The increase in iceberg discharge into the polar oceans highlights the importance of understanding how quickly icebergs are deteriorating and where the resulting freshwater injection is occurring. Recent advances in quantifying iceberg deterioration through combinations of modeling, remote sensing and direct in situ measurements have successfully calculated overall ablation rates, and surface and sidewall ablation; however, in situ measurements of basal melt rates have been difficult to obtain. Radar has successfully measured iceberg thickness, but repeat measurements, which would capture a change in iceberg thickness with time, have not yet been collected. Here we test the applicability of using an on-iceberg autonomous phase-sensitive radar (ApRES) to quantify basal ablation rates of a large (~800 m long) non-tabular Arctic iceberg during an intensive 2019 summer field campaign in Sermilik Fjord, southeast Greenland. We find that ApRES can be used to measure basal ablation even over a short deployment period (10 d), and also provide a lower bound on sidewall melt. This study fills a critical gap in iceberg research and pushes the limits of field instrumentation.

Carbapenamase-producing carbapenem-resistant Enterobacterales (CP-CRE) is an urgent public health threat for healthcare facilities. Solid organ transplant (SOT) recipients carry an increased risk for CRE infection and colonization due to prolonged exposures to antimicrobials, healthcare facilities and immunosuppression. CRE infection in SOT patients is associated with an increase in morbidity and mortality. Here, we describe a hospital outbreak investigation of three cases of New Delhi metallo-beta-lactamase (NDM) - CRE that led to novel findings with implications for further interdisciplinary investigations. An NDM-CRE infection in a critically-ill patient was identified during passive surveillance and prompted an investigation. Previous CP-CRE passive surveillance cases were reviewed. Rectal screening was performed for potentially exposed patients. 403 rectal swabs were tested for carbapenemase genes in active surveillance. Patients identified to have a new NDM-CRE isolate on active or passive surveillance were considered cases and underwent in-depth chart review including possible patient-to-patient exposures, hospital locations, procedures, devices, and consultations. NDM-CRE isolates were sent to the Minnesota Department of Health (MDH) for whole genome sequencing (WGS) to assess relatedness. Five NDM-CRE cases were identified, with all isolates harboring blaNDM including three NDM-Klebsiella pneumoniae (NDM-KP) cases (Figure 1). The first NDM-KP case, patient 1, developed mediastinal infection following lung transplantation. Review of United Network for Organ Sharing revealed that respiratory specimens from patient 1’s donor grew NDM-KP and a bronchial wash at the time of transplant yielded NDM-KP. The second NDM-KP case (patient 3) developed ventilator-associated pneumonia and was found to have used sequentially the same ventilator as patient 1. The third NDM-KP case (patient 4) was detected via rectal swab in active surveillance and shared wound care personnel in common with patients 1 and 3 (Figure 2). WGS demonstrated two single nucleotide polymorphisms (SNP) among all three isolates, strongly suggesting relatedness (Figure 3). Best practices for infection prevention were reviewed with wound care personnel. To date, no further NDM-KP isolates have been identified. Investigation was facilitated by in-depth chart review and WGS via the Central Region Antimicrobial Resistance Laboratory Network at MDH. Detection of the NDM-KP from a lung donor specimen appears genetically linked to clinical isolates in other patients, raising the possibility of a donor-derived hospital outbreak. This investigation is the first to describe a donor-derived NDM outbreak in a healthcare facility. Communication between organ procurement agencies, transplant centers, and infection prevention must be optimized to prevent CRE-associated morbidity in SOT receipts and CRE hospital outbreaks.

Background: Chordomas are rare, malignant bone tumors that present significant challenges in management and treatment due to their complex anatomical locations and propensity for recurrence. Advancements in artificial intelligence (AI) and machine learning (ML) show promise in improving chordoma management. Methods: A comprehensive literature search was conducted following PRISMA guidelines across multiple databases, including MEDLINE, Cochrane, Embase, Scopus, and Web of Science. The search targeted articles related to AI and ML applications in clinical tasks associated with chordoma management. The selection process involved systematic screening, data extraction, and assessment of inter-rater variability. Results: The search yielded 1,006 records, with 18 included for analysis. Convolutional neural networks (CNNs) excelled in tumor volume estimation, with the state-of-the-art model achieving a Dice similarity score of 74.2%, sensitivity of 79.4%, and positive predictive value of 74.3%. Clustering algorithms were effective in prognostic evaluations. Bayesian models and logistic regression demonstrated robustness in diagnostics. Support vector machines (SVMs) were noted for their diagnostic precision. Conclusions: AI and ML algorithms, particularly CNNs, clustering algorithms, Bayesian models, logistic regression, and SVMs, show promise in improving chordoma management through enhanced imaging, diagnostics, and prognostics. Future research should focus on larger, externally validated datasets and explore underutilized techniques like multi-modal data integration.

