A Bird’s Eye View: Development of an Operational ARM Unmanned Aerial Systems Capability for Atmospheric Research in Arctic Alaska

Unmanned aerial capabilities offer exciting new perspectives on the Arctic atmosphere and the US Department of Energy is working with partners to offer such perspectives to the research community. Thorough understanding of aerosols, clouds, boundary layer structure and radiation is required to improve representation of the Arctic atmosphere in weather forecasting and climate models. To develop such understanding, new perspectives are needed to provide details on the vertical structure and spatial variability of key atmospheric properties, along with information over difficult-to-reach surfaces such as newly-forming sea ice. Over the last three years, the US Department of Energy (DOE) has supported various flight campaigns using unmanned aircraft systems (UAS, also known as UAVs and drones) and tethered balloon systems (TBS) at Oliktok Point, Alaska. These activities have featured in-situ measurements of thermodynamic state, turbulence, radiation, aerosol properties, cloud microphysics and turbulent fluxes to provide a detailed characterization of the lower atmosphere. Alongside a suite of active and passive ground-based sensors and radiosondes deployed by the DOE Atmospheric Radiation Measurement (ARM) program through the third ARM Mobile Facility (AMF-3), these flight activities demonstrate the ability of such platforms to provide critically-needed information. In addition to providing new and unique datasets, lessons learned during initial campaigns have assisted toward the development of an exciting new community resource

Quality Assurance of ARM Program Climate Research Facility Data

This report documents key aspects of the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ACRF) data quality assurance program as it existed in 2008. The performance of ACRF instruments, sites, and data systems is measured in terms of the availability, usability, and accessibility of the data to a user. First, the data must be available to users; that is, the data must be collected by instrument systems, processed, and delivered to a central repository in a timely manner. Second, the data must be usable; that is, the data must be inspected and deemed of sufficient quality for scientific research purposes, and data users must be able to readily tell where there are known problems in the data. Finally, the data must be accessible; that is, data users must be able to easily find, obtain, and work with the data from the central repository. The processes described in this report include instrument deployment and calibration; instrument and facility maintenance; data collection and processing infrastructure; data stream inspection and assessment; the roles of value-added data processing and field campaigns in specifying data quality and haracterizing the basic measurement; data archival, display, and distribution; data stream reprocessing; and engineering and operations management processes and procedures. Future directions in ACRF data quality assurance also are presented

The interstitium in cardiac repair: role of the immune-stromal cell interplay

Cardiac regeneration, that is, restoration of the original structure and function in a damaged heart, differs from tissue repair, in which collagen deposition and scar formation often lead to functional impairment. In both scenarios, the early-onset inflammatory response is essential to clear damaged cardiac cells and initiate organ repair, but the quality and extent of the immune response vary. Immune cells embedded in the damaged heart tissue sense and modulate inflammation through a dynamic interplay with stromal cells in the cardiac interstitium, which either leads to recapitulation of cardiac morphology by rebuilding functional scaffolds to support muscle regrowth in regenerative organisms or fails to resolve the inflammatory response and produces fibrotic scar tissue in adult mammals. Current investigation into the mechanistic basis of homeostasis and restoration of cardiac function has increasingly shifted focus away from stem cell-mediated cardiac repair towards a dynamic interplay of cells composing the less-studied interstitial compartment of the heart, offering unexpected insights into the immunoregulatory functions of cardiac interstitial components and the complex network of cell interactions that must be considered for clinical intervention in heart diseases

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure

Hemoconcentration during the treatment of acute decompensated heart failure is a surrogate for plasma volume reduction and is associated with improved survival, but most definitions only allow for hemoconcentration to be determined retrospectively. An increase in serum creatinine can also be a marker of aggressive decongestion, but in isolation is not specific. Our objective was to determine if combined hemoconcentration and worsening creatinine could better identify patients that were aggressively treated and, as such, may have improved postdischarge outcomes. A total of 4,181 patients hospitalized with acute decompensated heart failure were evaluated. Those who experienced both hemoconcentration and worsening creatinine at any point had a profile consistent with aggressive in-hospital treatment and longer length of stay (p &lt;0.01), higher loop diuretic doses (p &lt;0.001), greater weight (p = 0.001), and net fluid loss (p &lt;0.001) compared with the remainder of the cohort. In isolation, neither worsening creatinine (p = 0.11) nor hemoconcentration (p = 0.36) at any time were associated with improved survival. However, patients who experienced both (21%) had significantly better survival (hazard ratio 0.80, 95% confidence interval 0.69 to 0.94, pinteraction = 0.005). In conclusion, this combination of hemoconcentration and worsening creatinine, which can be determined prospectively during patient care, was associated with in-hospital parameters consistent with aggressive diuresis and improved postdischarge survival