Reconstructing the Tropical Pacific Upper Ocean Using Online Data Assimilation With a Deep Learning Model.

A deep learning (DL) model, based on a transformer architecture, is trained on a climate-model data set and compared with a standard linear inverse model (LIM) in the tropical Pacific. We show that the DL model produces more accurate forecasts compared to the LIM when tested on a reanalysis data set. We then assess the ability of an ensemble Kalman filter to reconstruct the monthly averaged upper ocean from a noisy set of 24 sea-surface temperature observations designed to mimic existing coral proxy measurements, and compare results for the DL model and LIM.

The Behavior of Long Thin Rectangular Plates under Normal Pressure-A Thorough Investigation.

Thin rectangular plates are considered basic structures in various sectors like aerospace, civil, and mechanical engineering. Moreover, isotropic and laminated composite plates subjected to transverse normal loading and undergoing small and large deflections have been extensively studied and published in the literature. Yet, it seems that the particular case of long thin plates having a high aspect ratio appears to be almost ignored by various scholars despite its engineering importance.

Last Glacial Maximum pattern effects reduce climate sensitivity estimates.

Here, we show that the Last Glacial Maximum (LGM) provides a stronger constraint on equilibrium climate sensitivity (ECS), the global warming from increasing greenhouse gases, after accounting for temperature patterns. Feedbacks governing ECS depend on spatial patterns of surface temperature ("pattern effects"); hence, using the LGM to constrain future warming requires quantifying how temperature patterns produce different feedbacks during LGM cooling versus modern-day warming. Combining data assimilation reconstructions with atmospheric models, we show that the climate is more sensitive to LGM forcing because ice sheets amplify extratropical cooling where feedbacks are destabilizing.

Challenges of diagnosing severe malaria with complications in adult patients: a case report.

Background: Malaria is known to be the main cause of death in malaria-endemic areas. The authors report a case of severe malaria in an adult with no history of travel from an endemic area with good outcomes after hospitalization.

Case Presentation: A 46-year-old man was brought to the Emergency Room (ER) because of fever and chills for 6 days.

Last millennium hurricane activity linked to endogenous climate variability.

Despite increased Atlantic hurricane risk, projected trends in hurricane frequency in the warming climate are still highly uncertain, mainly due to short instrumental record that limits our understanding of hurricane activity and its relationship to climate. Here we extend the record to the last millennium using two independent estimates: a reconstruction from sedimentary paleohurricane records and a statistical model of hurricane activity using sea surface temperatures (SSTs). We find statistically significant agreement between the two estimates and the late 20th century hurricane frequency is within the range seen over the past millennium.

Innovative Insights on the Thin Square Plate Large Deflection Problem.

Thin plates subjected to transverse load and undergoing large deflections have been widely studied and published in the literature. However, there is still a lack of information and understanding about the membrane stresses created under large deflections and their associated Airy stress function, as displayed in the well-known von Kármán equations set. The present study aims at providing explicit expressions for the membrane stresses, the deflections, and the Airy stress function for a general square plate area vertically uniformly loaded to reach large deflection state.

Multiwall Rectangular Plates under Transverse Pressure-A Non-Linear Experimental and Numerical Study.

Large deflection of rectangular plates under transverse pressure is described by Föppl-von Kármán equations, which have only approximated solutions. One of these methods is the separation into a small deflection plate and a thin membrane described by a simple third order polynomial expression. The present study presents an analysis to obtain analytical expressions for its coefficients by using the plate's elastic properties and dimensions.

The added value of the nurse practitioner: An evolutionary concept analysis.

Aim: Nurse practitioners' added value is often mentioned in publications, but there is no consensus on what value is being added, what value is being added to, and in comparison with what can be considered to be an added value. A concept analysis was conducted to clarify the attributes, antecedents and meaning and better understand the Nurse practitioners' added value.

Design: Rodgers' evolutionary concept analysis.

Spatial patterns of climate change across the Paleocene-Eocene Thermal Maximum.

