Less than a year after the 2018 Kīlauea caldera collapse and eruption, water appeared in newly deepened Halemaʻumaʻu crater. The lake—unprecedented in the written record—grew to a depth of ∼50 m ...before lava from the December 2020 eruption boiled it away. Surface water heightened concerns of potential phreatic or phreatomagmatic explosions but also offered a new means of possibly identifying eruption precursors. The U.S. Geological Survey Hawaiian Volcano Observatory (HVO) monitored the lake via direct visual observation, webcams, thermal imaging, colorimetry, and laser rangefinders. HVO also employed uncrewed aircraft systems to sample the water and measure near‐lake gas composition. The lake's δD and δ18O indicate a groundwater source with substantial evaporation. The initial sample had a salinity (total dissolved solids concentration) of 71,000 mg/L and was rich in sulfate (∼53,000 mg/L), iron (∼500 mg/L), and magnesium (∼10,000 mg/L). Subsequent samples were slightly more dilute. The water's pH (∼4), δ34S (+4.3‰), and surface temperatures (up to 85°C) suggest, rather than significant scrubbing of magmatic volatiles, leaching of basalt and reactions with sulfate minerals resulted in high concentrations of sulfate and other solutes. Thermodynamic modeling and precipitate mineralogy indicate that water composition was controlled by iron oxidation and sulfate dissolution. Although the lake exhibited no detectable precursors before the next eruption, and phreatic or phreatomagmatic explosions did not materialize, our multi‐parameter approach to monitoring yielded an enhanced understanding of the hydrologic, geologic, and magmatic conditions that led to the formation of the unique and short‐lived lake.
Plain Language Summary
In 2019, ponded water was spotted within Kīlauea Volcano's summit crater—the first water body in the crater in written history. The presence of a crater lake was important, as it increased the chance of hazardous, explosive eruptions once Kīlauea resumed eruptive activity. However, the lake provided a new way to keep an eye on Kīlauea; other volcanic lakes have changed temperature, color, or chemistry, or even boiled away, before eruptions. We monitored Kīlauea's lake with various methods, including water sampling via drone. Data showed that the lake was fed by groundwater, not rainwater; the lake was acidic, but less so than most acid volcanic lakes; and the lake was not absorbing large amounts of volcanic gas directly. Instead, the lake's chemistry was controlled by reactions with rocks and sulfur‐bearing minerals in and near the crater. Ultimately, no changes to the lake were detected before the next eruption, most likely because of the nature of magma at Kīlauea, which is different from that at most volcanoes with crater lakes. The water lake also did not cause the eruption to be explosive, as lava merely flowed into the lake from above rather than being injected vigorously into the lake from beneath.
Key Points
Kīlauea Volcano's summit water lake was sampled three times to track any potential geochemical precursors to eruption
The lake was fed by groundwater and its chemistry was controlled by leaching of host basalt, iron oxidation, and sulfate dissolution
No precursory changes to the lake or phreatic activity occurred, likely owing to the nature of basaltic magma and eventual dike location
Abstract Background SF1126 is a peptidic pro-drug inhibitor of pan-PI3K/mTORC. A first-in-human study evaluated safety, dose limiting toxicities (DLT), maximum tolerated dose (MTD), pharmacokinetics ...(PK), pharmacodynamics (PD) and efficacy of SF1126, in patients with advanced solid and B-cell malignancies. Patients and methods SF1126 was administered IV days 1 and 4, weekly in 28 day-cycles. Dose escalation utilised modified Fibonacci 3+3. Samples to monitor PK and PD were obtained. Results Forty four patients were treated at 9 dose levels (90–1110 mg/m2 /day). Most toxicity was grade 1 and 2 with a single DLT at180 mg/m2 (diarrhoea). Exposure measured by peak concentration (Cmax ) and area under the time-concentration curve (AUC0-t ) was dose proportional. Stable disease (SD) was the best response in 19 of 33 (58%) evaluable patients. MTD was not reached but the maximum administered dose (MAD) was 1110 mg/m2 . The protocol was amended to enrol patients with CD20+ B-cell malignancies at 1110 mg/m2 . A CLL patient who progressed on rituximab R achieved SD after 2 months on SF1126 alone but in combination with R achieved a 55% decrease in absolute lymphocyte count and a lymph node response. PD studies of CLL cells demonstrated SF1126 reduced p-AKT and increased apoptosis indicating inhibition of activated PI3K signalling. Conclusion SF1126 is well tolerated with SD as the best response in patients with advanced malignancies.
