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Some years ago, the consensus was that asteroid (16) Psyche was almost entirely metal. New data on density, radar properties, and spectral signatures indicate that the asteroid is something perhaps even more enigmatic: a mixed metal and silicate world. Here we combine observations of Psyche with data from meteorites and models for planetesimal formation to produce the best current hypotheses for Psyche's properties and provenance. Psyche's bulk density appears to be between 3,400 and 4,100 kg m-3. Psyche is thus predicted to have between ~30 and ~60 vol% metal, with the remainder likely low-iron silicate rock and not more than ~20% porosity. Though their density is similar, mesosiderites are an unlikely analog to bulk Psyche because mesosiderites have far more iron-rich silicates than Psyche appears to have. CB chondrites match both Psyche's density and spectral properties, as can some pallasites, although typical pallasitic olivine contains too much iron to be consistent with the reflectance spectra. Final answers, as well as resolution of contradictions in the data set of Psyche physical properties, for example, the thermal inertia measurements, may not be resolved until the NASA Psyche mission arrives in orbit at the asteroid. Despite the range of compositions and formation processes for Psyche allowed by the current data, the science payload of the Psyche mission (magnetometers, multispectral imagers, neutron spectrometer, and a gamma-ray spectrometer) will produce data sets that distinguish among the models.

To gain insight into the thickness of the crust of Mercury, we use gravity and topography data acquired by the MErcury Surface, Space ENvironment, GEochemistry, and Ranging spacecraft to calculate geoid-to-topography ratios over the northern hemisphere of the planet. For an Airy model for isostatic compensation of variations in topography, we infer an average crustal thickness of 35 ± 18 km. Combined with the value of the radius of the core of Mercury, this crustal thickness implies that Mercury had the highest efficiency of crustal production among the terrestrial planets. From the measured abundance of heat-producing elements on the surface, we calculate that the heat production in the mantle from long-lived radioactive elements at 4.45 Ga was greater than 5.4 ×10-12W/kg. By analogy with the Moon, the relatively thin crust of Mercury allows for the possibility that major impact events, such as the one that formed the Caloris basin, excavated material from Mercury's mantle.

Coxsackieviruses (CV), as all enteroviruses, are small, non-enveloped, icosahedral-shaped capsid viruses. They belong to the family Picornaviridae. This group was named after the town of Coxsackie in New York State (USA) where was recognized the first human case of coxsackievirus infection in the 40s of the XX century. Coxsackie B (CVB) are distinguished from other enteroviruses by ability to infect many types of tissues and organs. This wide tropism reason that these viruses are etiologic agents of large number of different diseases. CVB cause infection of the heart, pleura, pancreas, lungs and liver, causing myocarditis, pleurodynia, pericarditis, pneumonia and hepatitis. They can invade the central nervous system and induce meningitis, encephalitis, or acute flaccid paralysis. They also cause systemic neonatal disease and chronic infections such as type 1 diabetes and chronic myocarditis. This pantropic character of CVB can be determinate by specific virus – receptor interaction, which initiate the infection and viral spread. CVB attach at least two receptor proteins: the coxsackievirus – adenovirus receptor (CAR) and the decay – accelerating factor (DAF). Moreover, other anonymous determinant may play a role in tissue permissiveness and disease severity. This article summarizes the main aspects of Coxsackieviruses B infection: replication, virus-receptor interaction, genetic variability, pathogenesis, epidemiology and diagnostics.

The results of grain size distribution of loess units are suitable for the study of past climate change. There are many methods for the analysis of the grain size, but clustering methods have not been used before. In this article, a new approach in the sediment research, the k-median method was used. This method separates the grain size classes of the youngest loess units of three loess-soil profiles in Poland: Biały Kościół, Złota and Tyszowce. In the analysis, only the content for the loess silt fraction (range from 4 to 63 µm) was used. This allowed eliminating the admixtures of sandy and clay fraction, considered as secondary material. For the purposes of this analysis, silt fractions were divided into smaller units using a 1/4 phi interval, resulting in 16 new subfractions. The grain size data from three profiles were combined into one data set. As a result, four classes with a similar internal of grain structure were obtained. The separated classes showed the sedimentological variability of the sediment well. It has been shown that the k-median method can be used to classify loess in a fast and objective way.

Fluoroscopy-guided percutaneous biopsy interventions are mostly performed with traditional free-hand technique. The practical experience of the surgeon influences the duration of the intervention and the radiation exposure for patients and him-/herself. Especially when the placement of heavy and long instruments in double oblique angles is required, manual techniques reach their technical limitations very fast. The system presented herein automatizes the needle positioning using only two 2D scans while the robotic platform guides the intervention. These two images were used to plan the needle pathway and to estimate the pose of the robot using a custom-made end-effector with embedded registration fiducials. The estimated pose was subsequently used to transfer the planed needle path to the robot’s coordinate system and finally to compute the movement parameters in order to align the robot with this plan. To evaluate the system, two phantoms with 11 different targets on it were developed. The targets were punctured, and the application accuracy was measured quantitatively. The solution achieved sub-millimetric accuracy for needle placement (min. 0.23, max. 1.04 in mm). Our approach combines the advantages of fluoroscopic imaging and ensures automatic needle alignment with highly reduced X-ray radiation. The proposed system shows promising potential to be a guidance platform that is easy to combine with available fluoroscopic imaging systems and provides valuable help to the physician in more difficult interventions.

The aim of the article is an analysis of tourist traffic in the Aconcagua massif, one of the most popular peaks of the Seven Summits. On the basis of statistical data, the tourist traffic was analysed in a temporal and spatial perspective. The applied data made it possible to capture the dynamics of visits in the period 2000/2001 – 2012/2013 and with a breakdown into months, which helped analyse the tourist traffic in this area. In each of the analysed periods, January dominates. Data concerning the origin of tourists according to countries and continents, their age, gender and type of mountaineering activity were also taken into account. Most tourists came from Argentina, the USA and Germany. These are people of age groups 21–30 (33%) and 31–40 (31%). Men account for over 75% of visitors. The favourite mountaineering activity is climbing (about 60%). Aconcagua has invariably been a very popular peak among tourists and climbers. It is a place for training and acclimatisation for alpinists, participating in Himalayan expeditions and climbers collecting peaks of the Seven Summits.

The paper compares three different types of energy storage system (ESS) in a tramway. It was assumed that the tram has to travel without catenary for 5 km. Two homogeneous energy storage systems were designed to provide energy for the ride: the first made of lithium-ion batteries and the second made of supercapacitors. The third solution is a hybrid ESS (HESS) composed of both of the aforementioned technologies. The comparison was made in terms of weight, price and power consumption when driving with and without a catenary. Using a well-fitted energy management strategy, 50% lower HESS mass was achieved compared to the homogeneous ESSes. The estimated price of the HESS is 29% lower than the battery ESS and 59% from the supercapacitor ESS. A comparison of the energy consumption of the tram with and without the ESS is also presented, depending on the amount of energy absorbed by other vehicles on the same power section. It follows that the use of the ESS allows for significant energy savings for driving with the catenary.

