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Health disparities in childhood‐onset systemic lupus erythematosus (SLE) disproportionately impact marginalized populations. Socioeconomically patterned missing data can magnify existing health inequities by supporting inferences that may misrepresent populations of interest. Our objective was to assess missing data and subsequent health equity implications among participants with childhood‐onset SLE enrolled in a large pediatric rheumatology registry. We evaluated co‐missingness of 12 variables representing demographics, socioeconomic position, and clinical factors (e.g., disease‐related indices) using Childhood Arthritis and Rheumatology Research Alliance Registry childhood‐onset SLE enrollment data (2015–2022; n = 766). We performed logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for missing disease‐related indices at enrollment (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI‐2K] and/or Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]) associated with data missingness. We used linear regression to assess the association between socioeconomic factors and SLEDAI‐2K at enrollment using 3 analytic methods for missing data: complete case analysis, multiple imputation, and nonprobabilistic bias analyses, with missing values imputed to represent extreme low or high disadvantage. On average, participants were missing 6.2% of data, with over 50% of participants missing at least 1 variable. Missing data correlated most closely with variables within data categories (i.e., demographic). Government‐assisted health insurance was associated with missing SLEDAI‐2K and/or SDI scores compared to private health insurance (OR 2.04 [95% CI 1.22, 3.41]). The different analytic approaches resulted in varying analytic sample sizes and fundamentally conflicting estimated associations. Our results support intentional evaluation of missing data to inform effect estimate interpretation and critical assessment of causal statements that might otherwise misrepresent health inequities.

Background:Individuals with neurodevelopmental disorders (NDD) are facing unprecedented challenges due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Congregate living, and conditions associated with NDD place increased challenges during infectious disease outbreaks and there is a need to understand evidence-based response procedures. The aim was to (1) map and synthesize literature regarding emergency response protocol in supported living environments for individuals with NDD and (2) identify gaps in the literature of response protocols in supported living environments for individuals with NDD.Methods:A scoping review was conducted to understand the published literature on emergency response across supported living environments for individuals with NDD during emergency situations and infectious disease outbreaks.Results:The ten studies included in the review detailed protocols including treatment, testing, isolation, surveillance, improved cleaning, use of protective equipment, and contact with public health professionals. The environment of supported living settings, and symptoms associated with NDD impacted the spread and severity of disease.Conclusion:The research findings highlight the susceptibility, severity and impact of infectious disease outbreaks for individuals with NDD in supported living environments. This research will promote the establishment and development of appropriate care and response during emergency situations in supported living environments.

The goal was to characterize short‐term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood‐onset systemic lupus erythematosus (cSLE) and nephritis. We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy‐proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. We identified 222 patients with kidney biopsy–proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8–29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21–12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01–1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short‐term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long‐term kidney outcomes.

Children with well‐controlled juvenile idiopathic arthritis (JIA) frequently experience flares after medication discontinuation, but the outcomes of these flares have not been well described. The objective of this study was to characterize the rates and predictors of disease recapture among children with JIA who restarted medication to treat disease flare. Children with JIA who discontinued conventional synthetic or biologic disease‐modifying antirheumatic drugs for well‐controlled disease but subsequently experienced a flare and restarted medication were identified from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. The primary outcome was inactive disease (ID) (physician global assessment <1 and active joint count = 0) 6 months after flare. A total of 333 patients had complete data for ID at 6 months after flare. The recapture rate for the cohort was 55%, ranging from 47% (persistent oligoarthritis) to 69% (systemic arthritis) (P= 0.4). Approximately 67% of children achieved ID by 12 months. In the multivariable model, history and reinitiation of biologic drugs were associated with increased odds of successful recapture (odds ratio [OR] 4.79 [95% confidence interval (95% CI) 1.22–18.78] and OR 2.74 [95% CI 1.62–4.63], respectively). Number of joints with limited range of motion was associated with decreased odds (OR 0.83 per 1 joint increase [95% CI 0.72–0.95]). Approximately half of JIA flares post‐discontinuation were recaptured within 6 months, but rates of recapture varied across JIA categories. These findings inform shared decision‐making for patients, families, and clinicians regarding the risks and benefits of medication discontinuation. Better understanding of biologic predictors of successful recapture in JIA are needed.

Substorms are a rapid release of energy that is redistributed throughout the magnetosphere‐ionosphere system, resulting in many observable signals, such as enhancements in the aurora, energetic particle injections, and ground magnetic field perturbations. Numerous substorm identification techniques and onset lists based on each of these signals have been provided in the literature, but often with no cross‐calibration. Since the signals produced are not necessarily unique to substorms and may not be sufficiently similar to be identified for each and every substorm, individual event lists may miss or misidentify substorms, hindering our understanding and the development and validation of substorm models. To gauge the scale of this problem, we use metrics derived from contingency tables to quantify the association between lists of substorms derived from SuperMAG SML/SMU indices, midlatitude magnetometer data, particle injections, and auroral enhancements. Overall, although some degree of pairwise association is found between the lists, even lists generated by applying conceptually similar gradient‐based identification to ground magnetometer data achieve an association with less than 50% event coincidence. We discuss possible explanations of the levels of association seen from our results, as well as their implications for substorm analyses. Less than 50% of the events from each list analyzed were associated with onsets identified by another signatureThe Chu et al. (2015, https://doi.org/10.1002/2015JA021104) and Newell and Gjerloev (2011, https://doi.org/10.1029/2011JA016779) lists show the highest levels of event coincidence with other onset listsSubstorm onsets identified using particle injection signatures showed poor association with other onset signatures Less than 50% of the events from each list analyzed were associated with onsets identified by another signature The Chu et al. (2015, https://doi.org/10.1002/2015JA021104) and Newell and Gjerloev (2011, https://doi.org/10.1029/2011JA016779) lists show the highest levels of event coincidence with other onset lists Substorm onsets identified using particle injection signatures showed poor association with other onset signatures