In 2018, Kīlauea Volcano experienced its largest lower East Rift Zone (LERZ) eruption and caldera collapse in at least 200 years. After collapse of the Pu'u 'Ō'ō vent on 30 April, magma propagated ...downrift. Eruptive fissures opened in the LERZ on 3 May, eventually extending ~6.8 kilometers. A 4 May earthquake moment magnitude (
) 6.9 produced ~5 meters of fault slip. Lava erupted at rates exceeding 100 cubic meters per second, eventually covering 35.5 square kilometers. The summit magma system partially drained, producing minor explosions and near-daily collapses releasing energy equivalent to
4.7 to 5.4 earthquakes. Activity declined rapidly on 4 August. Summit collapse and lava flow volume estimates are roughly equivalent-about 0.8 cubic kilometers. Careful historical observation and monitoring of Kīlauea enabled successful forecasting of hazardous events.
Context. A new challenging adaptive optics (AO) system, called multi-object adaptive optics (MOAO), has been successfully demonstrated on-sky for the first time at the 4.2 m William Herschel ...Telescope, Canary Islands, Spain, at the end of September 2010. Aims. This system, called CANARY, is aimed at demonstrating the feasibility of MOAO in preparation of a future multi-object near infra-red (IR) integral field unit spectrograph to equip extremely large telescopes for analysing the morphology and dynamics of high-z galaxies. Methods. CANARY compensates for the atmospheric turbulence with a deformable mirror driven in open-loop and controlled through a tomographic reconstruction by three widely separated off-axis natural guide star (NGS) wavefront sensors, which are in open loop too. We compared the performance of conventional closed-loop AO, MOAO, and ground-layer adaptive optics (GLAO) by analysing both IR images and simultaneous wave-front measurements. Results. In H-band, Strehl ratios of 0.20 are measured with MOAO while achieving 0.25 with closed-loop AO in fairly similar seeing conditions (r0 ≈ 15 cm at 0.5 μm). As expected, MOAO has performed at an intermediate level between GLAO and closed-loop AO.
Background:
A major complication of foot and ankle arthrodesis is nonunion, which occurs in approximately 12% of cases. Various factors influence a patient’s risk for nonunion following foot and ...ankle arthrodesis. We surveyed international foot and ankle surgeons to determine (1) risk factors perceived most important for nonunion, (2) factors considered absolute contraindications for arthrodesis, and (3) differences among expert groups regarding perceived risk factors and their stratification.
Methods:
A questionnaire was e-mailed to members of a major foot and ankle journal editorial board and four foot and ankle society executive committees. The relative risk of 18 potential nonunion risk factors was rated from 1 to 10, using smoking 1 pack/day as a benchmark score of 5.00.
Results:
The response rate was 72% (100/139); 81% declared foot and ankle surgery encompasses >90% of their practice. The highest perceived risk factors (p < 0.001) were smoking 2 packs/day (mean score 8.69), lack of fusion site stability (8.66), and poor local vascularity (7.66). The least important risk factors (p < 0.001) were perceived to be age >60 years (mean score 2.54), rheumatoid arthritis (3.05), and osteoporosis (3.56). The most frequently cited absolute contraindications to arthrodesis surgery were local infection (46%), poor local vascularity (41%), and smoking (32%).
Conclusion:
To improve arthrodesis outcomes, resource allocation and patient and surgeon education should focus on smoking, construct stability, and local vascularity. Development of an objective nonunion risk assessment tool to identify patients at risk for nonunion using these results could help maximize the efficiency of available resources.
BACKGROUND:Major modifications in the design and techniques of total ankle replacement have challenged the perception that ankle arthrodesis is the treatment of choice for end-stage ankle arthritis. ...High complication and revision rates have been reported after both procedures.