Energy storage systems (ESS) are based on electrochemical batteries and supercapacitors (SC). SCs have a lower energy density compared to batteries, but have an advantage over them in power density. The combined use of the two in a hybrid ESS (HESS) gives both high energy density and high power density of ESSs. Fractional-order impedance describes the SC dynamics better than commonly used integer order impedance. Such a description can be based on the dielectric relaxation equations e.g. Cole-Cole equation used in this work. The paper compares results of the impedance approximation of a number of SC’s with various fractional and integer models, on the basis of which the time responses are analysed. The methods of capacitance and ESR measurement recommended by the IEC standard are examined. They are compared with the methods used in practice by SC producers. The problem of energy losses in ESS with respect to charging/discharging current pulses is presented. A proper ESS designing requires an accurate approximation of the SC impedance over the frequency band in which the dominant part of the power spectrum of current pulses is located.

Abstract Background Increased transcription of oncogenes like the epidermal growth factor receptor (EGFR) is frequently caused by amplification of the whole gene or at least of regulatory sequences. Aim of this study was to pinpoint mechanistic parameters occurring during egfr copy number gains leading to a stable EGFR overexpression and high sensitivity to extracellular signalling. A deeper understanding of those marker events might improve early diagnosis of cancer in suspect lesions, early detection of cancer progression and the prediction of egfr targeted therapies. Methods The basal-like/stemness type breast cancer cell line subpopulation MDA-MB-468 CD44high/CD24-/low, carrying high egfr amplifications, was chosen as a model system in this study. Subclones of the heterogeneous cell line expressing low and high EGF receptor densities were isolated by cell sorting. Genomic profiling was carried out for these by means of SNP array profiling, qPCR and FISH. Cell cycle analysis was performed using the BrdU quenching technique. Results Low and high EGFR expressing MDA-MB-468 CD44+/CD24-/low subpopulations separated by cell sorting showed intermediate and high copy numbers of egfr, respectively. However, during cell culture an increase solely for egfr gene copy numbers in the intermediate subpopulation occurred. This shift was based on the formation of new cells which regained egfr gene copies. By two parametric cell cycle analysis clonal effects mediated through growth advantage of cells bearing higher egfr gene copy numbers could most likely be excluded for being the driving force. Subsequently, the detection of a fragile site distal to the egfr gene, sustaining uncapped telomere-less chromosomal ends, the ladder-like structure of the intrachromosomal egfr amplification and a broader range of egfr copy numbers support the assumption that dynamic chromosomal rearrangements, like breakage-fusion-bridge-cycles other than proliferation drive the gain of egfr copies. Conclusion Progressive genome modulation in the CD44+/CD24-/low subpopulation of the breast cancer cell line MDA-MB-468 leads to different coexisting subclones. In isolated low-copy cells asymmetric chromosomal segregation leads to new cells with regained solely egfr gene copies. Furthermore, egfr regain resulted in enhanced signal transduction of the MAP-kinase and PI3-kinase pathway. We show here for the first time a dynamic copy number regain in basal-like/stemness cell type breast cancer subpopulations which might explain genetic heterogeneity. Moreover, this process might also be involved in adaptive growth factor receptor intracellular signaling which support survival and migration during cancer development and progression.

Nigeria has the highest reported incidence of peripartum cardiomyopathy worldwide. This open-label, pragmatic clinical trial randomized pregnant and postpartum women to usual care or artificial intelligence (AI)-guided screening to assess its impact on the diagnosis left ventricular systolic dysfunction (LVSD) in the perinatal period. The study intervention included digital stethoscope recordings with point of-care AI predictions and a 12-lead electrocardiogram with asynchronous AI predictions for LVSD. The primary end point was identification of LVSD during the study period. In the intervention arm, the primary end point was defined as the number of identified participants with LVSD as determined by a positive AI screen, confirmed by echocardiography. In the control arm, this was the number of participants with clinical recognition and documentation of LVSD on echocardiography in keeping with current standard of care. Participants in the intervention arm had a confirmatory echocardiogram at baseline for AI model validation. A total of 1,232 (616 in each arm) participants were randomized and 1,195 participants (587 intervention arm and 608 control arm) completed the baseline visit at 6 hospitals in Nigeria between August 2022 and September 2023 with follow-up through May 2024. Using the AI-enabled digital stethoscope, the primary study end point was met with detection of 24 out of 587 (4.1%) versus 12 out of 608 (2.0%) patients with LVSD (intervention versus control odds ratio 2.12, 95% CI 1.05-4.27; P = 0.032). With the 12-lead AI-electrocardiogram model, the primary end point was detected in 20 out of 587 (3.4%) versus 12 out of 608 (2.0%) patients (odds ratio 1.75, 95% CI 0.85-3.62; P = 0.125). A similar direction of effect was observed in prespecified subgroup analysis. There were no serious adverse events related to study participation. In pregnant and postpartum women, AI-guided screening using a digital stethoscope improved the diagnosis of pregnancy-related cardiomyopathy. ClinicalTrials.gov registration: NCT05438576., (© 2024. The Author(s).)

