Short-term Observations Research Articles

Long-Term Sequences of Intergenerational Living Arrangements Among Older Americans

Living arrangements are critical for intra-family exchanges such as physical, financial, and emotional supports influencing older adults’ health and well-being. Existing research is largely based on short-term observations of living arrangements. This study aims to explore longer term dynamic patterns of intergenerational living arrangements among older Americans and their sociodemographic and health determinants. Data came from the 1998-2016 Health and Retirement Study. Sequence analysis was employed to identify long-term patterns of intergenerational living arrangements for 3,025 individuals who were age of 51-64 at the baseline (ages of 69-82 at the last wave), have at least one child, and were observed 10 consecutive times (Obs.=30,250). Living arrangements were categorized into co-residence, proximate residence (i.e., 10miles from children), and nursing home. Multinomial logistic regressions were used to evaluate the associations of individual characteristics with the different living arrangements sequences. Four patterns of eighteen-year living arrangement trajectories were identified: Transition to proximate residence (17%), stable in distant residence (24%), stable in proximate residence (38%), and stable in co-residence (22%). Younger age and working (vs. retired) status were associated with stable coresidence rather than proximate or distant residence. Respondents who retired during the study period were more likely to move close to their children. Contrary to expectations, changes in self-rated health and functional status had no significant effect in long-term living arrangement sequence patterns. These findings suggest that intergenerational living arrangements among older Americans tend to be stable and not to be significantly affected by their caregiving needs.

ПЕРОРАЛЬНАЯ ЭНДОСКОПИЧЕСКАЯ МИОТОМИЯ В ЛЕЧЕНИИ АХАЛАЗИИ ПИЩЕВОДА У ДЕТЕЙ

Etiological treatment of esophageal achalasia are absent. None of the currently available treatment methods can restore normal esophageal peristalsis and the functionality of the lower esophageal sphincter, thereby alleviating dysphagia and other symptoms of achalasia. Therapeutic procedures currently used for the effective treatment of achalasia of the esophagus are represented by laparoscopic Heller's myotomy and endoscopic balloon dilatation of the esophagus. According to the literature, Heller's myotomy is considered as a method of choice in children, since it provides more reliable results in comparison with pneumatic expansion during prolonged observation. Peroral endoscopic myotomy (POEM) is a new endoscopic method for the treatment of esophageal achalasia, first reported by P. Pasricha in experiment, and then H. Inoue performed this operation in adult patients. There are only a few studies on the use of POEM in children and adolescents. Existing studies have demonstrated the feasibility of this procedure in children, low level of complications and excellent results with short-term observation. Several studies have reported high efficacy in the use of POEM in children, ranging from 90% to 100%. Reports of the occurrence of complications after POEM in children are sporadic and are represented by the formation of subcutaneous emphysema, carboperitoneum, retroperitoneum and mediastinal emphysema. Obviously, detailed studies with longer observation are required before the role of POEM in the treatment of esophageal achalasia in children can be established. If preliminary results are confirmed, POEM can be a real alternative to Heller's myotomy in pediatric patients. This study is intended to explore the potential and safety of the use of POEM for the treatment of achalasia in children based on a review of existing data in the scientific literature.

Forecasting Future Traffic Trend by Short-Term Continuous Observation

Annual Average Daily Traffic (AADT) is a key parameter to understand the traffic flow rates, traffic density and to design any highway. Generally, short period observed traffic data mainly depends on that season in which the traffic surveys were conducted, which may be high or low compared to the other seasons. So, the behavior of seasonal variation of traffic must be considered for the AADT analysis. These seasonal variations can be found out using the past recorded data of that selected location. But in the case of a location where the past annual traffic data is not available, an alternative method is required to calculate the seasonal variation of the traffic data. The present study deals with the analysis of seasonal variation factors to estimate the AADT from the fuel sale data collected from the nearby petrol stations at the traffic survey point. This work explains how Annual Average Daily Traffic (AADT) can be estimated from a week’s limited traffic data when there is a scarcity of automatic traffic data collecting systems.

