搜索结果：Rheumatic diseases clinics of North America

Elucidating the statistical properties of extreme meteo-climatic events and capturing the physical processes responsible for their occurrence are key steps for improving our understanding of climate variability and climate change and for better evaluating the associated hazards. It has recently become apparent that large deviation theory is very useful for investigating persistent extreme events, and specifically, for flexibly estimating long return periods and for introducing a notion of dynamical typicality. Using a methodological framework based on large deviation theory and taking advantage of long simulations by a state-of-the-art Earth System Model, we investigate the 2021 North America Heatwave. Indeed, our analysis shows that the 2021 event can be seen as an unlikely but possible manifestation of climate variability, whilst its probability of occurrence is greatly amplified by the ongoing climate change. We also clarify the properties of spatial coherence of the 2021 heatwave and elucidate the role played by the Rocky Mountains in modulating hot, dry, and persistent extreme events in the Western Pacific region of North America.

Of the 2652 articles considered, 106 met the inclusion criteria. Review of the included papers resulted in identification of 43 chronic diseases, which were then further classified into 10 disease categories using ICD-10. The majority of studies focused on diseases of the circulatory system (n=38) while endocrine and metabolic diseases were fewest (n=14). This was due to the structure of clinical records related to metabolic diseases, which typically contain much more structured data, compared with medical records for diseases of the circulatory system, which focus more on unstructured data and consequently have seen a stronger focus of NLP. The review has shown that there is a significant increase in the use of machine learning methods compared to rule-based approaches; however, deep learning methods remain emergent (n=3). Consequently, the majority of works focus on classification of disease phenotype with only a handful of papers addressing extraction of comorbidities from the free text or integration of clinical notes with structured data. There is a notable use of relatively simple methods, such as shallow classifiers (or combination with rule-based methods), due to the interp

We present observations of near-infrared 2.12 micro-meter molecular hydrogen outflows emerging from 1.1 mm dust continuum clumps in the North America and Pelican Nebula (NAP) complex selected from the Bolocam Galactic Plane Survey (BGPS). Hundreds of individual shocks powered by over 50 outflows from young stars are identified, indicating that the dusty molecular clumps surrounding the NGC 7000 / IC 5070 / W80 HII region are among the most active sites of on-going star formation in the Solar vicinity. A spectacular X-shaped outflow, MHO 3400, emerges from a young star system embedded in a dense clump more than a parsec from the ionization front associated with the Pelican Nebula (IC 5070). Suspected to be a binary, the source drives a pair of outflows with orientations differing by 80 degrees. Each flow exhibits S-shaped symmetry and multiple shocks indicating a pulsed and precessing jet. The `Gulf of Mexico' located south of the North America Nebula (NGC 7000), contains a dense cluster of molecular hydrogen objects (MHOs), Herbig-Haro (HH) objects, and over 300 YSOs, indicating a recent burst of star formation. The largest outflow detected thus far in the North America and Pelican

Livestock mobility, particularly that of small and large ruminants, is one of the main pillars of production and trade in West Africa: livestock is moved around in search of better grazing or sold in markets for domestic consumption and for festival-related activities. These movements cover several thousand kilometers and have the capability of connecting the whole West African region thus facilitating the diffusion of many animal and zoonotic diseases. Several factors shape mobility patterns even in normal years and surveillance systems need to account for such changes. In this paper, we present a procedure based on temporal network theory to identify possible sentinel locations using two indicators: vulnerability (i.e. the probability of being reached by the disease) and time of infection (i.e. the time of first arrival of the disease). Using these indicators in our structural analysis of the changing network enabled us to identify a set of nodes that could be used in an early warning system. As a case study we simulated the introduction of F.A.S.T. (Foot and Mouth Similar Transboundary) diseases in Senegal and used data taken from 2020 Sanitary certificates (LPS, laissez-passer

In the area covering the complex of the North America and Pelican nebulae we identified 13 faint stars with J-H and H-Ks color indices which simulate heavily reddened O-type stars. One of these stars is CP05-4 classified as O5 V by Comeron and Pasquali (2005). Combining magnitudes of these stars in the passbands I, J, H, Ks and [8.3] we were able to suspect that two of them are carbon stars and five are late M-type AGB stars. Interstellar extinction in the direction of these stars was estimated from the background red clump giants in the J-H vs. H-Ks diagram and from star counts in the Ks passband. Four or five stars are found to have a considerable probability of being O-type stars, contributing to the ionization of North America and Pelican. If they really are O-type stars, their interstellar extinction A(V) should be from 16 to 35 mag. Two of them seem to be responsible for bright E and J radio rims discovered by Matthews and Goss (1980).

