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The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in the use of telemedicine across all medical fields but has also exposed telehealth care disparities with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the effects of telehealth on vascular visit compliance and to explore the effects of sociodemographic factors on vascular surgery outpatient telehealth usage during the COVID-19 pandemic. Consecutive patients who had undergone an outpatient vascular surgery evaluation between February 24, 2020 (the launch of our telemedicine program) and December 31, 2020, were reviewed. The baseline demographic and outcomes were obtained from the electronic medical records. Telehealth and in-person evaluations were defined according to the patient's index visit during the study period. Medical visit compliance was established on completion of the telehealth or in-person encounter. We used χ2 tests and logistic regression analyses. A total of 23,553 outpatient visits had been scheduled for 10,587 patients during the study period. Of the outpatient visits, 1559 had been scheduled telehealth encounters compared with 21,994 scheduled in-person encounters. Of the scheduled outpatient encounters, 13,900 medical visits (59.0%) had been completed: 1183 telehealth visits and 12,717 in-person visits. The mean travel distance saved for the telehealth visits was 22.1 ± 27.1 miles, and the mean travel time saved was 46.3 ± 41.47 minutes. We noted no sociodemographic differences between the patients scheduled for telehealth vs in-person visits. We found a trend toward a lower proportion of African-American patients in the telehealth group vs the in-person group (7.8% vs 10.6%; P =.116), without statistical significance. A significantly higher rate of medical visit completion was found for the telehealth group compared with the in-person group (79.5% vs 59.4%; P <.001). Among the patients scheduled for an outpatient medical visit, a scheduled telemedicine evaluation (vs in-person) was associated with 2.3 times the odds of completing the medical visit (odds ratio, 2.31; 95% confidence interval, 2.05-2.61), adjusting for age, sex, race, ethnicity, language, and the distance between the patient's home zip code and the outpatient vascular center's zip code. Selecting for scheduled telemedicine visits, African-American race was associated with a decreased odds of telemedicine usage (odds ratio, 0.73; 95% confidence interval, 0.59-0.90) after adjusting for age, sex, ethnicity, language, and visit type. Use of the vascular surgery outpatient telehealth evaluation appeared to improve medical visit completion in our region with apparent sociodemographic disparities. Further studies are needed to confirm whether telemedicine expansion has improved access to care in other geographic areas. [ABSTRACT FROM AUTHOR]

The goal of this study is to determine the maximum energy and solute particles' transportation growth in a 3D-heated region of Prandtl martial through a dynamic magnetic field. The effects of this field on the properties of solvent molecules and heat conduction are studied. A correctly stated functional method and a finite element approach are comparable to a certain type of differential equations. In order demonstrate the effects of various factors such as mass diffusion, heat generation, and thermal diffusivity on the investigation of the diffusion coefficient and thermal mass in a three-dimensional Newtonian flow, the study of viscous and heat conduction rates is presented. The results show that the comparisons of hybrid nanofluid F e 2 O 3 and A l 2 O 3 with base fluid and w.r.t Local skin friction coefficient, Nusselt number and Sherwood number. [ABSTRACT FROM AUTHOR]

The measles virus is an RNA virus belonging to the Paramyxoviridae family. It leads to an acute communicable illness that primarily involves the respiratory tract. Vaccination has significantly reduced the overall incidence and mortality worldwide; however, outbreaks still occur globally each year due to several factors. The SARS-CoV-2 pandemic has been a major hurdle since 2020. Despite the World Health Organization's goal to eradicate measles by 2023, there has been an increase in measles incidence in India, with 61,562 cases in 2022. Vaccination is a crucial preventive measure, and coverage needs to be increased through education, advocacy, and outreach to isolated communities. • Measles is an acute illness, characterized by high-grade fever, coryza, cough, conjunctivitis, and Koplik spots and measles virus is an RNA virus belonging to the Paramyxoviridae family. • Vaccination has significantly reduced the overall incidence and mortality worldwide since 1985, however, outbreaks still occur specially in developing countries each year due to several reasons. • Vaccination is a crucial preventive measure and coverage needs to be increased through education, advocacy, and outreach to isolated communities. [ABSTRACT FROM AUTHOR]

The continuous supply of reliable and affordable energy sources is crucial for driving a nation's economic activities. The phenomenon of continuous energy supply at affordable prices is called energy security. To date, more than two-thirds of the global energy demand is met by non-renewable energy derived from natural resources. The empirical connection between natural resource depletion and energy security risk remains unexplored in the prior literature. Thus, this study analyzes the empirical linkage between natural resource depletion and energy security risk by applying the CS-ARDL and PMG-ARDL models. As per our findings, natural resource depletion increases long-term energy security risks Globally and in Asia, America, Europe, and Africa. In short run, the role of natural resource depletion is mostly insignificant in energy security risk. In contrast, the GDP, financial development, trade openness, and technological development help reduce long-run energy security risk in all regions except Africa. In the short run, only GDP and trade openness help reduce energy security risks in most regions. Therefore, policymakers should focus on efficiently utilizing natural resources to mitigate energy security risks. • Research explores the link between natural resource depletion and energy security risks. • CS-ARDL and PMG-ARDL models have been used for empirical analysis. • Findings indicate that global and regional energy security risks increase due to natural resource depletion. • Policymakers should prioritize efficient natural resource use to mitigate energy security risks. [ABSTRACT FROM AUTHOR]

