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Abstract Open Science Partnerships (OSPs) are gaining attention as alternatives to university–industry collaborations with restrictive IPR and knowledge sharing policies. OSPs have different expected outcomes and deploy varying means to reach them. Appreciating these differences is crucial to understanding their scientific and socio-economic impact, and yet these differences have never been systematically investigated. This exploratory study draws on qualitative case studies of five biomedical OSPs involving academic partners and pharmaceutical companies. It identifies key elements—purpose, activities and structure—that can be used to describe how OSPs are designed. We identify two key aspects of purpose—predominant intent and research aims—which we argue affect the activities and structure of an OSP. Based on these two aspects, we propose four ideal types of OSPs that are designed to provide a starting point for researchers who explore the nature and impact of OSPs and for practitioners who are developing OSPs and wish to ensure that they deploy appropriate means to meet the intended outcomes of their partnership.

The treatment of relapsed and refractory multiple myeloma has improved substantially in the last 5–10 years based on the development and use of several novel classes of drugs and drug combinations. These advances have led to improvements in progression-free and overall survival as well as quality of life. The general tendency has been to advance drugs/combinations that have performed well in advanced disease to the earlier line settings (frontline, first/early relapse). There are several triplet drug combinations that, when used as part of first or early relapse, can provide remission durations of 3 years or longer. More recently, impressive responses have been seen with the use of targeted immunotherapeutics (chimeric antigen receptor T-cells and bispecific antibodies) in heavily pretreated patients with MM. These treatments, however, have been associated with some new and occasionally severe toxicities, including cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and severe infections, including opportunistic infections and profound cytopenias. These potential toxicities bring into question whether these immune-targeting drugs should remain as late-line therapeutics or whether the high single-agent overall response rates mandate that these agents be used in earlier line settings. Herein, the authors provide a point and counterpoint about the future use of these agents.

Abstract Artificial intelligence (AI) and machine learning (ML) pose a challenge for achieving science that is both reproducible and replicable. The challenge is compounded in supervised models that depend on manually labeled training data, as they introduce additional decision‐making and processes that require thorough documentation and reporting. We address these limitations by providing an approach to hand labeling training data for supervised ML that integrates quantitative content analysis (QCA)—a method from social science research. The QCA approach provides a rigorous and well‐documented hand labeling procedure to improve the replicability and reproducibility of supervised ML applications in Earth systems science (ESS), as well as the ability to evaluate them. Specifically, the approach requires (a) the articulation and documentation of the exact decision‐making process used for assigning hand labels in a “codebook” and (b) an empirical evaluation of the reliability” of the hand labelers. In this paper, we outline the contributions of QCA to the field, along with an overview of the general approach. We then provide a case study to further demonstrate how this framework has and can be applied when developing supervised ML models for applications in ESS. With this approach, we provide an actionable path forward for addressing ethical considerations and goals outlined by recent AGU work on ML ethics in ESS.

Abstract Air‐sea interaction in late boreal winter is studied over the extratropical North Atlantic (NA) during 1960–2020 by examining the relationship between sea‐surface temperature (SST) and total turbulent heat flux (THF). The two quantities are positively correlated on interannual timescales over the central‐midlatitude and subpolar NA, suggesting the atmosphere on average drives SST and THF variability is independent of SST. On decadal timescales and over the central‐midlatitude NA the correlation is negative, suggesting ocean processes on average drive SST and THF variability is sensitive to SST. The correlation is positive over the subpolar NA. There, interannual and decadal THF variability is governed by the North Atlantic Oscillation (NAO). During the major late 20th and early 21st century SST increase in the subpolar NA diminishing oceanic heat loss associated with a weakening NAO was observed. This study suggests that the atmosphere is more sensitive to SST over the central‐midlatitude than subpolar NA.

