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Background. Posterior urethral valves (PUV) are a common cause of congenital obstructive nephropathy. The outcome of patients with PUV at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa, has not been documented previously.Objectives. To describe the outcome of patients diagnosed with PUV over a 29-year period from January 1985 to December 2013, and to analyse risk factors for chronic kidney disease.Methods. This was a retrospective record review of boys aged

Background. Posterior reversible encephalopathy syndrome (PRES) is a reversible neurological condition presenting with seizures and visual disturbances and diagnosed on magnetic resonance imaging (MRI). Little is understood about its pathogenesis, particularly in children, but it is thought to be related to hypertension.Objectives. To review the presentation, diagnosis and outcome of PRES in paediatric renal patients at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, between 1 January 2000 and 31 January 2017 and compare these with published case reports to date.Methods. This was a retrospective analysis of five new cases and a review of the existing literature.Results. The five reported patients were all hypertensive at the time of diagnosis and presented with seizures. Most (91%) of the 64 reviewed patients were also hypertensive at initial presentation. All five of the reported and 91% of the reviewed patients presented with seizures. The most common pattern of change on MRI occurred in the parietal and occipital regions. Complete neurological recovery occurred in four of the five reported and 87.5% of the reviewed patients.Conclusion. All patients presented clinically with hypertensive crises and radiological evidence of PRES. Seizures were the most common presenting symptom. The prognosis for paediatric patients with PRES is favourable, so it is important to confirm the diagnosis in low-resource settings where intensive care is limited.Â

ABSTRACT Understanding the habitat use of individuals can facilitate methods to measure the degree to which populations will be affected by potential stressors. Such insights can be hard to garner for marine species that are inaccessible during phases of their annual cycles. Here, we quantify the link between foraging habitat and behaviour in an aquatic bird of high conservation concern, the red‐throated diver (Gavia stellata) across three breeding populations (Finland, Iceland and Scotland) during their understudied moult period. Specifically, we quantify the relationship between feather isotope values (δ13C and δ15N) and diving behaviour, within and between populations, examining the use of intra‐depth zone (IDZ) dives as a proxy for benthic foraging. We found a strong positive relationship between both higher δ15N values and, to a lesser extent, δ13C values and the proportion of IDZ dives. This relationship was consistent across all three populations, but the baseline δ13C values varied between them, indicative of the populations' different moulting areas. Our results demonstrate that red‐throated divers continue to be generalist foragers after their breeding seasons, and that behavioural flexibility varies within and between populations. Furthermore, due to the existence of these relationships, we reveal the potential of stable isotope analysis as a standalone tool for monitoring changes in habitat use in this ecologically significant species. The approach may also apply to other generalist foragers that are known to use multiple foraging strategies (e.g., foraging benthically and pelagically), with implications for future conservation efforts.

Introduction: Alzheimer's disease (AD) is a phenotypically and pathologically heterogenous neurodegenerative disorder. This heterogeneity can be studied and disentangled using data-driven clustering techniques. Methods: We implemented a self-organizing map clustering algorithm on baseline volumetric MRI measures from nine brain regions of interest (ROIs) to cluster 1041 individuals enrolled in the placebo arm of the EXPEDITION3 trial. Volumetric MRI differences were compared among clusters. Demographics as well as baseline and longitudinal cognitive performance metrics were used to evaluate cluster characteristics. Results: Three distinct clusters, with an overall silhouette coefficient of 0.491, were identified based on MRI volumetrics. Cluster 1 (N = 400) had the largest baseline volumetric measures across all ROIs and the best cognitive performance at baseline. Cluster 2 (N = 269) had larger hippocampal and medial temporal lobe volumes, but smaller parietal lobe volumes in comparison with the third cluster (N = 372). Significant between-group mean differences were observed between Clusters 1 and 2 (difference, 2.38; 95% CI, 1.85 to 2.91; P

Extreme-ultraviolet to x-ray free-electron lasers (FELs) in operation for scientific applications are up to now single-user facilities. While most FELs generate around 100 photon pulses per second, FLASH at DESY can deliver almost two orders of magnitude more pulses in this time span due to its superconducting accelerator technology. This makes the facility a prime candidate to realize the next step in FELs—dividing the electron pulse trains into several FEL lines and delivering photon pulses to several users at the same time. Hence, FLASH has been extended with a second undulator line and self-amplified spontaneous emission (SASE) is demonstrated in both FELs simultaneously. FLASH can now deliver MHz pulse trains to two user experiments in parallel with individually selected photon beam characteristics. First results of the capabilities of this extension are shown with emphasis on independent variation of wavelength, repetition rate, and photon pulse length.

