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It has been proposed that ~3.4 billion years ago an ocean fed by enormous catastrophic floods covered most of the Martian northern lowlands. However, a persistent problem with this hypothesis is the lack of definitive paleoshoreline features. Here, based on geomorphic and thermal image mapping in the circum-Chryse and northwestern Arabia Terra regions of the northern plains, in combination with numerical analyses, we show evidence for two enormous tsunami events possibly triggered by bolide impacts, resulting in craters ~30 km in diameter and occurring perhaps a few million years apart. The tsunamis produced widespread littoral landforms, including run-up water-ice-rich and bouldery lobes, which extended tens to hundreds of kilometers over gently sloping plains and boundary cratered highlands, as well as backwash channels where wave retreat occurred on highland-boundary surfaces. The ice-rich lobes formed in association with the younger tsunami, showing that their emplacement took place following a transition into a colder global climatic regime that occurred after the older tsunami event. We conclude that, on early Mars, tsunamis played a major role in generating and resurfacing coastal terrains.

Abstract Background Even with high standards of acute care and neurological early rehabilitation (NER) a substantial number of patients with neurological conditions still need mechanical ventilation and/or airway protection by tracheal cannulas when discharged and hence home-based specialised intensive care nursing (HSICN). It may be possible to improve the home care situation with structured specialized long-term neurorehabilitation support and following up patients with neurorehabilitation teams. Consequently, more people might recover over an extended period to a degree that they were no longer dependent on HSICN. Methods This healthcare project and clinical trial implements a new specialised neurorehabilitation outreach service for people being discharged from NER with the need for HSICN. The multicentre, open, parallel-group RCT compares the effects of one year post-discharge specialized outpatient follow-up to usual care in people receiving HSICN. Participants will randomly be assigned to receive the new form of healthcare (intervention) or the standard healthcare (control) on a 2:1 basis. Primary outcome is the rate of weaning from mechanical ventilation and/or decannulation (primary outcome) after one year, secondary outcomes include both clinical and economic measures. 173 participants are required to corroborate a difference of 30 vs. 10% weaning success rate statistically with 80% power at a 5% significance level allowing for 15% attrition. Discussion The OptiNIV-Study will implement a new specialised neurorehabilitation outreach service and will determine its weaning success rates, other clinical outcomes, and cost-effectiveness compared to usual care for people in need for mechanical ventilation and/or tracheal cannula and hence HSICN after discharge from NER. Trial registration The trial OptiNIV has been registered in the German Clinical Trials Register (DRKS) since 18.01.2022 with the ID DRKS00027326 .

We, here, provide a personal review article on the development of a functional MRI in the radiology departments of two German university medicine units. Although the international community for human brain mapping has met since 1995, the researchers fascinated by human brain function are still young and innovative. However, the impact of functional magnetic resonance imaging (fMRI) on prognosis and treatment decisions is restricted, even though standardized methods have been developed. The tradeoff between the groundbreaking studies on brain function and the attempt to provide reliable biomarkers for clinical decisions is large. By describing some historical developments in the field of fMRI, from a personal view, the rise of this method in clinical neuroscience during the last 25 years might be understandable. We aim to provide some background for (a) the historical developments of fMRI, (b) the establishment of two research units for fMRI in the departments of radiology in Germany, and (c) a description of some contributions within the selected fields of systems neuroscience, clinical neurology, and behavioral psychology.

Abstract A brief survey among members of the German Neurorehabilitation Society aimed to document the hospital capacities (“beds”) for prolonged weaning from a mechanical ventilator for patients with neuro-disabilities that require simultaneous multi-professional neurorehabilitation treatment. Sixty-eight institutions declared to have capacities with a broad distribution across Germany and its federal states. Overall, 1094 “beds” for prolonged weaning (and neurorehabilitation) were reported, 871 together with further information regarding their identification and hence regional location. These units had on average 16.1 beds for prolonged weaning (95% confidence interval 12.6 to 19.6) with a range from 2 to 68 beds per organization. The data indicate substantial capacities for the combined prolonged weaning and neurorehabilitation treatment in Germany. For most “beds” included in this analysis a basic validation was possible. While a reasonable coverage of these specialized service capacities by the survey is likely, the number reported could still be biased by underreporting by non-response. Both the broad variation of number of “beds” for prolonged weaning per unit and their unequal geographical distribution across federal states (per capita rate) warrant a more refined follow-up survey that will provide insights into reasons for the observed pattern of variation for these specialized hospital capacities.

The gold standard to acquire motor skills is through intensive training and practicing. Recent studies have demonstrated that behavioral gains can also be acquired by mere exposure to repetitive sensory stimulation to drive the plasticity processes. Single application of repetitive electric stimulation (rES) of the fingers has been shown to improve tactile perception in young adults as well as sensorimotor performance in healthy elderly individuals. The combination of repetitive motor training with a preceding rES has not been reported yet. In addition, the impact of such a training on somatosensory tactile and spatial sensitivity as well as on somatosensory cortical activation remains elusive. Therefore, we tested 15 right-handed participants who underwent repetitive electric stimulation of all finger tips of the left hand for 20 minutes prior to one hour of motor training of the left hand over the period of two weeks. Overall, participants substantially improved the motor performance of the left trained hand by 34%, but also showed a relevant transfer to the untrained right hand by 24%. Baseline ipsilateral activation fMRI-magnitude in BA 1 to sensory index finger stimulation predicted training outcome for somatosensory guided movements: those who showed higher ipsilateral activation were those who did profit less from training. Improvement of spatial tactile discrimination was positively associated with gains in pinch grip velocity. Overall, a combination of priming rES and repetitive motor training is capable to induce motor and somatosensory performance increase and representation changes in BA1 in healthy young subjects.