Abstract Background The ever-increasing availability of high-density genomic markers in the form of single nucleotide polymorphisms (SNPs) enables genomic prediction, i.e. the inference of phenotypes based solely on genomic data, in the field of animal and plant breeding, where it has become an important tool. However, given the limited number of individuals, the abundance of variables (SNPs) can reduce the accuracy of prediction models due to overfitting or irrelevant SNPs. Feature selection can help to reduce the number of irrelevant SNPs and increase the model performance. In this study, we investigated an incremental feature selection approach based on ranking the SNPs according to the results of a genome-wide association study that we combined with random forest as a prediction model, and we applied it on several animal and plant datasets. Results Applying our approach to different datasets yielded a wide range of outcomes, i.e. from a substantial increase in prediction accuracy in a few cases to minor improvements when only a fraction of the available SNPs were used. Compared with models using all available SNPs, our approach was able to achieve comparable performances with a considerably reduced number of SNPs in several cases. Our approach showcased state-of-the-art efficiency and performance while having a faster computation time. Conclusions The results of our study suggest that our incremental feature selection approach has the potential to improve prediction accuracy substantially. However, this gain seems to depend on the genomic data used. Even for datasets where the number of markers is smaller than the number of individuals, feature selection may still increase the performance of the genomic prediction. Our approach is implemented in R and is available at https://github.com/FelixHeinrich/GP_with_IFS/ .

Research indicates that student achievement enhances if coupled with information and communication technology (ICT). However, regardless of its extreme importance, there are examples of ICT underuse across all levels of classroom teaching and learning in Pakistan. Evidence from previous research studies suggests that teachers' perceptions, attitudes and motivation towards ICT determine the practical use of ICT in classroom teaching. The aim of this study was to find the effect of university teachers' perceptions, attitude, and motivation towards their readiness for the integration of ICT in their classroom teaching. A sample of 377 university teachers from 51 higher education institutions responded to the survey instrument. The data were analyzed by using Exploratory Factor Analysis (EFA) and Multiple Regression Analysis. The analysis of data revealed a statistically significant effect of university teachers' perceptions, attitude and motivation towards teachers' readiness for the integration of ICT in their classroom teaching. Based on the findings, the study recommends that university teachers with basic ICT literacy should be encouraged to have a positive attitude toward technology use for discharging professional responsibilities.

Summary: Cytoplasmic mislocalization and aggregation of the RNA-binding protein TDP-43 is a pathological hallmark of the motor neuron (MN) disease amyotrophic lateral sclerosis (ALS). Furthermore, while mutations in TARDBP (encoding TDP-43) have been associated with ALS, the pathogenic consequences of these mutations remain poorly understood. Using CRISPR-Cas9, we engineered two homozygous knock-in induced pluripotent stem cell lines carrying mutations in TARDBP encoding TDP-43A382T and TDP-43G348C, two common yet understudied ALS TDP-43 variants. Motor neurons (MNs) differentiated from knock-in iPSCs had normal viability and displayed no significant changes in TDP-43 subcellular localization, phosphorylation, solubility, or aggregation compared with isogenic control MNs. However, our results highlight synaptic impairments in both TDP-43A382T and TDP-43G348C MN cultures, as reflected in synapse abnormalities and alterations in spontaneous neuronal activity. Collectively, our findings suggest that MN dysfunction may precede the occurrence of TDP-43 pathology and neurodegeneration in ALS and further implicate synaptic and excitability defects in the pathobiology of this disease.

Abstract The globally averaged sea-surface temperature (SST) has steadily increased in the last four decades, consistent with the rising atmospheric greenhouse gas concentrations. Parts of the tropical Pacific exhibited less warming than the global average or even cooling, which is not captured by state-of-the-art climate models and the reasons are poorly understood. Here we show that the last four decades featured a strengthening atmospheric circulation and stronger trade winds over the tropical Pacific, which counteracted externally-forced SST warming. Climate models do not simulate the trends in the atmospheric circulation irrespective of whether an external forcing is applied or not and model bias is the likely reason. This study raises questions about model-based tropical Pacific climate change projections and emphasizes the need to enhance understanding of tropical Pacific climate dynamics and response to external forcing in order to project with confidence future climate changes in the tropical Pacific sector and beyond.