The objective of this study is to analyze the association between surgical day of the week and distance traveled with prolonged length of stay (LOS) following robotic-assisted partial nephrectomy (RAPN). 563 consecutive RAPN performed by a single surgeon were evaluated. Early week RAPN was considered Monday through Wednesday, while late-week RAPN was defined as surgery performed Thursday through Friday. Distance traveled for RAPN was evaluated as greater than or less than 60 miles. The respective groups were compared to see if the surgical day of the week or distance traveled influenced the hospital stay or prolonged hospital stay (defined as hospital length of stay equal or greater than 3 days). Overall, 213 patients (38.0%) undergoing RAPN experienced a prolonged LOS. A total of 380 patients underwent early week RAPN compared to 183 late-week RAPN. Patients undergoing late-week RAPN were more likely to have a prolonged LOS compared to early week RAPN (n = 81, 44% vs. n = 133, 35%, respectively; p = 0.004). 229 patients traveled less than 60 miles, while 332 patients traveled more than 60 miles to receive RAPN. 135 patients (40.7%) traveling more than 60 miles experienced a prolonged stay compared to 78 patients (34.1%) traveling less than 60 miles, although this difference was not statistically significant (p = 0.128). Patients who underwent RAPN at the end of the week were more likely to have a prolonged LOS, while distance traveled for RAPN did not appear to affect likelihood of prolonged LOS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Aims: Recently, deep learning artificial intelligence (AI) models have been trained to detect cardiovascular conditions, including hypertrophic cardiomyopathy (HCM), from the 12-lead electrocardiogram (ECG). In this external validation study, we sought to assess the performance of an AI-ECG algorithm for detecting HCM in diverse international cohorts., Methods and Results: A convolutional neural network-based AI-ECG algorithm was developed previously in a single-centre North American HCM cohort (Mayo Clinic). This algorithm was applied to the raw 12-lead ECG data of patients with HCM and non-HCM controls from three external cohorts (Bern, Switzerland; Oxford, UK; and Seoul, South Korea). The algorithm's ability to distinguish HCM vs. non-HCM status from the ECG alone was examined. A total of 773 patients with HCM and 3867 non-HCM controls were included across three sites in the merged external validation cohort. The HCM study sample comprised 54.6% East Asian, 43.2% White, and 2.2% Black patients. Median AI-ECG probabilities of HCM were 85% for patients with HCM and 0.3% for controls ( P < 0.001). Overall, the AI-ECG algorithm had an area under the receiver operating characteristic curve (AUC) of 0.922 [95% confidence interval (CI) 0.910-0.934], with diagnostic accuracy 86.9%, sensitivity 82.8%, and specificity 87.7% for HCM detection. In age- and sex-matched analysis (case-control ratio 1:2), the AUC was 0.921 (95% CI 0.909-0.934) with accuracy 88.5%, sensitivity 82.8%, and specificity 90.4%., Conclusion: The AI-ECG algorithm determined HCM status from the 12-lead ECG with high accuracy in diverse international cohorts, providing evidence for external validity. The value of this algorithm in improving HCM detection in clinical practice and screening settings requires prospective evaluation., Competing Interests: Conflict of interest: P.A.F., Z.I.A., P.A.N., M.J.A., and K.C.S. are co-inventors of the HCM AI-ECG algorithm. Mayo Clinic has licensed the algorithm to Anumana, Inc., with potential for commercialization. K.C.S. has received research funding from Anumana, Inc., for work related to the HCM AI-ECG algorithm (via the institution). M.J.A. is also a consultant for Abbott, Boston Scientific, Bristol Myers Squibb, Daiichi Sankyo, Invitae, LQT Therapeutics, and Medtronic. M.J.A. and Mayo Clinic also have licensing agreements with AliveCor, ARMGO Pharma, Pfizer, and UpToDate. S.W. reports research, travel, or educational grants to the institution from Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. He serves as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis with payments to the institution but no personal payments. He is also a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. B.R. is funded by the BHF Oxford Centre of Research Excellence (RE/18/3/34214). S.N. acknowledges support from the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Background: Identifying the projected incidence of hepatobiliary cancers and recognizing patient cohorts at increased risk can help develop targeted interventions and resource allocation. The expected incidence of subtypes of hepatobiliary cancers in different age groups, races, and genders remains unknown., Methods: Historical epidemiological data from the Surveillance, Epidemiology, and End Results (SEER) database was used to project future incidence of hepatobiliary malignancies in the United States and identify trends by age, race, and gender. Patients ≥18 years of age diagnosed with a hepatobiliary malignancy between 2001 and 2017 were included. US Census Bureau 2017 National Population projects provided the projected population from 2017 to 2029. Age-Period-Cohort forecasting model was used to estimate future births cohort-specific incidence. All analyses were completed using R Statistical Software., Results: We included 110381 historical patients diagnosed with a hepatobiliary malignancy between 2001 and 2017 with the following subtypes: hepatocellular cancer (HCC) (68%), intrahepatic cholangiocarcinoma (iCCA) (11.5%), gallbladder cancer (GC) (8%), extrahepatic cholangiocarcinoma (eCCA) (7.6%), and ampullary cancer (AC) (4%). Our models predict the incidence of HCC to double (2001 to 2029) from 4.5 to 9.03 per 100,000, with the most significant increase anticipated in patients 70-79 years of age. In contrast, incidence is expected to continue to decline among the Asian population. Incidence of iCCA is projected to increase, especially in the white population, with rates in 2029 double those in 2001 (2.13 vs. 0.88 per 100,000, respectively; p < 0.001). The incidence of GC among the black population is expected to increase. The incidence of eCCA is expected to significantly increase, especially among the Hispanic population, while that of AC will remain stable., Discussion: The overall incidence of hepatobiliary malignancies is expected to increase in the coming years, with certain groups at increased risk. These findings may help with resource allocation when considering screening, treatment, and research in the coming years.

Background: This retrospective study was designed to analyze the prevalence and impact of associated comorbidities on fibromyalgia (FM) outcomes (functionality, pain, depression levels) for patients who participated in an intensive multicomponent clinical program in a tertiary care center., Methods: Participants included a sample of 411 patients diagnosed with FM at a large tertiary medical center using the 2016 ACR criteria. Patients completed an intensive 2-day cognitive behavioral treatment (CBT) program, filled out the Fibromyalgia Impact Questionnaire Revised (FIQR), the Center for Epidemiologic Studies Depression Scale (CES-D), the Pain Catastrophizing Scale (PCS), and were followed for 6 months after treatment completion. T -tests were performed to analyze differences between the presence or absence of select comorbidities for the three outcomes at follow-up. Statistically significant comorbidities ( p  < 0.05) were used as predictors in multivariable logistic regression models., Results: The FM associated comorbidities in this cohort that had significant impact on the measured outcome domains after treatment program completed were Obesity (FIQR p  = 0.024), Hypothyroidism (CES-D p  = 0.023, PCS p  = 0.035), Gastroesophageal reflux disease GERD (PCS p  < 0.001), Osteoarthritis (CES-D p  = 0.047). Interestingly, Headache, the most frequent FM associated comorbidity in this cohort (33.6%), did not have a significant impact on the outcome domains at follow-up. Obesity (18.2%) was the only FM associated comorbidity significantly impacting all three outcome domains at follow-up., Conclusion: The present study suggests that addressing obesity may significantly impact outcomes in FM patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Rivera, Munipalli, Allman, Hodge, Wieczorek, Wang, Abril, Perlman, Knight and Bruce.)

Objective: To report the impact of resection base inner layer renorrhaphy suture type on renal artery pseudoaneurysm (RAP) rate following robotic-assisted partial nephrectomy (RAPN)., Methods: Five hundred and sixty-three consecutive RAPNs performed by a single surgeon were retrospectively reviewed. Patients were classified into 3 categories: (1) No base suture, (2) monofilament barbed suture (2-0 V-Loc 180 absorbable suture, Medtronic, Minneapolis, MN), (3) polyglactin 910 (2-0 Vicryl coated suture, Ethicon Inc, Cincinnati, OH). In a secondary analysis, we evaluated suturing (Vicryl and V-Loc) vs no base suture. All patients had outer cortical renorrhaphy performed with 0-Vicryl suture utilizing the standard sliding clip technique., Results: One hundred ten patients (19.5%) had V-Loc suturing, 255 patients (45.3%) had Vicryl suturing, and 198 patients (35.2%) had no base suture. Patients had a median age of 62.8years (interquartile range: 53.5-69.7) and median RENAL score was 8 (6-9). Median mass size from preoperative imaging was 3.0 cm (2.5-4.0) for V-Loc, 3.3 cm (2.5-4.2) for Vicryl, and 2.0 cm (1.8-3.0) for no base suture (P < .001). Overall, 21 patients (3.7%) developed a symptomatic postoperative RAP. The rate of RAP was 3.6% (4/110) for V-Loc, 3.9% (10/255) for 2-0 Vicryl, and 3.5% (7/198) for no base suture (P = 1.00). Similarly, the rate of RAP was 3.5% (7/198) for no base suture and 3.8% (14/365) for base suture (P = 1.00)., Conclusion: Utilization of base suture and type of base suture used during RAPN was not predictive of postoperative RAP development., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: To analyze the contribution of nonprocedural operating room (OR) times to transurethral resection of bladder tumor (TURBT) operative efficiency., Methods: Over a 24-month period, all nonprocedural OR times from TURBT surgeries performed at a single institution were prospectively collected. Nonprocedural times included: in-room to anesthesia release time, anesthesia release to cut time, and close to wheels out time. Procedural OR time was cut to close time. We also analyzed the impact of time of day on TURBT efficiency (morning vs afternoon). Comparisons between groups were made using the Wilcoxon rank sum test for continuous variables., Results: We identified 777 consecutive TURBT procedures from 2019 to 2020. The median total OR time was 63 minutes (interquartile range: 50-81 minutes). The nonprocedural time occupied a median of 49.4% of the total operating time (interquartile range: 38.9%-60.4%). Median anesthesia release to cut time was slower when 1 TURBT was performed a day compared to 2 or more (13 minutes vs 12 minutes, P = .04). Median close to wheels out time was faster when there was 1 TURBT in a day (7 minutes vs 8 minutes, P = .02). Median in-room to anesthesia release time was faster in the morning than it was in the afternoon (10 minutes vs 11 minutes, P = .02)., Conclusion: Nonprocedural times made up roughly half of the total TURBT operating time and should be considered in OR efficiency analyses. TURBT OR efficiency may be related to the number of TURBTs performed in a day as well as the time of day of TURBT start., Competing Interests: Declaration of Competing Interest TDL has served as a consultant for Bristol Myers Squibb and ImmunityBio. All remaining authors report no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