The importance of long-term studies on wildlife diseases and their interfaces with humans and domestic animals: A review.

Long-term wildlife disease research (LTWDR) and its interfaces with humans and domestic animals provide perspective to understand the diseases' main drivers and how they operate. In a systematic review, we analysed the temporal trend of the studies on LTWDR, their aims, and the hosts, pathogens and geographic areas studied. We also evaluated the added value that such studies provide. For analysis, we selected a total of 538 articles from 1993 to 2017 with a study period greater than or equal to 4 consecutive years. A marked increase in the number of studies published during the last 20years was observed that reflects a growing awareness of the outstanding role of wildlife as a reservoir of diseases. The most studied pathogen agents were viruses (39.2%), bacteria (38.5%) and protozoans (15.8%). Concerning the hosts, mammals (84.9%), particularly ungulates (40%) and carnivores (30.9%), and birds (12.5%) were the most represented in these long-term studies. Most articles reached conclusions concerning the effect of the disease on the infection/host dynamics (98.7%) and over 40% considered the economic consequences or proposed management and control measures. The research was mainly located in the Northern Hemisphere. While the definition of LTWDR is not only determined by the duration of the monitoring, the study must be long enough to: (a) address ecological and epidemiological questions that cannot be resolved with short-term observations or experiments, and (b) clarify the effects of different drivers. This review demonstrates that LTWDR has provided information about the causes and consequences of disease change that otherwise could not have been obtained. It may be used to inform decisions related to the emergence of disease and might help to design early warning systems of disease based on retrospective investigations.

Nonlinear trending of corrosion of high nickel alloys in extended marine and atmospheric exposures

AbstractThe relatively limited data for the corrosion and pitting of high nickel alloys are reviewed herein and time-dependent trends developed for exposures in marine and atmospheric environments. Data sets for average or ‘uniform’ corrosion losses that are sufficiently extensive show topological consistency with the bimodal functional model previously observed for steels and various copper-nickel and aluminum alloys. Trends for localized corrosion (pit or crevice depth) plateau after earlier rapid growth over several years. The present observations add support to the concept that there is a change in corrosion behavior with extended temporal exposure and that this is generally consistent for many alloys. They also reinforce that shorter-term observations of maximum corrosion or pit depth usually is unsuited for extrapolation to, and prediction of, longer-term corrosion as typically important for practical infrastructure applications.

Flood Hazard Assessment in Data-Scarce Watersheds Using Model Coupling, Event Sampling, and Survey Data

The application of hydrologic and hydrodynamic models in flash flood hazard assessment is mainly limited by the availability of robust monitoring systems and long-term hydro-meteorological observations. Nevertheless, several studies have demonstrated that coupled modeling approaches based on event sampling (short-term observations) may cope with the lack of observed input data. This study evaluated the use of storm events and flood-survey reports to develop and validate a modeling framework for flash flood hazard assessment in data-scarce watersheds. Specifically, we coupled the hydrologic modeling system (HEC-HMS) and the Nays2Dflood hydrodynamic solver to simulate the system response to several storm events including one, equivalent in magnitude to a 500-year event, that flooded the City of Tena (Ecuador) on 2 September, 2017. Results from the coupled approach showed satisfactory model performance in simulating streamflow and water depths (0.40 ≤ Nash-Sutcliffe coefficient ≤ 0.95; −3.67% ≤ Percent Bias ≤ 23.4%) in six of the eight evaluated events, and a good agreement between simulated and surveyed flooded areas (Fit Index = 0.8) after the 500-year storm. The proposed methodology can be used by modelers and decision-makers for flood impact assessment in data-scarce watersheds and as a starting point for the establishment of flood forecasting systems to lessen the impacts of flood events at the local scale.

