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Aims Methods Results Conclusions The aims of this study are to determine the long‐term overall survival (OS) after surgically treated malignant struma ovarii (MSO) and to evaluate prognostic effect of adjuvant thyroid‐related therapy (ATRT) in this setting.A systematic review in compliance with Preferred Reporting Items for Systematic reviews and Meta‐Analyses standards was conducted. MEDLINE, CINAHL, CENTRAL, Scopus, trial registries, and gray literature were searched. Due to rarity of the disease, all case reports including patients with surgically treated MSO were pooled to create a single cohort which was then compared with the eligible case series. The OS and survival time were primary outcomes. The OS was determined using Kaplan–Meier survival statistics, and the predictors of OS were determined using the stepwise Cox proportional‐hazards regression model.The study included 376 patients (95 from case reports and 281 from case series). The median age was 44 years; 79% (75/95) were symptomatic. In terms of ATRT, 39% (37/95) received thyroidectomy, 28% (27/95) radioactive iodine, 28% (27/95) hormone suppression therapy, and 55% (52/95) received no therapy. Recurrence occurred in 27% (26/95) with the median time to recurrence of 4 years. The pooled OS was 91% at 10 years and 87% at 20 years. The OS was not predicted by age (p = 0.320), symptomatic status (p = 0.371), follicular histology (p = 0.934), metastatic disease (p = 0.981); omentectomy (p = 0.523), total thyroidectomy (p = 0.371), radioactive iodine therapy (p = 0.285), and thyroid hormone therapy (p = 0.994).Surgically treated MSO may have excellent long‐term prognosis with or without ATRT. It is possible that thyroid‐specific treatments in MSO constitute overtreatment, with no demonstrable survival benefit. Limitations in the evidence base limit the ability to produce definitive conclusions. [ABSTRACT FROM AUTHOR]

Heatwaves in southeastern Australia have characteristic weather patterns that are well understood but are outnumbered by days with similar synoptic‐scale patterns that are not heatwaves. Accordingly, the aim of this study is to identify the key differences between heatwave and non‐heatwave days from 40 years of reanalysis data. A synoptic climatology of seven weather states was constructed by k$$ k $$‐means cluster analysis. Four of these states account for more than 80% of heatwave days across south‐and‐central eastern Australia. Moreover, the spatial maxima in the frequency of the heatwave days are distinct and geographically separated. Heatwave days have a stronger upper anticyclone or ridge that has propagated further equatorward in comparison with non‐heatwave days. The air upstream of the ridge is more humid on heatwave days, whereas downstream of the ridge the air is much drier. These dry anomalies are co‐located with midtropospheric subsidence and the moist anomalies with ascent, and their respective spatial distributions are consistent with regions of adiabatic warming and latent heating identified in recent studies of southeast Australian heatwaves. The corresponding vertical motion on non‐heatwave days is weaker and shifted further poleward. Southeast Queensland heatwave days exhibit increased baroclinicity over the Australian Subtropics and reduced rainfall over Queensland. Further south and west, heatwave days are associated with more amplified Rossby waves and increased rainfall over the Australian Tropics. Anticyclonic Rossby wave breaking is greatly enhanced on heatwave days south of 30°S. For every day in each of these four weather states, the 3‐day‐mean maximum temperature in the region of peak heatwave day frequency is positively correlated with 500 hPa geopotential height anomalies on the equatorward flank of the cluster‐mean upper ridge. These findings underline the importance of equatorward Rossby wave propagation in the dynamics of southeast Australian heatwaves. [ABSTRACT FROM AUTHOR]

The dynamical environment of the stratosphere, during the summer over North America, provides a natural integrator of the impact of convection in the lower stratosphere, as air can be confined for periods of a few days to more than a week. In situ data obtained during the NASA Dynamics and Chemistry of the Summer Stratosphere (DCOTSS) field campaign show increasing water vapor mixing ratios in background air as a function of time the air parcel spent within the North American Monsoon Anticyclone region. We find that water vapor added to the stratosphere by convection decreases with altitude and tends to drop below detectable limits by the 415 K isentrope in 2021 and the 430 K isentrope in 2022. Integrating between potential temperatures of 380 and 460 K we find that convection added between 20 and 32 Tg per summer to the stratosphere in 2021 and 2022. While the total amount is only 1%–4% of the amount ascending in the tropics across the tropical tropopause, small changes in the annual flux of water can have a significant effect on the radiation budget of the atmosphere. Locally, over North America we find that convection increased the water vapor mixing ratio at 380 K by as much as 40%. Tropopause‐penetrating convection is part of the yearly cycle of stratospheric water vapor and we suggest that it must be included in extratropical models to accurately predict future trends in stratospheric water vapor. Plain Language Summary: Water vapor in the stratosphere is important for regulating Earth's climate and also influences the amount of ozone in the stratosphere. Most air rises into the stratosphere through the tropical tropopause where the excess water freezes out leaving very dry air. But air and water can also be injected into the stratosphere via strong convective storm systems. During the summer months, strong storms over the Sierra Madre Occidental and the central United States are known to produce many overshoots that can be seen with radar and satellite. A recent NASA airborne campaign called Dynamics and Chemistry of the Summer Stratosphere (DCOTSS) aimed to study this region. The aircraft was equipped with 12 different sensors measuring gases, aerosols, and meteorological variables. We use these measurements to look at the cumulative effect these storms have on the background air in the stratosphere and specifically calculate the amount of water vapor added by convection as a function of altitude above the tropopause. We find that water added by storms over North America is 1%–4% of the total amount ascending in the tropics. Over North America convection may account for as much as a 40% increase in lower stratospheric water vapor. Key Points: Deep convection over North America lofts significant amounts of water to the lower stratosphereThe North American Monsoon Anticyclone (NAMA) provides a natural integrator of convective perturbations to the stratosphereConvective detrainment of water vapor and ice is quantified by looking at changes in background air as a function of time spent in the NAMA [ABSTRACT FROM AUTHOR]

It is suggested that in addition to seismicity deep fluid injection may cause surface uplift and subsidence in oil and gas‐producing regions. This study uses the Raton Basin as an example to investigate the hydromechanical processes of surface uplift and subsidence during wastewater injection. The Raton Basin, in southern central Colorado and northern central New Mexico, has experienced wastewater injection related to coalbed methane and gas production starting in 1994. In this study, we estimate the extent and magnitude of total vertical deformation in the Raton Basin from 1994 to 2020 and incremental deformation between the years 2017 to 2020. Results indicate a modeled uplift as much as 15 cm occurring between 1994 and 2020. Between 2017 and 2020, up to 3 cm of uplift occurred, largely near the northwestern injection wells. Most modeled uplift between 1994 and 2020 occurred near the southern wells, where the greatest cumulative volume of wastewater was injected. However, modeled subsidence occurred around the southern and eastern wells between 2017 and 2020, after the rate of injection decreased. Modeling indicates that while the magnitude of modeled uplift corresponds to cumulative injection volume and maximum rate in the long‐term, short‐term incremental deformation (uplift or subsidence) is controlled by changes in the rate of injection. The number of yearly earthquake events follows periods of rapid modeled uplifting throughout the Basin, suggesting that measurable surface deformation may be caused by the same injection‐induced pore pressure perturbations that initiate seismicity. [ABSTRACT FROM AUTHOR]