We propose a Bayesian, noisy-input, spatial-temporal generalised additive model to examine regional relative sea-level (RSL) changes over time. The model provides probabilistic estimates of component drivers of regional RSL change via the combination of a univariate spline capturing a common regional signal over time, random slopes and intercepts capturing site-specific (local), long-term linear trends and a spatial-temporal spline capturing residual, non-linear, local variations. Proxy and instrumental records of RSL and corresponding measurement errors inform the model and a noisy-input method accounts for proxy temporal uncertainties. Results focus on the decomposition of RSL over the past 3000 years along the Atlantic coast of North America.

We evaluate the performance of various configurations of the Canadian Regional Climate Model (CRCM6-GEM5) in simulating 10-meter wind speeds using data from 27 AmeriFlux stations across North America. The assessment employs a hierarchy of error metrics, ranging from simple mean bias to advanced metrics that account for the dependence of wind speeds on variables such as friction velocity and stability. The results reveal that (i) the value of roughness length (z0) has a large effect on the simulation of wind speeds, (ii) using a lower limit for the Obhukov length instead of a lower limit for the lowest level wind speed seems to deteriorate the simulation of wind speeds under very stable conditions, (iii) the choice of stability function has a small but noticeable impact on the wind speeds, (iv) the turbulent orographic form drag scheme shows improvement over effective roughness length approach.

We present and discuss broad band CCD $UBV(I)_C$ photometry and low resolution spectroscopy for stars in the region of the open cluster NGC 6996, located in the North America Nebula. The new data allow us to tightly constrain the basic properties of this object. We revise the cluster size, which in the past has been significantly underestimated. The width of the Main Sequence is mainly interpreted in terms of differential reddening, and indeed the stars' color excess $E_{B-V}$ ranges from 0.43 to 0.65, implying the presence of a significant and evenly distributed dust component. We cross-correlate our optical photometry with near infrared from 2MASS, and by means of spectral classification we are able to build up extinction curves for an handful of bright members. We find that the reddening slope and the total to selective absorption ratio $R_V$ toward NGC 6996 are anomalous. Moreover the reddening corrected colors and magnitudes allow us to derive estimates for the cluster distance and age, which turn out to be $760 \pm 70 pc$ ($V_{0}-M_{V} = 9.4 \pm 0.2$) and $\sim 350$ Myr, respectively. Basing on our results, we suggest that NGC 6996 is located in front of the North America Neb

Prion diseases are invariably fatal and highly infectious neurodegenerative diseases affecting humans and animals. By now there have not been some effective therapeutic approaches to treat all these prion diseases. In 2008, canine mammals including dogs (canis familials) were the first time academically reported to be resistant to prion diseases (Vaccine 26: 2601--2614 (2008)). Rabbits are the mammalian species known to be resistant to infection from prion diseases from other species (Journal of Virology 77: 2003--2009 (2003)). Horses were reported to be resistant to prion diseases too (Proceedings of the National Academy of Sciences USA 107: 19808--19813 (2010)). By now all the NMR structures of dog, rabbit and horse prion proteins had been released into protein data bank respectively in 2005, 2007 and 2010 (Proceedings of the National Academy of Sciences USA 102: 640--645 (2005), Journal of Biomolecular NMR 38:181 (2007), Journal of Molecular Biology 400: 121--128 (2010)). Thus, at this moment it is very worth studying the NMR molecular structures of horse, dog and rabbit prion proteins to obtain insights into their immunity prion diseases. This article reports the findings of th

The development of a kilometer-scale E3SM Land Model (km-scale ELM) is an integral part of the E3SM project, which seeks to advance energy-related Earth system science research with state-of-the-art modeling and simulation capabilities on exascale computing systems. Through the utilization of high-fidelity data products, such as atmospheric forcing and soil properties, the km-scale ELM plays a critical role in accurately modeling geographical characteristics and extreme weather occurrences. The model is vital for enhancing our comprehension and prediction of climate patterns, as well as their effects on ecosystems and human activities. This study showcases the first set of full-capability, km-scale ELM simulations over various computational domains, including simulations encompassing 21.6 million land gridcells, reflecting approximately 21.5 million square kilometers of North America at a 1 km x 1 km resolution. We present the largest km-scale ELM simulation using up to 100,800 CPU cores across 2,400 nodes. This continental-scale simulation is 300 times larger than any previous studies, and the computational resources used are about 400 times larger than those used in prior efforts