Predicting tidal heights for extreme environments: from 25 h observations to accurate predictions at Jang Bogo Antarctic Research Station, Ross Sea, Antarctica

Abstract. Accurate tidal height data for the seas around Antarctica are much needed, given the crucial role of these tides in the regional and global ocean, marine cryosphere, and climate processes. However, obtaining long-term sea level records for traditional tidal predictions is extremely difficult around ice-affected coasts. This study evaluates the ability of a relatively new tidal-species-based approach, the complete tidal species modulation with tidal constant corrections (CTSM + TCC) method, to accurately predict tides for a temporary observation station in the Ross Sea, Antarctica, using a record from a neighbouring reference station characterised by a similar tidal regime. Predictions for the “mixed, mainly diurnal” regime of Jang Bogo Antarctic Research Station (JBARS) were made and evaluated based on summertime (2017; and 2018 to 2019) short-term (25 h) observations at this temporary station, along with tidal prediction data derived from year-long observations (2013) from the neighbouring “diurnal” regime of Cape Roberts (ROBT). Results reveal the CTSM + TCC method can produce accurate (to within ∼5 cm root mean square errors) tidal predictions for JBARS when using short-term (25 h) tidal data from periods with higher-than-average tidal ranges (i.e. those at high lunar declinations). We demonstrate how to determine optimal short-term data collection periods based on the Moon's declination and/or the modulated amplitude ratio and phase lag difference between the diurnal and semidiurnal species predicted from CTSM at ROBT (i.e. the reference tidal station). The importance of using long-period tides to improve tidal prediction accuracy is also considered and, finally, the unique tidal regimes of the Ross Sea examined in this paper are situated within a wider Antarctic tidal context using Finite Element Solution 2014 (FES2014) model data.

Observational assessment of applicability of Pasquill stability class in urban areas for detection of neutrally stratified wind profiles

In wind-resistant designs of high-rise buildings, wind profiles are modeled for strong wind, where atmospheric stability is assumed to be neutral. When wind profiles are modeled from the results of short-term observations, which include few data on strong wind, a method to evaluate atmospheric stability and detect wind profiles under neutral conditions is required. In the present study, the applicability of the Pasquill stability class, a widely used index to evaluate atmospheric stability, was assessed in urban areas. The atmospheric stability evaluated from the Pasquill stability class was compared with that from the Monin–Obukhov length using the observation data obtained in Tokyo. 70% of the data of Pasquill stability class D (neutral class) corresponded to the neutral condition evaluated from the Monin–Obukhov length. Furthermore, the mean wind profiles, which were observed at another site in Tokyo using Doppler lidar, were classified according to the Pasquill stability class. As the Pasquill stability class transformed from unstable to neutral, the power law exponent increased. For the neutral class, the power law exponent was within the error range of previous observations of strong wind. The mean wind profile of the neutral class can approximate that of strong wind appropriately.

Intrinsic recurrence quantification analysis of nonlinear and nonstationary short-term time series.

Recurrence analysis is a powerful tool to appraise the nonlinear dynamics of complex systems and delineate the inherent laminar, divergent, or transient behaviors. Oftentimes, the effectiveness of recurrence quantification hinges upon the accurate reconstruction of the state space from a univariate time series with a uniform sampling rate. Few, if any, existing approaches quantify the recurrence properties from a short-term time series, particularly those sampled at a non-uniform rate, which are fairly ubiquitous in studies of rare or extreme events. This paper presents a novel intrinsic recurrence quantification analysis to portray the recurrence behaviors in complex dynamical systems with only short-term observations. As opposed to the traditional recurrence analysis, the proposed approach represents recurrence dynamics of a short-term time series in an intrinsic state space formed by proper rotations, attained from intrinsic time-scale decomposition (ITD) of the short time series. It is shown that intrinsic recurrence quantification analysis (iRQA), patterns harnessed from the corresponding recurrence plot, captures the underlying nonlinear and nonstationary dynamics of those short time series. In addition, as ITD does not require uniform sampling of the time series, iRQA is also applicable to unevenly spaced temporal data. Our findings are corroborated in two case studies: change detection in the Lorenz time series and early-stage identification of atrial fibrillation using short-term electrocardiogram signals.

