Routine Observations Research Articles

Temporal variability of ozone and its precursors at tropical megacity, Bengaluru, India: Effect of volatile organic compounds and meteorology

Routine observations of surface ozone (O3) and its precursors (NO, NO2, NOx) were taken over Bengaluru, a southern megacity, India, for 4 years period between January 2015 and December 2018. The seasonal variations of O3, NO, NO2, and NOx have been analysed to understand the short-term variability of the pollutants at this site. The magnitude of O3 varied significantly by season, with maximum concentration during winter (13.07 ppbv) and minimum concentration during monsoon (9.52 ppbv). The highest concentration was observed in the post-monsoon season (17.38 ppbv) for NO, while NO2 and NOx showed the highest (41.75, 50.42 ppbv) in the winter season. The lowest concentrations of NO (5.70 ppbv), NO2 (30.43 ppbv) and NOx(36.28 ppbv) were observed in summer. An estimate was performed to determine the site's VOC-NOx sensitivity, using the TNMHC/NOX ratio as a photochemical measure. This ratio indicates that the study region is NOX responsive in all seasons. Analysis was done on the effects of meteorological factors such as temperature, water vapour, and ventilation coefficient on pollutants. Higher correlation of O3 with temperature showed the role of photochemical reactions in the formation of ozone and water vapour content leads to the removal of ozone concentration. The influence of meteorological variables on NO2 and TNMHC did not appear to be very significant. An analysis of CAMS data with real-time measurements of ozone and oxides of nitrogen showed that ozone is significantly correlated, while nitrogen oxides are not significantly correlated with CAMS data.

Immediate Postoperative Changes After Expansion Pharyngoplasty and Hypoglossal Nerve Stimulation.

Patients with obstructive sleep apnea (OSA) are at an increased risk for perioperative cardiopulmonary complications. Our objective was to assess the postoperative effects of hypoglossal nerve stimulation implantation (HGNS) and expansion pharyngoplasty (EP) on longitudinal sleep apnea measures as a surrogate for respiratory complications. Prospective longitudinal cohort study of patients with OSA undergoing HGNS or EP. Sleep studies were performed with the NightOwl Mini peripheral arterial tonometry (PAT) device. Changes in apnea-hypopnea index (AHI) and oximetry time below 90% (T90) were assessed between two baseline PAT studies prior to surgery and nightly PAT studies for the first postoperative nights (PON) 1-7, 10, and 14. Thirty patients were enrolled (19 HGNS, 11 EP). The mean age was 52.6 years, 76.7% were male, and the mean clinical baseline AHI was 29.8/h. There were no significant changes in the AHI or T90 following HGNS implantation. Following EP, there was a statistically significant mean increase in AHI of +19.2/h on PON1, +24.9/h on PON2, and + 20/h on PON3 compared to baseline. T90 was also elevated after EP on PON1, 4, and 5. The mean increase in T90 was +7.4% (95% CI 2.9, 11.9) on PON1 compared to baseline. In the immediate postoperative period, there were no significant changes in AHI or hypoxemia after HGNS, suggesting that there is no need for routine overnight observation after HGNS. There were significant increases in AHI and hypoxemia after EP suggesting that postoperative disposition should be considered on a case-by-case basis. III Laryngoscope, 2024.

Improving measures of context in process evaluations: development and use of the Context Tracker tool

