South Region Research Articles

Coconut Cultivation in South Konkan Region of Maharashtra: A Study of Economic Well-being

A study on economic well-being was conducted in the South Konkan region with 144 sample coconut growers. The objective behind this study was to estimate cost, returns, profitability and financial feasibility of coconut production. The study was conducted by means of adoption index, standard cost concept and financial feasibility measures. Numerous technologies have been suggested by the Regional Coconut Research Station, Bhatye, Dr. Balasaheb Sawant Konkan Krishi Vidyapeeth, to enhance the quality of coconut production after extensive research in the field. The extent up to which the technologies were adopted was 45.51 per cent overall. This suggested a wide scope for raising the adoption rate. The economic analysis of coconut production in the research area showed that growing coconuts through the use of recommended technology was profitable. It was observed that farmers are saving more on each expense due to the high adoption rate. In coconut cultivation, the net present value was positive (Rs. 230665). The B: C ratio is greater than one (1.41) and the internal rate of return (IRR) is higher than the going interest rate (23.01%). This demonstrated the economic viability of coconut production. The policy should be made to spread the recommendations to the farmers and training should be provided to farmers on larger scale for more profitable production.

Investigating the Spatial Pattern of White Oak (Quercus alba L.) Mortality Using Ripley’s K Function across the Ten States of the Eastern US

White oak mortality is a significant concern in forest ecosystems due to its impact on biodiversity and ecosystem functions. Understanding the factors influencing white oak mortality is crucial for effective forest management and conservation efforts. In this study, we aimed to investigate the spatial pattern of WOM rates across the eastern US and explore the underlying processes behind the observed spatial patterns. Multicycle forest inventory and analysis data were compiled to capture all white oak plots. WOM data were selected across plot systems that utilized declining basal areas between two periods. Ripley’s K function was used to study the spatial pattern of WOM rates. Results showed clustered patterns of WOM rates at local and broad scales that may indicate stand-level competition and regional variables affecting white oaks’ dynamics across southern and northern regions. Results also indicated random patterns at broad scales, suggesting variations in topographic and hydrological conditions across the south and northern regions. However, the central region indicated both clustered and random patterns at the local scale that might be associated with inter-species competition and the possibility of environmental heterogeneity, respectively. Furthermore, uniform patterns of WOM rate at a broad scale across all regions might suggest regions with spatially homogeneous environmental factors acting on the dynamics of white oaks. This research might be helpful in identifying impacted areas of white oaks at varying scales. Future research is needed to comprehensively assess biotic and abiotic factors at various spatial scales aimed at mitigating WOM.

Effectiveness of website-based education program on activities of daily living and fear of falls among sub-acute stroke survivors: a pilot study in South Gujarat Region of India

BackgroundStroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors.MethodsA total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I).ResultsBoth groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05).ConclusionWEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care.

