Continental slope and rise geomorphology seaward of the Totten Glacier, East Antarctica (112°E-122°E)

The continental slope and rise seaward of the Totten Glacier and the Sabrina Coast, East Antarctica features continental margin depositional systems with high sediment input and consistent along-slope current activity. Understanding their genesis is a necessary step in interpreting the paleoenvironmental records they contain. Geomorphic mapping using a systematic multibeam survey shows variations in the roles of downslope and along slope sediment transport influenced by broad-scale topography and oceanography. The study area contains two areas with distinct geomorphology. Canyons in the eastern part of the area have concave thalwegs, are linked to the shelf edge and upper slope and show signs of erosion and deposition along their beds suggesting cycles of activity controlled by climate cycles. Ridges between these canyons are asymmetric with crests close to the west bank of adjacent canyons and are mostly formed by westward advection of fine sediment lofted from turbidity currents and deposition of hemipelagic sediment. They can be thought of as giant levee deposits. The ridges in the western part of the area have more gently sloping eastern flanks and rise to shallower depths than those in the east. The major canyon in the western part of the area is unusual in having a convex thalweg; it is likely fed predominantly by mass movement from the flanks of the adjacent ridges with less sediment input from the shelf edge. The western ridges formed by accretion of suspended sediment moving along the margin as a broad plume in response to local oceanography supplemented with detritus originating from the Totten Glacier. This contrasts with interpretations of similar ridges described from other parts of Antarctica which emphasise sediment input from canyons immediately up-current. The overall geomorphology of the Sabrina Coast slope is part of a continuum of mixed contourite-turbidite systems identified on glaciated margins.Australian Government 4333Australian Research Council DP170100557Italian Programma Nazionale di Richerch in Antartide (PNRA)Spanish Government CTM2014-60451-C2-1-P CTM2017-89711-C2-1-

Transient-optimised real-bogus classification with Bayesian Convolutional Neural Networks -- sifting the GOTO candidate stream

Large-scale sky surveys have played a transformative role in our understanding of astrophysical transients, only made possible by increasingly powerful machine learning-based filtering to accurately sift through the vast quantities of incoming data generated. In this paper, we present a new real-bogus classifier based on a Bayesian convolutional neural network that provides nuanced, uncertainty-aware classification of transient candidates in difference imaging, and demonstrate its application to the datastream from the GOTO wide-field optical survey. Not only are candidates assigned a well-calibrated probability of being real, but also an associated confidence that can be used to prioritise human vetting efforts and inform future model optimisation via active learning. To fully realise the potential of this architecture, we present a fully-automated training set generation method which requires no human labelling, incorporating a novel data-driven augmentation method to significantly improve the recovery of faint and nuclear transient sources. We achieve competitive classification accuracy (FPR and FNR both below 1%) compared against classifiers trained with fully human-labelled datasets, whilst being significantly quicker and less labour-intensive to build. This data-driven approach is uniquely scalable to the upcoming challenges and data needs of next-generation transient surveys. We make our data generation and model training codes available to the community

Comparing Presenting Clinical Features in 48 Children With Microscopic Polyangiitis to 183 Children Who Have Granulomatosis With Polyangiitis (Wegener's) : an ARChiVe Cohort Study

OBJECTIVE: To uniquely classify children with microscopic polyangiitis (MPA), to describe their demographic characteristics, presenting clinical features, and initial treatments in comparison to patients with granulomatosis with polyangiitis (Wegener's) (GPA). METHODS: The European Medicines Agency (EMA) classification algorithm was applied by computation to categorical data from patients recruited to the ARChiVe (A Registry for Childhood Vasculitis: e-entry) cohort, with the data censored to November 2015. The EMA algorithm was used to uniquely distinguish children with MPA from children with GPA, whose diagnoses had been classified according to both adult- and pediatric-specific criteria. Descriptive statistics were used for comparisons. RESULTS: In total, 231 of 440 patients (64% female) fulfilled the classification criteria for either MPA (n\u2009=\u200948) or GPA (n\u2009=\u2009183). The median time to diagnosis was 1.6 months in the MPA group and 2.1 months in the GPA group (ranging to 39 and 73 months, respectively). Patients with MPA were significantly younger than those with GPA (median age 11 years versus 14 years). Constitutional features were equally common between the groups. In patients with MPA compared to those with GPA, pulmonary manifestations were less frequent (44% versus 74%) and less severe (primarily, hemorrhage, requirement for supplemental oxygen, and pulmonary failure). Renal pathologic features were frequently found in both groups (75% of patients with MPA versus 83% of patients with GPA) but tended toward greater severity in those with MPA (primarily, nephrotic-range proteinuria, requirement for dialysis, and end-stage renal disease). Airway/eye involvement was absent among patients with MPA, because these GPA-defining features preclude a diagnosis of MPA within the EMA algorithm. Similar proportions of patients with MPA and those with GPA received combination therapy with corticosteroids plus cyclophosphamide (69% and 78%, respectively) or both drugs in combination with plasmapheresis (19% and 22%, respectively). Other treatments administered, ranging in decreasing frequency from 13% to 3%, were rituximab, methotrexate, azathioprine, and mycophenolate mofetil. CONCLUSION: Younger age at disease onset and, perhaps, both gastrointestinal manifestations and more severe kidney disease seem to characterize the clinical profile in children with MPA compared to those with GPA. Delay in diagnosis suggests that recognition of these systemic vasculitides is suboptimal. Compared with adults, initial treatment regimens in children were comparable, but the complete reversal of female-to-male disease prevalence ratios is a provocative finding

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Using a Single Daytime Performance Test to Identify Most Individuals at High-Risk for Performance Impairment during Extended Wake

10.1038/s41598-019-52930-yScientific Reports911668