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An atlas of protected hydrothermal vents
No full textActive hydrothermal vents are valued worldwide because of the importance of their biodiversity and their influence on scientific discovery and insight about life on Earth and elsewhere in the Universe. There exist at least 20 areas and area networks with conservation measures for deep-sea hydrothermal vents, established by 12 countries and three Regional Fisheries Management Organisations, in six oceanic regions. Area-based management tools (ABMT) implemented by these countries illustrate multiple categories and means of protection and management of these rare and vulnerable habitats. Some ABMTs only regulate bottom and deep-trawling fisheries activities, others manage additional activities such as mining, scientific research, and bioprospecting, while still others protect active hydrothermal vents through broad conservation interventions. This atlas summarizes the “who”, “what”, “when”, “where” of protected hydrothermal vents worldwide and underscores recognition of the importance of hydrothermal-vent ecosystems by coastal States
Investigating Flame Retardant Applications in Furniture and Impacts on Children's Exposure to Firemaster® 550
No full textFlame retardants are chemicals that have been commonly added to furniture, electronics, and construction materials in order to prevent or reduce the spread of fire. 2-ethylhexyl-2,3,4,5-tetrabromobenzoate(EH-TBB) is a component in a flame retardant mixture known as Firemaster® 550, which is a replacement for PentaBDE that was phased out in 2004 due to health concerns. This study investigated whether FM550 treatment in furniture contributed to higher levels of exposure in children residing in NC. Results demonstrated that the presence of Firemaster® 550 in furniture was associated with significantly higher levels of EH-TBB in house dust, in personal measures of exposure (e.g. hand wipes) and higher urinary levels of tetrabromobenzoic acid, the metabolite of EH-TBB (p<0.05). These findings demonstrate that children experience exposure to EH-TBB from the application of Firemaster® 550 in residential furniture
Timber and Wood Products Trade in India
No full textIndia's efforts to reduce deforestation have resulted in a gap between timber supply and demand, leading to increased imports of wood products, which can exhaust foreign exchange. However, trees outside of forests, such as those in agroforestry and farm forestry, can fulfill increasing demand for wood products. To meet demand with domestic supply, India passed the 2014 National Agroforestry Policy aimed to encourage the growth of forest cover and the use of agroforestry, however, the uptake of agroforestry has been slow. To investigate the reasons for this, we have developed a four-part approach aimed at understanding the interplay between domestic wood product policies, markets, and international trade dynamics. Our first step involves a data analysis to provide an overview of the primary import and export trends in India's wood product industry. In the second step, we use econometric analysis to identify the historical drivers of the trade imbalance for major forest products in India. Our third step involves a literature review to understand how markets and industries in India are driving farm forestry and agroforestry to provide wood products. Lastly, we conduct a value chain analysis in three states to examine whether India's comparative advantage lies in wood production. Our overall goal is to gain insights into the factors that hinder or facilitate the adoption of agroforestry in India and to identify potential solutions to increase its uptake
Development, Deployment, and Implementation of a Machine Learning Surgical Case Length Prediction Model and Prospective Evaluation.
No full textObjectiveImplement a machine learning model using only the restricted data available at case creation time to predict surgical case length for multiple services at different locations.BackgroundThe Operating Room (OR) is one of the most expensive resources in a health system, estimated to cost $22-133 per minute and generate about 40% of the hospital revenue. Accurate prediction of surgical case length is necessary for efficient scheduling and cost-effective utilization of the OR and other resources.MethodsWe introduced a similarity cascade to capture the complexity of cases and surgeon influence on the case length and incorporated that into a gradient boosting machine learning model. The model loss function was customized to improve the balance between over- and under-prediction of the case length. A production pipeline was created to seamlessly deploy and implement the model across our institution.ResultsThe prospective analysis showed that the model output was gradually adopted by the schedulers and outperformed the scheduler-predicted case length in Aug-Dec 2022. In 33,815 surgical cases across outpatient and inpatient platforms, the operational implementation predicted 11.2% fewer under-predicted cases and 5.9% more cases within 20% of the actual case length compared with the schedulers and only over-predicted 5.3% more. The model assisted schedulers to predict 3.4% more cases within 20% of the actual case length and 4.3% fewer under-predicted cases.ConclusionsWe created a unique framework that is being leveraged every day to predict surgical case length more accurately at case posting time and could be potentially utilized to deploy future machine learning models
Association between perceived risk of Alzheimer's disease and related dementias and cognitive function among U.S. older adults.