Temperature increase altered Daphnia community structure in artificially heated lakes: a potential scenario for a warmer future

Under conditions of global warming, organisms are expected to track their thermal preferences, invading new habitats at higher latitudes and altitudes and altering the structure of local communities. To fend off potential invaders, indigenous communities/populations will have to rapidly adapt to the increase in temperature. In this study, we tested if decades of artificial water heating changed the structure of communities and populations of the Daphnia longispina species complex. We compared the species composition of contemporary Daphnia communities inhabiting five lakes heated by power plants and four non-heated control lakes. The heated lakes are ca. 3–4 °C warmer, as all lakes are expected to be by 2100 according to climate change forecasts. We also genotyped subfossil resting eggs to describe past shifts in Daphnia community structure that were induced by lake heating. Both approaches revealed a rapid replacement of indigenous D. longispina and D. cucullata by invader D. galeata immediately after the onset of heating, followed by a gradual recovery of the D. cucullata population. Our findings clearly indicate that, in response to global warming, community restructuring may occur faster than evolutionary adaptation. The eventual recolonisation by D. cucullata indicates that adaptation to novel conditions can be time-lagged, and suggests that the long-term consequences of ecosystem disturbance may differ from short-term observations.

Fecal Microbiota Transplantation for Ulcerative Colitis: The Optimum Timing and Gut Microbiota as Predictors for Long-Term Clinical Outcomes.

INTRODUCTION:The previous researches aimed to evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for ulcerative colitis (UC) in a short-term observation. The present study aimed to explore the optimum timing of FMT for maintaining the long-term clinical benefits and to target the gut microbiota that may help to predict the long-term success or failure of FMT in UC.METHODS:Two hundred two patients with UC were recruited from November 2012 to September 2018. The primary endpoint of this study was the maintaining time of the first and second courses of FMT. Relapse was defined as partial Mayo score ≥2 after achieving clinical remission and an increase of partial Mayo score ≥1 after achieving clinical response. The stool samples were analyzed by 16S rRNA gene sequencing.RESULTS:The median maintaining time of the efficacy was 120 days (IQR, 45–180) and 182.5 days (IQR, 105–311.25) from the first course and second course of FMT, respectively. No FMT-related serious adverse events were observed. The differences of the relative abundance in Eggerthella, Lactobacillus, and Ruminococcus between pre-FMT and 5 days post-FMT were remarkably correlated with the long-term clinical remission (P < 0.05).DISCUSSION:This study demonstrated that patients with UC should undergo the second course of FMT within 4 months after the first course of FMT for maintaining the long-term clinical benefits. The short-term alterations of microbiota after FMT may be conducive to predicting the long-term efficacy of FMT in UC (see Visual , Supplementary Digital Content, http://links.lww.com/CTG/A363).

The Test of Time: Using Historical Methods to Assess Models of Ecological Change on California’s Hardwood Rangelands

Geographers and environmental scientists use conceptual models to understand ecological processes and support management decisions. Most of these models are based on short-term experiments and field observations, which might not account for longer term forces that shape ecosystems over decades to centuries. How can scholars use historical sources and methods to improve conceptual models of ecological change? In this article, we present the results of a study that employed methods from environmental history and historical geography to assess three conceptual models that researchers have used to study ecological changes on California’s hardwood rangelands: the succession and climax, state and transition, and cyclical replacement models. The succession and climax model fared poorly at all spatial scales. The historical record contained substantial evidence to support the predictions of the state and transition model at the small spatial scale of the plot or field (0.1–100 ha) and the very large spatial scale of the hardwood rangeland bioregion (4 million ha). The cyclical replacement model performed well at the intermediate scale of the landscape or typical cattle ranch (100–10,000 ha). Historical data and methods hold considerable untapped potential for assessing, building on, and improving conceptual models of ecological change in geography and the environmental sciences.

