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Abstract Symbrachydactyly is a rare congenital malformation of the hand characterized by short or even absent fingers with or without syndactyly, mostly unilaterally present. The hand condition can vary from a small hand to only nubbins on the distal forearm. This study aims to systematically review the surgical management options for symbrachydactyly and compare functional and aesthetic outcomes. The review was performed according to the PRISMA guidelines. Literature was systematically assessed searching the Cochrane Library, PubMed, Embase, and PROSPERO databases up to January 1, 2023. Studies were identified using synonyms for ‘symbrachydactyly’ and ‘treatment’. Inclusion criteria were the report of outcomes after surgical treatment of symbrachydactyly in humans. Studies were excluded if they were written in another language than English, German, or French. Case reports, letters to the editor, studies on animals, cadaveric, in vitro studies, biomechanical reports, surgical technique description, and papers discussing traumatic or oncologic cases were excluded. Twenty-four studies published were included with 539 patients (1037 digit corrections). Only one study included and compared two surgical techniques. The quality of the included studies was assessed using the Modified Coleman Methodology Score and ranged from 25 to 47. The range of motion was the main reported outcome and demonstrated modest results in all surgical techniques. The report on aesthetics of the hand was limited in non-vascularized transfers to 2/8 studies and in vascularized transfers to 5/8 studies, both reporting satisfactory results. On average, there was a foot donor site complication rate of 22% in non-vascularized transfers, compared to 2% in vascularized transfers. The hand-related complication rate of 54% was much higher in the vascularized group than in the non-vascularized transfer with 16%. No uniform strategy to surgically improve symbrachydactyly exists. All discussed techniques show limited functional improvement with considerable complication rates, with the vascularized transfer showing relative high hand-related complications and the non-vascularized transfer showing relative high foot-related complications. There were no high-quality studies, and due to a lack of comparing studies, the data could only be analysed qualitatively. Systematic assessment of studies showed insufficient evidence to determine superiority of any procedure to treat symbrachydactyly due to inadequate study designs and comparative studies. This systematic review was registered at the National Institute for Health Research PROSPERO International Prospective Register of Systematic Reviews number: CRD42020153590 and received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Level of evidence I. Systematic review registration PROSPERO CRD42020153590.

The effective radiative forcing, which includes the instantaneous forcing plus adjustments from the atmosphere and surface, has emerged as the key metric of evaluating human and natural influence on the climate. We evaluate effective radiative forcing and adjustments in 17 contemporary climate models that are participating in the Coupled Model Intercomparison Project (CMIP6) and have contributed to the Radiative Forcing Model Intercomparison Project (RFMIP). Present-day (2014) global-mean anthropogenic forcing relative to pre-industrial (1850) levels from climate models stands at 2.00 (±0.23) W m−2, comprised of 1.81 (±0.09) W m−2 from CO2, 1.08 (± 0.21) W m−2 from other well-mixed greenhouse gases, −1.01 (± 0.23) W m−2 from aerosols and −0.09 (±0.13) W m−2 from land use change. Quoted uncertainties are 1 standard deviation across model best estimates, and 90 % confidence in the reported forcings, due to internal variability, is typically within 0.1 W m−2. The majority of the remaining 0.21 W m−2 is likely to be from ozone. In most cases, the largest contributors to the spread in effective radiative forcing (ERF) is from the instantaneous radiative forcing (IRF) and from cloud responses, particularly aerosol–cloud interactions to aerosol forcing. As determined in previous studies, cancellation of tropospheric and surface adjustments means that the stratospherically adjusted radiative forcing is approximately equal to ERF for greenhouse gas forcing but not for aerosols, and consequentially, not for the anthropogenic total. The spread of aerosol forcing ranges from −0.63 to −1.37 W m−2, exhibiting a less negative mean and narrower range compared to 10 CMIP5 models. The spread in 4×CO2 forcing has also narrowed in CMIP6 compared to 13 CMIP5 models. Aerosol forcing is uncorrelated with climate sensitivity. Therefore, there is no evidence to suggest that the increasing spread in climate sensitivity in CMIP6 models, particularly related to high-sensitivity models, is a consequence of a stronger negative present-day aerosol forcing and little evidence that modelling groups are systematically tuning climate sensitivity or aerosol forcing to recreate observed historical warming.

