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Attention‐deficit/hyperactivity disorder (ADHD) and anxiety frequently occur together; however, the cognitive outcomes of comorbid anxiety and ADHD are not straightforward. A potential explanation for conflicting results in the literature may be that different core ADHD symptoms show different interactions with anxiety depending on the task‐processing demands. To address this question, we investigated whether different ADHD traits are related to different inhibitory outcomes, contingent upon the level of trait anxiety. The sample consists of 60 non‐clinical university students (X¯$$ \overline{X} $$age = 20.5, 53% male). Conners' Adult ADHD Rating Scale and State Trait Anxiety Inventory were used to measure ADHD traits and anxiety, respectively. The participants completed a visual Go/NoGo task with and without distractor conditions while continuous EEG was recorded. Inhibitory control was operationalized as the frontocentral N2 maximum peak amplitude elicited in response inhibition (NoGo/No Distractor), cognitive inhibition (Go/Distractor), dual inhibition (NoGo/Distractor), and control (Go/No Distractor) conditions. We analyzed the moderating effect of trait anxiety on the prediction of inhibitory control by ADHD scores for each Go/NoGo condition with the varying inhibition demands. Results showed that trait anxiety moderated the effects of total ADHD and hyperactivity‐impulsivity scores, but only in the response inhibition condition (NoGo/No Distractor). These findings suggest that depending on the inhibitory demands of the task, unique cognitive outcomes may occur when different ADHD traits coexist with anxiety. [ABSTRACT FROM AUTHOR]

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Objectives: Attention‐deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental condition and is characterized by inattention, hyperactivity, and impulsivity. Research suggests that some populations, such as females and individuals with high intelligence quotients may be a risk for late ADHD diagnosis and subsequent treatment. Our goal is to advance our understanding of ADHD diagnosis, by examining (1) how child sex and cognitive abilities together are related to the age of diagnosis and (2) whether symptom presentation, current internalizing and externalizing symptoms, and demographic factors are related to age of diagnosis. Methods: Our analyses contained children who completed the required tests (N = 568) from a pre‐existing dataset of 1380 children with ADHD from the Province of Ontario Neurodevelopmental Disorders (POND) Network (pond‐network.ca). First, we conducted a moderation analysis with sex as the predictor, cognitive abilities as the moderator, and age of diagnosis as the outcome. Second, we conducted correlation analyses examining how symptom presentation, current internalizing and externalizing symptoms, and demographic factors are related to age of diagnosis. Results: Higher IQ was related to a later age of diagnosis. Higher hyperactive–impulsive symptoms and externalizing symptoms were related to an earlier age of diagnosis. Internalizing symptoms were trend associated with a later age of diagnosis in girls. Higher socioeconomic status and non‐White maternal ethnicity were related to later age of diagnosis. Conclusions: IQ, sex, ADHD symptomology, internalizing symptoms, externalizing symptoms, and socio‐demographic factors affect the age of diagnosis. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression (PND) is a debilitating condition affecting maternal well‐being and child development. Allopregnanolone (ALLO) is important to perinatal neuroplasticity, however its relationship with depression severity and postpartum structural brain volume is unknown. Method: We examined perinatal temporal dynamics and bidirectional associations between ALLO and depression severity and the association between these variables and postpartum gray matter volume, using a random intercept cross‐lagged panel model. Results: We identified a unidirectional predictive relationship between PND severity and ALLO concentration, suggesting greater depression severity early in the perinatal period may contribute to subsequent changes in ALLO concentration (β = 0.26, p = 0.009), while variations in ALLO levels during the perinatal period influences the development and severity of depressive symptoms later in the postpartum period (β = 0.38, p = 0.007). Antepartum depression severity (Visit 2, β = 0.35, p = 0.004), ALLO concentration (Visit 2, β = 0.37, p = 0.001), and postpartum depression severity (Visit 3, β = 0.39, p = 0.031), each predicted the right anterior cingulate volume. Antepartum ALLO concentration (Visit 2, β = 0.29, p = 0.001) predicted left suborbital sulcus volume. Antepartum depression severity (Visit 1, β = 0.39, p = 0.006 and Visit 2, β = 0.48, p < 0.001) predicted the right straight gyrus volume. Postpartum depression severity (Visit 3, β = 0.36, p = 0.001) predicted left middle‐posterior cingulate volume. Conclusion: These results provide the first evidence of bidirectional associations between perinatal ALLO and depression severity with postpartum gray matter volume. [ABSTRACT FROM AUTHOR]

We study radio emissions from positive streamers in air using 3D simulations, from which the radiated electric field is computed by solving Jefimenko's equations. The simulations are performed at 0.5bar $0.5\,\mathrm{b}\mathrm{a}\mathrm{r}$ using two photoionization methods: the Helmholtz approximation for a photon density and a Monte Carlo method using discrete photons, with the latter being the most realistic. We consider cases with single streamers, streamer branching, streamers interacting with preionization and streamer‐streamer encounters. We do not observe a strong VHF radio signal during or after branching, which is confirmed by lab experiments. This indicates that the current inside a streamer discharge evolves approximately continuously during branching. On the other hand, stochastic fluctuations in streamer propagation due to Monte Carlo photoionization lead to more radio emission being emitted at frequencies of 100 MHz and above. Another process that leads to such high‐frequency emission is the interaction of a streamer with a weakly preionized region, which can be present due to a previous discharge. In agreement with previous work, we observe the strongest and highest‐frequency emission from streamer encounters. The amount of total energy that is radiated seems to depend primarily on the background electric field, and less on the particular streamer evolution. Finally, we present approximations for the maximal current along a streamer channel and a fit formula for a streamer's current moment. Plain Language Summary: The lightning channels in a thunderstorm are preceded by smaller discharges, so‐called streamers, which propagate at velocities of hundreds to thousands of kilometers per second. We cannot see these streamers from the ground, but we can detect their radio emission. However, it is currently not fully clear what the main mechanisms are by which streamers produce radio emission. In this paper we therefore perform 3D computer simulations of streamers under different conditions, from which we compute the resulting radio emissions. We find that streamer branching (the splitting of a streamer channel in two new ones) does not lead to a significant radio signal, which we furthermore have confirmed with lab experiments. We also show that small fluctuations in a streamer's propagation, which should also occur naturally, lead to radio emission at higher frequencies than in the absence of such fluctuations. Several other cases are also investigated, such as a "collision" between two streamers and streamers in different background electric fields. Key Points: Streamer branching does not lead to significant radio emission in our simulations and lab experimentsStochastic fluctuations during streamer propagation increase radio emission at frequencies of 100 MHz and aboveWhen streamers encounter an already partially ionized region, their properties rapidly change leading to emissions up to several 100 MHz [ABSTRACT FROM AUTHOR]

With increasing interest in computer‐assisted educa‐ tion, AI‐integrated systems become highly applicable with their ability to adapt based on user interactions. In this context, this paper focuses on understanding and analysing first‐year undergraduate student responses to an intelligent educational system that applies multi‐agent reinforcement learning as an AI tutor. With human–computer interaction at the centre, we discuss principles of interface design and educational gamification in the context of multiple years of student observations, student feedback surveys and focus group interviews. We show positive feedback from the design methodology we discuss as well as the overall process of providing automated tutoring in a gamified virtual environment. We also discuss students' thinking in the context of gamified educational systems, as well as unexpected issues that may arise when implementing such systems. Ultimately, our design iterations and analysis both offer new insights for practical implementation of computer‐assisted educational systems, focusing on how AI can augment, rather than replace, human intelligence in the classroom. Practitioner notes What is already known about this topic AI‐integrated systems show promise for personalizing learning and improving student education. Existing research has shown the value of personalized learner feedback. Engaged students learn more effectively. What this paper adds Student opinions of and responses to an HCI‐based personalized educational system. New insights for practical implementation of AI‐integrated educational systems informed by years of student observations and system improvements. Qualitative insights into system design to improve human–computer interaction in educational systems. Implications for practice and/or policy Actionable design principles for computer‐assisted tutoring systems derived from first‐hand student feedback and observations. Encourage new directions for human–computer interaction in educational systems. What is already known about this topic AI‐integrated systems show promise for personalizing learning and improving student education. Existing research has shown the value of personalized learner feedback. Engaged students learn more effectively. What this paper adds Student opinions of and responses to an HCI‐based personalized educational system. New insights for practical implementation of AI‐integrated educational systems informed by years of student observations and system improvements. Qualitative insights into system design to improve human–computer interaction in educational systems. Implications for practice and/or policy Actionable design principles for computer‐assisted tutoring systems derived from first‐hand student feedback and observations. Encourage new directions for human–computer interaction in educational systems. [ABSTRACT FROM AUTHOR]

