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D-allose inhibits TLR4/PI3K/AKT signaling to attenuate neuroinflammation and neuro-sp...
Yaowen Luo
Junkai Cheng

Yaowen Luo

and 10 more

July 14, 2023
Background: Ischemic stroke (IS) occurs when a vessel supplying blood to the brain is obstructed. Our previous study showed that D-allose exerts neuroprotective effects against acute cerebral ischemic/reperfusion (I/R) injury by reducing neuroinflammation. Here, we aim to clarify the beneficial effects and underlying mechanism of D-allose in suppressing IS-induced neuroinflammation damage, cytotoxicity and neuro-specific apoptosis and neurological deficits in vitro and in vivo. Methods: For in vivo study, the I/R model was induced by middle cerebral artery occlusion and reperfusion (MCAO/R) in C57BL/6J mice and D-allose was given intraperitoneal injection within 5min after reperfusion. In vitro, mouse hippocampal neuronal cells (HT22) with oxygen–glucose deprivation and reperfusion (OGD/R) were established as the cell model of IS. The neurological score evaluation, some cytokines, cytotoxicity and apoptosis in the brain and cell lines were measured. Moreover, Gal-3 short hairpin RNA, lentivirus and adeno-associated virus were employed to modulate Gal-3 expression in neuronal both in vitro and in vivo to reveal the molecular mechanism. Results: D-allose alleviated cytotoxicity, including cell viability, LDH release and apoptosis in HT22 cells after OGD/R, which also relieved brain injury, such as lesion volume, brain edema, neuronal apoptosis, as well as neurological functional deficits in a mouse model of I/R. Importantly, loss of Gal-3 enhanced the D-allose’s protection against I/R-induced HT22 cell injury, inflammation insults and apoptosis, whereas activation of TLR4 by selective agonist LPS increased the degree of injury of neuron, as well as abolished the protective effects of D-allose.
Localized expression of the olfactory receptor genes in the olfactory organ of common...
Ayumi Hirose
Masato Nikaido

Ayumi Hirose

and 5 more

July 14, 2023
Baleen whales (Mysticeti) possess the necessary anatomical structures and genetic elements for olfaction. Nevertheless, the olfactory receptor gene (OR) repertoire has undergone substantial degeneration in the cetacean lineage following the divergence of Artiodactyla and Cetacea. The functionality of the highly degenerated mysticete ORs within their olfactory epithelium remains unknown. In this study, we extracted total RNA from the nasal mucosa of common minke whales (Balaenoptera acutorostrata) to investigate the localized expression of ORs. All three sections of the mucosae examined in the nasal chamber displayed comparable histological structure, whereas the posterior portion of the frontoturbinal region exhibit notably high expression of ORs and another gene specific to the olfactory mucosa. Neither the olfactory bulb nor the external skin exhibited expression of these genes. Although this species possesses four intact class-1 ORs, all the ORs expressed in the nasal mucosa belong to class-2, implying the loss of aversion to specific odorants. These anatomical and genomic analyses suggest that ORs are still responsible for olfaction within the nasal region of baleen whales, enabling them to detect desirable scents such as prey and potential mating partners.
From current to potential distribution: the case of Taxus baccata L. (Taxaceae, Pinal...
Giacomo Calvia

Giacomo Calvia

July 14, 2023
Taxus baccata is a relic declining species, especially at the southern margins of its natural distribution, such as the Mediterranean and Irano-Turanian biogeographic regions. On the Island of Sardinia, it is still present in many mountain sites. This study identified 232 locations where yews grow. The species is indifferent to substrates, but prefers moist sites with northern aspects, and has elevation range is 695-1225 m a.s.l. To predict yew’s potential distribution in Sardinia, we collected data from the literature and field observations and applied the Maximum Entropy algorithm (MaxEnt). We used 202 field-based sites and 19 bioclimatic variables to model the potential distribution area under current climatic conditions. Annual precipitation, mean temperature of the warmest month and isothermality were the key drivers for the distribution of T. baccata in Sardinia. In terms of permutation importance, mean diurnal range and precipitation of the warmest quarter were the main environmental variables. The response curves showed that T. baccata prefers annual mean temperatures ranging from 8.65 to 12.55°C and annual mean precipitation from 770 to 1085 mm. Most potential suitable conditions were found in northern and central Sardinia. Using the Global Circulation Model, we also modelled future habitat suitability for T. baccata under two different scenarios, highlighting a substantial reduction of the habitat suitability for the species by the end of this century. This reduction is associated with climate change and poses an increasing concern about the future of the species and the priority habitat described in many parts of Sardinia.
Inadvertent injection of Ciprofloxacin instead of ropivacaine through epidural cathet...
Régis Fuzier
Geneviève Salvignol

