The accumulation area ratio (AAR) of a glacier reflects its current state of equilibrium, or disequilibrium, with climate and its vulnerability to future climate change. Here, we present an inventory of glacier-specific annual accumulation areas and equilibrium line altitudes (ELAs) for over 3000 glaciers in Alaska and northwest Canada (88% of the regional glacier area) from 2018 to 2022 derived from Sentinel-2 imagery. We find that the 5 year average AAR of the entire study area is 0.41, with an inter-annual range of 0.25–0.49. More than 1000 glaciers, representing 8% of the investigated glacier area, were found to have effectively no accumulation area. Summer temperature and winter precipitation from ERA5-Land explained nearly 50% of the inter-annual ELA variability across the entire study region (${R}^2=0.47$). An analysis of future climate scenarios (SSP2-4.5) projects that ELAs will rise by ∼170 m on average by the end of the 21st century. Such changes would result in a loss of 25% of the modern accumulation area, leaving a total of 1900 glaciers (22% of the investigated area) with no accumulation area. These results highlight the current state of glacier disequilibrium with modern climate, as well as glacier vulnerability to projected future warming.

We propose a physics-constrained convolutional neural network (PC-CNN) to solve two types of inverse problems in partial differential equations (PDEs), which are nonlinear and vary both in space and time. In the first inverse problem, we are given data that is offset by spatially varying systematic error (i.e., the bias, also known as the epistemic uncertainty). The task is to uncover the true state, which is the solution of the PDE, from the biased data. In the second inverse problem, we are given sparse information on the solution of a PDE. The task is to reconstruct the solution in space with high resolution. First, we present the PC-CNN, which constrains the PDE with a time-windowing scheme to handle sequential data. Second, we analyze the performance of the PC-CNN to uncover solutions from biased data. We analyze both linear and nonlinear convection-diffusion equations, and the Navier–Stokes equations, which govern the spatiotemporally chaotic dynamics of turbulent flows. We find that the PC-CNN correctly recovers the true solution for a variety of biases, which are parameterized as non-convex functions. Third, we analyze the performance of the PC-CNN for reconstructing solutions from sparse information for the turbulent flow. We reconstruct the spatiotemporal chaotic solution on a high-resolution grid from only 1% of the information contained in it. For both tasks, we further analyze the Navier–Stokes solutions. We find that the inferred solutions have a physical spectral energy content, whereas traditional methods, such as interpolation, do not. This work opens opportunities for solving inverse problems with partial differential equations.

Glacier fragmentation involves the detachment of tributary glaciers from the main glacier trunk and their subsequent fragmentation into smaller units. This reconfiguration, in turn, can lead to a redistribution of stresses and strain rates affecting the dynamics of the glacier. In our study, we examined changes in the frontal position and surface velocity of Bertacchi and Upsala Glaciers using Sentinel-1 derived velocity fields and orthoimages, covering the period between January 2015 and January 2023. Comparison of these results with bed topography and ice thickness datasets indicates that the Bertacchi tributary glacier acted as a strong lateral pinning point for the main flow unit from 2015 to 2018. This slowed its retreat rate to −6 ± 2.5 ma−1 despite the high surface velocity (1825 ± 11 ma−1) and buoyancy conditions. However, the loss of this pinning point in early 2019 led to accelerated retreat rates (−325 ± 2.5 ma−1) of the western tongue of Upsala Glacier, even though it retreated over a shallow bed and the surface velocity was 45% lower than previous. This retreat was synchronous with the advance of Bertacchi terminus (15 ± 2.5 ma−1), suggesting a reduction in the resistive stresses experienced by this glacier following unpinning.

Where and under what conditions the transfer of energy between electromagnetic fields and particles takes place in the solar wind remains an open question. We investigate the conditions that promote the growth of kinetic instabilities predicted by linear theory to infer how turbulence and temperature-anisotropy-driven instabilities are interrelated. Using a large dataset from Solar Orbiter, we introduce the radial rate of strain, a novel measure computed from single-spacecraft data, which we interpret as a proxy for the double-adiabatic strain rate. The solar wind exhibits high absolute values of the radial rate of strain at locations with large temperature anisotropy. We measure the kurtosis and skewness of the radial rate of strain from the statistical moments to show that it is non-Gaussian for unstable intervals and increasingly intermittent at smaller scales with a power-law scaling. We conclude that the velocity field fluctuations in the solar wind contribute to the presence of temperature anisotropy sufficient to create potentially unstable conditions.