Objective: Examine the nature of domestic and family violence (DFV) presentations to an ED in the Northern Territory and identify potential gaps in service delivery. Methods: Prospective descriptive study of DFV presentations in November 2021. Results: A total of 70 presentations were identified, representing 1.2% of all presentations aged 16 years and older. Disproportionately impacted were First Nations people (90%), women (77.1%) and those aged less than 40 years (67.1%). Most (81.4%) arrived outside of business hours and only 37.1% were assessed by the social worker. Case complexity was increased by high rates of homelessness (30%), concurrent alcohol consumption (44.3%) and pregnancy (11.1% of females). More than a third (37.1%) had attended on one to four occasions in the previous 6 months with a DFV‐related injury. Compared to non‐DFV attendances, the median ED length of stay was approximately twice as long (456 vs 210 min), admissions rates to the ED short stay unit five times higher (25.7% vs 5.7%; P < 0.01, odds ratio [OR] = 5.7 and 95% confidence interval [CI] = 3.3–9.8) and rates of self‐discharge prior to completion of care 9 times higher (12.9% vs 1.5%; P < 0.01, OR = 9.5 and 95% CI = 4.6–19.7). Conclusion: The data highlights the need for a 24 h trauma‐informed, culturally safe and integrated service to support people experiencing DFV. This could be achieved by a specialist unit designed and staffed by First Nations health practitioners. [ABSTRACT FROM AUTHOR]

Leaf litter dominates particulate organic carbon inputs to forest streams. Using data‐informed simulations, we explored how litter type (slow‐ vs. fast‐decomposing species), pulsed autumn litter inputs, groundwater‐mediated temperature regimes, and climate warming affect litter breakdown in a 3rd‐order stream network. We found that the time‐dependent interactions of these variables govern network‐scale litter breakdown phenology, with greater thermal sensitivity of slow‐decomposing litter for both current and future scenarios. Groundwater thermal inputs modified litter breakdown phenology by reducing spring and summer and elevating winter litter breakdown fluxes. Under future warming scenarios, the source depth of contributing groundwater influenced summer detrital resources; shallow groundwater‐fed streams had reduced summer resources compared to deep groundwater‐fed streams. Our results demonstrate that predicting in‐stream carbon cycling requires explicit consideration of the phenology of resource inputs and the seasonal timing of environmental factors, notably stream thermal regimes. [ABSTRACT FROM AUTHOR]

In the 1H‐NMR spectra of a series of N‐1 substituted 4‐substituted‐1H‐1,2,3‐triazoles that have been prepared, the lone heterocyclic ring hydrogen (H‐5) appears as a singlet in all cases except those compounds that contain a 2‐fluorophenyl moiety at Position 4. In those cases, H‐5 is a doublet with J ~3.7 Hz. Based on computational chemistry results and geometric considerations, we attribute this splitting to through‐space H‐F coupling. [ABSTRACT FROM AUTHOR]

Public policy addressing biodiversity loss is most likely to be effective when it is informed by appropriate evidence and considers potential unintended consequences. We evaluate key evidence relating to the Hunting Trophies (Import Prohibition) Bill that was discussed in the UK Parliament between 2022 and 2024. We characterize the UK's role in international hunting trophy trade by analyzing CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) trade data for 2000–2021 and 2015–2021. For CITES‐listed species imported to/exported from the UK as hunting trophies in these periods we use data from the International Union for Conservation of Nature (IUCN) Red List of Threatened Species to determine whether hunting designated as "trophy hunting" is (i) likely a major threat contributing to species being of elevated conservation concern, (ii) likely or possibly causing localized declines, or (iii) not a threat. We then use the Red List to determine whether such hunting provides, or potentially provides, benefits for species and/or people. Finally, we evaluate the UK Government's impact assessment of the bill. In 2000–2021 an estimated 3494 hunting trophies from 73 CITES‐listed species and subspecies were exported to the UK involving an estimated 2549 whole organism equivalents (WOEs), that is, individual animals. Imports involved 158.86 ± 66.53 (mean ± SD) trophies/year (115.83 ± 32.27 WOEs/year). In 2015–2021, 79% of imports were from countries where populations of the hunted species are stable, increasing, or abundant. Legal hunting for trophies is not a major threat to any of the species or subspecies imported to the UK, but likely or possibly represents a local threat to some populations of eight species. This hunting does, or could potentially, benefit 20 species and subspecies, and people. Among other concerns, the impact assessment failed to adequately consider the costs and benefits to local communities in countries where such hunting occurs. Informed by these analyses we discuss alternative regulatory options. [ABSTRACT FROM AUTHOR]

Diffuse large B‐cell Lymphoma (DLBCL) is an aggressive subtype of non‐Hodgkin lymphoma (NHL). The disease generally occurs in older patients. Although at a lower prevalence, the disease also occurs in the adolescent and young adult group (AYA). There is paucity of data in the literature on racial and ethnic disparities in the incidence and survival outcomes of DLBCL in the AYA group. The objective of our study is to demonstrate the disparities in these outcomes. Utilizing SEER, we obtained data on patient demographics, incidence, and survival from 2000 to 2020. We observed statistically significant reduced incidence of DLBCL in all racial groups, except the non‐Hispanic Asian and Pacific Islander group (NHAPI). The non‐Hispanic Black group (NHB) had one of the lowest survival despite showing the largest decrease in incidence in DLBCL. The differences in the survival could be secondary to socioeconomic factors, however other reasons need to be explored. The increased incidence among the NHAPI group mirrors that of large population‐based studies in East Asian countries, however, underlying reasons have not been elucidated. [ABSTRACT FROM AUTHOR]

Aims: Electronic health records (EHR) linked to Digital Imaging and Communications in Medicine (DICOM), biological specimens, and deep learning (DL) algorithms could potentially improve patient care through automated case detection and surveillance. We hypothesized that by applying keyword searches to routinely stored EHR, in conjunction with AI‐powered automated reading of DICOM echocardiography images and analysing biomarkers from routinely stored plasma samples, we were able to identify heart failure (HF) patients. Methods and results: We used EHR data between 1993 and 2021 from Tayside and Fife (~20% of the Scottish population). We implemented a keyword search strategy complemented by filtering based on International Classification of Diseases (ICD) codes and prescription data to EHR data set. We then applied DL for the automated interpretation of echocardiographic DICOM images. These methods were then integrated with the analysis of routinely stored plasma samples to identify and categorize patients into HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and controls without HF. The final diagnosis was verified through a manual review of medical records, measured natriuretic peptides in stored blood samples, and by comparing clinical outcomes among groups. In our study, we selected the patient cohort through an algorithmic workflow. This process started with 60 850 EHR data and resulted in a final cohort of 578 patients, divided into 186 controls, 236 with HFpEF, and 156 with HFrEF, after excluding individuals with mismatched data or significant valvular heart disease. The analysis of baseline characteristics revealed that compared with controls, patients with HFrEF and HFpEF were generally older, had higher BMI, and showed a greater prevalence of co‐morbidities such as diabetes, COPD, and CKD. Echocardiographic analysis, enhanced by DL, provided high coverage, and detailed insights into cardiac function, showing significant differences in parameters such as left ventricular diameter, ejection fraction, and myocardial strain among the groups. Clinical outcomes highlighted a higher risk of hospitalization and mortality for HF patients compared with controls, with particularly elevated risk ratios for both HFrEF and HFpEF groups. The concordance between the algorithmic selection of patients and manual validation demonstrated high accuracy, supporting the effectiveness of our approach in identifying and classifying HF subtypes, which could significantly impact future HF diagnosis and management strategies. Conclusions: Our study highlights the feasibility of combining keyword searches in EHR, DL automated echocardiographic interpretation, and biobank resources to identify HF subtypes. [ABSTRACT FROM AUTHOR]

