Background: Self-injurious behaviours (SIB) are repetitive, non-accidental movements that result in physical damage inflicted upon oneself, without suicidal intent. SIB are prevalent among children with autism spectrum disorder and can lead to permanent disability or death. Neuromodulation at a locus of neural circuitry implicated in SIB, the nucleus accumbens (NAc), may directly influence these behaviours. Methods: We completed a phase I, open-label clinical trial of deep brain stimulation (DBS) of the NAc in children with severe, treatment-refractory SIB (ClinicalTrials.gov NCT03982888). Participants were monitored for 12 months following NAc-DBS to assess the primary outcomes of safety and feasibility. Secondary outcomes included serial assessments of SIB, ambulatory actigraphy, and changes in brain glucose metabolism induced by DBS. Results: Six children underwent NAc-DBS without any serious adverse events. NAc-DBS resulted in significant reductions in SIB and SIB-associated behaviours across multiple standardized scales, concurrent with clinically meaningful improvements in quality-of-life. Ambulatory actigraphy showed reductions in high-amplitude limb movements and positron emission tomography revealed treatment-induced reductions in metabolic activity within the thalamus, striatum, and temporoinsular cortex. Conclusions: This first-in-children phase 1 clinical trial demonstrates the safety and feasibility of NAc-DBS in children with severe, refractory SIB at high risk of physical injury and death and supports further investigations.

In scientific collaborations, technologies have broadened access to scarce scientific and engineering resources. While broader access is often applauded, little attention has been focused on the problem of efficient and equitable resource allocation. This paper presents laboratory experiments designed to compare different allocation mechanisms for access to joint research facilities. Specifically, we study the Vickrey-Clarke-Groves (VCG) auction, a simultaneous ascending auction (the Resource Allocation Design, RAD), and a mechanism based on submitted rankings (Knapsack). Experimental results show that RAD and VCG are both more efficient than Knapsack, while Knapsack achieves a more equal distribution of resources than RAD or VCG. The findings highlight the need for systematic exploration of allocation mechanisms within collaboratories.

Earth System Science stands as the future operating framework to monitor the pulse of the Earth, and to diagnose and address the challenges of global change. Magmatism and volcanism are primary processes connecting the solid Earth to the atmosphere, hydrosphere, and biosphere. In addition to regulating the Earth system, they are both an unavoidable source of hazards and a tremendous resource of energy and raw materials. Accessing magma is the necessary next step in the exploration of our planet. It will enable us to develop next-generation geothermal energy (magma energy), to transform volcano monitoring strategies, and perhaps even to alleviate volcanic activity. Recent exploratory geothermal drilling activities around the world have serendipitously encountered shallow magma bodies in the Earth. Following these remarkable magma drilling occurrences, the Krafla Magma Testbed (KMT) has been established in Iceland in order to create the first magma observatory – a world-class international in situ magma laboratory with access to the magma-rock-hydrothermal boundary through wells suitable for advanced studies and experiments. Here we review the importance of magma in the Earth system, present the multifaceted need for magma observatories and introduce the benefits of KMT as we enter a new generation of energy demands and resilience strategies.

Scholarly and practitioner interest in authentic leadership has grown at an accelerating rate over the last decade, resulting in a proliferation of publications across diverse social science disciplines. Accompanying this interest has been criticism of authentic leadership theory and the methods used to explore it. We conducted a systematic review of 303 scholarly articles published from 2010 to 2023 to critically assess the conceptual and empirical strengths and limitations of this literature and map the nomological network of the authentic leadership construct. Results indicate that much of the extant research does not follow best practices in terms of research design and analysis. Based on the findings obtained, an agenda for advancing authentic leadership theory and research that embraces a signaling theory perspective is proposed.

This study investigates the influence of suspended kelp farms on ocean mixed layer hydrodynamics in the presence of currents and waves. We use the large eddy simulation method, where the wave effect is incorporated by solving the wave-averaged equations. Distinct Langmuir circulation patterns are generated within various suspended farm configurations, including horizontally uniform kelp blocks and spaced kelp rows. Intensified turbulence arises from the farm-generated Langmuir circulation, as opposed to the standard Langmuir turbulence observed without a farm. The creation of Langmuir circulation within the farm is attributed to two primary factors depending on farm configuration: (i) enhanced vertical shear due to kelp frond area density variability, and (ii) enhanced lateral shear due to canopy discontinuity at lateral edges of spaced rows. Both enhanced vertical and lateral shear of streamwise velocity, representing the lateral and vertical vorticity components, respectively, can be tilted into downstream vorticity to create Langmuir circulation. This vorticity tilting is driven by the Craik–Leibovich vortex force associated with the Stokes drift of surface gravity waves. In addition to the farm-generated Langmuir turbulence, canopy shear layer turbulence is created at the farm bottom edge due to drag discontinuity. The intensity of different types of turbulence depends on both kelp frond area density and the geometric configuration of the farm. The farm-generated turbulence has substantial consequences for nutrient supply and kelp growth. These findings also underscore the significance of the presence of obstacle structures in modifying ocean mixed layer characteristics.

Tight focusing with very small f-numbers is necessary to achieve the highest at-focus irradiances. However, tight focusing imposes strong demands on precise target positioning in-focus to achieve the highest on-target irradiance. We describe several near-infrared, visible, ultraviolet and soft and hard X-ray diagnostics employed in a ∼1022 W/cm2 laser–plasma experiment. We used nearly 10 J total energy femtosecond laser pulses focused into an approximately 1.3-μm focal spot on 5–20 μm thick stainless-steel targets. We discuss the applicability of these diagnostics to determine the best in-focus target position with approximately 5 μm accuracy (i.e., around half of the short Rayleigh length) and show that several diagnostics (in particular, 3$\omega$ reflection and on-axis hard X-rays) can ensure this accuracy. We demonstrated target positioning within several micrometers from the focus, ensuring over 80% of the ideal peak laser intensity on-target. Our approach is relatively fast (it requires 10–20 laser shots) and does not rely on the coincidence of low-power and high-power focal planes.