Abstract Longer-term outcomes with the anti-CD38 antibody isatuximab in combination with carfilzomib-dexamethasone (Isa-Kd) were evaluated in the randomized Phase 3 trial IKEMA (NCT03275285), in a prespecified, follow-up analysis of progression-free survival (PFS, primary study endpoint), final complete response (CR) using Hydrashift Isa immunofixation assay, minimal residual disease (MRD) negativity, and safety. Enrolled patients had relapsed/refractory multiple myeloma (1–3 prior treatment lines). Isa 10 mg/kg was administered intravenously weekly in cycle 1 then biweekly. Efficacy analyses were performed in the intent-to-treat population (Isa-Kd: n = 179, Kd: n = 123) and safety evaluated in treated patients (Isa-Kd: n = 177, Kd: n = 122). Consistent with the primary interim analysis, the addition of Isa to Kd prolonged PFS (HR 0.58, 95.4% CI: 0.42–0.79; median PFS 35.7 [95% CI: 25.8–44.0] vs 19.2 [95% CI: 15.8–25.0] months). PFS benefit was observed with Isa-Kd across subgroups, including patients with poor prognosis. The stringent CR/CR rate was 44.1% vs 28.5% (odds-ratio: 2.09, 95% CI: 1.26–3.48), the MRD negativity rate 33.5% vs 15.4% (odds-ratio: 2.78, 95% CI: 1.55–4.99) and the MRD negativity CR rate 26.3% vs 12.2%, with Isa-Kd vs Kd. The safety profile of Isa-Kd was similar to that reported in the prior interim analysis. These findings further support Isa-Kd as a standard-of-care treatment for relapsed multiple myeloma patients. Clinical trial information: ClinicalTrials.gov, NCT03275285.

We present JWST observations of the Crab Nebula, the iconic remnant of the historical SN 1054. The observations include NIRCam and MIRI imaging mosaics plus MIRI/MRS spectra that probe two select locations within the ejecta filaments. We derive a high-resolution map of dust emission and show that the grains are concentrated in the innermost, high-density filaments. These dense filaments coincide with multiple synchrotron bays around the periphery of the Crab's pulsar wind nebula (PWN). We measure synchrotron spectral index changes in small-scale features within the PWN’s torus region, including the well-known knot and wisp structures. The index variations are consistent with Doppler boosting of emission from particles with a broken power-law distribution, providing the first direct evidence that the curvature in the particle injection spectrum is tied to the acceleration mechanism at the termination shock. We detect multiple nickel and iron lines in the ejecta filaments and use photoionization models to derive nickel-to-iron abundance ratios that are a factor of 3–8 higher than the solar ratio. We also find that the previously reported order-of-magnitude higher Ni/Fe values from optical data are consistent with the lower values from JWST when we reanalyze the optical emission using updated atomic data and account for local extinction from dust. We discuss the implications of our results for understanding the nature of the explosion that produced the Crab Nebula and conclude that the observational properties are most consistent with a low-mass Fe core-collapse supernova, even though an electron-capture explosion cannot be ruled out.

Abstract It is insightful to report an estimator that describes how certain a model is in a prediction, additionally to the prediction alone. For regression tasks, most approaches implement a variation of the ensemble method, apart from few exceptions. Instead of a single estimator, a group of estimators yields several predictions for an input. The uncertainty can then be quantified by measuring the disagreement between the predictions, for example by the standard deviation. In theory, ensembles should not only provide uncertainties, they also boost the predictive performance by reducing errors arising from variance. Despite the development of novel methods, they are still considered the “golden-standard” to quantify the uncertainty of regression models. Subsampling-based methods to obtain ensembles can be applied to all models, regardless whether they are related to deep learning or traditional machine learning. However, little attention has been given to the question whether the ensemble method is applicable to virtually all scenarios occurring in the field of cheminformatics. In a widespread and diversified attempt, ensembles are evaluated for 32 datasets of different sizes and modeling difficulty, ranging from physicochemical properties to biological activities. For increasing ensemble sizes with up to 200 members, the predictive performance as well as the applicability as uncertainty estimator are shown for all combinations of five modeling techniques and four molecular featurizations. Useful recommendations were derived for practitioners regarding the success and minimum size of ensembles, depending on whether predictive performance or uncertainty quantification is of more importance for the task at hand.