The Paleocene-Eocene Thermal Maximum (PETM; 56 Ma) is one of our best geological analogs for understanding climate dynamics in a "greenhouse" world. However, proxy data representing the event are only available from select marine and terrestrial sedimentary sequences that are unevenly distributed across Earth's surface, limiting our view of the spatial patterns of climate change. Here, we use paleoclimate data assimilation (DA) to combine climate model and proxy information and create a spatially complete reconstruction of the PETM and the climate state that precedes it ("PETM-DA").

A Multiwall Path-Loss Prediction Model Using 433 MHz LoRa-WAN Frequency to Characterize Foliage's Influence in a Malaysian Palm Oil Plantation Environment.

Palm oil is the main cash crop of tropical Asia, and the implementation of LPWAN (low-power wide-area network) technologies for smart agriculture applications in palm oil plantations will benefit the palm oil industry in terms of making more revenue. This research attempts to characterize the LoRa 433 MHz frequency channels for the available spreading factors (SF7-SF12) and bandwidths (125 kHz, 250 kHz, and 500 kHz) for wireless sensor networks. The LoRa channel modeling in terms of path-loss calculation uses empirical measurements of RSS (received signal strength) in a palm oil plantation located in Selangor, Malaysia.

Which is the best choice for eradication? Dual therapy or quadruple therapy?

Introduction: Standard triple therapy used to be the first-line treatment for (Hp) infection, but today it is a treatment regimen with a low eradication rate due to increasing resistance to the antibiotics included in the triple therapy.Aim: To compare the eradication rates of dual treatment regimens and quadruple treatment regimens.

Material And Methods: Patients over 18 years of age, who were indicated to undergo upper gastrointestinal system (GIS) endoscopy for any reason, had their upper gastrointestinal endoscopy performed, were detected to have Hp as a result of the histopathological evaluation of the biopsy material, and in whom eradication control was also performed by histopathological evaluation, were included in the study.

Near Ground Pathloss Propagation Model Using Adaptive Neuro Fuzzy Inference System for Wireless Sensor Network Communication in Forest, Jungle and Open Dirt Road Environments.

In Wireless Sensor Networks which are deployed in remote and isolated tropical areas; such as forest; jungle; and open dirt road environments; wireless communications usually suffer heavily because of the environmental effects on vegetation; terrain; low antenna height; and distance. Therefore; to solve this problem; the Wireless Sensor Network communication links must be designed for their best performance using the suitable electromagnetic wave behavior model in a given environment. This study introduces and analyzes the behavior of the LoRa pathloss propagation model for signals that propagate at near ground or that have low transmitter and receiver antenna heights from the ground (less than 30 cm antenna height).

Pediatric Kidney Transplantation in Africa: A Case Report.

This case report shows the vital importance of vigilant observation of patients after transplant. In centers where ultrasonographs are not available, exploration of the patient may be necessary to salvage a precious kidney. In the patient reported here, who received a kidney transplant at St.

Large Deflections of Thin-Walled Plates under Transverse Loading-Investigation of the Generated In-Plane Stresses.

Thin-walled plates subjected to transverse loading undergoing large deflection have been the topic of a large number of studies. However, there is still a lack of information about the nature and the distribution membrane stresses generated under large deflections. The purpose of this paper is to calculate and display the distribution of the generated stresses and the respective deflections on the entire rectangular plate area.

A re-appraisal of the ENSO response to volcanism with paleoclimate data assimilation.

The potential for explosive volcanism to affect the El Niño-Southern Oscillation (ENSO) has been debated since the 1980s. Several observational studies, based largely on tree-ring proxies, have since found support for a positive ENSO phase in the year following large eruptions. In contrast, recent coral data from the heart of the tropical Pacific suggest no uniform ENSO response to explosive volcanism over the last millennium.

Durability of Response to Primary Chemoablation of Low-Grade Upper Tract Urothelial Carcinoma Using UGN-101, a Mitomycin-Containing Reverse Thermal Gel: OLYMPUS Trial Final Report.

