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Rayleigh wave ellipticity measurements from seismic ambient noise recorded on the Greenland Ice Sheet (GrIS) show complex and anomalous behavior at wave periods sensitive to ice (T < 3–4 s). To understand these complex observations, we compare them with synthetic ellipticity measurements obtained from synthetic ambient noise computed for various seismic velocity and attenuation models, including surface wave overtone effects. We find that in dry snow conditions within the interior of the GrIS, to first order the anomalous ellipticity observations can be explained by ice models associated with the accumulation and densification of snow into firn. We also show that the distribution of ellipticity measurements is strongly sensitive to seismic attenuation and the thermal structure of the ice. Our results suggest that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Plain Language Summary: Surface meltwater is increasingly being routed and distributed through the Greenland Ice Sheet (GrIS) changing the mechanical and thermal properties of the ice and resulting in accelerated ice flow. Here we observe complex and anomalous Rayleigh wave ellipticity measurements at periods sensitive to the ice structure. We compare our observations with ellipticity measurements made on simulated seismic noise for various seismic velocity and attenuation models. We demonstrate that in the interior of the GrIS the ellipticity is sensitive to the accumulation and densification of snow as it compacts into glacier ice. The variation in the measurements is strongly sensitive to the thermal structure of the ice sheet which we estimate to be warmer than about −10°. These results demonstrate that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Key Points: Densification of snow into firn has a first order effect on ellipticity measurements at periods sensitive to the iceThe distribution of ellipticity measurements is sensitive to the thermal composition of the iceEllipticity is a promising method for long term monitoring of ice properties and thickness beneath the seismic station [ABSTRACT FROM AUTHOR]

Aim: People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC. Method: A postal survey was designed to capture respondent demographics, treatment experienced within the previous 12 months and informational preferences by rating a long list of items. It was delivered through two hospitals that provide tertiary inflammatory bowel disease services. Descriptive analyses were performed to describe demographics and experiences. Principal component analysis was carried out using a varimax rotation to investigate informational needs. Results: A total of 101 responses were returned (20.1% response rate). The median age of respondents was 45 years and the median time since diagnosis was 10 years. Control preferences skewed towards shared (42.6%) or patient‐led but clinician‐informed (35.6%). Decision regret was low for the population (median 12.5/100, range 0–100). Key informational needs related to medical therapy were benefits and risks of long‐term therapy, burden of hospital attendance, reproductive health, need for steroid treatment and impact on personal life. For surgery, these were stoma information, effect on daily life, effect on sexual and reproductive health, risks and benefits and disruption of life due to surgery. Conclusion: This study has identified key areas for discussion when counselling patients about treatment decisions around medical therapy and surgery for UC. [ABSTRACT FROM AUTHOR]

We analyze observations of a solar energetic particle (SEP) event at Rosetta's target comet 67P/Churyumov‐Gerasimenko during 6–10 March 2015. The comet was 2.15 AU from the Sun, with the Rosetta spacecraft approximately 70 km from the nucleus placing it deep inside the comet's coma and allowing us to study its response. The Eastern flank of an interplanetary coronal mass ejection (ICME) also encountered Rosetta on 6 and 7 March. Rosetta Plasma Consortium data indicate increases in ionization rates, and cometary water group pickup ions exceeding 1 keV. Increased charge exchange reactions between solar wind ions and cometary neutrals also indicate increased upstream neutral populations consistent with enhanced SEP induced surface activity. In addition, the most intense parts of the event coincide with observations interpreted as an infant cometary bow shock, indicating that the SEPs may have enhanced the formation and/or intensified the observations. These solar transient events may also have pushed the cometopause closer to the nucleus. We track and discuss characteristics of the SEP event using remote observations by SOHO, WIND, and GOES at the Sun, in situ measurements at Solar Terrestrial Relations Observatory Ahead, Mars and Rosetta, and ENLIL modeling. Based on its relatively prolonged duration, gradual and anisotropic nature, and broad angular spread in the heliosphere, we determine the main particle acceleration source to be a distant ICME which emerged from the Sun on 6 March 2015 and was detected locally in the Martian ionosphere but was never encountered by 67P directly. The ICME's shock produced SEPs for several days which traveled to the in situ observation sites via magnetic field line connections. Key Points: We track a solar energetic particle (SEP) event in situ at Solar Terrestrial Relations Observatory Ahead, Mars and Rosetta and determine the main source to be a non‐local interplanetary coronal mass ejection shock distant to 67PIncreased solar wind charge exchange at 67P may indicate an increase in upstream neutral populations and associated SEP induced sputteringThe most intense parts of the SEP event at 67P coincide with observations of an infant bow shock and may have enhanced its formation [ABSTRACT FROM AUTHOR]