We present the first systematic inventory of surge-type glaciers for the whole of Greenland compiled from published datasets and multitemporal satellite images and digital elevation models. The inventory allows us to define the spatial and climatic distribution of surge-type glaciers and to analyse the timing of surges from 1985 to 2019. We identified 274 surge-type glaciers, an increase of 37% compared to previous work. Mapping surge-type glacier distribution by temperature and precipitation variables derived from ERA5-Land reanalysis data shows that the west and east clusters occur in well-defined climatic envelopes. Analysis of the timing of surge active phases during the periods ~1985 to 2000 (T1) and ~2000 to 2019 (T2) suggests that overall surge activity is similar in T1 and T2, but there appears to be a reduction in surging in the west cluster in T2. Our climate analysis shows a coincident increase in mean annual and mean winter air temperature between T1 and T2. We suggest that as glaciers thin under current warming, some surge-type glaciers in the west cluster may be being prevented from surging due to (1) their inability to build-up sufficient mass and (2) a switch from a polythermal to a largely cold-based thermal regime.

Many organisms live in fragmented populations, which has profound consequences on the dynamics of associated parasites. Metapopulation theory offers a canonical framework for predicting the effects of fragmentation on spatiotemporal host–parasite dynamics. However, empirical studies of parasites in classical metapopulations remain rare, particularly for vector-borne parasites. Here, we quantify spatiotemporal patterns and possible drivers of infection probability for several ectoparasites (fleas, Ixodes trianguliceps and Ixodes ricinus) and vector-borne microparasites (Babesia microti, Bartonella spp., Hepatozoon spp.) in a classically functioning metapopulation of water vole hosts. Results suggest that the relative importance of vector or host dynamics on microparasite infection probabilities is related to parasite life-histories. Bartonella, a microparasite with a fast life-history, was positively associated with both host and vector abundances at several spatial and temporal scales. In contrast, B. microti, a tick-borne parasite with a slow life-history, was only associated with vector dynamics. Further, we provide evidence that life-history shaped parasite dynamics, including occupancy and colonization rates, in the metapopulation. Lastly, our findings were consistent with the hypothesis that landscape connectivity was determined by distance-based dispersal of the focal hosts. We provide essential empirical evidence that contributes to the development of a comprehensive theory of metapopulation processes of vector-borne parasites.

Background: Meningiomas are the most common intracranial tumor, graded from 1 (benign) to 3 (malignant). The aim of this study was to identify clinical features associated with overall survival (OS), progression-free survival (PFS) and functional status for malignant meningiomas. Methods: Demographic, clinical and histopathological data from grade 3 intracranial meningioma cases were identified in the clinical databases from seven sites in North America and Europe from 1991-2022. Summary statistics and Kaplan-Meier OS and PFS curves were generated. Results: We identified 108 patients, with a median age 65 years (IQR: 52, 72) and 53.7% were female. Median OS was 109 months (95% CIs: 88, 227), and 5-year OS rate was 65% (95% CIs: 56, 76). Median PFS was 38 months (95% CIs: 24, 56) and 5-year PFS rate was 37% (95% CIs: 28, 49). OS and PFS were significantly lower in patients aged ≥65 years. Median preoperative KPS score was 80 (IQR: 70, 90), postoperatively KPS was 90 (IQR: 70, 98) and 1-year follow-up KPS was 70 (IQR: 50, 80). Conclusions: This study provides robust survival, recurrence and functional data for grade 3 meningiomas in North America and Europe over a 30-year period.

