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Models of the high-latitude ionospheric electric field (EF) are commonly used to specify the magnetospheric forcing in thermosphere or whole atmosphere models. The use of decades-old models based on spacecraft data is still widespread. Currently the Heelis et al. (1982, https://doi.org/10.1029/ja087ia08p06339) and Weimer (2005b, https://doi.org/10.1029/2005ja011270) climatology models are most commonly used but it is possible a more recent EF model could improve forecasting functionality. Modern EF models, derived from radar data, have been developed to incorporate advances in data availability (Bristow et al., 2022, https://doi.org/10.1029/2021sw002920; Thomas & Shepherd, 2018, https://doi.org/10.1002/2018ja025280; Walach et al., 2022, https://doi.org/10.1029/2021ja029559). It is expected that climatologies based on this larger and up-to-date data set will better represent the high latitude ionosphere and improve forecasting abilities. An example of two such models, which have been developed using line-of-sight velocity measurements from the Super Dual Auroral Radar Network (SuperDARN) are the Thomas and Shepherd model (TS18) (Thomas & Shepherd, 2018, https://doi.org/10.1002/2018ja025280), and Walach and Grocott geomagnetic Storm model (WGS21) (Walach et al., 2021, https://doi.org/10.1029/2020ja028512). Here we compare the outputs of these EF models during the September 2017 storm, covering a range of solar wind and interplanetary magnetic field (IMF) conditions. We explore the relationships between the IMF conditions and the model output parameters such as transpolar voltage, the polar cap size and the lower latitude boundary of convection. We find that the electric potential and field parameters from the spacecraft-based models have a significantly higher magnitude than the SuperDARN-based models. We discuss the similarities and differences in topology and magnitude for each model.

Objectives: The objective of this study was to compare open partial nephrectomy (OPN) and robotic-assisted PN (RAPN) based on a propensity score-matched sample and to test the Comprehensive Complication Index (CCI) as an end point for complications. Methods: Patients undergoing PN from 2010 to 2018 at a university care center were included. OPN and RAPN cases were matched in a 2:1 ratio using propensity score-matching with age, gender, BMI, RENAL score, and tumor size as confounders. The primary end point was complications measured with the CCI as continuous score (0–100, 100 indicating death). Results: Data of 570 patients were available. After matching, both cohorts (OPN = 166; RAPN = 83) showed no baseline differences. For the primary end point, CCI, RAPN was superior (RAPN 2.6 ± 7.9 vs. OPN 8.7 ± 13.9; p < 0.001). Additionally, RAPN was superior for length of stay (RAPN 6.5 ± 4.0 vs. OPN 7.4 ± 3.5 days; p < 0.001), hemoglobin drop (RAPN 2.8 ± 1.4 vs. OPN 3.8 ± 1.6 g/dL; p < 0.001), and drop of glomerular filtration rate (RAPN 11.4 ± 14.2 vs. OPN 19.5 ± 14.3 mL/min; p < 0.001). OPN had shorter operating times (RAPN 157 ± 43 vs. OPN 143 ± 45 min; p = 0.014) and less ischemia (RAPN 13% vs. OPN 28%; p = 0.016). Conclusions: RAPN provides superior short-term results regarding overall complications without compromising renal function for small and less complex tumors. However, OPN remains an important option for more complex and larger tumors.

The near-relativistic electron population in the outer Van Allen radiation belt is highly dynamic and strongly coupled to geomagnetic activity such as storms and substorms, which are driven by the interaction of the magnetosphere with the solar wind. The energy, content and spatial extent of electrons in the outer radiation belt can vary on timescales of hours to days, dictated by the continuously evolving influence of acceleration and loss processes. While net changes in the electron population are directly observable, the relative influence of different processes is far from fully understood. Using a continuous 12-year dataset from the Proton Electron Telescope (PET) on board the Solar Anomalous Magnetospheric Particle Explorer (SAMPEX), we statistically compare the relative variations of trapped electrons to those in the bounce loss cone. Our results show that there is a proportional increase in flux entering the bounce loss cone outside the plasmapause during storm main phase and early recovery phase. Loss enhancement is sustained on the dawnside throughout the recovery phase while loss on the duskside is enhanced around minimum Sym-H and quickly diminishes. Spatial variations are also examined in relation to geomagnetic activity, making comparisons to possible causal wave modes such as whistler-mode chorus and plasmaspheric hiss.

