The Growth and Decay of Intense GNSS Amplitude and Phase Scintillation During Non-Storm Conditions.

A multi-instrument study is conducted at the dayside polar ionosphere to investigate the spatio-temporal evolution of scintillation in Global Navigation Satellite System (GNSS) signals during non-storm conditions. Bursts of intense amplitude and phase scintillation started to occur at 9 MLT and persisted for more than 1 hour implying the simultaneous existence of Fresnel and large-scale sized irregularities of significant strength in the pre-noon sector. Measurements from the EISCAT radar in Svalbard (ESR) revealed the presence of dense plasma structures with significant gradients in regions of strong Joule heating/fast flows and soft precipitation when scintillation was enhanced.

Seven-Year Revision Rates for Cochlear Implants in Pediatric and Adult Populations of an Integrated Healthcare System.

Objective: We assessed three cochlear implant (CI) suppliers: Advanced Bionics, Cochlear Limited, and MED-EL, for implant revision requiring reoperation after CI placement.

Study Design: Retrospective cohort study of integrated-health-system database between 2010 and 2021. Separate models were created for pediatric (age <18) and adult (age ≥18) cohorts.

Disaggregating within- and between-person associations to test the aversive transmission of alcohol use in late adolescence through adulthood.

Objective: The theory of aversive transmission posits that children of parents who have an alcohol use disorder (AUD) may abstain or limit their own alcohol use because they believe themselves to be at risk of developing problems with alcohol. The present study examined relationships among parental AUD, perceived parental AUD, perceived risk for AUD, addiction avoidance reasons for limiting alcohol use, and alcohol use using a random intercept cross-lagged panel model.

Method: Participants ( = 805; 48% female; 28% Latinx) were from a longitudinal study investigating intergenerational transmission of AUD.

Future Exploration of the Outer Heliosphere and Very Local Interstellar Medium by Interstellar Probe.

A detailed overview of the knowledge gaps in our understanding of the heliospheric interaction with the largely unexplored Very Local Interstellar Medium (VLISM) are provided along with predictions of with the scientific discoveries that await. The new measurements required to make progress in this expanding frontier of space physics are discussed and include in-situ plasma and pick-up ion measurements throughout the heliosheath, direct sampling of the VLISM properties such as elemental and isotopic composition, densities, flows, and temperatures of neutral gas, dust and plasma, and remote energetic neutral atom (ENA) and Lyman-alpha (LYA) imaging from vantage points that can uniquely discern the heliospheric shape and bring new information on the interaction with interstellar hydrogen. The implementation of a pragmatic Interstellar Probe mission with a nominal design life to reach 375 Astronomical Units (au) with likely operation out to 550 au are reported as a result of a 4-year NASA funded mission study.

Large-Scale Traveling Atmospheric and Ionospheric Disturbances Observed in GUVI With Multi-Instrument Validations.

This study presents multi-instrument observations of persistent large-scale traveling ionosphere/atmospheric disturbances (LSTIDs/LSTADs) observed during moderately increased auroral electrojet activity and a sudden stratospheric warming in the polar winter hemisphere. The Global Ultraviolet Imager (GUVI), Gravity field and steady-state Ocean Circulation Explorer, Scanning Doppler Imaging Fabry-Perot Interferometers, and the Poker Flat Incoherent Scatter Radar are used to demonstrate the presence of LSTIDs/LSTADs between 19 UT and 5 UT on 18-19 January 2013 over the Alaska region down to lower midlatitudes. This study showcases the first use of GUVI for the study of LSTADs.

Localized mesospheric ozone destruction corresponding to isolated proton aurora coming from Earth's radiation belt.

Relativistic electron precipitation (REP) from the Earth's radiation belt plays an important role in mesospheric ozone loss as a connection between space weather and the climate system. However, the rapid (tens of minutes) destruction of mesospheric ozone directly caused by REP has remained poorly understood due to the difficulty of recognizing its location and duration. Here we show a compelling rapid correspondence between localized REP and ozone destruction during a specific auroral phenomenon, the called an isolated proton aurora (IPA).

Simultaneous Detection of Signatures of Conjugate Photoelectrons in the Ionosphere and Thermosphere.

We investigate the impact of conjugate photoelectrons (CPEs) on the topside (∼600 km altitude) ionosphere at low and midlatitudes using measurements of the ion temperature, density, and composition from the first Republic of China satellite during a period of the high to moderate solar activity (March 1999 to June 2004). Elevated ion temperatures and densities are observed in the dark Northern American-Atlantic sector during the December solstice and in the Australian sector during the June solstice. The oxygen ion fraction and density are also elevated at these locations.

Impact of September 2019 Antarctic Sudden Stratospheric Warming on Mid-Latitude Ionosphere and Thermosphere Over North America and Europe.

Limited observational evidence indicates that ionospheric changes caused by Arctic sudden stratospheric warmings (SSWs) occur at middle latitudes in the Southern Hemisphere. However, it is not known if a similar interhemispheric linkage is produced by Antarctic SSWs. Here we examine thermospheric and ionospheric anomalies observed in September 2019 at middle latitudes in the Northern Hemisphere.

Association of Sex With Risk of 2-Year Revision Among Patients Undergoing Total Hip Arthroplasty.

Importance: The worldwide population is aging and includes more female individuals than male individuals, with higher rates of total hip arthroplasty (THA) among female individuals. Although research on this topic has been limited to date, several studies are currently under way.

Objectives: To evaluate the association between sex and 2-year revision after THA.

