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We investigate the intermittent dynamics of momentum transport and its underlying time scales in the near-wall region of the neutrally stratified atmospheric boundary layer in the presence of a vegetation canopy. This is achieved through an empirical analysis of the persistence time scales (periods between successive zero-crossings) of momentum flux events, and their connection to the ejection-sweep cycle. Using high-frequency measurements from the GoAmazon campaign, spanning multiple heights within and above a dense canopy, the analysis suggests that, when the persistence time scales of momentum flux events from four different quadrants are separately normalized by (integral time scale of the vertical velocity), their distributions remain height-invariant. This result points to a persistent memory imposed by canopy-induced coherent structures, and to their role as an efficient momentum-transporting mechanism between the canopy airspace and the region immediately above. Moreover, exhibits a power-law scaling at times < tp, with an exponential tail appearing for. By separating the flux events based on, we discover that around 80 % of the momentum is transported through the long-lived events at heights immediately above the canopy, while the short-lived ones (

AIMS: Gene fusions assays are key for personalised treatments of advanced human cancers. Their implementation on cytological material requires a preliminary validation that may make use of cell line slides mimicking cytological samples. In this international multi-institutional study, gene fusion reference standards were developed and validated. METHODS: Cell lines harbouring EML4(13)-ALK(20) and SLC34A2(4)-ROS1(32) gene fusions were adopted to prepare reference standards. Eight laboratories (five adopting amplicon-based and three hybridisation-based platforms) received, at different dilution points two sets of slides (slide A 50.0%, slide B 25.0%, slide C 12.5% and slide D wild type) stained by Papanicolaou (Pap) and May Grunwald Giemsa (MGG). Analysis was carried out on a total of 64 slides. RESULTS: Four (50.0%) out of eight laboratories reported results on all slides and dilution points. While 12 (37.5%) out of 32 MGG slides were inadequate, 27 (84.4%) out of 32 Pap slides produced libraries adequate for variant calling. The laboratories using hybridisation-based platforms showed the highest rate of inadequate results (13/24 slides, 54.2%). Conversely, only 10.0% (4/40 slides) of inadequate results were reported by laboratories adopting amplicon-based platforms. CONCLUSIONS: Reference standards in cytological format yield better results when Pap staining and processed by amplicon-based assays. Further investigation is required to optimise these standards for MGG stained cells and for hybridisation-based approaches.

Large-scale intermittency is a widely observed phenomenon in convective surface layer turbulence that induces non-Gaussian temperature statistics, while such a signature is not observed for velocity signals. Although approaches based on probability density functions have been used so far, those are not able to explain to what extent the signals' temporal structure impacts the statistical characteristics of the velocity and temperature fluctuations. To tackle this issue, a visibility network analysis is carried out on a field-experimental dataset from a convective atmospheric surface layer flow. Through surrogate data and network-based measures, we demonstrate that the temperature intermittency is related to strong nonlinear dependencies in the temperature signals. Conversely, a competition between linear and nonlinear effects tends to inhibit the temperature-like intermittency behaviour in streamwise and vertical velocities. Based on present findings, new research avenues are likely to be opened up in studying large-scale intermittency in convective turbulence.

The characterization of heat and momentum fluxes in wall-bounded turbulence is of paramount importance for a plethora of applications ranging from engineering to Earth sciences. Nevertheless, how the turbulent structures associated with velocity and temperature fluctuations interact to produce the emergent flux signatures has not been evident until now. In this work, we investigate this fundamental issue by studying the switching patterns of intermittently occurring turbulent fluctuations from one state to another, a phenomenon called persistence. We discover that the persistence patterns for heat and momentum fluxes are widely different. Moreover, we uncover power-law scaling and length scales of turbulent motions that cause this behavior. Furthermore, by separating the phases and amplitudes of flux events, we explain the origin and differences between heat and momentum transfer efficiencies in convective turbulence. Our findings provide a new understanding of the connection between flow organization and flux generation mechanisms, two cornerstones of turbulence research.

BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHOD(S): Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULT(S): The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION(S): This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.

BACKGROUND: To the authors’ knowledge, the impact of the coronavirus disease 2019 (COVID-19) pandemic on cytopathology practices worldwide has not been investigated formally. In the current study, data from 41 respondents from 23 countries were reported. METHODS: Data regarding the activity of each cytopathology laboratory during 4 weeks of COVID-19 lockdown were collected and compared with those obtained during the corresponding period in 2019. The overall number and percentage of exfoliative and fine-needle aspiration cytology samples from each anatomic site were recorded. Differences in the malignancy and suspicious rates between the 2 periods were analyzed using a meta-analytical approach. RESULTS: Overall, the sample volume was lower compared with 2019 (104,319 samples vs 190,225 samples), with an average volume reduction of 45.3% (range, 0.1%-98.0%). The percentage of samples from the cervicovaginal tract, thyroid, and anorectal region was significantly reduced (P < .05). Conversely, the percentage of samples from the urinary tract, serous cavities, breast, lymph nodes, respiratory tract, salivary glands, central nervous system, gastrointestinal tract, pancreas, liver, and biliary tract increased (P < .05). An overall increase of 5.56% (95% CI, 3.77%- 7.35%) in the malignancy rate in nongynecological samples during the COVID-19 pandemic was observed. When the suspicious category was included, the overall increase was 6.95% (95% CI, 4.63%-9.27%). CONCLUSIONS: The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted.

