Steep Decline Research Articles

Effectiveness of ongoing single dose rifampicin post-exposure prophylaxis (SDR-PEP) implementation under routine programme conditions-An observational study in Nepal.

Leprosy control remains a challenge in Nepal. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) shows promise in reducing leprosy incidence among contacts of index cases, contributing to reducing the transmission of Mycobacterium (M.) leprae. This study evaluates the effectiveness of routine SDR-PEP implementation in Nepal in addition to contact screening, focusing on its impact on reducing leprosy risk among contacts and potential population-level effects. We conducted a retrospective cohort study to compare leprosy case notification rates and leprosy risk among close contacts. We compared two districts implementing SDR-PEP (the intervention group) and two without (the comparator group). Data from 2015 onwards included demographics, index case types, and contact relationships. Statistical analyses, including Cox regression and Kaplan-Meier survival curves, assessed the impact of SDR-PEP implementation. All four districts showed a decrease in case notification rates since 2015, with the steepest decline in the intervention districts. The risk of developing leprosy among contacts was significantly lower in the intervention districts (HR 0.28, 95% CI 0.18-0.44). SDR-PEP offered 72% protection, consistent over time, as shown in Kaplan-Meier plots. The protective effect was equally strong in blood-related contacts (HR 0.29 versus 0.27 in others, p = 0.32), and the proportion of MB cases among incident cases was not significantly different post-PEP (51.4% vs. 53.6%, p = 0.82). This study demonstrates the substantial protective effect of integrating SDR-PEP in routine leprosy control programs with contact screening, significantly lowering leprosy risk among contacts. SDR-PEP is equally effective for blood-related contacts and does not preferentially prevent PB cases. While suggesting potential population-level impact, the study design does not allow for firm conclusions at this level. Further research is needed to fully assess SDR-PEP's effectiveness in diverse contexts and optimize its implementation. Integrating SDR-PEP within well-organized contact screening programs is effective and is expected to reduce leprosy transmission when applied as a rolling intervention.

Changes in short-term variation of antenatal cardiotocography to identify intraamniotic infection: a historical cohort study

Introduction Intraamniotic infection (IAI) is one of the main possible complications of preterm prelabor rupture of membranes (PPROM) and can lead to severe consequences for the neonate, such as early onset neonatal sepsis (EONS). Available diagnostic tools for IAI have poor diagnostic performance, which may result in both over- and underdiagnoses of IAI. In a search for better diagnostic tools, we have examined short-term variation (STV) in fetal heart rate. We have previously shown that in IAI exposed pregnancies, the STV was more than 20% lower in the last cardiotocography trace before the start of labor, as compared to those not exposed to IAI. The association between IAI and STV needs further evaluation and we therefore continued by examining the longitudinal change in STV in association with IAI. Material and methods We performed a historical cohort study on 628 singleton pregnancies with PPROM, delivering between 24 + 0 to 33 + 6 gestational weeks. The main exposure of the study was IAI, using EONS as a proxy as no easily available method exists for confirming IAI antepartum, and IAI and EONS are strongly associated. The main outcome was STV in fetal heart rate. At least two available cardiotocography traces per fetus were required as a minimum, from PPROM or from seven days before birth, whichever came later, until the start of labor or planned cesarean birth. A total of 9 690 cardiotocography traces were analyzed. Results Fetuses exposed to IAI had a 26.5% steeper decline in their STV during the last 24 h before the start of labor when compared to fetuses not exposed (95% CI −32.9% to −19.4%; p < 0.001). After adjustment for antenatal corticosteroids, the decline remained significant. The decline became less prominent but the significance remained when also adjusting for the baseline frequency (−12.7% [95% CI −19.3% to −5.5%], p < 0.001). In the IAI-exposed group, the baseline frequency increased by 11.1 bpm during the last 12 h before the start of labor, beyond those who were not exposed (95% CI 8.3 bpm to 13.8 bpm; p < 0.001). Conclusions In pregnancies affected by IAI the STV declines steeper in the last 24 h before the start of labor as compared to pregnancies not affected by IAI, even after adjustment for increasing baseline frequency. The association of STV in relation to IAI needs to be further studied in order to evaluate and establish STVs usefulness in monitoring patients for IAI.