Régis Fuzier

and 4 more

July 14, 2023
Patient harm is often due to medication errors related to neuraxial and peripheral misconnection. We report a case of inadvertent injection of ciprofloxacin into the epidural space and discuss the strategies that could prevent such an incident. An adult patient presented a recurrence of an ovarian cancer. The recent discovery of an intrabdominal recurrence on CT-scan led us to propose a new surgical procedure. A thoracic epidural analgesia was performed prior to general anesthesia. Postoperative pain was controlled with patient-controlled epidural analgesia (PCEA) with ropivacaine-epinephrine. During the first night, abdominal pain appeared. During the second day, a nurse discovered that the bag connected to the pump contained ciprofloxacin and not ropivacaine. After aspiration of 2.5 ml sent to laboratory for analysis, the epidural catheter was removed. The investigation revealed the different causes leading to such an error. Three days after, the patient returned home, without any adverse symptom. This is the first report of the inadvertent administration of ciprofloxacin into the epidural space via a patient-controlled epidural analgesia technique. As there is no effective treatment for such errors, we discuss the neurological risk of ciprofloxacin and prevention strategy mainly based on organizational and human factors.
Fatigue life prediction of mistuned steam turbine blades subjected to deviations in b...
Makgwantsha Hermelton Mashiachidi
Dawood Desai A

Makgwantsha Hermelton Mashiachidi

and 1 more

July 14, 2023
The steam turbine blades are subjected to steam flow bending, centrifugal loading, vibration response, and structural mistuning. These mentioned factors significantly contribute to the fatigue failure of the steam turbine blades. Low-Pressure (LP) steam turbines experience premature blade and disk failures due to the stress concentrations at the blade root area of its bladed disk. This study of the mistuned steam turbine blades subjected to variation in blade geometry will be of great significance to the electricity generation industry. A simplified, scaled-down mistuned steam turbine bladed disk model was developed using ABAQUS finite element analysis (FEA) software. Acquisition of the vibration characteristics and steady-state stress response of the disk models was performed through FEA. Such studies are very limited. Thereafter, numerical stress distributions were acquired, and the model was subsequently exported to Fe-Safe software for fatigue life calculations based on centrifugal and harmonic sinusoidal pressure loading. The vibration characteristics and the response of the variation steam turbine geometric blade was conducted. The FEA natural frequencies compared well with published literature of the real steam turbines indicating reliability of the developed FEA model. The study found that the fatigue life is most sensitive to changes in blade length, followed by the width, and then the thickness, in this order. The analytical life cycles and Fe-Safe software shows the percentage difference of less than 4.86%. This concludes that the developed numerical methodology can be used for real-life mistuned steam turbine blades subjected to variations in blade geometry.
Association of catalase promoter haplotype and catalase level in the X-ray employment...
Zahraa Sami Razzaq Najjar
Zainab Mahdi Jasim Al-Saygh

Zahraa Sami Razzaq Najjar

and 2 more

July 14, 2023
the current study aims to detect Association of catalase promoter haplotype and catalase level and its relation with ROS in the X-ray employments , the results show that the mean of employments age was (36.90±2.330) and (39.23±0.06760) for control group , The level of CAT showed significant reduction in X-ray employments group (0.701±0.067) (p= 0.000), and non-significant differences observed in both groups that have approximately same results in ROS levels (p= 0.810), The correlation between CAT level and different work times in the X-ray employments group show inverse correlation with work time per day, and positive association with other times of working in non-significant differences, belong to ROS there was significant inverse correlation with work time per day and non-significant inverse relation with direct exposure per day and per week, the (CAT -89A>T) haplotypes detected using PCR-SSCP technique, the results show two types of haplotypes (single and double haplotypes) a strong association of double haplotypes with employments group (p= 0.000) was observed. The results concluded that there was significant reduction of CAT level and (CAT -89A>T) haplotypes with group exposed to X-ray radiation.
Effect of early life exposure to air pollutants on the incidence of eczema in childre...
Zhiping Wang
Yuxiu Liang

Zhiping Wang

and 7 more

July 14, 2023
Background: The incidence of eczema is higher in children aged 0-2 years, but the long-term effect of air pollutants exposure in early life on the risk of eczema development is unclear. Methods: We conducted a birth cohort study in Jinan, China, to explore the effect of early life air pollutant exposure on the risk of eczema in younger children. An inverse distance weighting method was used for individual exposure assessment. Binary and multivariate logistic models were used to investigate the effects of air pollutants on eczema, the distributed lag model to find sensitive windows of exposure, weighted quantile sum model and principal component analysis to explore the combined effects of multiple pollutants. Results: The cumulative incidence rate for eczema among 5819 children aged 2 was 19.8%. Exposure to high levels of O 3 during pregnancy ( OR 1.12, 95% CI 1.06-1.19) and during the first year after birth ( OR 1.24, 95% CI 1.03-1.50) increased the risk of eczema. PM 2.5-10 during pregnancy ( OR 1.31, 95% CI 1.20-1.43), PM 2.5 ( OR 1.08, 95% CI 1.01-1.15) and PM 2.5-10 ( OR 1.07, 95% CI 1.00-1.14) during the first year after birth also increased the risk of eczema. The critical window for O 3 and PM exposure was the third trimester and early postnatal period. Moreover, in the combined effect of multiple pollutants, O 3 played a dominant role during pregnancy (weighting > 0.3), with a predominantly O 3 principal component associated with eczema risk (adjusted OR 1.011, 95% CI 1.007-1.015). Conclusions: Exposure to air pollutants O 3 and PM in early life increased the risk of eczema at 0-2 years of age, and the sensitivity window appeared earlier. O 3 exposure during pregnancy played a key role in the combined effect of pollutants on eczema risk.
PARANEOPLASTIC JUVENILE IDIOPATHIC ARTHRITIS AS A MANIFESTATION OF A BENIGN TERATOMA...
Shivani Kamal
Sukesh Sukumaran