Oral anticoagulation (OAC) prevents stroke in atrial fibrillation, yet a residual stroke risk remains. In this single-center retrospective analysis of acute ischemic stroke patients despite OAC, suboptimal OAC treatment is common (30%: inappropriate dosing (17%); patient non-adherence (13%)). Other causes of stroke included OAC interruption (14.5%), a competing stroke mechanism (11.0%), and undetermined breakthrough stroke in 44.5%. Overall, easily modifiable causes of ischemic stroke despite OAC are common. Accordingly, strategies to improve treatment compliance, including appropriate dosing along with guideline-based risk factor and periprocedural OAC management, should be emphasized to improve secondary stroke prevention in this patient population.

In the search for rare earth and other critical elements in coal measures, the coals are emphasized with lesser consideration for the accompanying rocks. In this investigation, the focus is on a lanthanide-rich, 315–317 Ma (after Machlus et al., Chemical Geology, 539, art. no. 119485, 2020) volcanic ash-fall trachyandesite to trachyte tonstein which occurs in association with the Middle Pennsylvanian Duckmantian-age Fire Clay coal in eastern Kentucky. The tonstein was deposited largely during peat accumulation, although it is known to occur at the base of the coal or within the underclay. The mineralogy is dominated by kaolinite with illite and quartz as minor to major minerals. A number of accessory minerals, as detected by X-ray diffraction + Siroquant XRD software and scanning and transmission electron microscopy (S/TEM), include REE-bearing phosphates (apatite, crandallite, florencite, monazite), and Y-bearing zircon. The highest rare earth element + Y concentrations occur in the weathered tonsteins, probably due to the concentration of these minerals after weathering of kaolinite from the rock.

We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.

Background: Women continue to represent a minority of the neurosurgery workforce in Canada. We herein aim to provide an update of the current Canadian landscape to gain a better understanding of the factors contributing to this disparity. Methods: Chain-referral sampling, interviews, personal communications, and online resources were used as data sources. Online survey results obtained from women attending neurosurgeons across Canada were also utilized. Quantitative analyses were performed, including summary and comparative statistics. Qualitative analyses of free-text responses were performed using axial and open coding. Results: We observe a positive trend in the incoming and graduating of female residents across the country, although this trend is lagging compared to other surgical specialties. The proportion of women in active practice remains low. Positive enabling factors for success include supportive colleagues and work environment (52.6%), academic accomplishments (36.8%), and advanced fellowship training (47.4%). Perceived barriers reported included inequalities regarding career advancement opportunities (57.8%), conflicting professional and personal interests (57.8%), and lack of mentorship (36.8%). Conclusions: Women continue to represent a small proportion of practicing neurosurgeons across Canada. Our work highlights several key factors contributing to the low representation of women in neurosurgery and identifies actionable items that can be addressed by training programs and institutions.

Background: Status dystonicus (SD) is a life-threatening form of dystonia with limited treatments available. We sought to better understand the processes, outcomes, and complications of deep brain stimulation (DBS) for pediatric SD through a systematic review alongside an institutional case series. Methods: Data regarding treatment, stimulation parameters, dystonia severity and outcomes was collected for the case series (n=7) and systematic review (n=70, conducted in accordance with PRISMA guidelines). This was analysed descriptively (rates, outcome measures). For the case series we created probabilistic voxel-wise maps for improvement in dystonia based on brain region stimulated. Results: All patients in our case series and > 95% of patients in the systematic review had resolution of SD with DBS, typically within 2-4 weeks. Most patients in the review (84%) and all patients in the case series had DBS implanted to the globus pallidus internus. In terms of dystonia severity scores, there was a mean improvement of 25% (case series) or 49% (systematic review). Reported mortality was 4% in the systematic review. Conclusions: DBS for pediatric SD is feasible and safe. It allows for increased survival as well as quality of life - however risks still exist. More work is needed to determine timing, eligibility, and stimulation parameters.

This paper studied the use of eye movement data to form criteria for judging whether pilots perceive emergency information such as cockpit warnings. In the experiment, 12 subjects randomly encountered different warning information while flying a simulated helicopter, and their eye movement data were collected synchronously. Firstly, the importance of the eye movement features was calculated by ANOVA (analysis of variance). According to the sorting of the importance and the Euclidean distance of each eye movement feature, the warning information samples with different eye movement features were obtained. Secondly, the residual shrinkage network modules were added to CNN (convolutional neural network) to construct a DRSN (deep residual shrinkage networks) model. Finally, the processed warning information samples were used to train and test the DRSN model. In order to verify the superiority of this method, the DRSN model was compared with three machine learning models, namely SVM (support vector machine), RF (radom forest) and BPNN (backpropagation neural network). Among the four models, the DRSN model performed the best. When all eye movement features were selected, this model detected pilot perception of warning information with an average accuracy of 90.4%, of which the highest detection accuracy reached 96.4%. Experiments showed that the DRSN model had advantages in detecting pilot perception of warning information.

We used a self-reporting system to compare symptom frequency of hospital personnel with coronavirus disease 2019 before and after the emergence of the Omicron variant. Omicron was more likely to result in asymptomatic carriage (7% vs 12%; P = .009), and fewer symptoms were observed in those with booster vaccination.