We present spectroscopic observations of the double-lined early type eclipsing binary V1898\,Cyg. The radial velocities were obtained by means of the cross-correlation technique. Analyses of the BV light curves and RVs led to determination of the fundamental stellar parameters of the V1898\,Cyg's components. We derived new ephemerides for the eclipsing pair using the observed times of mid-eclipses. The residuals between the observed and computed times of mid-eclipses were analysed and a rate of the period change $\dot{P}/P= 6.68 \times 10^{-7}\,yr^{-1}$ was obtained. The orbital period is increased by about 0.38 s in the last 24 years due to the mass transfer from less massive secondary to the more massive primary star with an amount of $1.88\times10^{-7}\,$ \Msun in a year, assuming conservative case. Results of the light and radial velocity curves' analyses were combined and the physical parameters of the components were revealed. The absolute parameters for the stars are derived as: M$_1$=6.054$\pm$0.037 M$_{\odot}$, M$_2$=1.162$\pm$0.011 M$_{\odot}$, R$_1$=3.526$\pm$0.009 R$_{\odot}$, R$_2$=2.640$\pm$0.010 R$_{\odot}$, T$_{eff_1}$=18\,000$\pm$600 K, and T$_{eff_2}$=6\,200$\pm$2

We present a spectroscopic survey of over 3400 potential members in the North America and Pelican nebulae (NAP) using several low-resolution ($R\approx$ 1300-2000) spectrographs: Palomar/Norris, WIYN/HYDRA, Keck/DEIMOS, and MMT/Hectospec. We identify 580 young stars as likely members of the NAP region based on criteria involving infrared excess, Li I 6708 absorption, X-ray emission, parallax, and proper motions. The spectral types of individual spectra are derived by fitting them with templates that are either empirical spectra of pre-main sequence stars, or model atmospheres. The templates are artificially veiled, and a best-fit combination of spectral type and veiling parameter is derived for each star. We use the spectral types with archival photometry to derive $V$-band extinction and stellar luminosity. From the H-R diagram, the median age of the young stars is about 1 Myr, with a luminosity dispersion of $\sim$0.3--0.4 dex. We investigate the photometric variability of the spectroscopic member sample using ZTF data, and conclude that photometric variability, while present, does not significantly contribute to the luminosity dispersion. While larger than the formal errors, the

We use Transition Path Theory (TPT) to frame, in a statistically more robust fashion than earlier analyses, equatorward routes of North Atlantic Deep Water (NADW) in the subpolar North Atlantic. TPT is applied on all available RAFOS and Argo floats in the area by means of a discretization of the Lagrangian dynamics described by their trajectories. By considering floats at different depths, we investigate transition paths of NADW in its upper (UNADW) and lower (LNADW) layers. We find that the majority of UNADW transition paths sourced in the Labrador and southwestern Irminger Seas reach the western side of a target arranged zonally along the southern edge of the subpolar North Atlantic domain visited by the floats. This is accomplished in the form of a well-organized deep boundary current (DBC). LNADW transition paths sourced west of the Reykjanes Ridge reveal a similar pattern, while those sourced east of the ridge are found to hit the western side of the target via a DBC and also several other places along it in a less organized fashion, indicating southward flow along the eastern and western flanks of the Mid-Atlantic Ridge. Naked-eye inspection of trajectories suggest generally

Far red spectra for 34 stars with V magnitudes between 15 and 18 in the direction of the North America and Pelican nebulae (NAP) star-forming region are obtained. Some of these stars were known earlier as emission-line objects, others were suspected as pre-main-sequence stars from photometry in the J, H, Ks and Vilnius systems. We confirm the presence of the H alpha line emission in the spectra of 19 stars, some of them exhibit also emission in the O I and Ca II lines. In some of the stars the H alpha absorption line is filled with emission. To estimate their evolutionary status, the spectral energy distributions, based on Vilnius, 2MASS, MSX and Spitzer photometry, are applied. Only eight emission-line stars are found to be located at a distance of the NAP complex. Others are either chromospherically active stars in front of the complex or distant luminous stars with H alpha absorption and emission components. For five stars with faint emission the data are not sufficient to estimate their distance. One star is found to be a heavily reddened K-supergiant located in the Outer arm. The stars, for which we failed to confirm the emission in H alpha, are mostly red dwarfs located in fr

