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Climate change increases the occurrence and severity of droughts due to increasing temperatures, altered circulation patterns, and reduced snow occurrence. While Europe has suffered from drought events in the last decade unlike ever seen since the beginning of weather recordings, harmonized long-term datasets across the continent are needed to monitor change and support predictions. Here we present soil moisture data from 66 cosmic-ray neutron sensors (CRNSs) in Europe (COSMOS-Europe for short) covering recent drought events. The CRNS sites are distributed across Europe and cover all major land use types and climate zones in Europe. The raw neutron count data from the CRNS stations were provided by 24 research institutions and processed using state-of-the-art methods. The harmonized processing included correction of the raw neutron counts and a harmonized methodology for the conversion into soil moisture based on available in situ information. In addition, the uncertainty estimate is provided with the dataset, information that is particularly useful for remote sensing and modeling applications. This paper presents the current spatiotemporal coverage of CRNS stations in Europe and describes the protocols for data processing from raw measurements to consistent soil moisture products. The data of the presented COSMOS-Europe network open up a manifold of potential applications for environmental research, such as remote sensing data validation, trend analysis, or model assimilation. The dataset could be of particular importance for the analysis of extreme climatic events at the continental scale. Due its timely relevance in the scope of climate change in the recent years, we demonstrate this potential application with a brief analysis on the spatiotemporal soil moisture variability. The dataset, entitled "Dataset of COSMOS-Europe: A European network of Cosmic-Ray Neutron Soil Moisture Sensors", is shared via Forschungszentrum Jülich: 10.34731/x9s3-kr48 (Bogena and Ney, 2021). [ABSTRACT FROM AUTHOR]

The cosmic-ray neutron sensor method of soil moisture measurement is now widely used and is fundamental to the COSMOS-UK soil moisture monitoring network. The method is based on a relationship between a measured flux of neutrons and soil moisture, and requires the neutron count to be adjusted for time variations of atmospheric pressure, humidity and the incoming flux of cosmic-ray neutrons. This note describes an empirical approach to the development of a revised correction factor for the last of these. Using the revised correction factor makes a significant difference to the derived soil moisture at wetter sites. This has implications for quantifying the soil moisture regime at these sites and management decisions that depend on a proper understanding of soil moisture dynamics, such as flood management and the release of greenhouse gases. [ABSTRACT FROM AUTHOR]

Human-caused climate change increases the occurrence and severity of droughts due to increasing temperatures, altered circulation patterns and reduced snow occurrence. For example, Europe has suffered from drought events in the last decade like never since the beginning of weather recording. Here we present soil moisture data from 65 Cosmic-ray neutron sensors (CRNS) in Europe (COSMOS-Europe for short) covering recent drought events. The CRNS sites are distributed across Europe and cover all major land use types and climate zones in Europe. The raw neutron count data from the CRNS stations were provided by 23 research institutions and processed using state-of-the-art methods. The harmonised processing included correction of the raw neutron counts, and a harmonised methodology for the conversion into soil moisture based on available in-situ information. In addition, information on the data uncertainty is provided with the dataset, information that is particularly useful for remote sensing and modelling applications. This paper presents the current spatiotemporal coverage of CRNS stations in Europe and describes the protocols for data processing from raw measurements to consistent soil moisture products as well as first results on how the recent drought events have been captured by the CRNS network. This harmonised European soil moisture dataset will help both hydrologists and climate scientists to study individual drought events, to understand their causes, to evaluate and improve their modelling, and to estimate the extremity of current events. The dataset, entitled “Dataset of COSMOS-Europe: A European network of Cosmic-Ray Neutron Soil Moisture Sensors”, is shared via Forschungszentrum Jülich: https://doi.org/10.34731/x9s3-kr48 (Bogena and Ney, 2021). [ABSTRACT FROM AUTHOR]

The COSMOS-UK observation network has been providing field-scale soil moisture and hydrometeorological measurements across the UK since 2013. At the time of publication a total of 51 COSMOS-UK sites have been established, each delivering high-temporal resolution data in near-real time. Each site utilizes a cosmic-ray neutron sensor, which counts epithermal neutrons at the land surface. These measurements are used to derive field-scale near-surface soil water content, which can provide unique insight for science, industry, and agriculture by filling a scale gap between localized point soil moisture and large-scale satellite soil moisture datasets. Additional soil physics and meteorological measurements are made by the COSMOS-UK network including precipitation, air temperature, relative humidity, barometric pressure, soil heat flux, wind speed and direction, and components of incoming and outgoing radiation. These near-real-time observational data can be used to improve the performance of hydrological models, validate remote sensing products, improve hydro-meteorological forecasting, and underpin applications across a range of other scientific fields. The most recent version of the COSMOS-UK dataset is publically available at 10.5285/b5c190e4-e35d-40ea-8fbe-598da03a1185 (Stanley et al., 2021). [ABSTRACT FROM AUTHOR]