Abstract Atlantic climate displays an oscillatory mode at a period of 10–15 years described as pan-Atlantic decadal oscillation. Prevailing theories on the mode are based on thermodynamic air-sea interactions and the role of ocean circulation remains uncertain. Here we uncover ocean circulation variability associated with the pan-Atlantic decadal oscillation using observational datasets from 1900–2009. Specifically, a sea level-derived index of ocean circulation also exhibits 10-15 year periodicity and leads the surface climate oscillation. The underlying ocean circulation links the extratropical and tropical Atlantic, where the maximum variance in surface-ocean temperature feeds back on the North Atlantic Oscillation (the leading mode of atmospheric variability over the North Atlantic region). Our findings imply that, rather than a passive role postulated by the thermodynamic paradigm, ocean circulation across the Atlantic plays an active role for the pan-Atlantic decadal climate oscillation.

Biological selenium reduction processes are commonly employed as the best available technology (BAT) for selenium removal; however, as a by-product they produce trace amounts of organoselenium compounds with orders of magnitude greater bioaccumulation potential and toxicity. Here, we assessed buoyant photocatalysts (BPCs) as a potential passive advanced oxidation process (P-AOP) for organoselenium treatment. Using a synthetic mine-impacted water solution, spiked with selenomethionine (96 μg/L) as a representative organoselenium compound, photocatalysis with BPCs fully eliminated selenomethionine to

Purpose: There is limited research in Pakistan that describes how organizational learning, which is not contingent on funding, can be used to improve the quality of education in developing countries. This study addresses this gap in the literature with a study that examines the perceptions of educators at medium-cost schools in Karachi, Pakistan. Design/methodology/approach: As part of a larger mixed-method QUAN-qual study, this study used an instrument based on Watkins and Marsick's Dimensions of the Learning Organization, to collect survey data from 21 head teachers/coordinators, 653 teachers at 32 urban schools. This paper presents an analysis of survey data and findings related to two research questions. This paper used exploratory factor analysis and simultaneous regression analysis to test four hypotheses. Findings: The findings suggest that of the four levels of learning, global and school level learning predict knowledge performance at medium-cost urban schools in Karachi, Pakistan. Practical implications: The paper includes implications for both school leaders and the education leadership faculty who prepare them to play a vital role in schools. Originality/value: The paper adds to a limited body of literature that describes how organizational learning can be used to improve the quality of education in developing countries such as Pakistan.

The biological reconstruction of periprosthetic acetabular defects is essential for the success of revision total hip arthroplasty. However, a standardized in vivo defect model with good analogy to the human situation is still lacking, which has significantly limited the research and development of this highly important clinical entity. A defined animal defect model might be a possible solution as it offers the possibility to evaluate different biomaterials for periacetabular bone reconstruction in a reproducible setting. In an ovine periacetabular defect model (n = 27), a defined bone defect (1.5 × 1.5 × 1.5 cm/3.375 cm3) in the cranial load-bearing area of the acetabulum was augmented with two different biomaterials as well as autologous cancellous bone in an ovine periprosthetic defect model and bridged with a Ganz reinforcement ring (n = 9 animals per group). Eight months after implantation, radiological and macroscopic examination was performed. The operation with the establishment of a defined periacetabular defect could be performed in all cases. There were no intraoperative complications in the three groups. During the course of the experiment, three sheep had to be excluded due to complications. A macroscopic evaluation after 8 months showed a firm neocapsula surrounding the hip joint with macroscopic consolidation of the bony defect and a stable inlying implant. There were no detectable differences between the three groups in the macroscopic or radiological evaluation. In summary, the presented ovine model might offer the possibility to create a defined bone defect and investigate bone defect reconstruction with different materials.

This paper presents a study of global Rayleigh wave attenuation and group velocity at a period of around 20 s using data from the International Seismological Centre (ISC) bulletin. Rayleigh waves at this period are sensitive to the crustal structure beneath continents and the uppermost mantle beneath oceans. Tomographic imaging reveals strong continental-ocean contrasts due to this. Oceanic group velocities are high but vary with seafloor depth, while oceanic attenuation shows mid-ocean ridges. Subduction zone regions display high attenuation but little velocity reduction, indicating scattering attenuation. Low attenuation regions are associated with the Earth’s major cratonic regions, but there are no associated velocity changes. This implies that intrinsic attenuation is low and scattering dominates. Cratonic crustal scatterers have been annealed. A new surface wave magnitude scale is constructed that is valid from near-source to near-antipode distances.