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

Higher self‐reported rumination, a common form of trait perseverative cognition, is linked with lower resting heart rate variability (HRV), which indicates poorer cardiac function and greater disease risk. A meta‐analysis and systematic review indicated that in samples with fewer European Americans, the association of rumination with both heart rate and blood pressure was stronger. Thus, trait rumination may be more strongly associated with resting HRV among ethnically minoritized populations. The current study investigated whether differences in the association of self‐reported rumination with resting HRV varied by ethnicity in a sample (N = 513; Mage = 19.41; 226 Women) of self‐identified African Americans (n = 110), Asian Americans (n = 84), and European Americans (n = 319). Participants completed a five‐minute baseline period to assess resting HRV, followed by the Ruminative Responses Scale, which contains three facets of rumination including brooding, depressive, and reflective rumination. On average, Asian Americans reported higher levels of rumination relative to European Americans. African Americans had higher resting HRV than Asian Americans. Adjusting for covariates, higher self‐reported rumination was significantly associated with lower resting HRV in both African and Asian Americans, but not significantly so in European Americans. This finding was consistent for brooding and reflective, but not depressive rumination. Overall, this study lends insight into a psychological mechanism—rumination—that may impact health disparities among ethnically minoritized individuals, contributing to an understanding of how stress gets under the skin among such minoritized populations. [ABSTRACT FROM AUTHOR]

Purpose: Antimicrobial misuse contributes to antimicrobial resistance in thoracic transplant (TTx) and mechanical circulatory support (MCS) recipients. This study uses a modified Delphi method to define the expected appropriate antimicrobial prescribing for the common clinical scenarios encountered in TTx and MCS recipients. Methods: An online questionnaire on managing 10 common infectious disease syndromes was submitted to a multidisciplinary Delphi panel of 25 experts from various disciplines. Consensus was predefined as 80% agreement for each question. Questions where consensus was not achieved were discussed during live virtual live sessions adapted by an independent process expert. Results: An online survey of 62 questions related to 10 infectious disease syndromes was submitted to the Delphi panel. In the first round of the online questionnaire, consensus on antimicrobial management was reached by 6.5% (4/62). In Round 2 online live discussion, the remaining 58 questions were discussed among the Delphi Panel members using a virtual meeting platform. Consensus was reached among 62% (36/58) of questions. Agreement was not reached regarding the antimicrobial management of the following six clinical syndromes: (1) Burkholderia cepacia pneumonia (duration of therapy); (2) Mycobacterium abscessus (intra‐operative antimicrobials); (3) invasive aspergillosis (treatment of culture‐negative but positive BAL galactomannan) (duration of therapy); (4) respiratory syncytial virus (duration of antiviral therapy); (5) left ventricular assist device deep infection (initial empirical antimicrobial coverage) and (6) CMV (duration of secondary prophylaxis). Conclusion: This Delphi panel developed consensus‐based recommendations for 10 infectious clinical syndromes seen in TTx and MCS recipients. [ABSTRACT FROM AUTHOR]

Sleep during the midday, commonly referred to as siesta, is a common trait of animals that mainly sleep during the night. Work using Drosophila led to the identification of the daywake (dyw) gene, found to have anti‐siesta activity. Herein, we show that the DYW protein undergoes signal peptide‐dependent secretion, is present in the circulatory system, and accumulates in multiple organs, but, surprisingly, it is not detected in the brain where wake–sleep centers are located. The abundance of DYW in adult flies is regulated by age, sex, temperature, and the splicing efficiency of a nearby thermosensitive intron. We suggest that DYW regulates daytime wake–sleep balance in an indirect, extracerebral manner, via a multi‐organ network that interfaces with the circulatory system. [ABSTRACT FROM AUTHOR]

Donor‐derived infections in solid organ transplantation can be prevented by risk stratification of donors based on available information, and inquiries surrounding possible or diagnosed infection are common questions posed to transplant infectious disease subspecialists. This article outlines the five key steps in addressing a donor call from a transplant team in a systematic approach, focusing on donor and recipient‐specific factors, transmissibility and treatment of possible infections, and the likelihood of a patient's future organ offers and mortality remaining on the waitlist. These principles are then applied to five donor call cases, in which we review the key takeaway points and supporting literature. These cases can be used as a resource for teaching with trainees. [ABSTRACT FROM AUTHOR]

Campylobacter jejuni and Campylobacter coli infections are the leading cause of foodborne gastroenteritis in high‐income countries. Campylobacter colonizes a variety of warm‐blooded hosts that are reservoirs for human campylobacteriosis. The proportions of Australian cases attributable to different animal reservoirs are unknown but can be estimated by comparing the frequency of different sequence types in cases and reservoirs. Campylobacter isolates were obtained from notified human cases and raw meat and offal from the major livestock in Australia between 2017 and 2019. Isolates were typed using multi‐locus sequence genotyping. We used Bayesian source attribution models including the asymmetric island model, the modified Hald model, and their generalizations. Some models included an "unsampled" source to estimate the proportion of cases attributable to wild, feral, or domestic animal reservoirs not sampled in our study. Model fits were compared using the Watanabe–Akaike information criterion. We included 612 food and 710 human case isolates. The best fitting models attributed >80% of Campylobacter cases to chickens, with a greater proportion of C. coli (>84%) than C. jejuni (>77%). The best fitting model that included an unsampled source attributed 14% (95% credible interval [CrI]: 0.3%–32%) to the unsampled source and only 2% to ruminants (95% CrI: 0.3%–12%) and 2% to pigs (95% CrI: 0.2%–11%) The best fitting model that did not include an unsampled source attributed 12% to ruminants (95% CrI: 1.3%–33%) and 6% to pigs (95% CrI: 1.1%–19%). Chickens were the leading source of human Campylobacter infections in Australia in 2017–2019 and should remain the focus of interventions to reduce burden. [ABSTRACT FROM AUTHOR]

A monosynaptic pathway connects the substantia nigra pars compacta (SNpc) to neurons of the dorsal motor nucleus of the vagus (DMV). This monosynaptic pathway modulates the vagal control of gastric motility. It is not known, however, whether this nigro‐vagal pathway also modulates the tone and motility of the proximal colon. In rats, microinjection of retrograde tracers in the proximal colon and of anterograde tracers in SNpc showed that bilaterally labelled colonic‐projecting neurons in the DMV received inputs from SNpc neurons. Microinjections of the ionotropic glutamate receptor agonist, NMDA, in the SNpc increased proximal colonic motility and tone, as measured via a strain gauge aligned with the colonic circular smooth muscle; the motility increase was inhibited by acute subdiaphragmatic vagotomy. Upon transfection of SNpc with pAAV‐hSyn‐hM3D(Gq)‐mCherry, chemogenetic activation of nigro‐vagal nerve terminals by brainstem application of clozapine‐N‐oxide increased the firing rate of DMV neurons and proximal colon motility; both responses were abolished by brainstem pretreatment with the dopaminergic D1‐like antagonist SCH23390. Chemogenetic inhibition of nigro‐vagal nerve terminals following SNpc transfection with pAAV‐hSyn‐hM4D(Gi)‐mCherry decreased the firing rate of DMV neurons and inhibited proximal colon motility. These data suggest that a nigro‐vagal pathway modulates activity of the proximal colon motility tonically via a discrete dopaminergic synapse in a manner dependent on vagal efferent nerve activity. Impairment of this nigro‐vagal pathway may contribute to the severely reduced colonic transit and prominent constipation observed in both patients and animal models of parkinsonism. Key points: Substantia nigra pars compacta (SNpc) neurons are connected to the dorsal motor nucleus of the vagus (DMV) neurons via a presumed direct pathway.Brainstem neurons in the lateral DMV innervate the proximal colon. Colonic‐projecting DMV neurons receive inputs from neurons of the SNpc.The nigro‐vagal pathway modulates tone and motility of the proximal colon via D1‐like receptors in the DMV.The present study provides the mechanistic basis for explaining how SNpc alterations may lead to a high rate of constipation in patients with Parkinson's Disease. [ABSTRACT FROM AUTHOR]