Context.-Social media sites are increasingly used for education, networking, and rapid dissemination of medical information, but their utility for facilitating research has remained largely untapped. Objective.-To describe in detail our experience using a social media platform (Twitter) for the successful initiation, coordination, and completion of an international, multi-institution pathology research study. Design.-Following a tweet describing a hitherto-unreported biopsy-related histologic finding in a mediastinal lymph node following endobronchial ultrasound-guided transbronchial needle aspiration, a tweet was posted to invite pathologists to participate in a validation study. Twitter's direct messaging feature was used to create a group to facilitate communication among participating pathologists. Contributing pathologists reviewed consecutive cases of mediastinal lymph node resection following endobronchial ultrasound-guided transbronchial needle aspiration and examined them specifically for biopsy site changes. Data spreadsheets containing deidentified data and digital photomicrographs of suspected biopsy site changes were submitted via an online file hosting service for central review by 5 pathologists from different institutions. Results.-A total of 24 pathologists from 14 institutions in 5 countries participated in the study within 143 days of study conception, and a total of 297 cases were collected and analyzed. The time interval between study conception and acceptance of the manuscript for publication was 346 days. Conclusions.-To our knowledge, this is the first time that a social media platform has been used to generate a research idea based on a tweet, recruit coinvestigators publicly, communicate with collaborating pathologists, and successfully complete a pathology study.

Biopsy site changes in mediastinal lymph nodes (LNs) attributable to prior endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) have not been studied in a systematic manner. Twenty-four contributors from 14 institutions in 5 countries collaborated via social media (Twitter) to retrospectively review consecutive cases of resected mediastinal LNs from patients with prior EBUS-TBNA. Resected LNs were reexamined by submitting pathologists for changes attributable to EBUS-TBNA. Patients who received neoadjuvant therapy were excluded. Cases with suspected biopsy site changes underwent central review by 5 pathologists. A total of 297 mediastinal LN resection specimens from 297 patients (183 male/114 female, mean age: 65 y, range: 23 to 87) were reviewed. Biopsy site changes were most common in station 7 (10 cases) followed by 11R, 4R, and 10R, and were found in 34/297 (11.4%) cases, including displacement of tiny cartilage fragments into LN parenchyma in 26, intranodal or perinodal scars in 7, and hemosiderin in 1. Cartilage fragments ranged from 0.26 to 1.03 mm in length and 0.18 to 0.62 mm in width. The mean interval between EBUS-TBNA and LN resection was 38 days (range: 10 to 112) in cases with biopsy site changes. A control group of 40 cases without prior EBUS-TBNA, including 193 mediastinal LN stations, showed no evidence of biopsy site changes. Biopsy site changes are identified in a subset of resected mediastinal LNs previously sampled by EBUS-TBNA. The location of the abnormalities, temporal association with prior EBUS-TBNA, and the absence of such findings in cases without prior EBUS-TBNA support the contention that they are caused by EBUS-TBNA.

BACKGROUND: Bangladesh has experienced a sevenfold increase in its contraceptive prevalence rate (CPR) in less than forty years from 8% in 1975 to 62% in 2014. However, despite this progress, almost one-third of pregnancies are still unintended which may be attributed to unmet need for family planning and discontinuation and switching of methods after initiation of their use. METHODS: We conducted an extensive literature review on contraceptive use among married women of reproductive age (MWRA) in Bangladesh. A total of 263 articles were identified through database search and after final screening ten articles were included in this synthesis. RESULTS: Findings showed that method discontinuation and switching, method failure, and method mix may offset achievements in the CPR. Most of the women know of at least one contraceptive method. Oral pill is the most widely used (27%) method, followed by injectables (12.4%), condoms (6.4%), female sterilization (4.6%), male sterilization (1.2%), implants (1.7%), and IUDs (0.6%). There has been a decline in the use of long acting and permanent methods over the last two decades. Within 12 months of initiation, the rate of method discontinuation particularly the short-acting methods remain high at 36%. It is important to recognize the trends as married Bangladeshi women, on average, wanted 1.6 children, but the rate of actual children was 2.3. CONCLUSIONS: A renewed commitment from government bodies and independent organizations is needed to implement and monitor family planning strategies in order to ensure the adherence to and provision of the most appropriate contraceptive method for couples.

Information on groundwater chemistry in the central Ganges basin can provide insights into recharge, provenance, and fate of solutes in arsenic (As)-affected areas upstream of the more intensively studied Bengal basin. The geological and geomorphological units of the region are much more discernible than the Bengal basin aquifers. Moreover, the region is less affected by groundwater abstraction, which complicates interpretation of As distributions in the Bengal basin. The study area extends from the northern edge of the Indian craton outcrops to the foothills of the Himalayas. Geologic units in the area can be broadly classified as pre-Cenozoic metamorphics and volcanics (PC), older alluvial deposits of the Ganges and its tributaries (OA), younger or active alluvial deposits of the Ganges and its tributaries in the basin (YA), and sediments of the Himalayan foothills (piedmont, PD). Stable-isotopic analyses indicate groundwater in these units has been recharged by meteoric or surface water that has generally undergone some evaporation. The hydrochemical facies is generally a Ca-HCO 3 type. While most of the solutes in the YA groundwater are derived from carbonate dissolution, many of the PD, PC and OA groundwater samples are influenced by silicate weathering, suggesting that leaching of metamorphics and volcanics acts as a major source of solutes. Redox conditions are highly spatially variable (oxic to methanic, dominated by metal reduction), with no systematic depth variation within sampled aquifers. More than 75% of YA and PD groundwater samples have As=0.01mg/L, but As was detected in only one OA sample and no PC samples. Arsenic is probably mobilized by reductive dissolution of Fe-Mn (oxyhydr)oxides in the alluvium, with possibility of competitive anionic mobilization. Hence, relative to the Bengal basin, in addition to lower groundwater abstraction influence, groundwater chemistry in the study area reflects a greater variety of differences in the geological and