Summary: Background: In the UK, approximately 70% of surgical procedures are undertaken as day‐cases. Little information exists about recovery from day‐case surgery, yet international data highlights patients are at risk of developing significant longer‐term health problems including chronic post‐surgical pain and persistent postoperative opioid use. The Patient‐reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short‐ and longer‐term patient‐reported outcomes, postoperative pain and pain relief after day‐case surgery. Methods: This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day‐case surgical patients were recruited on the day of surgery. Baseline data including patient characteristics; procedure details; pre‐operative analgesic use; pre‐existing pain; and quality of life scores were recorded. Patients were followed up through automated short message service messages. Short‐term (postoperative days 1, 3 and 7) outcomes included: quality of recovery; pain severity; impact of pain on function; and analgesic use. Longer‐term outcomes (postoperative day 97) included: quality of life; analgesic use; incidence of chronic post‐surgical pain; and incidence persistent postoperative opioid use. Additional outcomes were completed by those patients with chronic post‐surgical pain and persistent postoperative opioid use, with 30 patients recruited to a qualitative semi‐structured interview study exploring postoperative expectations, recovery, postoperative pain and opioid use. Results: An embedded pilot study at four sites recruited 129 patients. Responses to the automated short message service were gained from 129 patients (100%) at day 1; 116 (89.9%) at day 3; 108 (83.7%) at day 7; and 77 (59.7%) at day 97 postoperatively. The pilot enabled refinement of the methods and processes before the national roll out. Conclusion: This paper outlines the methods for the POPPY study, the largest UK multicentre prospective observational study considering short‐ and longer‐term outcomes following day‐case surgery. [ABSTRACT FROM AUTHOR]

A 3‐year‐old male neutered domestic shorthair cat presented with lethargy, hyporexia, and pyrexia of unknown origin. Biochemical analysis using a Beckman Coulter AU480 demonstrated marked increases in creatine kinase and aspartate aminotransferase, indicative of severe muscle injury, with concurrent presumptive myoglobinuria on urinalysis. A marked, non‐physiologic increase in measured bicarbonate and resultant negative anion gap was documented; however, calculated bicarbonate obtained via a point‐of‐care blood gas analyzer was within normal limits. Laboratory error due to interference by lactate dehydrogenase was suspected and supported by the results of subsequent biochemical testing. Artifactual increases in bicarbonate have been documented in cases of rhabdomyolysis in horses, cows, and a bird. However, to the best of the authors' knowledge, this is the first report to demonstrate this spurious change in a cat. [ABSTRACT FROM AUTHOR]

Hydration of the stratosphere by tropopause‐overshooting convection has received increasing interest due to the extreme concentrations of water vapor that can result and, ultimately, the climate warming potential such hydration provides. Previous work has recognized the importance of numerous dynamic and physical processes that control stratospheric water vapor delivery by convection. This study leverages recent comprehensive observations from the NASA Dynamics and Chemistry of the Summer Stratosphere (DCOTSS) field campaign to determine the frequency at which each process operates during real events. Specifically, a well‐established analysis technique known as tracer‐tracer correlation is applied to DCOTSS observations of ozone, water vapor, and potential temperature to identify the occurrence of known processes. It is found that approximately half of convectively‐driven stratospheric hydration samples show no indication of significant air mass transport and mixing, emphasizing the importance of ice sublimation to stratospheric water vapor delivery. Furthermore, the temperature of the upper troposphere and lower stratosphere environment and/or overshoot appears to be a commonly active constraint, since the approximate maximum possible water vapor concentration that can be reached in an air mass is limited to the saturation mixing ratio when ice is present. Finally, little evidence of relationships between dynamic and physical processes and their spatial distribution was found, implying that stratospheric water vapor delivery by convection is likely facilitated by a complex collection of processes in each overshooting event. Plain Language Summary: Thunderstorms are capable of transporting air and water up to the second layer of Earth's atmosphere, the stratosphere. Resulting irreversible modifications to greenhouse gases that regulate climate, such as water vapor and ozone, are important to quantify and poorly understood. This study uses recently‐obtained aircraft observations to improve understanding of irreversible transport in thunderstorms and the environmental and storm factors that control it. By examining how multiple trace gases and other quantities co‐vary, it is found that half of observed stratospheric changes by thunderstorms only exhibit increases in water vapor, which is argued to be driven by transported ice. It is also found that the environmental temperature is an important constraint in any storm because it limits the amount of stratospheric water vapor change that can occur. Key Points: Recent airborne observations reveal key dynamic and physical processes controlling the stratospheric delivery of water vapor by convectionIn situ observations suggest that water vapor is delivered routinely via both air transport and ice sublimationTemperature is an important constraint for water vapor delivery in any stratospheric environment [ABSTRACT FROM AUTHOR]

ABSTRACT Mixture experimentation is commonly seen in pharmaceutical formulation studies, where the relative proportions of the individual components are modeled for effects on product attributes. The requirement that the sum of the component proportions equals 1 has given rise to the class of designs, known as mixture designs. The first mixture designs were published by Quenouille in 1953 but it took nearly 40 years for the earliest mixture design applications to be published in the pharmaceutical sciences literature by Kettaneh‐Wold in 1991 and Waaler in 1992. Since then, the advent of efficient computer algorithms to generate designs has made this class of designs easily accessible to pharmaceutical statisticians, although the use of these designs appears to be an underutilized experimental strategy even today. One goal of this tutorial is to draw the attention of experimental statisticians to this class of designs and their advantages in pursuing formulation studies such as excipient compatibility studies. We present sufficient materials to introduce the novice practitioner to this class of design, associated models, and analysis strategies. An example of a mixture‐process variable design is given as a case study. [ABSTRACT FROM AUTHOR]

Background: Given the growing reliance on digital devices, an increasing number of studies have examined the effects of text medium on reading outcomes in development; however, the results have been mixed. The goal of this systematic review is to look at how print and digital formats affect reading comprehension, engagement and other reading outcomes (e.g. vocabulary, reading speed) in children and adolescents aged 1–17 years old while also considering the influence of several participant, task and study characteristics. Methods: A comprehensive search strategy involving seven electronic databases yielded 88 eligible articles comparing digital and print formats on reading outcomes published between 2000 and 2023 (3 reviewer inter‐rater reliability: k =.54–.78). Three major characteristics were coded: participant‐level (grade/age, diverse populations, testing language); task‐level (text‐genre, shared reading, digital comparability); study‐level (publication recency, study quality) characteristics. Contingency tables were created for all studies, then for each reading outcome and for participant, task, and study characteristics separately to classify the percentage of studies that demonstrated outcomes favouring print, digital, no difference or reliance on specific reading measures or other factors. Results: Except in the case of engagement as an outcome, the most common finding was no difference between digital and print. When participant, task and study characteristics were examined separately for the various reading outcomes, the results varied. More studies examining reading comprehension (particularly of informational text and in older children) found 'print is better', whereas 'digital is better' was more common in studies examining engagement, other outcomes such as vocabulary and diverse learners. Conclusions: This review highlights the importance of examining multiple interacting factors when studying the impact of print versus digital mediums on reading outcomes in children and adolescents. Highlights: What is already known about this topicReading on digital devices is becoming increasingly common.Reading comprehension in adult typical populations tends to be poorer when reading on digital versus printed mediums. This is known as the 'screen inferiority effect'.Yet, digital platforms are often used to enhance learning and reading outcomes for children with learning differences and for multilingual learners. What this paper addsAcross a range of children's reading outcomes, ages, languages and text characteristics, most studies find no difference between print and digital mediums.Weak evidence for the screen inferiority effect found for reading comprehension in typical populations, older children and while reading informational text.Larger benefit of digital found for engagement and other reading outcomes (e.g. vocabulary), particularly in younger children, those with learning differences and when digital platform is enhanced (e.g. with animations). Implication for theory, policy or practiceEducators should know that older children's reading comprehension of informational text is often higher with print.Young children's engagement tends to be higher with enhanced digital media, and digital text may help even the playing field for diverse populations of children (e.g. with learning differences and multilingual learners).With a growing reliance on digital media, it is critical to further explore conditions under which digital media can support reading and engagement across different reader groups. [ABSTRACT FROM AUTHOR]