OBJECTIVES: To compare the operative and functional result of partial and radical nephrectomy in renal cell carcinomas of stages pT2-3a. METHODS: Consecutive patients with renal cell carcinoma of stages pT2-3a, cN0 and cM0, who underwent partial or radical nephrectomy between January 2005 and October 2019 at a tertiary care center were included. Data were collected retrospectively. End-points included severe postoperative complications (Clavien-Dindo classification ≥3), acute and chronic renal function impairment, and overall survival. Uni- and multivariable outcome analyses were based on logistic regression. RESULTS: A total of 158 patients were included (110 radical nephrectomy and 48 partial nephrectomy). Over time, partial nephrectomy was increasingly used. A RENAL score ≥10 was the only independent predictor influencing the surgical approach (radical nephrectomy vs partial nephrectomy, odds ratio 8.62, 95% confidence interval 3.32-22.37, P

Introduction: The aim was to evaluate the impact of perioperative blood transfusions (PBTs) on renal function after surgery for renal cell carcinoma (RCC). Methods: Consecutive patients with RCC who underwent partial nephrectomy or radical nephrectomy between 2005 and 2015 at a tertiary care center were included. Minimum follow-up period was 6 months. A PBT was defined as the transfusion of packed erythrocyte concentrate (EC) within 7 days before until 30 days after surgery. The multivariable analyses were carried out by Cox regression. Results: The overall cohort included 851 patients, of whom 93 (10.9%) received a PBT. The median follow-up was 46 months (range 28–72). In case of a PBT, a median of 2 EC was transfused. PBT patients were older and had a poorer performance status and more comorbidities as well as locally more advanced or metastatic tumors. In the multivariable analyses, PBT was an independent prognostic factor for acute as well as chronic renal impairment (hazard ratio (HR) 2.72, 95% confidence interval (95% CI) 1.45–5.10, p = 0.002 and HR 2.23, 95% CI 1.26–3.70, p = 0.007). Conclusion: PBT is associated with acute and chronic deterioration of kidney function after surgery for RCC. Thus, it may be used to identify patients requiring close nephrological monitoring.

Funding: T. Elsden was supported by a Leverhulme Trust Early Career Fellowship (ECF-2019-155), the University of Leicester and the University of Glasgow. I. J. Rae was supported by NERC Grants NE/P017185/1 and NE/V002554/2 and STFC Grant ST/V006320/1. T. K. Yeoman and M. K. James were supported by STFC Grant ST/S000429/1. J. K. Sandhu was supported by NERC Grants NE/P017185/2 and NE/V002554/2. M-T Walach was supported by NERC Grant NE/T000937/1. Previous observational studies have shown that the natural Alfvén frequencies of geomagnetic field lines vary significantly over the course of a geomagnetic storm, decreasing by up to 50% from their quiet time values outside the plasmasphere. This was recently demonstrated statistically using ground magnetometer observations across 132 geomagnetic storm events (Wharton et al., 2020). This then brings into question where field line resonances (FLRs) will form in storm-time conditions relative to quiet times. With storm-time radiation belt dynamics depending heavily upon wave-particle interactions, understanding how FLR locations change over the course of a storm will have important implications for this area. Using 3D magnetohydrodynamic (MHD) simulations, we investigate how changes in the Alfvén frequency continuum of the Earth's dayside magnetosphere over the course of a geomagnetic storm affect the fast-Alfvén wave coupling. By setting the model Alfvén frequencies consistent with the observations, and permitting a modest change in the plasmapause/magnetopause locations consistent with storm-time behavior, we show that FLR locations can change substantially during storms. The combined effects of higher fast waveguide frequencies and lower Alfvén frequencies during storm main phases, act together to move the FLR locations radially inwards compared to quiet times. FLRs outside of the plasmasphere are moved radially inward by 1.7 Earth radii for the cases considered. Publisher PDF