Free normal-flow (NF) conditions at the plasma boundary are shown to be essential for three-dimensional magnetohydrodynamic (MHD) simulations to agree with linear stability theory. A comparative verification study is presented between two different formulations of the boundary conditions (BCs) for velocity perturbations: (i) fully consistent free NF implementation and (ii) fixed NF formulation, neglecting flow perturbations at the numerical boundary. Numerical results are compared with consolidated figures of merit from the linear theory of external kink modes. We consider two classes of initial equilibria presenting different numerical challenges: a uniform current channel surrounded by pure vacuum and a shaped Wesson-like equilibrium, with smooth (polynomial) radial dependency. Only the fully consistent free NF formulation is invariably accurate in modelling the plasma interface at the numerical boundary, without the need of enforcing a pseudovacuum region at the edge of the simulation domain, as in most analogous past studies. This study employs the cylindrical code SPECYL (Cappello & Biskamp, Nucl. Fusion, vol. 36, no. 5, 1996, p. 571) that solves a full-MHD model without pressure gradients, whose fully consistent resistive wall module with free NF BCs was recently successfully verified against the independent code PIXIE3D (Spinicci et al., AIP Adv., vol. 13, no. 9, 2023, p. 095111).

Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity of clinical and translational science, diminishes uptake of innovations into practice, and restricts access to the potential benefits of participation. Despite efforts to increase diversity in clinical trials, children and adults from Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, and tools demonstrate promise in enhancing recruitment and enrollment in clinical trials. To demonstrate this promise, we draw upon our team’s experience conducting a randomized clinical trial that tests three behavioral interventions designed to promote equity in language and social-emotional skill acquisition among Latino parent–infant dyads from under-resourced communities. The recruitment activities took place during the COVID-19 pandemic, which intensified the need for responsive strategies and procedures. We used the Model for Improvement to achieve our recruitment goals. Across study stages, we engaged strategies such as (1) intentional team formation, (2) participatory approaches to setting goals, monitoring achievement, selecting change strategies, and (3) small iterative tests that informed additional efforts. These strategies helped our team overcome several barriers. These strategies may help other researchers apply quality improvement tools to increase participation in clinical and translational research among people from minoritized groups.

This position paper by the international IMMERSE consortium reviews the evidence of a digital mental health solution based on Experience Sampling Methodology (ESM) for advancing person-centered mental health care and outlines a research agenda for implementing innovative digital mental health tools into routine clinical practice. ESM is a structured diary technique recording real-time self-report data about the current mental state using a mobile application. We will review how ESM may contribute to (1) service user engagement and empowerment, (2) self-management and recovery, (3) goal direction in clinical assessment and management of care, and (4) shared decision-making. However, despite the evidence demonstrating the value of ESM-based approaches in enhancing person-centered mental health care, it is hardly integrated into clinical practice. Therefore, we propose a global research agenda for implementing ESM in routine mental health care addressing six key challenges: (1) the motivation and ability of service users to adhere to the ESM monitoring, reporting and feedback, (2) the motivation and competence of clinicians in routine healthcare delivery settings to integrate ESM in the workflow, (3) the technical requirements and (4) governance requirements for integrating these data in the clinical workflow, (5) the financial and competence related resources related to IT-infrastructure and clinician time, and (6) implementation studies that build the evidence-base. While focused on ESM, the research agenda holds broader implications for implementing digital innovations in mental health. This paper calls for a shift in focus from developing new digital interventions to overcoming implementation barriers, essential for achieving a true transformation toward person-centered care in mental health.