In this paper, we introduce two novel wavelet approximations tailored for functions g$$ g $$ exhibiting a restricted second derivative and a bounded Tth$$ {T}&#x0005E;{th} $$ derivative. Employing the Hermite wavelet method, we derive these approximations to address the need for effective representations of such functions. Our findings reveal that these new wavelet approximations offer enhanced accuracy and efficiency in capturing the underlying structure of g$$ g $$, making them valuable tools in various applications requiring precise function approximations with limited derivative constraints. [ABSTRACT FROM AUTHOR]

Well‐trained, competent therapists are crucial for safe and effective psychedelic‐assisted therapy (PAT). The question whether PAT training programs should require aspiring therapists to undergo their own PAT—commonly referred to as "experiential training"—has received much attention within the field. In this article, we analyze the potential benefits of experiential training in PAT by applying the framework developed by Rolf Sandell et al. concerning the functions of any training therapy (the therapeutic, modeling, empathic, persuasive, and theoretical functions). We then explore six key domains in which risks could arise through mandatory experiential training: physical and psychological risks; negative impact on therapeutic skill; justice, equity, diversity, and inclusion; dual relationships; privacy and confidentiality; and undue pressure. Ultimately, we argue that experiential training in PAT should not be mandatory. Because many PAT training programs already incorporate experiential training methods, our exploration of potential harms and benefits may be used to generate comprehensive risk‐mitigation strategies. [ABSTRACT FROM AUTHOR]

Selective breeding for production traits has yielded relatively rapid successes with high‐fecundity aquaculture species. Discovering the genetic changes associated with selection is an important goal for understanding adaptation and can also facilitate better predictions about the likely fitness of selected strains if they escape aquaculture farms. Here, we hypothesize domestication as a genetic change induced by inadvertent selection in culture. Our premise is that standardized culture protocols generate parallel domestication effects across independent strains. Using eastern oyster as a model and a newly developed 600K SNP array, this study tested for parallel domestication effects in multiple independent selection lines compared with their progenitor wild populations. A single contrast was made between pooled selected strains (1–17 generations in culture) and all wild progenitor samples combined. Population structure analysis indicated rank order levels of differentiation as [wild − wild] < [wild − cultured] < [cultured − cultured]. A genome scan for parallel adaptation to the captive environment applied two methodologically distinct outlier tests to the wild versus selected strain contrast and identified a total of 1174 candidate SNPs. Contrasting wild versus selected strains revealed the early evolutionary consequences of domestication in terms of genomic differentiation, standing genetic diversity, effective population size, relatedness, runs of homozygosity profiles, and genome‐wide linkage disequilibrium patterns. Random Forest was used to identify 37 outlier SNPs that had the greatest discriminatory power between bulked wild and selected oysters. The outlier SNPs were in genes enriched for cytoskeletal functions, hinting at possible traits under inadvertent selection during larval culture or pediveliger setting at high density. This study documents rapid genomic changes stemming from hatchery‐based cultivation of eastern oysters, identifies candidate loci responding to domestication in parallel among independent aquaculture strains, and provides potentially useful genomic resources for monitoring interbreeding between farm and wild oysters. [ABSTRACT FROM AUTHOR]

Objectives: Right ventricular failure following implantation of a durable left ventricular assist device (LVAD) is a major driver of mortality. Reported survival following biventricular (BiVAD) or total artificial heart (TAH) implantation remains substantially inferior to LVAD alone. We report our outcomes with LVAD and BiVAD HeartMate 3 (HM3). Methods: Consecutive patients undergoing implantation of an HM3 LVAD between November 2014 and December 2021, at The Alfred, Australia were included in the study. Comparison was made between the BiVAD and LVAD alone groups. Results: A total of 86 patients, 65 patients with LVAD alone and 21 in a BiVAD configuration underwent implantation. The median age of the LVAD and BiVAD groups was 56 years (Interquartile range 46–62) and 49 years (Interquartile range 37–55), respectively. By 4 years after implantation, 54% of LVAD patients and 43% of BiVAD patients had undergone cardiac transplantation. The incidence of stroke in the entire experience was 3.5% and pump thrombosis 5% (all in the RVAD). There were 14 deaths in the LVAD group and 1 in the BiVAD group. The actuarial survival for LVAD patients at 1 year was 85% and BiVAD patients at 1 year was 95%. Conclusions: The application of HM 3 BiVAD support in selected patients appears to offer a satisfactory solution to patients requiring biventricular support. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to examine the prevalence of overweight/obesity and excessive gestational weight gain (GWG) among military beneficiaries and to assess associations of these risk factors with maternal/neonatal complications and substantial postpartum weight retention (PPWR). Methods: We obtained data for 48,391 TRICARE beneficiaries who gave birth in 2018 or 2019 in the United States. We used logistic regression and ANOVA to examine relationships among overweight/obesity, GWG, maternal/neonatal complications, and substantial PPWR. Results: Most TRICARE beneficiaries (75%) had excessive GWG, and 42% had substantial PPWR. Dependents were less likely than active‐duty women to have excessive GWG (odds ratio [OR] = 0.73, 95% CI: 0.60–0.88). Women with excessive GWG were three times more likely to have substantial PPWR (OR = 3.57, 95% CI: 3.14–4.06). Those with excessive GWG were more likely to have maternal/neonatal complications (e.g., pregnancy‐induced hypertension, cesarean delivery). Conclusions: Excessive GWG is frequent among TRICARE beneficiaries, particularly active‐duty personnel, and is strongly associated with costly maternal/neonatal complications. Substantial PPWR is also common in this population, with excessive GWG as a key risk factor. [ABSTRACT FROM AUTHOR]

More is known about how 'push factors' motivate emigration and how immigrants adapt to their new environment than about psychological factors associated with migration intentions for those experiencing adversity in their country of origin. This paper explores the association between multisystem resilience and migration intentions among youth in Honduras. In this context of high economic need and contextual violence, higher levels of resilience are associated with higher levels of migration intentions among those who have a job and thus the ability to navigate or negotiate access to resources – economic, social and psychological – that make it possible to consider migration. Among those who have not been victims of violence and consequently may not have that motivation to migrate, higher levels of resilience are associated with lower migration intentions. [ABSTRACT FROM AUTHOR]

Background and Aim: Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol‐related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation. Design: Quantitative evaluation using four time series analytic methods (stepped‐wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost–benefit analysis was carried out alongside the effectiveness analysis. Setting and Participants: The general public in Greater Manchester, UK, between 2010 and 2020. Measurements: The primary outcome of interest was alcohol‐related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti‐social behaviour incidents. Findings Triangulation of the results did not indicate any consistent effect on area‐level alcohol‐related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti‐social behaviour associated with the implementation of CICA. The primary stepped‐wedge analysis indicated an increase in alcohol‐related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval −3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%. Conclusion: There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area‐level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol‐related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow‐up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes. [ABSTRACT FROM AUTHOR]

Sulfur compounds are the most important inorganic constituents of petroleum and require to be estimated beforehand because of their corrosive nature and other processing anomalies during crude oil processing. Paraffins, naphthene, and aromatics form the bulk of crude oil. Machine learning (ML) predictions of these constituents were made by training the ML model with a diverse industrial data set of 515 oils. The XGBoost model gave an excellent R2 in the range 0.88–0.99 for the bulk compounds. R2 for sulfur was in the modest range of 0.45–0.6, which improved significantly to 0.8 for additional inputs. ML applicability was thereby found to depend on the nature of the constituent. This work furthers ML‐based predictions, with the incentive of reducing expensive spectroscopic analytical methods. [ABSTRACT FROM AUTHOR]

