Long-range transport pathways of tropospheric source gases originating in Asia into the northern lower stratosphere during the Asian monsoon season 2012

Global simulations with the Chemical Lagrangian Model of the Stratosphere (CLaMS) using artificial tracers of air mass origin are used to analyze transport mechanisms from the Asian monsoon region into the lower stratosphere. In a case study, the transport of air masses from the Asian monsoon anticyclone originating in India/China by an eastward-migrating anticyclone which broke off from the main anticyclone on 20 September 2012 and filaments separated at the northeastern flank of the anticyclone are analyzed. Enhanced contributions of young air masses (younger than 5 months) are found within the separated anticyclone confined at the top by the thermal tropopause. Further, these air masses are confined by the anticyclonic circulation and, on the polar side, by the subtropical jet such that the vertical structure resembles a bubble within the upper troposphere. Subsequently, these air masses are transported eastwards along the subtropical jet and enter the lower stratosphere by quasi-horizontal transport in a region of double tropopauses most likely associated with Rossby wave breaking events. As a result, thin filaments with enhanced signatures of tropospheric trace gases were measured in the lower stratosphere over Europe during the TACTS/ESMVal campaign in September 2012 in very good agreement with CLaMS simulations. Our simulations demonstrate that source regions in Asia and in the Pacific Ocean have a significant impact on the chemical composition of the lower stratosphere of the Northern Hemisphere. Young, moist air masses, in particular at the end of the monsoon season in September/October 2012, flooded the extratropical lower stratosphere in the Northern Hemisphere with contributions of up to ≈30% at 380K (with the remaining fraction being aged air). In contrast, the contribution of young air masses to the Southern Hemisphere is much lower. At the end of October 2012, approximately 1.5 ppmv H$_{2}$O is found in the lower Northern Hemisphere stratosphere (at 380 K) from source regions both in Asia and in the tropical Pacific compared to a mean water vapor content of ≈5 ppmv. In addition to this main transport pathway from the Asian monsoon anticyclone to the east along the subtropical jet and subsequent transport into the northern lower stratosphere, a second horizontal transport pathway out of the anticyclone to the west into the tropics (TTL) is found in agreement with MIPAS HCFC-22 measurements

Major flaws in conflict prevention policies towards Africa : the conceptual deficits of international actors’ approaches and how to overcome them

Current thinking on African conflicts suffers from misinterpretations oversimplification, lack of focus, lack of conceptual clarity, state-centrism and lack of vision). The paper analyses a variety of the dominant explanations of major international actors and donors, showing how these frequently do not distinguish with sufficient clarity between the ‘root causes’ of a conflict, its aggravating factors and its triggers. Specifically, a correct assessment of conflict prolonging (or sustaining) factors is of vital importance in Africa’s lingering confrontations. Broader approaches (e.g. “structural stability”) offer a better analytical framework than familiar one-dimensional explanations. Moreover, for explaining and dealing with violent conflicts a shift of attention from the nation-state towards the local and sub-regional level is needed.Aktuelle Analysen afrikanischer Gewaltkonflikte sind häufig voller Fehlinterpretationen (Mangel an Differenzierung, Genauigkeit und konzeptioneller Klarheit, Staatszentriertheit, fehlende mittelfristige Zielvorstellungen). Breitere Ansätze (z. B. das Modell der Strukturellen Stabilität) könnten die Grundlage für bessere Analyseraster und Politiken sein als eindimensionale Erklärungen. häufig differenzieren Erklärungsansätze nicht mit ausreichender Klarheit zwischen Ursachen, verschärfenden und auslösenden Faktoren. Insbesondere die richtige Einordnung konfliktverlängernder Faktoren ist in den jahrzehntelangen gewaltsamen Auseinandersetzungen in Afrika von zentraler Bedeutung. Das Diskussionspapier stellt die große Variationsbreite dominanter Erklärungsmuster der wichtigsten internationalen Geber und Akteure gegenüber und fordert einen Perspektivenwechsel zum Einbezug der lokalen und der subregionalen Ebene für die Erklärung und Bearbeitung gewaltsamer Konflikte