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments.Technical Development + Testing: The LeVe (“Light”) CPAP system was developed using principles of frugal innovation to produce a solution of low complexity and high resource efficiency. The LeVe system exploits the air flow dynamics of electric fan blowers which are inherently suited to delivery of positive pressure at appropriate flow rates for CPAP. Laboratory evaluation demonstrated that performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP, achieving a 10 cm H2O target pressure within 2.4% RMS error and 50–70% FiO2 dependent with 10 L/min oxygen from a commercial concentrator.Pilot Evaluation: The LeVe CPAP system was tested to evaluate safety and acceptability in a group of ten healthy volunteers at Mengo Hospital in Kampala, Uganda. The study demonstrated that the system can be used safely without inducing hypoxia or hypercapnia and that its use was well-tolerated by users, with no adverse events reported.Conclusions: To provide respiratory support for the high patient numbers associated with the COVID-19 pandemic, healthcare providers require resource efficient solutions. We have shown that this can be achieved through frugal engineering of a CPAP ventilation system, in a system which is safe for use and well-tolerated in healthy volunteers. This approach may also benefit other respiratory conditions which often go unaddressed in Low and Middle Income Countries (LMICs) for want of context-appropriate technology designed for the limited oxygen resources available.

The German Aerospace Center (DLR) and Teledyne Brown Engineering (TBE) have established a collaboration to develop and operate a new space-based hyperspectral sensor, the DLR Earth Sensing Imaging Spectrometer (DESIS). DESIS will provide spacebased hyperspectral data in the VNIR with high spectral resolution and near-global coverage. While TBE provides the platform and infrastructure for operation of the DESIS instrument on the International Space Station, DLR is responsible for providing the instrument and the processing software. The DESIS instrument is equipped with novel characteristics for an imaging spectrometer such high spectral resolution (2.55 nm), a mirror pointing unit or a CMOS sensor operated in rolling shutter mode. We present here an overview of the DESIS instrument and its processing chain, emphasizing the effect of the novel characteristics of DESIS in the data processing and final data products. Furthermore, we analyse in more detail the effect of the rolling shutter on the DESIS data and possible mitigation/correction strategies.

The new hyperspectral instrument DLR Earth Sensing Imaging Spectrometer (DESIS) will be developed and integrated in the Multi-User-System for Earth Sensing (MUSES) platform installed on the International Space Station (ISS). The DESIS instrument will be launched to the ISS mid of 2017 and robotically installed in one of the four slots of the MUSES platform. After a four month commissioning phase the operational phase will last at least until 2020. The MUSES / DESIS system will be commanded and operated by the publically traded company TBE (Teledyne Brown Engineering), which initiated the whole program. TBE provides the MUSES platform and the German Aerospace Center (DLR) develops the instrument DESIS and establishes a Ground Segment for processing, archiving, delivering and calibration of the image data mainly used for scientific and humanitarian applications. Well calibrated and harmonized products will be generated together with the Ground Segment established at Teledyne. The article describes the Space Segment consisting of the MUSES platform and the instrument DESIS as well as the activities at the two (synchronized) Ground Segments consisting of the processing methods, product generation, data calibration and product validation. Finally comments to the data policy are given.

This study presents the results of a broad intercomparison of a total of 15 global aerosol models within the AeroCom project. Each model is compared to observations related to desert dust aerosols, their direct radiative effect, and their impact on the biogeochemical cycle, i.e., aerosol optical depth (AOD) and dust deposition. Additional comparisons to Angström exponent (AE), coarse mode AOD and dust surface concentrations are included to extend the assessment of model performance and to identify common biases present in models. These data comprise a benchmark dataset that is proposed for model inspection and future dust model development. There are large differences among the global models that simulate the dust cycle and its impact on climate. In general, models simulate the climatology of vertically integrated parameters (AOD and AE) within a factor of two whereas the total deposition and surface concentration are reproduced within a factor of 10. In addition, smaller mean normalized bias and root mean square errors are obtained for the climatology of AOD and AE than for total deposition and surface concentration. Characteristics of the datasets used and their uncertainties may influence these differences. Large uncertainties still exist with respect to the deposition fluxes in the southern oceans. Further measurements and model studies are necessary to assess the general model performance to reproduce dust deposition in ocean regions sensible to iron contributions. Models overestimate the wet deposition in regions dominated by dry deposition. They generally simulate more realistic surface concentration at stations downwind of the main sources than at remote ones. Most models simulate the gradient in AOD and AE between the different dusty regions. However the seasonality and magnitude of both variables is better simulated at African stations than Middle East ones. The models simulate the offshore transport of West Africa throughout the year but they overestimate the AOD and they transport too fine particles. The models also reproduce the dust transport across the Atlantic in the summer in terms of both AOD and AE but not so well in winter-spring nor the southward displacement of the dust cloud that is responsible of the dust transport into South America. Based on the dependency of AOD on aerosol burden and size distribution we use model bias with respect to AOD and AE to infer the bias of the dust emissions in Africa and the Middle East. According to this analysis we suggest that a range of possible emissions for North Africa is 400 to 2200 Tg yr−1 and in the Middle East 26 to 526 Tg yr−1.