Advances in online geospatial technologies (GST) have expanded access to K‐12 classrooms which has implications for the support teachers require to effectively integrate GSTs to promote learning. Previous studies have shown the impact of GST‐integrated lessons on student engagement, spatial thinking skills, and/or content knowledge; however, most of these studies have been small in scope and scale and frequently focus on the affordances of the technology, without addressing the context of the implementation and student characteristics for whom GST is most impactful. We attempt to address some of these gaps. Our program scaled an effective GST‐focused professional learning and development program to a national audience through a facilitator development model. This paper explores the student characteristics and lesson factors that resulted in student interest in science and technology and careers in those fields. After teaching a Geospatial Inquiry lesson created during a teacher workshop, teachers (n = 82) submitted the lessons and surveys on the implementation of Geospatial Inquiry lessons. The implementation surveys and lessons were scored for alignment to the principles of high‐quality Geospatial Inquiry. Students (n = 1924) completed a post‐lesson retrospective survey and indicated the extent to which their perceptions and attitudes toward science and technology changed because of the lesson. Results indicate that teacher GST performance is associated with increases in student outcomes. Students with previous exposure to science activities were more likely to have increased interest and excitement in science and careers in science but decreased interest in technology careers. Students who had previous exposure to technology activities had increased interest and excitement in technology and careers in technology but decreased interest in science careers. Geospatial Inquiry lessons also had a significant impact on students who are traditionally underrepresented in STEM fields. After participating in the lessons, students who identify as female reported higher engagement and interest in science and higher interest in science careers. Students who identified as Black or Hispanic also reported higher interest and excitement in science and technology, and students who identified as Black reported marginally higher interest in science careers. [ABSTRACT FROM AUTHOR]

Background: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. Method: Parents completed questions about their child (N = 564) ages 3–17 at Wave 1, Wave 2 (4–8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. Results: SMA was significantly associated with greater sleep disturbance, β =.11, 95% CI [.01,.21] and shorter sleep duration, β = −.16 [−.25, −.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β =.14 [.04,.24], externalizing, B =.23 [.12,.33], attention, β =.24 [.15,.34], and peer problems, β =.25 [.15,.35]. Longer sleep duration was associated with more externalizing, β =.13 [.04,.21], and attention problems, β =.12 [.02,.22], and fewer peer problems, β = −.09 [−.17, −.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = −.15 [−.23, −.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. Conclusions: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use. [ABSTRACT FROM AUTHOR]

Aim: To explore and summarise published literature with regards to secondments to clinical research and to identify the gaps in research to inform further work. Design: Systematic scoping review. Method: A scoping review was undertaken in accordance with the Patterns, Advances, Gaps, Evidence and Research framework. Databases searched included CINAHL, PubMed, Medline and Embase. Inclusion/exclusion criteria were applied by two independent reviewers. Two reviewers independently retrieved full‐text studies for inclusion and applied the framework as a tool for synthesising Patterns, Advances, Gaps, Evidence and Research recommendations. Results: Six papers and one abstract published between 2003 and 2018 were included. All secondees (n = 34) were released from NHS posts, with secondments (where specified) ranging in duration from 0.25 to 2 years and for 40%–100% of their working hours. All seven papers reported benefits for personal and professional development, predominantly in the form of personal reflections. Few described involvement with research delivery teams. Conclusion: Published initiatives vary in nature and lack standardised reporting and measurement of impact. Further research is required to identify benefits at a departmental or organisational level, the facilitators for setting up secondments and the application of knowledge gained from secondment opportunities. Implications for the Profession: Undertaking a research secondment is reported to offer professional and personal benefit for clinical staff. Research secondments are one way in which a research culture can practically be embedded within clinical settings. Impact: This scoping review identified a lack of published empirical research seeking to understand research secondments as a tool to enhance research and evidence engagement. Although there is a suggestion that secondments could positively impact staff retention, there is limited evidence about the benefit for the organisation or for patient care. These findings have implications for staff, managers and their organisations. Reporting Method: The PRISMA‐ScR guidelines were used to guide reporting. No Patient or Public Contribution: This was not relevant to the research design. [ABSTRACT FROM AUTHOR]

Genome assembly can be challenging for species that are characterized by high amounts of polymorphism, heterozygosity, and large effective population sizes. High levels of heterozygosity can result in genome mis‐assemblies and a larger than expected genome size due to the haplotig versions of a single locus being assembled as separate loci. Here, we describe the first chromosome‐level genome for the eastern oyster, Crassostrea virginica. Publicly released and annotated in 2017, the assembly has a scaffold N50 of 54 mb and is over 97.3% complete based on BUSCO analysis. The genome assembly for the eastern oyster is a critical resource for foundational research into molluscan adaptation to a changing environment and for selective breeding for the aquaculture industry. Subsequent resequencing data suggested the presence of haplotigs in the original assembly, and we developed a post hoc method to break up chimeric contigs and mask haplotigs in published heterozygous genomes and evaluated improvements to the accuracy of downstream analysis. Masking haplotigs had a large impact on SNP discovery and estimates of nucleotide diversity and had more subtle and nuanced effects on estimates of heterozygosity, population structure analysis, and outlier detection. We show that haplotig masking can be a powerful tool for improving genomic inference, and we present an open, reproducible resource for the masking of haplotigs in any published genome. [ABSTRACT FROM AUTHOR]

Aims: This study evaluates patient‐centered outcomes in patients undergoing full‐arch rehabilitation, with immediate loading of implants. Using the Oral Health Impact Profile questionnaire pre‐and post‐treatment, it assesses the hypothesis that immediate full arch loading significantly improves quality of life. Methodology: A dataset was defined as: 20 consecutive patients from a research database who had undergone IFAL surgery (maxilla, mandible, or both) and definitive restoration by a single clinician, and completed the OHIP‐14 questionnaire prior to treatment and after restoration. Results: Pre (T0) and post (T1) treatment questionnaires were analyzed from 20 consecutive patients in whom a total of 160 implants were placed. The mean T0 score was 26.7, and mean T1 score 4.6. Differences were statistically significant (p = 0.00008). Greatest improvements were seen in psychological discomfort and disability, and pain. Worsening quality of life was shown by questions relating to speech in six patients and taste in three patients. Conclusion: This study demonstrates that overall IFAL significantly improves tooth‐related quality of life. It suggests reasons for patients to seek treatment while providing evidence to manage expectations, such as possible implications on speech, thus supporting informed consent of future patients in a primary care setting. [ABSTRACT FROM AUTHOR]

A well‐designed crop rotation can create an unstable environment that disrupts weed population growth rates. In combination with effective herbicide programs, growers may maintain weed populations at levels below competitive and economic thresholds. The objectives of the present study were to evaluate how the preceding rotational crop determines the response of weed populations to in‐season postemergence herbicide programs and the weed population density of the following crop season. The first‐year crop treatments were corn (Zea mays L.), cotton (Gossypium hirsutum L.), peanut (Arachis hypogaea L.), grain sorghum [Sorghum bicolor (L.) Moench.], and soybean [Glycine max (L.) Merr.]. In the second year, all plots were planted with cotton, and herbicide treatments were single applications 2 or 6 weeks after planting (WAP), two sequential applications 2 and 4 or 4 and 6 WAP, three sequential applications 2, 4, and 6 WAP, and a weedy control without herbicides was included. In the absence of herbicides, corn had the lowest population growth rates for broadleaf weeds (λ = 0.8) while peanut and grain sorghum had the highest (λ = 1.7 and 1.3, respectively). The results indicated that herbicide applications focused exclusively on preventing yield loss may not be sufficient to ensure weed population reductions. Thus, the observed population growth rates (λ = 2 for grassy weeds and λ = 1.26 for broadleaved weeds) indicated that weed issues would continue increasing, despite meeting yield goals. Considering population growth rates when assessing weed management strategies is key to determining the sustainability of the crop production operation. Core Ideas: Integrated weed management strategies must consider both yield loss prevention and weed population dynamics.Corn showed the lowest population growth rates for broadleaf weeds compared with cotton, peanut, grain sorghum, and soybean.Herbicide application timing relative to the crop is a major determinant of weed population growth rates. [ABSTRACT FROM AUTHOR]