Introduction: Septic arthritis and osteomyelitis of the pubic symphysis (SAS) are rare conditions with nonspecific symptoms leading to diagnostic delay and treatment. Aim: We draw awareness to this condition elucidating the diagnostic procedures, surgical intervention and antibiotic management. Methods: This entail a retrospective follow-up study of 26 consecutive patients, median age of 71 years (range: 48–89) surgically treated for septic arthritis of the pubic symphysis between 2009 and 2020. Patient files, diagnostic imaging and bacterial cultures were evaluated. Results: Before diagnosed with SAS, 21 of the patients had previous pelvic surgery (16 due to malign conditions, 5 due to benign conditions), while 5 of the patients were not previously operated. Median follow-up period after SAS surgery was 18.5 months (range: 8 to 144.5 months). Dominating symptoms were severe suprapubic/pubic pain (n = 26), gait difficulties (n = 10) and intermittent fever (n = 9). Diagnostic delay was between 1 and 12 months. The diagnostic imaging included magnetic resonance imaging (MRI) (n = 24), computer tomography (CT) (n = 17) and/or PET-CT (n = 10), predominantly displaying bone destruction/erosion of the symphysis (n = 13), abscess (n = 12) and/or fistula (n = 5) in the adjacent muscles. All patients underwent surgical debridement with resection of the symphysis and received a minimum of 6 weeks antibiotic treatment. Fourteen patients presented with monocultures and 4 patients with polycultures. Five patients underwent at least one revision surgery. Twenty-three patients experienced postoperative pain relief at 6 weeks follow-up, and 19 patients were ambulant without walking aids. Conclusion: SAS are rare conditions and should be suspected in patients with infection, pubic pain and impaired gait, especially after pelvic surgery. Bone infection, abscess and fistula near the symphysis can be visualized with proper imaging, most frequently with MRI. For most patients in this cohort surgical debridement combined with a minimum of 6 weeks antibiotic treatment resulted in pain relief, improved walking ability and a low recurrence rate.

We use a standardized template for Pleistocene sea-level data to review last interglacial (Marine Isotope Stage 5 – MIS 5) sea-level indicators along the coasts of the western Atlantic and southwestern Caribbean, on a transect spanning from Brazil to Honduras and including the islands of Aruba, Bonaire, and Curaçao. We identified six main types of sea-level indicators (beach deposits, coral reef terraces, lagoonal deposits, marine terraces, Ophiomorpha burrows, and tidal notches) and produced 55 standardized data points, each constrained by one or more geochronological methods. Sea-level indicators are well preserved along the Brazilian coasts, providing an almost continuous north-to-south transect. However, this continuity disappears north of the Rio Grande do Norte Brazilian state. According to the sea-level index points (discrete past position of relative sea level in space and time) the paleo sea-level values range from ∼ 5.6 to 20 m above sea level (a.s.l.) in the continental sector and from ∼ 2 to 10 m a.s.l. in the Caribbean islands. In this paper, we address the uncertainties surrounding these values. From our review, we identify that the coasts of northern Brazil, French Guiana, Suriname, Guyana, and Venezuela would benefit from a renewed study of Pleistocene sea-level indicators, as it was not possible to identify sea-level index points for the last interglacial coastal outcrops of these countries. Future research must also be directed at improving the chronological control at several locations, and several sites would benefit from the re-measurement of sea-level index points using more accurate elevation measurement techniques. The database compiled in this study is available in spreadsheet format at the following link: https://doi.org/10.5281/zenodo.5516444 (Version 1.02; Rubio-Sandoval et al., 2021).

Abstract Background State Trait Anxiety Inventory (STAI) scale was developed in the 1980’s and has been widely used both in clinical settings and in research. However the Danish version of STAI has not been validated. The aim of this study was to assess the validity and reliability of STAI - state anxiety scale in Danish women aged 45 years and older with abnormal cervical cancer screening results. Methods Women ≥45 years referred with an abnormal cervical cytology and healthy volunteers (n = 12) underwent cognitive interview after completing STAI. Further, STAI was sent out in an electronic questionnaire to women (n = 109) seen at the gynecological department with abnormal cervical cancer screening test during 2018. Validity and reliability of STAI was evaluated according to the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist by examining internal consistency, test-retest reliability, measurement error, floor and ceiling, construct validity and content validity. Results In the cognitive interviews the content validity was evaluated to be very good. The internal consistency of the scale was excellent with Cronbach’s α = 0.93. Test-retest reliability was good with an intra-class correlation coefficient of 0.80 and the systematic difference between test-retest results was negligible. The construct validity was good. Conclusion To our best knowledge, this is the first validation study of the Danish translation of STAI-state anxiety scale. This version of STAI demonstrates an acceptable reliability and validity when used in a gynecological setting.