The ability to understand and model ionospheric plasma flow on all spatial scales has important implications for operational space weather models. This study exploits a recently developed method to statistically separate large‐scale and meso‐scale contributions to probability density functions (PDFs) of ionospheric flow vorticity measured by the Super Dual Auroral Radar Network (SuperDARN). The SuperDARN vorticity data are first sub‐divided depending on the Interplanetary Magnetic Field (IMF) direction, and the separation method is applied to PDFs of vorticity compiled in spatial regions of size 1° of geomagnetic latitude by 1 hr of magnetic local time, covering much of the high‐latitude ionosphere in the northern hemisphere. The resulting PDFs are fit by model functions using maximum likelihood estimation (MLE) and the spatial variations of the MLE estimators for both the large‐scale and meso‐scale components are presented. The spatial variations of the large‐scale vorticity estimators are ordered by the average ionospheric convection flow, which is highly dependent on the IMF direction. The spatial variations of the meso‐scale vorticity estimators appear independent of the senses of vorticity and IMF direction, but have a different character in the polar cap, the cusp, the auroral region, and the sub‐auroral region. The paper concludes by discussing the sources of the vorticity components in the different regions, and the consequences for the fidelity of ionospheric plasma flow models. The ability to accurately model the flow of ionized gases (plasma) in the Earth's ionosphere (the ionized region of the Earth's upper atmosphere) has important implications for operational space weather models. Large‐scale variations in this plasma flow are modeled well, but fluctuations on the meso‐scale and small scale are typically ignored in these models. This study uses measurements from a high‐latitude ground‐based radar network to measure the ionospheric plasma flow in terms of its vorticity (how straight or curved the flow is). The measured vorticity is separated into components related to both the large and meso‐scale fluctuations. The paper discusses the origins of the meso‐scale component, and what needs to be done before it can be confidently added to ionospheric plasma flow models. The spatial variation of meso‐scale ionospheric flow vorticity is independent of the prevailing IMF BydirectionMeso‐scale ionospheric flow vorticity is strongest in the cusp and the auroral regionMeso‐scale ionospheric flow vorticity is most intermittent in the polar cap and the sub‐auroral region The spatial variation of meso‐scale ionospheric flow vorticity is independent of the prevailing IMF Bydirection Meso‐scale ionospheric flow vorticity is strongest in the cusp and the auroral region Meso‐scale ionospheric flow vorticity is most intermittent in the polar cap and the sub‐auroral region

Down syndrome–associated arthritis (DA) is underrecognized, and current therapies used for juvenile idiopathic arthritis (JIA) appear to be poorly tolerated and less effective in patients with DA. The objective of this study was to characterize clinical manifestations and therapeutic preferences in DA compared to JIA, using the new Childhood Arthritis and Rheumatology Research Alliance (nCARRA) registry. In a case–control study, between July 2015 and March 2019, patients with a diagnosis of JIA and Down syndrome (DS) were identified and matched by age, sex, and JIA subtype to patients who have JIA without DS. Collected data included demographic characteristics, disease characteristics, laboratory results, treatment exposure, and outcome measures. A total of 36 children with DA and 165 with JIA were identified. Most patients presented with polyarticular rheumatoid factor–negative disease. At entry into the nCARRA registry, there were minimal differences between the groups, and at the last visit there were significant differences (P< 0.05) for multiple outcome measures. Patients with DA and those with JIA had similar therapeutic exposure to disease‐modifying antirheumatic drugs (DMARDs) and biologics, but those with DA had more DMARD‐related adverse events (93% versus 25%) and biologic therapy ineffectiveness (60% versus 17%). There was little difference between patients with DA and those with JIA at baseline, and similar therapy was implemented for those in the nCARRA registry; however, at the last visit, the patients with DA had greater disease burden. Additionally, there were more DMARD‐related adverse events and biologic ineffectiveness for those patients with DA. More research is needed to determine differences in pathophysiology and optimal therapeutic approaches.