There is an ongoing need to understand whether transplantation during acute Coronavirus disease 2019 (COVID‐19) can be performed safely, especially when urgent transplant is required. We collected retrospective data of all consecutive non‐lung transplant recipients who had a positive SARS‐CoV‐2 polymerase chain reaction (PCR) on the day of planned deceased donor organ implantation. Data were collected from two large transplant centers from 01/01/2022 to 02/01/2023. Demographics, details regarding COVID‐19 infection, waitlist priority, and details regarding transplantation were obtained. A descriptive analysis was performed. A total of 12 patients were identified: 7 renal, 4 liver, and 1 heart transplant recipient. All 12 patients were vaccinated for COVID‐19. Ten were asymptomatic outpatients found positive on admission and transplanted immediately. Two were in‐patients with mild COVID‐19 symptoms and were reactivated on the waitlist following 3 days of remdesivir when no progression to severe COVID‐19 occurred. Most patients (10/12) received remdesivir posttransplant. No complications attributed to COVID‐19 were noted nor were any secondary family or healthcare worker infections observed. All recipients were managed with special isolation precautions befitting their potentially infectious state. Standard induction therapy was used in all recipients. After a median follow up period of 143 days (interquartile range: 96–201 days), 3 episodes of rejection were documented, 2/7 renal recipients experienced delayed graft function, and 2/4 liver recipients required renal replacement therapy. Graft and patient survival were 100%. Transplantation can safely proceed in select, minimally symptomatic, non‐lung recipients with a positive SARS‐CoV‐2 PCR at the time of transplant. [ABSTRACT FROM AUTHOR]

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

Stratosphere‐troposphere exchange (STE) is important to the global radiation budget because it is capable of inducing significant changes in trace greenhouse gases such as ozone and water vapor. In the extratropics, stratosphere‐to‐troposphere—or downward—transport (STT) dominates and is routinely driven by upper‐troposphere jet circulations and cyclones. Tropopause‐overshooting convection provides a more rapid STE pathway, but STT in convection is less understood and targeted observations are limited to a handful of fortuitous aircraft encounters. In this study, we seek to improve understanding of STT near thunderstorm anvils using balloon observations of ozone, ground‐based radar observations, visible satellite imagery, and model output. Radar and satellite imagery are used to identify and ultimately target convection driving the "ozone‐wrapping" process. Herein, observations from a single mesoscale convective system in central Oklahoma are reported. A significant ozone enhancement 40%–60% greater than background concentrations in the free troposphere was observed during the balloon ascent underneath and within the anvil of the storm. Backwards particle trajectories were calculated to rule out other sources of this feature such as long‐range transport of stratospheric air and smoke pollution from nearby wildfires. To our knowledge, this work presents the first targeted ozonesonde launch and sampling of this STT process. Plain Language Summary: Ozone is an important greenhouse gas in the atmosphere that contributes to global climate change. Thunderstorms are one of many processes that transport stratospheric air (high in ozone) to the troposphere, but few studies examine the extent to which thunderstorms impact ozone concentrations in the upper troposphere via this process. In this study, we use novel balloon observations of ozone and additional observations of a storm and its environment to measure ozone change in the upper troposphere. During the passage of a large thunderstorm complex in central Oklahoma on 2 May 2022, our balloon observations measured significant ozone enhancement 40%–60% greater than background concentrations near the periphery of the storm in the upper troposphere. Other potential sources of this feature such as long‐range transport of stratospheric air and smoke pollution from nearby wildfires were ruled out. To our knowledge, this work presents the first targeted balloon launch and sampling of high ozone in the troposphere that was transported from the stratosphere by a thunderstorm. Key Points: The first known successful balloon sampling of the anvil wrapping stratosphere‐to‐troposphere transport process in midlatitude convectionOzone enhancements within the observed anvil wrapping are 40%–60% greater than background troposphere concentrationsSimilar ozone enhancements are found within the observed storm anvil [ABSTRACT FROM AUTHOR]

Recent studies have highlighted a key role played by the sympathetic nervous system (SNS) and adrenergic stress in mediating immune suppression associated with chronic inflammation in cancer and other diseases. The connection between chronic SNS activation, adrenergic stress and immune suppression is linked in part to the ability of catecholamines to stimulate the bone marrow release and differentiation of myeloid‐derived suppressor cells (MDSC). Rodent model studies have revealed an important role for β‐adrenergic receptor signalling in suppression of cancer immunity in mice subjected to chronic stresses, including thermal stress. Importantly, therapeutic blockade of beta‐adrenergic responses by drugs such as propranolol can partially reverse the generation and differentiation of MDSC, and partly restore tumour immunity. Clinical trials in both humans and dogs with cancer have demonstrated that propranolol blockade can improve responses to radiation therapy, cancer vaccines and immune checkpoint inhibitors. Thus, the SNS stress response has become an important new target to relieve immune suppression in cancer and other chronic inflammatory conditions. [ABSTRACT FROM AUTHOR]

Calanus finmarchicus were reared from eggs to adults at 12°C and 16°C with non‐limiting food in combination with ambient (600 μatm) and high (1100 μatm) pCO2. These conditions are likely to be encountered by the species at the southern margins of its biogeographical range by the end of the century. Dry weight (DW), carbon (C) and nitrogen (N) mass, oil‐sac volume (OSV), fatty acid composition (FA), and oxygen consumption rates (OCR) were measured on newly molted stage CV copepodites and recently molted adult females. By focusing our measurements on these precise events in the life cycle, we were able to obtain a more accurate comparison of growth and respiration across treatments. Copepods raised at 12°C had a significantly greater DW, OSV, and C and N mass than those raised at 16°C High pCO2, independent of temperature, was associated with a further increase in the DW and C content of the copepods. Interactive effects of temperature and pCO2 resulted in a larger OSV at low temperature and high pCO2. Mass‐specific respiration rates were significantly lower at lower temperatures and elevated pCO2 suggesting that the increase in mass (DW, C, and OSV) resulted from reduced metabolic cost. The composition of fatty acids in the copepods varied mainly with temperature. Two fatty acids varied with pCO2: 16:0 tended to decrease with higher pCO2 and 18:3n−3 tended to increase with higher pCO2. These observations suggest that elevated pCO2/lower pH in future oceans may have a beneficial effect on C. finmarchicus. [ABSTRACT FROM AUTHOR]

Age‐related macular degeneration (AMD) is the leading cause of blindness in the developed world and primarily affects the older population. This project developed a virtual reality (VR) simulation of AMD that allows users to alter the intensity of the impairments while using the simulation, as well as offering a guided timelapse of the possible progression of the condition. The simulation also demonstrates Charles Bonnet Syndrome (CBS), showing numerous different types of visual hallucinations that may occur alongside AMD. [ABSTRACT FROM AUTHOR]