Abstract Seed dispersal by mammals provides functional connectivity between isolated plant habitat patches. Across much of Europe, red deer (Cervus elaphus) populations are growing steadily, potentially leading to increasing importance of this large mammal species to plant dispersal. While deer endozoochory is relatively well studied, epizoochory via fur and hoof attachment is much less understood. Seed dispersal internally and externally on 57 red deer individuals was investigated by sampling the seed content of intestinal tracts, fur, and hooves of animals shot during annual hunts in four contrasted landscapes in Denmark. We assessed compositional differences between dispersal modes whether plant species' association to a dispersal mode could be predicted by seed traits, whole‐plant traits, and species' local abundance. We found the largest difference in seed species composition to be between epizoochory (fur and hooves) and endozoochory (gut contents). Probability of plant dispersal through guts and fur was correctly predicted from traits more often than not. Hoof‐epizoochory, however, could not be correctly predicted from plant traits. Most plant species encountered were picked up by all three dispersal modes, suggesting an overriding effect of plant abundance in the landscapes in which the deer roam, which was also indicated by the statistical analysis. Nonetheless, a significant proportion of species were associated with either gut, fur, or hoof‐borne dispersal, reflecting the effect of plant traits and, potentially, animal behavior. Plant species being dispersed more often than expected through intestines were mainly associated with ruderal habitats, whereas species transported via fur tended toward association with wooded habitats. Considering the increasing red deer populations in Europe, and the differences between seed dispersal modes, all modes of animal seed dispersal should be taken into account in future studies. OPEN RESEARCH BADGES This article has been awarded Open Data and Open Materials Badges. All materials and data are publicly accessible via the Open Science Framework at https://doi.org/10.6084/m9.figshare.7982483 and https://doi.org/10.6084/m9.figshare.7982483

We present a typology of ‘Stayers’ and ‘Leavers’ among rural island youth (aged 18-30) to illustrate their employment-education-location decision, based on semi-structured interviews with 30 young adults, and 81 older adults, in rural locations in Ireland, Newfoundland, Faroe Islands, and Shetland. Although there are exceptions, rural labour markets tend to be less diverse, and jobs in the primary sector, which have historically sustained these communities, face restructuring and decline in many places. Regardless of location, young people typically struggle to find good-quality work because of their relative lack of credentials and/or experience, and a shortage of local options can trap some, and force others to look ‘away’. Outmigration decisions are based on economics, but also social and emotional factors. Thus, even in places with low unemployment, young adults must consider where to live, and what to do next, and down the road. The reviewed literature suggests that there are commonalities among the choices typically facing those in rural and remote communities, whether on an island or on a mainland. We believe, though, that this dilemma can be exacerbated for those living on islands because of the logistical and psychological complexity of the ‘stay or leave’ decision. Rather than presenting detailed summaries from the young islanders whom we interviewed, our intended contribution is to present our typology as a way to spur on research towards specific policy remedies. The challenges facing any young rural islander can be complicated and individualized. Nonetheless, after conducting dozens of interviews in many island communities, some clear patterns of Stayers and Leavers emerged across the various jurisdictions. In turn, we argue for the development of social and economic policies tailored to suit each category of rural island youth.

The mechanisms by which organisms adapt their growth according to the availability of oxygen are incompletely understood. Here the authors identify the D rosophila fat body as a tissue regulating growth in response to oxygen sensing via a mechanism involving Hph inhibition, HIF1-a activation and insulin secretion.

An operational multi-model forecasting system for air quality including nine different chemical transport models has been developed and provides daily forecasts of ozone, nitrogen oxides, and particulate matter for the 37 largest urban areas of China (population higher than 3 million in 2010). These individual forecasts as well as the mean and median concentrations for the next 3 days are displayed on a publicly accessible website (http://www.marcopolo-panda.eu, last access: 7 December 2018). The paper describes the forecasting system and shows some selected illustrative examples of air quality predictions. It presents an intercomparison of the different forecasts performed during a given period of time (1–15 March 2017) and highlights recurrent differences between the model output as well as systematic biases that appear in the median concentration values. Pathways to improve the forecasts by the multi-model system are suggested.