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Climate and wildfire are closely linked. Climate regulates wildfire directly over short timescales through its effect on fuel aridity and indirectly over long timescales through vegetation productivity and the structure and abundance of fuels. Prediction of future wildfire regimes in a changing climate often uses empirical studies that presume current relationships between short‐term climate variables and wildfire activity will be stationary in the future. This is problematic because landscape‐scale wildfire dynamics exhibit non‐stationarity, with both positive and negative feedback loops that operate at different temporal and spatial scales. This requires that such feedbacks are accommodated in a model framework from which wildfire dynamics are emergent rather than pre‐specified. We use a new model, RHESSys‐WMFire, that integrates ecohydrology with fire spread and effects to simulate a 60‐yr time series of vegetation, fuel development, and wildfire in a 6572‐ha watershed in the Southern Sierra Nevada, USA, with a factorial design of increased temperature and severe drought. All climate scenarios had an initial pulse of elevated area burned associated with high temperature, low precipitation, and high fine fuel loading. There were positive correlations between annual area burned and mean annual maximum temperature and negative correlations with annual precipitation, consistent with understood direct effects of climate on wildfire in this system. Decreased vegetation productivity and increased fine fuel decomposition were predicted with increased temperature, resulting in long‐term reduced fine fuels and area burned relative to baseline. Repeated extreme drought increased area burned relative to baseline and over the long‐term had substantially reduced overstory biomass. Overstory biomass was resilient to repeat wildfire under baseline climate. The model system predicts that the short‐term direct effects of climate on wildfire can differ from long‐term indirect effects such that the simple maxim hotter/drier equals more wildfire can be both true and false, depending on scale.

Hydrologic models are one of the core tools used to project how water resources may change under a warming climate. These models are typically applied over a range of scales, from headwater streams to higher order rivers, and for a variety of purposes, such as evaluating changes to aquatic habitat or reservoir operation. Most hydrologic models require streamflow data to calibrate subsurface drainage parameters. In many cases, long-term gage records may not be available for calibration, particularly when assessments are focused on low-order stream reaches. Consequently, hydrologic modeling of climate change impacts is often performed in the absence of sufficient data to fully parameterize these hydrologic models. In this paper, we assess a geologic-based strategy for assigning drainage parameters. We examine the performance of this modeling strategy for the McKenzie River watershed in the US Oregon Cascades, a region where previous work has demonstrated sharp contrasts in hydrology based primarily on geological differences between the High and Western Cascades. Based on calibration and verification using existing streamflow data, we demonstrate that: (1) a set of streams ranging from 1st to 3rd order within the Western Cascade geologic region can share the same drainage parameter set, while (2) streams from the High Cascade geologic region require a different parameter set. Further, we show that a watershed comprised of a mixture of High and Western Cascade geologies can be modeled without additional calibration by transferring parameters from these distinctive High and Western Cascade end-member parameter sets. More generally, we show that by defining a set of end-member parameters that reflect different geologic classes, we can more efficiently apply a hydrologic model over a geologically complex landscape and resolve geo-climatic differences in how different watersheds are likely to respond to simple warming scenarios.

Chronic musculoskeletal (MSK) pain is a prominent health concern, resulting in pain-related disability, loss of functioning, and high health care costs. Physiotherapy rehabilitation is a gold-standard treatment for improving functioning in youth with chronic MSK pain. However, increasing physical activity can feel unattainable for many adolescents because of pain-related fear and movement avoidance. Virtual reality (VR) offers an immersive experience that can interrupt the fear-avoidance cycle and improve engagement in physiotherapy. Despite promising initial findings, data are limited and often lack the rigor required to establish VR as an evidence-based treatment for MSK pain. This trial evaluates physiorehabilitation with VR in adolescents with MSK pain. This protocol outlines the rationale, design, and implementation of a randomized controlled trial enhanced with a single-case experimental design. This study is a 2-group randomized controlled trial assessing the use of physiorehabilitation with VR in adolescents with MSK pain. The authors will collaborate with physical therapists to integrate VR into their standard clinical care. For participants enrolled in standard physiotherapy, there will be no VR integrated into their physical therapy program. Primary outcomes include physical function and engagement in VR. Secondary outcomes include pain-related fear and treatment adherence. Moreover, we will obtain clinician perspectives regarding the feasibility of integrating the intervention into the flow of clinical practice. The pilot study implementing physiorehabilitation with VR demonstrated that high engagement and use of physiorehabilitation with VR were associated with improvements in pain, fear, avoidance, and function. Coupled with qualitative feedback from patients, families, and clinicians, the pilot study results provide support for this trial to evaluate physiorehabilitation with VR for youth with chronic MSK pain. Analysis of results from the main clinical trial will begin as recruitment progresses, and results are expected in early 2024. Significant breakthroughs for treating MSK pain require mechanistically informed innovative approaches. Physiorehabilitation with VR provides exposure to progressive challenges, real-time feedback, and reinforcement for movement and can include activities that are difficult to achieve in the real world. It has the added benefit of sustaining patient motivation and adherence while enabling clinicians to use objective benchmarks to influence progression. These findings will inform the decision of whether to proceed with a hybrid effectiveness-dissemination trial of physiorehabilitation with VR, serving as the basis for potential large-scale implementation of physiorehabilitation with VR. ClinicalTrials.gov NCT04636177; https://clinicaltrials.gov/ct2/show/NCT04636177. DERR1-10.2196/40705.