Patients with multiple myeloma (MM) who experience early relapse within 12 months of therapy initiation are considered functional high-risk and represent an unmet need, needing better therapies to improve outcomes. The final IKEMA (clinicaltrials gov. identifier: NCT03275285) progression-free survival (PFS) analysis confirmed the significant PFS improvement reported at interim analysis with isatuximab (Isa) plus carfilzomib and dexamethasone (Kd; Isa-Kd) versus Kd in patients with relapsed MM (updated median PFS: 35.7 vs. 19.2 months; hazard ratio [HR] =0.58, 95% confidence interval [CI]: 0.42- 0.79). This IKEMA subgroup analysis examined efficacy and safety of Isa-Kd versus Kd in patients who experienced early (n=61 [Isa-Kd], n=46 [Kd]) vs. late relapse (n=104 [Isa-Kd], n=72 [Kd]). As expected, more aggressive features in baseline characteristics were observed in early relapse patients. Consistent with IKEMA overall population results, median PFS (early relapse: 24.7 vs. 17.2 months, HR=0.662, 95% CI: 0.407-1.077; late relapse: 42.7 vs. 21.9 months, HR=0.542, 95% CI: 0.355- 0.826), minimal residual disease negativity (MRD−) (early relapse: 24.6% vs. 15.2%; late relapse: 37.5% vs. 16.7%), and MRD− complete response (≥CR) rates (early relapse: 18.0% vs. 10.9%; late relapse: 30.8% vs. 13.9%) were higher with Isa-Kd versus Kd, respectively, in both early and late relapse patients. Grade ≥3, serious treatment-emergent adverse events, and death rates were higher in the late relapse Isa-Kd arm. However, the numbers of deaths were low and treatment exposure was significantly longer in Isa-Kd versus Kd late relapse patients. These results support the addition of Isa to Kd as standardof- care therapy for relapsed and/or refractory MM regardless of relapse timing.

The South African Early Jurassic morganucodontan Erythrotherium is considered by some authors to be potentially synonymous with Morganucodon, due to similar tooth morphology. However, despite their similar dental morphology, the occlusal pattern of Erythrotherium parringtoni has been described as embrasure occlusion, close to the mode of Megazostrodon rudnerae, rather than that of Morganucodon. In this study the molars of Erythrotherium were re-examined and the two alternative occlusal hypotheses were tested using the Occlusal Fingerprint Analyser (OFA). Morphological comparison of the molars of Erythrotherium parringtoni to those of Morganucodon watsoni showed similarities in cusp height and shape in lingual/buccal views, but the molars and individual cusps of Erythrotherium parringtoni are considerably narrower linguo-buccally, and more gracile. With cusps a and c close together in Erythrotherium parringtoni, cusp positioning differs from that of Morganucodon watsoni and shows similarities to the pattern in Megazostrodon rudnerae. Also, the upper molars of Erythrotherium parringtoni are aligned in a straight row and lack the angle, relative to the longitudinal axis, between the first and second upper molars that is present in Morganucodon watsoni. This results in embrasure occlusion being the only viable occlusal mode for Erythrotherium parringtoni, which was confirmed by the OFA analysis. A Morganucodon-like occlusion would allow only the main cusps a/A to contact their antagonists and thus major gaps would be present, causing considerable reduction of functionality of the dentition. Based on the morphological evidence and the differing occlusal mode, the perpetuation of Erythrotherium parringtoni as a separate genus is confirmed.

Abstract Amyotrophic lateral sclerosis (ALS) is a disease characterized by upper and lower motor neuron (MN) loss with a signature feature of cytoplasmic aggregates containing TDP-43, which are detected in nearly all patients. Mutations in the gene that encodes TDP-43 (TARBDP) are known to result in both familial and sporadic ALS. In ALS, disruption of neuromuscular junctions (NMJs) constitutes a critical event in disease pathogenesis, leading to denervation atrophy, motor impairments and disability. Morphological defects and impaired synaptic transmission at NMJs have been reported in several TDP-43 animal models and in vitro, linking TDP-43 dysregulation to the loss of NMJ integrity in ALS. Through the lens of the dying-back and dying-forward hypotheses of ALS, this review discusses the roles of TDP-43 related to synaptic function, with a focus on the potential molecular mechanisms occurring within MNs, skeletal muscles and glial cells that may contribute to NMJ disruption in ALS.