To analyze operating room (OR) efficiency by evaluating fixed and variable OR times for open (OPN) and robotic-assisted partial nephrectomies (RAPN). We analyzed consecutive OPN and RAPN performed by one surgeon over a 24-month period. All patients were placed in the lateral decubitus position and secured with a beanbag regardless of approach. Fixed (non-procedural) OR times were prospectively collected and defined as: in-room to anesthesia-release time (IRAT), anesthesia release to cut time (ARCT), and close to wheels-out time (CTWO). Variable OR time was procedural cut to close time (CTCT). Comparisons of fixed and variable OR time points between OPN and RAPN were performed using the Wilcoxon rank-sum test. 146 RAPN and 31 OPN were evaluated from 2019-2020. Median IRAT was similar for RAPN versus OPN [20 min (IQR: 16-25) vs. 20 min (IQR: 16-26), P = 0.57]. Median ARCT was longer for RAPN than it was for OPN [40 min (IQR: 36-46) vs. 34 min (IQR: 30-39), P < 0.001]. Median CTWO was similar for OPN (12 min, IQR: 9-14) and RAPN (11 min, IQR: 7-15) (P = 0.89). Median CTCT was longer for RAPN (202 min, IQR: 170-236) compared to OPN (164 min, IQR: 154-184) (P < 0.001). In a single surgeon, partial nephrectomy series with the same patient positioning, utilization of robotic technology was associated with longer surgeon operating time as well as less efficient fixed OR times, specifically ARCT., (© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Aims: Current non-invasive screening methods for cardiac allograft rejection have shown limited discrimination and are yet to be broadly integrated into heart transplant care. Given electrocardiogram (ECG) changes have been reported with severe cardiac allograft rejection, this study aimed to develop a deep-learning model, a form of artificial intelligence, to detect allograft rejection using the 12-lead ECG (AI-ECG)., Methods and Results: Heart transplant recipients were identified across three Mayo Clinic sites between 1998 and 2021. Twelve-lead digital ECG data and endomyocardial biopsy results were extracted from medical records. Allograft rejection was defined as moderate or severe acute cellular rejection (ACR) based on International Society for Heart and Lung Transplantation guidelines. The extracted data (7590 unique ECG-biopsy pairs, belonging to 1427 patients) was partitioned into training (80%), validation (10%), and test sets (10%) such that each patient was included in only one partition. Model performance metrics were based on the test set ( n = 140 patients; 758 ECG-biopsy pairs). The AI-ECG detected ACR with an area under the receiver operating curve (AUC) of 0.84 [95% confidence interval (CI): 0.78-0.90] and 95% (19/20; 95% CI: 75-100%) sensitivity. A prospective proof-of-concept screening study ( n = 56; 97 ECG-biopsy pairs) showed the AI-ECG detected ACR with AUC = 0.78 (95% CI: 0.61-0.96) and 100% (2/2; 95% CI: 16-100%) sensitivity., Conclusion: An AI-ECG model is effective for detection of moderate-to-severe ACR in heart transplant recipients. Our findings could improve transplant care by providing a rapid, non-invasive, and potentially remote screening option for cardiac allograft function., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Introduction: Atrial fibrillation/flutter (AF) is common among patients with pulmonary hypertension (PH) and is associated with poor clinical outcomes. AF has been shown to occur more commonly among patients with postcapillary PH, although AF also occurs among patients with precapillary PH. The goal of this study was to evaluate the independent impact of PH hemodynamic phenotype on incident AF among patients with PH., Methods: We retrospectively identified 262 consecutive patients, without a prior diagnosis of atrial arrhythmias, seen at the PH clinic at Mayo Clinic, Florida, between 1997 and 2017, who had right heart catheterization and echocardiography performed, with follow-up for outcomes through 2021. Kaplan-Meier analysis and Cox-proportional hazards regression modeling were used to evaluate the independent effect of PH hemodynamic phenotype on incident AF., Results: Our study population was classified into two broad PH hemodynamic groups: precapillary (64.9%) and postcapillary (35.1%). The median age was 59.5 years (Q1: 48.4, Q3: 68.4), and 72% were female. In crude models, postcapillary PH was significantly associated with incident AF (HR 2.17, 95% CI: 1.26-3.74, p = 0.005). This association was lost following multivariable adjustment, whereas left atrial volume index remained independently associated with incident AF (aHR 1.30, 95% CI: 1.09-1.54, p = 0.003)., Conclusion: We found PH hemodynamic phenotype was not significantly associated with incident AF in our patient sample; however, echocardiographic evidence of left atrial remodeling appeared to have a greater impact on AF development. Larger studies are needed to validate these findings and identify potential modifiable risk factors for AF in this population., (© 2023 S. Karger AG, Basel.)

The objective of the Psyche Magnetometry Investigation is to test the hypothesis that asteroid (16) Psyche formed from the core of a differentiated planetesimal. To address this, the Psyche Magnetometer will measure the magnetic field around the asteroid to search for evidence of remanent magnetization. Paleomagnetic measurements of meteorites and dynamo theory indicate that a diversity of planetesimals once generated dynamo magnetic fields in their metallic cores. Likewise, the detection of a strong magnetic moment ( > 2 × 10 14 Am 2 ) at Psyche would likely indicate that the body once generated a core dynamo, implying that it formed by igneous differentiation. The Psyche Magnetometer consists of two three-axis fluxgate Sensor Units (SUs) mounted 0.7 m apart along a 2.15-m long boom and connected to two Electronics Units (EUs) located within the spacecraft bus. The Magnetometer samples at up to 50 Hz, has a range of ± 80 , 000 nT , and an instrument noise of 39 pT axis - 1 3 σ integrated over 0.1 to 1 Hz. The two pairs of SUs and EUs provide redundancy and enable gradiometry measurements to suppress noise from flight system magnetic fields. The Magnetometer will be powered on soon after launch and acquire data for the full duration of the mission. The ground data system processes the Magnetometer measurements to obtain an estimate of Psyche's dipole moment., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s) 2023.)

