Trend In Direction Research Articles

Is the Modern Arctic Marginal Ice Zone More Susceptible to Summer Cyclones?

Abstract As Arctic sea ice melts, cyclones potentially enhance the mechanical and thermodynamic forces that influence the vulnerable ice edge. However, examples can be found in satellite observations and reanalyses where cyclones either locally increase or decrease ice within the marginal ice zone (MIZ). Two case studies with these opposing ice responses are presented. Guided by the tendencies during these events, 264 strong (minimum surface pressure below 984 hPa) summer cyclones were sorted by prevailing wind direction and sea surface temperature (SST) changes within the MIZ to quantify the net ice impacts in the present-day Arctic (2010–19) and early satellite era (1982–91). By tracking the MIZ ice area from 1 week before the cyclone’s formation through 2 weeks after, we find cyclones that enhance southerly winds mostly decrease the ice area, whereas enhanced northerlies generally increase the ice area within the MIZ later in the season. Furthermore, early summer storms tend to decrease the MIZ ice area more than late summer storms. A shift toward more frequent early summer storms is observed from the 1980s to the 2010s, resulting in almost two-thirds of recent storms decreasing area. Consequently, recent summer cyclones have more negative impacts, resulting in a decline of more than 40 000 km2 of MIZ ice area on average, whereas 1980s cyclones had little aggregate impact. Wind direction and SST trends partially reconcile the wide range of MIZ ice area changes due to cyclone passage, yet considerable variations in individual cyclones’ impacts remain even when controlling for these factors. These bulk diagnostics therefore only explain part of the complex ice–cyclone relationship. Significance Statement The purpose of this study is to better understand how intense summer storms in the Arctic impact the underlying, low-concentration sea ice around the ice edge (where the ice is most vulnerable to external changes). Both enhanced decreases and increases in ice area within this region over the lifetime of a storm were observed, with late summer impacts dominated by differences in mean wind direction over the sea ice. Overall, storms earlier in the summer season were found to decrease ice area more than storms later in the season. We also found a shift in the distribution of storms to earlier in the summer when comparing the 1980s–2010s, causing more negative effects from cyclones overall in recent years.

New Evidence of Holocene Faulting Activity and Strike-Slip Rate of the Eastern Segment of the Sunan–Qilian Fault from UAV-Based Photogrammetry and Radiocarbon Dating, NE Tibetan Plateau

The eastern segment of the Sunan-Qilian Fault (ES-SQF) is located within the seismic gap between the 1927 M8.0 Gulang earthquake and the 1932 M7.6 Changma earthquake in China. It also aligns with the extension direction of the largest surface rupture zone associated with the 2022 Mw6.7 Menyuan earthquake. Understanding the activity parameters of this fault is essential for interpreting strain distribution patterns in the central–western segment of the Qilian–Haiyuan fault zone, located along the northeastern margin of the Tibetan Plateau, and for evaluating the seismic hazards in the region. High-resolution Google Earth satellite imagery and UAV (Unmanned Aerial Vehicle)-based photogrammetry provide favorable conditions for detailed mapping and the study of typical landforms along the ES-SQF. Combined with field geological surveys, the ES-SQF is identified as a continuous, singular-fault structure extending approximately 68 km in length. The fault trends in the WNW direction and along its trace, distinctive features, such as ridges, gullies, and terraces, show clear evidence of synchronous left lateral displacement. This study investigates the Qingsha River and the Dongzhong River. High-resolution digital elevation models (DEMs) derived from UAV imagery were used to conduct a detailed mapping of faulted landforms. An analysis of stripping trench profiles and radiocarbon dating of collected samples indicates that the most recent surface-rupturing seismic event in the area occurred between 3500 and 2328 y BP, pointing to the existence of an active fault from the Holocene epoch. Using the LaDiCaoz program to restore and measure displaced terraces at the study site, combined with geomorphological sample collection and testing, we estimated the fault’s slip rate since the Holocene to be approximately 2.0 ± 0.3 mm/y. Therefore, the ES-SQF plays a critical role in strain distribution across the central–western segment of the Qilian–Haiyuan fault zone. Together with the Tuolaishan fault, it accommodates and dissipates the left lateral shear deformation in this region. Based on the slip rate and the elapsed time since the last event, it is estimated that a seismic moment equivalent to Mw 7.5 has been accumulated on the ES-SQF. Additionally, with the significant Coulomb stress loading on the ES-SQF caused by the 2016 Mw 5.9 and 2022 Mw 6.7 Menyuan earthquakes, there is a potential for large earthquakes to occur in the future. Our results also indicate that high-resolution remote sensing imagery can facilitate detailed studies of active tectonics.