An Observational Study of the Behaviour of Captive Rehabilitant Sun Bears (Helarctos malayanus)

ABSTRACT Rehabilitant Malayan sun bears often remain in captivity for long periods of time and may experience significant welfare challenges including disability and persistent lip lesions. This study aimed to investigate whether short-term observations of behavior such as oral stereotypies are useful as noninvasive indicators of lip lesion pain, and whether behavior differs between able-bodied and disabled bears. Observations were collected from 21 captive, rehabilitant Malayan sun bears, of both sexes, a range of ages, and with lip lesions ranging in severity. Some also had disabilities. Oral stereotypy frequency was unrelated to lip lesion severity (p > 0.05), and no relationships with other behaviors were found; however, visual disabilities had significant effects on behavior. For example, visually disabled bears walked more than able-bodied bears (p = 0.003) or those with physical disabilities (p = 0.01). Further research on the feeding behavior of bears suffering from lip lesions may elucidate other potential behavioral indicators of pain. Researching effects of visual disabilities in bears with a larger sample size is also recommended to determine generalizable impacts in affected individuals and resulting welfare implications.

Corneal Biomechanical Properties after Small Incision Lenticule Extraction Surgery on Thin Cornea

ABSTRACT Purpose To explore the biomechanical changes in thin corneas after the small incision lenticule extraction (SMILE) surgery. Methods This prospective survey screened patients scheduled for the SMILE surgery from November 2017 to March 2018. Patients with thin corneas (central corneal thickness [CCT] ≤500 μm) and those with normal corneal thickness (CCT > 500 μm) were enrolled. Corneal biomechanics were examined by the ocular response analyser and Corvis ST, preoperatively and at 1 day, 3 weeks, and 3 months postoperatively. Results Twenty-seven patients (46 eyes) with mean spherical equivalent of −5.1 ± 1.7 D were assigned to the thin cornea group, and 28 (45 eyes) cases with mean spherical equation of −5.3 ± 1.8 D were assigned to the control group. Safety and efficacy did not differ between the two age- and refraction-matched groups (safety index, 1.15 ± 0.14 vs 1.14 ± 0.17 [P = .7]; efficacy index, 1.11 ± 0.13 vs 1.16 ± 0.22 [P = .2]). All biomechanical parameters changed significantly after SMILE. The thin cornea group showed less decrease in the second applanation time (A2 Time), stiffness parameters at first applanation (SP-A1). Pooling data from two groups, lower CCT was correlated with less A2 Time change (r = 0.37, P < .01) and less SP-A1 change (r = −0.33, P < .01). Less bIOP change was correlated with higher residual stromal thickness index and thicker CCT (P = .003, R2 = 0.12). Conclusion Over a short-term observation period, less corneal biomechanic deterioration may have contributed to the safety of SMILE on thin cornea.

Zirconia Implants and Marginal Bone Loss: A Systematic Review and Meta-Analysis of Clinical Studies.

The purpose of this study was to provide sufficient information on the clinical outcome of zirconia implants, mainly observing the survival rate and marginal bone loss (MBL), with a minimum follow-up of 12 months, to verify the adoption of ceramics as a rational possibility for dental implants. A systematic electronic search through the PubMed (MEDLINE) and EMBASE databases was performed by two independent reviewers to identify clinical studies published between January 2005 and April 2019 containing a minimum of 10 patients per study and 12 months of follow-up after functional loading. References from the selected articles were manually reviewed for further studies. From the initial 1,225 articles retrieved, 19 met all the inclusion criteria. The marginal bone remodeling accounted for mean losses of 0.8 mm (95% CI: 0.60 to 1.00 mm) and 1.01 mm (95% CI: 0.72 to 1.29 mm) at 1 year and 2 years postloading, respectively. The failure rate of 6.8% was calculated for a mean follow-up period of 2.75 years, where the prevalence of early failure, late failure, and implant fracture was 3.4%, 1.7%, and 1.7%, respectively. The meta-analysis associated with the survival rate of one- and two-piece zirconia dental implants was hindered due to the lack of confidence interval or standard deviation information in most of the included articles. Zirconia implants presented MBL values consistent with the standard in the global consensus, high survival rates, and considerable clinical results at short-term observation periods following prosthetic delivery.