Background & Aims: Recommended surveillance intervals after complete eradication of intestinal metaplasia (CE-IM) after endoscopic eradication therapy (EET) are largely not evidence-based. Using recurrence rates in a multicenter international Barrett's esophagus (BE) CE-IM cohort, we aimed to generate optimal intervals for surveillance., Methods: Patients with dysplastic BE undergoing EET and achieving CE-IM from prospectively maintained databases at 5 tertiary-care centers in the United States and the United Kingdom were included. The cumulative incidence of recurrence was estimated, accounting for the unknown date of actual recurrence that lies between the dates of current and previous endoscopy. This cumulative incidence of recurrence subsequently was used to estimate the proportion of patients with undetected recurrence for various surveillance intervals over 5 years. Intervals were selected that minimized recurrences remaining undetected for more than 6 months. Actual patterns of post-CE-IM follow-up evaluation are described., Results: A total of 498 patients (with baseline low-grade dysplasia, 115 patients; high-grade dysplasia [HGD], 288 patients; and intramucosal adenocarcinoma [IMCa], 95 patients) were included. Any recurrence occurred in 27.1% and dysplastic recurrence occurred in 8.4% over a median of 2.6 years of follow-up evaluation. For pre-ablation HGD/IMCa, intervals of 6, 12, 18, and 24 months, and then annually, resulted in no patients with dysplastic recurrence undetected for more than 6 months, comparable with current guideline recommendations despite a 33% reduction in the number of surveillance endoscopies. For pre-ablation low-grade dysplasia, intervals of 1, 2, and 4 years balanced endoscopic burden and undetected recurrence risk., Conclusions: Lengthening post-CE-IM surveillance intervals would reduce the endoscopic burden after CE-IM with comparable rates of recurrent HGD/IMCa. Future guidelines should consider reduced surveillance frequency., (Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Objective: To validate a new baseline estimated glomerular filtration rate (NB-GFR) formula in a cohort of robotic-assisted partial nephrectomies (RAPN)., Methods: NB-GFR = 35 + preoperative GFR (× 0.65) - 18 (if radical nephrectomy) - age (× 0.25) + 3 (if tumor size >7 cm) - 2 (if diabetes). NB-GFR was calculated in 464 consecutive RAPN from a single surgeon cohort. 143 patients were excluded secondary to insufficient eGFR follow up. We analyzed NB-GFR accuracy utilizing the last observed eGFR 3-12 months post RAPN. Categorical variables were summarized with the frequency and percentage of patients. Numerical variables were summarized with the median, 25 th percentile, and 75 th percentile., Results: The mean difference between observed and predicted NB-GFR was 4.6 ml/min/1.73m 2 (95% CI -6.9 to 16.1 ml/min/1.73m 2 ). There was a pattern of higher observed NB-GFRs being underestimated by the NB-GFR equation while lower observed NB-GFRs were overestimated by the NB-GFR equation. The NB-GFR formula had a high level of accuracy with 98.8% of predicted NB-GFRs falling within 30% of the observed NB-GFR (95% CI 86.8% to 99.5%). The median and interquartile range of the difference between observed and predicted NB-GFR was 3.9 ml/min/1.73m 2 (IQR 0.7 to 8.2 ml/min/1.73m 2 ). The sensitivity, specificity, positive predictive value, and negative predictive value for the ability of predicted NB-GFR to identify those with an observed NB-GFR <60 ml/min/1.73m 2 after RAPN was 98%, 92%, 88%, and 99%, respectively., Conclusion: The NB-GFR equation developed with partial and radical nephrectomy cohorts is accurate in predicting post-operative eGFR 3-12 months following RAPN., (© 2022 The Japanese Urological Association.)

Objective: To evaluate factors influencing fixed operating room time during holmium laser enucleation of the prostate., Materials and Methods: A prospective observational study was performed for all holmium laser enucleation of the prostate (HoLEP) cases performed by a single surgeon over a 24-month period. Operating room (OR) time was divided into fixed and variable time. The variable time was defined as cut-to-close time. Fixed time included in room time to anesthesia release time (IRAT), anesthesia release time to cut time (ARCT), and close time to wheels out (CTWO). The effects of time of day and anesthesia personnel (AP) changes on fixed operating room time were evaluated., Results: A total of 406 HoLEPs were analyzed. There was no statistically significant difference in nonprocedural OR times between morning and afternoon surgeries (IRAT, P = .38, ARCT P = .10, CTWO P = .77). Median nonprocedural OR times accounted for 27% (IQR: 22%-31%) of the total procedure time in the AM group and 29% (IQR: 24%-33%) in the PM group (P = .005). Of the HoLEPs,78.1% (178/228) experienced one or more AP changes during the procedure. The median fixed OR time was not significantly different between procedures with 1 AP and procedures with ≥2 APs (IRAT, P = .53; ARCT, P = .71; CTWO, P = .98)., Conclusion: Fixed operating room time makes up a significant portion of HoLEP procedures and should be considered when evaluating OR efficiency. The time of day and number of anesthesia personnel involved did not affect the fixed OR times., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective: To evaluate the impact of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, on operating room (OR) efficiency for urologic procedures using the concept of fixed OR times., Patients and Methods: Over a 24-month period, urology OR data were prospectively collected. Operations were divided into fixed and variable time points. The fixed OR times were in-roomw to anesthesia-release time, anesthesia-release to cut time, in-room to cut time, and close to wheels-out time. Data from January 1, 2019, to December 31, 2019, were pre-COVID-19 data, and data from April 1, 2020, to December 31, 2020, were post-COVID-19 data. Operations were grouped into endoscopic, implant, major open, and robotic-assisted cases. In the post-COVID-19 era, all patients had a negative polymerase chain reaction test result within 48 hours of operation. The Wilcoxon rank sum test was used to compare the fixed OR times between the pre- and post-COVID-19 eras., Results: A total of 3189 procedures were evaluated: 2058 endoscopic operations (1124 in the pre-COVID-19 era and 934 in the post-COVID-19 era), 343 implant procedures (192 in the pre-COVID-19 era and 151 in the post-COVID-19 era), 222 major open procedures (119 in the pre-COVID-19 era and 103 in the post-COVID-19 era), and 566 robotic-assisted procedures (338 in the pre-COVID-19 era and 228 in the post-COVID-19 era). There were no fixed OR times in any of the examined groups that were negatively impacted by COVID-19. The percentage of the total OR time occupied by fixed OR variables in the pre-COVID-19 era was 40.6% for endoscopic operations, 41.1% for implant procedures, 29.8% for major open procedures, and 21.8% for robotic-assisted procedures., Conclusion: A substantial portion of the total OR time includes fixed time points. Furthermore, COVID-19 did not have a negative impact on fixed OR times in a negative testing environment. Urologic OR efficiency should be maintained in the post-COVID-19 era., (© 2022 The Authors.)