China is currently the largest energy-consuming nation; however, its contribution to renewable energy investment (REI) is significant and warrants examination. Many studies have analyzed how various factors may contribute to REI. However, the roles of environmental higher education (EHE), formal finance (FF), and energy security risk (ESR) in determining REI has not been sufficiently investigated. This analysis is an effort to examine the nexus between EHE, FF, ESR, and REI in China at the aggregate and disaggregate levels from 1996 to 2022. This study employed the autoregressive distributed lag (ARDL) and quantile autoregressive distributed lag (QARDL) models. The results indicate FF, EHE, and ESR effectively stimulate long-run aggregate REI. However, at the disaggregate level, FF significantly escalates investments in solar, wind, geothermal, and hydro energies. At the same time, EHE promotes investments in solar, wind, and hydro energies, and ESRs cause investments in solar and wind energies to grow. The QARDL model confirmed that FF, EHE, and ESR promote REI across most quantiles in the long run. Therefore, it is recommended that policymakers integrate these factors into REI policies. [ABSTRACT FROM AUTHOR]

Achieving equitable development that supports climate mitigation in an uncertain future remains a daunting task, particularly for post-conflict societies. In this paper, we present results from a local stakeholder participatory scenario workshop investigating emerging priorities for anticipatory action, with respect to future climate impacts, in the vulnerable conflict-affected Khyber-Pakhtunkhwa Province of Pakistan. Importantly, our findings reveal that stakeholders were less focused on addressing climate impacts, and more interested in local development initiatives to enhance tourism offerings and the regional national park network. The novelty of our work lies in the use of participatory scenarios to both initiate a process of healing and provide a forum for the co-production of future narratives focused on sustainable and inclusive development. However, this first involves mending the social fabric that ties individuals and communities together in an inclusive and informed way. As such, our work adds to the scholarship of environmental peacebuilding, creating a local context-specific knowledge base using a bottom-up approach to understand a shared future. The case study presented here highlights the perspectives of policymakers from the global south and brings local stakeholders together in a space where top-down management approaches often dominate. • Using scenarios is only one step towards providing an opportunity for healing by co-producing narratives of a local future. • Our work reflects on ways to avoid future conflict and other undesirable prospects. • Our findings highlight the need to reflect on technocratic versus political approaches to address the issue of climate change. • We add to the scholarship of environmental peacebuilding and create a localised and context-specific knowledge. • We bring stakeholders together in a space where top-down management approaches dominate in policymaking. [ABSTRACT FROM AUTHOR]

• This study examines lake Shinji, a mesohaline lake with intermittent saline water intrusion. • It employs a 3-D hydrodynamic model, EcoPARI, in hindcast mode for 2012 (Jan-Sep). • The focus was on optimizing the vertical turbulence diffusion model and identifying ideal parameters. • Differential model constants for temperature and salinity are explored, enhancing simulation results. • The tuned model successfully replicates a historical upwelling event in September, driven by strong westerly winds from a nearby typhoon. Lake Shinji is a mesohaline lake that has intermittent saline water intrusion from its east coast connection of Ohashi River. This intrusion is often in the shape of a very thin layer that moves along the Lake bottom and stayed at the center due to bowl shape bathymetry of the Lake having maximum depth at the center. To elucidate the intrusion mechanism a 3-D hydrodynamic model (EcoPARI) was employed in a hindcast mode covering the year 2012 from the beginning of January to the end of September. Initially, the core emphasis was given to the vertical turbulence diffusion model and optimum model parameters were determined to accurately simulate the hydrodynamics. It was highlighted by the numerical simulations that alteration of one model constant, which is the multiplying coefficient of Richardson number, "α", is influential instead of altering all the constants to tune the turbulence model. The possibility of using differential model constants for temperature and salinity was also tested and it helped in the improvement of simulations. Finally, the performance of the model was also assessed under extreme weather conditions and a historical upwelling event was simulated. The model was able to reproduce the intrusion in the summer months as well as the upwelling event in September due to strong westerly winds caused by a nearby passing typhoon. [ABSTRACT FROM AUTHOR]