Historical geographies of a Damascan population crisis: Jawlān and Ḥawrān in the late Mamluk - early Ottoman periods

This multidisciplinary study examines the potential causes of a severe and rapid population and settlement decline during the period of transition in the Jawlān and eastern Ḥawrān regions in the province of Damascus. The Jawlān had been part of a relatively small and centralized sultanate in the Mamluk period. However, in the sixteenth century it was incorporated into an empire that ruled over three continents, thus its importance and standing gradually diminished. Newly recovered data from archaeological surveys, two archaeological excavations, fifteenth-century Arabic chroniclers and sixteenth-century Ottoman tax registers (defters) evidence the magnitude of a demographic crisis that occurred in one of the province's most fertile areas at a time when neighboring regions enjoyed continuity, stability and growth. The study conclusions are significant: nomadization in conjunction with an internal, seasonal migration process likely caused the steep decline, and not external migration or sudden demographic decline due to plagues or natural disasters. This shift from sedentary to nomadic or semi-nomadic life lasted for a long time; the vast majority of the area residents were Bedouin, able to adapt quickly to the new reality that combined work in the (mazra'as) with cattle raising.

Radical hope: Reimagining church and society in Scotland

This article proposes an interdisciplinary approach to understanding the factors that have led to the Church of Scotland’s current programme of reorganisation of its presbyteries and parishes in the face of a steep decline in its membership and recruitment to ordained ministry. Drawing on sociological, philosophical, and theological sources, it argues that the Kirk is experiencing the devastation of its local parish culture and way of life as an integral part of modern, industrial Scotland under the impact of hyper-individualism in a post-industrial and post-modern Scottish society, but like the Crow tribe, it can find radical hope in its traditions.

Association Between the Ionized-to-Total Calcium Ratio and the Risk of Acute Kidney Injury in Patients With Severe Autoimmune Diseases: A Retrospective Analysis From the MIMIC-IV Database.

To investigate the relationship between the ionized-to-total calcium ratio and the incidence of acute kidney injury (AKI) in critically ill patients with autoimmune diseases. A retrospective study was conducted utilizing data from the Medical Information Mart for Intensive Care IV database. In-hospital AKI was the primary outcome. Patients were classified into four distinct categories depending on the calcium ratio. Cox proportional hazards model and restricted cubic spline (RCS) analysis were applied to assess the association between the calcium ratio and AKI risk. Subgroup analyses were conducted to evaluate the consistency of this association across various patient characteristics. A total of 1054 critically ill patients with autoimmune diseases were enrolled and stratified by calcium ratio quartiles into four groups (< 0.515; 0.515-0.546; 0.546-0.576; > 0.576). Cumulative incidence curves showed significant difference in AKI risk among the four groups. Patients in the highest calcium ratio quartile experienced a markedly reduced likelihood of AKI versus those in the lowest, especially in the fully adjusted model (HR = 0.66, 95% CI 0.51-0.84, p < 0.001). RCS analysis demonstrated an obvious nonlinear relationship, showing a steep decline in AKI risk with increasing calcium ratio, which eventually plateaued. This protective effect of higher calcium ratios against AKI was consistent across subgroups, except in those with chronic kidney disease at baseline. The ionized-to-total calcium ratio proves to be significantly associated with the development of AKI in critically ill patients with autoimmune diseases, with its elevation indicating a reduced AKI risk.

The Excess of JWST Bright Galaxies: A Possible Origin in the Ground State of Dynamical Dark Energy in the Light of DESI 2024 Data

Recent observations by JWST yield a large abundance of luminous galaxies at z ≳ 10 compared to that expected in the ΛCDM scenario based on extrapolations of the star formation efficiency measured at lower redshifts. While several astrophysical processes can be responsible for such observations, here we explore to what extent such an effect can be rooted in the assumed dark energy (DE) sector of the current cosmological model. This is motivated by recent results from different cosmological probes combined with the last data release of the Dark Energy Spectroscopic Instrument, which indicate a tension in the DE sector of the concordance ΛCDM model. We have considered the effect of assuming a DE characterized by a negative Λ as the ground state of a quintessence field on the galaxy luminosity function at high redshifts. We find that such models naturally affect the galaxy UV luminosities in the redshift range 10 ≲ z ≲ 15 needed to match the JWST observations, and with the value of ΩΛ = [−0.6, −0.3] remarkably consistent with that required by independent cosmological probes. A sharp prediction of such models is the steep decline of the abundance of bright galaxies in the redshift range 15 ≲ z ≲ 16.

Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India

India’s high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. Limited studies on TB patients with silicosis highlight the need to address this vulnerable group’s specific challenges, particularly to improve diagnosis and management. This retrospective cohort study analyzed survival data from 137 silico-tuberculosis and 2,605 TB-only patients in Khambhat, India, using Kaplan-Meier curves, log-rank tests, and comparisons between Cox proportional hazards and accelerated failure time (AFT) models. The lognormal AFT model, selected for its lowest Akaike Information Criterion (AIC), estimated survival times based on age, gender, HIV status, and prior TB treatment. Among the 2,742 patients, 309 (11%) died within 27 months. Median time from diagnosis to outcome was shorter for deceased patients (1.7 months) than for censored patients (5.6 months, p < 0.001, median test). Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p < 0.001, log-rank test). Silico-tuberculosis was associated with a two-fold increased mortality risk (HR = 2.0, 95% CI: 1.4-3.0, p < 0.001, Cox-proportional hazards regression). The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within India’s TB program for high-risk occupational groups.

Compressive behavior of concrete jacketed in basalt TRM shell: Experiments and predictions

Numerous studies have investigated the behavior of textile reinforced mortar (TRM)-confined concrete, yielding various stress-strain models predominantly derived from fiber-reinforced polymer (FRP)-confined concrete. Yet, these models frequently overlook the intricate constitutive behavior of TRM materials and inadequately capture how TRM delivers its confinement effects. This often leads to inaccurate representation of the true characteristics of the confinement system, particularly the crucial role of mortar. This paper focuses on the impact of variations in textile layers and mortar matrix strength on the stress-strain behavior of basalt TRM (BTRM)-confined concrete, aiming to enhance our understanding of the confinement mechanism. Additionally, the study critically evaluates the key components of an existing analysis-oriented stress-strain model for FRP-confined concrete and introduces a refined version that more precisely depicts the behavior of confined concrete. This refined model integrates an identified confinement mechanism to provide accurate predictions of BTRM-confined concrete behavior. Our results reveal that low-grade mortar significantly decreases the actual confinement stiffness of BTRM jackets, inducing a steeper decline in the stress-strain curve, while high-strength mortar slightly diminishes the hoop rupture strain. To address the challenges of quantifying the complex confinement effect-compounded by the variable stress state and constitutive behavior of TRM-a novel coefficient, termed km, is introduced to gauge the influence of mortar strength on the confinement stiffness within the confining pressure equation. Predictive outcomes, including stress-strain and axial-to-lateral strain curves, show close alignment with experimental data, particularly in the slope at the plateau stage. This research significantly advances the quantitative understanding of TRM confinement effects and proposes the potential for designing more ductile structures using these materials, which could lead to enhanced resilience against seismic events and other structural challenges.

Triglyceride-lowering therapies in hypertriglyceridemia-associated acute pancreatitis in China: a multicentre prospective cohort study

BackgroundNo specific triglyceride-lowering therapy is recommended in patients with hypertriglyceridemia-associated acute pancreatitis (HTG-AP), primarily because of the lack of quality evidence. This study aimed to describe practice variations in triglyceride-lowering therapies for early HTG-AP patients and assess whether more rapid triglyceride decline is associated with improving organ failure.MethodsThis is a multicentre, prospective cohort study recruiting HTG-AP patients with elevated plasma triglyceride (> 11.3 mmol/L) admitted within 72 h from the onset of symptoms. Patients were dichotomised on study day 3 into either target reaching (plasma triglyceride ≤ 5.65 mmol/L) or not. The primary outcome was organ failure-free days (OFFD) to 14 days of enrolment. The association between target-reaching and OFFD was modelled. Additionally, the slope in plasma triglyceride over the first three days in response to treatment was calculated, and its association with OFFD was assessed as a sensitivity analysis.ResultsAmong the 300 enrolled patients, 211 underwent exclusive medical treatment, and 89 underwent various blood purification therapies. Triglyceride levels were available in 230 patients on study day 3, among whom 122 (53.0%) had triglyceride levels of ≤ 5.65 mmol/l. The OFFD was not different between these patients and those in whom plasma triglyceride remained > 5.65 mmol/L [median (IQR): 13 (10–14) vs. 14 (10–14), p = 0.46], even after adjustment for potential confounders. For the decline slopes, there was no significant change in OFFD with a steeper decline slope [risk difference, − 0.088, 95% CI, − 0.334 to 0.158, p = 0.48].ConclusionsTriglyceride-lowering therapies vary greatly across centres. More rapid triglyceride decline was not associated with improving incidence and duration of organ failure.

