Global increase in the occurrence and impact of multiyear droughts.

Persistent multiyear drought (MYD) events pose a growing threat to nature and humans in a changing climate. We identified and inventoried global MYDs by detecting spatiotemporally contiguous climatic anomalies, showing that MYDs have become drier, hotter, and led to increasingly diminished vegetation greenness. The global terrestrial land affected by MYDs has increased at a rate of 49,279 ± 14,771 square kilometers per year from 1980 to 2018.

Cross-Sectional Association Between Left Ventricular Geometric Patterns, Cortical Cerebral Microinfarcts, and Cognition.

Background: Left ventricular (LV) geometric patterns are associated with cognitive impairment and cerebral small vessel disease. As a novel magnetic resonance imaging marker of cerebral small vessel disease and a risk factor for cognitive dysfunction, cortical cerebral microinfarcts (CMIs) have been associated with heart disease through mechanisms including cardioembolism and cerebral hypoperfusion. Further investigation is required to determine whether cortical CMIs could arise from hemodynamic changes related to LV geometry, thus elucidating the connection between LV geometry and cognitive function.

Cost-Effectiveness Analysis of Inclisiran for the Treatment of Primary Hypercholesterolemia or Mixed Dyslipidemia in Singapore.

Objectives: This analysis evaluated the cost-effectiveness of inclisiran plus standard of care (SoC; comprising statins, ezetimibe, and fenofibrate) in primary hypercholesterolemia or mixed dyslipidemia from a Singapore healthcare system perspective. Inclisiran + SoC was separately compared with SoC, alirocumab + SoC, and evolocumab + SoC.

Methods: A lifetime Markov model in the United Kingdom (UK) was adapted to the Singapore setting.

Dynamic event-triggered tolerant containment control protocol for discrete multiagent systems based on finite index policy iteration algorithm.

For tolerant containment control of multi-agent systems, considering the challenges in modeling and the impact of actuator faults on system security and reliability, a finite index dynamic event-triggered policy iteration algorithm is proposed. This algorithm only requires input and output data, without relying on system models, and simultaneously considers the faults and energy consumption issues to improve the system reliability and save energy consumption. The conditions are provided to demonstrate the convergence and optimality of the algorithm, including a convergence speed, that is, the number of iterations required for convergence is finite.

A critical view of silk fibroin for non-viral gene therapy.

Exogenous genes are inserted into target cells during gene therapy in order to compensate or rectify disorders brought on by faulty or aberrant genes. However, gene therapy is still in its early stages because of its unsatisfactory therapeutic effects which are mainly due to low transfection efficiency of vectors, high toxicity, and poor target specificity. A natural polymer with numerous bioactive sites, good mechanical qualities, biodegradability, biocompatibility, and processability called silk fibroin has gained attention as a possible gene therapy vector.

Metabolomics signatures of serotonin reuptake inhibitor (escitalopram), serotonin norepinephrine reuptake inhibitor (duloxetine) and cognitive-behavioral therapy on key neurotransmitter pathways in major depressive disorder.

Metabolomics provides powerful tools that can inform about heterogeneity in disease and response to treatments. In this exploratory study, we employed an electrochemistry-based targeted metabolomics platform to assess the metabolic effects of three randomly-assigned treatments: escitalopram, duloxetine, and Cognitive-Behavioral Therapy (CBT) in 163 treatment-naïve outpatients with major depressive disorder. Serum samples from baseline and 12 weeks post-treatment were analyzed using targeted liquid chromatography-electrochemistry for metabolites related to tryptophan, tyrosine metabolism and related pathways.

Hepatic adverse events associated with ketamine and esketamine: A population-based disproportionality analysis.

Background And Objective: To determine whether there is disproportionate reporting of hepatobiliary disorders in the United States (US) FDA Adverse Event Reporting System (FAERS) for individuals prescribed ketamine or esketamine.

Design: We identified Medical Dictionary for Regulatory Activities (MedDRA) terms in the FAERS related to hepatobiliary disorders.

Main Measures: Formulations of ketamine and esketamine were evaluated for the proportionality of reporting for each hepatobiliary disorder parameter using the reporting odds ratio (ROR).

Finerenone and new-onset diabetes in heart failure: a prespecified analysis of the FINEARTS-HF trial.

Background: Data on the effect of mineralocorticoid receptor antagonist therapy on HbA levels and new-onset diabetes are conflicting. We aimed to examine the effect of oral finerenone, compared with placebo, on incident diabetes in the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF) trial.

Methods: In this randomised, double-blind, placebo-controlled trial, 6001 participants with heart failure with New York Heart Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomly assigned to finerenone or placebo, administered orally.

Change surface regression for nonlinear subgroup identification with application to warfarin pharmacogenomics data.

Pharmacogenomics stands as a pivotal driver toward personalized medicine, aiming to optimize drug efficacy while minimizing adverse effects by uncovering the impact of genetic variations on inter-individual outcome variability. Despite its promise, the intricate landscape of drug metabolism introduces complexity, where the correlation between drug response and genes can be shaped by numerous nongenetic factors, often exhibiting heterogeneity across diverse subpopulations. This challenge is particularly pronounced in datasets such as the International Warfarin Pharmacogenetic Consortium (IWPC), which encompasses diverse patient information from multiple nations.

Draft genomes of fluoroquinolone-resistant subspecies strains isolated from Cambodian poultry marketplaces.

High-quality draft genomes of six subspecies strains from Cambodian poultry marketplaces were sequenced. The strains were identified as Corvallis-, Monschaui-, and Kentucky-serovars. The fluoroquinolone resistance gene, was found in three strains in different Cambodian provinces.