Bladed mixers are commonly used for processing granular materials, requiring significant mechanical energy for optimal blending. During this process, heat is generated due to dissipated mechanical energy within the granular medium. However, our understanding of heat generation mechanisms without external thermal loads is limited. This article investigates heat generation by monitoring temperature changes in granular beds mixed using an overhead stirrer. First‐order kinetic equations are employed to extrapolate experimental data to a thermal equilibrium where heat generation and loss rates are balanced. Lead, steel, and glass particles are utilized under different operating conditions. Notably, metallic particles exhibit faster heating due to their lower heat capacity. Increasing rotation speed, fill ratio, and particle size result in greater temperature rises. Additionally, flat blades generate more heat compared to tilted blades. Through dimensional analysis, the experimental data are collapsed into linear curves that correlate system power consumption and granular bed temperature with operating conditions. [ABSTRACT FROM AUTHOR]

See article on page 2032–2039, in this issue [ABSTRACT FROM AUTHOR]

Summary: Patients who require emergency laparotomy are defined as high risk if their 30‐day predicted risk of mortality is ≥ 5%. Despite a large difference in the characteristics of patients with a mortality risk score of between 5% and 50%, these outcomes are aggregated by the National Emergency Laparotomy Audit (NELA). Our aim was to describe the outcomes of the cohort of patients at extreme risk of death, which we defined as having a NELA‐predicted 30‐day mortality of ≥ 50%. All patients enrolled in the NELA database between December 2012 and 2020 were included. We compared patient characteristics; length of hospital stay; rates of unplanned return to the operating theatre; and 90‐day survival in extreme‐risk groups (predicted ≥ 50%) and high‐risk patients (predicted 5–49%). Of 161,337 patients, 5193 (3.2%) had a predicted mortality of ≥ 50%. When patients were further subdivided, 2437 (47%) had predicted mortality of 50–59% (group 50–59); 1484 (29%) predicted mortality of 60–69% (group 60–69); 840 (16%) predicted mortality of 70–79% (group 70–79); and 423 (8%) predicted mortality of ≥ 80% (group 80+). Extreme‐risk patients were significantly more likely to have been admitted electively than high‐risk patients (p < 0.001). Length of stay increased from a median (IQR [range]) of 26 (16–43 [0–271]) days in group 50–59 to 35 (21–56 [0–368]) days in group 80+, compared with 17 (10–30 [0–1136]) days for high‐risk patients. Rates of unplanned return to the operating theatre were higher in extreme‐risk groups compared with high‐risk patients (11% vs. 8%). The 90‐day survival was 43% in group 50–59, 34% in group 60–69, 27% in group 70–79 and 17% in group 80+. These data underscore the need for a differentiated approach when discussing risk with patients at extreme risk of mortality following an emergency laparotomy. Clinicians should focus on patient priorities on quantity and quality of life during informed consent discussions before surgery. Future work should extend beyond the immediate postoperative period to encompass the longer‐term outcomes (survival and function) of patients who have emergency laparotomies. [ABSTRACT FROM AUTHOR]

Since the first description of Parkinson's disease (PD) over two centuries ago, the recognition of rare types of atypical parkinsonism has introduced a spectrum of related PD‐like diseases. Among these is progressive supranuclear palsy (PSP), a neurodegenerative condition that clinically differentiates through the presence of additional symptoms uncommon in PD. As with PD, the initial symptoms of PSP generally present in the sixth decade of life when the underpinning neurodegeneration is already significantly advanced. The causal trigger of neuronal cell loss in PSP is unknown and treatment options are consequently limited. However, converging lines of evidence from the distinct neurodegenerative conditions of PD and amyotrophic lateral sclerosis (ALS) are beginning to provide insights into potential commonalities in PSP pathology and opportunity for novel therapeutic intervention. These include accumulation of the high abundance cuproenzyme superoxide dismutase 1 (SOD1) in an aberrant copper‐deficient state, associated evidence for altered availability of the essential micronutrient copper, and evidence for neuroprotection using compounds that can deliver available copper to the central nervous system. Herein, we discuss the existing evidence for SOD1 pathology and copper imbalance in PSP and speculate that treatments able to provide neuroprotection through manipulation of copper availability could be applicable to the treatment of PSP. [ABSTRACT FROM AUTHOR]

Background: Gel dosimeters are a potential tool for measuring the complex dose distributions that characterize modern radiotherapy. A prototype tabletop solid‐tank fan‐beam optical CT scanner for readout of gel dosimeters was recently developed. This scanner does not have a straight raypath from source to detector, thus images cannot be reconstructed using filtered backprojection (FBP) and iterative techniques are required. Iterative image reconstruction requires a system matrix that describes the geometry of the imaging system. Stored system matrices can become immensely large, making them impractical for storage on a typical desktop computer. Purpose: Here we develop a method to reduce the storage size of optical CT system matrices through use of polar coordinate discretization while accounting for the refraction in optical CT systems. Methods: A ray tracing simulator was developed to track the path of light rays as they traverse the different mediums of the optical CT scanner. Cartesian coordinate discretized system matrices (CCDSMs) and polar coordinate discretized system matrices (PCDSMs) were generated by discretizing the reconstruction area of the optical CT scanner into a Cartesian pixel grid and a polar coordinate pixel grid, respectively. The length of each ray through each pixel was calculated and used to populate the system matrices. To ensure equal weighting during iterative reconstruction, the radial rings of PCDSMs were asymmetrically spaced such that the area of each polar pixel was constant. Two clinical phantoms and several synthetic phantoms were produced and used to evaluate the reconstruction techniques under known conditions. Reconstructed images were analyzed in terms of spatial resolution, signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), signal nonuniformity (SNU), and Gamma map pass percentage. Results: A storage size reduction of 99.72% was found when comparing a PCDSM to a CCDSM with the same total number of pixels. Images reconstructed with a PCDSM were found to have superior SNR, CNR, SNU, and Gamma (1 mm, 1%) pass percentage compared to those reconstructed with a CCDSM. Increasing spatial resolution in the radial direction with increasing radial distance was found in both PCDSM and CCDSM reconstructions due to the outer regions refracting light more severely. Images reconstructed with a PCDSM showed a decrease in spatial resolution in the azimuthal directions as radial distance increases, due to the widening of the polar pixels. However, this can be mitigated with only a slight increase in storage size by increasing the number of projections. A loss of spatial resolution in the radial direction within 5 mm radially from center was found when reconstructing with a PCDSM, due to the large innermost pixels. However, this was remedied by increasing the number of radial rings within the PCDSM, yielding radial spatial resolution on par with images reconstructed with a CCDSM and a storage size reduction of 99.26%. Conclusions: Discretizing the image pixel elements in polar coordinates achieved a system matrix storage size reduction of 99.26% with only minimal reduction in the image quality. [ABSTRACT FROM AUTHOR]

Summary: The probability of death after emergency laparotomy varies greatly between patients. Accurate pre‐operative risk prediction is fundamental to planning care and improving outcomes. We aimed to develop a model limited to a few pre‐operative factors that performed well irrespective of surgical indication: obstruction; sepsis; ischaemia; bleeding; and other. We derived a model with data from the National Emergency Laparotomy Audit for patients who had emergency laparotomy between December 2016 and November 2018. We tested the model on patients who underwent emergency laparotomy between December 2018 and November 2019. There were 4077/40,816 (10%) deaths 30 days after surgery in the derivation cohort. The final model had 13 pre‐operative variables: surgical indication; age; blood pressure; heart rate; respiratory history; urgency; biochemical markers; anticipated malignancy; anticipated peritoneal soiling; and ASA physical status. The predicted mortality probability deciles ranged from 0.1% to 47%. There were 1888/11,187 deaths in the test cohort. The scaled Brier score, integrated calibration index and concordance for the model were 20%, 0.006 and 0.86, respectively. Model metrics were similar for the five surgical indications. In conclusion, we think that this prognostic model is suitable to support decision‐making before emergency laparotomy as well as for risk adjustment for comparing organisations. [ABSTRACT FROM AUTHOR]