Shivani Kamal

and 3 more

July 14, 2023
PARANEOPLASTIC JUVENILE IDIOPATHIC ARTHRITIS AS A MANIFESTATION OF A BENIGN TERATOMA IN A FIVE-YEAR-OLD GIRL
Central Nervous System Metastases in Pediatric Patients with Ewing Sarcoma
Leonora Slatnick
Carrye Cost

Leonora Slatnick

and 4 more

July 14, 2023
Metastatic central nervous system (CNS) involvement is rare in pediatric primary extracranial Ewing sarcoma (ES). We describe the incidence and course of six patients with extracranial ES who developed metastatic CNS lesions treated at a single institution. Median time to CNS disease detection was 16.3 months (10.0-28.3 months). Event free and overall survival after CNS disease detection were 1.9 months (0.4-10.3 months) and 4.6 months (1.1-50.9 months), respectively. One patient was alive at the time of analysis. Clinical status and ability to obtain disease control should be considered when making decisions regarding aggressive interventions in these patients with poor prognosis.
Treatment Outcomes for Hepatoblastoma: 15-years-experience of a Single Institution –...
Laila Alkhouli
Saja Fetyan

Laila Alkhouli

and 2 more

July 14, 2023
Background: Hepatoblastoma is the most common malignant liver tumor in children. Treatment protocols varies. In our center, we have adopted the Children’s Oncology Group (COG) AHEP0731 protocol, in addition to some experimental regimens for relapsed solid tumors. Methods: We aimed to investigate the outcome of the current hepatoblastoma treatment protocol at our center. 15 patients were included between January 2008 and June 2023. A retrospective review was carried to review the clinical presentation, serum α-fetoprotein (AFP) level at diagnosis, histological subtype, treatment, and outcomes. Results: 12 patients (80%) were symptomatic at time of diagnosis, with abdominal mass being the most common presenting complaint. Nine patients (60%) presented in stage 3 PRETEXT staging system. Epithelial histopathological subtype was predominant subtype. Thirteen patients have received preoperative chemotherapy, followed by surgical resection; only one patient underwent upfront surgical resection followed by chemotherapy. Preoperative chemotherapy consists of 2 to 4 cycles of Cisplatin, Fluorouracil, Vincristine and Doxorubicin (C5VD), followed by surgical resection. Four of them underwent neoadjuvent experimental chemotherapy utilizing agents such as Pazopanib, Pembrolizumab and Sorafenib. During follow-up, six patients died of progressive disease. The median survival time was 42 months (95% confidence interval: 18–42%). Five-year overall survival was 44.09% (95% confidence interval: 18–42%). Conclusions: The combination of surgery and chemotherapy for hepatoblastoma is an effective approach. Utilization of new-targeted therapies and relapsed solid tumors regimens may prolong life in patients who did not respond to standard therapy. Further studies are required to validate its usage on patients with advanced hepatoblastoma.
Challenges and Opportunities in Liquid Biopsy for Hematologic Malignancies
Amin A. Alamin

Amin Alamin

July 14, 2023
Liquid biopsy has emerged as a promising non-invasive method for detecting and monitoring hematologic malignancies through the analysis of circulating tumor DNA (ctDNA) and other biomarkers in the blood. While the technique has shown potential for improving diagnosis, prognosis, minimal residual disease detection, therapeutic monitoring, and research in hematologic malignancies, there are still challenges that must be addressed, including improving sensitivity and specificity, optimizing mutation detection, and reducing costs. With continued advances, liquid biopsy has the potential to revolutionize the way hematologic malignancies are diagnosed and treated.
Syphilitic chancre of the lower lip
Yao Ni
Lingyi Zhao