BackgroundProcess evaluations are increasingly integrated into randomised controlled trials (RCTs) of complex interventions to document their delivery and interactions with local systems and dynamics, helping understand observed health outcomes. Yet process evaluations often struggle to assess relevant contextual determinants, leaving much of the important role of “context” in shaping an intervention’s mechanisms opaque in many studies. A lack of easily adapted data collection methods to help define and operationalise indicators of context likely contributes to this.MethodsWe present a method to help structure measures of context in process evaluations and describe its use in two very different settings. The “Context Tracker” is an innovative tool for use within trials and quasi-experiments to more systematically capture and understand key dimensions of context. It was developed in Zimbabwe as part of a cluster randomised controlled trial and then adapted for a quasi-experimental evaluation in the UK. Both studies provided harm reduction and health services for marginalised and hard-to-reach populations.ResultsWe developed the Context Tracker to be both standardised (i.e. formatted and applied in the same way across study sites) and flexible enough to allow unique features to be explored in greater detail. Drawing on the Context and Implementation of Complex Interventions (CICI) and Risk Environments frameworks, we mapped 5 domains across micro, meso and macro levels in a simple table and used existing evidence and experience to predict factors likely to affect delivery of and participation in intervention components. We tracked these over time across study sites using routine programme statistics, observation and qualitative methods. The Context Tracker enables identification and comparison of facilitators and barriers to implementation, variations in engagement with interventions, and how mechanisms of action are (or are not) triggered in different settings.ConclusionsThe Context Tracker is one example of how evidence-based contextual determinants can be used to guide data collection and analysis within process evaluations. It is relevant in low- and high-income settings and applicable to both qualitative and quantitative analyses. While perhaps most useful to process evaluations of complex interventions targeting marginalised communities, the broader approach would benefit a more general research audience.

Development and Evaluation of the Telehealth in Motor Neuron Disease System: The TIME Study Protocol.

For more responsive care provision for motor neuron disease and caregivers, a digital system called Telehealth in MND-Care (TiM-C) was created. TiM-C sends regular symptom questionnaires to users; their responses are sent to health care professionals (HCPs). To enable people with motor neuron disease to participate in research studies more easily, a parallel platform was developed from TiM-C, called Telehealth in MND-Research (TiM-R). TiM-R can advertise studies, collect data, and make them available to MND researchers. This study has 4 work packages (WPs) to facilitate service approval, codevelop the TiM systems, and evaluate the service. Each WP aims to understand (1) what helps and hinders the approval of the TiM-C system as a National Health Service; (2) what aspects of MND care and research are currently unmet and can be addressed through the TiM-C and TiM-R systems; (3) how TiM-C influences MND care, from the perspective of people with motor neuron disease, their caregivers, and HCPs; and (4) the costs and benefits associated with TiM-C. WP1 will use semistructured interviews with 10-15 people involved in the approval of TiM-C to understand the barriers and facilitators to governance processes. WP2 will use individual and group interviews with 25-35 users (people with motor neuron disease, caregivers, HCPs, MND researchers, and industry) of TiM-C and TiM-R to understand the current unmet needs of these user groups and how TiM services can be developed to meet these needs. WP3 will use a process evaluation involving 5 elements; local context, engagement, user experiences, service impact, and mechanisms of action. A range of methods, including audits, analysis of routine data, questionnaires, interviews, and observations will be used with people with motor neuron disease, caregivers, and HCPs, both those using the system and those who declined the service when invited. WP4 will use data collected through the process evaluation and known costs to conduct a cost-consequence and budget impact analysis to explore the cost-benefit of the TiM-C service. Most data collected will be qualitative, with thematic and framework analysis used to develop themes from transcripts and observations. Descriptive statistics or t tests and chi-square tests will be used to describe and analyze quantitative data. This study has received ethical approval and has begun recruitment in 1 site. Further, 13 specialist MND centers will adopt TiM-C and the TIME study, beginning in July 2024. The study will conclude in November 2026 and a final report will be produced 3 months after the completion date. This study will facilitate the implementation and development of TiM-C and TiM-R and fully evaluate the TiM-C service, enabling informed decision-making among health care providers regarding continued involvement and contribute to the wider literature relating to how technology-enabled care services can affect clinical care. DERR1-10.2196/57685.

AI-Enhanced GraphoText Analysis for Tracking Counselling Therapy Progress: Integrating Multimodal Graphology and Machine Learning

Despite the robustness of existing instruments, routine manual observation in psychotherapy faces significant challenges, including lack of time, labour, high implementation costs, and potential biases such as response bias and social desirability. This study proposes a dynamic assessment approach using machine learning and multimodal features extracted from handwriting, incorporating graphology-based and content-based features. The integration of content-based and graphology-based features involves combining text and handwriting features with the Support Vector Machine (SVM) using the Radial Basis Function Kernel (RBF). The results show that this approach achieves an impressive accuracy rate of 86.25%. The proposed framework not only improves psychotherapeutic practise, but also offers new insights into human cognition and emotional dynamics by revealing intricate patterns in handwriting. This advance facilitates data-driven decision-making, improves the quality of patient care, and overcomes challenges associated with manual monitoring, including social desirability bias and response set bias. This research paves the way for innovative methods at the interface of mental health and technology, and promises a more objective and efficient approach to monitoring the progress of psychotherapy.

