Deformable plate tectonic models of the southern North Atlantic

Significant, poly-phase deformation occurred prior to, simultaneous with, and after the opening of the North Atlantic Ocean. Understanding this deformation history is essential for understanding the regional development and the mechanisms controlling rifting and subsequent failure or breakup. Here, we primarily use published constraints to construct deformable plate tectonic models for the southern North Atlantic from 200 Ma to present using GPlates. The aim of this work is to test both the capability of the GPlates deformable modelling approach and the reliability of published plate reconstructions. Overall, modelled crustal thickness values at 0 Ma produced from the deformable models show general, regional-scale, similarities with values derived from the inversion of gravity data for crustal thickness. However, the deformable models typically underestimate thinning in marginal basins and overestimate crustal thickness in continental fragments compared to values from gravity inversion. This is possibly due to: 1) thinning occurring earlier than the 200 Ma start time modelled, 2) variations in the original crustal thickness, 3) depth-dependent stretching, 4) rigid blocks undergoing some degree of thinning, and 5) variations in the mesh density of the models. The results demonstrate that inclusion of micro-continental fragments, and locally defined limits of continental crust, generally produce results more akin to observations. One exception is the Grand Banks where global GPlates models produce more realistic deformation, likely due to the inclusion of the exhumed domains continent-ward of the transition zone boundary. Results also indicate that Flemish Cap rotation is required to provide a reasonable fit between North America and Iberia, with the palaeo-position of the Flemish Cap likely to be the proto-Orphan sub-basins. Moreover, the East and West Orphan sub-basins formed separately due to the respective rotations of the Flemish Cap and the Orphan Knoll, which was likely associated with other continental fragments that subsequently contributed to the thicker crust forming the boundary between the East and West Orphan basins. The results also suggest a link between tectonic and magmatic processes. For example, the inclusion of an Orphan Knoll micro-continental block results in greater extension (higher beta factors) in the northern West Orphan Basin near the termination of the Charlie-Gibbs Fracture Zone, and the site of the Charlie-Gibbs Volcanic Province (CGVP). Thus, we infer that the CGVP was likely influenced by plate tectonic processes through the concentration of strain resulting from interaction in proximity to the transform system. Finally, marginal basins that were considered to be conjugate and thus related, may only appear conjugate through later rotation of micro-continental blocks, and thus their genesis is not directly related

A clinician’s guide to understanding and critically appraising machine learning studies: a checklist for Ruling Out Bias Using Standard Tools in Machine Learning (ROBUST-ML)

Developing functional machine learning (ML)-based models to address unmet clinical needs requires unique considerations for optimal clinical utility. Recent debates about the rigours, transparency, explainability, and reproducibility of ML models, terms which are defined in this article, have raised concerns about their clinical utility and suitability for integration in current evidence-based practice paradigms. This featured article focuses on increasing the literacy of ML among clinicians by providing them with the knowledge and tools needed to understand and critically appraise clinical studies focused on ML. A checklist is provided for evaluating the rigour and reproducibility of the four ML building blocks: data curation, feature engineering, model development, and clinical deployment. Checklists like this are important for quality assurance and to ensure that ML studies are rigourously and confidently reviewed by clinicians and are guided by domain knowledge of the setting in which the findings will be applied. Bridging the gap between clinicians, healthcare scientists, and ML engineers can address many shortcomings and pitfalls of ML-based solutions and their potential deployment at the bedside

Capacity for the management of kidney failure in the International Society of Nephrology Africa region:Report from the 2023 ISN Global Kidney Atlas (ISN-GKHA)

The burden of chronic kidney disease (CKD) and associated risk of kidney failure are increasing in Africa. The management of people with CKD is fraught with numerous challenges because of limitations in health systems and infrastructures for care delivery. From the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), we describe the status of kidney care in the ISN Africa region using the World Health Organization building blocks for health systems. We identified limited government health spending which in turn led to increased out-of-pocket costs for people with kidney disease at the point of service delivery. The healthcare workforce across Africa was sub-optimal and further challenged by the exodus of trained healthcare workers out of the continent. Medical products, technologies, and services for the management of people with non-dialysis CKD and for kidney replacement therapy (KRT) were scarce due to limitations in health infrastructure that was inequitably distributed. There were few kidney registries and advocacy groups championing kidney disease management in Africa compared to the rest of the world. Strategies for ensuring improved kidney care in Africa include focusing on CKD prevention and early detection, improving the effectiveness of the available healthcare workforce (e.g., multidisciplinary teams, task substitution, and telemedicine), augmenting kidney care financing, providing quality, up-to-date health information data, and improving the accessibility, affordability, and delivery of quality treatment (KRT or conservative kidney management) for all people living with kidney failure

Why do people file share unlawfully? A systematic review, meta-analysis and panel study

Unlawful digital media sharing is common and believed to be extremely damaging to business. Understanding unlawful file sharers’ motivations offers the opportunity to develop business models and behavioral interventions to maximize consumers’ and businesses’ benefit. This paper uses a systematic review of unlawful file sharing research, and the Theory of Planned Behavior, to motivate a large-scale panel study in which initial determinants were used to predict subsequent behavior. A meta-analysis found Attitudes, Subjective Norms and Perceived Behavioral Control were all associated with unlawful file sharing. Media type and demographic differences in the importance of Perceived Behavioral Control were found and attributed to more accurate evaluation of familiar activities, i.e., greater experience increases the influence of Perceived Behavioral Control but age does not. The panel study confirmed that greater past experience was associated with Perceived Behavioral Control and Intention. We conclude that past experience increases the efficacy of the Theory of Planned Behavior and specifically Perceived Behavioral control in predicting behavior, contrary to some widely held beliefs about the role of experience. The role of experience is therefore crucial to understanding people’s choices. Practically, improving social approval, positive evaluation and access to lawful media should reduce unlawful behavior

Radiation techniques for acromegaly

Radiotherapy (RT) remains an effective treatment in patients with acromegaly refractory to medical and/or surgical interventions, with durable tumor control and biochemical remission; however, there are still concerns about delayed biochemical effect and potential late toxicity of radiation treatment, especially high rates of hypopituitarism. Stereotactic radiotherapy has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. Radiation can be delivered in a single fraction by stereotactic radiosurgery (SRS) or as fractionated stereotactic radiotherapy (FSRT) in which smaller doses are delivered over 5-6 weeks in 25-30 treatments. A review of the recent literature suggests that pituitary irradiation is an effective treatment for acromegaly. Stereotactic techniques for GH-secreting pituitary tumors are discussed with the aim to define the efficacy and potential adverse effects of each of these techniques