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Nature Food Jun 2024Crop migration can moderate the impacts of global warming on crop production, but its feedback on the climate and environment remains unknown. Here we develop an...
Crop migration can moderate the impacts of global warming on crop production, but its feedback on the climate and environment remains unknown. Here we develop an integrated framework to capture the climate impacts and the feedback of adaptation behaviours with the land-water-energy-carbon nexus perspective and identify opportunities to achieve the synergies between climate adaptation and environmental sustainability. We apply the framework to assess wheat and maize migration in the North China Plain and show that adaptation through wheat migration could increase crop production by ~18.5% in the 2050s, but at the cost of disproportional increment in land use (~19.2%), water use (~20.2%), energy use (~19.5%) and carbon emissions (~19.9%). Irrigation and fertilization management are critical mitigation opportunities in the framework, through which wheat migration can be optimized to reduce the climatic and environmental impacts and avoid potential carbon leakage. Our work highlights the sustainable climate adaptation to mitigate negative environmental externalities.
PubMed: 38942937
DOI: 10.1038/s43016-024-01008-8 -
Pharmaceutical Medicine Jun 2024To optimize cost effectiveness, engagement, reach, inclusivity, insight quality and quantity, and participant satisfaction of pharmaceutical meetings such as advisory...
BACKGROUND
To optimize cost effectiveness, engagement, reach, inclusivity, insight quality and quantity, and participant satisfaction of pharmaceutical meetings such as advisory boards, the organizers have to carefully weigh the pros and cons of the available meeting formats (in-person, synchronous virtual, asynchronous, hybrid). While budgets and organizer preferences are typically key considerations, participants' preferences are rarely factored into this decision. Hence, the objectives of this study were to gain a better understanding of participants' preferences for meeting format, frequency, and updates.
METHODS
Between September 1, 2022, and December 31, 2023, health care providers (HCPs) participating in asynchronous advisory board touchpoints on a proprietary virtual platform were asked to answer between 1-4 survey questions, selected at the pharmaceutical organizers' discretion.
RESULTS
A total of 443 HCPs answered the survey. Among respondents, 76.0% preferred meetings with a virtual component. Overall, the most popular meeting approach was a combination of synchronous and asynchronous virtual meetings over time (34.6%). The preference for hybrid meetings increased from 14.3 to 27.3% between 2022 and 2023. The preferred meeting frequency was 2-3 times a year (39.2%), followed by quarterly (33.2%). According to the respondents, the most important benefits of virtual over in-person meetings include: (i) superior convenience and flexibility (81.0%), (ii) avoidance of time off work and away from patients (62.3%), (iii) the low environmental impact and carbon footprint (32.5%).
CONCLUSIONS
Although these findings are preliminary and from a small dataset, they highlight the importance of customizing each pharmaceutical meeting or program with the target audience in mind.
PubMed: 38942923
DOI: 10.1007/s40290-024-00531-0 -
Journal of Hand Therapy : Official... Jun 2024Musician's focal dystonia (mFD) is a rare, neurological, task-specific disorder that mainly affects the upper extremity (especially the hands) and generally appears as a...
BACKGROUND
Musician's focal dystonia (mFD) is a rare, neurological, task-specific disorder that mainly affects the upper extremity (especially the hands) and generally appears as a painless muscular incoordination that can mark the end of a musician's professional career. The present literature review intends to highlight the current understanding of musician's focal dystonia, its underlying neural mechanisms and the role of prevention and treatment in physiotherapy, psychotherapy and other fields as occupational therapy.
PURPOSE
The aim of the present literature review was to gain an overview of mFD in the medical, psychological and physical therapy literature and investigate what strategies for diagnosis and rehabilitation are available today.
STUDY DESIGN
The present article is a literature review, based on the search for full-text publications with the goal of comparing the main strategies for mFD rehabilitation and prevention presented in the literature.
METHODS
This literature review compared many relevant papers and studies available in literature today for mFD epidemiology, neural mechanisms, treatment and prevention, to discuss what we know today and highlight the aspects that can still be enhanced in the future.