Yao Ni

and 3 more

July 14, 2023
Syphilitic chancre of the lower lipLingyi Zhao1Yao Ni1,3Jingying Sun1Janzhou Ye2*Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, ChinaDepartment of Dermatovenereology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, ChinaDepartment of Dermatovenereology, Nanjing University of Traditional Chinese Medicine, Nanjing, China* Corresponding Author: kmyjz63@sina.comrunning head: Syphilitic chancre of the lower lipThe category of the article: LetterKeywords: Syphilitic chancre, lower lipManuscript word count: 679 wordsThe number of figures: 2The number of tables: 0The number of references: 7Correspondence to: Janzhou Ye, M.D, Ph.D., Department of Dermatovenereology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, 650021, China.Tel: +86 13908710661; E-mail: kmyjz63@sina.comFull conflict of interest statement: Lingyi Zhao, and my co-authors have no conflict of interest to declare.Ethics statement: The patient has consented to publish this information.Data availability statement:Data sharing does not apply to this article as no new data were created or analyzed in this study.Funding sources: noneDear Editor,Syphilis is a chronic infectious disease usually caused by spirochete Treponema pallidum. Nowadays, it is estimated that there are more than 11 million new cases of syphilis in the world every year, and more than 90% of the cases are in developing countries1. Syphilis re-emerges mainly in men who have sex with men(MSM)in high-income countries. In contrast, it is an endemic disease in low-income countries. Although its mortality rate decreases, its varied clinical manifestations are likely to lead to misdiagnosis or delayed diagnosis, especially when the primary lesions occur in the extragenital regions. Treponema pallidum usually enters the human body through microlesions in the skin or mucous membrane. The typical primary painless ulcerative lesion, which is called a chancre, often develops at the site of inoculation within 10 to 90 days after unprotected sexual intercourse.Here we report a 26-year-old man presented to the dermatology department with a painless ulcer on the midline of his lower lip for 3 weeks (Fig. 1). The isosceles triangular ulcer is measured 1.3cm in waist length, 0.7cm in base length with a smooth, clean base and indurated, elevated borders, which was slightly bleeding. The patient announced not any other lesion on his trunk or limbs. He initially visited a clinic and was prescribed mupirocin ointment. He used the ointment for a week and went to another clinic due to no significant improvement of the ulcer. This time he applied acyclovir cream. After two weeks, the ulcer had not improved. The patient claimed to have had unprotected orogenital sex with two women in two months. He declared he had not any prior sexually transmitted infection. Physical examination showed no remarkable signs on the trunk, limbs, especially genitals or anus. Peripheral lymphadenopathy was not revealed clearly. Toluidine red unheated serum testing was positive with a titer of 1:16, in the meantime treponema pallidum particle agglutination assay was positive. He tested negative for human immunodeficiency virus. The situation of those women was unclear because he had been out of touch with them. The patient was treated with benzathine penicillin (2.4 million) once a week for 3 consecutive weeks. The lesion was undetectable completely after 4 weeks (Fig. 2).
Genomic epidemiology of the main SARS-CoV-2 variants circulating in Italy in 2020 and...
Annalisa Bergna
A. Lai

Annalisa Bergna

and 33 more

July 14, 2023
Since the beginning of the pandemic, SARS-CoV-2 has shown a great genomic variability, resulting in the continuous emergence of new variants that has made their global monitoring and study a priority. This work aimed to study the genomic heterogeneity, the temporal origin, the rate of viral evolution and the population dynamics of the main circulating variants (20E.EU1, Alpha and Delta) in Italy, in August 2020-January 2022 period. For phylogenetic analyses, two datasets were evaluated for each variant, the former comprising international genomes and the latter focusing on clusters containing at least 70% of Italian sequences. The international dataset showed 26 (23% Italians, 23% singleton, 54% mixed), 40 (60% mixed, 37.5% Italians, 1 singleton) and 42 (85.7% mixed, 9.5% singleton, 4.8% Italians) clusters with at least one Italian sequence, in 20E.EU1 clade, Alpha and Delta variants, respectively. International clusters presented tMRCAs between 13/06/2020-27/07/2021. R e values showed the highest level between May-June until autumn 2020 in 20E.EU1 clade. The Alpha variant showed an increase in the R e in December 2020, when the highest mean value was estimated. Delta variant presented two peaks: the first between March-May, and the second between June-July 2021. The present work highlighted a different evolutionary dynamic of studied lineages with a high concordance between epidemiological parameters estimation and phylodynamic trends suggesting that the mechanism of replacement of the SARS-CoV-2 variants must be related to a complex of factors involving the transmissibility, as well as the implementation of control measures, and the level of cross-immunization within the population.
An Efficient Implementation for Linear Convolution with Reduced Latency in FPGA
Dingli Xue
Linda DeBrunner

Dingli Xue

and 5 more

July 14, 2023
A recently developed linear convolution filter based on Hirschman theory has shown its advantage in saving computations compared with other convolution filters. In this paper, we ameliorate the Hirschman convolution filter with the usage of split-radix algorithm and explore its latency-reduced advantage for the first time. We present a comparison of hardware resource in FPGA for the proposed Hirschman-based filter and other convolution filters. Simulation results indicate that the split-radix Hirschman convolution filter achieves a promising reduction in latency by averagely 18.15% with an acceptable power consumption rise, compared with the main competitor using extended SRFFT. In the case of device capacity limited, the proposed Hirschman convolution filter is still computationally attractive as it performs small-size originator function, instead of larger Fourier transform required by other convolution filters.
EXPERIMENTAL INVESTIGATION ON SHAPE SEGREGATION OF 3D PRINTED PARTICLES USING A FT4 F...
Shishir Shekhar
Joshua Tuohey

Shishir Shekhar

and 5 more

July 14, 2023
This study examines how granular mixtures of differently shaped particles segregate in a Freeman (FT4) rheometer. The mixtures contained two sets of particles with varying shapes and relative sizes. While our main focus was on the effect of particle shape on segregation, we recognized that even slight differences in size could lead to segregation. We specifically investigated when particles of different shapes have the same effective size, exploring three cases: 1) the largest sphere within a cubic particle (inscribed sphere), 2) the smallest sphere enclosing a cubic particle (circumscribed sphere), and 3) a sphere and cube with equal volume. Our findings reveal that binary mixtures of cubical and spherical particles can significantly segregate radially in the bed. We propose that the primary mechanism for this radial segregation is percolation caused by radial centrifugal forces pushing the particles outward.
A novel semi-resolved CFD-DEM method with two-grid mapping:methodology and validation
Hanqiao Che
Christopher Windows-Yule