Critical Analysis of Leadership Strategies, Hospital Efficiency, And Patient-Centered Care Models

The healthcare industry is still developing; the directional trends have started to lean towards better hospital management strategies that would result in better patient care. In this paper, I critically review different leadership approaches in hospital contexts with success in organizational effectiveness and patient care delivery systems. Issues like leadership styles, including transformational, transactional, and servant leadership, logistical factors and clinical implications, and patient satisfaction are discussed on the operational level. Qualitative interviews are conducted Using qualitative and quantitative study methods, with results being statistically compared with corresponding quantitative hospital variables such as patient satisfaction, staff turnover, and readmission rates. The research indicates that the study has provided recommendations showing that Michigan Organizational QL is essentially predictive of cross-functional team collaboration and can be used to predict patient-centered care models. Finally, the paper contemplates the best recommendations that healthcare administrators and policymakers should consider embracing in order to raise standards in the direction, quality, and productivity of hospitals and care outcomes through purposes that embrace patient-centered care.

Body size and evolutionary rate analyses reveal complex evolutionary history of Alvarezsauria.

Some of the smallest examples of dinosaurian body size are from alvarezsaurians, an enigmatic group of maniraptoran coelurosaurians with a peculiar combination of anatomical features unique among theropods. Despite the large number of alvarezsaurian species described worldwide and the increased understanding this has provided, the body-size macroevolution of alvarezsaurians has received little attention. Here we reconstruct and analyse directional trends of alvarezsaurian body-size evolution through an integrated analysis of body mass, ontogenetic age, and morphological rate data enabled by a comprehensively revised phylogeny. Our analyses identify four periods of high morphological rate evolution (Bathonian-Callovian, Hauterivian-early Berriasian, early Cenomanian, and late Cenomanian-Turonian) that we link to the key effects of animal body-size changes for the first time, including morphological novelty, structural reduction and simplification, elevated homoplasy, and behavioral changes associated with miniaturization. In doing so, this study provides a holistic example of miniaturization in a Mesozoic vertebrate group that offers a framework for other detailed studies of animal body-size evolution, including in more disparate groups.

The Impact of Artificial and Natural Additives in Meat Products on Neurocognitive Food Perception: A Narrative Review.

The holistic sensory experience creates a unified perception that influences consumer memory. Consumer interest in clean label products underlines an accelerated trend towards products without artificial additives. From a sensory point of view, food appeal is significantly influenced by how additives actively participate in the organoleptic properties of the final product. This research aims to shed light on the impact of artificial and natural additives in meat products on neurocognitive food perception, which is essential for understanding how they influence the consumer's final decision and direct food trends. Different neural mechanisms involved in multimodal sensory integration confirm differences in perception of meat products containing artificial and natural additives. Analysis confirms that neurocognitive perception integrates organoleptic sensations to form a complete sensory experience. The encephalon simultaneously processes multimodally integrated stimuli from organoleptic properties, reaching the orbitofrontal cortex and other regions involved in the neuroprocessing of the final product. The reformulation and development of meat products need a detailed analysis of the impact of additives on sensory properties contributing to the shaping of consumption trends.