Background: Radiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis, a malalignment of the spinal vertebrae, may be a co-existing condition contributing to pain; yet the effect of RFA on advancing listhesis is unknown. To the extent that denervating RFA may weaken paraspinal muscles that provide stability to the spine, the therapy can potentially contribute to progressive spinal instability. Methods: Single-center, prospective, observational pilot study in an interventional pain practice to test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis. Fifteen participants with pre-existing degenerative Grade I or Grade II spondylolisthesis and coexisting axial lumbar pain underwent lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis. Results: The primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared with non-intervention inferred baseline advancement of 2% per very limited observational studies. Among the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow-up time 23.9 months). The mean advancement of spondylolisthesis per year after RFA was 1.30% (95% CI − 0.14 to 2.78%), with 9/14 below 1.25%. Conclusion: Among patients with lumbar pain originating from facets in the setting of degenerative spondylolisthesis who underwent lumbar RFA, the observed advancement of spondylolisthesis is clinically similar to the estimated maximum baseline of 2% per year change. The study findings did not find a destabilizing effect of lumbar RFA in advancing spondylolisthesis in this patient population. [ABSTRACT FROM AUTHOR]

The COSMOS-UK observation network has been providing field scale soil moisture and hydrometeorological measurements across the UK since 2013. At the time of publication a total of 51 COSMOS-UK sites have been established, each delivering high temporal resolution data in near-real time. Each site utilises a cosmic-ray neutron sensor, which counts fast neutrons at the land surface. These measurements are used to derive field scale near-surface soil water content, which can provide unique insight for science, industry, and agriculture by filling a scale gap between localised point soil moisture and large-scale satellite soil moisture datasets. Additional soil physics and meteorological measurements are made by the COSMOS-UK network including precipitation, air temperature, relative humidity, barometric pressure, soil heat flux, wind speed and direction, and components of incoming and outgoing radiation. These near-real time observational data can be used to improve the performance of hydrological models, validate remote sensing products, improve hydro-meteorological forecasting and underpin applications across a range of other scientific fields. The most recent version of the COSMOS-UK dataset is publically available at https://doi.org/10.5285/37702a54-b7a4-40ff-b62e-d14b161b69ca (Stanley et al., 2020). [ABSTRACT FROM AUTHOR]

The UK Hydrological Outlook (UKHO) is a seasonal forecast of future river flows and groundwater levels. The UKHO contains both presentations of outputs from models simulating future conditions and a high-level summary. The summary is produced by an expert panel of forecasters that considers the model outputs together with other recent hydrological and meteorological information. Whilst the skill and uncertainty of the individual models have been explored and published, this study sets out to establish the performance of the high-level summary, and presents such an assessment of the river flow forecasts at the 1-month timescale. Both qualitative and quantitative assessments are presented and compared with two naïve forecasting methods. The UKHO summary is found to have a similar Gerrity skill score to a "same as last month" forecast, an outcome that generates suggestions for improvements in how the different model outputs should be considered and presented in the high-level summary. [ABSTRACT FROM AUTHOR]

Objective. We aim to study the impact of preoperative opioid dosage on postoperative length of stay (LOS) in patients undergoing thoracic spinal cord stimulator (SCS) placement surgery as a primary objective. Secondary objectives of this study include investigating patient-controlled analgesia (PCA) usage and postoperative complications like fever in relation to patients' preoperative opioid dosage and postoperative LOS. Methods. A total of 47 patients who underwent thoracic SCS for first time were retrospectively studied through chart review. These patients were categorized into two groups, with Group I patients taking a morphine equivalent dose (MED) of less than 100mg and Group II patients taking an MED of more than 100mg preoperatively. Results. Group I had 22 patients, and Group II had 25 patients. The average age in Group I was 53.45 years, and the average age in Group II was 50.16 years. There were seven males (38%) and 15 females (62%) in Group I, and in Group II there were 11 males (44%) and 14 females (56%). The average LOS in both groups was two days. In Group I, there were 16 patients (73%) who had an LOS of one day and six patients (27%) who had an LOS of more than one day, and in Group II there were 11 patients (44%) who had an LOS of less than one day and 14 patients (56%) who had an LOS of more than one day, with a P value of 0.047. On univariate analysis, postoperative fever and PCA usage correlated with longer hospital stay, with a P value of < 0.001. Conclusion. Patients on high-dose chronic opioid therapy, defined as an MED greater than 100 mg, who undergo thoracic spinal cord stimulator surgery tend to have longer postoperative hospital stays compared with patients on lower-dose opioid therapy. [ABSTRACT FROM AUTHOR]