Frontal ablation, the combination of submarine melting and iceberg calving, changes the geometry of a glacier's terminus, influencing glacier dynamics, the fate of upwelling plumes and the distribution of submarine meltwater input into the ocean. Directly observing frontal ablation and terminus morphology below the waterline is difficult, however, limiting our understanding of these coupled ice–ocean processes. To investigate the evolution of a tidewater glacier's submarine terminus, we combine 3-D multibeam point clouds of the subsurface ice face at LeConte Glacier, Alaska, with concurrent observations of environmental conditions during three field campaigns between 2016 and 2018. We observe terminus morphology that was predominately overcut (52% in August 2016, 63% in May 2017 and 74% in September 2018), accompanied by high multibeam sonar-derived melt rates (4.84 m d−1 in 2016, 1.13 m d−1 in 2017 and 1.85 m d−1 in 2018). We find that periods of high subglacial discharge lead to localized undercut discharge outlets, but adjacent to these outlets the terminus maintains significantly overcut geometry, with an ice ramp that protrudes 75 m into the fjord in 2017 and 125 m in 2018. Our data challenge the assumption that tidewater glacier termini are largely undercut during periods of high submarine melting.

Limited scientific literature is available for developing ‘best practice’ guidelines for the management of dairy goats (Capra hircus), particularly goat kids. Disbudding practices for kids and calves appear to be similar; however, it is important to recognise that kids are not small calves. Disbudding causes pain and is performed on calves and kids — welfare concerns surrounding disbudding affect both industries. In this review, we evaluate literature on disbudding of kids and calves and compare methodologies across the two species. In addition, we catalogue behavioural and physiological responses to disbudding and, finally, review alternatives to disbudding (or refinements). Although there may be certain similarities between the response of goat kids and calves to cautery disbudding, it is important to highlight the differences that do exist between the species to reduce the risk of potential detrimental effects (eg brain injury). Cautery disbudding is the most common and efficacious method of disbudding kids and calves; however, kids have thinner skulls and are disbudded at a younger age, which can increase the risk of thermal injury to the brain. Kids and calves show behavioural and physiological responses indicative of pain; however, variability in these responses between studies are likely due to differences in disbudding methodologies, study design and within-species variation. Effective pain mitigation strategies may differ across species; therefore, future research is needed to optimise pain mitigation strategies for kids. Currently, alternatives to cautery disbudding including: (i) selection for polled animals; (ii) managing horned animals; or (iii) the development of novel disbudding methods (eg cryosurgery, clove oil injection) have been deemed unsuitable by the industries as the methods are either impracticable or ineffective. Therefore, if disbudding is to continue, species-appropriate pain mitigation strategies need to be refined. Establishing best practice guidelines for disbudding kids requires managers to recognise that they are not small calves.

While unobscured and radio-quiet active galactic nuclei are regularly being found at redshifts $z > 6$ , their obscured and radio-loud counterparts remain elusive. We build upon our successful pilot study, presenting a new sample of low-frequency-selected candidate high-redshift radio galaxies (HzRGs) over a sky area 20 times larger. We have refined our selection technique, in which we select sources with curved radio spectra between 72–231 MHz from the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey. In combination with the requirements that our GLEAM-selected HzRG candidates have compact radio morphologies and be undetected in near-infrared $K_{\rm s}$ -band imaging from the Visible and Infrared Survey Telescope for Astronomy Kilo-degree Infrared Galaxy (VIKING) survey, we find 51 new candidate HzRGs over a sky area of approximately $1200\ \mathrm{deg}^2$ . Our sample also includes two sources from the pilot study: the second-most distant radio galaxy currently known, at $z=5.55$ , with another source potentially at $z \sim 8$ . We present our refined selection technique and analyse the properties of the sample. We model the broadband radio spectra between 74 MHz and 9 GHz by supplementing the GLEAM data with both publicly available data and new observations from the Australia Telescope Compact Array at 5.5 and 9 GHz. In addition, deep $K_{\rm s}$ -band imaging from the High-Acuity Widefield K-band Imager (HAWK-I) on the Very Large Telescope and from the Southern Herschel Astrophysical Terahertz Large Area Survey Regions $K_{\rm s}$ -band Survey (SHARKS) is presented for five sources. We discuss the prospects of finding very distant radio galaxies in our sample, potentially within the epoch of reionisation at $z \gtrsim 6.5$ .