Abdominal aortic aneurysm (AAA) repair is recommended for aneurysms greater than 5.5 cm in men and 5 cm in women. Because AAA is more common among the elderly, we sought to evaluate contemporary practices of elective AAA repair and 2-year postoperative outcomes in octogenarians. We identified octogenarians undergoing elective AAA repair in the Vascular Quality Initiative from 2012 to 2019. We included patients undergoing endovascular (EVAR) and open (OAR) aortic repair. Demographics and comorbid conditions were compared between patient groups. Frailty was calculated using previously published methods. Patients with frailty scores above the 75th percentile of the operative cohort were considered high frailty. The primary outcome was 1- and 2-year mortality. Secondary outcomes included postoperative complications. Standard statistical methods were utilized. Cox proportional hazard models were used to identify factors that affect mortality. The frequency of AAA repair in octogenarians has remained stable. Of all aortic operations, 21.4% were performed on octogenarians; 9735 (23.3% of 41,712) EVAR and 755 (10.3% of 7325) OARs. Among octogenarian patients, 42.0% of EVARs were under size thresholds: 48.3% males ≤5.5 cm diameter and 21.5% females ≤5.0 cm diameter compared with 18.8% OARs: 23.4% males and 10.7% females. Additionally, 25.6% had high frailty scores. Among octogenarians, 1- and 2-year mortality was 9.3% ± 0.3% and 14.8% ± 0.4% for EVAR and 15.2% ± 1.3% and 18.9% ± 1.5% for OAR patients, respectively (P <.01). In-hospital mortality rate was higher after OAR (0.87% EVAR vs 7.55% OAR; P <.01) and differed with frailty (EVAR, low frailty 0.2% vs high frailty 1.7%; OAR, low frailty 2.3% vs high frailty 15.6%). For EVAR, patient factors associated with mortality included heart failure (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.06-1.25; P =.001) and dialysis (HR, 1.71; 95% CI, 1.13-2.59; P =.012). For OAR, coronary artery disease (HR, 1.55; 95% CI, 0.98-2.44; P =.062) was associated with mortality. Statin use was protective of mortality for all patients (EVAR: HR, 0.68; 95% CI, 0.60-0.78; P <.01): OAR: HR, 0.58; 95% CI, 0.37-0.92; P =.020). Among octogenarians, high frailty was independently associated with 2-year mortality (EVAR: HR, 3.36; 95% CI, 2.62-4.31; P <.01 and OAR: HR, 2.35; 95% CI, 1.09-5.10; P =.030). Nationally, a large portion of elective AAA repair in octogenarians is performed below recommended size thresholds, one-quarter of whom are frail with poor long-term 2-year mortality rates. High 2-year mortality following AAA repair in this age group exceeds the published risk of rupture for 5- to 5.5-cm AAA, suggesting that increase in the size threshold of elective repair among octogenarians should be explored. [ABSTRACT FROM AUTHOR]

First-pass efficacy (FPE) is an established marker of technical and clinical efficacy among mechanical thrombectomy (MT) techniques. It is unclear what the optimal approach is in achieving FPE. We present a single-center experience comparing rates of FPE among 2 MT techniques and evaluate the potential predictors of FPE among other outcomes. A single-center retrospective analysis was carried out of patients with consecutive large-vessel occlusion strokes (LVOS) of anterior circulation from September 2015 to April 2019 who underwent MT and for whom data were available on the status of FPE. Four MT techniques were identified: ADAPT (a direct first-pass aspiration), SrADAPT (stent retriever with aspiration), SRBG (stent retriever with balloon guide catheter), and STRAP (stent retriever-aspiration and proximal flow arrest). The primary outcome was FPE and secondary outcomes included the rate of successful reperfusion. Among 226 patients with LVOS of the anterior circulation who underwent MT, data were available for 164 on FPE for the 4 MT techniques. SRBG was the most prevalent technique. No significant difference was found in rates of FPE among the 4 MT techniques (P = 0.332). No independent predictors of FPE were identified on multivariable analysis. STRAP had the highest rate of successful reperfusion compared with the other techniques (P = 0.049) and was the only independent predictor of that outcome (P = 0.027). Among patients with LVOS of the anterior circulation, the rate of FPE did not differ among the 4 MT techniques. There were no predictors of FPE among the studied variables. STRAP was the only predictor of successful reperfusion. [ABSTRACT FROM AUTHOR]