Regional distribution of anaplastic thyroid cancer in the United States

Abstract Introduction/Objective Anaplastic thyroid cancer (ATC) is an aggressive rare malignancy found in less than 2% of thyroid cancer patients. Its low occurrence rate presents challenges for collecting sufficiently large cohorts at a single institution, making statistical analysis about the disease’s spread, geographical distribution, and prevalence difficult. Nationwide data lakes such as Oracle EHR Real-World Data (ORWD, formerly Cerner Real World Data) offer a boost in cohort sizes and an opportunity to study ATC’s geographical distribution and assess regional differences. Methods/Case Report We searched ATC distribution across US regions defined by ZIP codes recorded in ORWD using multiple coding parameters, including ICD9, ICD10, and SNOMED as well as direct text searches for “anaplastic thyroid carcinoma”. We analyzed the geographical associations defined by ORWD (region) with sex, race, and age of ATC onset using the Fisher’s exact test. We combined 10 regions into 4 representative groups because of the small sample size. The groups are West Coast including the Rockies, Midwest from North Dakota to Texas, East Coast, and New England. Results (if a Case Study enter NA) Search for ATC condition codes in ORWD produced only 200 region-coded patient records across the US using multiple methods to try and identify cases. The mid-section of the US and coastal regions shows the highest numbers of ATC patients while New England and South regions show the lowest. While more women have ATC overall, the East Coast group has significantly more males (p value = 0.04). ATC is a predominantly white disease (79.8% overall) with black population increasing in East Coast group and other races (Asian/Undeclared) in West Coast (p-value &amp;lt; 0.001). There appears to be no significant association between age of ATC onset and the geographical groups. Conclusion The data shows geographic differences in distribution of ATC although this preliminary analysis neither explains the nature of these differences nor allows for a clearer view. The rarity of the disease complicates data analysis. This study was also limited by number of cases retrievable from the database itself and lack of granularity in coding available for ATC to find cases of interest, highlighting the difficulty of accurate tumor classifications in large data lakes. Further research into geographical distribution and environmental factors (radioactivity, pollution) of thyroid cancer using more advanced tools, such as GeoSpark, are planned.

The Physician King Buddhadasa: A Mine of Virtues, as the Sea is of Jewels.

King Buddhadasa was a monarch of the Kingdom of Anuradhapura, Sri Lanka, in the 4th century A.D. He was a unique king with sound knowledge and skill in medicine according to the traditional medical system. The primary source of Sri Lankan history describes him as "a mine of virtues, as the sea is of jewels." This is due to his virtue of being a righteous king and a compassionate physician, whose healing extended to both humans and animals. His contributions went beyond curative medicine to include preventative care, medical administration, and scholarly work such as the Sarartha Sangrahaya. Similar to Charaka and Sushruta in the South Asian region, his life and work are exemplary and inspirational to modern-day physicians. This review provides an account of the life of King Buddhadasa as recorded in the primary chronicle of Sri Lankan history. Some of his healing accounts may seem mystical to the reader. The article also endeavours to find plausible explanations for those occurrences based on allopathy and science. These records serve as important lessons for modern-day physicians, encouraging the inculcation of good conscience and morality in medical practice.

Management of the Territory Restoration Process Following a Disaster: The Case of the South Moravian Region in the Czech Republic

The article presents a methodology for the management of repairs to property damaged by a disaster. The article describes the procedure for the development of an organizational layout, along with planning and managing activities leading to the restoration of damaged property. Last but not least, the article deals with financial planning. The methodology presented was applied to a case study that was conducted in the village of Hrušky, South Moravian region, the Czech Republic, which was hit by a tornado in 2021. More than three years have passed since this tragedy, and repairs to the village’s property are still planned to continue until the middle of 2025. Qualitative approaches to data collection and evaluation were used for data collection, especially in-depth interviews related to the given issue. The mayor of the village, the village management, and representatives of construction companies were involved in the in-depth interviews. Another important source of data was the project documentation and the municipality’s accounting records. The main outputs include a list of construction works, which served as a basis for the financial damages; the municipality’s participation in state subsidy programs for the financing of the restoration; and, last but not least, a list of works that was used to create the project documentation for the reconstruction of individual buildings. Other outputs of the work include a structural plan, which has been developed for the purposes of planning and managing activities leading to the restoration of the damaged area, and a financial plan, which contains information on expenses and funding sources. The key contribution of the paper is a methodical procedure for the identification, the design, and the execution of crucial activities connected with the restoration of the territory after a disaster. The methodological procedure is designed considering the experience associated with a specific disaster, namely, a tornado in the southeastern part of the Czech Republic, which served as the basis for this case study.