RESULTS
According to our results, current literature gives a good understanding of mFD epidemiology, but further studies are needed to fully comprehend the neurological aspects and develop more rehabilitation strategies, especially in the psychological field. Our research also highlighted the need for a multidisciplinary approach that considers both physical and psychological aspects.
CONCLUSIONS
Physical rehabilitation strategies are helpful but, considering the amount of psychological aspects involved in mFD, a holistic approach should be considered and developed in the future. Finally, prevention must have a primary role in mFD treatment, raising awareness around it and, possibly, avoiding its development.
PubMed: 38942654
DOI: 10.1016/j.jht.2024.02.011 -
International Journal of Biological... Jun 2024Transdermal drug delivery refers to the administration of drugs through the skin, after which the drugs can directly act on or circulate through the body to the target... (Review)
Review
Transdermal drug delivery refers to the administration of drugs through the skin, after which the drugs can directly act on or circulate through the body to the target organs or cells and avoid the first-pass metabolism in the liver and kidneys experienced by oral drugs, reducing the risk of drug poisoning. From the initial singular approach to transdermal drug delivery, there has been a shift toward combining multiple methods to enhance drug permeation efficiency and address the limitations of individual approaches. Technological advancements have also improved the accuracy of drug delivery. Optimizing insulin itself also enables its long-term release via needle-free injectors. In this review, the diverse transdermal delivery methods employed in insulin therapy and their respective advantages and limitations are discussed. By considering factors such as the principles of transdermal penetration, drug delivery efficiency, research progress, synergistic innovations among different methods, patient compliance, skin damage, and posttreatment skin recovery, a comprehensive evaluation is presented, along with prospects for potential novel combinatorial approaches. Furthermore, as insulin is a macromolecular drug, insights gained from its transdermal delivery may also serve as a valuable reference for the use of other macromolecular drugs for treatment.
PubMed: 38942414
DOI: 10.1016/j.ijbiomac.2024.133452 -
Journal of Vascular Surgery Jun 2024Outcomes for weekend surgical interventions are associated with higher rates of mortality and complications compared to weekday interventions. While prior investigations...
OBJECTIVE
Outcomes for weekend surgical interventions are associated with higher rates of mortality and complications compared to weekday interventions. While prior investigations have reported the 'weekend effect' for carotid endarterectomy (CEA), this association remains unclear for Transcarotid Artery Revascularization (TCAR) and Transfemoral Carotid Artery Stenting (TFCAS). We investigated the weekend effect for all three carotid revascularization methods.
METHODS
We queried the Vascular Quality Initiative (VQI) for patients undergoing CEA, TCAR, and TFCAS between 2016-2022. Chi-square and logistic regression modeling analyzed outcomes including in-hospital stroke, death, MI, and 30-day mortality by weekend vs. weekday intervention. Backward stepwise regression was utilized to identify significant confounding variables and were ultimately included in each final logistic regression model. Logistic regression of outcomes was substratified by symptomatic status. Secondary multivariable analysis compared outcomes between the three revascularization methods by weekend vs. weekday interventions.
RESULTS
155,962 procedures were analyzed including 103,790 CEA, 31,666 TCAR and 20,506 TFCAS. Of these, 1988 CEA, 246 TCAR and 820 TFCAS received weekend interventions. Logistic regression demonstrated no significant differences for TCAR, and increased odds of in-hospital stroke/death/MI for CEA [OR:1.31,(1.04-1.65)] and TFCAS [OR:1.46,(1.09-1.96)] weekend procedures. Asymptomatic TCAR patients had nearly triple the odds of 30-day mortality [OR:2.85,(1.06-7.68), P=0.038]. Similarly, odds of in-hospital death were nearly tripled for asymptomatic CEA [OR:2.89,(1.30-6.43), P=0.009] and asymptomatic TFCAS [OR:2.78,(1.34-5.76), P=0.006] patients. Secondary analysis demonstrated that CEA and TCAR had no significant differences for all outcomes. TFCAS was associated with increased odds of stroke and death compared to CEA and TCAR.
CONCLUSION
In this observational cohort study, we found that weekend carotid revascularization is associated with increased odds of complications and mortality. Furthermore, asymptomatic weekend patients perform worse in the CEA and TFCAS procedural groups. Among the three revascularization methods, TFCAS is associated with the highest odds of perioperative stroke and mortality. As such, our findings suggest that TFCAS procedures should be avoided over the weekend, in favor of CEA or TCAR. In patients who are poor candidates for CEA, TCAR offers the lowest morbidity and mortality for weekend procedures.