Remote coaching for supporting the implementation of treatment for depression in primary care in Madhya Pradesh, India: protocol for a cluster randomized controlled trial.

Upwards of ninety percent of individuals living with depression in India do not have access to evidence-based treatments, especially in rural areas. Integrating these treatments into primary care is essential for bridging this care gap. This trial aims to evaluate whether a remote coaching implementation support strategy, referred to as Enhanced Implementation Support, is superior to routine support, referred to as Routine Implementation Support, in supporting the delivery of collaborative depression care in rural primary care centers. Employing a cluster-randomized hybrid type-III implementation trial design, 14 primary care facilities in Sehore district, Madhya Pradesh, will implement a collaborative depression care package based on the WHO's mhGAP program. Facilities will be randomized to either Enhanced Implementation Support or the Routine Implementation Support control condition. Enhanced Implementation Support consists of remote coaching and technical assistance, supplemented with in-person visits, and guided by the Plan-Do-Study-Act implementation cycles. The primary implementation outcome is the proportion of outpatients screened for depression by facility staff, with secondary outcomes including the proportions of outpatients who screen positive for depression, are referred to the medical officer, and initiate treatment. Secondary patient outcomes include proportion of patients who achieve reduction in depression symptom severity at 3-month follow up. Acceptability, feasibility, and fidelity of the depression care package will be assessed through routine observations collected during field visits, facility audits, and qualitative exit interviews with facility staff. Costs of delivering the Enhanced Implementation Support strategy will also be estimated. This trial can inform efforts to integrate depression care in rural primary care facilities in a low-resource setting, and illuminate whether external coaching support is superior relative to existing implementation support for achieving these goals. NCT05264792.

OCCURRENCE OF LAMPROGLENA PULCHELLA (NORDMANN, 1832) (COPEPODA: LERNAEIDAE) IN SOME CYPRINID FISH FROM OHRID LAKE (MACEDONIA)

The representatives of the class Copepoda are of great importance in fish pathology. Lamproglena pulchella (Nordmann, 1832) (Copepoda: Lernaeidae) is an ectoparasite of many cyprinid fish, widespread in Europe up to the Aral Sea. During the long-term investigations of 12 species of cyprinid fish from the Lake Ohrid, a total of 7 specimens of Lamproglena pulchella was found in 5 fish from 4 fish species: Rutilus ohridanus, Squalius squalus, Scardinius knezevici and Chondrostoma ohridanus. Only fresh fish were subjected to routine parasitological examinations, dissection, and observation methods. Parasite identification was performed morphologically, based on the character of their maxilla, maxilliped, antennae, legs and uropods, using a referent key for determination. The 3 parasite specimens were found in two samples of Rutilus ohridanus, followed by 2 parasite specimens in Squalius squalus and one specimen in Scardinius knezevici and Chondrostoma ohridanus, each. These parasites attach to gills and general body surfaces by their maxilla and maxilliped, causing wounds that become the spots of secondary infection by microbes. The damage caused by this parasite is more pronounced in aquaculture systems. We did not find many parasites, but considering the potential danger that Lamproglena pulchella poses to the fish health, we point out the need to monitor infestations with this parasite and take preventive measures so that the parasite does not spread massively among fish in Lake Ohrid and to prevent its introduction into other waters in Macedonia. The record of Lamproglena pulchella in all four cyprinid fish in the present study is considered as the first from the Ohrid Lake. At the same time, Rutilus ohridanus, Scardinius knezevici and Chondrostoma ohridanus represent new hosts for this parasite, worldwide.