Spatial scale drives pedodiversity-elevation relationship in Botswana

Elevational distribution affects pedodiversity (a measure or indicator of soil diversity) by controlling factors like climate, vegetation, and water drainage. It plays a vital role as a constant variable in soil formation processes (e.g., mineralization, eluviation, and illuviation, etc.) thus promoting diverse soil types at different toposequence formations. However, the relationship between pedodiversity and elevation at various spatial scales remains poorly understood and obscure, especially for dryland regions. Here, we first derive a national-scale pedodiversity map of Botswana, explaining more than 50% of the variance. For this map, elevation is among the most important environmental covariates influencing soil diversity. We further examine how spatial scale indicators such as spatial extent (i.e., countrywide, and locally) and resolution (i.e., 90m, 900m, 9000m, and 90000m) systematically influence landscape pedodiversity. While viewing the data countrywide, the relationship between pedodiversity and elevation maintained a negative or inverse linear trend (i.e., meaning that as elevation increases, pedodiversity decreases), but when viewed locally—for the small district, it showed a positive or direct linear trend (i.e., both elevation and pedodiversity increase simultaneously). This can be explained by differences in elevation patterns together with complex and dynamic interactions between scale-dependent soil-forming factors like land use type which tend to dominate local scales. Significant differences in pedodiversity related to the spatial resolution of geodata inputs were noticeable, for example, the local coefficient of determination values ranged from 0.06 to 0.65 for fine to coarse spatial resolutions respectively. Together, our findings demonstrate that the relationships between pedogenesis factors (e.g. elevation) and pedodiversity are scale-dependent. Even a small change in spatial resolution can lead to significant variations in pedodiversity, especially in semi-arid areas. Therefore, taking this into account can reduce overly optimistic conclusions about the landscape patterns we observe.

Insights on the multiple ions distribution in concrete under stray current: From experiments to multi-field simulation

Stray current can not only corrode steel bars but also cause the movement and accumulation of ions inside concrete. To investigate the distribution law and change mechanism of ions under the effect of stray current, a stray current corrosion experiment lasting 120 hours is carried out on a reinforced concrete beam. The pH value and concentrations of sodium, calcium and chloride ions of solution in the beam are measured at intervals. And the ion concentration distribution is simulated using DuCOM numerical platform. Results show that the ion concentration distribution is basically stable after three days of electrification. The alkalinity at the negative electrode increases, and the acidity at the positive electrode increases significantly. Sodium ion. The daughter and calcium ions gather at the negative electrode under the action of stray current and are far away from the positive electrode. The chloride ion concentration is at the positive electrode. Increase, decrease at the negative pole. The simulation by DuCOM can well reflect the directional movement trend of ions under the action of external current, with prediction error lower than 15%.

Research on Traffic Flow Prediction Methods Based on Deep Learning

In recent years, traffic flow prediction technology has been transformed from statistics based parametric methods and machine learning driven non-parametric methods to big data driven deep learning methods. This paper summarizes and summarizes the existing methods and improvement measures of long and short term traffic flow prediction based on deep learning. The time range of traffic flow forecast based on the model is divided into long-term and short term. The short-term traffic flow forecasting methods are subdivided into time series model, non-parametric forecasting model and probability forecasting model, and the advantages and disadvantages of each method and the feasibility of the specific methods are summarized. As for the long-term model, it is mainly based on the application of GCN model to other models, and then the specific methods of its hybrid model are outlined, systematically describing the value of deep learning in traffic flow prediction. Finally, the future research direction and development trend in this field are predicted and prospected.

Reduced evolutionary constraint accompanies ongoing radiation in deep-sea anglerfishes.

Colonization of a novel habitat is often followed by phenotypic diversification in the wake of ecological opportunity. However, some habitats should be inherently more constraining than others if the challenges of that environment offer few evolutionary solutions. We examined this push-and-pull on macroevolutionary diversification following habitat transitions in the anglerfishes (Lophiiformes). We constructed a phylogeny with extensive sampling (1,092 loci and ~38% of species), combined with three-dimensional phenotypic data from museum specimens. We used these datasets to examine the tempo and mode of phenotypic diversification. The deep-sea pelagic anglerfishes originated from a benthic ancestor and shortly after experienced rapid lineage diversification rates. This transition incurred shifts towards larger jaws, smaller eyes and a more laterally compressed body plan. Despite these directional trends, this lineage still evolved high phenotypic disparity in body, skull and jaw shapes. In particular, bathypelagic anglerfishes show high variability in body elongation, while benthic anglerfishes are constrained around optimal shapes. Within this radiation, phenotypic evolution was concentrated among recently diverged lineages, notably those that deviated from the archetypical globose body plan. Taken together, these results demonstrate that spectacular evolutionary radiations can unfold even within environments with few ecological resources and demanding physiological challenges.