Abstract 4138715: Disparities in Aortic Dissection and Aortic Aneurysm-Related Mortality in The United States From 1999-2020

Background: Aortic dissection (AD) and aneurysm (AA) have a low incidence but are severe health risks associated with high mortality rates, and based on location, can have a mortality rate of over 80%. We aim to highlight disparities in mortality based on gender, race, age and demographic background. Methods: This retrospective study analyzed death certificate data for AD and AA (ICD-10 code I71) from 1999 to 2020 using the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 were assessed for adults aged 25 and older by gender, race, year, state, and place of death, while crude mortality rates (CMR) per 100,000 were used for age groups. Joinpoint regression calculated the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals. Results: From 1999 to 2020, AD and AA resulted in 400,748 deaths in the US. During this period, AAMR for men (12.19) was approximately double that for women (5.77). Overall, the AAMR decreased from 12.40 to 6.71 (AAPC: -2.93; 95% CI: -3.06 to -2.79; p-value&lt;0.000001). NH whites had the highest AAMR at 8.93, while Hispanic and Latino populations had the lowest at 4.20. Approximately 52.3% of the deaths occurred in inpatient medical facilities, whereas 18.4% occurred at home. Vermont, West Virginia, and Wyoming had the highest AAMRs, at 11.60, 11.47, and 11.30, respectively. Among racial groups, both males and females experienced a decrease in AAMR except for NH black men. For this group, there was an increase in AAMR from 9.42 in 2012 to 10.43 in 2020 (APC:1.03; 95% CI: 0.15 to 2.22; p-value:0.028). The CMR for young adults rose significantly from 0.62 in 2014 to 0.73 in 2020 (APC:2.55; 95% CI 1.11 to 6.74; p-value:0.02), and for middle-aged adults from 3.09 in 2010 to 3.61 in 2020 (APC: 1.57; 95% CI 1.04 to 2.25; p-value&lt;0.000001). Conversely, a steep decline in CMR was observed for older adults from 27.93 in 2014 to 25.4 in 2020 (APC:-1.34; 95% CI -1.9 to -0.69; p-value:0.0004). Conclusion: Although AD and AA mortality rates have declined over time, significant disparities persist for NH Black men and young/middle-aged adults. This highlights the need for early screening programs and equitable healthcare provision for all populations.

Effect of Nozzle Type on Combustion Characteristics of Ammonium Dinitramide-Based Energetic Propellant

The present study explores the influence of diverse nozzle geometries on the combustion characteristics of ADN-based energetic propellants. The pressure contour maps reveal a rapid initial increase in the average pressure of ADN-based propellants across the three different nozzles. Subsequently, the pressure tapers off gradually as time elapses. Notably, during the crucial initial period of 0–5 μs, the straight nozzle exhibited the most significant pressure surge at 30.2%, substantially outperforming the divergent (6.67%) and combined nozzles (15.5%). The combustion product variation curves indicate that the contents of reactants ADN and CH3OH underwent a steep decline, whereas the product N2O displayed a biphasic behavior, initially rising and subsequently declining. In contrast, the CO2 concentration remained on a steady ascent throughout the entire combustion process, which concluded within 10 μs. Our findings suggest that the straight nozzle facilitated the more expeditious generation of high-temperature and high-pressure combustion gases for ADN-based propellants, expediting reaction kinetics and enhancing combustion efficiency. This is attributed to the reduced intermittent interactions between the nozzle wall and shock waves, which are encountered in the divergent and combined nozzles. In conclusion, the superior combustion characteristics of ADN-based propellants in the straight nozzle, compared to the divergent and combined nozzles, underscore its potential in informing the design of advanced propulsion systems and guiding the development of innovative energetic propellants.