Beet armyworm, Spodoptera exigua (Hübner) is an agronomical important and most devastating polyphagous pest that damages a variety of crops around the globe including China. Quercetin is one of the abundant dietary flavonoids and the important defense allelochemicals in plants. Therefore, the changes in insect detoxification enzymes activities in response to plants allelochemicals may result increased the sensitivity to insecticides. In this study, we examined the induced effect of quercetin on larval tolerance to lambda-cyhalothrin in S. exigua. Application of cytochrome P450 inhibitor piperonyl butoxide (PBO) significantly synergized the lambda-cyhalothrin toxicity in quercetin-fed S. exigua larvae. Moreover, larval weight significantly reduced in quercetin, lambda-cyhalothrin, and quercetin + lambda-cyhalothrin treatment. Furthermore, our results showed that the P450 detoxification enzyme effectively increased in all treatments as compared to the control. Quantitative Real-time PCR analysis revealed that expression level of CYP6AE10 significantly upregulated in larvae treated with quercetin, lambda-cyhalothrin and quercetin + lambda-cyhalothrin in the midgut and fat body respectively. In addition, RNAi mediated knockdown of CYP6AE10 in S. exigua larvae significantly decreased the transcription level of target cytochrome P450 gene followed by the exposure with quercetin, lambda-cyhalothrin, and quercetin + lambda-cyhalothrin. Similarly, the knockdown of CYP6AE10 by the injection of dsRNA led to increased mortality after the treatment with respective chemicals. Overall, these data showed that P450s might possibly play an important role in the metabolic adaptation of S. exigua larvae to its host plant defense allelochemicals as well as insecticides. In conclusion, S. exigua can take benefit from its host plant's secondary metabolites to elaborate its defense against synthetic insecticides. [ABSTRACT FROM AUTHOR]

Different temperature zones have significant impact on the population dynamics of Plutella xylostella. Effective management of P. xylostella requires the knowledge of temperature tolerance by different life stages. In the current study, fitness parameters of diamondback moth were reported by using age-stage, two-sex life table traits at four constant temperatures (15, 20, 25 and 30 °C). The life cycle of P. xylostella was significantly longer at 15 °C. The 20 °C level of temperature was found optimal for fecundity, gross reproductive rate (51.74 offspring) and net reproductive rate (44.35 offspring per individual). The adult pre-oviposition period was statistically at par at all four level of temperatures. However, the survival was maximum at 20 °C as compared to other three temperature ranges. Based on the current study, it was concluded that temperature has a great role in population build-up of P. xylostella and effective management tactics should be applied to prevent significant damage to cabbage and other cruciferous crops when the temperature in the field is near 20 °C. [ABSTRACT FROM AUTHOR]

Multiple organ failure (MOF) is associated with poor outcomes and increased mortality in sepsis and trauma. There are limited data regarding MOF in patients after ruptured abdominal aortic aneurysm (rAAA) repair. We aimed to identify the contemporary prevalence and characteristics of patients with rAAA with MOF. We retrospectively reviewed patients with rAAA who underwent repair (2010-2020) at our multihospital institution. Patients who died within the first 2 days after repair were excluded. MOF was quantified by modified (excluding hepatic system) Denver, Sequential Organ Failure Assessment (SOFA) score, and Multiple Organ Dysfunction Score (MODS) for postoperative days 3 to 5 to determine the prevalence of MOF. MOF was defined as a Denver score of >3, dysfunction in two or more organ systems by SOFA score, or a MODS score of >8. Kaplan-Meier curves and log-rank testing were used to evaluate differences in 30-day mortality between multiple organ failure and patients without MOF. Logistic regression was used to assess predictors of MOF. Of 370 patients with rAAA, 288 survived past two days (mean age, 73±10.1 years; 76.7% male; 44.1% open repair), and 143 had data for MOF calculation recorded. From postoperative days 3 to 5, 41 (14.24%) had MOF by Denver, 26 (9.03%) by SOFA, and 39 (13.54%) by MODS criteria. Among these scoring systems, pulmonary and neurological systems were impacted most commonly. Among patients with MOF, pulmonary derangement occurred in 65.9% (Denver), 57.7% (SOFA), and 56.4% (MODS). Similarly, neurological derangement occurred in 92.3% (SOFA) and 89.7% (MODS), but renal derangement occurred in 26.8% (Denver), 23.1% (SOFA), and 10.3% (MODS). MOF by all three scoring systems was associated with increased 30-day mortality (Denver: 11.3% vs 41.5% [ P <.01]; DOFA: 12.6% vs 46.2% [ P <.01]; MODS: 12.5% vs 35.9% [ P <.01]), as was MOF by any criteria (10.8% vs 35.7 %; P <.01). Patients with MOF were more likely to have a higher body mass index (55.9±26.6 vs 49.0±15.0; P =.011) and to have had a preoperative stroke (17.9% vs 6.0%; P =.016). Patients with MOF were less likely to have undergone endovascular repair (30.4% vs 62.1%; P <.001). Endovascular repair was protective against MOF (any criteria) on multivariate analysis (odds ratio, 0.23; 95% confidence interval, 0.08-0.64; P =.019) after adjusting for age, gender, and presenting systolic blood pressure. MOF occurred in only 9% to 14% of patients after rAAA repair, but was associated with a three-fold increase in mortality. Endovascular repair was associated with a reduced MOF incidence. [ABSTRACT FROM AUTHOR]