Spatial distribution and transport characteristics of debris flow sediment using high resolution UAV images in the Ohya debris flow fan

Debris flows are significant geomorphic processes that can pose hazards to human settlements and infrastructure, making the understanding of their sediment transfer characteristics and impacts on the surrounding landscape crucial for effective land management and hazard mitigation strategies. This study investigates the distribution patterns of sandstone, vegetation, and shale classes within the Ohya debris flow fan, aiming to gain insights into the sediment characteristics, grain size variations, and vegetation cover trends along the flow path. Using a combination of field surveys and image processing we analyzed sediment characteristics and grain size variations a three study zones: upstream, transfer, and downstream. Statistical parameters such as mean, mode, skewness, and kurtosis were employed to quantify the grain size distribution and identify variations across the study zones. Results reveal distinct spatial variations in the distribution of sandstone, vegetation, and shale classes along the flow path. We observed a decrease in sandstone and vegetation cover from the upstream to the downstream sections, while the area covered by the shale class exhibited an increasing trend in the downstream direction. These findings suggest that debris flows selectively remove smaller particles downstream. The distribution of particle sizes within the sandstone class also exhibited variations, with a higher proportion of smaller pebbles downstream due to more effective removal of finer particles in the upstream zone. This study highlights the complex interplay between debris flow dynamics, sediment transport, and vegetation colonization. The findings contribute to the scientific knowledge of debris flow processes and can be used to inform land management decisions and mitigate the hazards associated with debris flows in similar environments.

Direct oral anticoagulant prescribing trends for venous thromboembolism among adult patients with obesity at University of Utah Health

BackgroundAnticoagulants, including warfarin and direct oral anticoagulants (DOACs), are used to prevent and treat venous thromboembolism (VTE) which is common in patients with obesity. Guidance statements regarding use of DOACs for VTE treatment in this patient population have been updated. ObjectiveExamine DOAC prescribing trends in patients with obesity and VTE. MethodsWe performed a retrospective, single-site cross-sequential study of DOAC prescribing trends in adult patients with obesity (BMI ≥30) and objectively confirmed VTE diagnosis between 2014 and 2022. The primary outcome of interest was the proportion of patients with obesity prescribed DOACs. ResultsA total of 1826 patients were included in our analysis. Most patients were of White race (85.8 %) and approximately half were female. Pulmonary embolism was the most common VTE type (62.2 %). A total of 1018 patients were prescribed DOAC therapy (55.8 %), 524 warfarin therapy (28.7 %), and 284 enoxaparin (15.6 %). Logistic regression analysis revealed that the utilization of DOACs exhibited a significant upward trend from 2017 to 2022 (odds ratio [OR] 1.85 to 14.08 compared to 2014), but not from 2015 to 2016 (OR 1.30 to 1.52). Patients with BMI ≥ 40 and ≥ 50 were twice and 4-times as likely to be prescribed warfarin than DOACs, respectively. ConclusionBetween 2017 and 2022, the proportion of patients with obesity prescribed DOACs for the treatment of VTE increased significantly. This suggests an increasing likelihood to prescribe DOACs in this patient population despite the lack of safety and efficacy data from randomized controlled trials except for very heavy patients.

Rutting extraction from vehicle-borne laser point clouds

Rutting is a type of structural road damage that seriously affects traffic safety, and rutting conditions are typically analyzed only from a two-dimensional cross-sectional perspective. Rutting detection currently lacks directional features and trends along the traveling direction. To address this issue, this paper develops a rutting extraction methodology from vehicle-borne laser point clouds to reflect the actual rutting conditions. The proposed method locates rutting points from cross-sectional data and further integrates the spatial correlation information of continuous cross sections to accurately extract dangerous rutting regions and longitudinal feature lines. Comprehensive experiments show that the Recall and Precision of rutting extraction are higher than 85 % and 90 % respectively, while also exhibiting higher robustness compared to other methods. These results demonstrate the effectiveness and accuracy of the proposed method for rutting extraction in large-scale road scenes. Future research will focus on deep learning-based road damage monitoring and provide valuable references for traffic management, road maintenance, and safety.