Optimizing anterior cruciate ligament reconstruction: Individualizing the decision-making process using data from the Kaiser Permanente ACLR Registry: 2018 OREF award paper.

Despite years of study, controversy remains regarding the optimal graft for anterior cruciate ligament reconstruction (ACLR), suggesting that a single graft type is not ideal for all patients. A large community based ACLR Registry that collects prospective data is a powerful tool that captures information and can be analyzed to optimize surgery for individual patients. The studies highlighted in this paper were designed to optimize and individualize ACLR surgery and have led to changes in surgeon behavior and improvements in patient outcomes.

Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study.

Background: Metabolic acidosis is a major complication of critical illness. However, its current epidemiology and its treatment with sodium bicarbonate given to correct metabolic acidosis in the ICU are poorly understood.

Method: This was an international retrospective observational study in 18 ICUs in Australia, Japan, and Taiwan.

Origin and Distribution of Daytime Electron Density Irregularities in the Low-Latitude Region.

Electron density irregularities on the dayside in the low-latitude region are understood as remnants (or fossils) of nighttime plasma bubbles. We provide observational evidence of the connection of daytime irregularities to nighttime bubbles and the transport of the daytime irregularities by the vertical motion of the background ionosphere. The distributions of irregularities are derived using the measurements of the ion density by the first Republic of China satellite from March 1999 to June 2004.

Estimated Community Seroprevalence of SARS-CoV-2 Antibodies - Two Georgia Counties, April 28-May 3, 2020.

Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is ongoing in many communities throughout the United States. Although case-based and syndromic surveillance are critical for monitoring the pandemic, these systems rely on persons obtaining testing or reporting a COVID-19-like illness. Using serologic tests to detect the presence of SARS-CoV-2 antibodies is an adjunctive strategy that estimates the prevalence of past infection in a population.

The Benefits of National and Regional Arthroplasty Registries.

Since the first arthroplasty registries were established in the 1970s, they have become powerful tools in improving the efficiency of health care delivery and patient outcomes. As demonstrated over the past decades, registries can offer benefits not only to patients and surgeons but also to a variety of other stakeholders, such as hospitals, payers, and implant manufacturers. Registry data may be leveraged to address a variety of pressing concerns in the field of arthroplasty.

Unlocking Radiology Reporting Data: an Implementation of Synoptic Radiology Reporting in Low-Dose CT Cancer Screening.

Cancer Care Ontario (CCO) is the clinical advisor to the Ontario Ministry of Health and Long-Term Care for the funding and delivery of cancer services. Data contained in radiology reports are inaccessible for analysis without significant manual cost and effort. Synoptic reporting includes highly structured reporting and discrete data capture, which could unlock these data for clinical and evaluative purposes.

SCAI/ACVP expert consensus statement on cardiovascular catheterization laboratory economics: If the cath lab is your home you should understand its finances: This statement was endorsed by the Alliance of Cardiovascular Professionals (ACVP) in April 2019.

This article is intended for any physician, administrator, or cardiovascular catheterization laboratory (CCL) staff member who desires a fundamental understanding of finances and economics of CCLs in the United States. The authors' goal is to illuminate general economic principles of CCL operations and provide details that can be used immediately by CCL leaders. Any article on economics in medicine should start by acknowledging the primacy of the principles of medical ethics.

Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated malaria and prevalence of Pfk13 and Pfmdr1 polymorphisms after a decade of using artemisinin-based combination therapy in mainland Tanzania.

Background: The World Health Organization recommends regular therapeutic efficacy studies (TES) to monitor the performance of first and second-line anti-malarials. In 2016, efficacy and safety of artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria were assessed through a TES conducted between April and October 2016 at four sentinel sites of Kibaha, Mkuzi, Mlimba, and Ujiji in Tanzania. The study also assessed molecular markers of artemisinin and lumefantrine (partner drug) resistance.

Framework To Guide The Collection And Use Of Patient-Reported Outcome Measures In The Learning Healthcare System.

Background: Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed.

Methods: We identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation.

Patient demographic and surgical characteristics in anterior cruciate ligament reconstruction: a description of registries from six countries.

Objective: Findings from individual anterior cruciate ligament reconstruction (ACLR) registry studies are impactful, but how various registries from different countries compare with different patient populations and surgical techniques has not been described. We sought to describe six ACLR registry cohorts to understand variation across countries.

Methods: Five European registries and one US registry participated.

Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar.

Background: Mass drug administration (MDA) appears to be effective in reducing the risk of malaria parasitaemia. This study reports on programmatic coverage and compliance of MDA using artemisinin-based combination therapy (ACT) in four shehias (smallest administration unit) that had been identified as hotspots through Zanzibar's malaria case notification surveillance system.

Methods: Mass drug administration was done in four shehias selected on the basis of: being an established malaria hot spot; having had mass screening and treatment (MSaT) 2-6 weeks previously; and exceeding the epidemic alert threshold of 5 cases within a week even after MSaT.

Surveillance for sulfadoxine-pyrimethamine resistant malaria parasites in the Lake and Southern Zones, Tanzania, using pooling and next-generation sequencing.

Background: Malaria in pregnancy (MiP) remains a major public health challenge in areas of high malaria transmission. Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended to prevent the adverse consequences of MiP. The effectiveness of SP for IPTp may be reduced in areas where the dhps581 mutation (a key marker of high level SP resistance) is found; this mutation was previously reported to be common in the Tanga Region of northern Tanzania, but there are limited data from other areas.