We present the first results from a CARMA high-resolution $^{12}$CO(1-0), $^{13}$CO(1-0), and C$^{18}$O(1-0) molecular line survey of the North America and Pelican (NAP) Nebulae. CARMA observations have been combined with single-dish data from the Purple Mountain 13.7m telescope to add short spacings and produce high-dynamic-range images. We find that the molecular gas is predominantly shaped by the W80 HII bubble that is driven by an O star. Several bright rims are probably remnant molecular clouds heated and stripped by the massive star. Matching these rims in molecular lines and optical images, we construct a model of the three-dimensional structure of the NAP complex. Two groups of molecular clumps/filaments are on the near side of the bubble, one being pushed toward us, whereas the other is moving toward the bubble. Another group is on the far side of the bubble and moving away. The young stellar objects in the Gulf region reside in three different clusters, each hosted by a cloud from one of the three molecular clump groups. Although all gas content in the NAP is impacted by feedback from the central O star, some regions show no signs of star formation, while other areas clea

We present a study of 323 photometrically variable young stellar objects that are likely members of the North America and Pelican (NAP) nebulae star forming region. To do so, we utilize over two years of data in the $g$ and $r$ photometric bands from the Zwicky Transient Facility (ZTF). We first investigate periodic variability, finding 46 objects ($\sim$15\% of the sample) with significant periods that phase well, and can be attributed to stellar rotation. We then use the quasi-periodicity (Q) and flux asymmetry (M) variability metrics to assign morphological classifications to the remaining aperiodic light curves. Another $\sim$39\% of the variable star sample beyond the periodic sources are also flux-symmetric, but with a quasi-periodic (moderate $Q$) or stochastic (high $Q$) nature. Concerning flux-asymmetric sources, our analysis reveals $\sim$14\% bursters (high negative $M$) and $\sim$29\% dippers (high positive $M$). We also investigate the relationship between variability slopes in the $g$ vs $g-r$ color-magnitude diagram, and the light curve morphological classes. Burster-type objects have shallow slopes, while dipper-type variables tend to have higher slopes that are con

The prevailing conceptual model for the production of severe local storm (SLS) environments over North America asserts that upstream elevated terrain and the Gulf of Mexico are both essential to their formation. This work tests this hypothesis using two prescribed-ocean climate model experiments with North American topography removed or the Gulf of Mexico converted to land and analyzes how SLS environments and associated synoptic-scale drivers (southerly Great Plains low-level jets, drylines, elevated mixed layers, and extratropical cyclones) change relative to a control historical run. Overall, SLS environments depend strongly on upstream elevated terrain but weakly on the Gulf of Mexico. Removing elevated terrain substantially reduces SLS environments especially over the continental interior due to broad reductions in both thermodynamic and kinematic parameters, leaving a more zonally-uniform residual distribution that is maximized near the Gulf coast and decays toward the continental interior. This response is associated with a strong reduction in synoptic-scale drivers and a cooler and drier mean-state atmosphere. Replacing the Gulf of Mexico with land modestly reduces SLS envi

AI-powered stethoscopes offer a promising alternative for screening rheumatic heart disease (RHD), particularly in regions with limited diagnostic infrastructure. Early detection is vital, yet echocardiography, the gold standard tool, remains largely inaccessible in low-resource settings due to cost and workforce constraints. This review systematically examines machine learning (ML) applications from 2015 to 2025 that analyze electrocardiogram (ECG) and phonocardiogram (PCG) data to support accessible, scalable screening of all RHD variants in relation to the World Heart Federation's "25 by 25" goal to reduce RHD mortality. Using PRISMA-ScR guidelines, 37 peer-reviewed studies were selected from PubMed, IEEE Xplore, Scopus, and Embase. Convolutional neural networks (CNNs) dominate recent efforts, achieving a median accuracy of 97.75%, F1-score of 0.95, and AUROC of 0.89. However, challenges remain: 73% of studies used single-center datasets, 81.1% relied on private data, only 10.8% were externally validated, and none assessed cost-effectiveness. Although 45.9% originated from endemic regions, few addressed demographic diversity or implementation feasibility. These gaps underscore t

Scientists collaborate through intricate networks, which impact the quality and scope of their research. At the same time, funding and institutional arrangements, as well as scientific and political cultures, affect the structure of collaboration networks. Since such arrangements and cultures differ across regions in the world in systematic ways, we surmise that collaboration networks and impact should also differ systematically across regions. To test this, we compare the structure of collaboration networks among prominent researchers in North America and Europe. We find that prominent researchers in Europe establish denser collaboration networks, whereas those in North-America establish more decentralized networks. We also find that the impact of the publications of prominent researchers in North America is significantly higher than for those in Europe, both when they collaborate with other prominent researchers and when they do not. Although Europeans collaborate with other prominent researchers more often, which increases their impact, we also find that repeated collaboration among prominent researchers decreases the synergistic effect of collaborating.