Pine Island Glacier has thinned and accelerated over recent decades, significantly contributing to global sea level rise. Increased oceanic melting of its ice shelf is thought to have triggered those changes. Observations and numerical modeling reveal large fluctuations in the ocean heat available in the adjacent bay and enhanced sensitivity of ice shelf melting to water temperatures at intermediate depth, as a seabed ridge blocks the deepest and warmest waters from reaching the thickest ice. Oceanic melting decreased by 50% between January 2010 and 2012, with ocean conditions in 2012 partly attributable to atmospheric forcing associated with a strong La Niña event. Both atmospheric variability and local ice shelf and seabed geometry play fundamental roles in determining the response of the Antarctic Ice Sheet to climate.One Sentence Summary: Ocean melting of the Pine Island Glacier ice shelf was halved in two years as an underlying seabed ridge makes it highly sensitive to climatic forcing. Main Text:Austral summer observations in the Amundsen Sea, West Antarctica, show that lightlymodified, warm (0.5-1.2°C) and saline (>34.6) Circumpolar Deep Water (CDW), 2-4°C above the in-situ freezing point, pervades a network of glacially scoured seabed troughs (1, Fig. 1A).The CDW reaches nearby Antarctic glaciers and delivers heat to the base of their 200-1000 mthick ice shelves (2-4). It is overlain by a 200-300 m-thick layer of cold (-1.5°C) and fresh (salinity<34.4) Winter Water (WW, Fig. 2A) that is seasonally replenished by interaction with the atmosphere and sea ice.Pine Island Glacier (PIG), a major outlet glacier feeding one such ice shelf, has shown apparently continuous thinning (5, 6) and intermittent acceleration (7-9) from 1973 to 2009.During this period, its ice shelf has also thinned (6,(10)(11)(12), and the reduction in buttressing driven by oceanic melting is believed to be responsible for the changes inland. Earlier analysis indicated that a higher CDW volume and temperature in Pine Island Bay (PIB) in January 2009caused an increase in ice-shelf melting and in the associated meltwater-driven circulation, relative to 1994 (2). The lack of sub-annual variability in CDW temperature during one yearlong measurement in PIB (1) and the long-term correlation between the oceanic melting and the mass loss required to sustain thinning of the ice shelf gave the impression that the ice-ocean system had shown progressive change over the last two decades. This is consistent with a positive geometrical feedback, with oceanic melt enlarging the cavity under the ice shelf, allowing stronger circulation and further melting.However, such ice-ocean systems are likely to be more complex. The glacier's rapid change over the last few decades was probably triggered by its ungrounding from a the top of a seabed ridge transverse to the ice flow at some time before the 1970s (4). Subsequent migration of the glacier's grounding line (13) down the seabed slope upstream from the ridge crest was probably an inevitable respon...

Many procedures in modern clinical medicine rely on the use of electronic implants in treating conditions that range from acute coronary events to traumatic injury. However, standard permanent electronic hardware acts as a nidus for infection: bacteria form biofilms along percutaneous wires, or seed haematogenously, with the potential to migrate within the body and to provoke immune-mediated pathological tissue reactions. The associated surgical retrieval procedures, meanwhile, subject patients to the distress associated with re-operation and expose them to additional complications. Here, we report materials, device architectures, integration strategies, and in vivo demonstrations in rats of implantable, multifunctional silicon sensors for the brain, for which all of the constituent materials naturally resorb via hydrolysis and/or metabolic action, eliminating the need for extraction. Continuous monitoring of intracranial pressure and temperature illustrates functionality essential to the treatment of traumatic brain injury; the measurement performance of our resorbable devices compares favourably with that of non-resorbable clinical standards. In our experiments, insulated percutaneous wires connect to an externally mounted, miniaturized wireless potentiostat for data transmission. In a separate set-up, we connect a sensor to an implanted (but only partially resorbable) data-communication system, proving the principle that there is no need for any percutaneous wiring. The devices can be adapted to sense fluid flow, motion, pH or thermal characteristics, in formats that are compatible with the body's abdomen and extremities, as well as the deep brain, suggesting that the sensors might meet many needs in clinical medicine.