Evaluation of the ENIGMA mentoring pilot; an approach to tackle leadership inequalities for ethnically diverse female pharmacists in general practice

Abstract Introduction Diversity in leadership positively impacts teams and productivity yet remains limited in pharmacy leadership. The NHS Pharmacy Workforce Race Equality Standard (PWRES) report1 highlights significant underrepresentation of ethnically diverse pharmacists in senior NHS Trust roles (Agenda for Change band 8a and above) compared to their representation in the general pharmacist workforce. This disparity is particularly pronounced for female pharmacists from ethnically diverse backgrounds, who make up 31.9% of all pharmacists but only 24.2% of those in band 8a and above, with a steep decline from 27.6% at band 8a to just 5.9% at band 91,2. To begin addressing this, we piloted the ENhancing leadershIp amonGst ethnically diverse feMale phArmacists (ENIGMA) mentoring scheme in general practice within Leeds. Aim The aim was to determine whether ENIGMA mentoring relationships supported leadership skill development, fostered networking, and developed authentic allies. We assessed the success of the pilot by exploring the perspectives of mentors and mentees and identifying their satisfaction with the scheme. Methods We recruited 18 experienced female senior leaders as mentors for ENIGMA. Mentee recruitment was conducted through dissemination of a flyer via social media, Microsoft Teams, email, and citywide meetings, offering places to the first 18 pharmacists who expressed interest, with no selection process. Mentors and mentees were paired based on mentee goals and mentor expertise. Mentees met their mentor 3 times in a 6-month period. Evaluation was undertaken through Microsoft Forms questionnaires completed anonymously by both mentors and mentees exploring how they experienced ENIGMA, benefits of the scheme, if they felt the scheme had enabled leadership skill development and how it had (or anticipated it would) impact(ed) on career development for the mentee. Ethical approval was deemed unnecessary as this was a service evaluation. Neither author-affiliated organisation is associated with the project. Results Of 18 mentoring pairs, 13 successfully completed the 6-month program. For five pairs, mentees did not establish contact. 62% of mentors responded to the questionnaire. 88% felt a positive impact on their mentoring skills and described a noticeable increase in mentee confidence and career focus. 100% of mentors would recommend the scheme. For mentees, 62% responded. 88% were ‘most satisfied’ with the experience and 88% felt their leadership skills improved because of participating. 75% met specific goals and 88% commented particularly on positive impact of the scheme. 100% of mentees would recommend ENIGMA to others. Discussion/conclusion The pilot was a great success, impacting positively on mentors and mentees. All responding participants would recommend it to others. Mentors and mentees expressed some challenges: finding a mutual time for meetings, and support from employers to use work time for meetings. Questionnaires were not returned by 38% of participants, which is a potential limitation. An identified improvement is to offer mentors an alternative mentee if their original mentee does not make contact. Offer of an annual ENIGMA cohort will continue in Leeds. Additionally, a second pilot is planned in another Integrated Care Board (ICB) to establish how ENIGMA could work in a different area, and if successful, we intend to share this model nationally.

Effect of electrode size and distance to tissue on unipolar and bipolar voltage electrograms and their implications for a near-field cutoff

Characteristics of electrograms depend on the electrode design and distance to the electric source. Our aim was to assess the impact of electrode design and distance from the myocardial electric source on the unipolar and bipolar electrograms to deduce a far-field cut-off. We retrospectively analyzed left atrial electroanatomical maps of 25 patients acquired using an ablation catheter with a 4.5 mm tip-, mini- and 2 mm ring electrodes. The unipolar and bipolar electrograms were characterized based on peak-to-peak amplitude, signal duration, maximal slope, and relative power of the high frequency spectrum above 50 Hz (HF_rel). The unipolar electrograms of ring electrodes showed an increased amplitude (140%), slope (150%) and HF_rel (16% vs. 11%) compared to the tip- and mini-electrodes. The median amplitude, slope, and HF_rel for the ring electrodes followed a power-law decay with distance with a steep decline up to 4 mm. This near-field cut-off can be identified based on a HF_rel above 10% in unipolar electrograms. In conclusion, we observed a higher unipolar amplitude for small ring-electrodes compared to larger tip-electrodes. The rapid decay of the amplitude, slope, and HF_rel up to a distance of 4 mm is suggestive for near-field cut-off identified based on HF_rel above 50 Hz.Clinical Trial Registration: NCT04095559.

Tri-Level Anxiety and Depression Symptom Trajectory in Adolescents:the Role of Emotion Regulation Diversity

Anxiety and depression are associated with impaired emotion regulation (ER). Recently, a novel construct named ER diversity has been proposed to assess the diversity in ER strategy use. Low ER diversity, particularly under stressful circumstances, may be a transdiagnostic vulnerability factor for anxiety and depression. This study utilized a longitudinal design to examine the association between ER diversity and transdiagnostic anxiety and depressive symptom trajectory in adolescents (N = 627 at baseline), while accounting for life stress. Measures of ER strategy use, chronic interpersonal life stress, neuroticism, and transdiagnostic dimensional symptoms of anxiety and depression were assessed. The ER diversity index and the traditional ER sum score were computed. Higher ER diversity index was associated with steeper decline in the Fears symptom factor over time, above and beyond the ER sum score and neuroticism. Moreover, chronic interpersonal life stress influenced these associations. When chronic interpersonal life stress was low, Fears declined over time regardless of the ER diversity level; when chronic interpersonal life stress was high, Fears only declined when ER diversity was high. Thus, low diversity in ER strategy use, particularly under stressful circumstances, may be a vulnerability factor for fear symptom development.