Traditionally, assessment of animal welfare generally focused on physiological signs of health with less consideration of psychological well-being. More recently, the Five Domains model highlighted the concept of all aspects of an animal's life influencing their affective state. In equestrianism, however, there is a lack of awareness of the Five Domains model and, specifically, how different factors may affect the mental well-being of horses (Equus caballus). This divide between scientific research and lay horse owners could compromise equine welfare by failing to recognise horses as sentient beings with species-specific needs. The present study therefore aimed to explore how evidence-based information can be effectively communicated to equestrians (n = 259) through an online survey and whether increased knowledge of equine welfare needs has any impact on horse caregivers' assessment of their own horses' quality of life. Results showed that a simple educational infographic based on the Five Domains model had a significant impact on equestrians' assessment of equine welfare, although longitudinal, empirical studies are needed. Scores on a Likert scale for health, behaviour/human interactions and overall welfare were significantly lower following the intervention but scores for emotional well-being were significantly higher. This may suggest that, whilst the infographic increased participant awareness of the importance of emotional state and the factors affecting welfare, there were difficulties or inconsistencies in objectively assessing these emotions. This highlights the need for equine welfare science to be communicated more proactively to horse owners in an accessible, engaging format. [ABSTRACT FROM AUTHOR]

To describe characteristics of children with enthesitis‐related arthritis (ERA) and juvenile psoriatic arthritis (PsA) who were enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. All children with ERA and those with juvenile PsA were identified. Demographic characteristics, clinical characteristics, and treatments were described. The children with sacroiliitis and those without sacroiliitis were compared. In the children with sacroiliitis, the first visit with clinically active sacroiliitis (which came first in 72% of cases) was compared to the first visit without clinically active sacroiliitis. A total of 902 children with ERA or juvenile PsA were identified. Children with ERA were older at diagnosis (ages 10.8 years versus 8.2 years; P< 0.01) and were more likely to be male (56% versus 38%; P< 0.01). Polyarticular involvement was reported in 57% of children with ERA and in 72% of those with juvenile PsA. Of the children tested, HLA–B27 was positive in 38% of those in the ERA group and in 12% of those in the juvenile PsA group. At least 1 biologic was taken by 72% of those with ERA and 64% of those with juvenile PsA. Sacroiliitis (diagnosed clinically and/or by imaging) was reported in 28% of the children (40% of those with ERA and 12% of those with juvenile PsA). Of these, 54% of the children were female, 36% were HLA–B27 positive, and 81% took at least 1 biologic. In children with sacroiliitis, scores according to the physician global assessment of disease activity, parent/patient global assessment of well‐being, and clinical Juvenile Arthritis Disease Activity Score 10 were all significantly worse at the first visit with clinically active sacroiliitis versus the first visit without active sacroiliitis. In this registry, there are more than 900 children with ERA or juvenile PsA. There was high biologic use in this population, especially in those with sacroiliitis. Further, there was equal sex representation in those children with sacroiliitis.

ABSTRACTIt is time to move beyond the era of conflict and develop a new shared vision for the management of Australia’s public forests. We need more holistic approaches that encompass all forest values across the landscape, rather than the current approach of dividing public forest management up across different government agencies. More collaborative approaches will be required to galvanise the resources, skills and knowledge that enables this shift in shared governance. Recent bushfires in Australia have heightened concerns that the management of public forest lands has largely failed to ensure the health of forest ecosystems, build resilience, and secure a promised balance between economic, social and environmental values. Investment in efforts to adapt forest management to address climate change has been limited; and empowering and increasing the role of Indigenous Australians in forest management could be significantly improved. Furthermore, the COVID-19 pandemic has highlighted the need to improve the resilience of regional communities to major shocks and stresses caused by factors that encompass market dynamics, supply-chain disruptions and natural disasters. Three key strategies are proposed to strengthen forest management in Australia: first, establishing new shared governance models that bring together government agencies with Indigenous Australians and actors from the private sector and civil society; second, extending active and adaptive management across forest landscapes that builds resilience in our forests, local communities and society; and third, integrating traditional knowledge with scientific evidence and innovative technologies to enhance forest management for improved resilience and other outcomes.

Solar eclipses present a rare glimpse into the impact of ionospheric electrodynamics on the magnetosphere independent of other well studied seasonal influences. Despite decades of study, we still do not have a complete description of the conditions for geomagnetic substorm onset. We present herein a mutual information based study of previously published substorm onsets and the past two decades of eclipses which indicates the likelihood of co‐occurrence is greater than random chance. A plausible interpretation for this relation suggests that the abrupt fluctuations in ionospheric conductivity during an eclipse may influence the magnetospheric preconditions of substorm initiation. While the mechanism remains unclear, this study presents strong evidence of a link between substorm onset and solar eclipses. Geomagnetic substorms are a long‐studied phenomenon with significant potential for impact on human infrastructure and activities. Despite decades of research, a comprehensive description of what causes these violent eruptions of space plasma near earth has yet to be agreed upon. Although their evolution is well documented, the precise conditions required for substorms to manifest appear to be more complex than previously understood. We present evidence in this manuscript of a mutual dependence between solar eclipses and substorms, which suggests that changes to the upper atmosphere like those occurring during an eclipse may influence substorm development. In a given 2 hr window between 2001 and 2021, a substorm occurs roughly 40% of the time, increasing to 67% during windows including an eclipseConditional Point‐wise Mutual Information analysis suggests the probability of eclipse‐substorm co‐occurrence is higher than random chanceThe mutual dependence between eclipses and substorms is likely the result of ionospheric conductivity feedback into the magnetosphere In a given 2 hr window between 2001 and 2021, a substorm occurs roughly 40% of the time, increasing to 67% during windows including an eclipse Conditional Point‐wise Mutual Information analysis suggests the probability of eclipse‐substorm co‐occurrence is higher than random chance The mutual dependence between eclipses and substorms is likely the result of ionospheric conductivity feedback into the magnetosphere