Abstract Background Insufficient pain control after lower limb arthroplasty results in delayed recovery and increased risk for pain chronicization. The ideal kind of analgesia is still discussed controversially. We conducted a retrospective analysis of single-center routine data from a German university hospital, including patients receiving either total hip (THA) or knee arthroplasty (TKA). Methods All patients received general anesthesia. Patients undergoing THA received either continuous epidural ropivacaine infusion (0.133%, Epi) or patient-controlled analgesia (PCA) with the Wurzburg Pain Drip (tramadol, metamizole and droperidol, WPD) or with piritramide (Pir). After TKA, patients received either continuous femoral nerve block (ropivacaine 0.2%, PNB) or Pir. Results The analyzed cohort comprised 769 cases. Use of WPD after THA (n = 333) resulted in significantly reduced Numeric Rating Scale (NRS) values at rest, compared to Epi (n = 48) and Pir (n = 72) (.75 [IQR 1.14] vs. 1.17 [1.5], p = .02 vs. 1.47 [1.33], p

We present new high-spectral-resolution observations ( R = λ /Δ λ = 7000) of the filamentary nebula surrounding NGC 1275, the central galaxy of the Perseus cluster. These observations have been obtained with SITELLE, an imaging Fourier transform spectrometer installed on the Canada–France–Hawai Telescope with a field of view of $11^{\prime} \times 11^{\prime} $ , encapsulating the entire filamentary structure of ionized gas despite its large size of 80 kpc × 50 kpc. Here, we present renewed fluxes, velocities, and velocity dispersion maps that show in great detail the kinematics of the optical nebula at [S ii ] λ 6716, [S ii ] λ 6731, [N ii ] λ 6584, H α (6563 Å), and [N ii ] λ 6548. These maps reveal the existence of a bright flattened disk-shaped structure in the core extending to r ∼10 kpc and dominated by a chaotic velocity field. This structure is located in the wake of X-ray cavities and characterized by a high mean velocity dispersion of 134 km s ^−1 . The disk-shaped structure is surrounded by an extended array of filaments spread out to r ∼ 50 kpc that are 10 times fainter in flux, remarkably quiescent, and have a uniform mean velocity dispersion of 44 km s ^−1 . This stability is puzzling given that the cluster core exhibits several energetic phenomena. Based on these results, we argue that there are two mechanisms that form multiphase gas in clusters of galaxies: a first triggered in the wake of X-ray cavities leading to more turbulent multiphase gas and a second, distinct mechanism, that is gentle and leads to large-scale multiphase gas spreading throughout the core.

Abstract Background Shoulder complaints are common and the recommended first-line treatment is exercise therapy. However, it remains unknown if increased shoulder pain after an exercise session is a barrier for subsequent exercise dose, particularly in people with high fear-avoidance beliefs. Such knowledge could indicate ways to optimise shoulder rehabilitation. The aim was to examine whether increased shoulder pain across an exercise session was associated with a lower subsequent exercise dose, and if high fear-avoidance beliefs exaggerated this association. Methods We conducted a prospective cohort study using data from a randomised controlled trial in Central Denmark Region 2017–2019. Participants were employees (n = 79) with shoulder complaints and high occupational shoulder exposures. The intervention was a home-based or partly supervised exercise programme lasting 2–3 months. Linear mixed models were used to examine the associations between change in shoulder pain and exercise dose (number of repetitions, progression level (1–3), resistance level (1–3), and time until next exercise session [days]). Results At baseline, the participants had a median pain intensity at rest of 2 on a numerical rating scale (0–10). For a 1-cm increase in pain on a visual analogue scale (0–10 cm) during an exercise session, the subsequent number of repetitions, progression level and resistance level were − 1.3 (95% confidence interval [CI] − 3.4 to 0.9), 0.0 (95% CI − 0.1 to 0.0) and − 0.0 (95% CI − 0.1 to 0.0), respectively. Likewise, the time until next exercise session was − 0.6 (95% CI − 2.4 to 1.3) days for a 1-cm increase. There were no interactions with fear-avoidance beliefs. Conclusion Increased pain across an exercise session was not associated with subsequent exercise dose, regardless of fear-avoidance beliefs, among employees with shoulder complaints and high occupational shoulder exposures. Trial registration The trial was registered at Clinicaltrials.gov 19/05/2017 (ID: NCT03159910).