Purpose: Our goal was to evaluate long-term safety and durability of response to UGN-101, a mitomycin-containing reverse thermal gel, as primary chemoablative treatment for low-grade upper tract urothelial carcinoma.

Materials And Methods: In this open-label, single-arm, multicenter, phase 3 trial (NCT02793128), patients ≥18 years of age with primary or recurrent biopsy-proven low-grade upper tract urothelial carcinoma received 6 once-weekly instillations of UGN-101 via retrograde catheter to the renal pelvis and calyces. Those with complete response (defined as negative ureteroscopic evaluation, negative cytology and negative for-cause biopsy) 4-6 weeks after the last instillation were eligible for up to 11 monthly maintenance instillations and were followed for ≥12 months with quarterly evaluation of response durability.

Globally resolved surface temperatures since the Last Glacial Maximum.

Climate changes across the past 24,000 years provide key insights into Earth system responses to external forcing. Climate model simulations and proxy data have independently allowed for study of this crucial interval; however, they have at times yielded disparate conclusions. Here, we leverage both types of information using paleoclimate data assimilation to produce the first proxy-constrained, full-field reanalysis of surface temperature change spanning the Last Glacial Maximum to present at 200-year resolution.

Evaluation of colon mucosa using screening colonoscopy and flexible spectral imaging color enhancement in patients with long lasting ulcerative colitis.

Aim: To determine which flexible spectral imaging color enhancement (FICE) channel best visualizes colon mucosa in ulcerative colitis (UC) and to compare FICE imaging with standard imaging.

Methods: The study enrolled patients with ulcerative colitis in remission who had inflammatory bowel disease for at least 8 years. All patients underwent screening colonoscopy.

Development of ex situ normothermic reperfusion as an innovative method to assess pancreases after preservation.

Static cold storage (SCS) is the standard method for pancreas preservation prior to transplantation; however, it does not permit organ assessment. Normothermic reperfusion (NR) is utilized clinically for other organs to assess viability. Our aim was to develop NR using normothermic machine perfusion technique to simulate reperfusion at the time of transplantation, enabling evaluation of oxygenated hypothermic machine perfusion (HMPO2) as a newer strategy to optimize pancreas preservation.

Prostate interventions in patients with mild haemophilia: Safe and feasible.

Introduction: To date, there is no specific recommendation or evaluation of the morbidity of prostate surgery in patients with haemophilia (PWH) although this surgery is common and at high risk of bleeding.

Aim: To assess the post-operative morbidity of benign prostate hyperplasia (BPH) surgeries and of oncological prostate interventions in patients with mild haemophilia A or B.

Methods: We performed a monocentre, epidemiological, in real life study.

Rate of mass loss from the Greenland Ice Sheet will exceed Holocene values this century.

The Greenland Ice Sheet (GIS) is losing mass at a high rate. Given the short-term nature of the observational record, it is difficult to assess the historical importance of this mass-loss trend. Unlike records of greenhouse gas concentrations and global temperature, in which observations have been merged with palaeoclimate datasets, there are no comparably long records for rates of GIS mass change.

Glacial cooling and climate sensitivity revisited.

The Last Glacial Maximum (LGM), one of the best studied palaeoclimatic intervals, offers an excellent opportunity to investigate how the climate system responds to changes in greenhouse gases and the cryosphere. Previous work has sought to constrain the magnitude and pattern of glacial cooling from palaeothermometers, but the uneven distribution of the proxies, as well as their uncertainties, has challenged the construction of a full-field view of the LGM climate state. Here we combine a large collection of geochemical proxies for sea surface temperature with an isotope-enabled climate model ensemble to produce a field reconstruction of LGM temperatures using data assimilation.

Atmospheric dynamics drive most interannual U.S. droughts over the last millennium.

The American West exemplifies drought-sensitive regions with growing populations. Paleoclimate investigations have documented severe droughts in this region before European settling, with major implications for water management and planning. Here, we leverage paleoclimate data assimilation to reconstruct past climate states, enabling a large-scale multivariate investigation of U.