Effect of adding dune sand to tuff in Saharan road construction

The south region of Algeria is characterized by a wide surface, a scattered population and a very small ratio of road length per habitant. To allow the development of agricultural, industrial and touristic activities between different cities in the south of Algeria, it is necessary to maintain and to develop the road infrastructure. However the development of these infrastructures necessitates the use of huge amount of certified aggregates from quarries which is not available in the vicinity of the need. For these raisons, in the framework of sustainable development, a strategy which consists in using local materials like fine sediments (dune sand) and other types of material is engaged. The materials constituting the road layers, until today, have been limited to certain so-called noble materials (gravel, aggregates, etc.), but these are being depleted as a result of the intensive exploitation and the scarcity of quality careers. Gypso-limestone encrustation tuffs, the most used materials in pavements (base course and base course) in the Saharan areas such as southern Algeria, have shown acceptable behavior for many years until these last days, when this type of material begins to present certain limits under the effect of the intensity of the traffic. In order to promote the abundant wind sands in these regions, we are interested in developing the dune sands in the pavement as a mixture with the tuffs. The present work presents a contribution to the study of the behavior of the tuff of the Adrar region (South of Algeria) alone and mixed with the sand dunes in different formulations. The aim is to evaluate the evolution of mechanical properties including resistance to simple compression, the ability to compaction and punching (RBC). The work also discusses the influence of the addition of cement in low levels on the performance of the mixture.

Atmospheric Gravity Wave Detection in Low-Light Images: A Transfer Learning Approach

Atmospheric gravity waves, as a key fluctuation in the atmosphere, have a significant impact on climate change and weather processes. Traditional observation methods rely on manually identifying and analyzing gravity wave stripe features from satellite images, resulting in a limited number of gravity wave events for parameter analysis and excitation mechanism studies, which restricts further related research. In this study, we focus on the gravity wave events in the South China Sea region and utilize a one-year low-light satellite dataset processed with wavelet transform noise reduction and light pixel replacement. Furthermore, transfer learning is employed to adapt the Inception V3 model to the classification task of a small-sample dataset, performing the automatic identification of gravity waves in low-light images. By employing sliding window cutting and data enhancement techniques, we further expand the dataset and enhance the generalization ability of the model. We compare the results of transfer learning detection based on the Inception V3 model with the YOLO v10 model, showing that the results of the Inception V3 model are greatly superior to those of the YOLO v10 model. The accuracy on the test dataset is 88.2%.

Agricultural resilience: Impact of extreme weather events on the adoption of rural insurance in Brazil

Brazil’s agricultural, livestock, and forestry production is essential, feeding more than 10% of the global population. However, climate change and extremes affect quality and production, challenging the Sustainable Development Goals of eradicating hunger and poverty. Extreme weather events generate economic and social costs, driving the use of adaptation strategies, with rural insurance being one of the main instruments to manage these risks. This study analyzes the impact of extreme weather events on rural insurance contracting in Brazil, using daily precipitation and temperature data to calculate extreme weather indices and perform panel regressions. The analysis of Minimum Comparable Areas (MCAs) between 2006 and 2016 showed that events such as “Frost” and “Hot Days” significantly increased insurance contracting, especially in the South and Central-West regions. The results highlight the importance of extreme variables and the need to consider regional differences and insurance alternatives. Despite the importance of insurance, increasing financial unviability suggests the need for additional strategies, such as crop diversification, community solidarity, and conservation of agricultural practices.

Unveiling invisibility: the lived experiences of former students at New Zealand's second chance education secondary school

ABSTRACT This paper examines the lived experiences of former students who attended a second chance education [SCE] secondary school in New Zealand. Like charter schools in New Zealand, School A (Pseudonym) was established to work in collaboration with a local tertiary education provider and secondary schools within the wider South Auckland region. This collaboration was to provide opportunities for secondary school students who had dropped out or did not fit into the mainstream education system in New Zealand. Drawing on qualitative methods, we give meaning to the lived experiences of eight individuals and highlight how sociocultural and socioeconomic factors led these individuals to feel invisible in the mainstream education system and how School A's practices, such as addressing teachers by their first names and emphasising hands-on learning experiences transformed lives. This research provides insights into the potential of SCE schools in reengaging disengaged youth and fostering a pathway towards creating a responsible citizen.