СОДЕРЖАНИЕ ОЗОНА НАД ТЕРРИТОРИЕЙ РОССИЙСКОЙ ФЕДЕРАЦИИ ВО ВТОРОМ КВАРТАЛЕ 2024 Г

The review is based on the results of total ozone (TO) monitoring over the CIS and Baltic countries by the system functioning in operational mode at the Central Aerological Observatory (CAO). The monitoring system uses the data from the national network equipped with M-124 filter ozonometers that is under the methodological supervision of the Main Geophysical Observatory. The quality of the functioning of the entire system is operationally controlled at CAO by the comparison with the OMI satellite equipment observations (NASA, USA). Basic TO observation data are generalized for each month of the second quarter of 2024 and for the whole second quarter. The data of surface ozone routine observations in the Moscow region are also summarized.

A universal triangle method for evapotranspiration estimation with MODIS products and routine meteorological observations: Algorithm development and global validation

The surface temperature (Ts) and vegetation index (VI) triangle method is one of the most famous and widely applied methods for regional evapotranspiration (ET) estimation. However, no robust validation has been performed yet to evaluate its accuracy on a global scale, making its accuracy unclear when compared with other global ET models. The main reason behind it is that most traditional triangle models depend on the Ts-VI feature space within a certain spatial domain to parameterize their boundary conditions. The domain dependency makes it impossible to derive universal boundaries for continental or global application. Under this background, this study presented a universal triangle method for ET estimation with Moderate Resolution Imaging Spectroradiometer (MODIS) products and routine meteorological observations. The solution for boundary conditions was performed pixel by pixel without the consideration of spatial domain based configuration. Specifically, the dry boundary was solved theoretically based on the surface energy balance equation, and the wet boundary was substituted by wet-bulb temperature estimated from dew point temperature and air temperature. The validation against ground observations collected from 33 flux towers worldwide shows that this universal triangle method achieved evaporative fraction (EF) estimation with the correlation coefficient of 0.65, the mean absolute error of 0.17, the root-mean-square-error of 0.20, and the bias of 0.13. These four metrics of daily ET estimation were 0.83, 0.71 mm/d, 0.90 mm/d, and 0.41 mm/d, respectively. This analysis is the first comprehensive validation of the triangle method on a global scale. The comparison with early work suggests that our universal triangle method on a global scale has reached a comparable accuracy to traditional triangle models at regional scale. However, the universal triangle method has the capacity to monitor ET continuously pixel by pixel without domain dependency. This is just what most traditional triangle methods do not possess.

Evaluation and Improvement of a CALIPSO-Based Algorithm for Cloud Base Height in China

Clouds are crucial in regulating the Earth’s energy budget. Global cloud top heights have been easily retrieved from satellite measurements, but there are few methods for determining cloud base height (CBH) from satellite measurements. The Cloud Base Altitude Spatial Extrapolator (CBASE) algorithm was proposed to derive the height of the lower-troposphere liquid cloud base by using the Cloud-Aerosol Lidar with Orthogonal polarization cloud aerosol LiDAR (CALIOP) profiles and weather observations at airports from aviation routine and special weather report (METARs and SPECIs, called METAR) observation data in the United States. A modification to the CBASE algorithm over China (CNMETAR-CBASE) is presented in this paper. In this paper, the ability of the CBASE algorithm to calculate CBH in China is evaluated, and METAR observations over China (CNMETAR) were then used to modify the CBASE algorithm. The results including CNMETAR observation data in China can better retrieve CBH over China compared with the results using the original CBASE algorithm, and the accuracy of the global CBH results has been improved. Overestimations of CBH with the original algorithm range from 500 to 800 m in China, which have been reduced to about 300 m with an improved algorithm. The deviations calculated by the algorithm also have a significant reduction, from 480 m (CBASE) to 420 m (CNMETAR-CBASE). In conclusion, the modified CBASE algorithm not only calculates the CBH more accurately in China but also improves the results of the global CBH retrieved from satellites.

A real-world pharmacovigilance study of FDA adverse event reporting system (FAERS) events for sunitinib.