Clinical pharmacists are highly trained professionals who provide comprehensive medication management across a majority of health care settings. These clinicians have numerous responsibilities, which may include teaching, administrative, and scholarly responsibilities in addition to patient care activities. Many clinical pharmacists report a high degree of burnout and stress. In addition, practice models with limited options for buy‐downs or stipends (eg, for committees, projects, or residency program director roles), inability to generate revenue for services provided, public perception, and little upward mobility for career advancement have led to a perceived trend of clinical pharmacists leaving practice to pursue careers removed from patient care that favor work‐life balance. The purpose of this review is to summarize factors associated with premature attrition of clinical pharmacists, call attention to this trend, and provide suggestions for improvements. [ABSTRACT FROM AUTHOR]

The JUpiter ICy moons Explorer (JUICE) of the European Space Agency will investigate Jupiter and its icy moons Europa, Ganymede, and Callisto, with the aim to better understand the origin and evolution of our Solar System and the emergence of habitable worlds around gas giants. The Particle Environment Package (PEP) on board JUICE is designed to measure neutrals and ions and electrons at thermal, suprathermal, and radiation belt energies (eV to MeV). In the vicinity of Callisto, PEP will characterize the plasma environment, the outer parts of Callisto's atmosphere and ionosphere and their interaction with Jupiter's dynamic magnetosphere. Roughly 20 Callisto flybys with closest approaches between 200 and 5,000 km altitude are planned over the course of the JUICE mission. In this article, we review the state of the art regarding Callisto's ambient environment and magnetospheric interaction with recent modeling efforts for Callisto's atmosphere and ionosphere. Based on this review, we identify science opportunities for the PEP observations to optimize scientific insight gained from the foreseen JUICE flybys. These considerations will inform both science operation planning of PEP and JUICE and they will guide future model development for Callisto's atmosphere, ionosphere, and their interaction with the plasma environment. Key Points: Particle Environment Package (PEP) on JUpiter ICy moons Explorer (JUICE) will provide in situ and remote measurements of Callisto's atmosphere and its space environment during ∼20 flybysWe investigate operation plans and instrument capabilities to optimize science return from PEP observationsThe interactions of the atmosphere with the space environment and surface are complex and must be further analyzed in preparation for JUICE [ABSTRACT FROM AUTHOR]

The Pre‐Industrial climate model simulation is intended as an equilibrium control experiment that uses constant external forcing, yet in the Coupled Model Intercomparison Project Phase 6 (CMIP6) model HadGEM3‐GC31‐LL a distinct change in climate state occurs around year 500 of the 2000 year simulation. The global mean near surface air temperature increases by almost 0.5 K associated with a reduction in southern hemisphere sea ice area of almost 20%. Here we show this step change in the state of the climate to be a consequence of the onset of deep convection in the Weddell and Ross Sea gyres. The delayed onset of convection in the gyres is a consequence of a positive, downward, top‐of‐atmosphere radiative balance, and continual ocean heat up‐take during the model spin‐up and the initial pre‐industrial control simulation. Consequently, model spin‐up strategy should be revised to initialize pre‐industrial simulations that are in energy balance. Plain Language Summary: The Pre‐industrial control simulation of climate models is a reference for climate change simulations. Consequently it should simulate a stable climate. However, if the model is not in radiative equilibrium, the ocean continually accumulates heat, becoming unstable at high latitudes and generating large climate fluctuations. This results in a control simulation that is not a steady state. Consequently the methodologies used to initialize and formulate climate models should be revised to ensure a steady state is achieved. Key Points: The long timescales associated with deep ocean heat uptake suggests simulations may not be equilibriated before forcing is perturbedSouthern Ocean venting of heat reduces sea ice cover and increases global mean temperature, leading to a warmer climate stateNet top‐of‐atmosphere energy imbalance can have implications for the methodologies used for climate model spin‐up [ABSTRACT FROM AUTHOR]