This paper describes the development of the first operational seasonal hydrological forecasting service for the UK, the Hydrological Outlook UK (HOUK). Since June 2013, this service has delivered monthly forecasts of streamflow and groundwater levels, with an emphasis on forecasting hydrological conditions over the next three months, accompanied by outlooks over longer time horizons. This system is based on three complementary approaches combined to produce the outlooks: (i) national-scale modelling of streamflow and groundwater levels based on dynamic seasonal rainfall forecasts, (ii) catchment-scale modelling where streamflow and groundwater level models are driven by historical meteorological forcings (i.e. the Ensemble Streamflow Prediction, ESP, approach), and (iii) a catchment-scale statistical method based on persistence and historical analogues. This paper provides the background to the Hydrological Outlook, describes the various component methods in detail and then considers the impact and usefulness of the product. As an example of a multi-method, operational seasonal hydrological forecasting system, it is hoped that this overview provides useful information and context for other forecasting initiatives around the world. [ABSTRACT FROM AUTHOR]

Objective Intracranial monitoring is fundamental to epilepsy surgery, with reported complication rates of 3-17%. We aimed to assess the differences in complication rates between subdural and depth electrodes. Methods We conducted a retrospective review of 317 electrode implantation procedures. All documented abnormal postoperative findings were recorded in our study. Those that resulted in a significant alteration of treatment course, including neurologic deficit, long-term medication use, reoperation, or hospital readmission, were deemed clinically significant. When possible, findings were attributed to a particular electrode type based on relative location to each electrode. Results Postoperative abnormalities were associated with SDE placement in 152 (47.9%) procedures and 40 (25.2%) DE placements (p < 0.001). Twenty-nine (9.1%) clinically significant complications were seen in the subdural electrode ( SDE) group compared to 10 associated with DEs (6.3%, p = 0.37). SDEs were associated with increased rates of any postoperative hemorrhage (p < 0.001) or extraaxial collection (p = 0.007). Subdural grid placement was associated with an increased risk of any extraaxial collection (odds ratio [ OR 2.42), as well as clinically significant collections ( OR 9.47). Previous craniotomy was found to be associated with any abnormal postoperative finding ( OR 1.71) as well as radiographic hemorrhage ( OR 1.99). Concurrent resection is also associated with abnormal findings ( OR 1.83) and extraaxial collections ( OR 2.37). The overall complication rate was 9.1%, with 13 procedures (4.1%) resulting in neurologic deficit. However, only two patients (0.6%) had permanent neurologic sequelae resulting from lead placement. Significance Subdural electrodes appear to have an increased rate of abnormal postoperative findings, including hemorrhage and extraaxial collections; however, there was no difference in clinically significant findings. Subdural grids also appear to be associated with symptomatic extraaxial collections, and previous craniotomy increases the risk of hemorrhage. Overall, intracranial monitoring remains a safe and effective procedure for localization of operative seizure foci. Patient selection and risk education for various modalities is an essential aspect of preoperative evaluation. [ABSTRACT FROM AUTHOR]

Models are widely used to assist water managers in their duties, yet there is little advice to help water managers select a model appropriate to their particular application. The advice that is available is specific to either the application type or models considered, focused on one aspect of model application, e.g. goodness-of-fit comparisons between observations and simulations and unrealistic, e.g. in separating model selection from wider aspects of the intended application. This paper proposes a model selection protocol that recognises the particular requirements of the application, the roles of individuals associated with modelling studies, and the importance of establishing an informed dialogue between them. Establishing this common understanding at the outset of any modelling study is highly important in securing a successful outcome to the modelling process. [ABSTRACT FROM AUTHOR]