Hanqiao Che

and 3 more

July 14, 2023
The semi-resolved CFD-DEM method has emerged as a prominent tool for modelling particle-fluid interactions in granular materials with high particle size ratios. However, challenges arise from conflicting requirements regarding the CFD grid size, which must adequately resolve fluid flow in the pore space while maintaining a physically meaningful porosity field. This study addresses these challenges by introducing a two-grid mapping approach. Initially, the porosity field associated with fine particles is estimated using a coarse CFD grid, which is then mapped to a dynamically refined grid. To ensure conservation of total solid volume, a volume compensation procedure is implemented. The proposed method has been rigorously validated using benchmark cases, showing its high computational efficiency and accurate handling of complex porosity calculations near the surface of coarse particles. Moreover, the previously unreported impact of the empirical drag correlation on fluid-particle force calculations for both coarse and fine particles has been revealed.
Detection and density estimation for a cryptic species
Giselle Owens

Giselle Owens

and 6 more

July 25, 2023
Giselle Owens1,4, Ana Gracanin2, Joanne Potts3, Catherine M. Young1, Robert Heinsohn1, Philip Gibbons1, Dejan Stojanovic1Fenner School of Environment and Society, Australian National University, Canberra, AustraliaCentre for Sustainable Ecosystem Solutions, School of Earth, Atmospheric and Life Sciences, Faculty of Science, Medicine and Health, University of Wollongong Australia, New South Wales, AustraliaThe Analytical Edge Statistical Consulting, Hobart, AustraliaCorresponding author: giselle.owens@anu.edu.auRunning Head: Detection and density estimation for a cryptic speciesKey Words: detection probability, spatially explicit capture-recapture, SECR, meta-analysis, literature review, bait, lure, Petaurus notatus , sugar glider, density
Genetic Predisposition of Vulnerable Groups to Schizophrenia and Bipolar I via AKAP11...
Peyton Tillie

Peyton Tillie

and 4 more

July 25, 2023
Recent exome sequencing analyses have shown that schizophrenia and bipolar I disorder, collectively affecting 2% of the population, may extend from a common genetic origin of the AKAP11 gene.  Though several studies have been put forth to examine the relationship between the pathogenesis of these mental illnesses and AKAP11 variants, a model has yet to be created that tests this hypothesis by accounting for real–world diagnosis frequencies in addition to a genetic framework.  Analogously, no genetic study has been put forth to identify specific vulnerable groups in the development of either schizophrenia or bipolar disorder.  To provide additional insight into the pathogenesis of these diseases, we perform ordinal logistic regression on every AKAP11 variant in the SCHEMA and BipEx data sets.  Primarily using the CADD genome annotation, we establish the probability that each variant is deleterious.  We use a chi–square goodness of fit test to demonstrate that the amino acids coded for by high–risk variants are similar between schizophrenia and bipolar disorder, suggesting a common underlying genetic origin.  Additionally, a sequence of one–sided t tests is run to compare the age and sex frequencies of these high­–risk variants to the frequencies of schizophrenia and bipolar I diagnoses among the Canadian population.  In total, we find that AKAP11 exhibits a strong correlation with bipolar I disorder and a moderate correlation with schizophrenia.  We also find that males under 30 and females between 50 and 55 are most vulnerable to schizophrenia and bipolar I, respectively.
Fed-SAD:A secure aggregation federated learning method for distributed load forecasti...
Jian Li
Hexiao Li

Jian Li

and 4 more

July 25, 2023
The distributed and privacy-preserving characteristics of fine-grained smart grid data hinder data sharing, making federated learning an attractive approach for collaborative training among data owners with similar load patterns. However, malicious models can interfere with training in the federated learning aggregation process, making it difficult to ensure the accuracy and safety of the central model in load forecasting. Therefore, we propose a secure aggregation federated learning method for distributed load forecasting based on similarity and distance (Fed-SAD), which effectively eliminates the interference of malicious models by securely aggregating models, thereby ensuring accurate and safe distributed scenario prediction. Experimental results demonstrate that Fed-SAD maintains high accuracy and robustness in both the presence and absence of malicious models, while maintaining data and model security.
THE HIDDEN STRUGGLE OF OVERWORKED UROLOGY RESIDENTS “THE HOUR”: THE OVERLOOKED BURNOU...
Alain Mwamba Mukendi