Although major advancements have been made in the therapeutics for people with cystic fibrosis (PwCF), many still require the use of multiple medications to manage acute exacerbations of disease and maintain health. Iterative trial and error processes of pharmacotherapeutic management can be optimized by assessing and incorporating pharmacogenetics. For 82 PwCF, we reviewed 2 years of medication use and response history and interrogated metabolizer status for common pharmacogenes, revealing 3336 medication exposure events (MEEs) to 286 unique medications. As expected, the more frequent MEEs were those commonly used to treat cystic fibrosis (CF), such as antibiotics and respiratory medications. Antibiotics also comprised 56.7% of the undesirable drug responses. The impact of gene variants on drug responses was assessed using Pharmacogenomics Knowledgebase (PharmGKB) and Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Thirty‐three (11.5%) medications have strong evidence of genetic influence on response as evidenced by gene‐based dosing guidelines. 110 (38.5%) unique medications had at least one association with a very important pharmacogene, whereas 143 (50%) were associated with at least one clinical or variant annotation. Over 97% of participants had at least one actionable genotype. Eleven (13.4%) patients with an actionable genotype, taking the impacted medication, had an undesirable drug response described in the CPIC guidelines that could potentially have been mitigated with a priori knowledge of the genotype. PwCF take many medications for disease management, with frequent dose changes to elicit a desired clinical effect. As CF care evolves, implementing pharmacogenetics testing can improve efficiency and safety of prescribing practices using precision selection and dosing at medication initiation. [ABSTRACT FROM AUTHOR]

The blood brain barrier (BBB) has the essential function to protect the brain from potentially hazardous molecules while also enabling controlled selective uptake. How these processes and signaling inside BBB cells control neuronal function is an intense area of interest. Signaling in the adult Drosophila BBB is required for normal male courtship behavior and relies on male‐specific molecules in the BBB. Here we show that the dopamine receptor D2R is expressed in the BBB and is required in mature males for normal mating behavior. Conditional adult male knockdown of D2R in BBB cells causes courtship defects. The courtship defects observed in genetic D2R mutants can be rescued by expression of normal D2R specifically in the BBB of adult males. Drosophila BBB cells are glial cells. Our findings thus identify a specific glial function for the DR2 receptor and dopamine signaling in the regulation of a complex behavior. [ABSTRACT FROM AUTHOR]

Beaked whale foraging pulses were detected on the Pacific Missile Range Facility (PMRF) off Kauaʻi, Hawaiʻi, via long term passive acoustic monitoring. The unidentified pulses do not match foraging pulses of known species on the range but are similar to the unidentified beaked whale first detected at Cross Seamount, Hawaiʻi. Although there has not been a visual confirmation of the unidentified beaked whale species, analysis of data collected from 2007 to 2019 has identified beaked whale foraging dive characteristics from echolocation pulses. From the 13 years of data, the most distinct patterns were that all foraging dives occurred at night and the nighttime foraging dive rate was 0.11 group vocal periods (GVP) per hour, with most detections on shallow hydrophones (625–1,000 m deep) over steep bathymetric slopes. Data collected during U.S. Navy training events were used to compare dive behavior during mid‐frequency active sonar (MFAS) activity against baseline periods; it was determined that the whales reduced GVPs during sonar and these remained low for at least 3 days after the training events. These results are the first long‐term record of acoustic signals from the Cross Seamount beaked whale and provide important insights into their habitat use and occurrence patterns. [ABSTRACT FROM AUTHOR]

Circadian rhythm disruption is implicated in the initiation and progression of many diseases, including cancer. External stimuli, such as sunlight, serve to synchronize physiological processes and cellular functions to a 24‐h cycle. The immune system is controlled by circadian rhythms, and perturbation of these rhythms can potentially alter the immune response to infections and tumors. The effect of circadian rhythm disruption on the immune response to tumors remains unclear. Specifically, the effects of circadian disruption (CD) on immunosuppressive cell types within the tumor, such as myeloid‐derived suppressor cells (MDSCs), are unknown. In this study, a shifting lighting schedule is used to disrupt the circadian rhythm of mice. After acclimation to lighting schedules, mice are inoculated with 4T1 or B16‐F10 tumors. Tumor growth is increased in mice housed under circadian disrupting lighting conditions compared to standard lighting conditions. Analysis of immune populations within the spleen and tumor shows an increased accumulation of MDSCs within these tissues, suggesting that MDSC mediated immunosuppression plays a role in the enhanced tumor growth caused by circadian disruption. This paves the way for future studies of the effects of CD on immunosuppression in cancer. [ABSTRACT FROM AUTHOR]

The Organ Procurement and Transplantation Network maintains a data review that is regularly updated as a potential source of additional information.13 We commend transplant centers for sharing their experiences transplanting organs from COVID-positive recipients and urge others to do the same. As the coronavirus disease 2019 (COVID-19) pandemic evolves, transplant centers are successfully exploring avenues to safely utilize organs from donors testing positive for COVID-19. As the SARS-CoV2 virus becomes endemic, donors will continue to test positive for COVID-19, and transplant centers need to understand how to assess these donors and safely utilize these organs. [Extracted from the article]

Tropopause‐overshooting convection in the midlatitudes rapidly transports lower troposphere air and cloud material to the upper troposphere and lower stratosphere (UTLS), with notable events resulting in the formation of above‐anvil cirrus plumes (AACPs). However, there is limited understanding of how transport driven by overshooting convection and AACP properties are modified by variations in UTLS environments, especially the extent of stratosphere‐to‐troposphere (i.e., downward) transport. Here, AACP development and UTLS transport sensitivities to lower stratosphere stability and the UTLS wind environment are evaluated. The Bryan Cloud Model is used to simulate midlatitude supercell convection and evaluate resulting UTLS composition changes within two common midlatitude thermodynamic environments: a single tropopause and a double tropopause, and two UTLS wind environments: one with a stronger stratospheric wind profile supportive of frequent gravity wave breaking and AACP development and the other with a weaker stratospheric wind profile to suppress gravity wave breaking and discourage AACP formation. Multiple passive tracers and water vapor concentrations are used to evaluate the exchange of air between the troposphere and stratosphere and transport confined to each layer. It is found that greater troposphere‐to‐stratosphere transport (TST) and stratospheric hydration occurs in storms with AACPs, while stratosphere‐to‐troposphere transport (STT) is greater in storms without AACPs. This STT is facilitated by a mechanical oscillation induced by the overshoot. AACP‐producing storms have increased downward transport of stratospheric overworld air to the lowermost stratosphere, which is enhanced within a double tropopause environment. More expansive AACPs, deeper overshoots, and greater TST also occurs in double tropopause environments. Key Points: Stratosphere stability has a minimal impact on stratosphere‐to‐troposphere transport in overshooting convectionStratosphere‐to‐troposphere transport is greater in storms without above‐anvil cirrus plumesA mechanical oscillation induced by the overshoot facilitates stratosphere‐to‐troposphere transport [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis can be transmitted via organ donation and result in severe outcomes. To better understand donor‐derived tuberculosis (DDTB), all potential transmissions reported to the Organ Procurement and Transplantation Network (OPTN) Ad Hoc Disease Transmission Advisory Committee between 2008 and 2018 were analyzed. Among 51 total reports, nine (17%) (9 donors/35 recipients) had ≥ 1 recipient with proven/probable disease transmission. Of these, eight were reported due to recipient disease, and one was reported due to a positive donor result. Proven/probable DDTB transmissions were reported in six lung and five nonlung recipients. The median time to diagnosis was 104 days posttransplant (range 0–165 days). Pulmonary TB, extrapulmonary TB, pulmonary plus extrapulmonary TB, and asymptomatic TB infection with positive interferon‐gamma release assay were present in five, three, one, and two recipients, respectively. All recipients received treatment and survived except for one whose death was not attributed to TB. All donors associated with proven/probable DDTB had ≥ 1 TB risk factor. Six were born in a TB‐endemic country, five had traveled to a TB‐endemic country, three had been incarcerated, and three had latent TB infection. These cases highlight the importance of evaluating donors for TB based on risk factors. Early posttransplant TB in organ recipients of donors with TB risk factors requires prompt reporting to OPTN to identify other potential affected recipients and implement timely treatment interventions. [ABSTRACT FROM AUTHOR]