No full textIntroductionThe aim of the study was to assess factors associated with the perceived risk of developing Alzheimer's disease and related dementias (ADRD) and how the perceived risk of ADRD was related to cognitive function.MethodsWe conducted a retrospective cohort study using 5 waves of data from the Health and Retirement Study (2012-2022) that included adults aged 65 years or older with no previous diagnosis of ADRD at baseline. Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7's test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range = 0-35). Perceived risk of developing ADRD was categorized at baseline as "definitely not" (0% probability), "unlikely" (1-49%), "uncertain" (50%), and "more than likely" (>50-100%). Additional baseline measures included participants' sociodemographic background, psychosocial resources, health behaviors, physiological status, and healthcare utilization.ResultsOf 1457 respondents (median age 74 [IQR = 69-80] and 59.8% women), individuals who perceived that they were "more than likely" to develop ADRD had more depressive symptoms and were more likely to be hospitalized in the past two years than individuals who indicated that it was "unlikely" they would develop ADRD. Alternatively, respondnets who perceived that they would "definitely not" develop ADRD were more likely to be non-Hispanic Black, less educated, and have lower income than individuals who indicated it was "unlikely" they would develop ADRD. Respondents who reported their risks of developing ADRD as "more than likely" (β = -2.10, P ConclusionsPerceived risk of developing ADRD is associated with cognitive function. The (dis)concordance between individuals' perceived risk of ADRD and their cognitive function has important implications for increasing public awareness and developing interventions to prevent ADRD
Association of chronic non-cancer pain status and buprenorphine treatment retention among individuals with opioid use disorder: Results from electronic health record data.
No full textBackgroundAlthough chronic non-cancer pain (CNCP) is common among individuals with opioid use disorder (OUD), its impact on buprenorphine treatment retention is unclear. The goal of this study was to use electronic health record (EHR) data to examine the association of CNCP status and 6-month buprenorphine retention among patients with OUD.MethodsWe analyzed EHR data of patients with OUD who received buprenorphine treatment in an academic healthcare system between 2010 and 2020 (N = 676). We used Kaplan-Meier curves and Cox proportional hazards regression to estimate risk of buprenorphine treatment discontinuation (≥90 days between subsequent prescriptions). We used Poisson regression to estimate the association of CNCP and the number of buprenorphine prescriptions over 6 months.ResultsCompared to those without CNCP, a higher proportion of patients with CNCP were of older age and had comorbid diagnoses for psychiatric and substance use disorders. There were no differences in the probability of buprenorphine treatment continuation over 6 months by CNCP status (p = 0.15). In the adjusted cox regression model, the presence of CNCP was not associated with time to buprenorphine treatment discontinuation (HR = 0.90, p = 0.28). CNCP status was associated with a higher number of prescriptions over 6 months (IRR = 1.20, p ConclusionsThese findings suggest that the presence of CNCP alone cannot be reliably associated with buprenorphine retention in patients with OUD. Nonetheless, providers should be aware of the association between CNCP and greater psychiatric comorbidity among patients with OUD when developing treatment plans. Research on the influence of additional characteristics of CNCP on treatment retention is needed
Gestational exposure to nicotine and/or benzo[a]pyrene causes long-lasting neurobehavioral consequences.
No full textTobacco smoke is a complex mixture that includes thousands of compounds. Previously, we have found that gestational exposure to the complex mixture of tobacco smoke extract caused long-term neurobehavioral impairments. In this study, we examined the interaction of two of the most biologically active, nicotine and benzo[a]pyrene (BaP). Developmental effects were determined in Sprague-Dawley rats prenatally exposed to low doses of BaP and nicotine (0.03 mg/kg/day of BaP and 2 mg/kg/day of nicotine) via maternal osmotic minipumps throughout gestation. Behavioral function was assessed in the offspring via a battery of tests through adolescence into adulthood. There were sex-selective effects in four of the behavioral tests. In the elevated plus maze, there was a significant interaction of BaP and sex, where BaP-treated males showed a trend for increased activity. In the novelty suppressed feeding test, there were significant sex selective effects in males such that the normal sex difference in the behavior in this test was eliminated. Male offspring with prenatal exposure to either nicotine or BaP showed significant reductions in fear response. In the Figure-8 locomotor activity test, BAP-exposed male offspring were significantly hyperactive. This also eliminated the sex difference typically seen in this test. This effect persisted into adulthood. In the attention task, males exposed to nicotine during gestation showed a significant percent hit impairment. BaP reversed this effect. No significant effects were seen with percent correct rejection. These data show that both nicotine and BaP cause persisting sex-selective behavioral effects that persist into adulthood
Late Response of Antiretroviral Therapy in an HIV-1-Infected Patient due to Hepatitis B and C Coinfections: The First Case Report in Nepal.