Alain Mwamba Mukendi

July 25, 2023
IntroductionBurnout, which is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment due to prolonged workplace stress, is a major concern for healthcare professionals, including urology residents [1]. The literature has increasingly focused on the prevalence, risk factors, and consequences of burnout within the urology field in recent years. Urology residents are highly susceptible to burnout. A study published in the Journal of Urology found that 54% of urology residents experienced burnout, with emotional exhaustion being the most reported symptom. High workload, poor work-life balance, and limited socialsupport were identified as key risk factors for burnout among urology residents. The impact of burnout on urology residents can be profound, potentially leading to reduced job satisfaction, decreased empathy for patients, and even early retirement from the field [1,2].In this narrative review, we use both thematic and critical review methods to gain deeper insight into the complex issue of burnout among urology residents. Our thematic review explores key themes such as the impact of excessive workload on physical and mental health and the inadequate support for overworked urology residents, while our critical review examines contributing factors such as the culture of the medical field and poor leadership practices. Our critical review examines contributing factors such as the culture of the medical field and poor leadership practices. In this culture, long work hours and a high workload are seen as necessary sacrifices to become successful physicians. As a result, overworked urology residents may feel that burnout is a personal failure or that acknowledging it is a sign of weakness. Additionally, poor leadership practices, disregarding the residents’ wellbeing, are associated with inadequate staffing and unrealistic expectations.By identifying contributing factors and proposing workable solutions, we aim to improve the quality of care while mitigating negative outcomes for urology residents suffering from burnout.KEY REFERENCESKiehl MT, Oermann EK. Burnout in urology residency: a hidden crisis. Curr Urol Rep. 2020;21(7):29.Avery DM, Ruffolo LI, Kozlowski JA, Goldfarb DA. Burnout among urology residents: a systematic review and meta-analysis. Curr Urol Rep. 2019;20(11):77.Bordin CA, Carlotto AP. The experience of work-related burnout hiding: A grounded theory study. Burn Res. 2019; 12:45-51.Demerouti E, Bakker AB, Peeters MCW, Breevaart K. New directions in burnout research. Eur J Work Organ Psychol. 2021;30(5):686-691.Edú-Valsania S, Laguía A, Moriano JA. Burnout: A Review of Theory and Measurement. Int J Environ Res Public Health. 2022 Feb;19(3):1780.Busireddy KR, Miller JA, Ellison K, Ren V, Qayyum R, Panda M. Impact of leadership behavior on physician well-being, burnout, professional fulfilment and intent to leave: a multicentre cross-sectional survey study. BMJ Open. 2019;9(9): e030209. doi:10.1136/bmjopen-2019-030209.Meister A, Cheng BH, Dael N, Krings F. How to Recover from Work Stress, According to Science. Harvard Business Review. 2022.Heng YT, Schabram K. Your Burnout Is Unique. Your Recovery Will Be, Too. Harvard Business Review. 2021.
Consistency of public-domain precipitation products: coupling  traditional evaluation...
khalifa

