Pulsed gravity currents are generated by the sequential release of dense material into a lighter ambient. We investigate the dynamics of pulsed gravity currents using physical scale experiments, two-dimensional depth-averaged shallow water equation (SWE) based models and three-dimensional lattice Boltzmann method (LBM) simulations. Integrating these results we show for the first time that short duration pulsed releases generate intrusive layers, which accelerate front propagation relative to an instantaneously released current of the same total volume. Conversely, a long delay time between pulses produces a current that propagates slower than an equivalent instantaneous release. This finding is supported by physical experiments and depth-resolving LBM simulations. The depth-resolving simulations show that intrusions in pulsed flows experience less drag resistance than those generated by instantaneous releases. The depth-averaged model considered in the present study does not accurately capture the intrusive flow dynamics of pulsed currents. However, the limitations of the finite-depth SWE model may be mitigated by extensions to incorporate entrainment and density stratification. The results also motivate further research into the impact of buoyancy Reynolds number and channel slope on the propagation of pulsed currents.

AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews, version 2) and ROBIS are tools used to assess the methodological quality and the risk of bias in a systematic review (SR). We applied AMSTAR-2 and ROBIS to a sample of 200 published SRs. We investigated the overlap in their methodological constructs, responses by item, and overall, percentage agreement, direction of effect, and timing of assessments. AMSTAR-2 contains 16 items and ROBIS 24 items. Three items in AMSTAR-2 and nine in ROBIS did not overlap in construct. Of the 200 SRs, 73% were low or critically low quality using AMSTAR-2, and 81% had a high risk of bias using ROBIS. The median time to complete AMSTAR-2 and ROBIS was 51 and 64 minutes, respectively. When assessment times were calibrated to the number of items in each tool, each item took an average of 3.2 minutes per item for AMSTAR-2 compared to 2.7 minutes for ROBIS. Nine percent of SRs had opposing ratings (i.e., AMSTAR-2 was high quality while ROBIS was high risk). In both tools, three-quarters of items showed more than 70% agreement between raters after extensive training and piloting. AMSTAR-2 and ROBIS provide complementary rather than interchangeable assessments of systematic reviews. AMSTAR-2 may be preferable when efficiency is prioritized and methodological rigour is the focus, whereas ROBIS offers a deeper examination of potential biases and external validity. Given the widespread reliance on systematic reviews for policy and practice, selecting the appropriate appraisal tool remains crucial. Future research should explore strategies to integrate the strengths of both instruments while minimizing the burden on assessors.

Medicinal cannabis has been trialled for Tourette syndrome in adults, but it has not been studied in adolescents. This open-label, single-arm trial study evaluated the feasibility, acceptability and signal of efficacy of medicinal cannabis in adolescents (12–18 years), using a Δ9-tetrahydrocannabinol:cannabidiol ratio of 10:15, with dose varying from 5 to 20 mg/day based on body weight and response. The study demonstrated feasibility of recruitment, acceptability of study procedures, potential benefits and a favourable safety profile, with no serious adverse events. Commonly reported adverse events were tiredness and drowsiness, followed by dry mouth. Statistically significant improvement was observed in parent and clinician reports on tics (paired t-test P = 0.003), and behavioural and emotional issues (paired t-test P = 0.048) and quality of life as reported by the parent and young person (paired t-test P = 0.027 and 0.032, respectively). A larger-scale, randomised controlled trial is needed to validate these findings.

Prospective university students experience substantial academic stressors and psychological vulnerabilities, yet their mental health literacy (MHL) remains inadequately explored. This study investigates four dimensions of MHL – help-seeking behaviors, stigma, knowledge about mental health and understanding of mental illnesses. Besides, Geographic Information System (GIS) techniques are employed to analyze spatial disparities in MHL, which is the first in the context of MHL research. A total of 1,485 students were assessed for sociodemographic characteristics, admission-related variables, health behaviors and family histories of mental health issues. Data were analyzed using SPSS and ArcGIS software. Multivariable linear regression analyses unveiled predictors of the MHL dimensions, with gender, family income, admission test performance, smoking, alcohol and drug use, physical and mental health history, current depression or anxiety and family history of mental health and suicide incidents emerging as common predictors. GIS analysis unraveled notable regional disparities in MHL, particularly in knowledge of mental health and mental illness, with northern and some southern districts displaying higher literacy levels. In conclusion, these findings accentuate significant gender and sociodemographic inequalities in MHL among prospective university students, highlighting the imperative for targeted interventions to enhance MHL and foster mental well-being in this cohort.