Objectives: To explore the impact of COVID‐19 on the management and outcomes of acute paediatric mastoiditis across the UK. Design: National retrospective and prospective audit. Setting: 48 UK secondary care ENT departments. Participants: Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis. Main outcome measures: Cases were divided into Period 1 (01/11/19‐15/03/20), before the UK population were instructed to reduce social contact, and Period 2 (16/03/20‐30/04/21), following this. Periods 1 and 2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical). Results: 286 cases met criteria (median 4 per site, range 0–24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in December 2020‐Febraury 2021. Patient age differed between periods 1 and 2 (3.2 vs 4.7 years respectively, p < 0.001). 85% of children in period 2 were tested for COVID‐19 with a single positive test. In period, 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% vs 24.3%, p = 0.001). Treatment success was high, with failure of initial management in 6.3%, and 30‐day re‐admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2. Conclusion: The COVID‐19 pandemic led to a significant change in the presentation and case mix of acute paediatric mastoiditis in the UK. [ABSTRACT FROM AUTHOR]

Climate change and a long legacy of fire suppression are leading to an increased prevalence of 'mega‐disturbances' such as drought and wildfire in terrestrial ecosystems. Evidence for the immediate effects of these novel disturbances on wildlife is accumulating, but little information exists on longer term impacts to species and ecosystems. We studied the occurrence dynamics of an iconic old‐forest species, the spotted owl (Strix occidentalis), on a long‐term study area in the Sierra Nevada, CA, USA from 1989 to 2020 to evaluate their multi‐scale population response following a 2014 megafire (the 'King' Fire) that affected a portion of our study area. We found that extensive severe fire within spotted owl sites resulted in both immediate site abandonment and prolonged lack of re‐colonization by owls six years post‐fire. Sites that experienced high pyrodiversity – a mosaic of burn severities – were more likely to persist after the fire, but this effect was only apparent at finer spatial scales. A potentially confounding factor, post‐fire salvage logging, did not explain variability in the probability of either owls persisting at sites or sites becoming re‐colonized; effects could be attributed only to severe fire extent and pyrodiversity. Our study demonstrates the prolonged effects of severe fire on the occupancy of this forest‐dependent species, suggesting that forest restoration that reduces megafires could benefit spotted owls. Our work emphasizes that long‐term monitoring can offer surprising learning opportunities and provide unparalleled value for understanding and addressing emerging environmental concerns. [ABSTRACT FROM AUTHOR]

Globally, the impacts of anthropogenic climate change can displace species into more favourable climates. Semi‐arid desert specialists, such as the sandhill dunnart, Sminthopsis psammophila, are typically susceptible to rainfall deficits, wildfires and extreme temperatures caused by anthropogenic climate change. We first used maximum entropy (MaxEnt) species distribution models (SDMs) to predict the current distribution of S. psammophila. Between 2016 and 2018, we ground validated the model's predictions throughout Western Australia, confirming S. psammophila in 18 locations in which it was predicted to occur. The predicted distribution of S. psammophila appears mostly constrained to within its known range. However, S. psammophila was verified 150 km north of its range in Western Australia and connectivity between the South Australian populations was correctly predicted. In 2019, we used updated occurrence data to project SDMs for S. psammophila during the mid‐Holocene, present day and under two future representative concentration pathways (RCPs) of RCP 4.5 (an optimistic emissions scenario) and RCP 8.5 ("business as usual") for 2050 and 2070. By 2050 (RCP 8.5), almost all Western Australian Great Victoria Desert (WAGVD) habitat is predicted to be unsuitable for S. psammophila. By 2070 (RCP 8.5), the climates of the WAGVD and Yellabinna Regional Reserve populations are predicted to become unsuitable, and the species' geographical range is predicted to contract in Australia by 80%. However, the 2070 (RCP 4.5) scenario predicts that this contraction could be halved. As a sandy desert specialist, the distribution of S. psammophila is geographically limited at its southern bounds due to the cessation of suitable spinifex (Triodia spp.) habitats, and so further extension of the range southwards is not possible. Sympatric desert species may be similarly affected, and we suggest that SDMs will be a useful tool in helping to predict the effects of climate change on their distributions. [ABSTRACT FROM AUTHOR]