Objective In this study, the effects of vibration therapy (VT) on delayed-onset muscle soreness (DOMS) and associated inflammatory markers after downhill running were determined. Methods 29 male recreational runners (33 (8) years; Vo2peak 57 (6) ml kg−1 min−1) completed a 40-min downhill run and were randomly allocated to a VT group or Control group. For 5 days post-run, the VT group underwent once-daily sessions of VT on the upper and lower legs. DOMS was assessed pre-run and for 5 days post-run by visual analogue scale. Immune cell subsets and plasma inflammatory markers were assessed pre-run, post-run, 24 and 120 h post-run by full differential cell count, and by ELISA and enzyme immunoassay, respectively. Data were analysed as per cent change from pre-run (ANOVA) and the magnitude of the treatment effect (Cohen's effect size statistics). Results VT significantly reduced calf pain 96 h post-run (−50% (40%), 90% confidence limits) and gluteal pain 96 h (−50% (40%)) and 120 h post-run (−30% (30%)); decreased interleukin 6 (IL6) 24 h (−46% (31%)) and 120 h post-run (−65% (30%)); substantially decreased histamine 24 h (−40% (50%)) and 120 h post-run (−37% (48%)); substantially increased neutrophils (8.6% (8.1%)) and significantly decreased lymphocytes (−17% (12%)) 24 h post-run. There were no clear substantial effects of VT on other leukocyte subsets and inflammatory markers. Conclusion VT reduces muscle soreness and IL6. It may stimulate lymphocyte and neutrophil responses and may be a useful modality in treating muscle inflammation.

Background: Shoulder injury related to vaccine administration (SIRVA) is a recognized complication and possible source of morbidity associated with incorrectly administered intramuscular deltoid vaccinations. As this site is commonly used for intramuscular injection, both clinicians and vaccine administrators should be familiar with SIRVA to minimize risk and monitor for its clinical presentation.Case Report: A 49-year-old male presented with shoulder pain that began 1 day after intramuscular administration of an influenza vaccine and point tenderness near the site of injection. Magnetic resonance imaging of the shoulder demonstrated focal osseous edema in the humeral head related to suboptimal needle placement.Conclusion: Based on the combination of history, physical examination findings, and imaging findings, the diagnosis of SIRVA was made with confidence in this clinical scenario.

We report on gravitational wave discoveries from compact binary coalescences detected by Advanced LIGO and Advanced Virgo in the first half of the third observing run (O3a) between 1 April 2019 15:00 UTC and 1 October 2019 15:00 UTC. By imposing a false-alarm-rate threshold of two per year in each of the four search pipelines that constitute our search, we present 39 candidate gravitational wave events. At this threshold, we expect a contamination fraction of less than 10%. Of these, 26 candidate events were reported previously in near real-time through GCN Notices and Circulars; 13 are reported here for the first time. The catalog contains events whose sources are black hole binary mergers up to a redshift of ~ 0.8, as well as events whose components could not be unambiguously identified as black holes or neutron stars. For the latter group, we are unable to determine the nature based on estimates of the component masses and spins from gravitational wave data alone. The range of candidate event masses which are unambiguously identified as binary black holes (both objects ≥ 3 M⨀) is increased compared to GWTC-1, with total masses from ∼ 14M⨀ for GW190924 021846 to ∼ 150M⨀ for GW190521. For the first time, this catalog includes binary systems with significantly asymmetric mass ratios, which had not been observed in data taken before April 2019. We also find that 11 of the 39 events detected since April 2019 have positive effective inspiral spins under our default prior (at 90% credibility), while none exhibit negative effective inspiral spin. Given the increased sensitivity of Advanced LIGO and Advanced Virgo, the detection of 39 candidate events in ∼26 weeks of data (∼1.5 per week) is consistent with GWTC-1.

BackgroundPatient engagement in research priority-setting is intended to democratize research and increase impact. The objectives of the Canadian Frailty Priority Setting Partnership (PSP) were to engage people with lived or clinical experience of frailty, and produce a list of research priorities related to care, support, and treatment of older adults living with frailty.MethodsThe Canadian Frailty PSP was supported by the Canadian Frailty Network, coordinated by researchers in Toronto, On-tario and followed the methods of the James Lind Alliance, which included establishing a Steering Group, inviting partner organizations, gathering questions related to care, support and treatment of older adults living with frailty, processing the data and prioritizing the questions.ResultsIn the initial survey, 799 submissions were provided by 389 individuals and groups. The 647 questions that were within scope were categorized, merged, and summarized, then checked against research evidence, creating a list of 41 unanswered questions. Prioritization took place in two stages: first, 146 individuals and groups participated in survey and their responses short-listed 22 questions; and second, an in-person workshop was held on September 26, 2017 in Toronto, Ontario where these 22 questions were discussed and ranked.ConclusionResearchers and research funders can use these results to inform their agendas for research on frailty. Strategies are needed for involving those with lived experience of frailty in research.

The Pandora Software Development Kit and algorithm libraries provide pattern-recognition logic essential to the reconstruction of particle interactions in liquid argon time projection chamber detectors. Pandora is the primary event reconstruction software used at ProtoDUNE-SP, a prototype for the Deep Underground Neutrino Experiment far detector. ProtoDUNE-SP, located at CERN, is exposed to a charged-particle test beam. This paper gives an overview of the Pandora reconstruction algorithms and how they have been tailored for use at ProtoDUNE-SP. In complex events with numerous cosmic-ray and beam background particles, the simulated reconstruction and identification efficiency for triggered test-beam particles is above 80% for the majority of particle type and beam momentum combinations. Specifically, simulated 1 GeV/ c charged pions and protons are correctly reconstructed and identified with efficiencies of 86.1 ± 0.6 % and 84.1 ± 0.6 %, respectively. The efficiencies measured for test-beam data are shown to be within 5% of those predicted by the simulation.

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6 × 6 × 6 m3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019–2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.