General Circulation Models (GCMs) have for decades exhibited difficulties in modelling the diurnal cycle of precipitation (DCP). This issue can be related to inappropriate representation of the processes controlling sub-diurnal phenomena like convection. In this study, 11 single-column versions of GCMs are used to investigate the interactions between convection and environmental conditions, processes that control nocturnal convections, and the transition from shallow to deep convection on a diurnal time-scale. Long-term simulations are performed over two continental land sites: the Southern Great Plains (SGP) in the USA for 12 summer months from 2004 to 2015 and the Manacapuru site at the central Amazon (MAO) in Brazil for two full years from 2014 to 2015. The analysis is done on two regimes: afternoon convective regime and nocturnal precipitation regime. Most models produce afternoon precipitation too early, likely due to the missing transition of shallow-to-deep convection in these models. At SGP, the unified convection schemes better simulate the onset time of precipitation. At MAO, models produce the heating peak in a much lower level compared with observation, indicating too shallow convection in the models. For nocturnal precipitation, models that produce most of nocturnal precipitation all allow convection to be triggered above the boundary layer. This indicates the importance of model capability to detect elevated convection for simulating nocturnal precipitation. Sensitivity studies indicate that (a) nudging environmental variables towards observations has a minor impact on DCP, (b) unified treatment of shallow and deep convection and the capability to capture mid-level convection can help models better capture DCP, and (c) the interactions of the atmosphere with other components in the climate system (e.g. land) are also important for DCP simulations in coupled models. These results provide long-term statistical insights on which physical processes are essential in climate models to simulate DCP. [ABSTRACT FROM AUTHOR]

General Circulation Models (GCMs) have for decades exhibited difficulties in modelling the diurnal cycle of precipitation (DCP). This issue can be related to inappropriate representation of the processes controlling sub‐diurnal phenomena like convection. In this study, 11 single‐column versions of GCMs are used to investigate the interactions between convection and environmental conditions, processes that control nocturnal convections, and the transition from shallow to deep convection on a diurnal time‐scale. Long‐term simulations are performed over two continental land sites: the Southern Great Plains (SGP) in the USA for 12 summer months from 2004 to 2015 and the Manacapuru site at the central Amazon (MAO) in Brazil for two full years from 2014 to 2015. The analysis is done on two regimes: afternoon convective regime and nocturnal precipitation regime. Most models produce afternoon precipitation too early, likely due to the missing transition of shallow‐to‐deep convection in these models. At SGP, the unified convection schemes better simulate the onset time of precipitation. At MAO, models produce the heating peak in a much lower level compared with observation, indicating too shallow convection in the models. For nocturnal precipitation, models that produce most of nocturnal precipitation all allow convection to be triggered above the boundary layer. This indicates the importance of model capability to detect elevated convection for simulating nocturnal precipitation. Sensitivity studies indicate that (a) nudging environmental variables towards observations has a minor impact on DCP, (b) unified treatment of shallow and deep convection and the capability to capture mid‐level convection can help models better capture DCP, and (c) the interactions of the atmosphere with other components in the climate system (e.g. land) are also important for DCP simulations in coupled models. These results provide long‐term statistical insights on which physical processes are essential in climate models to simulate DCP.Eleven single‐column models are used to study the diurnal cycle of precipitation and related physical processes over two continental sites, SGP and MAO. Most models produce afternoon precipitation too early, likely due to the missing transition of shallow‐to‐deep convection in the models. Many models cannot produce convection occurring at night‐time. Unified treatment of shallow and deep convection and the capability to capture mid‐level convection are important for models to capture the diurnal cycle of precipitation. [ABSTRACT FROM AUTHOR]

Copyright of Journal der Deutschen Dermatologischen Gesellschaft is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Although rare, psychocutaneous disorders induced by prescription stimulants have been reported throughout the literature. A systematic review was conducted to identify all case reports and case series of prescription stimulant‐induced trichotillomania, tactile hallucinations, and delusional infestation. A total of 22 case reports were identified and relevant information was analyzed. Patients presenting with trichotillomania and tactile hallucinations induced by prescription stimulants were typically pediatric male patients being treated for attention deficit hypersensitivity disorder. Symptoms resolved after discontinuation of the offending medication. Patients presenting with delusional infestation secondary to stimulant use or abuse were typically adults who were misusing or abusing stimulant medication. Although symptoms typically improved or resolved after decreasing or discontinuing medication, several patients required the use of antipsychotic medication. While the observational nature of case reports and small number of patients limits meaningful analysis of trends and comparison, this study demonstrates that physicians, especially dermatologists and psychiatrists, should be aware of the potential for prescription stimulants to precipitate adverse psychocutaneous disorders in a minority of individuals. [ABSTRACT FROM AUTHOR]

Tropopause‐overshooting convection transports air from the lower troposphere to the upper troposphere and lower stratosphere (UTLS) where the resulting chemistry and mixing of trace gases can modify the radiation budget. While recent work has examined output from model simulations as well as aircraft and satellite observations of the impacts of tropopause‐overshooting convection on UTLS composition, the range of potential impacts and their dependence on characteristics of storms and their environments is not known. Here, two 10‐day periods, one representative of springtime convection and one representative of summertime convection, were simulated with the Weather Research and Forecasting (WRF) model with Chemistry to examine the range of UTLS composition impacts from tropopause‐overshooting convection. Overall, springtime convection has a larger impact on UTLS composition than summertime convection, with a net effect of increasing water vapor (H2O) in the lower stratosphere and increasing ozone (O3) in the upper troposphere. Springtime convection frequently increases the domain average H2O mixing ratio in the lowermost stratosphere by over 20% while changes in stratospheric H2O from summertime convection are much lower (∼7%–11% increase), reflecting a dependence of the maximum possible H2O increase on UTLS temperature. Increases in upper troposphere O3 mixing ratios span the range 8%–19% from springtime convection and are minimal from summertime convection. Changes in the composition of the UTLS from tropopause‐overshooting convection are largely dependent on the height and temperature of the tropopause, with the largest changes being in environments with relatively low tropopause heights between 11 and 13 km (typical of springtime environments in the United States). Key Points: Moist convection frequently reaches the tropopause in the United States and mixes air between the troposphere and stratosphereTropopause‐overshooting convection occurring during May drastically increases lower stratospheric water vapor mixing ratiosThe impact that convection has on upper troposphere and lower stratosphere (UTLS) composition appears to largely depend on the height of the tropopause [ABSTRACT FROM AUTHOR]

Waitlisted patients in urgent need of an organ, such as patients with end stage heart disease or fulminant liver failure, may be considered for organ transplant from a COVID-19 positive donor. A case report of successful kidney transplantation from a deceased donor with terminal COVID-19-related lung damage: ongoing dilemma between discarding and accepting organs in COVID-19 era! All three recipients developed critical COVID-19 infection, and one died.6 No other cases of donor derived COVID-19 have been reported among other types of solid organ transplant recipients. Already challenged by organ shortages and high waitlist mortality, the field of organ transplantation has suffered considerably from the COVID-19 pandemic. [Extracted from the article]