We evaluate black carbon (BC) model predictions from the AeroCom model intercomparison project by considering the diversity among year 2000 model simulations and comparing model predictions with available measurements. These model-measurement intercomparisons include BC surface and aircraft concentrations, aerosol absorption optical depth (AAOD) retrievals from AERONET and Ozone Monitoring Instrument (OMI) and BC column estimations based on AERONET. In regions other than Asia, most models are biased high compared to surface concentration measurements. However compared with (column) AAOD or BC burden retreivals, the models are generally biased low. The average ratio of model to retrieved AAOD is less than 0.7 in South American and 0.6 in African biomass burning regions; both of these regions lack surface concentration measurements. In Asia the average model to observed ratio is 0.7 for AAOD and 0.5 for BC surface concentrations. Compared with aircraft measurements over the Americas at latitudes between 0 and 50N, the average model is a factor of 8 larger than observed, and most models exceed the measured BC standard deviation in the mid to upper troposphere. At higher latitudes the average model to aircraft BC ratio is 0.4 and models underestimate the observed BC loading in the lower and middle troposphere associated with springtime Arctic haze. Low model bias for AAOD but overestimation of surface and upper atmospheric BC concentrations at lower latitudes suggests that most models are underestimating BC absorption and should improve estimates for refractive index, particle size, and optical effects of BC coating. Retrieval uncertainties and/or differences with model diagnostic treatment may also contribute to the model-measurement disparity. Largest AeroCom model diversity occurred in northern Eurasia and the remote Arctic, regions influenced by anthropogenic sources. Changing emissions, aging, removal, or optical properties within a single model generated a smaller change in model predictions than the range represented by the full set of AeroCom models. Upper tropospheric concentrations of BC mass from the aircraft measurements are suggested to provide a unique new benchmark to test scavenging and vertical dispersion of BC in global models.

We investigate the issue of "dangerous human-made interference with climate" using simulations with GISS modelE driven by measured or estimated forcings for 1880–2003 and extended to 2100 for IPCC greenhouse gas scenarios as well as the "alternative" scenario of Hansen and Sato (2004). Identification of "dangerous" effects is partly subjective, but we find evidence that added global warming of more than 1°C above the level in 2000 has effects that may be highly disruptive. The alternative scenario, with peak added forcing ~1.5 W/m2 in 2100, keeps further global warming under 1°C if climate sensitivity is ~3°C or less for doubled CO2. The alternative scenario keeps mean regional seasonal warming within 2σ (standard deviations) of 20th century variability, but other scenarios yield regional changes of 5–10σ, i.e. mean conditions outside the range of local experience. We conclude that a CO2 level exceeding about 450 ppm is "dangerous", but reduction of non-CO2 forcings can provide modest relief on the CO2 constraint. We discuss three specific sub-global topics: Arctic climate change, tropical storm intensification, and ice sheet stability. We suggest that Arctic climate change has been driven as much by pollutants (O3, its precursor CH4, and soot) as by CO2, offering hope that dual efforts to reduce pollutants and slow CO2 growth could minimize Arctic change. Simulated recent ocean warming in the region of Atlantic hurricane formation is comparable to observations, suggesting that greenhouse gases (GHGs) may have contributed to a trend toward greater hurricane intensities. Increasing GHGs cause significant warming in our model in submarine regions of ice shelves and shallow methane hydrates, raising concern about the potential for accelerating sea level rise and future positive feedback from methane release. Growth of non-CO2 forcings has slowed in recent years, but CO2 emissions are now surging well above the alternative scenario. Prompt actions to slow CO2 emissions and decrease non-CO2 forcings are required to achieve the low forcing of the alternative scenario.