Substorms are a highly variable process, which can occur as an isolated event or as part of a sequence of multiple substorms (compound substorms). In this study we identify how the low‐energy population of the ring current and subsequent energization varies for isolated substorms compared to the first substorm of a compound event. Using observations of H+and O+ions (1 eV to 50 keV) from the Helium Oxygen Proton Electron instrument onboard Van Allen Probe A, we determine the energy content of the ring current in L‐MLT space. We observe that the ring current energy content is significantly enhanced during compound substorms as compared to isolated substorms by ∼20–30%. Furthermore, we observe a significantly larger magnitude of energization (by ∼40–50%) following the onset of compound substorms relative to isolated substorms. Analysis suggests that the differences predominantly arise due to a sustained enhancement in dayside driving associated with compound substorms compared to isolated substorms. The strong solar wind driving prior to onset results in important differences in the time history of the magnetosphere, generating significantly different ring current conditions and responses to substorms. The observations reveal information about the substorm injected population and the transport of the plasma in the inner magnetosphere. Quantitative estimates of ring current energy for compound and isolated substorms are shownThe energy content and postonset enhancement is larger for compound compared to isolated substormsSolar wind coupling is a key driver for differences in the ring current between isolated and compound substorms

We analyze the spatial variation in the response of the surface geomagnetic field (or the equivalent ionospheric current) to variations in the solar wind. Specifically, we regress a reanalysis of surface external and induced magnetic field (SEIMF) variations onto measurements of the solar wind. The regression is performed in monthly sets, independently for 559 regularly spaced locations covering the entire northern polar region above 50° magnetic latitude. At each location, we find the lag applied to the solar wind data that maximizes the correlation with the SEIMF. The resulting spatial maps of these independent lags and regression coefficients provide a model of the localized SEIMF response to variations in the solar wind, which we call “Spatial Information from Distributed Exogenous Regression.” We find that the lag and regression coefficients vary systematically with ionospheric region, season, and solar wind driver. In the polar cap region the SEIMF is best described by the Bycomponent of the interplanetary magnetic field (50–75% of total variance explained) at a lag ∼20–25 min. Conversely, in the auroral zone the SEIMF is best described by the solar wind ϵfunction (60–80% of total variance explained), with a lag that varies with season and magnetic local time (MLT), from ∼15–20 min for dayside and afternoon MLT (except in Oct–Dec) to typically 30–40 min for nightside and morning MLT and even longer (60–65 min) around midnight MLT. Lag of peak correlation between the surface external and induced magnetic field (SEIMF) and solar wind varies in latitude and local timeDifferent solar wind parameters describe most SEIMF variance in different locationsHigher F10.7 lowers the dependence of the SEIMF variation on the solar wind coupling function epsilon

We show that a white‐light all‐sky imager can estimate Pedersen conductance with an uncertainty of 3 mho or 40%. Using a series of case studies over a wide range of geomagnetic activity, we compare estimates of Pedersen conductance from the backscatter spectrum of the Poker Flat Incoherent Scatter Radar with auroral intensities. We limit this comparison to an area bounding the radar measurements and within a limited area close to (but off) imager zenith. We confirm a linear relationship between conductance and the square root of auroral intensity predicted from a simple theoretical approximation. Hence, we extend a previous empirical result found for green‐line emissions to the case of white‐light off‐zenith emissions. The difference between the radar conductance and the best‐fit relationship has a mean of −0.76 ± 4.8 mho and a relative mean difference of 21% ± 78%. The uncertainties are reduced to −0.72 ± 3.3 mho and 0% ± 40% by averaging conductance over 10 min, which we attribute to the time that auroral features take to move across the imager field being greater than the 1‐min resolution of the radar data. Our results demonstrate and calibrate the use of Time History of Events and Macroscale Interactions during Substorms all‐sky imagers for estimating Pedersen conductance. This technique allows the extension of estimates of Pedersen conductance from Incoherent Scatter Radars to derive continental‐scale estimates on scales of ~1–10 min and ~100 km2. It thus complements estimates from low‐altitude satellites, satellite auroral imagers, and ground‐based magnetometers. The Sun is a rotating magnetic plasma ball that releases energetic charged particles and magnetism in a “solar wind.” Sometimes, this wind “shakes hands” with the Earth's magnetic field, allowing energy to be pumped into region near the Earth, stretching magnetic field lines like an elastic band. Much energy is released explosively in a “substorm” causing complex and brilliant auroral light displays about the size of a continent. This can be examined really well over several kilometers by radars on the ground. However, the radars cannot tell you what is happening for the whole substorm which is the size of a continent. It had been suggested that you can use a surface camera with a filter on it to estimate the part of the conductivity that tells us how much electric currents are heating the atmosphere. We asked whether the network of nonfiltered cameras stretching across North America could measure the conductivity as well as a radar can. We found they do half as well as the radar. This means we can use this camera network and its data archive to learn more about how much substorms heat up the atmosphere and how complicated and changeable this behavior is. We use a white‐light all‐sky imager to estimate Pedersen conductance to within an uncertainty of 3 mho or 40%We relate Pedersen conductance to the optical intensity with a single parabolic relationship across a wide range of geomagnetic activityOur results enable the exploitation of white‐light camera networks to study continental‐scale phenomena such as substorms