The gastrointestinal microbiota of cattle is important for feedstuff degradation and feed efficiency determination. This study evaluated the fecal microbiome of Angus steers with distinct feed efficiencies during the feedlot-finishing phase. Angus steers ( n = 65), fed a feedlot-finishing diet for 82 days, had growth performance metrics evaluated. Steers were ranked based upon residual feed intake (RFI), and the 5 lowest RFI (most efficient) and 5 highest RFI (least efficient) steers were selected for evaluation. Fecal samples were collected on 0-d and 82-d of the finishing period and microbial DNA was extracted and evaluated by 16S rRNA gene sequencing. During the feedlot trial, inefficient steers had decreased ( p = 0.02) Ruminococcaceae populations and increased ( p = 0.01) Clostridiaceae populations. Conversely, efficient steers had increased Peptostreptococcaceae ( p = 0.03) and Turicibacteraceae ( p = 0.01), and a trend for decreased Proteobacteria abundance ( p = 0.096). Efficient steers had increased microbial richness and diversity during the feedlot period, which likely resulted in increased fiber-degrading enzymes in their hindgut, allowing them to extract more energy from the feed. Results suggest that cattle with better feed efficiency have greater diversity of hindgut microorganisms, resulting in more enzymes available for digestion, and improving energy harvest in the gut of efficient cattle.

Objective: To analyze operating room (OR) efficiency by evaluating fixed OR times for three common urologic robot-assisted procedures. Methods: Over a 24-month period, we prospectively collected intraoperative data for 635 consecutive robot-assisted surgeries. Fixed (nonprocedural) OR times were evaluated for robot-assisted partial nephrectomy (RAPN) ( n  = 146), robot-assisted radical cystectomy (RARC) ( n  = 77), and robot-assisted radical prostatectomy (RARP) ( n  = 412). Fixed OR times were defined as nonprocedural time in the OR, including in-room time to anesthesia release time (IRAT), anesthesia release to cut time (ARCT), in-room time to cut time (IRCT; IRAT+ARCT), and close time to wheels out time (CTWO). The effects of operation time of day and the number of anesthesia personnel (AP) present in procedure on fixed OR times were also analyzed. Results: Fixed OR times occupied 15.1% (IQR: 12.9%-17.1%) (RARC), 26.6% (22.9%-30.8%) (RAPN), and 20.1% (17.4%-23.1%) (RARP) of total OR time. Time of day did not have a negative effect on fixed OR times for robotic urologic surgeries. Median AP count was highest for RARC (median: 3 and range: 1-7). We did not find any association between AP count and fixed OR times for any of the procedures ( p  ≥ 0.19). Conclusions: Fixed OR times made up a significant percentage of total OR time for robot-assisted procedures and should be incorporated into OR efficiency analyses. The number of AP per case and time of day of procedure did not negatively impact fixed OR times in urologic robotic surgeries.

The asteroid (16) Psyche may be the metal-rich remnant of a differentiated planetesimal, or it may be a highly reduced, metal-rich asteroidal material that never differentiated. The NASA Psyche mission aims to determine Psyche's provenance. Here we describe the possible solar system regions of origin for Psyche, prior to its likely implantation into the asteroid belt, the physical and chemical processes that can enrich metal in an asteroid, and possible meteoritic analogs. The spacecraft payload is designed to be able to discriminate among possible formation theories. The project will determine Psyche's origin and formation by measuring any strong remanent magnetic fields, which would imply it was the core of a differentiated body; the scale of metal to silicate mixing will be determined by both the neutron spectrometers and the filtered images; the degree of disruption between metal and rock may be determined by the correlation of gravity with composition; some mineralogy (e.g., modeled silicate/metal ratio, and inferred existence of low-calcium pyroxene or olivine, for example) will be detected using filtered images; and the nickel content of Psyche's metal phase will be measured using the GRNS., Competing Interests: Conflict of InterestNot applicable., (© The Author(s) 2022.)

Background: About 4 out of 10 fibromyalgia patients suffer from depression. The European Alliance of Associations for Rheumatology (EULAR) guidelines recommend using antidepressants to treat fibromyalgia., Objective: To determine predictors of improved outcomes following a multicomponent treatment program., Design: We designed this longitudinal treatment outcome study to evaluate the prevalence of depression symptoms in patients diagnosed with fibromyalgia at a tertiary care facility, and the impact of depression on functional outcomes after completing a multicomponent fibromyalgia treatment program., Setting: Tertiary care center., Patients: This study included 411 adult patients with fibromyalgia who completed a multicomponent treatment program for fibromyalgia. Expert physicians performed comprehensive evaluations following American College of Rheumatology (ACR) criteria to confirm fibromyalgia before referral to the program., Intervention: An intensive outpatient multicomponent treatment program consisting of 16 hours of cognitive behavioral strategies served as the intervention., Measurements: Functional status was assessed using the Fibromyalgia Impact Questionnaire Revised (FIQR). Depression was evaluated with the Center for Epidemiologic Study of Depression (CES-D) measure. Measures were administered prior to participation in the program and approximately 5 months following completion of the program., Results: The cohort had a high prevalence of depressive symptoms (73.2% had depression at admission). Higher depression scores at baseline predicted poorer outcomes following multi-component treatment. Effectively treated depression resulted in improved functioning at follow-up., Limitations: Findings limited to tertiary care center cohort of fibromyalgia patients. Patients did not undergo a structured clinical diagnostic interview to diagnose depression., Conclusions: The current data links depression to poorer outcomes in patients with fibromyalgia. Depression is an important modifiable factor in the management of fibromyalgia. Guidelines should reflect the importance of assessing and effectively treating depression at the time of diagnosis of fibromyalgia, to improve functional outcomes., Registration: Specific registry and specific study registration number-Institutional Review Board-(IRB# 19-000495)., Funding Source: No funding.