A method of model evaluation is presented which utilises a comparison with a benchmark model. The proposed benchmarking concept is one that can be applied to many hydrological models but, in this instance, is implemented in the context of an in-stream water quality model. The benchmark model is defined in such a way that it is easily implemented within the framework of the test model, i.e. the approach relies on two applications of the same model code rather than the application of two separate model codes. This is illustrated using two case studies from the UK, the Rivers Aire and Ouse, with the objective of simulating a water quality classification, general quality assessment (GQA), which is based on dissolved oxygen, biochemical oxygen demand and ammonium. Comparisons between the benchmark and test models are made based on GQA, as well as a step-wise assessment against the components required in its derivation. The benchmarking process yields a great deal of important information about the performance of the test model and raises issues about a priori definition of the assessment criteria. [ABSTRACT FROM AUTHOR]

Targeted overexpression of an ornithine decarboxylase (ODC) transgene to mouse skin (the K6/ ODC mouse) significantly enhances susceptibility to carcinogenesis. While in most strain backgrounds the predominant tumor type resulting from initiation-promotion protocols is benign squamous papilloma, K6/ODC mice on a FVB/N background develop malignant squamous cell carcinomas (SCCs) rapidly and in high multiplicity after carcinogen treatment. We have investigated the utility of polyamine-based therapy against SCCs in this model using the ODC inhibitor 2- difluoromethylornithine delivered orally. At a 2% concentration in drinking water, DFMO caused rapid tumor regression, but in most cases, tumors eventually regrew rapidly even in the presence of DFMO. The tumors that regrew were spindle cell carcinomas, an aggressive undifferentiated variant of SCC. At 1% DFMO in the drinking water, tumors also responded rapidly, but tumor regrowth did not occur. The majority of DFMO-treated SCCs were classified as complete responses, and in some cases, apparent tumor cures were achieved. The enzymatic activity of ODC, the target of DFMO, was substantially reduced after treatment with 1% DFMO and the high SCC polyamine levels, especially putrescine, were also significantly lowered. Based on the results of BrdUrd labeling and TUNEL assays, the effect of DFMO on SCC growth was accompanied by a significant reduction in tumor proliferation with no increase in the apoptotic index. These results demonstrate that SCCs, at least in the mouse, are particularly sensitive to polyamine-based therapy. [ABSTRACT FROM AUTHOR]

Objective: To determine the rate of change of antimüllerian hormone (AMH) level in the late reproductive years and its associations with time to menopause (TTM). We hypothesized that the rate of change between two measures of AMH reflects follicular atresia and varies among women independent of age.Design: A14-year follow-up.Setting: A randomly identified, population-based cohort (Penn Ovarian Aging Study).Patient(s): Two measures of AMH were evaluated in survival analysis of 293 women.Intervention(s): None.Main Outcome Measure(s): Time to menopause.Result(s): The rate of AMH change was a strong independent predictor of TTM in multivariable analysis after adjusting for AMH baseline, age, and smoking (hazard ratio for 1 SD change = 1.82, 95% confidence interval 1.56-2.14). Among women with similar AMH levels, TTM differed by approximately 2 years when compared between a slow and fast rate of AMH change. A significant interaction of AMH rate of change and age indicated that a faster decrease in AMH level was associated with an increased risk of menopause in women aged 35-39 years (hazard ratio 6.97, 95% confidence interval 3.81-12.72), with less dramatic but significant associations in women aged 40-44 and 45-48 years.Conclusion(s): The AMH rate of change was independently associated with TTM in late reproductive-age women and increased the precision of estimates of TTM when included with an AMH baseline level and age. The rate of AMH change may be a more direct surrogate than age and increases the precision of estimates of TTM during this clinically important time period. [ABSTRACT FROM AUTHOR]