Sunitinib is approved for the treatment of metastatic renal cell carcinoma (mRCC), imatinib-resistant gastrointestinal stromal tumors (GIST), and advanced pancreatic neuroendocrine tumors (PNET). This study aims to investigate the safety profiles of sunitinib through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS). The individual case safety reports (ICSRs) on sunitinib from 2006 Q1 to 2024 Q1 were collected from the ASCII data packages in the Food and Drug Administration Adverse Event Reporting System (FAERS). After standardizing the data, a variety of disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the bayesian confidence propagation neural network (BCPNN), and the multi-item gamma Poisson shrinker (MGPS) were employed to identify the potential safety signals of sunitinib-associated AEs. A total of 35,923 ICSRs of sunitinib as the "primary suspected" drug were identified within the reporting period. The search detected 276 disproportionate preferred terms (PTs). The most common AEs, including diarrhea, asthenia, decreased appetite, hypertension, and dysgeusia, were consistent with the drug label and clinical trials. Unexpected significant AEs, such as uveal melanocytic proliferation, salivary gland fistula, yellow skin, eyelash discoloration, scrotal inflammation, were detected. The median onset time of sunitinib-related AEs was 57 days (interquartile range [IQR]16-170 days), with most of the ICSRs developing within the first month (n = 4,582, 39.73%) after sunitinib therapy as initiated. The results of our study were consistent with routine clinical observations, and some unexpected AEs signals were also identified for sunitinib, providing valuable evidence for the safe use of sunitinib in the real-world and contributing to the clinical monitoring and risk identification of sunitinib.

A Pain in the Pilot.

Multi-agency guidelines recommend use of a functional pain assessment tool as an objective assessment of pain, rather than relying on a subjective verbal rating scale. This project was created to address issues managing Patients' pain in inpatient settings. The project aimed to answer: 'How can we adopt the use of a Functional Pain Assessment into our clinical practice, optimising its effectiveness for ALL patient groups in our inpatient ward areas?' Output from multi-disciplinary working group: two electronic documents were created - Pain Assessment Tool and Pain Observations Chart: for staff to document routine pain observations. Five wards participated in the pilot study, with training/support provided. Result: Staff and patients preferred the new approach, compared to previous pain documentation method. However, documentation compliance was not as good as expected. Pilot proved the concept, documents are effective in pain management, but more education and support is needed to embed cultural shift.

Analysis of percutaneous nephrostomy exchange intervals: insights from a retrospective Merative MarketScan analysis between 2009-2021.

Current practices in nephrostomy exchange are guided by institutional or societal expert-consensus rather than evidence-based recommendations. To examine the temporal distribution of exchanges and assess whether the observed distributions align with institutional, or expert-recommended guidelines where routine exchanges would be expected to occur within 60-89 days. Non-routine exchanges would be expected to occur either after 60 days or after 89 days. Data were collected from the Merative™ MarketScan Commercial Claims and Encounters Databases and included all patients who underwent a PCN exchange from 2009 to 2021. The dataset was queried using ICD-9/10 and CPT coding systems. Outpatient exchanges were classified as routine exchanges, whereas inpatient exchanges were classified as non-routine exchanges. Chi-Square Goodness-of-Fit tests were used to compare observed frequencies against expected distributions of routine exchanges within the 59-89day window, and non-routine exchanges to occur after either 60 or after 89 days. There was a total of 19,689 exchanges: of those, 41% (n = 8,058) exchange encounters occurred within 29 days, 67% (n = 13,213) occurred within 59 days, and 81% (n = 15,899) occurred within 89 days. Routine exchanges accounted for 76% of total exchanges: of those routine exchanges, 39% (n = 5,863) of routine exchanges occurred within 29 days, 67% (n = 10,057) occurred within 59 days, and 82% (n = 12,256) occurred within 89 days. Non-routine exchanges account for 24% of all exchanges in the study cohort. Of all non-routine exchanges (n = 4,737), 46% (n = 2,035) of non-routine exchange encounters occurred within 29 days, 67% (n = 3,156) within 60 days, and 77% (n = 3,643) within 89 days. Chi-square tests indicated significant deviations from the expected distributions for both routine (p < 0.01) and non-routine (p < 0.01) exchanges. A significant proportion of routine exchanges occur outside a 60-89day window, and with a majority of routine exchange observations occurring prior to 59 days. A significant proportion of non-routine exchanges occur prior to 60 days and prior to 89 days. Significant disparities between existing guidelines and clinical practice, underscoring the need for evidence-based guidelines to reduce complication rates, improve patient outcomes, and reduce the burden of cost on the healthcare system.