No full textAimDual coinfection of HCV and HBV in HIV-1-infected population is a leading cause of morbidity and mortality. Also, they share routes of HIV transmission; however, it might be associated with an independent factor like injecting drug use for HCV and unsafe sex for HBV. This case report suggests that hepatitis virus coinfection may lead to late response of antiretroviral therapy (ART) in HIV-1 patients.Patients and methodsA 49-year-old male patient visited for the routine follow-up investigation at the National Public Health Laboratory (NPHL), Teku, Nepal. He was an HIV-1-positive injecting drug user (IDU) co-infected with HCV and HBV. The patient was under ART as per the National HIV Testing and Treatment Guidelines 2017, Nepal. Further, serological and viral load testing was performed for confirmation and monitoring therapy, respectively.ResultsIt is the first report that highlights the dual coinfection of HCV and HBV in an HIV-1 patient from Nepal. The follow-up investigation shows improved response to ART with an increase in CD4+ cells. However, detectable viral loads indicated for a late response might be due to effects of coinfections or viral interactions.ConclusionsDual coinfection is rare; however, it is more serious with poorly defined epidemiology and evolution in an HIV-1-infected population. Thus, universal screening of HBV or/and HCV coinfection in HIV-1-infected population requires immediate implementation for true prevalence, proper management, and early intervention
Xipho-pubic angle (XPA) correlates with patient's reported outcomes in a population of adult spinal deformity: results from a multi-center cohort study.
No full textSTUDY DESIGN:Retrospective multi-center cohort study. PURPOSE:Sagittal misalignment causes changes in the abdominal shape. Xipho-pubic angle (XPA) has been previously described to radiographically evaluate the shape of the abdominal cavity in patients with spine deformity. The aims of this study are to evaluate the correlation of XPA-to-spinopelvic sagittal parameters and to patients' health-related quality-of-life (HRQoL) scores. METHODS:278 patients from a multi-center database with diagnosis adult spinal deformity (ASD) (one or more of: coronal Cobb angle > 20°, sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, and thoracic kyphosis > 60°) were included. Cut-off values for moderate and severe disability (ODI-Oswestry Disability Index-20 and 40%) were calculated. Pearson's correlation was tested between XPA and spinopelvic parameters and between XPA and HRQoL scores. RESULTS:The cut-off value of XPA to identify ODI severe disability (40/100) was identified with XPA smaller than 103°; minimal (20/100) disability was identified by XPA greater than 113°. XPA showed strong correlation to sagittal spinopelvic parameters-PT, SVA, lumbar lordosis (LL), pelvic incidence (PI) minus LL-and to HRQoL scores-ODI, SF-36 PCS and SRS-22 activity and pain. XPA was the parameter with the strongest correlation to HRQoL scores. CONCLUSIONS:Xipho-pubic angle reflects changes in spinal changes and has strong correlation to HRQoL and spinopelvic parameters. It can discriminate between patients with minimal, moderate, and severe disability as measured by ODI scores. These slides can be retrieved under Electronic Supplementary Material
Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScope<sup>Ⓡ</sup>-Global Registry for Emerging Fungal Infections.
No full textObjectivesEmerging invasive fungal infections (IFI) have become a notable challenge. Apart from the more frequently described fusariosis, lomentosporiosis, mucormycosis, scedosporiosis, and certain dematiaceae or yeasts, little is known about extremely rare IFI.MethodsExtremely rare IFI collected in the FungiScopeⓇ registry were grouped as Dematiaceae, Hypocreales, Saccharomycetales, Eurotiales, Dermatomycetes, Agaricales, and Mucorales.ResultsBetween 2003 and June 2019, 186 extremely rare IFI were documented in FungiScopeⓇ. Dematiaceae (35.5%), Hypocreales (23.1%), Mucorales (11.8%), and Saccharomycetales (11.3%) caused most IFI. Most patients had an underlying malignancy (38.7%) with acute leukemia accounting for 50% of cancers. Dissemination was observed in 26.9% of the patients. Complete or partial clinical response rate was 68.3%, being highest in Eurotiales (82.4%) and in Agaricales (80.0%). Overall mortality rate was 29.3%, ranging from 11.8% in Eurotiales to 50.0% in Mucorales.ConclusionsPhysicians are confronted with a complex variety of fungal pathogens, for which treatment recommendations are lacking and successful outcome might be incidental. Through an international consortium of physicians and scientists, these cases of extremely rare IFI can be collected to further investigate their epidemiology and eventually identify effective treatment regimens