The Disease Transmission Advisory Committee (DTAC) of the Organ Procurement and Transplantation Network focuses on issues related to the transmission of disease through organ transplantation. Providing a review of potential cases of transmission, translating aggregate data into actionable education and guidance for the transplant community, and providing input for policy development, DTAC aims to improve the safety of organ transplantation through a reduction in donor‐derived transmission events. Through its nearly 20‐year history, DTAC has provided education, guidance, and policy, addressed numerous emerging infections, and continuously focused on the community's understanding of risk assessment related to donor‐derived transmission. By updating the DTAC mission to both decrease transmission and safely expand the donor pool with additional guidance to safely use organs previously not considered for transplantation due to transmission concerns, the Committee's role will remain critical. [ABSTRACT FROM AUTHOR]

The hyperdiverse order Coleoptera comprises a staggering ~25% of known species on Earth. Despite recent breakthroughs in next generation sequencing, there remains a limited representation of beetle diversity in assembled genomes. Most notably, the ground beetle family Carabidae, comprising more than 40,000 described species, has not been studied in a comparative genomics framework using whole genome data. Here we generate a high‐quality genome assembly for Nebria riversi, to examine sources of novelty in the genome evolution of beetles, as well as genetic changes associated with specialization to high‐elevation alpine habitats. In particular, this genome resource provides a foundation for expanding comparative molecular research into mechanisms of insect cold adaptation. Comparison to other beetles shows a strong signature of genome compaction, with N. riversi possessing a relatively small genome (~147 Mb) compared to other beetles, with associated reductions in repeat element content and intron length. Small genome size is not, however, associated with fewer protein‐coding genes, and an analysis of gene family diversity shows significant expansions of genes associated with cellular membranes and membrane transport, as well as protein phosphorylation and muscle filament structure. Finally, our genomic analyses show that these high‐elevation beetles have endosymbiotic Spiroplasma, with several metabolic pathways (e.g., propanoate biosynthesis) that might complement N. riversi, although its role as a beneficial symbiont or as a reproductive parasite remains equivocal. [ABSTRACT FROM AUTHOR]

Stratosphere‐reaching moist convection can significantly alter the dynamics, chemistry, and climate of the Earth system. This study seeks to add to the emerging understanding of the frequency, depth, and stratospheric impact of such events using 22 years (1996–2017) of ground‐based radar observations in the contiguous United States. While most prior studies identify such storms using the temperature lapse‐rate tropopause (LRT) as a troposphere‐stratosphere boundary, this study is the first to identify convection that reaches into stratospheric air below the LRT (tropopause depressions, excluding folds) as well. It is found that tropopause depression (TD) overshooting and LRT overshooting occur at similar frequency over the United States, with TD overshooting being more episodic in nature than LRT overshooting. TD overshooting is also found more often throughout the cooler months of the year, while LRT overshooting dominates all overshooting in the summer months. Stratospheric residence of overshoot material, as estimated using trajectory calculations driven by large‐scale winds, suggests that the vast majority of TD overshoot material does not remain in the stratosphere within 5 days downstream and rarely impacts altitudes more than 1 km above the LRT. Conversely, the majority of LRT overshoot material remains in the stratosphere downstream and routinely impacts altitudes >1 and >2 km above the tropopause. Key Points: Stratosphere‐reaching convection over the United States is roughly twice as frequent as previously recognizedConvection that overshoots tropopause depressions (stratospheric air below the lapse‐rate tropopause) is common but has a limited impactTropopause depression overshooting is more episodic than lapse‐rate tropopause overshooting [ABSTRACT FROM AUTHOR]

Many U.S. states require farmers to evaluate the risk of P loss from farm fields using P site assessment tools, such as the Phosphorus Index (P‐Index). The simplicity of the P‐Index allows for users with various backgrounds to utilize the tool; however, the P‐Index may be limited in its ability to reliably predict P losses across variable farm terrain, for instance where saturation‐excess runoff generation dominates. The objective of this study was to identify potential improvements that could be made to the Vermont P‐Index (VT P‐Index) by comparing VT P‐Index predictions of P loss with those of a model that considers topographic controls on P transport. Scenarios with varying P management strategies were developed and modeled for corn (Zea mays L.) silage production fields in a small agricultural watershed (360 ha) located in Vermont using both the VT P‐Index and a modified version of the Soil and Water Assessment Tool (SWAT). Modeled outputs from both the VT P‐Index and SWAT were aggregated based on topographic index (TI) class and compared for the directional agreement of P risk assessments and relative annual average dissolved and particulate P losses. The P‐Index nutrient management recommendations gave higher P loss risk ratings than SWAT for 94% of the 120 unique scenario combinations simulated. Results from this study suggest that the VT P‐Index could improve its ability to support farm nutrient management planning by incorporating topographic controls on runoff production into its estimation of P transport. Core Ideas: Consideration of topographic factors can improve estimation of dissolved P loss in the VT P‐Index.Best management practice effectiveness can be increased in the VT P‐Index by accounting for VSA hydrology.Generally, the VT P‐Index resulted in a higher risk of P loss rating than SWAT‐VSA. [ABSTRACT FROM AUTHOR]

Monitoring of planktonic salmon louse (Lepeophtheirus salmonis salmonis) abundance and parameterization of key life‐history traits has been hindered by labour‐intensive and error‐prone quantification using traditional light microscopy. Fluorescence illumination has been proposed as a means of improving visualization, but prior to this study adequate investigation of the relevant fluorescence profiles and measurement conditions has not been undertaken. We investigated the fluorescence profiles of L. salmonis and non‐target copepod spp. with excitation and emission matrices (200–600 nm) and identified unique fluorescence signals. Fluorescence microscopy using excitation wavelengths of 470 ± 40 nm, and emission wavelengths of 525 ± 50 nm, showed that after 90 days of formalin storage salmon lice have a mean fluorescence intensity that is 2.4 times greater than non‐target copepods (copepodid and adult stages). A 7‐day heat treatment of 42°C in formalin increased the difference between salmon louse copepodids and non‐target copepods to a factor of 3.6, eliminating the need for prolonged storage. Differences in the fluorescence signal and endogenous fluorophores were investigated with respect to variation in sea lice species, age, stage and host fish origin. Under the conditions outlined in this paper, the fluorescence signal was found to be a reliable means of visualizing and differentiating salmon lice from non‐target zooplankters. Adaptation of the fluorescence signal would greatly expedite traditional methods of enumerating salmon louse larvae in plankton samples and could provide a means of automated detection. [ABSTRACT FROM AUTHOR]

Humans are exposed to varying amounts of ultraviolet radiation (UVR) through sunlight. UVR penetrates into human skin leading to release of neuropeptides, neurotransmitters and neuroendocrine hormones. These messengers released from local sensory nerves, keratinocytes, Langerhans cells (LCs), mast cells, melanocytes and endothelial cells (ECs) modulate local and systemic immune responses, mediate inflammation and promote differing cell biologic effects. In this review, we will focus on both animal and human studies that elucidate the roles of calcitonin gene‐related peptide (CGRP), substance P (SP), nerve growth factor (NGF), nitric oxide and proopiomelanocortin (POMC) derivatives in mediating immune and inflammatory effects of exposure to UVR as well as other cell biologic effects of UVR exposure. [ABSTRACT FROM AUTHOR]