Regional Economic Development, Climate Change, and Work Force in a Gender Perspective in Chile: Insights from the Input–Output Matrix

Most nations fulfilled the commitment to reduce their emissions after the Paris Climate Agreement, and as a result, each nation has produced suitable plans to reach those goals. In this sense, Chile is hardly an exception. The emission multiplier product matrix (eMPM) and labor multiplier product matrix (lMPM), which are associated with the gender differences in the labor market, a state-of-the-art technique that integrates CO2 emissions with multi-region input–output table (MRIO) databases and elasticity to estimate the pollution caused by inter-industrial activity in the nation’s various north, center, and south regions, are used in this article to analyze the emissions of Chilean industries. This approach, by studying the economic territorial consistency (ETC) issue, is expected to establish a connection between each region’s production structure and interregional relationships between gender and the main industries that produce emissions. Indeed, the study aims to determine which regions foster economic development from an equitable perspective through the ETC study. The ETC in Chile depends on some variables, such as labor force, gender and CO2 emissions. The improvement in terms ofion will depend on the use of technology and the proper state regulation in line with the promises gained by Chile following the convening of COP25.

Recent increase in Candida auris frequency in the SENTRY surveillance program: antifungal activity and genotypic characterization.

We observed an increase in the frequency of Candida auris among invasive candidiasis isolates in the 2022 SENTRY Antifungal Surveillance Program compared to prior years: ≤0.1% before 2018, 0.4%-0.6% from 2018 to 2021, and 1.6% in 2022. C. auris isolates were collected in seven countries, but 28 (35.9%) isolates were recovered in the USA (five states; more common in New York, Texas, and New Jersey) and 26 (33.3%) in Panama. Greece and Turkey had 12 and 9 isolates, respectively. Overall, 82.1% of the isolates were resistant to fluconazole; 17.9% were resistant to amphotericin B; and 1.3% were resistant to caspofungin, anidulafungin, or micafungin (Centers for Disease Control and Prevention tentative resistance breakpoints). Rezafungin inhibited 96.2% of the isolates (Clinical and Laboratory Standards Institute susceptibility breakpoint). Pandrug resistance was not observed, but 17.9% of the isolates were resistant to fluconazole and amphotericin B. South Asian (Clade I) isolates were most common (n = 40, 51.3%); of these, 97.5% were resistant to fluconazole and 30.0% were resistant to amphotericin B. Thirty (38.5%) isolates belonged to the South American region (Clade IV), and 56.7% of those were resistant to fluconazole and 6.7% to amphotericin B. Seven isolates belonged to the South African Clade III and one to East Asian Clade II. Erg11 (Y132F, K143R, and F126L) and MRR1 (N647T) alterations were detected. One isolate that was resistant to all echinocandins carried an FKS R1354G alteration. Two isolates displayed elevated rezafungin minimum inhibitory concentration (MIC) values but low MIC values against other echinocandins and no FKS alterations. As C. auris is spreading globally, monitoring this species is prudent.

Heavy Metals Distribution in Mangrove Leaves in Various Sudanese Coastal Zones at The Red Sea