Water vapor's contribution to Earth's radiative forcing is most sensitive to changes in its lower stratosphere concentration. One recognized pathway for rapid increases in stratospheric water vapor is tropopause‐overshooting convection. Since this pathway has been rarely sampled, the NASA Dynamics and Chemistry of the Summer Stratosphere (DCOTSS) field project focused on obtaining in situ observations of stratospheric air recently affected by convection over the United States. This study reports on the extreme altitudes to which convective hydration was observed. The data show that the overworld stratosphere is routinely hydrated by convection and that past documented records of stratospheric heights of convective hydration were exceeded during several DCOTSS flights. The most extreme event sampled is highlighted, for which stratospheric water vapor was increased by up to 26% at an altitude of 19.25 km, a potential temperature of 463 K, and an ozone mixing ratio >1500 ppbv. Plain Language Summary: When thunderstorms reach into the second layer of the atmosphere above Earth's surface, the stratosphere, they may impact the concentration and distribution of trace gases that are important to chemistry and climate. One gas that is routinely affected during these events is water vapor, which is typically scarce in the stratosphere. This study presents new aircraft observations of extreme heights in the stratosphere moistened by these thunderstorms. Since increases in stratospheric water vapor positively contribute to warming of Earth's climate and can activate chemistry that destroys ozone, better understanding of this phenomenon helps refine our understanding of its role in the climate system. The new aircraft observations provide clear evidence that water vapor is enhanced by thunderstorms at higher levels in the stratosphere than previously recognized. Key Points: Tropopause‐overshooting convection in the United States hydrates the stratosphere to exceptional heightsObservations of the height of stratospheric convective hydration during the Dynamics and Chemistry of the Summer Stratosphere field campaign exceed all prior global recordsThe overworld stratosphere is routinely hydrated by midlatitude overshooting convection [ABSTRACT FROM AUTHOR]

Arctic outflow winds bring cold air from the continent to the coastline through mountain passes. Using observational data and a 2‐D model, we show that a February 2019 outflow event caused the upper 100 m in Bute Inlet, British Columbia (within the traditional territory of the Homalco Nation) to cool up to 1.9°C and gain up to 4.1 mLL−1 of oxygen. The cold, oxygenated water persisted for almost 1 year within the 1,023–1,023.5 kgm−3 isopycnal range (∼50–150 m). Atmospheric (from 1929 to 2022) and oceanographic (from 1951 to 2022) data showed a statistically significant relationship between continental air temperature at Tatlayoko Lake and temperature and oxygen in Bute Inlet. This local mechanism that counters some effects of climate change could create a biological refugium as surrounding waters warm and lose oxygen at a faster rate. The number of outflow events decreased from 1951 to 2018, and increased since. Plain Language Summary: There are times during most winters that Arctic air masses settle over the British Columbia (BC) interior east of the coast mountain range. Some of this cold air is transported to the coast as an outflow wind via coast mountain valleys. Using observational air and ocean data and a model, we examine an outflow event in February 2019. During this event, we find that outflow winds can cause mixing of the upper 100 m in Bute Inlet and this mixing can cause the ocean to rapidly cool and gain oxygen. Historical air data from 1929 to 2022 and ocean data from 1951 to 2022 were examined and it was found that the number of outflow events have generally decreased from the 1950s to 2018s, and increased afterward. This work identifies an important mechanism that could protect parts of BC's coastal ocean from climate change induced warming and loss of oxygen. Key Points: In February 2019, Arctic outflow winds caused the upper 100 m in Bute Inlet to cool by up to 1.9°C and gain up to 4.1 mLL−1 of oxygenApril to October Bute Inlet intermediate water properties are significantly correlated continental air temperature from the previous winterArctic outflow events decreased since the 1950s, but disruption of the polar vortex may increase these events with climate change [ABSTRACT FROM AUTHOR]

According to the world health organization report, brain cancer has the highest death rate. magnetic resonance imaging (MRI) for detecting brain tumours is adopted these days due to several advantages over other detection techniques. This paper presents a novel methodology to classify MR images based on texture and deep features, z‐score normalization, and, Comprehensive learning elephant herding optimization (CLEHO) based feature optimization and classification. Deep features of brain MR images have been extracted through DenseNet121 convolutional neural network and texture features have been extracted by using the Gabor 2D filter, Haralick texture feature, edge continuity texture feature, first order statistical texture feature, local binary pattern feature, difference theoretic texture feature, and spectral texture feature techniques. Normalization has been done using three normalization techniques that is, z score, mean median absolute deviation (MMAD), and Tanh‐based after aggregating the features extracted from the previous step. z‐score normalization has been suggested for feature normalization after comparing the results attained from the three techniques. Lastly, binary CLEHO has been proposed for selecting an optimal feature set and also optimizing the 'k' value of the k‐NN classifier. The outcome of this proposed work is compared with other state‐of‐the‐art methods for a publicly available magnetic resonance image Fighshare dataset of 3064 slices from 233 patients. The proposed work has a brain tumour average classification accuracy of 98.97%, which is better than the other state‐of‐the‐art methods. The proposed work can be used to assist the radiologist in the screening of multi‐class brain tumours. [ABSTRACT FROM AUTHOR]

Background: This is Part 3 of the first consensus guidelines for optimal care of patients undergoing emergency laparotomy using an enhanced recovery after surgery (ERAS) approach. This paper addresses organizational aspects of care. Methods: Experts in management of the high-risk and emergency general surgical patient were invited to contribute by the International ERAS® Society. PubMed, Cochrane, Embase, and MEDLINE database searches were performed for ERAS elements and relevant specific topics. Studies were selected with particular attention to randomized clinical trials, systematic reviews, meta-analyses and large cohort studies, and reviewed and graded using the Grading of Recommendations, Assessment, Development and Evaluation system. Recommendations were made on the best level of evidence, or extrapolation from studies on elective patients when appropriate. A modified Delphi method was used to validate final recommendations. Results: Components of organizational aspects of care were considered. Consensus was reached after three rounds of a modified Delphi process. Conclusions: These guidelines are based on best current available evidence for organizational aspects of an ERAS® approach to patients undergoing emergency laparotomy and include discussion of less common aspects of care for the surgical patient, including end-of-life issues. These guidelines are not exhaustive but pull together evidence on important components of care for this high-risk patient population. As much of the evidence is extrapolated from elective surgery or emergency general surgery (not specifically laparotomy), many of the components need further evaluation in future studies. [ABSTRACT FROM AUTHOR]

Background: This is Part 2 of the first consensus guidelines for optimal care of patients undergoing emergency laparotomy (EL) using an Enhanced Recovery After Surgery (ERAS) approach. This paper addresses intra- and postoperative aspects of care. Methods: Experts in aspects of management of high-risk and emergency general surgical patients were invited to contribute by the International ERAS® Society. PubMed, Cochrane, Embase, and Medline database searches were performed for ERAS elements and relevant specific topics. Studies on each item were selected with particular attention to randomized clinical trials, systematic reviews, meta-analyses, and large cohort studies and reviewed and graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Recommendations were made on the best level of evidence, or extrapolation from studies on elective patients when appropriate. A modified Delphi method was used to validate final recommendations. Some ERAS® components covered in other guideline papers are outlined only briefly, with the bulk of the text focusing on key areas pertaining specifically to EL. Results: Twenty-three components of intraoperative and postoperative care were defined. Consensus was reached after three rounds of a modified Delphi Process. Conclusions: These guidelines are based on best available evidence for an ERAS® approach to patients undergoing EL. These guidelines are not exhaustive but pull together evidence on important components of care for this high-risk patient population. As much of the evidence is extrapolated from elective surgery or emergency general surgery (not specifically laparotomy), many of the components need further evaluation in future studies. [ABSTRACT FROM AUTHOR]

As climate change accelerates, adaptive social protection programmes are becoming increasingly more popular than conventional social assistance programmes, since they are seen to enhance people's resilience and well‐being outcomes. Despite this upsurge, little is known about the impacts of adaptive programmes on resilience and well‐being outcomes as compared to conventional programmes. This paper examines the economic functions that both types of social protection programmes offer through empirical studies in two climate‐vulnerable zones in Bangladesh. By operationalising a simplified analytical framework to comprehend subjective resilience, the qualitative data reveal that the adaptive programme is more effective in enhancing beneficiaries' perceived resilience to climate risks. Regrettably, neither programme is found to contribute much significantly in terms of enabling beneficiaries to achieve the desired well‐being outcomes that one might expect to see. The paper offers rich insights into the design components of the programmes, affording an on‐the‐ground understanding of their implications for resilience and well‐being. [ABSTRACT FROM AUTHOR]