Treatment decisions and employment of breast cancer patients: Results of a population‐based survey

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142258/1/cncr30959.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142258/2/cncr30959_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142258/3/cncr30959-sup-0001-suppinfo1.pd

Oral HPV infection and MHC class II deficiency (A study of two cases with atypical outcome)

<p>Abstract</p> <p>Background</p> <p>Major histocompatibility complex class II deficiency, also referred to as bare lymphocyte syndrome is a rare primary Immunodeficiency disorder characterized by a profondly deficient human leukocyte antigen class II expression and a lack of cellular and humoral immune responses to foreign antigens. Clinical manifestations include extreme susceptibility to viral, bacterial, and fungal infections. The infections begin in the first year of life and involve usually the respiratory system and the gastrointestinal tract. Severe malabsorption with failure to thrive ensues, often leading to death in early childhood. Bone marrow transplantation is the curative treatment.</p> <p>Case reports</p> <p>Here we report two cases with a late outcome MHC class II deficiency. They had a long term history of recurrent bronchopulmonary and gastrointestinal infections. Bone marrow transplantation could not be performed because no compatible donor had been identified. At the age of 12 years, they developed oral papillomatous lesions related to HPV (human papillomavirus). The diagnosis of HPV infection was done by histological examination. HPV typing performed on the tissue obtained at biopsy showed HPV type 6. The lesions were partially removed after two months of laser treatment.</p> <p>Conclusions</p> <p>Viral infections are common in patients with MHC class II and remain the main cause of death. Besides warts caused by HPV infection do not exhibit a propensity for malignant transformation; they can cause great psychosocial morbidity.</p

Enhancing return-to-work in cancer patients, development of an intervention and design of a randomised controlled trial

ABSTRACT: BACKGROUND: Compared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large. Therefore, return-to-work of cancer patients needs to be improved by way of an intervention. The objective is to describe the development and content of a work-directed intervention to enhance return-to-work in cancer patients and to explain the study design used for evaluating the effectiveness of the intervention. METHODS: Development and content of the intervention The work-directed intervention has been developed based on a systematic literature review of work-directed interventions for cancer patients, factors reported by cancer survivors as helping or hindering their return-to-work, focus group and interview data for cancer patients, health care professionals, and supervisors, and vocational rehabilitation literature. The work-directed intervention consists of: 1) 4 meetings with a nurse at the treating hospital department to start early vocational rehabilitation, 2) 1 meeting with the participant, occupational physician, and supervisor to make a return-to-work plan, and 3) letters from the treating physician to the occupational physician to enhance communication. Study design to evaluate the intervention The treating physician or nurse recruits patients before the start of initial treatment. Patients are eligible when they have a primary diagnosis of cancer, will be treated with curative intent, are employed at the time of diagnosis, are on sick leave, and are between 18 and 60 years old. After the patients have given informed consent and have filled out a baseline questionnaire, they are randomised to either the control group or to the intervention group and receive either care as usual or the work-directed intervention, respectively. Primary outcomes are return-to-work and quality of life. The feasibility of the intervention and direct and indirect costs will be determined. Outcomes will be assessed by a questionnaire at baseline and at 6, 12, 18, and 24 months after baseline. DISCUSSION: This study will provide information about the effectiveness of a work-directed intervention for cancer patients. The intention is to implement the intervention in normal care if it has been shown effective. Trial registration: NTR165