Characterizing vascular and hormonal changes in women across the life span: a cross-sectional analysis.

Vascular dysfunction, marked by lower endothelial function and increased aortic stiffness, is a nontraditional risk factor that precedes the development of cardiovascular disease (CVD). However, the age at which these changes in vascular function occur in women and the degree to which reproductive hormones mediate these changes has not been characterized. Women free from major disease were enrolled across the adult life span (aged 18-70 yr, n = 140). Endothelial function was assessed as flow-mediated dilation (FMD) of the brachial artery during reactive hyperemia using duplex ultrasound and expressed as percent dilation. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Blood samples were obtained to quantify reproductive hormone concentration. Regression models determined age-related breakpoints and mediating factors between age and vascular outcomes. FMD declined with age with a breakpoint and steeper decline occurring at 47 yr of age. Thereafter, age was independently associated with lower FMD (B = -0.13, P < 0.001). cfPWV was relatively stable until a breakpoint at age 48, and age was independently associated with higher cfPWV thereafter (B = 0.10, P < 0.001). Path analysis revealed that the association between age and FMD was partially mediated by follicle-stimulating hormone (abind = 0.051, P = 0.01) and progesterone (abind = 0.513, P < 0.001) but not estradiol (abind = -0.004, P = 0.08). No mediation was present for cfPWV. Age was associated with endothelial dysfunction and aortic stiffness in women beginning at 47 and 48 yr old, respectively, 3 to 4 yr before the average age of menopause. The association between age and endothelial dysfunction was explained in part by elevations in follicle-stimulating hormone and progesterone, but not declining estradiol.NEW & NOTEWORTHY We demonstrate that the age at which endothelial function declines and aortic stiffness increases in healthy women is 47 and 48, respectively. The inflection point in flow-mediated dilation (FMD) is 6 yr earlier than previously reported, and the association between age and FMD was mediated by follicle-stimulating hormone (FSH) and progesterone (P4) but not estradiol (E2).

Age-Related Changes in the Cholinergic System in Adults with Down Syndrome Assessed Using [18F]-Fluoroethoxybenzovesamicol Positron Emission Tomography Imaging.

Adults with Down syndrome are genetically predisposed to developing Alzheimer's disease after the age of 40. The cholinergic system, which is critical for cognitive functioning, is known to decline in Alzheimer's disease and although first investigated in individuals with Down syndrome 40 years ago, remains relatively understudied. Existing studies suggest individuals with Down syndrome have an intact cholinergic system at birth that declines through adulthood alongside the development of Alzheimer's disease pathology. The present study provides the first description of cholinergic terminals in vivo in non-demented adults with Down syndrome utilizing [18F]-fluoroethoxybenzovesamicol PET imaging. In addition, we investigated age-associated decline in cholinergic terminal density. Sixteen non-demented adults with Down syndrome and 20 neurotypically developed individuals were studied, comparing radiotracer uptake groupwise and associations with age utilizing a voxel-based approach. Adults with Down syndrome displayed significantly increased [18F]-fluoroethoxybenzovesamicol uptake in the cerebellum, brainstem, thalamus, and numerous cortical regions compared to age-matched controls. Cholinergic terminal density in numerous cortical regions showed a steeper decline associated with increasing age in adults with Down syndrome than observed in neurotypically developed adults in the age range tested. These data suggest increased cholinergic terminal density in early adulthood in individuals with Down syndrome with a more rapid or earlier age-associated decline than is observed in neurotypically developed individuals.