METHODS:We performed radiographic evaluations at a mean of thirty-nine months following 114 total ankle replacements done with use of commonly used implants and at a mean of thirty-seven months following forty-seven ankle arthrodeses. The mean age was sixty-four years for the patients (fifty-one female and sixty-three male) who underwent total ankle replacement and fifty-nine years in the patients (fifteen female and thirty-two male) who underwent ankle arthrodesis. The impact of complications was analyzed with use of the Ankle Osteoarthritis Scale (AOS), a validated outcome instrument.
RESULTS:Both groups had significant improvement in the mean AOS score (p < 0.001). There was no significant difference in the mean improvement between the two groups (p = 0.96). The complication rate was 54% following total ankle replacement and 26% following ankle arthrodesis, which was a significant difference (p = 0.003). The impact of major complications on the AOS outcome score was significant in both the total ankle replacement group (p = 0.031) and the ankle arthrodesis group (p = 0.02).
CONCLUSIONS:At the time of follow-up, at a minimum of two years postoperatively, the outcomes of total ankle replacement and ankle arthrodesis, with regard to pain relief and function, were comparable. While the rate of complications was significantly higher following total ankle replacement, the impact of complications on outcome was clinically relevant in both groups.
LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
Adolescents and young adults aged 15–39 years with cancer face unique medical, practical and psychosocial issues. In the UK, principal treatment centres and programmes have been designed to care for ...teenage and young adult patients aged 13–24 years in an age-appropriate manner. However, for young adults (YAs) aged 25–39 years with cancer, little access to age-specific support is available. The aim of this study was to examine this possible gap by qualitatively exploring YA care experiences, involving patients as research partners in the analysis to ensure robust results.
We conducted a phenomenological qualitative study with YAs diagnosed with any cancer type between ages 25 and 39 years old in the last 5 years. Participants took part in interviews or focus groups and data were analysed using inductive thematic analysis. Results were shaped in an iterative process with the initial coders and four YA patients who did not participate in the study to improve the rigor of the results.
Sixty-five YAs with a range of tumour types participated. We identified seven themes and 13 subthemes. YAs found navigating the healthcare system difficult and commonly experienced prolonged diagnostic pathways. Participants felt under-informed about clinical details and the long-term implications of side-effects on daily life. YAs found online resources overwhelming but also a source of information and treatment support. Some patients regretted not discussing fertility before cancer treatment or felt uninformed or rushed when making fertility preservation decisions. A lack of age-tailored content or age-specific groups deterred YAs from accessing psychological support and rehabilitation services.
YAs with cancer may miss some benefits provided to teenagers and young adults in age-tailored cancer services. Improving services for YAs in adult settings should focus on provision of age-specific information and access to existing relevant support.
•Young adults (YAs) aged 25–39 years found navigating the healthcare system difficult.•Participants felt under-informed about clinical details and impacts of side-effects.•Some YAs did not discuss fertility before cancer treatment or felt uninformed about the risks.•Lack of age-relevance deterred YAs from using psychological and rehabilitation services.•Improving services for YAs should focus on timely provision of age-specific information.
Embryonal and alveolar rhabdomyosarcoma (ERMS, ARMS) are subtypes of RMS that mainly occur in children, with relatively good outcomes. The incidence in adults is extremely low and survival is ...significantly worse compared with children. Data are scarce and literature generally combines all RMS subtypes, including pleomorphic RMS, which primarily occurs in adults and behaves more like undifferentiated pleomorphic sarcoma. The aim of this study was to evaluate patient and tumour characteristics, outcome and prognostic factors in adult patients with ERMS and ARMS.
All adult (18 years or older) ERMS and ARMS patients (presenting 1990–2016) were identified from a prospectively maintained database and were included in this analysis.
Overall, 66 patients were included (42 men, 24 women). The median age at presentation was 28 years (range 18–71). The median overall survival for all ARMS (n = 42) and ERMS (n = 24) patients was 18 months, with a 5-year overall survival rate of 27%. Patients presenting with localised disease (n = 38, 58%) and metastatic disease (n = 25, 42%), had a 5-year overall survival rate of 36% and 11%, respectively. In univariate analysis we found alveolar subtype, fusion gene positivity, infiltrative tumour and metastatic presentation to be negative prognostic factors.