&lt;p style="text-align:justify;"&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;Mangrove ecosystem contamination, especially in the Red Sea region, has caused major concerns on a worldwide scale. The heavy metal accumulation typical of a mangrove species, &lt;/span&gt;&lt;em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;Avicenna marina&amp;nbsp;&lt;/span&gt;&lt;/em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;L. (&lt;/span&gt;&lt;em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;A. marina&lt;/span&gt;&lt;/em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;) leaves and soluble salts in sediments have not been studied on the Red Sea coast of Sudan.&amp;nbsp; The present study investigates the two nutrients calcium (Ca) and iron (Fe) and heavy metals such as barium (Ba), titanium (Ti), and strontium (Sr) in the mangrove species &lt;/span&gt;&lt;em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt;A. marina&lt;/span&gt;&lt;/em&gt;&lt;span style="font-family:&amp;quot;Times New Roman&amp;quot;,serif;font-size:10.0pt;line-height:107%;"&gt; in the leaves of six different locations in the Red Sea coastal area, as follows: (Hamasyat (HM)&amp;nbsp;Keligo (KG), and Enkfel (EK) of the Gulf of Dunnabeb, and three sites were selected in the south of the Sudanese coast as follows: (Amarat Island (AM), Ibn Abbas Island (BN), and&amp;nbsp;Ras Kassar (RK). The results demonstrate that the maximum calcium (Ca) and iron (Fe) concentrations in mangrove leaves were 35.9 mg/kg and 4.10 mg/kg recorded at RK and AM, respectively, in the south region of the Red Sea. The heavy metal concentrations (mg/kg) vary between different locations. The higher concentration of heavy metals in mangrove leaves increased as Ba was 1.1 mg/kg in the EG north region. While Ti (0.5 mg/kg) and Sr (2.80 mg/kg) higher concentrations were recorded in AM and EK, respectively, in the south area than in the other experimental sites. &amp;nbsp; Heavy metals and soluble salts in sediments are continuously monitored in mangrove habitats to ensure they keep within allowed limits. These results could be useful as a database for prospective ecological research, preservation efforts, and long-term sustainable management of the Sudanese mangrove ecosystems throughout the Red Sea coastal.&lt;/span&gt;&lt;/p&gt;

Extreme Precipitation Over the Southern Slope of the Tibetan Plateau and the Associated Atmospheric Circulation Anomalies

AbstractThe southern slope of the Tibetan Plateau (SSTP) is one of the rainiest regions in the world where geological hazards caused by extreme precipitation often occur. This study investigates the characteristics and mechanisms of extreme precipitation over SSTP from June to September during 2001–2020 using Global Precipitation Measurement satellite observation. The extreme precipitation days are defined as the days with top 5% of regional‐mean daily precipitation over SSTP in this period, which has an average precipitation of 27.2 mm/d. Averaging over the extreme precipitation days, precipitation peaks at an altitude of about 300 m, coinciding with the climatological maximum precipitation, but with a much larger value of 37.2 mm/d than the climatology of 11.9 mm/d. Composite analysis of circulations on extreme days reveals significant circulation anomalies in both the lower and upper troposphere. Specifically, the lower‐tropospheric circulations are characterized by significant westerly anomalies over northern India, and the upper‐tropospheric circulations are characterized by northerly anomalies over the central Tibetan Plateau, which are statistically independent. The lower‐tropospheric westerly anomalies blowing toward SSTP are blocked by the topography, favoring extreme precipitation over SSTP. The upper‐tropospheric northerly anomalies, on the other hand, correspond to anomalous northeasterlies north of SSTP in the middle troposphere and southeasterlies to the south in the lower troposphere, and the convergence of these circulation anomalies favors extreme precipitation over SSTP. Lastly, the lower‐tropospheric westerly and upper‐tropospheric northerly anomalies, respectively, correspond to less precipitation over the South Asian monsoon region and the Tibetan Plateau.

Chronic obstructive pulmonary disease attributable to air pollution in the South Asian countries: global burden of disease study 1990 - 2019.

This study investigates the burden of COPD attributable to air pollution in South Asia using data from the Global Burden of Disease Study from 1990 to 2019. Method Data for this study were obtained from the Global Burden of Disease Study 2019. The burden was measured in terms of death, disability-adjusted life years (DALYs), and Years of life lost (YLLs). Results Since 1990, several countries in South Asia registered substantial declines in mortality rates attributed to COPD, ranging from -37.47% in Pakistan to -66.25% in Bangladesh. Similar trends were observed for DALYs and YLLs as well, which have potentially contributed to a considerable decrease in mortality rates at the regional level (-43.13%) compared to a 32.59% decline in Low SDI and 56.87% decline globally. Conclusion Despite significant declines since 1990, the burden of COPD attributable to air pollution reductions in the South Asian region's rates remains alarmingly high.