Accurately quantifying all the components of the surface energy balance (SEB) is a prerequisite for the reliable estimation of surface melt and the surface mass balance over ice and snow. This study quantifies the SEB closure by comparing the energy available for surface melt, determined from continuous measurements of radiative fluxes and turbulent heat fluxes, to the surface ablation measured on the Greenland ice sheet between 2003 and 2023. We find that the measured daily energy available for surface melt exceeds the observed surface melt by on average 18 ± 30 W m−2 for snow and 12 ± 54 W m−2 for ice conditions (mean ± SD), which corresponds to 46 and 10% of the average energy available for surface melt, respectively. When the surface is not melting, the daily SEB is on average closed within 5 W m−2. Based on the inter-comparison of different ablation sensors and radiometers installed on different stations, and on the evaluation of modelled turbulent heat fluxes, we conclude that measurement uncertainties prevent a better daily to sub-daily SEB closure. These results highlight the need and challenges in obtaining accurate long-term in situ SEB observations for the proper evaluation of climate models and for the validation of remote sensing products.

Bangladesh is experiencing a rapid increase in hypertension prevalence, particularly in socio-economically disadvantaged communities. The higher use of solid fuel in these communities could be one of the significant factors contributing to this trend, but evidence supporting this hypothesis is limited in Bangladesh. Therefore, this study aims to investigate the associations of household solid fuel use and its exposure level with systolic and diastolic blood pressure (DBP) and hypertension. We analysed 7,320 women’s data from 2017/18 Bangladesh Demographic and Health Survey. We considered three outcome variables: (i) systolic blood pressure (BP) (continuous response), (ii) DBP (continuous response), and (iii) hypertension status (yes, no). Our primary exposures of interest were fuel type (clean vs solid) and the potential level of household air pollution exposure through solid fuel use (unexposed, moderately exposed, and highly exposed). We used a multilevel mixed-effects Poisson regression model with robust variance to determine association between exposure and outcome variables while adjusting for confounders. Of the total respondents analysed, approximately 82% used solid fuel for cooking. The age-standardised prevalence of hypertension was 28%. Respondents using solid fuel were found to be 1.44 times (95% confidence interval [CI], 1.04–1.89) more likely to develop hypertension compared to clean fuel users. Compared to women using clean fuel, the likelihood of hypertension was found to be 1.61 times (95% CI, 1.07–2.20) higher among the moderately exposed group and 1.80 times (95% CI, 1.27–2.32) higher among the highly exposed group. Similar associations were reported for systolic and DBP. The use of solid fuel increases the risk of becoming hypertensive and elevates systolic and DBP. Policies and programmes are necessary to increase awareness of the adverse effects of solid fuel use on health, including hypertension. Efforts should be made to reduce solid fuel use and ensure proper ventilation systems in households where solid fuel is used.

Grassland habitats currently face severe anthropogenic exploitation, thereby affecting the survival of grassland-dependent biodiversity globally. The biodiversity-rich grasslands of India lack quantitative spatiotemporal information on their status. We evaluated the status of upper Gangetic Plains grasslands in 2015 and compared it with those from 1985, 1995 and 2005. On-ground mapping and visual classifications revealed a 57% decline in these grasslands between 1985 (418 km2) and 2015 (178 km2), mostly driven by habitat conversion (74% contribution by cropland). Limited radiotelemetry data from endemic swamp deer indicated a possible grassland-dominated average home range size of 1.02 km2, and these patches were highly preferred (average Ivlev’s index = 0.85) over other land-use classes at both spatial and temporal scales. Camera-trapping within the core habitats suggests the critical use of these patches as fawning/breeding grounds. Habitat suitability analysis indicates only c. 17% of the area along the Ganges is suitable as swamp deer habitat. We recommend the protection of these critical grassland patches to maintain ‘dynamic corridors’, with restoration and other management approaches involving multiple stakeholders to ensure the survival of this critical ecosystem.