PubMed: 38942398
DOI: 10.1016/j.jvs.2024.06.163 -
World Neurosurgery Jun 2024Pineal tumors are rare but surgically challenging due to their deep location and proximity to major veins and brainstem. Getting biopsy along with ETV is essential...
Pineal tumors are rare but surgically challenging due to their deep location and proximity to major veins and brainstem. Getting biopsy along with ETV is essential before surgical resection. The supracerebellar infratentorial approach provides direct symmetrical exposure of the pineal region inferior to the vein of Galen. 3D-exoscopes are increasingly utilized due to better ergonomics, greater depth of field, and equivalent image quality of microscope. The endoscope provides angled optics to visualize hidden areas of tumor adherent to neurovascular structures, avoiding blind dissection. These become especially advantageous during suboccipital keyhole surgery in the sitting position, which averts both cerebellar retraction and frequent soiling of the endoscope. In this case of a giant pineal papillary tumor in a 16-year-old, we used both a 3D-exoscope and a 45°-angled endoscope complementarily. The tumor underwent straight-ahead internal decompression using an exoscope. Once some space became available, the angled endoscope was inserted to excise the tumor initially in the inferior aspect, then rotated towards either side to dissect the tumor from the basal veins of Rosenthal, and last, the superior pole stuck to the undersurface of the vein of Galen was gradually excised. There were no neurological deficits. Histopathology was a high-grade papillary tumor. MRI confirmed gross total resection. This is probably the first report of a supracerebellar infratentorial keyhole approach for gross total resection of a giant pineal tumor, effectively utilizing the better ergonomics and depth of field of a 3D-exoscope along with angled optics provided by an endoscope, resulting in an excellent outcome.
PubMed: 38942144
DOI: 10.1016/j.wneu.2024.06.107 -
Cell Jun 2024A number of species have recently recovered from near-extinction. Although these species have avoided the immediate extinction threat, their long-term viability remains...
A number of species have recently recovered from near-extinction. Although these species have avoided the immediate extinction threat, their long-term viability remains precarious due to the potential genetic consequences of population declines, which are poorly understood on a timescale beyond a few generations. Woolly mammoths (Mammuthus primigenius) became isolated on Wrangel Island around 10,000 years ago and persisted for over 200 generations before becoming extinct around 4,000 years ago. To study the evolutionary processes leading up to the mammoths' extinction, we analyzed 21 Siberian woolly mammoth genomes. Our results show that the population recovered quickly from a severe bottleneck and remained demographically stable during the ensuing six millennia. We find that mildly deleterious mutations gradually accumulated, whereas highly deleterious mutations were purged, suggesting ongoing inbreeding depression that lasted for hundreds of generations. The time-lag between demographic and genetic recovery has wide-ranging implications for conservation management of recently bottlenecked populations.
PubMed: 38942016
DOI: 10.1016/j.cell.2024.05.033 -
Physics in Medicine and Biology Jun 2024Reducing the radiation dose leads to the X-ray computed tomography (CT) images suffering from heavy noise and artifacts, which inevitably interferes with the subsequent...
Reducing the radiation dose leads to the X-ray computed tomography (CT) images suffering from heavy noise and artifacts, which inevitably interferes with the subsequent clinic diagnostic and analysis. Leading works have explored diffusion models for low-dose CT imaging to avoid the structure degeneration and blurring effects of previous deep denoising models. However, most of them always begin their generative processes with Gaussian noise, which has little or no structure priors of the clean data distribution, thereby leading to long-time inference and unpleasant reconstruction quality. To alleviate these problems, this paper presents a Structure-Aware Diffusion model (SAD), an end-to-end self-guided learning framework for high-fidelity CT image reconstruction. First, SAD builds a nonlinear diffusion bridge between clean and degraded data distributions, which could directly learn the implicit physical degradation prior from observed measurements. Second, SAD integrates the prompt learning mechanism and implicit neural representation into the diffusion process, where rich and diverse structure representations extracted by degraded inputs are exploited as prompts, which provides global and local structure priors, to guide CT image reconstruction. Finally, we devise an efficient self-guided diffusion architecture using an iterative updated strategy, which further refines structural prompts during each generative step to drive finer image reconstruction. Extensive experiments on AAPM-Mayo and LoDoPaB-CT datasets demonstrate that our SAD could achieve superior performance in terms of noise removal, structure preservation, and blind-dose generalization, with few generative steps, even one step only.