Enhancing Small-for-Gestational-Age Prediction: Multi-Country Validation of Nuchal Thickness, Estimated Fetal Weight, and Machine Learning Models.

Objective: The first objective is to develop a nuchal thickness reference chart. The second objective is to compare rule-based algorithms and machine learning models in predicting small-for-gestational-age infants.

Method: This retrospective study involved singleton pregnancies at University Malaya Medical Centre, Malaysia, developed a nuchal thickness chart and evaluated its predictive value for small-for-gestational-age using Malaysian and Singapore cohorts.

Defining the Critical Requisites for Accurate Simulation of SARS-CoV-2 Viral Dynamics: Patient Characteristics and Data Collection Protocol.

Mathematical models of viral dynamics are crucial in understanding infection trajectories. However, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load data often includes limited sparse observations with significant heterogeneity. This study aims to: (1) understand the impact of patient characteristics in shaping the temporal viral load trajectory and (2) establish a data collection protocol (DCP) to reliably reconstruct individual viral load trajectories.

Low serum serotonin is associated with functional decline, mild behavioural impairment and brain atrophy in dementia-free subjects.

Brain serotonin dysregulation is associated with dementia and neuropsychiatric symptomology. However, the prognostic utility of circulating serotonin levels in detecting features of prodromal dementia including functional decline, cognitive impairment, mild behavioural impairment and brain atrophy remains unclear. In this prospective study of memory clinic subjects followed-up for ≤5 years, dementia-free subjects, classified as having no cognitive impairment or cognitive impairment, no dementia at baseline, underwent annual neuropsychological assessments including Montreal Cognitive Assessment, Global Cognition scores and Clinical Dementia Rating Scale Global Scores (where a ≥ 0.

Influence of dietary protein and fiber intake interactions on the human gut microbiota composition and function: a systematic review and network meta-analysis of randomized controlled trials.

Quantity and source of dietary protein intakes impact the gut microbiota differently. However, these effects have not been systematically studied. This review aimed to investigate these effects whilst controlling for fiber intake.

Epigenetic Control of Redox Pathways in Cancer Progression.

Growing evidence indicates the importance of redox reactions homeostasis, mediated predominantly by reactive oxygen species (ROS) in influencing the development, differentiation, progression, metastasis, programmed cell death, tumor microenvironment, and therapeutic resistance of cancer. Therefore, reviewing the ROS-linked epigenetic changes in cancer is fundamental to understanding the progression and prevention of cancer. We review in depth the molecular mechanisms involved in ROS-mediated epigenetic changes that lead to alteration of gene expression by altering DNA, modifying histones, and remodeling chromatin and noncoding RNA.

A comprehensive study of quantum arithmetic circuits.

In recent decades, the field of quantum computing has experienced remarkable progress. This progress is marked by the superior performance of many quantum algorithms compared with their classical counterparts, with Shor's algorithm serving as a prominent illustration. Quantum arithmetic circuits, which are the fundamental building blocks in numerous quantum algorithms, have attracted much attention.

The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.

Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability. This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system.

The global prevalence of emotional eating in overweight and obese populations: A systematic review and meta-analysis.

This systematic review aims to investigate the current prevalence of emotional eating and its associated factors in overweight and obese populations. We included studies that (1) reported prevalence of emotional eating; (2) were in the context of weight gain or overweight and obesity; (3) used a validated psychometric tool to assess emotional eating; (4) were published as an internationally referred journal article and (5) were reported in the English language. Articles were searched on eight electronic databases (CINAHL, EMBASE, PsychINFO, ProQuest, PubMed, Scopus, The Cochrane Library and Web of Science) from the journals' inception to 11 April 2024.

Engineering Atom-Scale Cascade Catalysis via Multi-Active Site Collaboration for Ampere-Level CO Electroreduction to C Products.

Electrochemical reduction of CO to value-added multicarbon (C) productions offers an attractive route for renewable energy storage and CO utilization, but it remains challenging to achieve high C selectivity at industrial-level current density. Herein, a MoCu single-atom alloy (SAA) catalyst is reported that displays a remarkable C Faradaic efficiency of 86.4% under 0.

A policy framework for leveraging generative AI to address enduring challenges in clinical trials.

Can artificial intelligence improve clinical trial design? Despite their importance in medicine, over 40% of trials involve flawed protocols. We introduce and propose the development of application-specific language models (ASLMs) for clinical trial design across three phases: ASLM development by regulatory agencies, customization by Health Technology Assessment bodies, and deployment to stakeholders. This strategy could enhance trial efficiency, inclusivity, and safety, leading to more representative, cost-effective clinical trials.

Associations between potential risk factors and blood-brain barrier water permeability in middle-aged and older adults.

Blood-brain barrier (BBB) dysfunction is suggested to be a potential mediator between vascular risk factors and cognitive impairment, leading to vascular cognitive impairment. To investigate the relationships between age, sex, and vascular risk factors and BBB water permeability as well as their relationship with cognition. To measure BBB permeability, a novel arterial spin labelling MRI technique (ME-ASL) was applied to derive the time of exchange (Tex), arterial time transit (ATT), and cerebral blood flow (CBF).

Initial Decline in Glomerular Filtration Rate With Finerenone in HFmrEF/HFpEF: A Prespecified Analysis of FINEARTS-HF.

Background: An initial decline in estimated glomerular filtration rate (eGFR) often leads to reluctance to continue life-saving therapies in patients with heart failure (HF).

Objectives: The goal of this study was to describe the association between initial decline in eGFR and subsequent clinical outcomes in patients randomized to placebo or finerenone.

Methods: In this prespecified analysis of FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), we examined the association between initial decline in eGFR (≥15%) from randomization to 1 month and subsequent outcomes in patients assigned to finerenone or placebo.