Survival in adult ERMS and ARMS patients is poor and the current data may be useful in the design of trials with novel agents. Ideally, paediatric and adult oncologists should set up trials together to get a better understanding of biological, genetic and clinically relevant factors in this disease.
•Embryonal RMS (ERMS) and alveolar RMS (ARMS) are extremely rare in adults.•66 adult patients with ERMS and ARMS treated in a referral centre were studied.•42% of patients had metastatic disease at diagnosis.•The 5-year overall survival of all patients was 27% and for metastatic patients was 11%.•Survival in adult patients is much poorer than in paediatric patients.
Threats from climate change and growing populations require innovative solutions for restoring streamflow in many regions. In the arid western U.S., attempts to increase streamflow (Q) through forest ...management have had mixed results, but these approaches may be more successful in the eastern U.S. where greater precipitation (P) and lower evapotranspiration (ET) offer greater potential to increase Q by reducing ET. Longleaf pine (Pinus palustris Mill.) (LLP) woodlands, once the dominant land cover in the southeastern United States, often have lower ET than other forest types but it is unclear how longleaf pine cover impacts watershed-scale hydrology. To address this question, we analyzed 21 gaged rural watersheds. We estimated annual water balance ET (ET
) as the difference between precipitation (P) and streamflow (Q) between 1989 and 2021 and quantified low flow rates (7Q10) among watersheds with high and low LLP cover. To control for climate variability among watersheds, we compared variation in hydrology metrics with biotic and abiotic variables using the Budyko equation (ET
) to understand the differences between the two ET estimates (∆ET). Watersheds with 15-72 % LLP cover had 17 % greater mean annual Q, 7 % lower annual ET
, and 92 % greater 7Q10 low flow rates than watersheds with <3 % LLP. LLP cover decreased ET and increased Q by 2.4 mm or 0.15 % Q/P per 1 % of watershed area, but only when LLP was managed as open woodlands. Our results demonstrate that ecological forest restoration in these systems, which entails mechanical thinning and re-introduction of low-intensity prescribed fire to maintain open woodlands, and enhance understory diversity, can contribute to decreases in ET and increases in Q in eastern forests.
Water and land resource management planning benefits greatly from accurate prediction and understanding of the spatial distribution of wetness. The topographic wetness index (TWI) was conceived to ...predict relative surface wetness, and thus hydrologic responsiveness, across a watershed based on the assumption that shallow slope-parallel flow is a major driver of the movement and distribution of soil water. The index has been extensively used in modeling of landscape characteristics responsive to wetness, and some studies have shown the TWI performs well in landscapes where interflow is a dominant process. However, groundwater flow dominates the hydrology of low-slope landscapes with high subsurface conductivities, and the TWI assumptions are not likely to perform well in such environments. For groundwater dominated systems, we propose a hybrid wetness index (Wetness Index based on Landscape position and Topography, WILT) that inversely weights the upslope contributing area by the distance to the nearest surface water feature and the depth to groundwater. When explicit depth to groundwater data are not available, height above and separation from surface water features can act as surrogates for proximity to groundwater. The resulting WILT map provides a more realistic spatial distribution of relative wetness across a low-slope Coastal Plain landscape as demonstrated by improved prediction of hydric soils, depth to groundwater, nitrogen and carbon concentrations in the A horizon of the soil profile, and sensitivity to DEM scale.
Landscape features such as depth-to-groundwater and distance to waterbody were incorporated to topographic data to create wetness Index that is consistent with field observations and landscape processes. Display omitted
•Modified TWI better predicts relative wetness in landscapes with dominant groundwater flow.•Wetness is affected by proximity to distance to surface water and depth to groundwater.•WILT produces spatial patterns of wetness that are more consistent with field observations.•WILT provides better wetness maps of hydric soils, wetlands, and observed groundwater depths.•WILT showed improved correlation with C & N concentrations.
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