OPTIMISING HOLISTIC CARE OF WOMEN AT RISK OF OR LIVING WITH BIA-ALCL: A SURVEY OF UK HEALTH CARE PROFESSIONALS B Introduction: b Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was classified by the World Health Organisation in 2016. Breast surgeons made up the largest proportion of respondents (36%, 28/78) with over half of respondents having cared for a patient with BIA-ALCL (58% 42/78). [Extracted from the article]

Objective: Analyse uptake of the core outcome set (COS) within preterm birth (PTB) clinical trials., Design: On 26 June 2023, we conducted a systematic search of phase III/IV trial registry entries regarding PTB interventions via ClinicalTrials.gov and the International Clinical Trial Registry Platform. These trials were analysed for the outcomes measured., Setting: N/A., Sample: After searching the two databases, 5257 randomised controlled trials (RCTs) were screened, resulting in 92 RCTs for analysis., Methods: Inclusion criteria were the following: subjects were patients receiving an intervention for PTB, study enrolment began within 5 years prior to publication of PTB COS to 26 June 2023, and evaluated the efficacy of interventions. Authors screened and extracted data in masked, duplicate fashion, then performed an interrupted time series analysis, analysis of variance and correlation analysis., Main Outcome Measures: We extracted outcomes measured by each clinical trial in our sample. Trials were analysed for the percentage of adopted outcomes from PTB COS., Results: After COS publication, there was no significant change in percentage of COS outcomes measured. The most measured outcome was 'offspring mortality' (54.34%, 50/92) and the least measured outcome was 'late neonatal neurodevelopment morbidity' (3.26%, 3/92). Additionally, 22.83% (21/92) of trials measured zero outcomes related to the PTB COS., Conclusion: Our results demonstrated no significant change in outcome measurement before or after PTB COS publication. We recommend focusing on both the measurement of outcomes and the assessments that are used., (© 2023 John Wiley & Sons Ltd.)

Aim: Young people with common mood disorders face the prospect of shortened life expectancy largely due to premature cardiovascular disease. Metabolic dysfunction is a risk factor for premature cardiovascular disease. There is an ongoing debate whether metabolic dysfunction can be simply explained by weight gain secondary to psychotropic medications or whether shared genetic vulnerability, intrinsic immune-metabolic disturbances or other system perturbations (e.g. dysregulated sympathetic nervous system, circadian dysfunction) are more relevant determinants of premature cardiovascular disease. Thus, we aimed to investigate underlying drivers of metabolic dysfunction and premature cardiovascular disease in young people in the early phases of common mood disorders., Methods: We evaluated the relationships between insulin resistance (assessed by HOMA2-IR) and body mass index (BMI), sex, diagnosis, medication, inflammatory markers and hormonal factors in 327 inpatients with emerging affective and major mood disorders admitted to the Young Adult Mental Health Unit, St Vincent's Private Hospital, Sydney., Results: While HOMA2-IR scores were positively associated with BMI (r s  = 0.465, p < .001), they were also higher in those prescribed mood stabilizers (p = .044) but were not associated with specific diagnoses, other medication types or the number of prescribed medications. Further, high-sensitivity C-reactive protein levels (but not thyroid-stimulating hormone and ferritin levels) were positively associated with HOMA2-IR (r s  = 0. 272, p < .001) and BMI (r s  = . 409, p < .001)., Conclusions: In addition to BMI, other non-specific markers of inflammation are associated with early metabolic dysfunction in young people with emerging affective and major mood disorders., (© 2021 John Wiley & Sons Australia, Ltd.)

Induction therapy for acute myeloid leukaemia (AML) has changed with the approval of a number of new agents. Clinical guidelines can struggle to keep pace with an evolving treatment and evidence landscape and therefore identifying the most appropriate front-line treatment is challenging for clinicians. Here, we combined drug eligibility criteria and genetic risk stratification into a digital format, allowing the full range of possible treatment eligibility scenarios to be defined. Using exemplar cases representing each of the 22 identified scenarios, we sought to generate consensus on treatment choice from a panel of nine aUK AML experts. We then analysed >2500 real-world cases using the same algorithm, confirming the existence of 21/22 of these scenarios and demonstrating that our novel approach could generate a consensus AML induction treatment in 98% of cases. Our approach, driven by the use of decision trees, is an efficient way to develop consensus guidance rapidly and could be applied to other disease areas. It has the potential to be updated frequently to capture changes in eligibility criteria, novel therapies and emerging trial data. An interactive digital version of the consensus guideline is available., (© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)