A 54-year record of changes at Chalaati and Zopkhito glaciers, Georgian Caucasus, observed from archival maps, satellite imagery, drone survey and ground-based investigation

Individual glacier changes are still poorly documented in the Georgian Caucasus. In this paper, the change of Chalaati and Zopkhito glaciers in Georgian Caucasus has been studied between 1960 and 2014. Glacier geometries are reconstructed from archival topographic maps, Corona and Landsat images, along with modern field surveys. For the first time in the Georgian Caucasus aerial photogrammetric survey of both glacier termini was performed (2014) using a drone or Unmanned Aerial Vehicle, where high-resolution orthomosaics and digital elevation models were produced. We show that both glaciers have experienced area loss since 1960: 16.2±4.9 per cent for Chalaati Glacier and 14.6±5.1 per cent for Zopkhito Glacier with corresponding respective terminus retreat by ~675 m and ~720 m. These were accompanied by a rise in the equilibrium line altitudes of ~35 m and ~30 m, respectively. The glacier changes are a response to regional warming in surface air temperature over the last half century. We used a long-term temperature record from the town of Mestia and short-term meteorological observations at Chalaati and Zopkhito glaciers to estimate a longer-term air temperature record for both glaciers. This analysis suggests an increase in the duration of the melt season over the 54-year period, indicating the importance of summertime air temperature trends in controlling glacier loss in the Georgian Caucasus. We also observed supra-glacial debris cover increase for both glaciers over the last half century: from 6.16±6.9 per cent to 8.01±6.8 per cent for Chalaati Glacier and from 2.80±6.3 per cent to 8.53±5.7 per cent for Zopkhito Glacier.

Effects of nutrient addition on degraded alpine grasslands of the Qinghai-Tibetan Plateau: A meta-analysis

Climate warming and human disturbance are supposed to have severely affected the alpine grasslands on the Qinghai-Tibetan Plateau (QTP), a region where the extremely harsh and fragile ecological environment has attracted great attention because of its sensitivity to global change. However, there is still no unified understanding of the degree and magnitude of grassland degradation and the effectiveness of nutrient addition in this vast landscape, since most previous studies have focused on short-term observations at a single site. Here, we conducted a meta-analysis of 145 published studies on degraded alpine grassland along with 90 published studies, which concerning nutrient addition (nitrogen [N], phosphorus [P], and combined N and P [NP]) to quantitatively assess the responses of plant and soil characteristics to land degradation and restoration. Our results revealed that the response ratio (RR) of above-ground biomass (AGB), below-ground biomass (BGB), soil organic carbon (SOC), and soil total N (TN) decreased significantly (−47.23 %, −43.45 %, −32.35 %, and −37.97 %, respectively) in degraded grassland compared with non-degraded grassland. The RR of AGB was correlated with mean annual precipitation (MAP), while the RR of BGB was correlated with the interaction of MAP and mean annual temperature (MAT). Severely degraded grassland required additional nutrients to aid recovery. NP addition to severely degraded sites increased plant AGB (+32.44 %), TN (+10.99 %), soil total P (+32.25 %), and soil moisture (+9.21 %), but significantly decreased species richness (−45.46 %), diversity (−30.40 % for Shannon−Wiener index) and soil pH (−3.91 %). N addition increased the RR of AGB and grass biomass significantly by 28.77 % and 36.49 %, but had no significant effect on sedge and forb biomass. MAP influenced the RR of AGB, TN, TP under NP addition, the RR of BGB and the AGB of different function groups were significantly affected by MAT. We evidenced that the QTP has endured severe vegetation and soil degradation, which cannot be completely mitigated by supplementary fertilisation. Fertilisation could yield positive effects on plant performance and soil quality, but negative effects on biodiversity. Climate warming and associated precipitation change may regulate the effects of fertiliser on plant biomass and soil nutrients.