Introduction: This consensus statement of Australian clinicians provides new recommendations for the pharmacological management of heart failure based on studies reported since the publication of the 2018 Australian heart failure guidelines.Main Recommendations: ▪Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors to prevent hospitalisation for heart failure in type 2 diabetes mellitus can be extended to patients with multiple cardiovascular risk factors, albuminuric chronic kidney disease, or atherosclerotic cardiovascular disease. ▪New evidence supports the use of a mineralocorticoid receptor antagonist (finerenone) to prevent heart failure in type 2 diabetes mellitus associated with albuminuric chronic kidney disease. ▪In addition to renin angiotensin system inhibitors (angiotensin receptor neprilysin inhibitor preferred), beta blockers and mineralocorticoid receptor antagonists, an SGLT2 inhibitor (dapagliflozin or empagliflozin) is recommended in all patients with heart failure with reduced left ventricular ejection fraction (LVEF ≤ 40%) (HFrEF). Lower quality evidence supports these therapies in patients with heart failure with mildly reduced LVEF (41-49%) (HFmrEF). ▪A soluble guanylate cyclase stimulator (vericiguat), selective cardiac myosin activator (omecamtiv mecarbil) and, if iron deficient, intravenous iron (ferric carboxymaltose) provide additional benefits in persistent HFrEF. ▪An SGLT2 inhibitor (empagliflozin) should be considered in patients with heart failure with preserved LVEF (≥ 50%) (HFpEF). Key changes in management from this statement: This document broadens the scope of angiotensin receptor neprilysin inhibitor use in patients with HFrEF and HFmrEF. SGLT2 inhibitor use expands to become a cornerstone therapy in HFrEF, with increasing evidence to support its use in HFmrEF and HFpEF. [ABSTRACT FROM AUTHOR]

In this paper, we obtain degree of convergence of a function of two‐dimensional variables in generalized Hölder spaces by matrix means of its conjugate Fourier series. We also obtain degree of convergence of a function of N‐dimensional variables in generalized Hölder spaces by matrix means of its conjugate Fourier series. We also deduce important corollaries from our main results. [ABSTRACT FROM AUTHOR]

We report the first observations of negative intracloud (IC) dart‐stepped leaders accompanied by regular trains of microsecond‐scale pulses, simultaneously detected by shielded broadband magnetic loop antennas and the radio telescope Low Frequency Array (LOFAR). Four investigated pulse trains occurred during complicated IC flashes on 18 June 2021, when heavy thunderstorms hit the Netherlands. The pulses within the trains are unipolar, a few microseconds wide, and with an average inter‐pulse interval of 5–7 μs. The broadband pulses perfectly match energetic, regularly distributed, and relatively isolated bursts of very high frequency sources localized by LOFAR. All trains were generated by negative dart‐stepped leaders propagating at a lower speed than usual dart leaders. They followed channels of previous leaders occurring within the same flash several tens of milliseconds before the reported observations. The physical mechanism remains unclear as to why we observe dart‐stepped leaders, which show mostly regular stepping, emitting energetic microsecond‐scale pulses. Plain Language Summary: Lightning phenomena inside thunderclouds can be explored using their electromagnetic radiation. To study these processes at small temporal and spatial scales, we combine broadband magnetic loop antennas with the Low Frequency Array (LOFAR) radio telescope. Measurements of broadband antennas acquired during a severe Dutch thunderstorm showed pulse sequences composed of tens microsecond‐scale unipolar pulses, which were surprisingly regularly distributed. Such regular pulse trains have been rarely reported from previous observations. When we thoroughly lined up the timestamps of both simultaneously measuring observational systems, we found that the regular broadband pulses perfectly match with localized isolated bursts of energetic very high frequency radiation detected by LOFAR. The 3D mapping of the radio sources of these bursts allowed us to place the investigated events into the context of the parent intracloud (IC) lightning flash. The results revealed negative IC dart leaders, which propagated along the preconditioned channels originally formed by previous positive or negative IC leaders. Some of these dart leaders then exhibited unusual stepping manifested by the observed regular pulses. We assume that a favorable combination of the conductivity of preexisting lightning channels and the strength of the ambient electric field inside thunderclouds might be needed to trigger this unusual stepping. Key Points: We observed intracloud negative dart‐stepped leaders producing regular trains of broadband electromagnetic microsecond‐scale pulsesVery High Frequency sources follow channels of previous leaders occurring within the same flash tens of milliseconds before the reported observationsConductivity of decaying channels and strength of the ambient electric field might act together to trigger this unusual stepping process [ABSTRACT FROM AUTHOR]

We have used the LOw‐Frequency ARray (LOFAR) to image a few lightning flashes during a particularly severe thunderstorm. The images show an exceptional amount of VHF activity at altitudes above 10 km. Much of this is in the form of small‐scale discharges, not exceeding a few hundred meter, occurring seemingly randomly around the centers of active storm cells. To emphasize the incidental nature of these small‐scale discharges or sparks we refer to them as "sparkles." A detailed investigation shows evidence that these sparkles are indicative of positive leader channels and that they are equivalent to the needle activity seen around positive leader tracks at lower altitudes. Plain Language Summary: At the height of the tropopause in very active lightning cells many seemingly unrelated small discharges have been observed. Using the LOw‐Frequency ARray radio telescope, mainly intended for astronomical observations, we have imaged these structures in unprecedented detail and found strong evidence that these are negative discharges that form around a network of positive leaders. Key Points: In the tops of severe thunderstorms many seemingly isolated sources for VHF radiation are observedThe VHF sources in these tops are small negative discharges, conjectured to be related to an extensive positive leader structureThe charge‐layer structure in these tops is mixed [ABSTRACT FROM AUTHOR]

Groundwater is critical for maintaining stream baseflow and thermal stability; however, the influence of groundwater on streamflow has been difficult to evaluate at broad spatial scales. Techniques such as baseflow separation necessitate streamflow records and do not directly indicate whether groundwater inflow may be sourced from more dynamic shallow flowpaths. We present a web tool application PASTA (Paired Air and Stream Temperature Analysis; https://cuahsi.shinyapps.io/pasta/) that capitalizes on increased public stream temperature data availability and large‐scale, gridded climate observations to provide new and efficient insights regarding relative groundwater influence on streams. PASTA analyzes paired air and stream water temperature signals to evaluate spatiotemporal patterns in stream thermal sensitivity and relative groundwater influence, including inference regarding the dominant source groundwater depth (shallow or deep (i.e., approximately >6 m depth)). The tool is linked to publicly available stream temperature datasets and accepts user‐uploaded datasets. As local air temperature is not often monitored, PASTA pulls daily air temperature data from the comprehensive Daymet products when directly measured data are unavailable, allowing the repurposing of existing stream temperature data. After data are selected or uploaded, the tool (a) fits sinusoidal curves of daily stream and air temperatures by year (water or calendar) to indicate groundwater influence characteristics and (b) performs linear regressions for stream versus air temperatures to indicate stream thermal sensitivity. Results are exported in ASCII file format, creating an efficient and approachable analysis tool for the adoption of newly developed heat tracing analysis from stream reach to landscape scales. Plain Language Summary: Comparing stream temperature to air temperature records can identify streamflow sources, or examine stream vulnerability to land use (e.g., impervious cover), climate change, or river use practices (e.g., dams). We have created a website that allows users to conduct two methods of stream and air temperature comparison using their stream temperature data or use publicly available stream temperature resources in a consistent and accessible format. These analyses generate metrics that indicate similarities and differences in air and stream temperature records over time that can provide insight into hydrologic connectivity for a single site or can be compared across time or space to inform changes in stream process within an area or period of interest. Key Points: PASTA is a web application for analyzing paired stream water and air temperature from public and user‐owned datasets, even without air dataThe output metrics can evaluate stream thermal sensitivity, relative groundwater contributions, and effective source depthApplication design allows method consistency and accessibility for various flowing water communties [ABSTRACT FROM AUTHOR]