Purpose To examine frailty and comorbidity as predictors of outcome of nephron sparing surgery (NSS) and as decision tools for identifying candidates for active surveillance (AS) or tumor ablation (TA). Methods Frailty and comorbidity were assessed using the modified frailty index of the Canadian Study of Health and Aging (11-CSHA) and the age-adjusted Charlson-Comorbidity Index (aaCCI) as well as albumin and the radiological skeletal-muscle-index (SMI) in a cohort of n = 447 patients with localized renal masses. Renal tumor anatomy was classified according to the RENAL nephrometry system. Regression analyses were performed to assess predictors of surgical outcome of patients undergoing NSS as well as to identify possible influencing factors of patients undergoing alternative therapies (AS/TA). Results Overall 409 patient underwent NSS while 38 received AS or TA. Patients undergoing TA/AS were more likely to be frail or comorbid compared to patients undergoing NSS (aaCCI: p p = 0.001) and hospital re-admission (aaCCI ≥ 6: OR = 4.93, p = 0.003) in the NSS cohort. No impact was found for albumin levels and SMI. An aaCCI > 6 and/or 11-CSHA ≥ 0.27 (OR = 9.19, p p = 0.005) and hypoalbuminemia (OR = 4.6, p = 0.009), but not tumor complexity, were decisive factors to undergo AS or TA rather than NSS. Conclusion In patients with localized renal masses, frailty and comorbidity indices can be useful to predict surgical outcome and support decision-making towards AS or TA.

We study the role of substorms and steady magnetospheric convection (SMC) in magnetic flux transport in the magnetosphere, using observations of field‐aligned currents by the Active Magnetosphere and Planetary Electrodynamics Response Experiment. We identify two classes of substorm, with onsets above and below 65° magnetic latitude, which display different nightside field‐aligned current morphologies. We show that the low‐latitude onsets develop a poleward‐expanding auroral bulge, and identify these as substorms that manifest ionospheric convection‐braking in the auroral bulge region as suggested by Grocott et al. (2009, https://doi.org/10.5194/angeo-27-591-2009). We show that the high‐latitude substorms, which do not experience braking, can evolve into SMC events if the interplanetary magnetic field remains southward for a prolonged period following onset. We conclude that during periods of ongoing driving, the magnetosphere displays repeated substorm activity or SMC depending on the rate of driving and the open magnetic flux content of the magnetosphere prior to onset. We speculate that sawtooth events are an extreme case of repeated onsets and that substorms triggered by northward‐turnings of the interplanetary magnetic field mark the cessation of periods of SMC. Our results provide a new explanation for the differing modes of response of the terrestrial system to solar wind‐magnetosphere‐ionosphere coupling by invoking friction between the ionosphere and atmosphere. publishedVersion

The expanding/contracting polar cap (ECPC) model, or the time-dependent Dungey cycle, provides a theoretical framework for understanding solar wind-magnetosphere-ionosphere coupling. The ECPC describes the relationship between magnetopause reconnection and substorm growth phase, magnetotail reconnection and substorm expansion phase, associated changes in auroral morphology, and ionospheric convective motions. Despite the many successes of the model, there has yet to be a rigorous test of the predictions or nowcasts made regarding ionospheric convection, which remains a final hurdle for the validation of the ECPC. In this study we undertake a comparison of ionospheric convection, as measured in situ by ion drift meters on board DMSP (Defense Meteorological Satellite Program) satellites and from the ground by SuperDARN (Super Dual Auroral Radar Network), with motions nowcasted by a theoretical model. The model is coupled to measurements of changes in the size of the polar cap made using global auroral imagery from the IMAGE FUV (Imager for Magnetopause to Aurora Global Exploration Far Ultraviolet) instrument, as well as the dayside reconnection rate, estimated using the OMNI data set. The results show that we can largely nowcast the magnitudes of ionospheric convection flows using the context of our understanding of magnetic reconnection at the magnetopause and in the magnetotail.