Muhammad khalifa

and 8 more

July 25, 2023
Muhammad Khalifa 1,2*, Wolfgang Korres 2, Samah Mahmood Saif 1,3, Nadir Ahmed Elagib 1, Oscar M. Baez-Villanueva 1,4, Mohammed Basheer 5, Saher Ayyad 1, Lars Ribbe 1, Karl Schneider 21 Institute for Technology and Resources Management in the Tropics and Subtropics (ITT), Cologne University of Applied Sciences, Cologne 50679, Germany2 Institute of Geography, University of Cologne, Albertus-Magnus-Platz, D-50923 Cologne, Germany3 Department of Sanitary and Environmental Engineering, University of Kassel, 34109 Kassel, Germany4 Faculty of Spatial Planning, Technical University of Dortmund University, Dortmund, Germany5 Department of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester, United Kingdom* Corresponding author: Muhammad Khalifa (msakhalifa@hotmail.com)Key Points:For efficiently managing water resources, precipitation needs to be monitored spatially and temporally.Public-domain Precipitation Products (PPs) are important sources of data, especially for data-scarce regions such as the Blue Nile Basin.We provided insights on the variations between 17 PPs using traditional evaluation methods and data mining techniques.AbstractThe efficient use of water requires understanding its spatial and temporal availability and pattern of use. However, in-situ measurements of the components of the hydrological cycle are often unavailable. This is particularly the case for precipitation. In this respect, Public-domain Precipitation Products (PPs) represent an alternative source of information. Nonetheless, precipitation estimates by PPs show discrepancies in spatial and temporal domains; thus, in-depth analyses of similarities and differences of these products is imperative to provide accurate precipitation estimations for water applications. We introduce and test a novel approach for evaluating the performance of PPs. This approach couples traditional evaluation methods (pixel-to-point and pixel-to-pixel) with data mining techniques (Hierarchical Clustering and Principal Component Analyses). It was used to assess the performance of 17 PPs over the Blue Nile Basin (BNB) for the period 2001-2005 on monthly and annual scales. A sensitivity analysis was carried out to test the affinity of the studied PPs. The analysis results were used to guide assimilating several PPs to create Merged Precipitation Products (MPPs). Results exhibit considerable differences between the studied PPs. Noticeable spatial and temporal discrepancies were found between the 17 PPs on the one hand and between PPs and rain gauge data on the other hand. Data mining techniques proved to be useful in detecting similar and dissimilar PPs. Given their advantages over traditional methods, these techniques should be used routinely in PPs assessment. The findings of the current research provide helpful insights to advance the use of PPs in water resources applications.Keywords: Precipitation, Blue Nile Basin, Public-domain, Hierarchical Clustering, Principal Component Analyses, Remote sensing.1 IntroductionWater monitoring is crucial for hydrological, ecological, and development purposes. Due to population growth and climate change, water has become increasingly scarce in many parts of the world (Kummu et al., 2016; Liu et al., 2017). Therefore, decision-makers are required to adopt immediate, efficient and sustainable management practices to meet current and future human development and environmental water demands. However, the lack of ground-based data is one of the main challenges that hinder good practices of water management (McDonnel, 2008). Effective management of water resources requires continuous monitoring and an accurate estimation of the spatio-temporal patterns of different components of the hydrological cycle such as precipitation, evapotranspiration, runoff, and water storage changes (Ayyad et al., 2019; Cosgrove & Loucks, 2015; Fernández-Prieto et al., 2012; Su et al., 2010; Sun et al., 2018). In most regions of the world, water availability is directly linked to precipitation amount and seasonality (Dinku et al., 2007; Ligaray et al., 2015; Noy-Meir, 1973). Variations in the spatio-temporal patterns of precipitation can cause environmental hazards such as floods and droughts, which have direct socio-economic impacts (Brown & Lall, 2006), and often result in loss of lives and infrastructure. For example, Masih et al., (2014) reported that during 1965-2012, drought events affected ~67 million people over Ethiopia, bringing an estimated economic loss of above 92 million US$ and a death toll of more than 400,000. These numbers emphasize the need for accurate precipitation data to support decision-making, especially in areas vulnerable to high climate variability such as the Nile Basin (Bastiaanssen et al., 2014; Beyene et al., 2010; Cao et al., 2018b).Traditionally, precipitation has been measured using in-situ rain gauges (Gabriele et al., 2017; Kidd, 2001). However, the accuracy in the characterization of precipitation, when only ground-based measurements are used, depends largely on the density and distribution of the rain gauge network (Shaghaghian & Abedini, 2013). While radar data can provide a spatially distributed estimation of precipitation (Yoon et al., 2012), rain gauges are considered the most reliable source of precipitation measurements at the point scale (Villarini et al., 2008) and they still required for calibration and validation purposes. Despite that, the rain gauges are sensitive to environmental conditions (Michelson, 2004), and the accuracy of their records has to be controlled (Levy et al., 2017). However, in many regions (especially in developing countries), rain gauges are sparsely distributed (Kaba et al., 2014), and their number is decreasing (Sun et al., 2018). Rain gauges are sensitive to environmental conditions (Michelson, 2004), and the accuracy of their records needs to be checked (Levy et al., 2017). A dense network is expensive and hard to maintain, hindering an accurate spatial representation of the precipitation patterns, especially in high altitude areas. Systematic under-catch of gauge measurements (Beck, Wood, McVicar, et al., 2019), unsystematic errors such as gaps in time series (Woldesenbet et al., 2017), latency in data availability, in addition to inaccessibility of data are additional challenges that limit the use of rain gauge data in many regions of the world (Montesarchio et al., 2015; Thiemig et al., 2012). In Africa, the implementation of an adequate rain gauge network is challenging because of driver factors such as the desired accuracy and the cost of implementation, maintenance and data collection (Pardo-Igúzquiza, 1998).The recent technological development in sensors, algorithms and new satellite missions designed to measure environmental processes, have enabled the opportunity to derive gridded precipitation estimates. This has enabled the opportunity to account for the spatial distribution of precipitation (Kidd, 2001; Zambrano-Bigiarini et al., 2017), thus providing data which is otherwise often not feasible to obtain. The public-domain policy of these products has encouraged the use of their datasets for different applications such