Racial/ethnic differences in job loss for women with breast cancer

IntroductionWe examined race/ethnic differences in treatment-related job loss and the financial impact of treatment-related job loss, in a population-based sample of women diagnosed with breast cancer.MethodsThree thousand two hundred fifty two women with non-metastatic breast cancer diagnosed (August 2005-February 2007) within the Los Angeles County and Detroit Metropolitan Surveillance Epidemiology and End Results registries, were identified and asked to complete a survey (mean time from diagnosis = 8.9&nbsp;months). Latina and African American women were over-sampled (n = 2268, eligible response rate 72.1%).ResultsOne thousand one hundred eleven women (69.6%) of working age (&lt;65&nbsp;years) were working for pay at time of diagnosis. Of these women, 10.4% (24.1% Latina, 10.1% African American, 6.9% White, p &lt; 0.001) reported that they lost or quit their job since diagnosis due to breast cancer or its treatment (defined as job loss). Latina women were more likely to experience job loss compared to White women (OR = 2.0, p = 0.013)), independent of sociodemographic factors. There were no significant differences in job loss between African American and White women, independent of sociodemographic factors. Additional adjustments for clinical and treatment factors revealed a significant interaction between race/ethnicity and chemotherapy (p = 0.007). Among women who received chemotherapy, Latina women were more likely to lose their job compared to White women (OR = 3.2, p &lt; 0.001), however, there were no significant differences between Latina and White women among those who did not receive chemotherapy. Women who lost their job were more likely to experience financial strain (e.g. difficulty paying bills 27% vs. 11%, p &lt; 0.001).ConclusionJob loss is a serious consequence of treatment for women with breast cancer. Clinicians and staff need to be aware of aspects of treatment course that place women at higher risk for job loss, especially ethnic minorities receiving chemotherapy

Ice particle sampling from aircraft – influence of the probing position on the ice water content

The ice water content (IWC) of cirrus clouds is an essential parameter determining their radiative properties and thus is important for climate simulations. Therefore, for a reliable measurement of IWC on board research aircraft, it is important to carefully design the ice crystal sampling and measuring devices. During the ML-CIRRUS field campaign in 2014 with the German Gulfstream GV HALO (High Altitude and Long Range Research Aircraft), IWC was recorded by three closed-path total water together with one gas-phase water instrument. The hygrometers were supplied by inlets mounted on the roof of the aircraft fuselage. Simultaneously, the IWC is determined by a cloud particle spectrometer attached under an aircraft wing. Two more examples of simultaneous IWC measurements by hygrometers and cloud spectrometers are presented, but the inlets of the hygrometers were mounted at the fuselage side (M-55 Geophysica, StratoClim campaign 2017) and bottom (NASA WB57, MacPex campaign 2011). This combination of instruments and inlet positions provides the opportunity to experimentally study the influence of the ice particle sampling position on the IWC with the approach of comparative measurements. As expected from theory and shown by computational fluid dynamics (CFD) calculations, we found that the IWCs provided by the roof inlets deviate from those measured under the aircraft wing. As a result of the inlet position in the shadow zone behind the aircraft cockpit, ice particle populations with mean mass sizes larger than about 25 µm radius are subject to losses, which lead to strongly underestimated IWCs. On the other hand, cloud populations with mean mass sizes smaller than about 12 µm are dominated by particle enrichment and thus overestimated IWCs. In the range of mean mass sizes between 12 and 25 µm, both enrichment and losses of ice crystals can occur, depending on whether the ice crystal mass peak of the size distribution – in these cases bimodal – is on the smaller or larger mass mode. The resulting deviations of the IWC reach factors of up to 10 or even more for losses as well as for enrichment. Since the mean mass size of ice crystals increases with temperature, losses are more pronounced at higher temperatures, while at lower temperatures IWC is more affected by enrichment. In contrast, in the cases where the hygrometer inlets were mounted at the fuselage side or bottom, the agreement of IWCs is most frequently within a factor of 2.5 or better – due to less disturbed ice particle sampling, as expected from theory – independently of the mean ice crystal sizes. The rather large scatter between IWC measurements reflects, for example, cirrus cloud inhomogeneities and instrument uncertainties as well as slight sampling biases which might also occur on the side or bottom of the fuselage and under the wing. However, this scatter is in the range of other studies and represent the current best possible IWC recording on fast-flying aircraft.</p

Cancer Survivors’ Social Context in the Return to Work Process:Narrative Accounts of Social Support and Social Comparison Information

Purpose: Returning to work is a process that is intertwined with the social aspects of one’s life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients’ perceptions of the role of their social context in relation to returning to work following treatment. Methods: Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results: Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers’ support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions: Two functions of the social context of returning to work after cancer were apparent in the participants’ narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one’s readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual’s successful return to the workplace