The majority of continental arc volcanoes go through decades or centuries of inactivity, thus, communities become inured to their threat. Here we demonstrate a method to quantify hazard from sporadically active volcanoes and to develop probabilistic eruption forecasts. We compiled an eruption-event record for the last c. 9,500 years at Mt Taranaki, New Zealand through detailed radiocarbon dating of recent deposits and a sediment core from a nearby lake. This is the highest-precision record ever collected from the volcano, but it still probably underestimates the frequency of eruptions, which will only be better approximated by adding data from more sediment core sites in different tephra-dispersal directions. A mixture of Weibull distributions provided the best fit to the inter-event period data for the 123 events. Depending on which date is accepted for the last event, the mixture-of-Weibulls model probability is at least 0.37–0.48 for a new eruption from Mt Taranaki in the next 50 years. A polymodal distribution of inter-event periods indicates that a range of nested processes control eruption recurrence at this type of arc volcano. These could possibly be related by further statistical analysis to intrinsic factors such as step-wise processes of magma rise, assembly and storage.

New spacecraft data provide increasing evidence for a dynamic environment on present‐day Mars. Exogenic processes such as impact cratering, mass wasting processes, and active dune migration have all been observed to modify the surface. No traces of current endogenic activity have been found yet, but some studies point to very localized volcanism in the last few millions of years. However, no systematic study of young volcanic surfaces had been performed so far. We present absolute model age determinations of plains volcanism on Mars as derived from impact crater size‐frequency distributions. Extended areas in Tharsis, the largest volcano‐tectonic region on Mars, have been resurfaced by lava flows in the last few tens of millions of years. We also present results on the rheologic properties of these lava flows, inferred from morphometric measurements. Yield strengths are in the range of 100–300 Pa, and viscosities reach values of 102 to 103 Pa s, indicating basaltic compositions. The results imply that Mars retained until recently, and probably still retains, enough internal heat to produce wide‐spread plain‐style volcanism, producing low‐viscosity lava flows throughout large parts of Tharsis. Key Points Recent and wide‐spread volcanism on Mars Rheology indicates basaltic composition Mars may not be volcanically extinct yet

Objectives: To establish: (1) inter-rater and test–retest reliability of standardized guidelines for the Fugl-Meyer upper limb section, Action Research Arm Test and Box and Block Test in patients with paresis secondary to stroke, multiple sclerosis or traumatic brain injury and (2) correlation between these arm motor scales and more general measures of impairment and activity limitation. Design: Multicentre cohort study. Setting: Three European referral centres for neurorehabilitation. Subjects: Thirty-seven stroke, 14 multiple sclerosis and five traumatic brain injury patients. Main measures: Scores of the Fugl-Meyer Test (arm section), Action Research Arm Test, and Box and Block Test derived from video information. Results: All three motor tests showed very high inter-rater and test–retest reliability (ICC and rho for main variables>0.95). Correlation between the motor scales was very high (rho>0.92). Motor scales correlated moderately highly with the Hemispheric Stroke Scale, a measure of impairment (rho=0.660–0.689), but not with the Modified Barthel Index, a measure of the ability to cope with basic activities of daily living (rho=0.044–0.086). Conclusions: The standardized guidelines assured comparability of test administration and scoring across clinical facilities. The arm motor scales provided information that was not identical to information from the Hemispheric Stroke Scale or the Modified Barthel Index. Address for correspondence: Priv.-Doz. Dr T Platz, Klinik Berlin, Kladower Damm 223, 14089 Berlin, Germany.

Five decades of observations of Ceres suggest that the dwarf planet has a composition similar to carbonaceous meteorites and may have an ice-rich outer shell protected by a silicate layer. NASA's Dawn spacecraft has detected ubiquitous clays, carbonates and other products of aqueous alteration across the surface of Ceres, but surprisingly it has directly observed water ice in only a few areas. Here we use Dawn Framing Camera observations to analyse lobate morphologies on Ceres' surface and we infer the presence of ice in the upper few kilometres of Ceres. We identify three distinct lobate morphologies that we interpret as surface flows: thick tongue-shaped, furrowed flows on steep slopes; thin, spatulate flows on shallow slopes; and cuspate sheeted flows that appear fluidized. The shapes and aspect ratios of these flows are different from those of dry landslides--including those on ice-poor Vesta--but are morphologically similar to ice-rich flows on other bodies, indicating the involvement of ice. Based on the geomorphology and poleward increase in prevalence of these flows, we suggest that the shallow subsurface of Ceres is comprised of mixtures of silicates and ice, and that ice is most abundant near the poles.