as drought assessment (Agutu et al., 2017; Gao et al., 2018; Sahoo et al., 2015; Zambrano-Bigiarini et al., 2019), flood forecasting (Tekeli et al., 2017), hydrological modeling (Kite & Pietroniro, 1996; Siddique-E-Akbor et al., 2014), water balance studies (Bastiaanssen et al., 2014; Karimi, et al., 2013), among others.A wide range of sensors, input data, and estimation algorithms are used to produce these Public-domain Precipitation Products (PPs) (Sun et al., 2018). Accuracy of the PPs estimation can be affected by climatological of catchment-specific factors such as elevation (Ayehu et al., 2018; Dinku et al., 2018; Habib et al., 2012; Hirpa et al., 2010). Hence, the accuracy of the PPs in representing the spatio-temporal precipitation patterns varies greatly depending on the region. Although some studies have reported an overall accuracy as high as 95% (Karimi & Bastiaanssen, 2015), the accuracy of these PPs might vary at different temporal scales and geographic settings (Baez-Villanueva et al., 2018).Traditionally, the PPs are evaluated by comparing their estimates with in-situ measurements, for example, (i) using a pixel-to-point analysis, where the rain gauge data are compared to the estimates of the respective grid-cells of the PPs (Bai & Liu, 2018; Burton et al., 2018; Cao et al., 2018; Gebrechorkos et al., 2018; Thiemig et al., 2012); (ii) using a pixel-to-pixel approach, which compares a gridded version of the rain gauge data with the corresponding grid-cell of the PPs product (Amitai et al., 2009; Bajracharya et al., 2015; Chen et al., 2014; Saber et al., 2016). Additionally, the evaluation of PPs could be carried out indirectly by using the PPs to force a hydrologic model and evaluate the simulated discharge with streamflow observations (Beck et al., 2017; Casse et al., 2015; Chintalapudi et al., 2014; Tramblay et al., 2016; Voisin et al., 2007). In some cases, there are no enough ground-based data to evaluate these products; and therefore, information on the performance of the different PPs can be assessed through a cross-correlation analysis (Salih et al., 2018). Such inter-comparison would provide the relative differences in precipitation between the different PPs, and might shed some light on their similarities and differences. Given the large number of data that needs to be handled in such evaluation approaches using grid-cells values, data mining techniques, such as Hierarchical Clustering Analysis (HCA) and Principal Components Analysis (PCA) can be effective in reducing effort and time needed to assess these big data (Lever et al., 2017; Zhang et al., 2017).Since all PPs have advantages, limitations, and uncertainties, merging different PPs may provide a better estimation for precipitation (Baez-Villanueva et al., 2020; Bastiaanssen et al., 2014; Peña-Arancibia et al., 2013; Xie et al., 2003). However, most of the available ensemble algorithms are complex to implement, and their performance normally improves when increasing the number of rain gauges (Baez-Villanueva et al., 2020). Therefore, merging products over extremely data-scarce regions such as the Nile Basin remains a challenge. To this end, simple merging methods, like the one followed in the current research, would benefit massively from the comprehensive assessment that couples traditional evaluation methods with data mining techniques suggested herein.Many previous studies have been conducted to evaluate the performance of PPs over the Blue Nile Basin (BNB) (e.g. Abera et al., 2016; Mekonnen and Disse, 2018; Romilly and Gebremichael, 2011). For a summarized review of some of these studies, the reader is referred to the supplementary material (Table S1). These studies have focused only on the upstream part (UBNB) of the basin, with few exceptions that targeted the lower BNB (LBNB) (e.g. Basheer et al., 2018), and only a limited number of PPs were evaluated. These studies have evaluated the PPs products performance through a direct comparison with rain gauge data to assess their ability to represent the precipitation patterns (Thiemig et al., 2012). This approach is limited over data-scarce regions because there is no enough data to implement an informative evaluation (Bastiaanssen et al., 2014). It is worth to mention here that the number of rain gauges in operation over the BNB is decreasing (see the supplementary material: Text S1; Figures 1 and 2).Therefore, the objectives of the current research are: (i) to detect the similarities and differences between 17 PPs over the BNB at monthly and annual temporal scales using mean annual precipitation values through a pixel-to-pixel inter-comparison and data mining techniques, and to cluster them into groups based on their similarities; (ii) to evaluate the performance of these PPs over the BNB using rain gauge data; and (iii) to evaluate the applicability of this integrated analysis of PPs in guiding simple merging procedures of PPs. The merging exercise aims at creating Merged Precipitation Products (MPPs) to improve the precipitation estimation, as a potential solution to improve precipitation estimation of PPs over data-scarce regions. The present analysis aims to advance the current understanding of the performance of PPs over the BNB, as an example of data-scare regions. To the best of our knowledge, such a comprehensive investigation at the given scale integrating traditional evaluation approaches with data mining techniques has not been conducted so far, neither for the BNB nor any other river basins.2 Data and Materials2.1 Study areaThe BNB is a transboundary river basin shared by Ethiopia and Sudan (Fig. 1a). The basin has an area of about 307,177 km2, of which around two-thirds are located in Ethiopia (Upper BNB, UBNB) and the rest is in Sudan (Lower BNB, LBNB). Whereas the UBNB is characterized by complex topography, the LBNB is relatively flat. The BNB contributes to nearly 62% of the total streamflow of the Nile River (Amdihun et al., 2014), and is crucial for food and hydropower production (Allam & Eltahir, 2019; Elagib et al., 2019; Wheeler et al., 2016). The rainfed and irrigated agricultural schemes in the basin produce a large fraction of the annual domestic food production of Ethiopia and Sudan (Awulachew et al., 2012; Elagib et al., 2019). The BNB is the main source of water for the Gezira irrigation scheme - one of the largest irrigated schemes in the world with an area of around 0.88 million hectares (World Bank, 1990). Precipitation in the BNB is difficult to predict (Cheung et al., 2008; Meze-Hausken, 2004) and highly variable in time and space (Beyene et al., 2010; Conway, 2000). The intra-annual and inter-annual variability of precipitation has a direct impact on rainfed agriculture, and also on irrigated agriculture as a result of reduced river flows under drought conditions (Kim et al., 2008; Siam & Eltahir, 2017). The rainy season in the basin is relatively short and lasts for only five months (from June to October). The mean annual precipitation in the basin varies from ~120 mm at the outlet of the basin in Khartoum (in the LBNB) to more than 2000 mm in some parts of the UBNB (Roth et al., 2018).
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