Background: Concern around perceived neurocognitive decline is increasing, leading to increased number of referrals and anxiety for patients. We aimed to explore the likelihood of the “worried well” experiencing neurocognitive decline. Methods: 166 “worried well” patients who attended the Rural and Remote Memory Clinic between 2004 and 2019 were included. Mini Mental Status Examination, Center for Epidemiologic Studies Depression Scale, and Functional Assessment Questionnaire scores were measured and compared at initial assessment and at 1-year follow-up. MMSE scores over time were assessed with a mean follow-up of 2.95 years (SD 2.87). Results: There was no statistically significant difference in MMSE, CESD, or FAQ scores between clinic day and one-year follow-up, and no consistent pattern of MMSE score over time. Of the 166 patients with SCI on initial assessment, nine were eventually given a neurological diagnosis. Conclusions: There is no pattern of neurologic decline observed in the “worried well”. Though the likelihood of a patient with SCI developing a neurological diagnosis is reassuringly low, (9/166), it is not irrelevant. This, along with the benefits of early diagnosis and treatment for dementia, leads us to believe that patients with SCI should still be seen in follow-up at least at the one-year mark.

Adolescent e-cigarette use has been labeled an epidemic and alcohol use during this developmental period is associated with deleterious outcomes. Though specific temperamental dimensions have been shown to predict substance use, profiles of temperament have rarely been examined as predictors. This study examines dimensions and profiles of adolescent temperament as predictors of early use of e-cigarettes and alcohol. The sample was comprised of adolescent (62.07% female, 87.59% White, 82.76% Hispanic/Latinx)/caregiver dyads (N = 146) who completed the first two timepoints (M age at second timepoint = 16.16, SD = 0.68) of a longitudinal adolescent substance use study. Models showed parent-reported effortful control predicted protection against adolescent use of e-cigarettes, whereas adolescent report of effortful control predicted protection against alcohol use. Though dissimilar in temperamental pattern, three profiles emerged from both parent- and adolescent-report-based latent profile analysis models. Adolescents characterized by parents as displaying a Resilient profile had greater odds of e-cigarette use than those characterized by a Reserved profile, whereas adolescents who self-characterized as Mixed-type had markedly greater odds of alcohol use than those who self-characterized as Resilient. Utilization of temperamental profiles may aid in identification of particularly vulnerable subgroups of adolescents who may benefit from relevant preventative programing.

Through laboratory experiments and numerical simulations, we examine the evolution of buoyant plumes as they are influenced by background rotation in a uniform density ambient fluid. The source Rossby number is sufficiently large that rotation does not directly affect the plume at early times. However, on a time scale of the order of half a rotation period, the plume becomes deflected from the vertical axis. For some experiments and simulations, the deflection persists and the flow precesses about the vertical axis. In other cases, shortly after being deflected, the plume laminarizes near the source to form a near-vertical columnar vortex, which we refer to as a ‘tornado’. Tornado formation occurs in some experiments and not in others even if the source and background rotation parameters are identical. However, their formation is more likely if the plumes are ‘lazy’. Simulations reveal that this is a consequence of the competing dynamics that occurs on comparable time scales. As a consequence of entrainment, vertical vorticity builds up within the plume reducing the Rossby number and suppressing vertical motion at distances progressively closer to the source. Meanwhile, the swirl (the ratio of the azimuthal to vertical flow) around the vicinity of the source increases, which tends to suppress three-dimensional turbulence in the near-source flow. Although the former process ultimately acts to deflect the plume off axis, in some instances, the swirl around the source succeeds in laminarizing the flow, resulting in tornado formation.

Iceberg calving strongly controls glacier mass loss, but the fracture processes leading to iceberg formation are poorly understood due to the stochastic nature of calving. The size distributions of icebergs produced during the calving process can yield information on the processes driving calving and also affect the timing, magnitude, and spatial distribution of ocean fresh water fluxes near glaciers and ice sheets. In this study, we apply fragmentation theory to describe key calving behaviours, based on observational and modelling data from Greenland and Antarctica. In both regions, iceberg calving is dominated by elastic-brittle fracture processes, where distributions contain both exponential and power law components describing large-scale uncorrelated fracture and correlated branching fracture, respectively. Other size distributions can also be observed. For Antarctic icebergs, distributions change from elastic-brittle type during ‘stable’ calving to one dominated by grinding or crushing during ice shelf disintegration events. In Greenland, we find that iceberg fragment size distributions evolve from an initial elastic-brittle type distribution near the calving front, into a steeper grinding/crushing-type power law along-fjord. These results provide an entirely new framework for understanding controls on iceberg calving and how calving may react to climate forcing.