 min after exposure to high- versus low-toxicity conditions. This study also subjected ND2360114 flies to diverse stressors before isoflurane exposure to test whether isoflurane toxicity could be diminished by preconditioning. The ND2360114 mutation had a greater effect on isoflurane- than sevoflurane-mediated changes in gene expression. Isoflurane and sevoflurane did not affect expression of heat shock protein (Hsp) genes (Hsp22, Hsp27, and Hsp68) in wild-type flies, but isoflurane substantially increased expression of these genes in ND2360114 mutant flies. Furthermore, isoflurane and sevoflurane induced expression of oxidative (GstD1 and GstD2) and xenobiotic (Cyp6a8 and Cyp6a14) stress genes to a similar extent in wild-type flies, but the effect of isoflurane was largely reduced in ND2360114 flies. In addition, activating stress response pathways by pre-exposure to anesthetics, heat shock, hyperoxia, hypoxia, or oxidative stress did not suppress isoflurane-induced toxicity in ND2360114 mutant flies. Mutation of a mitochondrial electron transport chain complex I subunit generates differential effects of isoflurane and sevoflurane on gene expression that may underlie their differential effects on neurotoxicity. Additionally, the mutation produces resistance to preconditioning by stresses that protect the brain in other contexts. Therefore, complex I activity modifies molecular and physiologic effects of anesthetics in an anesthetic-specific manner.

Historical archives reveal record rainfall and severe flooding in December 1867 resulting from an atmospheric river and snowmelt, western Washington, USA

The flooding of 1861-1862 in California and Oregon is the most severe flood event documented in the far western USA and stands as a benchmark for a worst-case atmospheric-river flooding event. In western Washington, historical data are sparser, and 19th-century flood events have consequently not been well documented. We found that rainfall observations from five locations spanning western Washington had no detectable bias when compared to nearby 20th and 21st-century comparator stations. Time series of the four-day precipitation sum revealed an event in December 1867 that was greater than any of the last century at three locations, and in the top two events at the other two locations. Summing over all locations, the regional three-day or four-day peak precipitation in 1867 exceeded the 150-yr recurrence magnitude by nearly 150 mm, indicative of non-stationarity of precipitation extremes. Newspapers and historical accounts document flood damage to settlements, farms, and bridges from the Columbia River to central Puget Sound. Reported high water levels at two locations indicate floodplains under more than a meter of water. Reanalysis data (20CRv3) is poorly spatially constrained in 1867, and underestimates the magnitude of this event, but it clearly shows the atmospheric-river cause of the event and supports snowmelt as a significant contributor to flooding. Compared to the most recent extensive flooding in 1996, the 1867 floods were likely of a similar extent but centered further north, and with notably more precipitation and enhanced by snowmelt. The 1867 rainfall amounts were also greater than those produced by the 2006 atmospheric river, though flooding in 2006 was not enhanced by snowmelt and record stream discharges were limited to mountain catchments. The combined rainfall and flood evidence from 1867 shows the potential for events more extreme than have occurred in recent history in the major urban corridors of western Washington.

Women in Microsurgery Fellowships: Trends and Impact on Future Practice Patterns.

While the number of female plastic surgeons has continued to increase over time, plastic surgery has historically been a male-dominated profession with only 15% of practicing plastic surgeons being female. Microsurgery, as a subspecialty, has been long perceived as an even more male-centric career path. The objective of this study was to determine the representation of females in the subspecialty field of microsurgery and the impact of microsurgical fellowship training. A review of all microsurgery fellowship programs participating in the microsurgery fellowship match from 2010 to 2019 were analyzed. Fellows were identified through fellowship Web site pages or direct contact with fellowship program coordinators and directors. The current type of practice and performance of microsurgery were also identified through a Web search and direct contact with fellowship program coordinators and directors. A total of 21 programs and 317 fellows over a 10-year period were analyzed. Over this 10-year period, there was a total of 100 (31.5%) female microsurgery fellows and 217 (68.5%) male microsurgery fellows. There was a small, statistically insignificant increase in the yearly percentage of female microsurgery fellows over this 10-year period with an average yearly increase of 2.7% (p = 0.60; 95% confidence interval: -6.9 to 13.2%). There were significantly fewer females who continued to practice microsurgery compared to males (75 [75.0%] vs. 186 [85.7%], p = 0.02). There was no significant difference in the current practice types (academic, private, and nonacademic hospital) between females and males (p = 0.29). Women are underrepresented in the field of microsurgery to a similar extent as they are underrepresented in overall plastic surgery. While there is a small insignificant increase in the number of female microsurgery fellows every year, a significantly smaller proportion of females continue to practice microsurgery compared to males.