Disaster Communication in Forest and Land Fire Management in South Kalimantan

The recurrence of forest and land fires in the South Kalimantan region can be attributed to the insufficient implementation of disaster risk communication. Hence, it is imperative for this study to address the topic of disaster risk communication as a means of mitigating forest and land fires in the region of South Kalimantan. This study addresses the scientific subject of why the southern Kalimantan provincial government is still struggling to coordinate the resolve of forest and land fires, despite the implementation of forest and land fire disaster control measures. The research methodology employed in this study utilizes a qualitative approach, namely of a descriptive nature. The data collection approaches employed in this study include interviews, documentation analysis, and literature review. This study aims to elucidate the dearth of educational information pertaining to the prevention and mitigation of forest and land fires within communities. The presence of suitable information and education boards is lacking. Despite the government's extensive endeavors in forest and land fire disaster management in the South Kalimantan region, the absence of an early preventive system pertaining to such calamities remains evident. The proper implementation of educational initiatives pertaining to disaster prevention and early detection has not been effectively carried out. The current state of optimizing information pertaining to public education within the realm of catastrophes remains constrained by the limited involvement of the government in actively engaging with other relevant parties, particularly the media.

Microbial mechanisms for CO2 and CH4 emissions in Robinia pseudoacacia forests along a North–South transect in the Loess Plateau

Forest soil microbes play a crucial role in regulating atmospheric-soil carbon fluxes. Environmental heterogeneity across forest types and regions may lead to differences in soil CO2 and CH4 emissions. However, the microbial mechanisms underlying these emission variations are currently unclear. In this study, we measured CO2 and CH4 emissions of Robinia pseudoacacia forests along a north–south transect in the Loess Plateau. Using metagenomic sequencing, we investigated the structural and functional profiles of soil carbon cycling microbial communities. Results indicated that the forest CO2 emissions of Robinia pseudoacacia was significantly higher in the north region than in the south region, while the CH4 emission was oppositely. This is mainly attributed to changes in gene abundance driven by soil pH and moisture in participating carbon degradation and methane oxidation processes across different forest regions. The gene differences in carbon fixation processes between regions primarily stem from the Calvin cycle, where the abundance of rbcL, rbcS, and prkB genes dominates microbial carbon fixation in forest soils. Random forest models revealed key genes involved in predicting forest soil CO2 emissions, including SGA1 and amyA for starch decomposition, TYR for lignin decomposition, chitinase for chitin decomposition, and pectinesterase for pectin decomposition. Microbial functional characterization revealed that interregional differences in CH4 emissions during methane metabolism may originate from methane oxidation processes, and the associated gene abundances (glyA, ppc, and pmoB) were key genes for predicting CH4 emissions from forest soils. Our results provide new insights into the microbial mechanisms of CO2 and CH4 emissions from forest soils, which will be crucial for accurate prediction of the forest soil carbon cycle in the future.

Projected changes in heatwaves over Central and South America using high-resolution regional climate simulations

Heatwaves (HWs) pose a severe threat to human and ecological systems. Here we assess the projected changes in heatwaves over Latin America using bias corrected high-resolution regional climate simulations under two Representative Concentration Pathway scenarios (RCPs). Heatwaves are projected to be more frequent, long-lasting, and intense in the mid-century under both RCP2.6 and RCP8.5 scenarios, with severe increases under the RCP8.5 scenario. Even under the low emissions scenario of RCP2.6, the frequency of heatwaves doubles over most of the region. A three- to tenfold rise in population exposure to heatwave days is projected over Central and South America, with climate change playing a dominant role in driving these changes. Results show that following the low emission pathway would reduce 57% and 50% of heatwave exposure for Central and South American regions respectively, highlighting the need to control anthropogenic emissions and implement sustainable practices.