Background: The United States (US) Expanded Access Program (EAP) to coronavirus disease 2019 (COVID-19) convalescent plasma was initiated in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. While randomized clinical trials were in various stages of development and enrollment, there was an urgent need for widespread access to potential therapeutic agents. The objective of this study is to report on the demographic, geographical, and chronological characteristics of patients in the EAP, and key safety metrics following transfusion of COVID-19 convalescent plasma., Methods and Findings: Mayo Clinic served as the central institutional review board for all participating facilities, and any US physician could participate as a local physician-principal investigator. Eligible patients were hospitalized, were aged 18 years or older, and had-or were at risk of progression to-severe or life-threatening COVID-19; eligible patients were enrolled through the EAP central website. Blood collection facilities rapidly implemented programs to collect convalescent plasma for hospitalized patients with COVID-19. Demographic and clinical characteristics of all enrolled patients in the EAP were summarized. Temporal patterns in access to COVID-19 convalescent plasma were investigated by comparing daily and weekly changes in EAP enrollment in response to changes in infection rate at the state level. Geographical analyses on access to convalescent plasma included assessing EAP enrollment in all national hospital referral regions, as well as assessing enrollment in metropolitan areas and less populated areas that did not have access to COVID-19 clinical trials. From April 3 to August 23, 2020, 105,717 hospitalized patients with severe or life-threatening COVID-19 were enrolled in the EAP. The majority of patients were 60 years of age or older (57.8%), were male (58.4%), and had overweight or obesity (83.8%). There was substantial inclusion of minorities and underserved populations: 46.4% of patients were of a race other than white, and 37.2% of patients were of Hispanic ethnicity. Chronologically and geographically, increases in the number of both enrollments and transfusions in the EAP closely followed confirmed infections across all 50 states. Nearly all national hospital referral regions enrolled and transfused patients in the EAP, including both in metropolitan and in less populated areas. The incidence of serious adverse events was objectively low (<1%), and the overall crude 30-day mortality rate was 25.2% (95% CI, 25.0% to 25.5%). This registry study was limited by the observational and pragmatic study design that did not include a control or comparator group; thus, the data should not be used to infer definitive treatment effects., Conclusions: These results suggest that the EAP provided widespread access to COVID-19 convalescent plasma in all 50 states, including for underserved racial and ethnic minority populations. The study design of the EAP may serve as a model for future efforts when broad access to a treatment is needed in response to an emerging infectious disease., Trial Registration: ClinicalTrials.gov NCT#: NCT04338360., Competing Interests: The authors have declared that no competing interests exist.

Seismological constraints obtained from receiver function (RF) analysis provide important information about the crust and mantle structure. Here, we explore the utility of the free-surface multiple of the P-wave (PP) and the corresponding conversions in RF analysis. Using earthquake records, we demonstrate the efficacy of PPs-RFs before illustrating how they become especially useful when limited data is available in typical planetary missions. Using a transdimensional hierarchical Bayesian deconvolution approach, we compute robust P-to-S (Ps)- and PPs-RFs with InSight recordings of five marsquakes. Our Ps-RF results verify the direct Ps converted phases reported by previous RF analyses with increased coherence and reveal other phases including the primary multiple reverberating within the uppermost layer of the Martian crust. Unlike the Ps-RFs, our PPs-RFs lack an arrival at 7.2 s lag time. Whereas Ps-RFs on Mars could be equally well fit by a two- or three-layer crust, synthetic modeling shows that the disappearance of the 7.2 s phase requires a three-layer crust, and is highly sensitive to velocity and thickness of intra-crustal layers. We show that a three-layer crust is also preferred by S-to-P (Sp)-RFs. While the deepest interface of the three-layer crust represents the crust-mantle interface beneath the InSight landing site, the other two interfaces at shallower depths could represent a sharp transition between either fractured and unfractured materials or thick basaltic flows and pre-existing crustal materials. PPs-RFs can provide complementary constraints and maximize the extraction of information about crustal structure in data-constrained circumstances such as planetary missions., (© 2021. The Authors.)

The lunar cratering record is used to constrain the bombardment history of both the Earth and the Moon. However, it is suggested from different perspectives, including impact crater dating, asteroid dynamics, lunar samples, impact basin-forming simulations, and lunar evolution modelling, that the Moon could be missing evidence of its earliest cratering record. Here we report that impact basins formed during the lunar magma ocean solidification should have produced different crater morphologies in comparison to later epochs. A low viscosity layer, mimicking a melt layer, between the crust and mantle could cause the entire impact basin size range to be susceptible to immediate and extreme crustal relaxation forming almost unidentifiable topographic and crustal thickness signatures. Lunar basins formed while the lunar magma ocean was still solidifying may escape detection, which is agreeing with studies that suggest a higher impact flux than previously thought in the earliest epoch of Earth-Moon evolution., (© 2021. The Author(s).)

A planet's crust bears witness to the history of planetary formation and evolution, but for Mars, no absolute measurement of crustal thickness has been available. Here, we determine the structure of the crust beneath the InSight landing site on Mars using both marsquake recordings and the ambient wavefield. By analyzing seismic phases that are reflected and converted at subsurface interfaces, we find that the observations are consistent with models with at least two and possibly three interfaces. If the second interface is the boundary of the crust, the thickness is 20 ± 5 kilometers, whereas if the third interface is the boundary, the thickness is 39 ± 8 kilometers. Global maps of gravity and topography allow extrapolation of this point measurement to the whole planet, showing that the average thickness of the martian crust lies between 24 and 72 kilometers. Independent bulk composition and geodynamic constraints show that the thicker model is consistent with the abundances of crustal heat-producing elements observed for the shallow surface, whereas the thinner model requires greater concentration at depth., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

The Orientale basin is the youngest and best-preserved multiring impact basin on the Moon, having experienced only modest modification by subsequent impacts and volcanism. Orientale is often treated as the type example of a multiring basin, with three prominent rings outside of the inner depression: the Inner Rook Montes, the Outer Rook Montes, and the Cordillera. Here we use gravity data from NASA's Gravity Recovery and Interior Laboratory (GRAIL) mission to reveal the subsurface structure of Orientale and its ring system. Gradients of the gravity data reveal a continuous ring dike intruded into the Outer Rook along the plane of the fault associated with the ring scarp. The volume of this ring dike is ~18 times greater than the volume of all extrusive mare deposits associated with the basin. The gravity gradient signature of the Cordillera ring indicates an offset along the fault across a shallow density interface, interpreted to be the base of the low-density ejecta blanket. Both gravity gradients and crustal thickness models indicate that the edge of the central cavity is shifted inward relative to the equivalent Inner Rook ring at the surface. Models of the deep basin structure show inflections along the crust-mantle interface at both the Outer Rook and Cordillera rings, indicating that the basin ring faults extend from the surface to at least the base of the crust. Fault dips range from 13-22° for the Cordillera fault in the northeastern quadrant, to 90° for the Outer Rook in the northwestern quadrant. The fault dips for both outer rings are lowest in the northeast, possibly due to the effects of either the direction of projectile motion or regional gradients in pre-impact crustal thickness. Similar ring dikes and ring faults are observed around the majority of lunar basins.

Multiring basins, large impact craters characterized by multiple concentric topographic rings, dominate the stratigraphy, tectonics, and crustal structure of the Moon. Using a hydrocode, we simulated the formation of the Orientale multiring basin, producing a subsurface structure consistent with high-resolution gravity data from the Gravity Recovery and Interior Laboratory (GRAIL) spacecraft. The simulated impact produced a transient crater, ~390 kilometers in diameter, that was not maintained because of subsequent gravitational collapse. Our simulations indicate that the flow of warm weak material at depth was crucial to the formation of the basin's outer rings, which are large normal faults that formed at different times during the collapse stage. The key parameters controlling ring location and spacing are impactor diameter and lunar thermal gradients., (Copyright © 2016, American Association for the Advancement of Science.)