Grassland intensification effects cascade to alter multifunctionality of wetlands within metaecosystems

Sustainable agricultural intensification could improve ecosystem service multifunctionality, yet empirical evidence remains tenuous, especially regarding consequences for spatially coupled ecosystems connected by flows across ecosystem boundaries (i.e., metaecosystems). Here we aim to understand the effects of land-use intensification on multiple ecosystem services of spatially connected grasslands and wetlands, where management practices were applied to grasslands but not directly imposed to wetlands. We synthesize long-term datasets encompassing 53 physical, chemical, and biological indicators, comprising >11,000 field measurements. Our results reveal that intensification promotes high-quality forage and livestock production in both grasslands and wetlands, but at the expense of water quality regulation, methane mitigation, non-native species invasion resistance, and biodiversity. Land-use intensification weakens relationships among ecosystem services. The effects on grasslands cascade to alter multifunctionality of embedded natural wetlands within the metaecosystems to a similar extent. These results highlight the importance of considering spatial flows of resources and organisms when studying land-use intensification effects on metaecosystems as well as when designing grassland and wetland management practices to improve landscape multifunctionality.

A pragmatic approach to analyze the ability of ethylene‐octene copolymer in the long chain branching of polypropylene in molten and solid state

AbstractThe investigation of chain branching in polypropylene (PP) holds significant importance for comprehending the impact of structural modifications on the properties of PP. The utilization of ethylene‐octene copolymer (EOC) presents a valuable opportunity to examine the influence of branching density on the ability of electron beam irradiation or a chemical agent in a PP blend. The introducing long chain branches (LCB) into PP can enhance its mechanical properties, particularly impact strength. This characteristic is of particular significance in applications where the material is subjected to mechanical stress, such as automotive components or packaging materials. Blends of PP/EOC were produced using 20 and 30 wt% of EOC and 0.5 phr trimethylolpropane trimethacrylate (TMPTMA) monomer. To evaluate the efficiency of branching in both solid and molten states, irradiated samples and samples mixed with dicumyl peroxide (DCP) were selected. The rheological properties of the molten blends in shear and extensional modes were assessed, and their morphology was examined using scanning electron microscopy. The existence of LCB in all samples was confirmed through dynamic viscoelastic measurements. It was concluded that although the irradiation promoted chain scission within the backbone, which resulted in long chain branching, DCP created LCB on the backbone chains of PP through chemical reaction in the melt state. Additionally, the strain hardening constant (n) was calculated, and its value for the irradiated sample PP/EOC 80/20 was 0.19, whereas its value for this blend when employing DCP was 0.14. While the complex viscosity of irradiated blend (8764 Pa.s) was greater than that of melt state branched blend (8377 Pa.s) at 0.1 rad/s, in the higher frequencies it became smaller due to the more effective creation of long chain branches through peroxide grafting in the molten state. The results of the study verified the presence of LCB in the materials by observing longer relaxation time and strain hardening behavior.Highlights The chain branching of PP/EOC blends was investigated in both the melt state and solid state through the presence of TMPTMA monomer. The effectiveness of TMPTMA monomer in grafting was mostly notable in the molten state. The steady state viscosity of LCB‐(PP/EOC) was higher in the presence of dicumyl peroxide compared to irradiated PP/EOC. The samples containing 80 wt% of PP exhibited longer side branches compared to the sample with 70 wt% of PP according to shear and extensional rheometry. The induced side chain branches resulting from irradiation and the use of dicumyl peroxide help increase the miscibility of the polymers to a similar extent.