Measurements of ionospheric flow vorticity can be used for studying ionospheric plasma transport processes, such as convection and turbulence, over a wide range of spatial scales. Here, we analyze probability density functions (PDFs) of ionospheric vorticity for selected regions of the northern hemisphere high‐latitude ionosphere as measured by the Super Dual Auroral Radar Network over a 6‐year interval (2000–2005 inclusive). Subdividing these PDFs for opposite polarities of the Bycomponent of the prevailing interplanetary magnetic field allows the separation into two distinct components: (a) A single‐sided Weibull distribution which relates to the large‐scale convection driven by magnetic reconnection; (b) A double‐sided and symmetric q‐exponential distribution which arises from meso‐scale plasma flow related to processes such as turbulence. This study investigates the processes that contribute to the vorticity of the flow of ionized gases (plasma) in the Earth's ionosphere (at an altitude of ∼250–400 km). Vorticity is a measure of how straight or curved this flow of plasma is at a particular location. We show that the measured probability distributions of ionospheric vorticity at high‐latitude locations can be explained as a combination of vorticity inherent in the large‐scale ionospheric plasma flow pattern driven by variations in the solar wind (plasma and magnetic field ejected by the Sun), and vorticity resulting from meso‐scale fluid processes such as turbulence. Being able to model ionospheric vorticity in this way helps to improve models of the ionospheric flow process, which are often key components of larger operational space weather models. Subdividing ionospheric vorticity probability density functions by the interplanetary magnetic field Bydirection allows their separation into large‐scale and meso‐scale componentsThe large‐scale vorticity relates predominantly to convection and the meso‐scale vorticity to processes such as turbulenceModels of ionospheric plasma flow need to incorporate the effects of meso‐scale processes such as turbulence Subdividing ionospheric vorticity probability density functions by the interplanetary magnetic field Bydirection allows their separation into large‐scale and meso‐scale components The large‐scale vorticity relates predominantly to convection and the meso‐scale vorticity to processes such as turbulence Models of ionospheric plasma flow need to incorporate the effects of meso‐scale processes such as turbulence

The substorm process releases large amounts of energy into the magnetospheric system, although where the energy is transferred to and how it is partitioned remains an open question. In this study, we address whether the substorm process contributes a significant amount of energy to the ring current. The ring current is a highly variable region, and understanding the energization processes provides valuable insight into how substorm‐ring current coupling may contribute to the generation of storm conditions and provide a source of energy for wave driving. In order to quantify the energy input into the ring current during the substorm process, we analyze Radiation Belt Storm Probes Ion Composition Experiment and Helium Oxygen Proton Electron ion flux measurements for H+, O+, and He+. The energy content of the ring current is estimated and binned spatially for Land magnetic local time. The results are combined with an independently derived substorm event list to perform a statistical analysis of variations in the ring current energy content with substorm phase. We show that the ring current energy is significantly higher in the expansion phase compared to the growth phase, with the energy enhancement persisting into the substorm recovery phase. The characteristics of the energy enhancement suggest the injection of energized ions from the tail plasma sheet following substorm onset. The local time variations indicate a loss of energetic H+ions in the afternoon sector, likely due to wave‐particle interactions. Overall, we find that the average energy input into the ring current is ∼9% of the previously reported energy released during substorms. The Earth's near‐space environment is populated by energetic charged particles, whose motion is largely controlled by the global geomagnetic field. This region, known as the magnetosphere, is highly dynamic and variable, strongly coupled to the solar wind (a continuous stream of charged particles outflowing from the Sun). At times, the Earth's magnetic field can become highly distorted and release a large amount of energy into the magnetospheric system. This process is termed a substorm, and the release of energy has significant consequences for the structure of the region and the characteristics of the plasma within it. The amount of energy that is transferred to the magnetospheric particle population remains to be fully understood. In this study, we use spacecraft measurements of highly energetic particles observed by the Van Allen Probes between 2012 and 2017. Using a statistical approach, we quantify the magnitude of the energy input into the particle population due to a typical substorm. Furthermore, we investigate the location of the energy enhancements, providing an insight into how energy is transported throughout the magnetospheric system. This study explored the spatial variations of the average ring current energy content for H+, O+, and He+ ionsThe ring current energy content increases following substorm onset with strong spatial dependencesApproximately 9% of the energy released in a typical substorm is transferred to the ring current