Acquiring fundamental knowledge of properties of actinide‐based materials is a necessary step to create new possibilities for addressing the current challenges in the nuclear energy and nuclear waste sectors. In this report, we established a photophysics–electronics correlation for actinide‐containing metal‐organic frameworks (An‐MOFs) as a function of excitation wavelength, for the first time. A stepwise approach for dynamically modulating electronic properties was applied for the first time towards actinide‐based heterometallic MOFs through integration of photochromic linkers. Optical cycling, modeling of density of states near the Fermi edge, conductivity measurements, and photoisomerization kinetics were employed to shed light on the process of tailoring optoelectronic properties of An‐MOFs. Furthermore, the first photochromic MOF‐based field‐effect transistor, in which the field‐effect response could be changed through light exposure, was constructed. As a demonstration, the change in current upon light exposure was sufficient to operate a two‐LED fail‐safe indicator circuit. [ABSTRACT FROM AUTHOR]

Background: Increased acute postoperative pain intensity has been associated with the development of persistent postsurgical pain (PPP) in mechanistic and clinical investigations, but it remains unclear which aspects of acute pain explain this linkage. Methods: We analysed clinical postoperative pain intensity assessments using symbolic aggregate approximations (SAX), a graphical way of representing changes between pain states from one patient evaluation to the next, to visualize and understand how pain intensity changes across sequential assessments are associated with the intensity of postoperative pain at 1 (M1) and 6 (M6) months after surgery. SAX‐based acute pain transition patterns were compared using cosine similarity, which indicates the degree to which patterns mirror each other. Results: This single‐centre prospective cohort study included 364 subjects. Patterns of acute postoperative pain sequential transitions differed between the 'None' and 'Severe' outcomes at M1 (cosine similarity 0.44) and M6 (cosine similarity 0.49). Stratifications of M6 outcomes by preoperative pain intensity, sex, age group, surgery type and catastrophising showed significant heterogeneity of pain transition patterns within and across strata. Severe‐to‐severe acute pain transitions were common, but not exclusive, in patients with moderate or severe pain intensity at M6. Conclusions: Clinically, these results suggest that individual pain‐state transitions, even within patient or procedural strata associated with PPP, may not alone offer good predictive information regarding PPP. Longitudinal observation in the immediate postoperative period and consideration of patient‐ and surgery‐specific factors may help indicate which patients are at increased risk of PPP. Significance: Symbolic aggregate approximations of clinically obtained, acute postoperative pain intraday time series identify different motifs in patients suffering moderate to severe pain 6 months after surgery. [ABSTRACT FROM AUTHOR]

Moist convection frequently reaches the tropopause and alters the distribution and concentration of radiatively important trace gases in the upper troposphere and lower stratosphere (UTLS), but the overall impact of convection on regional and global UTLS composition remains largely unknown. To improve understanding of convection‐driven changes in water vapor (H2O), ozone (O3), and carbon monoxide (CO) in the UTLS, this study utilizes 13 years of observations of satellite‐based trace gas profiles from the Microwave Limb Sounder (MLS) aboard the Aura satellite and convection from the operational network of ground‐based weather radars in the United States. Locations with and without convection identified via radar are matched with downstream MLS observations through three‐dimensional, kinematic forward trajectories, providing two populations of trace gas observations for analysis. These populations are further classified as belonging to extratropical or tropical environments based on the tropopause pressure at the MLS profile location. Extratropical regions are further separated by tropopause type (single or double), revealing differing impacts. Results show that convection typically moistens the UT by up to 300% and the LS by up to 100%, largely reduces O3 by up to 40%, and increases CO by up to 50%. Changes in H2O and O3 are robust, with LS O3 reduced more by convection within tropical environments, where the median concentration decrease is 34% at ∼2 km above tropopause, compared to 24% in extratropical environments. Quantification of CO changes from convection is less reliable due to differences being near the MLS measurement precision and accuracy. Key Points: Trajectory matching of cloud and trace gas data enables unprecedented sampling of convective influence on near‐tropopause compositionImpacts to near‐tropopause composition from convection depend on tropopause height and vertical structure (single or double tropopause)Transport of troposphere air alone cannot explain the larger stratospheric ozone decrease found in high tropopause (tropical) environments [ABSTRACT FROM AUTHOR]

Large macrocyclic peptides can achieve surprisingly high membrane permeability, although the properties that govern permeability in this chemical space are only beginning to come into focus. We generated two libraries of cyclic decapeptides with stable cross‐β conformations, and found that peptoid substitutions within the β‐turns of the macrocycle preserved the rigidity of the parent scaffold, whereas peptoid substitutions in the opposing β‐strands led to "chameleonic" species that were rigid in nonpolar media but highly flexible in water. Both rigid and chameleonic compounds showed high permeability over a wide lipophilicity range, with peak permeabilities differing significantly depending on scaffold rigidity. Our findings indicate that modulating lipophilicity can be used to engineer favorable ADME properties into both rigid and flexible macrocyclic peptides, and that scaffold rigidity can be used to tune optimal lipophilicity. [ABSTRACT FROM AUTHOR]

This Communication describes the use of CuInS2/ZnS quantum dots (QDs) as photocatalysts for the reductive deprotection of aryl sulfonyl‐protected phenols. For a series of aryl sulfonates with electron‐withdrawing substituents, the rate of deprotection for the corresponding phenyl aryl sulfonates increases with decreasing electrochemical potential for the two electron transfers within the catalytic cycle. The rate of deprotection for a substrate that contains a carboxylic acid, a known QD‐binding group, is accelerated by more than a factor of ten from that expected from the electrochemical potential for the transformation, a result that suggests that formation of metastable electron donor–acceptor complexes provides a significant kinetic advantage. This deprotection method does not perturb the common NHBoc or toluenesulfonyl protecting groups and, as demonstrated with an estrone substrate, does not perturb proximate ketones, which are generally vulnerable to many chemical reduction methods used for this class of reactions. [ABSTRACT FROM AUTHOR]

Introduction: The authors provide an updated, systematic and comprehensive summary of the literature concerning management of the N0 neck in patients for whom primary irradiation for squamous cell carcinoma of the larynx has been unsuccessful and salvage surgery in the form of total laryngectomy (TL) advocated. Methods: Bibliographic databases MEDLINE, Cochrane, PubMed and Embase were searched from inception to April 2019, with no language restrictions. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Risk of bias was defined using the Joanna Briggs Institute guidelines. Outcome measures were defined as the impact of END on locoregional control, complication rate, disease‐specific and overall survival (DSS and OS). Results: The primary search identified 19 eligible articles, comprising 1353 patients, (1552 ENDs). The overall risk of occult metastases was 14% (9% of ENDs). The relative risk (RR) of developing complications was 1.29 when END was performed, compared to observation of the neck (CI 0.86‐1.92). Contrariwise, patients in whom the neck was managed with neck dissection had a decreased risk of developing regional recurrence (RR 0.62, CI 0.35‐1.08). There was no statistically significant variation between DSS and OS between END and neck observation groups, respectively. Summary: END during salvage TL may reduce the rate of regional recurrence, but not at the expense of improving DSS or OS. Rates of occult metastases, regional recurrence and "cure" through salvage neck dissection are not equivalent. Significant bias in all collated manuscripts should encourage the reader to interpret conclusions with caution. Patients should be fully involved in the decision‐making process and their performance status and co‐morbidities taken carefully into account when deciding to increase the extent of surgery, which we believe should remain limited to TL in the majority of cases. [ABSTRACT FROM AUTHOR]