Due to the importance of clay minerals in metal sorption, many studies have attempted to derive mechanistic models that describe adsorption processes. These models often include several different types of adsorption sites, including permanent charge sites and silanol and aluminol functional groups on the edges of clay minerals. To provide a basis for development of adsorption models it is critical that molecular-level studies be done to characterize sorption processes. In this study we conducted X-ray absorption fine structure (XAFS) and electron paramagnetic resonance (EPR) spectroscopic experiments on copper (II) sorbed on smectite clays using suspension pH and ionic strength as variables. At low ionic strength, results suggest that Cu is sorbing in the interlayers and maintains its hydration sphere. At high ionic strength, Cu atoms are excluded from the interlayer and sorb primarily on the silanol and aluminol functional groups of the montmorillonite or beidellite structures. Interpretation of the XAFS and EPR spectroscopy results provides evidence that multinuclear complexes are forming. Fitting of extended X-ray absorption fine structure spectra revealed that the Cu-Cu atoms in the multinuclear complexes are 2.65 Å apart, and have coordination numbers near one. This structural information suggests that small Cu dimers are sorbing on the surface. These complexes are consistent with observed sorption on mica and amorphous silicon dioxide, yet are inconsistent with previous spectroscopic results for Cu sorption on montmorillonite. The results reported in this paper provide mechanistic data that will be valuable for modeling surface interactions of Cu with clay minerals, and predicting the geochemical cycling of Cu in the environment.

For more than forty years, The Clay Minerals Society has dispensed a set of source clays which have enabled a large number of researchers to work on similar materials. Many of these source clays remained unchanged over the years but, conversely, other clays have gone out of stock and thus were replaced. This was the fate of montmorillonite STx-1a, which was replaced by STx-1b. Although STx-1a and STx-1b share many basic chemical and mineralogical features, some minor differences exist that can affect behavior. A baseline characterization of the source clay STx-1b, which was the objective of this study, was, therefore, necessary to provide researchers a tool useful not only for new investigation but also to compare new results obtained on STx-1b with literature data on STx-1a. This characterization was gained using traditional and advanced methods that included: 1) chemical composition (major and trace elements); 2) cation exchange capacity determination; 3) thermal analyses coupled with evolved gas mass spectrometry; 4) quantitative mineralogical characterization using powder X-ray diffraction and Rietveld- RIR (Reference Intensity Ratio) refinement; 5) X-ray absorption spectroscopy at the Fe K-edge; 6) diffuse reflectance ultraviolet-visible and infrared spectroscopies; and 7) 29Si, 27Al, and 1H magic-angle spinning nuclear magnetic resonance measurements. According to this multi-analytical approach, the chemical formula for STx-1b is [4](Si7.753Al0.247) [6](Al3.281Mg0.558Fe0.136Ti0.024Mn0.002) [12](Ca0.341Na0.039 K0.061)O20(OH)4.

Adolescent men who have sex with men (AMSM) and transgender women (ATGW) enrolled as part of the PrEP1519 study between April 2019 and February 2021 in Salvador were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections.We performed real-time polymerase chain reaction using oropharyngeal, anal, and urethral swabs; assessed factors associated with NG and CT infections using multivariable Poisson regression analysis with robust variance; and estimated the prevalence ratios (PRs) and 95% confidence intervals (95% CIs). In total, 246 participants were included in the analyses (median age: 18.8; IQR: 18.2–19.4 years). The overall oropharyngeal, anal, and urethral prevalence rates of NG were 17.9%, 9.4%, 7.6%, and 1.9%, respectively. For CT, the overall, oropharyngeal, anal, and urethral prevalence rates were 5.9%, 1.2%, 2.4%, and 1.9%, respectively. A low level of education, clinical suspicion of STI (and coinfection with Mycoplasma hominis were associated with NG infection. The prevalence of NG and CT, especially extragenital infections, was high in AMSM and ATGW. These findings highlight the need for testing samples from multiple anatomical sites among adolescents at a higher risk of STI acquisition, implementation of school-based strategies, provision of sexual health education, and reduction in barriers to care.