Field‐aligned currents (FACs), also known as Birkeland currents, are the agents by which energy and momentum are transferred to the ionosphere from the magnetosphere and solar wind. This coupling is enhanced at substorm onset through the formation of the substorm current wedge. Using FAC data from the Active Magnetosphere and Planetary Electrodynamics Response Experiment and substorm expansion phase onsets identified using the Substorm Onsets and Phases from Indices of the Electrojet technique, we examine the Northern Hemisphere FACs in all local time sectors with respect to substorm onset and subdivided by season. Our results show that while there is a strong seasonal dependence on the underlying FACs, the increase in FACs following substorm onset only varies by 10% with season, with substorms increasing the hemispheric FACs by 420 kA on average. Over an hour prior to substorm onset, the dayside currents in the postnoon quadrant increase linearly, whereas the nightside currents show a linear increase starting 20–30 min before onset. After onset, the nightside Region 1, Region 2, and nonlocally closed currents and the SuperMAG AL (SML) index follow the Weimer (1994, https://doi.org/10.1029/93JA02721) model with the same time constants in each season. These results contrast earlier contradictory studies that indicate that substorms are either longer in the summer or decay faster in the summer. Our results imply that, on average, substorm FACs do not change with season but that their relative impact on the coupled magnetosphere‐ionosphere system does due to the changes in the underlying currents. Earth is surrounded by electrical currents flowing in space. These currents, which can be 10,000 times greater than domestic electrical supplies, can flow along the Earth's magnetic field and into the upper atmosphere and are linked to aurora. The size of this current depends on atmospheric conditions, with the upper atmosphere being a better conductor when it is sunlit, and the interaction between particles flowing from the Sun and the Earth's magnetic field. During space weather events known as substorms, which happen several times per day on average, the aurora brightens massively and the currents flowing into the upper atmosphere increase. Using data from the Iridium communications satellites, the increase in this current can be measured. While the strength of the day‐to‐day current varies with season, as expected from simple models of the system, the increases due to these space weather events are the same throughout the year. While underlying field‐aligned currents (FACs) vary with season, currents from substorm activity show little seasonal variabilityFACs increase in the postnoon and premidnight quadrants before onset, with faster nightside increases occurring after dayside increasesThe time profile of substorm field‐aligned currents and SML agrees with a resistive‐capacitive model of the current system

We apply the method of data‐interpolating empirical orthogonal functions (EOFs) to ground‐based magnetic vector data from the SuperMAG archive to produce a series of month length reanalyses of the surface external and induced magnetic field (SEIMF) in 110,000 km2equal‐area bins over the entire northern polar region at 5 min cadence over solar cycle 23, from 1997.0 to 2009.0. Each EOF reanalysis also decomposes the measured SEIMF variation into a hierarchy of spatiotemporal patterns which are ordered by their contribution to the monthly magnetic field variance. We find that the leading EOF patterns can each be (subjectively) interpreted as well‐known SEIMF systems or their equivalent current systems. The relationship of the equivalent currents to the true current flow is not investigated. We track the leading SEIMF or equivalent current systems of similar type by intermonthly spatial correlation and apply graph theory to (objectively) group their appearance and relative importance throughout a solar cycle, revealing seasonal and solar cycle variation. In this way, we identify the spatiotemporal patterns that maximally contribute to SEIMF variability over a solar cycle. We propose this combination of EOF and graph theory as a powerful method for objectively defining and investigating the structure and variability of the SEIMF or their equivalent ionospheric currents for use in both geomagnetism and space weather applications. It is demonstrated here on solar cycle 23 but is extendable to any epoch with sufficient data coverage. This study processes over a decade of ground‐based magnetometer data at 5 min resolution to arrive at a new model for the magnetic field external to the Earth's surface. The purpose of the model is threefold: (1) Infill the gaps in the available data using meteorological methods. These produce infill solutions that depend on the data alone, rather than on modeling assumptions, thus improving the infill accuracy. (2) Decompose the infilled data into independent spatial and temporal patterns, each of which describe the maximum possible data variance of any possible pattern. We need these because the structure of the patterns—which is unknown prior to doing the analysis—provides insight into the geomagnetic perturbations at ground level. For instance, we resolve spatiotemporal patterns that we interpret as well‐known ionospheric equivalent electrical current systems, thus we can describe the variation of these systems in time. (3) We wanted to approach the classification of the spatiotemporal patterns in a systematic manner, so we applied a cluster analysis to 12 years of monthly models. This provides a clear overview of geomagnetic variations spanning an 11 year solar cycle. Eigenanalysis method infills missing magnetic field data and provides decomposition into spatial and temporal patterns of maximum varianceGraph theory applied to eigenanalysis models to find clusters of spatially similar patterns in 12 years of monthly analyses (1997.0–2009.0)Combination of eigenanalysis and graph theory resolves seasonal and solar cycle variability in key equivalent ionospheric current systems

This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications. The authors propose more can and should be done to maximise metabolic control, promote appropriate behavioural modifications and encourage timely treatment intensification when indicated to ameliorate diabetes-related complications. All people with diabetes should be screened for sight-threatening diabetic retinopathy promptly and regularly. It is shown that attitudes towards treatment adherence in diabetic macular oedema appear to mirror patients’ views and health behaviours towards the management of their own diabetes. Awareness of diabetic macular oedema remains low among people with diabetes, who need access to education early in their disease about how to manage their diabetes to delay progression and possibly avoid eye-related complications. Ophthalmologists and allied healthcare professionals play a vital role in multidisciplinary diabetes management and establishment of dedicated diabetic macular oedema clinics is proposed. A broader understanding of the role of the diabetes specialist nurse may strengthen the case for comprehensive integrated care in ophthalmic practice. The recommendations are based on round table presentations and discussions held in London, UK, September 2016.