Divergent age-related changes in parasite infection occur independently of behaviour and demography in a wild ungulate.

As animals age, they exhibit a suite of phenotypic changes, often including reductions in movement and social behaviour ('behavioural ageing'). By altering an individual's exposure to parasites, behavioural ageing may influence infection status trajectories over the lifespan. However, these processes could be confounded by age-related changes in other phenotypic traits, or by selective disappearance of certain individuals owing to parasite-induced mortality. Here, we uncover contrasting age-related patterns of infection across three helminth parasites in wild adult female red deer (Cervus elaphus). Counts of strongyle nematodes (order: Strongylida) increased with age, while counts of liver fluke (Fasciola hepatica) and tissue worm (Elaphostrongylus cervi) decreased, and lungworm (Dictyocaulus) counts did not change. These relationships could not be explained by socio-spatial behaviours, spatial structuring, or selective disappearance, suggesting behavioural ageing is unlikely to be responsible for driving age trends. Instead, social connectedness and strongyle infection were positively correlated, such that direct age-infection trends were directly contrasted with the effects implied by previously documented behavioural ageing. This suggests that behavioural ageing may reduce parasite exposure, potentially countering other age-related changes. These findings demonstrate that different parasites can show contrasting age trajectories depending on diverse intrinsic and extrinsic factors, and that behaviour's role in these processes is likely to be complex and multidirectional.This article is part of the discussion meeting issue 'Understanding age and society using natural populations'.

Relationship between stressors with emotional exhaustion and coping strategies: The mediating role of academic stress symptoms in Peruvian adolescents

The research was conducted with the aim of evaluating the direct and indirect effects of academic stress symptoms related to academic stressors, emotional exhaustion, and coping strategies in an academic context. The study had a cross-sectional predictive design, composed of 387 adolescents aged 13 to 17 years (M = 15.6, SD = 1.53, 56.8 % female) from different educational institutions in Lima, Peru. The results showed significant effects with a direct trend for each of the variables. In addition, academic stress symptoms had a stronger indirect effect on the relationship of academic stressors with emotional exhaustion (β = 0.392, p < .001), in contrast to the effect of academic stressors with coping strategies (β = 0.083, p < .05). It was also found by multigroup analysis that the proposed model was invariant as a function of sex. Therefore, it is concluded that adolescents who are exposed to greater academic stressors will perceive greater symptoms of academic stress, which in turn intensifies the occurrence of emotional exhaustion and the coping strategies. These results were equivalent in both men and women.

Adapting spatiotemporal gait symmetry to functional electrical stimulation during treadmill walking.

Individuals with neurological impairments often exhibit asymmetrical gait patterns. This study explored the potential of using functional electrical stimulation (FES) as a perturbation method during treadmill walking to promote gait symmetry adaptation by investigating whether the FES perturbation could induce gait adaptation concerning spatial and temporal gait symmetry in healthy subjects. In the FES perturbation, both legs received electrical pulses at the same period as the subjects' initial stride duration, and the temporal gap between the two pulses for each leg was manipulated over a 7-min period. Following this, subjects continued to walk for another 5 minutes without FES. Subjects participated in two trials: implicit and explicit. In the implicit trial, they walked comfortably during FES perturbation without consciously adjusting their gait. In the explicit trial, they voluntarily synchronized their toe-off phase to the stimulation timing. To examine the effects of the FES perturbation, we measured step length and stance time and then analyzed changes in step length and stance time symmetries alongside their subsequent aftereffects. During the explicit trial, subjects adapted their gait patterns to the electrical pulses, resulting in a directional change in stance time (temporal) symmetry, with the left stance becoming shorter than the right. The stance time asymmetry induced by FES perturbation showed a slight residual effect. In the implicit trial, the directional change trend was slightly observed but not statistically significant. No consistent trend in step length (spatial) symmetry changes was observed in either condition, indicating that subjects may adapt their spatial gait patterns independently of their temporal patterns. Our findings suggest that the applied FES perturbation strategy under explicit condition can induce adaptations in subjects' temporal gait asymmetry, particularly in stance. The implicit condition showed a similar slight trend but was not statistically significant. Further experiments would provide deeper understanding into the mechanism behind subjects' response to FES perturbations, as well as the long-term effects of these perturbations on the spatial and temporal aspects of gait symmetry.