Background: The CDC recommends a public health response when novel and targeted multidrug-resistant organisms (nMDROs), such as carbapenem-resistant organisms or Candida auris, are identified in healthcare settings in nonendemic areas. nMDRO responses are supported by healthcare-associated infection-antimicrobial resistance programs in 50 state and 6 local and territorial health departments. Annually, health departments report nMDRO responses to the CDC. We summarize nMDRO responses nationally and report our assessment of colonization screening positivity rates by healthcare setting and pathogen. Methods: We analyzed nMDRO response data reported by health departments for the period August 2019–July 2021; we excluded prevention efforts (ie, widespread screening based on facility-level risk factors). Among nMDRO responses in which colonization screening was performed, we calculated the proportion of responses in which screening detected additional cases of the index nMDRO and the colonization screening positivity, by healthcare setting and pathogen. Results: Among 2,051 nMDRO responses, 732 (36%) had ≥1 colonization screening (representing 44,845 colonization screenings), of which 24 (representing 17,467 colonization screenings) were prevention efforts and were excluded. Among the remaining 708 nMDRO responses, the healthcare setting most frequently included was acute-care hospitals (ACHs; 337 of 708, 48%); the least frequently included was long-term ACHs (LTACHs; 83 of 708, 12%). Carbapenem-resistant Enterobacterales were the most common index nMDRO prompting a response (408 of 708, 58%). Screening identified additional cases of the index nMDRO in 248 responses (35%) and 2,378 (9%) of 27,378 colonization screenings. Identification of the index nMDRO varied by pathogen and setting (Fig. 1). Overall, ventilator-capable skilled nursing facilities (vSNFs) were the facility type in which colonization screening most frequently identified additional cases of the index nMDRO (63 of 92 responses, 63%), and LTACHs had the highest colonization screening positivity (750 of 5,798, 13%). Similar colonization screening positivity was observed in ACHs (9%) and vSNFs (8%). On average, Candida auris and carbapenem-resistant Acinetobacter baumannii (CRAB) had the highest colonization screening positivity rates across all healthcare settings: CRAB, 493 (12.6%) of 3,907 screened; Candida auris, 1,344 (11.7%) of 11,466 screened (Fig. 1B). More than one-half of responses identified ≥1 case of the index nMDRO. Conclusions: During public health nMDRO responses, additional cases were regularly identified through colonization screening. Responses in vSNFs and LTACHs and to environmental pathogens like Candida auris and CRAB detected additional cases in more than one-half of responses, suggesting that spread commonly occurred prior to detection of the first clinical case. The use of colonization screening is an effective strategy to detect unidentified nMDRO colonization, especially in high-acuity postacute-care settings.

Disclosures: None

The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken. This resulted in 18 triage, eight life support and damage control interventions, and 23 process consensus statements. These findings will be utilized in the development of evidence-based prehospital mass-casualty incident response tools and guidelines.

Environmental control strategies are commonly practised to limit biodeterioration issues threatening indoor cultural heritage objects, while they are still poorly exploited for the conservation of outdoor stone heritage surfaces, including rock art. In this study, we evaluated the environmental factors driving the diversity and abundance of lithobiontic communities in the Rock Engravings National Park of Naquane (UNESCO WHS n. 94, Italy). The survey considered 23 rocks that had been cleaned in the last three (3YC) or twelve (12YC) years or more than 40 years ago (NRC). A cyanobacteria-dominated biofilm and lichens (37 taxa) were the most widespread and abundant lithobiontic components, prevailing on 3YC–12YC and NRC rocks, respectively. On the latter, a turnover of xerophytic and meso-hygrophytic lichen communities was observed. On 3YC–12YC rocks lichen colonization, if present, was limited to nitrophytic species, including common epiphytes from surrounding trees and a small number of meso-hygrophytic species, with a prevalence of asexual reproductive strategies. Multivariate analyses including environmental parameters (canonical correspondence analyses) indicated that tree cover and the presence of bare or vegetated ground upstream of the rocks, probably prolonging wetness and providing nutrients by water transport, are the factors mostly related to the microbial and lichen recolonization of 3YC–12YC surfaces. On this basis, an experiment on preventive conservation was conducted, consisting of a new cleaning of a strongly recolonized 3YC surface combined with the building of a small wall to protect part of the rock from prolonged water fluxes. The fluorimetric and colorimetric monitoring of the rock surface, carried out 40 months after this new cleaning intervention, displayed recolonization on the unprotected area only, indicating the potential of preventive conservation strategies in outdoor environments.