We describe a method of producing high‐resolution models of the Earth's combined external and induced magnetic field using the method of empirical orthogonal functions (EOFs) applied to the SuperMAG archive of ground‐based magnetometer data. EOFs partition the variance of a system into independent modes, allowing us to extract the spatiotemporal patterns of greatest dynamical importance without applying the a priori assumptions of other methods (such as spherical harmonic analysis, parameterized averaging, or multivariate regression). We develop an approach based on that of Beckers and Rixen (2003) and use the EOF modes to infill missing data in a self‐consistent manner. Applying our method to a north polar case study spanning February 2001 (chosen for its proximity to solar maximum and good data coverage), we demonstrate that 41.7% and 9.4% of variance is explained by the leading two modes, respectively, describing the temporal variations of the disturbance polar types 2 and 1 (DP2 and DP1) patterns. A further 14.1% of variance is explained by four modes that describe separate aspects of the motion of the DP1 and DP2 systems. Thus, collectively over 65% of variance is described by the leading six modes and is attributable to DP1 and DP2. This attribution is based on inspection of the spatial morphology of the modes and analysis of the temporal variation of the mode amplitudes with respect to solar wind measures and substorm occurrence. This study is primarily a demonstration of the technique and a prelude to a model spanning the full solar cycle. Disturbance polar equivalent currents types 1 and 2 (DP1 and DP2) resolved at 5 min cadence in all LT sectors and all polar latitudes via EOFDP1 and DP2 shown to collectively account for 65% of the total external and induced magnetic field variance in the polar regionData predictions based on the EOF reanalysis were used to derive time series of the polar cap radius in two local time sectors

On 04 December 2021, a total solar eclipse occurred over west Antarctica. Nearly an hour beforehand, a geomagnetic substorm onset was observed in the northern hemisphere. Eclipses are suggested to influence magnetosphere‐ionosphere (MI) coupling dynamics by altering the conductivity structure of the ionosphere by reducing photoionization. This sudden and dramatic change in conductivity is not only likely to alter global MI coupling, but it may also introduce a variety of localized instabilities that appear in both hemispheres. Global navigation satellite system (GNSS) based observations of the total electron content (TEC) in the southern high latitude ionosphere during the December 2021 eclipse show signs of wave activity coincident with the eclipse peak totality. Ground magnetic observations in the same region show similar activity, and our analysis suggest that these observations are due to an “eclipse effect” rather than the prior substorm. We present the first multi‐point interhemispheric study of a total south polar eclipse with local TEC observational context in support of this conclusion. Solar eclipses occur when the Moon intersects the line between the Earth and the Sun. This configuration of Sun and Moon presents a unique opportunity to investigate the effects of the upper atmosphere's electrical conductivity on plasma waves that is independent of season or geomagnetic field orientation. We present observations of plasma waves in the high latitude region of Earth's upper atmosphere during the eclipse on 04 December 2021. These waves are similar to those else‐wise observed near dawn in regions where the magnetic field lines connect to dark skies in one hemisphere and sunlit skies in the other. We suggest that the waves observed during the December 2021 eclipse have a similar generation mechanism to those that occur near dawn, a result of the difference in conductivities between magnetic field‐line footprints. A total solar eclipse occurred over Antarctica on 4 December 2021 alongside a geomagnetic substormVariations in total electron content (TEC) are spatiotemporally correlated with eclipse shadow peakSimilar ground magnetic variations are observed in both hemispheres, suggesting eclipse driven waves A total solar eclipse occurred over Antarctica on 4 December 2021 alongside a geomagnetic substorm Variations in total electron content (TEC) are spatiotemporally correlated with eclipse shadow peak Similar ground magnetic variations are observed in both hemispheres, suggesting eclipse driven waves

We wanted to examine tolerability and efficacy of NSI-189, a benzylpiperizine-aminiopyridine neurogenic compound for treating major depressive disorder (MDD). This was a Phase 1B, double blind, randomized, placebo controlled, multiple-dose study with three cohorts. The first cohort received 40 mg q.d. (n=6) or placebo (n=2), the second cohort 40 mg b.i.d. (n=6) or placebo (n=2), and the third cohort 40 mg t.i.d. (n=6) or placebo (n=2). Twenty-four patients with MDD were recruited, with the diagnosis and severity confirmed through remote interviews. Eligible patients received NSI-189 or placebo for 28 days in an inpatient setting with assessments for safety, pharmacokinetics (PK) and efficacy. Outpatient follow-up visits were conducted until day 84 (±3). NSI-189 was relatively well tolerated at all doses, with no serious adverse effects. NSI-189 area under the curve increased in a dose-related and nearly proportional manner across the three cohorts, with a half-life of 17.4–20.5 h. The exploratory efficacy measurements, including Symptoms Of Depression Questionnaire (SDQ), Montgomery-Asberg Depression Scale (MADRS), Clinical Global Impressions—Improvement (CGI-I), and The Massachusetts General Hospital (MGH) Cognitive and Physical Functioning Questionnaire (CPFQ) showed a promising reduction in depressive and cognitive symptoms across all measures for NSI-189, with significant improvement in the SDQ and CPFQ, and a medium to large effect size for all measures. These improvements persisted during the follow-up phase. In summary, NSI-189 shows potential as a treatment for MDD in an early phase study. The main limitation of this preliminary study was the small sample size of each cohort.