Objective The neuroendocrine response to critical illness is dichotomous as it is adaptive during the acute phase then transitions to maladaptive as critical illness becomes prolonged in 25-30% of patients. Presently, monitoring all critically ill patients for endocrinopathies is not the standard of care. However, given the negative impact on patient prognosis, a need to identify those at risk for endocrinopathies, may exist. Thus, a screening tool to identify endocrinopathies along the somatotroph and gonadal axes in a cardiothoracic surgery population was developed. Methods A prospective observational pilot study was conducted in two cardiothoracic surgery intensive care units (ICU) within a multi-site healthcare system. Total testosterone and somatomedin C levels were obtained from 20 adult patients who remained in the ICU for greater than seven days after cardiothoracic surgery and were tolerating nutrition, had a risk of malnutrition and a mobility score of moderate to dependent assistance. Results Twenty patients were included for descriptive analysis (seven females). Thirteen patients tested low for total testosterone, with males more likely to have a testosterone-related endocrinopathy as compared to females (100% vs. 0 to 43%, p = 0.0072). A higher proportion of low somatomedin C levels was found in females than males (57% vs. 31%); however, the difference was not statistically significant (p = 0.251). Conclusions The screening tool used in this pilot study accurately predicted low total testosterone in all men and reasonably predicted low somatomedin C in a majority of women. However, the ability of the tool to predict low total testosterone in women and low somatomedin C in men is less certain. A gender-specific screening tool might be necessary to predict hormonal deficiencies., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Ward et al.)

Introduction: Celiac plexus neurolysis (CPN) has been verified for mitigating pancreatic cancer pain. However, information regarding CPN's use beyond this remains limited., Objectives: Identify which cancers benefit from CPN, which symptoms improve, and when symptoms improve., Methods: Retrospective analysis was conducted on 173 patients who received CPN for pain caused by various malignancies. Mean symptom changes on the MD Anderson Symptom Inventory (MDASI) from baseline to 2 weeks, 1 month, and 2 months after CPN were analyzed overall and then by cancer type: pancreatic (all stages and stages III-IV), hepatobiliary, and nonpancreatic, nonhepatobiliary gastrointestinal (NPNH-gastrointestinal)., Results: Eighty-two pancreatic, 43 NPNH-gastrointestinal, 14 hepatobiliary, and 34 patients with other cancers met inclusion criteria. Statistically significant changes included decrease in the pain score at 1 month by 1.01 points for all cancers, 1.65 points for all pancreatic cancers, and 1.88 points for late-stage pancreatic cancers. At 2 months, pain decreased by 1.50 points for all cancers, 1.68 points for all pancreatic cancers, 2.37 points for late-stage pancreatic cancers, and 1.50 points in NPNH-gastrointestinal cancers. At 2 months, quality of life improved by 1.07 points for all cancers and 1.53 points for all pancreatic cancers. Sleep improved at 2 months for all cancers by 0.73 points and 1.60 points in late-stage pancreatic cancers. At 2 months, pancreatic cancer patients improved in general activity by 0.93 points, walking by 1.00 points, and working by 1.12 points., Conclusion: Celiac plexus neurolysis can decrease cancer symptom burden beyond pain including quality of life and sleep for pancreatic and nonpancreatic cancers, as well as general activity for pancreatic cancers., Competing Interests: Dr. Vinita Singh is a consultant for Releviate LLC. The remaining authors have no conflicts of interest to declare. Dr. V. Singh is a KL2 scholar at the Georgia, Clinical, and Translational Science Alliance and would like to acknowledge that this article was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award number ULTR002378 and KL2TR002381. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)

Targeted overexpression of an ornithine decarboxylase (ODC) transgene to mouse skin (the K6/ODC mouse) significantly enhances susceptibility to carcinogenesis. While in most strain backgrounds the predominant tumor type resulting from initiation-promotion protocols is benign squamous papilloma, K6/ODC mice on a FVB/N background develop malignant squamous cell carcinomas (SCCs) rapidly and in high multiplicity after carcinogen treatment. We have investigated the utility of polyamine-based therapy against SCCs in this model using the ODC inhibitor 2-difluoromethylornithine delivered orally. At a 2% concentration in drinking water, DFMO caused rapid tumor regression, but in most cases, tumors eventually regrew rapidly even in the presence of DFMO. The tumors that regrew were spindle cell carcinomas, an aggressive undifferentiated variant of SCC. At 1% DFMO in the drinking water, tumors also responded rapidly, but tumor regrowth did not occur. The majority of DFMO-treated SCCs were classified as complete responses, and in some cases, apparent tumor cures were achieved. The enzymatic activity of ODC, the target of DFMO, was substantially reduced after treatment with 1% DFMO and the high SCC polyamine levels, especially putrescine, were also significantly lowered. Based on the results of BrdUrd labeling and TUNEL assays, the effect of DFMO on SCC growth was accompanied by a significant reduction in tumor proliferation with no increase in the apoptotic index. These results demonstrate that SCCs, at least in the mouse, are particularly sensitive to polyamine-based therapy.