Dynamics of the extremely elongated cloud on Mars Arsia Mons volcano

Starting in September 2018, a daily repeating extremely elongated cloud was observed extending up to 1800km from the Mars Arsia Mons volcano. We study this Arsia Mons Elongated Cloud (AMEC) using images from VMC, HRSC, and OMEGA on board Mars Express, IUVS on MAVEN, MCC on Mars Orbiter Mission (MOM), MARCI on MRO, and Visible Camera on Viking 2 orbiter. We study the daily cycle of this cloud, showing how the morphology and other parameters of the cloud evolved rapidly with local time. The cloud expands every morning from the western slope of the volcano, at a westward velocity of around 160m/s, and an altitude of around 45km over martian areoid. The expansion starts with sunrise, and resumes around 2.5 hours later, when cloud formationresumes and the elongated tail detaches from the volcano and keeps moving westward until it evaporates before afternoon, when most sun-synchronous missions observe. This daily cycle repeated regularly for at least 80 sols in 2018 (Martian Year 34). We find in images from past years that this AMEC is an annually repeating phenomenon that takes place around the Solar Longitude range 220º-320º. We study the AMEC in Martian Year 34 in terms of Local Time and Solar Longitude, and then compare with observations from previous years, in search for interannual variations, taking into account the possible influence of the recent Global Dust Storm

Dynamics of the extremely elongated cloud on Mars Arsia Mons volcano

Starting in September 2018, a daily repeating extremely elongated cloud was observed extending from the Mars Arsia Mons volcano. We study this Arsia Mons Elongated Cloud (AMEC) using images from VMC, HRSC, and OMEGA on board Mars Express, IUVS on MAVEN, and MARCI on MRO. We study the daily cycle of this cloud, showing how the morphology and other parameters of the cloud evolved with local time. The cloud expands every morning from the western slope of the volcano, at a westward velocity of around 150m/s, and an altitude of around 30-40km over the local surface. Starting around 2.5 hours after sunrise (8.2 Local True Solar Time, LTST), the formation of the cloud resumes, and the existing cloud keeps moving westward, so it detaches from the volcano, until it evaporates in the following hours. At this time, the cloud has expanded to a length of around 1500km. Short time later, a new local cloud appears on the western slope of the volcano, starting around 9.5 LTST, and grows during the morning. This daily cycle repeated regularly for at least 90 sols in 2018, around Southern Solstice (Ls 240-300) in Martian Year (MY) 34. According with these and previous MEx/VMC observations, this elongated cloud is a seasonal phenomenon occurring around Southern Solstice every Martian Year. We study the interannual variability of this cloud, the influence of the Global Dust Storms in 2018 on the cloud’s properties (Sánchez-Lavega et al., Geophys. Res. Lett. 46, 2019), and its validity as a proxy for the global state of the Martian atmosphere (Sánchez-Lavega et al., J. Geophys. Res., 123, 3020, 2018). We discuss the physical mechanisms behind the formation of this peculiar cloud in Mars

Determinants and Differences in Satisfaction with the Inhaler Among Patients with Asthma or COPD

Satisfaction with the inhaler is an important determinant of treatment adherence in patients with asthma and chronic obstructive pulmonary disease (COPD). However, few studies have compared these 2 groups to identify the factors associated with satisfaction with the inhaler. To assess and compare satisfaction with the inhaler in patients with asthma or COPD and to determine the variables associated with high inhaler satisfaction. A multicenter, cross-sectional study of 816 patients (406 with asthma and 410 with COPD) was conducted. Satisfaction was assessed with the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire. All participants completed the Test of Adherence to Inhalers and either the Asthma Control Test (ACT) or the COPD Assessment Test (CAT). Overall, the asthma group was significantly more satisfied with the inhaler (mean [standard deviation] FSI-10 scores: 44.1 [6.5] vs 42.0 [7.7]; P <.001) and more satisfied on most (7 of 10; 70%) items. Patients with asthma were significantly more satisfied with the inhaler regardless of the adherence level or the type of nonadherence pattern. Younger age, good disease control (ACT ≥20 or CAT ≤10), previous inhaler training, and absence of unwitting nonadherence were all independently and significantly associated with high inhaler satisfaction. Age, disease control, and training in inhalation technique all play a more significant role than the specific diagnosis in explaining satisfaction with the device in patients with asthma and COPD. These findings underscore the need to provide better training and more active monitoring of the inhalation technique to improve patient satisfaction, treatment adherence, and clinical outcomes

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

A meta-analysis of genome-wide association studies of multiple myeloma among men and women of African ancestry

Persons of African ancestry (AA) have a twofold higher risk for multiple myeloma (MM) compared with persons of European ancestry (EA). Genome-wide association studies (GWASs) support a genetic contribution to MM etiology in individuals of EA. Little is known about genetic risk factors for MM in individuals of AA. We performed a meta-analysis of 2 GWASs ofMMin 1813 cases and 8871 controls and conducted an admixture mapping scan to identify risk alleles. We fine-mapped the 23 known susceptibility loci to find markers that could better capture MM risk in individuals of AA and constructed a polygenic risk score (PRS) to assess the aggregated effect of known MM risk alleles. In GWAS meta-analysis, we identified 2 suggestive novel loci located at 9p24.3 and 9p13.1 at P < 1 × 10-6; however, no genome-wide significant association was noted. In admixture mapping, we observed a genome-wide significant inverse association between local AA at 2p24.1-23.1 and MM risk in AA individuals. Of the 23 known EA risk variants, 20 showed directional consistency, and 9 replicated at P < .05 in AA individuals. In 8 regions, we identified markers that better captureMMrisk in persons with AA. AA individuals with a PRS in the top 10% had a 1.82-fold (95% confidence interval, 1.56-2.11) increased MM risk compared with those with average risk (25%-75%). The strongest functional association was between the risk allele for variant rs56219066 at 5q15 and lower ELL2 expression (P = 5.1 × 10-12). Our study shows that common genetic variation contributes to MM risk in individuals with AA