POST-DESIGN MONITORING OF THE IRRIGATION IMPACT ON THE ENVIRONMENT

Approaches to conducting post-design monitoring of the impact of irrigation on soil condition are highlighted on the example of an individual agricultural farm of LLC "Granex-Cherkasy". The results of the implementation of the five-year post-design monitoring program under the conditions of irrigation by groundwater using sprinkling and drip methods proved the need to develop both unified general approaches to the formation of monitoring programs, as well as the mandatory consideration of the peculiarities of its management under different irrigation methods and hydrogeological-ameliorative conditions on the irrigation sites. As a basis for the development of a system of post-design monitoring of the impact of irrigation on the state of environmental components, it is proposed to use approaches to the organization and performance of local (on-site) monitoring of irrigated lands based on the requirements of current regulatory and methodological documents. The observation system, based on previous studies, included periodic determination of irrigation water quality indicators in storage ponds or in the places of watering and routine observations of soil conditions at permanent monitoring points (observation points), which are recommended to be taken as coordinate points of the previously conducted testing study (at the stage of the preparation of the environmental impact assessment report). The results of the post-design monitoring proved the ecological admissibility of the impact of irrigation within the farm with the groundwater of I and II quality classes (suitable and limitedly suitable according to individual quality indicators). Based on the results of monitoring, it was established that the soils under irrigation did not undergo significant classification changes in terms of deterioration for 5 years. The lack of manifestations of secondary (irrigation) salinization, sodification, and alkalinization of soils under the influence of irrigation indicates the environmental safety of the latter following the accepted standards for indicators of the degree of development of the specified soil degradation processes.

Features of underground flow formation to the Golovesnya river (Desna basin) during the dry period 2007-2021

Purpose. To analyze the peculiarities of the dynamics of underground flow on the catchment of the Golovesnya River, a right-bank tributary of the Desna River, during the dry period of 2007-2021 in comparison with the period of 1960-1985 - before the beginning of noticeable climatic changes. Methods. The hydrodynamic finite-difference method of calculating the specific consumption of groundwater based on the data of routine observations of the levels of groundwater and surface water, the hydrodynamic method of calculating the components of the groundwater balance. Results. The specific flow of groundwater to the Golovesnya River was calculated based on the data of observations for 2007-2021; the share of groundwater flow in the total flow of the river was determined, changes in the dynamics of infiltration nutrition and the inflow of groundwater to the river were revealed, which can be associated with the sign of the charge of the static electric field of the surface layer of the atmosphere, an increase in air temperature, and an increase in the volume of moisture retention in the aeration zone after reducing GWT. Underground flow to the river largely compensates for the losses and stabilizes the river flow in low-water years and during prolonged hydrological drought. Important factors in the regulation of the groundwater regime in low-water periods (in addition to precipitation) are the level and flow of water in the river, as well as the loss of moisture due to the saturation of the aeration zone, and therefore, the lithological and granulometric composition of this zone. Losses in the aeration zone are also an important regulatory factor of balance and river flow in the scale of the Desna River catchment. The largest volumes of underground runoff to the Golovesnya River for 2007-2021 were set for the multi-water year 2016, the smallest - for 2021. By 2016, the chronological graphs show clearer seasonal patterns: repeatability of underground flow fluctuations in the spring and autumn seasons; opposite flow fluctuations in winter and spring and a relatively stable summer flow; typical for autumn are maximum, and for summer always minimum values ​​of reserves and infiltration recharge of groundwater. In the abundant water year of 2016, infiltration recharge and groundwater reserves during autumn and winter sharply decrease and acquire negative values ​​due to a significant decrease in GWT in the previous period, an unfavorable course of temperature and precipitation distribution, and increased outflow to the river. In 2017-2021, the seasonal differences in the recharge of the river with groundwater are almost equalized: the role of recharge increases during the summer period, and decreases during the spring and autumn seasons. The role of the condensation mechanism of moisture transfer in the aeration zone is increasing. During the summer, the lateral inflow of groundwater to the river was the highest in 2016-2018. Conclusions. Calculations and analysis of the dynamics of infiltration feeding and groundwater flow to the Golovesnya River have been performed. Changes in groundwater supply and discharge, especially in the period after 2015, have been identified, which can be interpreted as the consequences of adverse weather and climate conditions in 2014-2015. In 2018-2021, there was a decrease in groundwater and surface water resources, which corresponds to signs of hydrological drought.