Monolithic Screw-Retained Lithium Disilicate Implant Crowns: Preliminary Data of a Prospective Cohort Study.

To analyze the clinical behavior of screw-retained monolithic lithium disilicate (LDS) implant-supported single crowns (ISSCs) over a 1-year follow-up. A total of 28 patients were restored with 45 screw-retained monolithic LDS (press-fabricated) ISSCs bonded to titanium bases in posterior sites. Modified United States Public Health Service criteria and Kaplan-Meier survival and success rates were evaluated. A total of 27 patients with 44 ISSCs were evaluated 12 months (mean ± standard deviation: 13.02 ± 2.28) after prosthesis delivery. No implant or crown failures occurred. The Kaplan-Meier survival and success rates were each 100% after 1 year. Minorly increased surface roughness was noted in the occlusal contact point areas of 9 ISSCs (20.5% Bravo rating). Marginal adaptation, color match, and anatomical form stayed favorable over time. Press-fabricated LDS monolithic screw-retained implant crowns appear to be a promising treatment option for posterior implants under short-term observation.

Sediment controls dynamic behavior of a Cordilleran Ice Stream at the Last Glacial Maximum

The uncertain response of marine terminating outlet glaciers to climate change at time scales beyond short-term observation limits models of future sea level rise. At temperate tidewater margins, abundant subglacial meltwater forms morainal banks (marine shoals) or ice-contact deltas that reduce water depth, stabilizing grounding lines and slowing or reversing glacial retreat. Here we present a radiocarbon-dated record from Integrated Ocean Drilling Program (IODP) Site U1421 that tracks the terminus of the largest Alaskan Cordilleran Ice Sheet outlet glacier during Last Glacial Maximum climate transitions. Sedimentation rates, ice-rafted debris, and microfossil and biogeochemical proxies, show repeated abrupt collapses and slow advances typical of the tidewater glacier cycle observed in modern systems. When global sea level rise exceeded the local rate of bank building, the cycle of readvances stopped leading to irreversible retreat. These results support theory that suggests sediment dynamics can control tidewater terminus position on an open shelf under temperate conditions delaying climate-driven retreat.

Dupilumab improves clinical manifestations, symptoms, and quality of life in adult patients with chronic nodular prurigo

Chronic nodular prurigo (CNPG) is a multifactorial skin disease characterized by itchy papules and nodules, usually resistant to standard treatment and associated with markedly impaired quality of life. To describe dupilumab effectiveness and tolerability in treating adult patients with CNPG refractory to both topical and systemic therapies. Retrospective, multicenter study including adult patients affected by CNPG, who were treated with dupilumab for at least 16weeks. Twenty-seven CNPG patients showed clinical improvement in terms of skin lesions, itch, sleeplessness, and quality of life. A consistent proportion of patients (24/27; 88.9%) had at least 16-week continuous treatment and achieved Investigator Global Assessment score 1 (11/24; 45.8%). An increased number of patients achieved at least a 2-grade reduction in Investigator Global Assessment score (19/24; 79.2%). Numeric rating scale values for itch and sleeplessness decreased from 8.9 to 2.7 and from 8.2 to 1.7, respectively (P<.001) after 16-week therapy. Ten patients achieved 36weeks of continuous treatment while maintaining clinical efficacy. Major limitations included lack of validated assessment tools at the initial data collection, a limited cohort of treated patients, and a short-term observation period. Dupilumab was proven effective in reducing itch and improving CNPG skin lesions.