Substorms are fundamental and dynamic processes in the magnetosphere, converting captured solar wind magnetic energy into plasma energy. These substorms have been suggested to be a key driver of energetic electron enhancements in the outer radiation belts. Substorms inject a keV “seed” population into the inner magnetosphere which is subsequently energized through wave-particle interactions up to relativistic energies; however, the extent to which substorms enhance the radiation belts, either directly or indirectly, has never before been quantified. In this study, we examine increases and decreases in the total radiation belt electron content (TRBEC) following substorms and geomagnetically quiet intervals. Our results show that the radiation belts are inherently lossy, shown by a negative median change in TRBEC at all intervals following substorms and quiet intervals. However, there are up to 3 times as many increases in TRBEC following substorm intervals. There is a lag of 1–3?days between the substorm or quiet intervals and their greatest effect on radiation belt content, shown in the difference between the occurrence of increases and losses in TRBEC following substorms and quiet intervals, the mean change in TRBEC following substorms or quiet intervals, and the cross correlation between SuperMAG AL(SML) and TRBEC. However, there is a statistically significant effect on the occurrence of increases and decreases in TRBEC up to a lag of 6?days. Increases in radiation belt content show a significant correlation with SML and SYM-H, but decreases in the radiation belt show no apparent link with magnetospheric activity levels. The radiation belts are inherently lossySubstorms increase the likelihood of an increase in the radiation belts to 50%The radiation belts have a memory of magnetospheric activity for up to 6?days

There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

During substorm growth phases, magnetic reconnection at the magnetopause extracts ~1015J from the solar wind which is then stored in the magnetotail lobes. Plasma sheet pressure increases to balance magnetic flux density increases in the lobes. Here we examine plasma sheet pressure, density, and temperature during substorm growth phases using 9 years of Cluster data (>316,000 data points). We show that plasma sheet pressure and temperature are higher during growth phases with higher solar wind driving, whereas the density is approximately constant. We also show a weak correlation between plasma sheet temperature before onset and the minimum SuperMAG AL (SML) auroral index in the subsequent substorm. We discuss how energization of the plasma sheet before onset may result from thermodynamically adiabatic processes; how hotter plasma sheets may result in magnetotail instabilities, and how this relates to the onset and size of the subsequent substorm expansion phase. Growth phase plasma sheet temperature varies with solar wind drivingHigher temperatures observed in intervals of higher drivingPlasma sheet temperature can influence substorm onset and size

The balance of dayside and nightside reconnection processes within the Earth's magnetosphere and its effect on the amount of open magnetic flux threading the ionosphere is well understood in terms of the expanding‐contracting polar cap model. However, the nature and character of the consequential fluctuations in the polar cap boundary are poorly understood. By using the poleward auroral luminosity boundary (PALB), as measured by the FUV instrument of the IMAGE spacecraft, as a proxy for the polar cap boundary, we have studied the motion of this boundary for more than 2 years across the complete range of magnetic local time. Our results show that the dayside PALB dynamics are broadly self‐similar on timescales of 12 min to 6 h and appear to be monofractal. Similarity with the characteristics of solar wind and interplanetary magnetic field variability suggests that this dayside monofractal behavior is predominantly inherited from the solar wind via the reconnection process. The nightside PALB dynamics exhibit scale‐free behavior at intermediate time scales (12–90 min) and appear to be multifractal. We propose that this character is a result of the intermittent multifractal structure of magnetotail reconnection. Auroral boundary fluctuations exhibit scale‐free behaviorDayside boundary motion is monofractal and inherited from the solar windNightside boundary motion is multifractal and inherited from the magnetotail

Mental health for all is the main goal of the global mental health movement. Central characteristics to achieving this are examination of the social determinants of health and a more preventive approach; greater task shifting or task sharing; emphasis on common as well as serious mental disorder; a strong research base and a commitment to human rights. Putting the interventions in place in countries with limited resources and particularly African countries that will best promote mental health is challenging and requires a careful balancing of priorities and approaches. Evidence in the form of randomised control trials and cost-effectiveness studies are necessary but not sufficient to achieving the set objectives. This editorial points to various considerations that may contribute towards the quest for mental health for all.

This study describes an analysis of major risk factors that influence complications due to islet autotransplantation following total pancreatectomy and recommends thresholds for tissue volume infusion and changes in portal pressure.