Hemostatic potential of recombinant von Willebrand factor and standard or pegylated extended half-life recombinant factor VIII on thrombus formation under high shear flow

BackgroundVon Willebrand factor (VWF) and factor VIII (FVIII) complex play a pivotal role in hemostasis. A deficiency or defect of VWF causes von Willebrand disease (VWD). Recombinant (r)VWF product has proved to be effective for hemostatic treatment of VWD, but limited information is available on their role in moderating thrombus formation under flow condition. We aimed to assess thrombus formation in the presence of rVWF combined with rFVIII or pegylated-extended half-life rFVIII (peg-EHL-rFVIII) in VWD whole blood under high shear flow.MethodsPerfusion chamber experiments under high shear (2,500 s− 1) combined with immunostaining were performed using patient’s whole blood with type 1 VWD, mixed with rVWF (Vonvendi®; 1.6 IU/mL), rFVIII or peg-EHL-rFVIII (Advate® or Adynovate®; 1.0 IU/mL), or both. Similar experiments were also conducted with clinical medical devices (T-TAS®).ResultsThe addition of rFVIII did not augment thrombus formation assessed by surface coverage (SC) and thrombus height (TH), whereas rVWF enhanced these parameters (SC 19.1 ± 1.1% vs. 30.1 ± 4.1%, TH 2.2 ± 0.14 μm vs. 3.6 ± 0.40 μm, respectively). The co-presence of rVWF/rFVIII was comparable to plasma-derived VWF/FVIII (Confact®, VWF:FVIII ratio = 1.6:1.0) for increasing thrombogenicity in SC (32.5 ± 4.3% vs. 38.7 ± 5.5%) and in TH (5.0 ± 0.60 μm vs. 5.5 ± 0.64 μm), respectively. The pre-incubation time with rVWF and rFVIII appeared to have a little effect on the size of thrombus. Peg-EHL-rFVIII mediated thrombus formation to similar extent as rFVIII in the co-presence of rVWF. Similar results were obtained even with T-TAS. Immunostaining demonstrated that rFVIII and peg-EHL-rFVIII were similarly co-localized with rVWF in formed thrombi, indicating that pegylation did not interfere with molecular complexes.ConclusionThe effects of high-level rVWF and peg-EHL-rFVIII on thrombus formation were comparable to conventional therapeutic products in a patient’s whole blood with VWD under high shear flow.

Utilising Pancreatic Exocrine Insufficiency in the Detection of Resectable Pancreatic Ductal Adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed late, leading to a high mortality rate. Early detection facilitates better treatment options. The aim of this UK-based case-control study was to determine whether two validated tests for pancreatic exocrine insufficiency (PEI), namely, the 13C-mixed triglyceride breath test (13C-MTGBT) and a faecal elastase (FE-1) test, can discriminate between patients with resectable PDAC versus healthy volunteers (HVs) along with a comparison group with chronic pancreatitis (CP). Discrimination between disease states and HVs was tested with receiver operator characteristic (ROC) curves. In total, 59 participants (23 PDAC (16 men), 24 HVs (13 men) and 12 CP (10 men)) were recruited, with a similar age in each population, and a combined median (IQR) age of 66 (57-71). The areas under the ROC curve for discriminating between PDAC and HVs were 0.83 (95% CI: 0.70-0.96) for the 13C-MTGBT, and 0.85 (95% CI: 0.75-0.95) for the FE-1 test. These were similar to CP vs. HV. In conclusion, PEI occurs in resectable PDAC to a similar extent as in CP; further large-scale, prospective studies using these tests in the primary care setting on high-risk groups are warranted.

Intraspecific variability and species turnover drive variations in Collembola body size along a temperate-boreal elevation gradient

Investigating functional facets of biodiversity across elevation gradients provides the perspective to deepen understanding of the response of communities to global changes. Functional ecology approaches typically assume that filtering of traits across broad environmental gradients is largely due to species turnover rather than intraspecific trait variability. However, few studies quantified the relative importance of species turnover versus intraspecific variability for the composition of soil animal communities across environmental gradients. Here, for the first time, we investigated the relative contribution of species turnover, intraspecific trait variability and their covariation to changes in Collembola body size based on measurements at the individual level along a temperate-boreal elevation gradient in northeastern China. The results indicated that community weighted mean (CWM) body size of Collembola varied significantly with elevation as well as with life form, with the variations in CWM body size in total, epedaphic and hemiedaphic species being similar and more pronounced than in euedaphic Collembola. These variations in body size were driven to a similar extent by intraspecific trait variability and species turnover, with the former being somewhat higher in total, epedaphic and euedaphic but not in hemiedaphic Collembola. Further, variations in body size were better explained by local habitat-related soil factors than by temperature, but the relative importance of these factors differed among ecological groups of Collembola. Overall, these findings show that intraspecific variations in traits may be of similar importance than the turnover of species and needs closer consideration when using trait approaches to understand biodiversity – ecosystem functioning relationships in face of global change.