PubMed: 38942004
DOI: 10.1088/1361-6560/ad5d47 -
British Journal of Hospital Medicine... Jun 2024Although electromyography has been extensively used in the diagnosis of neurological diseases, there is no comprehensive understanding of the electromyography...
Specific electromyography characteristics can distinguish longitudinally extensive transverse myelitis from congestive myelopathy due to spinal dural arteriovenous fistula: a retrospective study.
Although electromyography has been extensively used in the diagnosis of neurological diseases, there is no comprehensive understanding of the electromyography manifestations of spinal dural arteriovenous fistula. Given the widespread use of electromyography in the diagnosis of neurological conditions, it is worthwhile to holistically analyse the electromyography findings of spinal dural arteriovenous fistula to differentiate it from neurological diseases that share similar clinical manifestations. The aim of this study is to evaluate whether electromyography can distinguish spinal dural arteriovenous fistula from longitudinally extensive transverse myelitis. We holistically reviewed files of all patients who were diagnosed with spinal dural arteriovenous fistula or longitudinally extensive transverse myelitis at The First Medical Centre of PLA General Hospital from 1 January 2010 to 31 December 2020. We compared the symptomology, epidemiology, and imaging results of patients with spinal dural arteriovenous fistula and longitudinally extensive transverse myelitis, placing emphasis on their electromyography manifestations. Student's t test was used to analyse normally distributed data, while Chi-square test was used to compare classification statistics. Lesions of spinal dural arteriovenous fistula shown on images tend to appear at lower lumbar and sacral segments, whereas lesions of the cervical and upper thoracic segments are more characteristic of longitudinally extensive transverse myelitis. Spinal dural arteriovenous fistula patients and longitudinally extensive transverse myelitis patients overlap in terms of clinical manifestations. After comparison, the two groups of patients had different demographics (age, sex), onset mode, predisposing factors before onset, and electromyographic features. The electromyographic features of patients with spinal dural arteriovenous fistula were associated with neurogenic damage ( < 0.001). In patients with spinal dural arteriovenous fistula, electromyography can help clinicians to identify early disease, avoid patient treatment delay, and eliminate unnecessary treatment.
Topics: Humans; Electromyography; Male; Female; Myelitis, Transverse; Central Nervous System Vascular Malformations; Retrospective Studies; Middle Aged; Adult; Aged; Diagnosis, Differential; Spinal Cord Diseases; Magnetic Resonance Imaging
PubMed: 38941974
DOI: 10.12968/hmed.2024.0111 -
Journal of Environmental Management Jun 2024Understanding the relationships between ecosystem services (ES) and the factors driving their changes over long periods and multiple scales is key for landscape managers...
Understanding the relationships between ecosystem services (ES) and the factors driving their changes over long periods and multiple scales is key for landscape managers in decision-making. However, the widespread implementation of restoration programs has led to significant ES changes, with trade-offs across space and time that have been little explored empirically, making it challenging to provide effective experience for managers. We quantified changes and interactions among five ES across various stages of the Grain-to-Green Program in the eastern Loess Plateau, examining these dynamics at threefold spatial scales. We observed notable increases in soil retention and Net Ecosystem Production but declines in habitat quality and Landscape aesthetics under afforestation. Over time, and with more integrated restoration strategies, synergies between ES pairs weakened, and non-correlations (even trade-offs) increased. To avoid unnecessary trade-offs, we recommend incorporating socio-ecological factors driving ES changes and ES bundles, informed by empirical experience, into proactive spatial planning and environmental management strategies for multi-ES objectives. The temporal lags and spatial trade-offs highlighted by this study offer crucial insights for large-scale restoration programs worldwide.
PubMed: 38941856
DOI: 10.1016/j.jenvman.2024.121591