Simple Summary Radiomics may answer questions where the conventional interpretation of medical imaging has limitations. The aim of our systematic review and meta-analysis was to assess the (current) status of evidence in the application of radiomics in the field of renal masses. We focused on its role in diagnosis, sub-entity discrimination and treatment response assessment in renal cell carcinoma (RCC) and benign renal masses. Our quantitative synthesis showed promising results in discrimination of tumor dignity, nevertheless, the value added to human assessment remains unclear and should be the focus of future research. Furthermore, the benefit regarding treatment response assessment remains unclear as well, since the existing studies are investigating already abandoned systemic therapies (ST), which no longer represent the current “reference” standard. Open science could enable to establish technical and clinical validity of radiomic signatures prior to the incorporation of radiomics into everyday clinical practice. Abstract Radiomics may increase the diagnostic accuracy of medical imaging for localized and metastatic RCC (mRCC). A systematic review and meta-analysis was performed. Doing so, we comprehensively searched literature databases until May 2020. Studies investigating the diagnostic value of radiomics in differentiation of localized renal tumors and assessment of treatment response to ST in mRCC were included and assessed with respect to their quality using the radiomics quality score (RQS). A total of 113 out of 1098 identified studies met the criteria and were included in qualitative synthesis. Median RQS of all studies was 13.9% (5.0 points, IQR 0.25–7.0 points), and RQS increased over time. Thirty studies were included into the quantitative synthesis: For distinguishing angiomyolipoma, oncocytoma or unspecified benign tumors from RCC, the random effects model showed a log odds ratio (OR) of 2.89 (95%-CI 2.40–3.39, p < 0.001), 3.08 (95%-CI 2.09–4.06, p < 0.001) and 3.57 (95%-CI 2.69–4.45, p < 0.001), respectively. For the general discrimination of benign tumors from RCC log OR was 3.17 (95%-CI 2.73–3.62, p < 0.001). Inhomogeneity of the available studies assessing treatment response in mRCC prevented any meaningful meta-analysis. The application of radiomics seems promising for discrimination of renal tumor dignity. Shared data and open science may assist in improving reproducibility of future studies.

A symptomatic pseudoaneurysm (SPA) is a rare but severe complication after partial nephrectomy (PN). Selective trans-arterial embolization (TAE) is the treatment of choice with high success rates. However, the influence of this intervention on postsurgical renal function has not been studied. Between 2005 and 2016 we performed 1047 PNs at our institution. Postsurgical SPA occurred in 40 patients (3.8%). Patients with and without SPA were matched in a 1:2 ratio concerning tumor complexity (RENAL) and pre-operative renal function (CKD stage). Any CKD upstage and a relevant CKD progression (CKD ≥ III) were defined as endpoints. Furthermore, the influence of the amount of contrast agent applied during TAE was assessed. All patients with SPA were treated successfully with TAE. No significant difference could be detected concerning clinical, functional and surgical aspects. Median follow-up time accounted for 12.5 (6.75–27.5) months. Kaplan–Meier analyses detected an increased rate of any CKD upstage (p = 0.066) and relevant CKD progression (p = 0.01) in patients with SPA. Multivariate analysis identified post-operative SPA to be an independent predictor for a relevant CKD progression (HR 4.15, p = 0.01). The amount of contrast agents used did not have an impact on the development of a relevant CKD progression (p = 0.72). Patients treated with TAE after PN show an additional risk for an impairment of renal function over time. Hence, those patients should explicitly be informed about possible consequences and closely monitored by nephrologists.

Magnetospheric modes, including substorms, sawtooth events, and steady magnetospheric convection events, have in the past been described as different responses of the magnetosphere to coupling with the solar wind. Using previously determined event lists for sawtooth events, steady magnetospheric convection events, and substorms, we produce a statistical study of these event types to examine their similarities and behavior in terms of solar wind parameters, auroral brightness, open magnetospheric flux, and geomagnetic indices. A superposed epoch analysis shows that individual sawteeth show the same signatures as substorms but occur during more extreme cases of solar wind driving as well as geomagnetic activity. We also explore the limitations of current methods of identifying steady magnetospheric convection events and explain why some of those events are flagged inappropriately. We show that 58% of the steady magnetospheric convection events considered, as identified by criteria defined in previous studies are part of a prolonged version of substorms due to continued dayside driving during expansion phase. The remaining 42% are episodes of enhanced magnetospheric convection, occurring after extended periods of dayside driving.

Two coexisting transpolar arcs are observed on 31 August 2005. We track the formation and motion of the arcs in both the Northern and Southern Hemispheres, using data from two independent satellites (Imager for Magnetopause to Aurora Global Exploration and a Defence Meteorological Satellite Program satellite). The observations are supported by supplementary ground-based ionospheric convection data from the Super Dual Auroral Radar Network. The two arcs form during a period of northward interplanetary magnetic field. Following a change in the direction of the interplanetary magnetic field BY component from negative to positive, the dawnside arc traverses the polar cap to the duskside in the Northern Hemisphere. Over the same time period and in the Southern Hemisphere, the duskside arc traverses the polar cap to the dawnside. A complex magnetic field line topology resulting in the coexistence of two tongues of closed field lines protruding into the otherwise open polar cap is implied. We discuss these observations in terms of magnetic conjugacy and a model of transpolar arcs formation.