12537 Once Daily Oral Atumelnant (CRN04894) Induces Rapid And Profound Reductions Of Androstenedione And 17-Hydroxyprogesterone In Participants With Classical Congenital Adrenal Hyperplasia: Initial Results From A 12-Week, Phase 2, Open-Label Study

Abstract Disclosure: R.J. Auchus: Consulting Fee; Self; Corcept Therapeutics, H Lundbeck A/S, Quest Diagnostics, Sparrow Pharmaceuticals, Neurocrine Biosciences, Novo Nordisk, Recordati Rare Diseases, Diurnal, Xeris Pharmaceuticals. Research Investigator; Self; Corcept Therapeutics, Adrenas Therapeutics, Neurocrine Biosciences, Diurnal, Spruce Biosciences. P.J. Trainer: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc.. K.J. Lucas: None. D. Bruera: None. J. Marko: Consulting Fee; Self; Crinetics Pharmaceuticals, Inc. A. Ayala: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. Y. Wu: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. C.T. Ferrara-Cook: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. E. De La Torre: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. A. Krasner: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. H. Lagast: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. R. Luo: Employee; Self; Crinetics Pharmaceuticals Inc.. Stock Owner; Self; Crinetics Pharmaceuticals Inc. T.A. Bachega: Research Investigator; Self; Spruce Biosciences. R.S. Struthers: Employee; Self; Crinetics Pharmaceuticals Inc.. Stock Owner; Self; Crinetics Pharmaceuticals Inc. S.F. Betz: Employee; Self; Crinetics Pharmaceuticals, Inc.. Stock Owner; Self; Crinetics Pharmaceuticals, Inc. U. Srirangalingam: Consulting Fee; Self; Diurnal, H Lundbeck A/S. Atumelnant (CRN04894) is a potent, once-daily, orally bioavailable, nonpeptide, first-in-class competitive and selective melanocortin type 2 receptor (MC2R, or ACTH receptor) antagonist being developed for the treatment of CAH and ACTH-Dependent Cushing’s Syndrome. Here we report initial results from an open-label, dose-finding phase 2 study of atumelnant in patients with CAH (NCT05907291). Patients (aged ≥18-75, ≥16 years in USA) with classical CAH on a stable dose of GC replacement for at least 6 months were enrolled and received once daily, oral atumelnant for 12 weeks. Key efficacy endpoints include early morning androstenedione (A4) and 17-hydroxyprogesterone (17-OHP) levels. Ten (10) participants have been enrolled and dosed. Data from the first 4 participants (3 females, median age 34 [range 25-42] years, methylprednisone 8 mg/day [hydrocortisone equivalent {HCeq} 32 mg/day, n=2], prednisone 10 mg/day [HCeq 40 mg/day, n=2]) who received 80 mg once daily, oral atumelnant are available. Baseline morning A4 levels in these participants ranged from 116 to 604 ng/dL (reference range [RR]: females 30-200 ng/dL; males 40-150 ng/dL). In these 4 participants, treatment with atumelnant resulted in rapid and profound A4 reductions within 2 weeks which were maintained for the duration of therapy. A4 reductions ranged from 74% to 99% throughout the study. There have been no instances of A4 being above the upper limit of normal on treatment with atumelnant. Baseline 17-OHP levels in these participants ranged from 4740 to 6905 ng/dL (RR: females &amp;lt;80 ng/dL [follicular], &amp;lt;285 ng/dL [luteal]; males &amp;lt;220 ng/dL). In these 4 participants, treatment with atumelnant resulted in rapid and profound 17-OHP reductions within 2 weeks which were maintained for the duration of therapy. 17-OHP reductions ranged from 68% to &amp;gt;99% throughout the study. Two female participants in this cohort menstruated for the first time in over 2 years. Mean baseline morning ACTH ranged from 155 to 1009 pg/mL (RR: 7.2-63 pg/mL), and while modest variations were seen with atumelnant, no consistent directional trend was observed. In conclusion, these data demonstrate rapid, profound, and sustained suppression of A4 and 17-OHP with 80 mg once daily, oral atumelnant. There were no serious or treatment-related adverse events and atumelnant was generally well-tolerated. This ongoing study will explore further the safety and efficacy of various doses of atumelnant. Support: Crinetics Pharmaceuticals, Inc. Presentation: 6/3/2024

Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic.

Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a Brazilian university hospital between January 2020 and August 2023. Bacterial identification was conducted using MALDI-TOF, while carbapenemase genes were detected by qPCR. Demographic and clinical data were collected, and univariate analysis was performed using the chi-square test (p < 0.05). Variables with p ≤ 0.10 were further investigated using the chi-square test for linear trend, along with stratified analysis. Out of 1,133 samples, 111 (9.79%) showed CRE growth, with 46 isolates included in the final sample, predominantly comprising Klebsiella pneumoniae (65.21%) and Serratia marcescens (19.57%). The blaKPC gene was prevalent (78.26%), while blaNDM was detected in 21.74% of cases. The identified population was predominantly male (67.39%), elderly (69.57%), white (56.52%), unmarried (63.04%), and had a low level of education (56.52%). Most patients (69.57%) were in the intensive care unit and remained hospitalized for more than 30 days (76.08%). There was a significant inverse trend between Klebsiella pneumoniae and age (p = 0.045), as well as a direct linear trend between blaNDM and the annual increase in COVID-19 cases in Brazil (p = 0.050). A high probability of finding non-Klebsiella pneumoniae bacteria was observed in patients with prolonged hospital stays, independent of COVID-19 (p = 0.006) and the type of resistance genes (p = 0.020). The persistent prevalence of CRE, especially with blaKPC, underscores the urgency of effective control measures.

Microstructure and mechanical properties of 2195 Al-Li alloy via friction stir additive manufacturing with different stirring paths

Friction stir additive manufacturing (FSAM) is increasingly becoming a feasible method for aluminum alloy structure due to the unique forming characteristics. In this study, two different stirring paths were explored for 2195 Al-Li alloy and the microstructure evolution and mechanical properties were ‌investigated. An ultrafine grained microstructure was formed in the FSAMed zone with an average grain size ranging from 1 to 5μm. The microstructure in the FSAMed zone at the bottom exhibited a consistent direction trend and a significant increase in dislocation density. Different stirring paths had minimal impact on the phase distribution. Frictional heating led to the re-dissolution and re-precipitation of precipitates, resulting in T1, θ', and δ'/β' were distributed within the grains. The samples of intersecting stirring path showed similar mechanical properties in different directions, while the UTS of LD was 52.56 MPa higher than TD of the reciprocating path samples. The microhardness range for the intersecting stirring path ranged from 87.0 HV0.2 to 126.6 HV0.2, while the reciprocating stirring path exhibited a microhardness range of 83.8 HV0.2 to 132.4 HV0.2. In summary, this study provides valuable insights into designing processing paths for FSAM of 2195 Al-Li alloy.

Review of emerging trends and projection of future developments in large language models research in ophthalmology

BackgroundLarge language models (LLMs) are fast emerging as potent tools in healthcare, including ophthalmology. This systematic review offers a twofold contribution: it summarises current trends in ophthalmology-related LLM research and...

Library Trends and Developments in a Technologically Driven Era

The rapid evolution of digital technologies has significantly impacted how libraries operate and serve their communities, leading to a transformative shift in library services internationally. Despite the widespread acknowledgment of this digital shift, there remains a substantial gap in understanding of how libraries are adapting to these changes, particularly in terms of integrating digital innovations to enhance user access and engagement. This study aims to bridge this knowledge gap by examining the directional trends of library development in the context of digital transformation. By analysing library services in three regions - Europe, the United States of America, and Asia - critical adaptations and innovations are identified that are shaping the future of library services. The goal is to illuminate the current landscape and propose strategic directions to help library stakeholders with planning and implementation.