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Accurate determination of the planetary boundary layer (PBL) height, mixing-layer height (MLH), and aerosol layer top (ALT) is essential for air quality and climate studies, particularly in regions with complex aerosol dynamics such as Chiang Mai, northern Thailand. This study introduces a novel lidar-based retrieval method that integrates a temperature-dependent, dynamic maximum analysis altitude (MAA) into the traditional Haar wavelet covariance transform (WCT) framework. Unlike conventional fixed-altitude WCT approaches, which often misclassify the ALT as the PBL – especially under stable nighttime or transitional conditions – this dynamic approach adapts the vertical search range for PBL detection in real time using observed surface temperature variations. The method is physically grounded in boundary layer thermodynamics, allowing for more accurate identification of the true PBL top while reducing contamination from residual aerosol layers and low clouds. Validation against radiosonde observations and comparison with previously validated WRF-Chem simulations demonstrate strong agreement, with the lidar-derived PBL heights capturing diurnal variations more reliably than traditional methods. The findings also reveal model biases during high-aerosol events, highlighting the need for improved aerosol–meteorology coupling in mesoscale models. This integrated retrieval framework represents a significant advancement in lidar-based boundary layer detection and offers a robust tool for enhancing pollutant dispersion analysis, air quality forecasting, and climate modeling across aerosol-rich regions in Southeast Asia.

Novelistic length is immediately apparent just from the physical size of a book in combination with the density of text on any one of its uniform pages. Speaking at the first Powys Society conference in 1972, in a lecture considering why Powys is read so little, George Steiner suggested that 'The first [reason] is almost puerile to say - the books are very very long, and very taxing to read'1. Whilst there's a large sphere of theory relating to the short story, analysing that genre as a singular phenomenon and also in terms of the effects and consequences of its shortness, the failure to even name or create a genre distinction for prose fiction works of great length has inevitably served to further critical neglect of this form, and how it functions. In Margaret Drabble's words, '[Powys] is so far outside the canon that he defies the concept of a canon'.15 The other criteria are that the encyclopedic narrative should use synecdoche to portray the 'full range of knowledge and beliefs of a national culture',16 be set in the recent past as opposed to the 'legendary past'of the epic,17 include a 'full account of a technology or science',18 offer a similar account of an art form outside of written literature,19 relate the 'complexities of statecraft',20 feature images of giants or gigantism that reflect the narrative's own 'monstrous' scale,21 veer from brief interludes of romantic love towards 'the wider expanses of national and mythical history',22 that it should not culminate in the consummation of sexual love,23 and that it usually enters into its culture 'from a position of exile or illegality'24 reflecting that it was written from a place of opposition and thus

Respiratory arrest secondary to megaoesophagus is a rare complication of achalasia. We treated an 85-year-old female with a history of achalasia who presented with sudden respiratory arrest and cardiopulmonary resuscitation in the community. In the emergency department, she was intubated for respiratory distress secondary to upper airway obstruction and reduced consciousness. Flexible nasal endoscopy revealed a retropharyngeal bulge, and computed tomography (CT) demonstrated megaoesophagus with distal tapering. She was managed with gastric decompression and percutaneous endoscopic gastrostomy (PEG) feeding with an uncomplicated hospital course. This case provides a rare differential for a patient with acute upper airway obstruction and cardiopulmonary arrest and is the first such case described in the literature in Aotearoa New Zealand.

AbstractObjectiveTo systematically document the patterns of war related injuries in Gaza, Palestine.DesignSurvey study of international healthcare workers, August 2024 to February 2025.SettingGaza, Palestine.Participants78 international healthcare workers deployed to Gaza.Main outcome measuresThe main outcome was the type of injuries observed by international healthcare workers during the conflict in Gaza. A Delphi informed survey was distributed through non-governmental organisation rosters and secure WhatsApp and email groups. Respondents completed the survey using contemporaneous logbooks and shift records.ResultsThe survey collected data on 12 anatomical regions, mechanisms of trauma, and general medical conditions. 78 healthcare workers reported 23 726 trauma related injuries and 6960 injuries related to weapons. The most common traumatic injuries were burns (n=4348, 18.3%), lower limb injuries (n=4258, 17.9%), and upper limb injuries (n=3534, 14.9%). Explosive injuries accounted for most of the weapon related trauma (n=4635, 66.6%), predominantly affecting the head (n=1289, 27.8%), whereas firearm injuries disproportionately affected the lower limbs (n=526, 22.6%). Healthcare workers reported 4188 people with chronic disease across 11 domains requiring long term treatment.ConclusionHealthcare workers deployed to Gaza reported an injury phenotype defined by extensive polytrauma (≥2 anatomical regions), complex blast injuries from high yield explosives, firearm related injuries to upper and lower limbs, and severe disruption to primary care and the treatment of chronic diseases. The results provide actionable insights to tailor humanitarian response and highlight the urgent need for structured, resilient clinical surveillance systems.Editor’s noteThis paper is based on research from an active war zone, where conventional research methods may be impossible to apply.

Abstract Context The American College of Radiology Thyroid Image Reporting and Data System (ACR TI-RADS) was developed to predict malignancy risk in thyroid nodules using ultrasound features. TI-RADS was derived from a database of patients already selected for fine-needle aspiration (FNA), raising uncertainty about applicability to unselected patients. Objective We aimed to assess the effect of ACR TI-RADS reporting in unselected patients presenting for thyroid ultrasound in a real-world setting. Methods Records for all patients presenting for thyroid ultrasonography in Canterbury, New Zealand, were reviewed across two 18-month periods, prior to and after implementation of TI-RADS reporting. Patient outcomes were compared between the 2 periods. Malignancy rates were calculated for nodules 10 mm or larger with a definitive FNA or histology result. Results A total of 1210 nodules were identified in 582 patients prior to implementation of TI-RADS; 1253 nodules were identified in 625 patients after implementation of TI-RADS. TI-RADS category was associated with malignancy rate (0% in TR1 and TR2, 3% in TR3, 5% in TR4, 12% in TR5; P = .02); however, 63% of nodules were graded TR3 or TR4, for which malignancy rate did not meaningfully differ from baseline risk. After implementation of TI-RADS there was a small reduction in the proportion of patients proceeding to FNA (49% vs 60%; P < .01) or surgery (14% vs 18%; P < .05), with no difference in cancer diagnoses (3% vs 4%, not significant). Conclusion TI-RADS category is associated with malignancy rate and may alter clinical decision-making in a minority of patients; however, it is nondiscriminatory in the majority of nodules. In this study of unselected patients, nodules classified as TR5 and thus considered “highly suspicious” for cancer had only a modest risk of malignancy.