A machine learning model for estimating the temperature of small rivers using satellite-based spatial data

The influence of anthropogenic activity and land cover alteration on stream temperatures has major ecological implications, such as limiting fish survival. While these ecological impacts have been extensively studied at varying spatial scales for major rivers, our understanding of the range and complexity of this relationship across climates and geographies for smaller rivers (less than ∼60 m wide) remains limited. This is in part because although such rivers comprise a vast majority (∼97%) of total stream length, most smaller rivers lack routine temperature observations despite extensive gage networks. While existing gage networks in many regions are sufficient to support satellite remote sensing-based modeling of small stream temperatures, most large regions including the contiguous United States do not have modeled data products at high spatial and temporal resolution for small rivers.In this study, we developed a statistical model, TempEst (“temperature estimation”), to estimate monthly average water temperatures for smaller rivers and evaluated the model with rivers ranging from 3 m to 1000 m (1 km) in width, using land cover, topography, and satellite-based land surface temperature. The rivers chosen for development of the model are representative of a range of urban and rural land uses and cover eight US Environmental Protection Agency Level I ecoregions. The model was calibrated and validated using observed stream temperatures from the United States Geological Survey. TempEst is able to predict monthly average temperature for streams of any size with an overall median RMSE of about 1.5 °C and bias of 0%. Model accuracy has a consistent trend with training gauge network density, with median RMSE increasing to about 2.0 °C in more sparsely-gauged regions. As a simple demonstration, we used TempEst to estimate thermal suitability conditions for cutthroat trout in Rocky Mountain streams in the United States. The developed model, available as open-source R (model) and Google Earth Engine (data retrieval) scripts, will facilitate the study of stream temperature behaviors at higher resolutions than previously available across the contiguous United States and can be easily adapted to support global river systems.

Post-reduction observation and recurrence of pediatric intussusception in New Zealand: A national multicenter retrospective study

BackgroundIntussusception is the most common cause of preschool intestinal obstruction. International data suggest that following uncomplicated enema reduction, 4-hour observation with prompt return to oral diet is safe. We aimed to investigate the rate and timing of intussusception recurrence across Aotearoa New Zealand, compared to the cost of routine post-reduction observation. MethodsWe performed a national 15-year retrospective, multicenter cohort study of all children treated for intussusception between 01 Jan 2007 and 01 Jan 2022 across AoNZ. A robust clinical dataset was collected using a REDCap proforma. We also investigated the financial and time costs of current in-hospital observation practices. ResultsDuring this period, primary enema reduction without general anesthetic was successful in 339 cases, requiring a median of 2 attempts (1–8). The median age was 0.8 years; 70.8% were male, and 17.1% were Māori. The median length of hospital stay was 25.9 h, primarily comprised of post-reduction observation (21.6 h). Intussusception recurrence within 30 days occurred in 29 children (8.5%) at a median time of 24.7 h post-reduction. Of the 19 cases recurring before discharge, 12 (3.5%) recurred between 4 and 24 h. The median observation period for those with successful primary enema reduction was 21.6 h; if reduced to 4 h, savings of NZD 883,632 (USD 529,825) and 7342 ward hours were possible. ConclusionsNationally, the intussusception recurrence rate after uncomplicated enema reduction was 8.5%, but only 3.5% occurred between the 4–24 hour period post-reduction. Expediting discharge by avoiding routine overnight observation appears safe and economically viable.