This paper investigates the auroral evolution during different magnetospheric modes: substorms, steady magnetospheric convection, and sawtooth events. We undertake a superposed epoch analysis using data from the Imager for Magnetopause-to-Aurora Global Exploration Far Ultraviolet spectrographic imager and wideband imaging camera for each of these event types. We find that the auroral oval narrows and shows an equatorward movement prior to substorm onset. At substorm onset, the auroral oval brightens explosively near 23 magnetic local time (MLT). After this the aurorae expand poleward and the brightening stretches duskward and dawnward, with the duskward expansion being faster. Approximately 20 min after substorm onset, the aurorae begin to dim. Steady magnetospheric convection events with preceding substorms initially show the same signatures as substorms, but instead of the recovery after 20 min postonset, the aurorae stay bright for an extended period of time (at least 4 h after onset). Despite continued dayside driving of the system during steady magnetospheric convection events, we see a reconfiguration in the nightside auroral activity, taking place between 120 to 150 min after onset. Sawtooth events show very similar signatures to substorms, except for the auroral emission being much brighter, covering a wider MLT extent, and taking significantly less time to recover. The proton aurorae during substorms take ∼2–4 h to dim, during sawtooth events this process takes less than 1 h, despite enhanced reconnection rates. A similar effect is seen in the electron aurorae, albeit not as extreme.

We review the morphology and dynamics of the electrical current systems of the terrestrial magnetosphere and ionosphere. Observations from the Active Magnetosphere and Planetary Electrodynamics Response Experiment (AMPERE) over the three years 2010 to 2012 are employed to illustrate the variability of the field-aligned currents that couple the magnetosphere and ionosphere, on timescales from minutes to years, in response to the impact of solar wind disturbances on the magnetosphere and changes in the level of solar illumination of the polar ionospheres. The variability is discussed within the context of the occurrence of magnetic reconnection between the solar wind and terrestrial magnetic fields at the magnetopause, the transport of magnetic flux within the magnetosphere, and the onset of magnetic reconnection in the magnetotail. The conditions under which the currents are expected to be weak, and hence minimally contaminate measurements of the internally-produced magnetic field of the Earth, are briefly outlined. publishedVersion

©2016. The Authors. We present the first large-scale comparison of the spatial distribution of field-aligned currents as measured by the Active Magnetosphere and Planetary Electrodynamics Response Experiment, with the location and brightness of the average auroral oval, determined from the Imager for Magnetopause-to-Aurora Global Exploration far ultraviolet instrument. These distributions are compared under the same interplanetary magnetic field magnitude and clock angle conditions. The field-aligned currents and auroral oval drop to lower latitudes, as the interplanetary magnetic field becomes both increasingly stronger in magnitude and increasingly southward. We find that the region 2 currents are more closely aligned with the distribution of auroral UV emission, whether that be in the discrete auroral zone about dusk or in the postmidnight diffuse aurora sector. The lack of coincidence between the region 1 field-aligned currents with the auroral oval in the dusk sector is contrary to expectation.

Flux transfer events (FTEs) are the manifestation of bursty and/or patchy magnetic reconnection at the magnetopause. We compare two sequences of the ionospheric signatures of flux transfer events observed in global auroral imagery and coherent ionospheric radar measurements. Both sequences were observed during very similar seasonal and interplanetary magnetic field (IMF) conditions, though with differing solar wind speed. A key observation is that the signatures differed considerably in their local time extent. The two periods are 26 August 1998, when the IMF had components $\mathit{B}_{\mathit{z}}$ $\approx$ -10 nT and $\mathit{B}_{\mathit{y}}$ $\approx$ 9 nT and the solar wind speed was $\mathit{V}_{\mathit{x}}$ $\approx$ 650 km $s^{-1}$, and 31 August 2005, IMF $\mathit{B}_{\mathit{z}}$ $\approx$ -7 nT, $\mathit{B}_{\mathit{y}}$ $\approx$ 17 nT, and $\mathit{V}_{\mathit{x}}$ $\approx$ 380 km $s^{-1}$. In the first case, the reconnection rate was estimated to be near 160 kV, and the FTE signatures extended across at least 7 h of magnetic local time (MLT) of the dayside polar cap boundary. In the second, a reconnection rate close to 80 kV was estimated, and the FTEs had a MLT extent of roughly 2 h. We discuss the ramifications of these differences for solar wind-magnetosphere coupling.