The Orientale basin is the youngest and best-preserved major impact structure on the Moon. We used the Gravity Recovery and Interior Laboratory (GRAIL) spacecraft to investigate the gravitational field of Orientale at 3- to 5-kilometer (km) horizontal resolution. A volume of at least (3.4 ± 0.2) × 10 6 km 3 of crustal material was removed and redistributed during basin formation. There is no preserved evidence of the transient crater that would reveal the basin's maximum volume, but its diameter may now be inferred to be between 320 and 460 km. The gravity field resolves distinctive structures of Orientale's three rings and suggests the presence of faults associated with the outer two that penetrate to the mantle. The crustal structure of Orientale provides constraints on the formation of multiring basins., (Copyright © 2016, American Association for the Advancement of Science.)

Observations from the Gravity Recovery and Interior Laboratory (GRAIL) mission indicate a marked change in the gravitational signature of lunar impact structures at the morphological transition, with increasing diameter, from complex craters to peak-ring basins. At crater diameters larger than ~200 km, a central positive Bouguer anomaly is seen within the innermost peak ring, and an annular negative Bouguer anomaly extends outward from this ring to the outer topographic rim crest. These observations demonstrate that basin-forming impacts remove crustal materials from within the peak ring and thicken the crust between the peak ring and the outer rim crest. A correlation between the diameter of the central Bouguer gravity high and the outer topographic ring diameter for well-preserved basins enables the identification and characterization of basins for which topographic signatures have been obscured by superposed cratering and volcanism. The GRAIL inventory of lunar basins improves upon earlier lists that differed in their totals by more than a factor of 2. The size-frequency distributions of basins on the nearside and farside hemispheres of the Moon differ substantially; the nearside hosts more basins larger than 350 km in diameter, whereas the farside has more smaller basins. Hemispherical differences in target properties, including temperature and porosity, are likely to have contributed to these different distributions. Better understanding of the factors that control basin size will help to constrain models of the original impactor population.

New estimates of the thickness of the lunar highlands crust based on data from the Gravity Recovery and Interior Laboratory mission, allow us to reassess the abundances of refractory elements in the Moon. Previous estimates of the Moon fall into two distinct groups: earthlike and a 50% enrichment in the Moon compared with the Earth. Revised crustal thicknesses and compositional information from remote sensing and lunar samples indicate that the crust contributes 1.13-1.85 wt% Al2O3 to the bulk Moon abundance. Mare basalt Al2O3 concentrations (8-10 wt%) and Al2O3 partitioning behaviour between melt and pyroxene during partial melting indicate mantle Al2O3 concentration in the range 1.3-3.1 wt%, depending on the relative amounts of pyroxene and olivine. Using crustal and mantle mass fractions, we show that that the Moon and the Earth most likely have the same (within 20%) concentrations of refractory elements. This allows us to use correlations between pairs of refractory and volatile elements to confirm that lunar abundances of moderately volatile elements such as K, Rb and Cs are depleted by 75% in the Moon compared with the Earth and that highly volatile elements, such as Tl and Cd, are depleted by 99%. The earthlike refractory abundances and depleted volatile abundances are strong constraints on lunar formation processes., (© 2014 The Author(s) Published by the Royal Society. All rights reserved.)

Maps of crustal thickness derived from NASA's Gravity Recovery and Interior Laboratory (GRAIL) mission revealed more large impact basins on the nearside hemisphere of the Moon than on its farside. The enrichment in heat-producing elements and prolonged volcanic activity on the lunar nearside hemisphere indicate that the temperature of the nearside crust and upper mantle was hotter than that of the farside at the time of basin formation. Using the iSALE-2D hydrocode to model impact basin formation, we found that impacts on the hotter nearside would have formed basins with up to twice the diameter of similar impacts on the cooler farside hemisphere. The size distribution of lunar impact basins is thus not representative of the earliest inner solar system impact bombardment.

High-resolution gravity data from the Gravity Recovery and Interior Laboratory spacecraft have clarified the origin of lunar mass concentrations (mascons). Free-air gravity anomalies over lunar impact basins display bull's-eye patterns consisting of a central positive (mascon) anomaly, a surrounding negative collar, and a positive outer annulus. We show that this pattern results from impact basin excavation and collapse followed by isostatic adjustment and cooling and contraction of a voluminous melt pool. We used a hydrocode to simulate the impact and a self-consistent finite-element model to simulate the subsequent viscoelastic relaxation and cooling. The primary parameters controlling the modeled gravity signatures of mascon basins are the impactor energy, the lunar thermal gradient at the time of impact, the crustal thickness, and the extent of volcanic fill.

Spacecraft-to-spacecraft tracking observations from the Gravity Recovery and Interior Laboratory (GRAIL) have been used to construct a gravitational field of the Moon to spherical harmonic degree and order 420. The GRAIL field reveals features not previously resolved, including tectonic structures, volcanic landforms, basin rings, crater central peaks, and numerous simple craters. From degrees 80 through 300, over 98% of the gravitational signature is associated with topography, a result that reflects the preservation of crater relief in highly fractured crust. The remaining 2% represents fine details of subsurface structure not previously resolved. GRAIL elucidates the role of impact bombardment in homogenizing the distribution of shallow density anomalies on terrestrial planetary bodies.

High-resolution gravity data obtained from the dual Gravity Recovery and Interior Laboratory (GRAIL) spacecraft show that the bulk density of the Moon's highlands crust is 2550 kilograms per cubic meter, substantially lower than generally assumed. When combined with remote sensing and sample data, this density implies an average crustal porosity of 12% to depths of at least a few kilometers. Lateral variations in crustal porosity correlate with the largest impact basins, whereas lateral variations in crustal density correlate with crustal composition. The low-bulk crustal density allows construction of a global crustal thickness model that satisfies the Apollo seismic constraints, and with an average crustal thickness between 34 and 43 kilometers, the bulk refractory element composition of the Moon is not required to be enriched with respect to that of Earth.

The earliest history of the Moon is poorly preserved in the surface geologic record due to the high flux of impactors, but aspects of that history may be preserved in subsurface structures. Application of gravity gradiometry to observations by the Gravity Recovery and Interior Laboratory (GRAIL) mission results in the identification of a population of linear gravity anomalies with lengths of hundreds of kilometers. Inversion of the gravity anomalies indicates elongated positive-density anomalies that are interpreted to be ancient vertical tabular intrusions or dikes formed by magmatism in combination with extension of the lithosphere. Crosscutting relationships support a pre-Nectarian to Nectarian age, preceding the end of the heavy bombardment of the Moon. The distribution, orientation, and dimensions of the intrusions indicate a globally isotropic extensional stress state arising from an increase in the Moon's radius by 0.6 to 4.9 kilometers early in lunar history, consistent with predictions of thermal models.

The Moon possesses strong magnetic anomalies that are enigmatic given the weak magnetism of lunar rocks. We show that the most prominent grouping of anomalies can be explained by highly magnetic extralunar materials from the projectile that formed the largest and oldest impact crater on the Moon: the South Pole-Aitken basin. The distribution of projectile materials from a model oblique impact coincides with the distribution of magnetic anomalies surrounding this basin, and the magnetic properties of these materials can account for the intensity of the observed anomalies if they were magnetized in a core dynamo field. Distal ejecta from this event can explain the origin of isolated magnetic anomalies far from this basin.