Recent observational studies have shown that stratospheric air rich in ozone (O3) is capable of being transported into the upper troposphere in association with tropopause‐penetrating convection (anvil wrapping). This finding challenges the current understanding of upper tropospheric sources of O3, which is traditionally thought to come from thunderstorm outflows where lightning‐generated nitrogen oxides facilitate O3 formation. Since tropospheric O3 is an important greenhouse gas and the frequency and strength of tropopause‐penetrating storms may change in a changing climate, it is important to understand the mechanisms driving this transport process so that it can be better represented in chemistry‐climate models. Simulations of a mesoscale convective system (MCS) around which this transport process was observed are performed using the Weather Research and Forecasting model coupled with Chemistry. The Weather Research and Forecasting model coupled with Chemistry model adequately simulates anvil wrapping of ozone‐rich air. Possible mechanisms that influence the transport, including small‐scale static and dynamic instabilities and MCS‐induced mesoscale circulations, are evaluated. Model results suggest that anvil wrapping is a two‐step transport process (1) compensating subsidence surrounding the MCS, which is driven by mass conservation as the MCS transports tropospheric air into the upper troposphere and lower stratosphere, followed by (2) differential advection beneath the core of the MCS upper‐tropospheric outflow jet which wraps high O3 air around and under the MCS cloud anvil. Static and dynamic instabilities are not a leading contributor to this transport process. Continued fine‐scale modeling of these events is needed to fully represent the stratosphere‐to‐troposphere transport process. Key Points: WRF‐Chem is capable of reproducing downward transport around the MCS anvilDownward transport results from compensating vertical motions driven by mass continuity and differential advection between the anvil outflow and environmental flowAir transported downward primarily originated in the upper parts of the troposphere instead of the stratosphere [ABSTRACT FROM AUTHOR]

Upright convection can impact extratropical cyclone (ETC) precipitation and dynamics differently than isentropic ascent, but how often it occurs and how much it contributes to total precipitation within an ETC have not been systematically documented in previous literature. Herein, convection in ETCs is analyzed using ground‐based radar observations over the Eastern United States. Convection occupies 1%–5% of the precipitating region and constitutes 1%–15% of total cyclone precipitation. Furthermore, the location of convective activity occurs preferentially in the warm sector early in a cyclone's life cycle, and then as the storm evolves, more convection occurs along and behind the cold front. The precipitation rates in regions with convection are more likely to be stronger than those in other precipitating regions of the cyclone. However, the cyclones with the largest area‐average precipitation rates include only a small contribution from convection. Plain Language Summary: This research is motivated by the potential influence of convection on extratropical cyclone circulation. We utilize a newly derived dataset of upright convection and a cyclone‐tracking framework to quantify convective activity in extratropical cyclones over the United States, east of the Rocky Mountains. We find that upright convection only occupies a small portion of the precipitating region, and the relative contribution to total precipitation has relatively small variability as the cyclone evolves. We find that the location of convective activity occurs preferentially in the warm sector early in a cyclone's life cycle, and as the storm evolves, more convection occurs along and behind the cold front. We find that precipitation rates in regions with convection are more likely to be stronger than those in other precipitating regions of the cyclone. However, the cyclones with the largest area‐average precipitation rates include only a small contribution from convection. Key Points: Convection occurs in 1%–5% of precipitating regions of extratropical cyclones over eastern United States and contributes 1%–15% of total precipitationThe majority of upright convection occurs ahead of the cold front and disperses into other regions as the cyclone agesWhile convection produces larger rain rates, cyclones with greater total precipitation do not have a large convective contribution [ABSTRACT FROM AUTHOR]

Wildfires are extreme events associated with weather, climate, and environment and have been increasing globally in frequency, burn season length, and burned area. It is of great interest to understand the impacts of wildfires on severe convective storms through releasing heat and aerosols into the atmosphere. We have developed a model capability that can account for the impact of sensible heat fluxes from wildfires on thermodynamics and is computationally efficient. The pyrocumulonimbus clouds associated with the Texas Mallard Fire on 11–12 May 2018 are well simulated by accounting for both heat and aerosols emitted from the wildfire. Both heat and aerosol effects increase low‐level temperatures and midlevel buoyancy and enhance convective intensity. Intensified convection along with more supercooled liquid condensate due to stronger vertical transport results in larger hailstones and enhanced lightning. The effects of heat flux on the convective extremes are more significant than those of aerosol emissions. Plain Language Summary: The length of wildfire burning season and burned area have been increasing globally. Besides being a globally important source of aerosol particles that could impact clouds, precipitation, and radiation, wildfire activity heats the environment dramatically and can significantly perturb the environmental thermodynamics. However, this impact on environmental thermodynamics and the subsequent convection generated is poorly represented in models. We have developed and evaluated a model capability that accounts for the impact of heat flux from wildfires and is computationally efficient. We have used the new model to explore a pyrocumulonimbus event that occurred in Texas and Oklahoma on 11–12 May 2018 triggered by the Mallard Fire. The simulation accounting for effects of both heat flux and aerosol emissions from the wildfire predicts radar reflectivity, precipitation, hailstone size, and lightning reasonably well based on comparisons with observations. Both the heat flux and aerosol emissions from the wildfire increase low‐level temperatures and midlevel thermal buoyancy significantly, causing stronger upward motion that lifts more supercooled water to higher levels. The increase in available supercooled water for hail growth and invigorated updrafts leads to larger hail size and enhanced lightning. The effect of heat flux on storm intensity is considerably more significant than that of aerosol emissions. Key Points: A new model capability to computationally efficiently account for the impact of heat flux on thermodynamics from wildfires in WRF‐Chem is developedBoth the heat and aerosol emissions from wildfires invigorate the pyroconvection, enlarge hail size, and enhance lightningEffects of heat from wildfire on convective intensity, hail size, and lightning are more significant than those of aerosol emissions [ABSTRACT FROM AUTHOR]

Abstract: Background: Glycogen storage disease type Ia (GSD Ia) in dogs closely resembles human GSD Ia. Untreated patients with GSD Ia develop complications associated with glucose‐6‐phosphatase (G6Pase) deficiency. Survival of human patients on intensive nutritional management has improved; however, long‐term complications persist including renal failure, nephrolithiasis, hepatocellular adenomas (HCA), and a high risk for hepatocellular carcinoma (HCC). Affected dogs fail to thrive with dietary therapy alone. Treatment with gene replacement therapy using adeno‐associated viral vectors (AAV) expressing G6Pase has greatly prolonged life and prevented hypoglycemia in affected dogs. However, long‐term complications have not been described to date. Methods: Five GSD Ia‐affected dogs treated with AAV‐G6Pase were evaluated. Dogs were euthanized due to reaching humane endpoints related to liver and/or kidney involvement, at 4 to 8 years of life. Necropsies were performed and tissues were analyzed. Results: Four dogs had liver tumors consistent with HCA and HCC. Three dogs developed renal failure, but all dogs exhibited progressive kidney disease histologically. Urolithiasis was detected in two dogs; uroliths were composed of calcium oxalate and calcium phosphate. One affected and one carrier dog had polycystic ovarian disease. Bone mineral density was not significantly affected. Conclusions: Here, we show that the canine GSD Ia model demonstrates similar long‐term complications as GSD Ia patients in spite of gene replacement therapy. Further development of gene therapy is needed to develop a more effective treatment to prevent long‐term complications of GSD Ia. [ABSTRACT FROM AUTHOR]