Epidemiological Study of Adenoid Cystic Carcinoma and Its Outcomes: Insights from the Surveillance, Epidemiology, and End Results (SEER) Database

Objective: Adenoid cystic carcinoma (ACC) is a rare malignant tumor that mainly arises in the head and neck area. We aimed to compare the long-term survival of patients with ACC based on their geographic regions within the United States using the Surveillance, Epidemiology, and End Results (SEER) registry data. Methods: We queried the SEER database to evaluate the geographic distribution of ACC patients based on inpatient admissions. The states included in the study were divided into four geographical regions (Midwest, Northeast, South, and West) based on the U.S. Census Bureau-designated regions and divisions. Demographic and clinical variables were compared between the groups. Kaplan–Meier curves and Cox regression were used to assess late mortality. Results: A total of 5150 patients were included (4.2% from the Midwest, 17.2% from the Northeast, 22.5% from the South, and 56.1% from the West regions). The median follow-up was 12.3 (95% CI: 11.6–13.1 years). Median overall survival was 11.0 (95% CI: 9.2-NR years), 14.3 (95% CI: 12.4–16.4 years), 11.3 (95% CI: 9.7–14.8 years), and 12.0 (95% CI: 11.3–13.0 years) for Midwest, Northeast, South, and West regions, respectively. In multivariable analysis, older age, male sex, thoracic cancer, the presence of regional and distal disease, receiving chemotherapy, not undergoing surgical resection, and being treated in the West vs. Northeast region were found to be independent predictors of poor survival. We identified a significant survival difference between the different regions, with the West exhibiting the worst survival compared to the Northeast region. Conclusions: In addition to the well-known predictors of late mortality in ACC (tumor location, stage, and treatment modalities), our study identified a lack of social support (being unmarried) and geographic location (West region) as independent predictors of late mortality in multivariable analysis. Further research is needed to explore the causal relationships.

Impact of compound warm and wet events on dengue fever infection in South and Southeast Asian countries

BackgroundMultiple studies have reported the profound influence of various climate factors on dengue fever infection, while the effects of joint exposure to warm and wet environment, a condition favouring dengue vectors, on disease transmission were less evaluated. This study aims to investigate the impact of various compound temperature, rainfall, and relative humidity exposures on dengue fever infection in the South and Southeast Asia regions. MethodsWeekly dengue fever surveillance data from 2012 to 2020 were collected from 48 locations in four countries named Singapore (1 location), Sri Lanka (15 locations), Malaysia (9 locations), and Thailand (23 locations, with 11 locations having different study periods). The distributed lag non-linear models were built to assess the impacts of compound temperature, rainfall, and relative humidity exposures on dengue fever infection risks. ResultsA total of 1,359,993 dengue fever cases were reported with 9.33%, 24.02%, 48.73%, and 17.91% cases contributed by Singapore, Sri Lanka, Malaysia, and Thailand, respectively. Compared to non-warm-non-wet, compound warm-wet was associated with an increased dengue risk (RR:1.32, 95% CI:1.21–1.44). Compared to moderate temperature-humidity, warm-wet environment was also associated with an increase in dengue risk (RR:1.37, 95% CI:1.22–1.55). In comparison to weeks with moderate temperature-rainfall, warm-wet weeks was linked to an elevated dengue risk (RR:1.39, 95% CI:1.27–1.52), whereas cold-dry weather would significantly reduce the infection risk (RR:0.70, 95% CI:0.62–0.80). Modification effects showed that the hot effect on dengue infection was more pronounced under higher humidity, while the impact of rainfall increased with warmer temperature. ConclusionWarm-wet events were associated with an increased dengue fever risk, while the infection risk would decline in cold-dry environment, and modification effects exist among exposures. Findings from this study highlight the importance of considering joint temperature, humidity, and rainfall dependency of dengue fever infection in disease prevention and control.