Page kidney is a pathologic phenomenon in which extrinsic compression of renal parenchyma from a subcapsular collection causes secondary systemic hypertension, via activation of the renin-angiotensin-aldosterone system. Following the first description of Page kidney, the condition was most often recognized following blunt trauma to the flank. Increasingly, non-traumatic and iatrogenic etiologies of Page kidney have been described. We present a case of Page kidney as a complication of image-guided native renal parenchymal core needle biopsy. The current literature on etiologies, pathophysiology, and treatment options for Page kidney are summarized.

BackgroundClimate change and its consequences on our everyday life have also tremendous impacts on public health and the health of each individual. The healthcare sector currently accounts for 4.4% of global greenhouse gas emissions. The share of the emissions in the health care system caused by the transportation sector is 7%. The study analyses the effect of video consultation on the CO2 emissions during the Covid-19 pandemic in an outpatient clinic of the department of orthopaedics and traumatology surgery at a German university hospital.MethodsThe study participants were patients who obtained a video consultation in the period from June to December 2020 and voluntarily completed a questionnaire after the consultation. The type of transport, travel time and waiting time as well as patient satisfaction were recorded by questionnaire.ResultsThe study comprised 51 consultations. About 70% of respondents would have travelled to the clinic by car. The reduction in greenhouse gas emissions of video consultations compared to a face-to-face presentation was 97% in our model investigation.ConclusionThe video consultation can be a very important part of the reduction of greenhouse gas emissions in the health care system. It also saves time for the doctor and patient and can form an essential part of individual patient care.

Most researchers assume minimal impact of pretreatment on strontium isotope ratios (87Sr/86Sr) for bones and teeth, and methods vary tremendously. We compared 14 pretreatment methods, including no prep other than powdering enamel, ashing, soaking in water, an oxidizing agent (bleach or hydrogen peroxide) or acetic acid (0.1 M, 1.0 M, and 1.0 M buffered with calcium acetate), and a combination of these steps. We prepared and analyzed aliquots of powdered molar enamel from three proboscideans (one modern captive Indian elephant, Elephas maximus indicus; one Pleistocene mastodon, Mammut americanum; and one Miocene gomphothere, Afrochoerodon kisumuensis). Each pretreatment was performed in triplicate and we measured 87Sr/86Sr, Sr concentration, and uranium (U) concentration, using the same lab space and instrumentation for all samples. Variability in 87Sr/86Sr and Sr and U concentrations was considerable across pretreatments. Mean 87Sr/86Sr across methods ranged from 0.70999 to 0.71029 for the modern tooth, 0.71458 to 0.71502 for the Pleistocene tooth, and 0.70804 to 0.70817 for the Miocene tooth. The modern tooth contained the least Sr and negligible U. The Pleistocene tooth contained slightly more Sr and measurable amounts of U, and the Miocene tooth had approximately 5x more Sr and U than the Pleistocene tooth. For all three teeth, variance in 87Sr/86Sr, Sr concentrations, and U concentrations among replicates was statistically indistinguishable across pretreatments, but there were apparent differences among pretreatments for the modern and Pleistocene teeth. Both contained relatively little Sr, and it is possible that small amounts of exogenous Sr from reagents, building materials or dust affected some replicates for some pretreatments. For the modern tooth, median 87Sr/86Sr varied considerably (but statistically insignificantly) across pretreatments. For the Pleistocene tooth, variability in median 87Sr/86Sr was also considerable; some pretreatments were statistically distinct but there were no obvious patterns among methods. For the Miocene tooth, variability in median 87Sr/86Sr was much smaller, but there were significant differences among pretreatments. Most pretreatments yielded 87Sr/86Sr and Sr concentrations comparable to, or lower than, untreated powder, suggesting selective removal of exogenous material with high 87Sr/86Sr. Further evaluation of the mechanisms driving isotopic variability both within and among pretreatment methods is warranted. Researchers should clearly report their methods and avoid combining data obtained using different methods. Small differences in 87Sr/86Sr could impact data interpretations, especially in areas where isotopic variability is low.