Background: Clostridioides difficile infection (CDI) is the most common cause of infectious diarrhea in hospitalized patients. Probiotics have been studied as a measure to prevent CDI. Timely probiotic administration to at-risk patients receiving systemic antimicrobials presents significant challenges. We sought to determine optimal implementation methods to administer probiotics to all adult inpatients aged 55 years receiving a course of systemic antimicrobials across an entire health region. Methods: Using a randomized stepped-wedge design across 4 acute-care hospitals (n = 2,490 beds), the probiotic Bio-K+ was prescribed daily to patients receiving systemic antimicrobials and was continued for 5 days after antimicrobial discontinuation. Focus groups and interviews were conducted to identify barriers, and the implementation strategy was adapted to address the key identified barriers. The implementation strategy included clinical decision support involving a linked flag on antibiotic ordering and a 1-click order entry within the electronic medical record (EMR), provider and patient education (written/videos/in-person), and local site champions. Protocol adherence was measured by tracking the number of patients on therapeutic antimicrobials that received BioK+ based on the bedside nursing EMR medication administration records. Adherence rates were sorted by hospital and unit in 48- and 72-hour intervals with recording of percentile distribution of time (days) to receipt of the first antimicrobial. Results: In total, 340 education sessions with >1,800 key stakeholders occurred before and during implementation across the 4 involved hospitals. The overall adherence of probiotic ordering for wards with antimicrobial orders was 78% and 80% at 48 and 72 hours, respectively over 72 patient months. Individual hospital adherence rates varied between 77% and 80% at 48 hours and between 79% and 83% at 72 hours. Of 246,144 scheduled probiotic orders, 94% were administered at the bedside within a median of 0.61 days (75th percentile, 0.88), 0.47 days (75th percentile, 0.86), 0.71 days (75th percentile, 0.92) and 0.67 days (75th percentile, 0.93), respectively, at the 4 sites after receipt of first antimicrobial. The key themes from the focus groups emphasized the usefulness of the linked flag alert for probiotics on antibiotic ordering, the ease of the EMR 1-click order entry, and the importance of the education sessions. Conclusions: Electronic clinical decision support, education, and local champion support achieved a high implementation rate consistent across all sites. Use of a 1-click order entry in the EMR was considered a key component of the success of the implementation and should be considered for any implementation strategy for a stewardship initiative. Achieving high prescribing adherence allows more precision in evaluating the effectiveness of the probiotic strategy.

Funding: Partnerships for Research and Innovation in the Health System, Alberta Innovates/Health Solutions Funding: Award

Disclosures: None

Kalasha (ISO 639-3: kls), also known as Kalashamon, is a Northwestern Indo-Aryan language spoken in Chitral District of Khyber Pakhtunkwa Province in northern Pakistan, primarily in the valleys of Bumburet, Rumbur, Urtsun, and Birir, as shown in Figure 1. The number of speakers is estimated between 3000 and 5000. The Ethnologue classifies the language status as ‘vigorous’ (Eberhard, Simons & Fennig 2019) but some researchers consider it ‘threatened’ (Rahman 2006, Khan & Mela-Athanasopoulou 2011). Kalasha has been in close contact with Nuristani and other Northwestern Indo-Aryan languages. Among the latter, the influence of Khowar has been particularly strong because it functions as a lingua franca of Chitral District (Liljegren & Khan 2017). The Kalasha lexicon includes many loanwords from Khowar, as well as from Persian, Arabic, and Urdu (Trail & Cooper 1999). Early efforts to put the language in writing employed Arabic script but a Latin-based script was adopted in 2000 (Cooper 2005, Kalash & Heegård 2016).

A seedling bioassay was used to determine the response of triallate-resistant (R) and -susceptible (S) wild oat populations to difenzoquat and EPTC. The bioassay, based on seedling shoot length at 10 d after treatment, provided a reliable and rapid means of determining if wild oat populations were resistant to difenzoquat. Using a bioassay concentration of 15 ppm difenzoquat, it was possible to identify populations that were resistant to the recommended foliar-applied rate (0.85 kg ai/ha). Expected herbicide dosages that reduced shoot length by 50% (ED50) derived from nonlinear regression analysis indicated three and two levels of response to difenzoquat among eight S and seven R populations, respectively, indicating within population variability in their response to difenzoquat. Of the populations tested, none was resistant to EPTC. On the contrary, some R populations had lower ED50 values than did S populations, suggesting an increased sensitivity to EPTC.

Emissive PbS/CdS core/shell nanosheets are synthesized using a cation-exchange method. A significant blue-shift of the photoluminescence is observed, indicating a stronger quantum confinement in the PbS core as its thickness is reduced to eight atomic layers. High resolution transmission-electron-microscopy images of the cross-sections of the core/shell nanosheets show atomically sharp interfaces between PbS and CdS. Accurate analysis of the thickness of each layer reveals the relationship between the energy-gap and the thickness in the extremely one-dimensionally confined nanostructure.