Mass loss from the Amundsen Sea sector of the West Antarctic Ice Sheet has increased in recent decades, suggestive of sustained ocean forcing or ongoing, possibly unstable response to a past climate anomaly. Lengthening satellite records appear incompatible with either process, however, revealing both periodic hiatuses in acceleration and intermittent episodes of thinning. Here we use ocean temperature, salinity, dissolved-oxygen and current measurements taken from 2000-2016 near Dotson Ice Shelf to determine temporal changes in net basal melting. A decadal cycle dominates the ocean record, with melt changing by a factor of ~4 between cool and warm extremes via a non-linear relationship with ocean temperature. A warm phase that peaked around 2009 coincided with ice shelf thinning and retreat of the grounding line, which readvanced during a post-2011 cool phase. Those observations demonstrate how discontinuous ice retreat is linked with ocean variability, and that the strength and timing of decadal extremes is more influential than changes in the longer-term mean state. The non-linear response of melting to temperature change heightens the sensitivity of Amundsen Sea ice shelves to such variability, possibly explaining the vulnerability of the ice sheet in that sector, where subsurface ocean temperatures are relatively high.

IMPORTANCE Data on P2Y12 inhibitor monotherapy after short-duration dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention are limited. OBJECTIVE To determine whether P2Y12 inhibitor monotherapy after 3 months of DAPT is noninferior to 12 months of DAPT in patients undergoing PCI. DESIGN, SETTING, AND PARTICIPANTS The SMART-CHOICE trial was an open-label, noninferiority, randomized study that was conducted in 33 hospitals in Korea and included 2993 patients undergoing PCI with drug-eluting stents. Enrollment began March 18, 2014, and follow-up was completed July 19, 2018. INTERVENTIONS Patients were randomly assigned to receive aspirin plus a P2Y12 inhibitor for 3 months and thereafter P2Y12 inhibitor alone (n = 1495) or DAPT for 12 months (n = 1498). MAIN OUTCOMES AND MEASURES The primary end point was major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke) at 12 months after the index procedure. Secondary end points included the components of the primary end point and bleeding defined as Bleeding Academic Research Consortium type 2 to 5. The noninferiority margin was 1.8%. RESULTS Among 2993 patients who were randomized (mean age, 64 years; 795 women [26.6%]), 2912 (97.3%) completed the trial. Adherence to the study protocol was 79.3% of the P2Y12 inhibitor monotherapy group and 95.2% of the DAPT group. At 12 months, major adverse cardiac and cerebrovascular events occurred in 42 patients in the P2Y12 inhibitor monotherapy group and in 36 patients in the DAPT group (2.9% vs 2.5%; difference, 0.4% [1-sided 95% CI,-ϱ% to 1.3%]; P = .007 for noninferiority). There were no significant differences in all-cause death (21 [1.4%] vs 18 [1.2%]; hazard ratio [HR], 1.18; 95% CI, 0.63-2.21; P = .61), myocardial infarction (11 [0.8%] vs 17 [1.2%]; HR, 0.66; 95% CI, 0.31-1.40; P = .28), or stroke (11 [0.8%] vs 5 [0.3%]; HR, 2.23; 95% CI, 0.78-6.43; P = .14) between the 2 groups. The rate of bleeding was significantly lower in the P2Y12 inhibitor monotherapy group than in the DAPT group (2.0% vs 3.4%; HR, 0.58; 95% CI, 0.36-0.92; P = .02). CONCLUSIONS AND RELEVANCE Among patients undergoing percutaneous coronary intervention, P2Y12 inhibitor monotherapy after 3 months of DAPT compared with prolonged DAPT resulted in noninferior rates of major adverse cardiac and cerebrovascular events. Because of limitations in the study population and adherence, further research is needed in other populations.

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We study the statistical properties of the sampled scale-free networks, deeply related to the proper identification of various real-world networks. We exploit three methods of sampling and investigate the topological properties such as degree and betweenness centrality distribution, average path length, assortativity, and clustering coefficient of sampled networks compared with those of original networks. It is found that the quantities related to those properties in sampled networks appear to be estimated quite differently for each sampling method. We explain why such a biased estimation of quantities would emerge from the sampling procedure and give appropriate criteria for each sampling method to prevent the quantities from being overestimated or underestimated.

Microfluidic technologies have recently been shown to hold significant potential as novel tools for producing micro- and nano-scale structures for a variety of applications in tissue engineering and cell biology. Over the last decade, microfluidic spinning has emerged as an advanced method for fabricating fibers with diverse shapes and sizes without the use of complicated devices or facilities. In this critical review, we describe the current development of microfluidic-based spinning techniques for producing micro- and nano-scale fibers based on different solidification methods, platforms, geometries, or biomaterials. We also highlight the emerging applications of fibers as bottom-up scaffolds such as cell encapsulation or guidance for use in tissue engineering research and clinical practice.