The impact of major infectious disease events and government relief packages on the film industry: evidence from Taiwan

This study focuses on the impact of COVID-19 on the film industry and the effectiveness of government relief policies. Taiwan was a region with a low level of infection at the beginning of the COVID-19 pandemic (2020), and the film industry could be maintained under government policies; therefore, this case study was conducted. Multiple regression models were used to explore the explanatory factors for movie box offices based on running size, production studios and countries, vacations, and the COVID-19 pandemic. The analysis covered a period from September 30, 2019, to September 27, 2020, encompassing a 52-week sample of 5686 films. The results indicated that weekly box office receipts (number of tickets sold) experienced a steep decline of more than 50% despite the implementation of various relief measures. While the number of locally produced films screened diminished significantly, the number of theatres, films, and rerun films and their market share increased substantially. This suggests that although the quantity of films remained stable during the pandemic, their quality or novelty did not correspondingly improve. Key findings from the regression models included the following: (1) there is a size effect (number of theaters screening the film) on the box office; (2) box offices decrease with the number of weeks since the opening week, and films from well-known producers and major studios, as well as products from the US, Japan, and Taiwan, can have positive effects on the box office; (3) student vacations have had a positive effect; and (4) the COVID-19 pandemic has had a negative effect.

Declines in victims calling the police in 21st-century America: how the trends vary by race/ethnicity and racial-immigration contexts

Victims’ willingness to call the police facilitates access to the justice system and potential resources. Research shows a decline in police notification in the United States in recent decades, but the research has not assessed variation in trends across different racial/ethnic groups and different racial-immigration contexts. This study uses the National Crime Victimization Survey (NCVS) data from 52 metropolitan areas in the United States from 2000 to 2015 to investigate how victims across racial/ethnic groups vary in the likelihood of crime reporting based on geographic context. The results show that Black, Latino, and Asian victims’ crime-reporting behavior is influenced by the racial/ethnic and immigrant composition of the metropolitan areas. While the likelihood of police notification between racial/ethnic minorities and Whites is often similar when averaged across areas, minority victims in areas with higher percentages of Black or immigrant residents show a lower likelihood of crime reporting than their White counterparts. The higher percentage of immigrants is also associated with a steeper decline in the reporting of property crimes. These findings demonstrate the context-dependent nature of crime reporting. They help explain mixed evidence on the associations of race/ethnicity with police notification. To understand the crime-reporting behavior of victims, especially those who are racially marginalized, more attention to racial-immigration contexts is needed.

Lifespan trajectories of negative and positive affect: A coordinated analysis of 14 longitudinal studies

Lifespan developmental theories suggest age-related shifts in motivation, cognition, emotion regulation, and stressor experience lead to changes in mean levels of negative and positive affect across the lifespan. The present research used coordinated data analysis to examine mean-level affective trajectories in 186,752 participants ranging from 11–104 years old across 14 longitudinal studies. Random-effects models were used to estimate meta-analytic effect sizes. On average, negative affect decreased until early older adulthood, and then remained stable throughout older adulthood. Meanwhile, positive affect remained stable across most of the younger and middle-aged adult lifespan, before starting its descent in later middle-aged adulthood and continuing to decline throughout older adulthood. Studies with older samples showed a clearer flattening effect of negative affect and steeper decline of positive affect in late-life relative to younger samples. These findings suggest that lifespan developmental affect trajectories are nuanced and not a direct inverse of each other.

Declining population of Harlequin Duck (&lt;i&gt;Histrionicus histrionicus&lt;/i&gt;) on the Bow River, Alberta, Canada: 25 years of monitoring

Harlequin Duck (Histrionicus histrionicus) is a small sea duck that winters in coastal waters and breeds on fast-movingmountain streams in western North America. Because of its dependency on streams and coastal near-shore habitat with healthy macroinvertebrate populations, population trends of this species can be used as an indication of healthy freshwater and marine ecosystems. From 1995 to 2020 we conducted roadside surveys for Harlequin Ducks on the Bow River in Banff National Park, Alberta. We calculated the population’s trend by modelling maximum annual count, which showed a population decline over the 25 years of 3.3% per year. The trajectory varied over time: a relatively stable population from 1995 to 2005, a steep decline until 2011, then stabilising at a much lower level with a slight rebound in recent years. The predicted number of ducks from our state-space model closely tracked the maximum number of ducks observed in annual counts. During stable or slightly increasing population estimates the male:female (M:F) ratio fluctuated considerably but stayed high (1.4:1 and 1.3:1, respectively), and during the period of steep population decline the M:F ratio was at its lowest (1.1:1). This declining population trend is concerning because it is occurring in a protected area, but it is similar to data from other studies in the Rocky Mountains and at the coastal wintering area, suggesting that causes may not be solely due to issues on the breeding streams.