Same-day discharge after percutaneous renal cryoablation and its effect on 30 day hospital re-admission rates and post-procedural complications

PurposeThe purpose of this study is to identify if the local institutional shift from routine overnight observation to same-day discharge following percutaneous cryoablation (PCA) of renal tumors increases 30 day re-admission rates or serious adverse events (AEs). Materials and methodsThis retrospective study included 133 adult patients. PCA patients in calendar years 2018-2019 were routinely observed overnight in the hospital, comprising the control group (Group A). PCA patients in calendar years 2021-2022 were routinely discharged the same day, comprising the test group (Group B). Relevant demographic information, tumor characteristics, technical outcomes, and clinical outcomes were recorded. Results15 patients (11.3 %) from the total cohort were re-admitted to the hospital within 30 days of PCA for any reason. Seven patients (10.4 %) and eight patients (12.1 %) were re-admitted for any reason within 30 days in Group A and Group B, respectively, with no difference between the two groups (p = 0.76). Nine patients (6.8 %) from the total cohort were re-admitted to the hospital within 30 days for a diagnosis secondary to the procedure. Four patients (6 %) and five patients (7.6 %) were re-admitted within 30 days for reasons related to PCA in Group A and Group B, respectively, with no significant difference between the groups (p = 0.71). Eight patients (12 %) and four patients (6 %) had major AEs following PCA in Group A and Group B, respectively, with no difference between the two groups (p = 0.43). ConclusionOverall, the change in post-procedural care after PCA did not have a deleterious effect on 30 day re-admission rates or rates of major AEs.

Priority sites for coral aquaculture in Kume Island based on numerical simulation

Global and local stresses such as increased water temperature and terrestrial sediment runoff significantly affect coral reef ecosystems. Over the past three decades, the increase in the intensity and frequency of coral bleaching has been a significant problem in tropical and subtropical coastal seas, and maintaining healthy coral reef ecosystems has long been a challenge. Coral cover in Shimajiri Bay on Kume Island, located in the Nansei Islands (Okinawa Prefecture, southern Japan), has declined due to exposure to high water temperatures, an outbreak of coral predators, and sediment (red soil) inflow from the land. From such a background, coral aquaculture has been implemented at a few stations in the bay. Therefore, it is essential to conduct aquaculture in suitable locations for coral growth and survival. This study aimed to select suitable locations for coral culture with high spatial resolution in an enclosed bay that was greatly affected by red soil runoff, mainly from a sugarcane field. A freshwater and red soil runoff model for the watershed was merged with a coastal hydrodynamic, red soil dispersal, and accumulation model at a spatial resolution of 75 m for Shimajiri Bay. The simulation results were validated using in situ continuous and routine observations. Simulations were conducted over ten years. Locations not subjected to high water temperature in the bay or river loading were selected based on topography, simulated water temperature, salinity, and red soil content of sea sediment. This coupled model enables us to evaluate the growth and survival conditions of cultured corals with high spatiotemporal resolution and quantitatively consider the reduction target of red soil runoff to realize robust coral growth and survival.

Coronagraphic Observations of Si x 1430 nm Acquired by DKIST/Cryo-NIRSP with Methods for Telluric Absorption Correction

We report commissioning observations of the Si x 1430 nm solar coronal line observed coronagraphically with the Cryogenic Near-Infrared Spectropolarimeter at the National Science Foundation’s Daniel K. Inouye Solar Telescope. These are the first known spatially resolved observations of this spectral line, which has strong potential as a coronal magnetic field diagnostic. The observations target a complex active region located on the solar northeast limb on 2022 March 4. We present a first analysis of these data that extracts the spectral line properties through a careful treatment of the variable atmospheric transmission that is known to impact this spectral window. Rastered images are created and compared with extreme-UV observations from the Solar Dynamics Observatory (SDO) Atmospheric Imaging Assembly (AIA) instrument. A method for estimating the electron density from the Si x observations is then demonstrated that makes use of the forbidden line density-sensitive emissivity and an emission-measure analysis of the SDO/AIA bandpass observations. In addition, we derive an effective temperature and nonthermal line width across the region. This study informs the calibration approaches required for more routine observations of this promising diagnostic line.