We have developed a graphical interface to allow the researcher to view and assess the quality of sequencing results using a series of program scripts developed to process data generated by automated sequencers. The scripts are written in Perl programming language and are executable under the cgibin directory of a Web server environment. The scripts direct nucleic acid sequencing trace file data output from automated sequencers to be analyzed by the phredmolecular biology program and are displayed as graphical hypertext mark-up language (HTML) pages. The scripts are mainly designed to handle 96-well microtiter dish samples, but the scripts are also able to read data from 384-well microtiter dishes 96 samples at a time. The scripts may be customized for different laboratory environments and computer configurations. Web links to the sources and discussion page are provided.

No abstract available.

This paper continues the previous investigations [1]‐[3] for process of intensive oil burnout in glass fabric. Aliejaus išdeginimo iš stiklo gaminių matematinis modelis Santrauka Darbe toliau sistemingai nagrinejami stiklo gaminimo procesu matematiniai modeliai. Tiriama ivairiu faktoriu (stiklo mases judejimo greičio, metalo plokšteliu savybiu, gaminio storio) itaka stiklo gaminio kokybei. Kadangi aliejaus išdeginimas vyksta labai aukštoje temperatūroje ir labai trumpai, tai matematiniai modeliai leidžia detaliai ištirti procesa bei parinkti optimalias parametru reikšmes. Matematini modeli sudaro nestacionari lygtis, aprašanti difuzijos, konvekcijos ir chemines reakcijos procesus. Vidurkinimo metodu uždavinys suvedamas i vienmati modeli. Chemines reakcijos greitis modeliuojamas panaudojant Aremijaus modeli. Pateikiami skaičiavimo eksperimento rezultatai. First Published Online: 14 Oct 2010

The delay line distribution system is an alternative to conventional pulse compression, which enhances the peak power of rf sources while matching the long pulse of those sources to the shorter filling time of accelerator structures. We present an implementation of this scheme that combines pairs of parallel delay lines of the system into single lines. The power of several sources is combined into a single waveguide delay line using a multimode launcher. The output mode of the launcher is determined by the phase coding of the input signals. The combined power is extracted from the delay line using mode-selective extractors, each of which extracts a single mode. Hence, the phase coding of the sources controls the output port of the combined power. The power is then fed to the local accelerator structures. We present a detailed design of such a system, including several implementation methods for the launchers, extractors, and ancillary high power rf components. The system is designed so that it can handle the 600 MW peak power required by the Next Linear Collider design while maintaining high efficiency.

The sustainable development goals (SDGs) constitute an ambitious comprehensive global framework including monitoring mechanisms and indicators to evaluate progress towards precise targets of sustainable development. Most European countries have adapted their national sustainability indicator systems to conform to the UN Agenda 2030 for sustainable development, introducing new indicators and monitoring frameworks and governance processes in which these are embedded. What do we know about the political processes and struggles of implementing this important global framework? How does the politics of indicators differ in national contexts? We propose a classification of national indicator systems along dimensions of indicator selection, appraisal landscape, participatory nature, and political communication. We empirically explore these dimensions for four European national sustainability indicator systems through a comparative analysis based on national policy documents, indicator databases, and web portals as well as inputs from workshops and expert interviews. Given the considerable variation with respect to the trajectory of national sustainability indicator systems, we posit that these differences correspond to different national interpretations of sustainability., (© 2023. The Author(s).)

The United Nations 2030 Agenda and Sustainable Development Goals (SDGs) define a path towards a sustainable future, but given that uncertainty characterises the outcomes of any SDG-related actions, risks in the implementation of the Agenda need to be addressed. At the same time, most risk assessments are narrowed to sectoral approaches and do not refer to SDGs. Here, on the basis of a literature review and workshops, it is analysed how SDGs and risks relate to each other's in different communities. Then, it is formally demonstrated that, as soon as the mathematical definition of risks is broadened to embrace a more systemic perspective, acting to maintain socio-environmental systems within their sustainability domain can be done by risk minimisation. This makes Sustainable Development Goals and risks "the Yin and the Yang of the paths towards sustainability". Eventually, the usefulness of the SDG-risk nexus for both sustainability and risk management is emphasized., (© 2022. The Author(s) under exclusive licence to Royal Swedish Academy of Sciences.)