Can treatment success with 5% lidocaine medicated plaster be predicted in cancer pain with neuropathic components or trigeminal neuropathic pain?

An expert group of 40 pain specialists from 16 countries performed a first assessment of the value of predictors for treatment success with 5% lidocaine-medicated plaster in the management of cancer pain with neuropathic components and trigeminal neuropathic pain. Results were based on the retrospective analysis of 68 case reports (sent in by participants in the 4 weeks prior to the conference) and the practical experience of the experts. Lidocaine plaster treatment was mostly successful for surgery or chemotherapy-related cancer pain with neuropathic components. A dose reduction of systemic pain treatment was observed in at least 50% of all cancer pain patients using the plaster as adjunct treatment; the presence of allodynia, hyperalgesia or pain quality provided a potential but not definitively clear indication of treatment success. In trigeminal neuropathic pain, continuous pain, severe allodynia, hyperalgesia, or postherpetic neuralgia or trauma as the cause of orofacial neuropathic pain were perceived as potential predictors of treatment success with lidocaine plaster. In conclusion, these findings provide a first assessment of the likelihood of treatment benefits with 5% lidocaine-medicated plaster in the management of cancer pain with neuropathic components and trigeminal neuropathic pain and support conducting large, well-designed multicenter studies

Localness of energy cascade in hydrodynamic turbulence, II. Sharp spectral filter

We investigate the scale-locality of subgrid-scale (SGS) energy flux and inter-band energy transfers defined by the sharp spectral filter. We show by rigorous bounds, physical arguments and numerical simulations that the spectral SGS flux is dominated by local triadic interactions in an extended turbulent inertial-range. Inter-band energy transfers are also shown to be dominated by local triads if the spectral bands have constant width on a logarithmic scale. We disprove in particular an alternative picture of ``local transfer by nonlocal triads,'' with the advecting wavenumber mode at the energy peak. Although such triads have the largest transfer rates of all {\it individual} wavenumber triads, we show rigorously that, due to their restricted number, they make an asymptotically negligible contribution to energy flux and log-banded energy transfers at high wavenumbers in the inertial-range. We show that it is only the aggregate effect of a geometrically increasing number of local wavenumber triads which can sustain an energy cascade to small scales. Furthermore, non-local triads are argued to contribute even less to the space-average energy flux than is implied by our rigorous bounds, because of additional cancellations from scale-decorrelation effects. We can thus recover the -4/3 scaling of nonlocal contributions to spectral energy flux predicted by Kraichnan's ALHDIA and TFM closures. We support our results with numerical data from a $512^3$ pseudospectral simulation of isotropic turbulence with phase-shift dealiasing. We conclude that the sharp spectral filter has a firm theoretical basis for use in large-eddy simulation (LES) modeling of turbulent flows.Comment: 42 pages, 9 figure

Effect of sulfate aerosol on tropospheric NOx and ozone budgets: Model simulations and TOPSE evidence

The distributions of NOx and O3 are analyzed during TOPSE (Tropospheric Ozone Production about the Spring Equinox). In this study these data are compared with the calculations of a global chemical/transport model (Model for OZone And Related chemical Tracers (MOZART)). Specifically, the effect that hydrolysis of N2O5 on sulfate aerosols has on tropospheric NOx and O3 budgets is studied. The results show that without this heterogeneous reaction, the model significantly overestimates NOx concentrations at high latitudes of the Northern Hemisphere (NH) in winter and spring in comparison to the observations during TOPSE; with this reaction, modeled NOx concentrations are close to the measured values. This comparison provides evidence that the hydrolysis of N2O5 on sulfate aerosol plays an important role in controlling the tropospheric NOx and O3 budgets. The calculated reduction of NOx attributed to this reaction is 80 to 90% in winter at high latitudes over North America. Because of the reduction of NOx, O3 concentrations are also decreased. The maximum O3reduction occurs in spring although the maximum NOx reduction occurs in winter when photochemical O3 production is relatively low. The uncertainties related to uptake coefficient and aerosol loading in the model is analyzed. The analysis indicates that the changes in NOxdue to these uncertainties are much smaller than the impact of hydrolysis of N2O5 on sulfate aerosol. The effect that hydrolysis of N2O5 on global NOx and O3 budgets are also assessed by the model. The results suggest that in the Northern Hemisphere, the average NOx budget decreases 50% due to this reaction in winter and 5% in summer. The average O3 budget is reduced by 8% in winter and 6% in summer. In the Southern Hemisphere (SH), the sulfate aerosol loading is significantly smaller than in the Northern Hemisphere. As a result, sulfate aerosol has little impact on NOx and O3 budgets of the Southern Hemisphere

Physical Response of the York River Estuary to Hurricane Isabel

After making landfall on the North Carolina coast on the morning of 18 September 2003, Category 2 Hurricane Isabel tracked northward parallel to and slightly west of the Chesapeake Bay. At Gloucester Point, near the mouth of the York River estuary, strong onshore winds with speeds in excess of 20 m⋅s-1 persisted for over 12 hours and peak winds reached over 40 m⋅s-1, causing a sustained up-estuary wind stress. Storm surge exceeded 2 m throughout most of the lower Chesapeake Bay. A 600 kHz acoustic Doppler current profiler (ADCP), deployed at a depth of 8.5 m off Gloucester Point, provided high-quality data on waves, storm surge, currents, and acoustic backscatter throughout the water column before, during, and after the storm. Pressure and salinity sensors at three additional sites further up the estuary provided information on water surface slope and saltwater excursion up the estuary. A first-order estimate of three terms of the along-channel momentum equation (barotropic pressure gradient, acceleration, and friction) showed that the pressure gradient appeared to be balanced by the wind stress and the acceleration during the storm. The storm’s path and slow speed were the primary causes of the extremely high storm surge relative to past storms in the area.https://scholarworks.wm.edu/vimsbooks/1001/thumbnail.jp

Localness of energy cascade in hydrodynamic turbulence, I. Smooth coarse-graining

We introduce a novel approach to scale-decomposition of the fluid kinetic energy (or other quadratic integrals) into band-pass contributions from a series of length-scales. Our decomposition is based on a multiscale generalization of the ``Germano identity'' for smooth, graded filter kernels. We employ this method to derive a budget equation that describes the transfers of turbulent kinetic energy both in space and in scale. It is shown that the inter-scale energy transfer is dominated by local triadic interactions, assuming only the scaling properties expected in a turbulent inertial-range. We derive rigorous upper bounds on the contributions of non-local triads, extending the work of Eyink (2005) for low-pass filtering. We also propose a physical explanation of the differing exponents for our rigorous upper bounds and for the scaling predictions of Kraichnan (1966,1971). The faster decay predicted by Kraichnan is argued to be the consequence of additional cancellations in the signed contributions to transfer from non-local triads, after averaging over space. This picture is supported by data from a $512^3$ pseudospectral simulation of Navier-Stokes turbulence with phase-shift dealiasing.Comment: 26 pages, 4 figure

Changing patterns of malaria during 1996-2010 in an area of moderate transmission in Southern Senegal

<p>Abstract</p> <p>Background</p> <p>Malaria is reportedly receding in different epidemiological settings, but local long-term surveys are limited. At Mlomp dispensary in south-western Senegal, an area of moderate malaria transmission, year-round, clinically-suspected malaria was treated with monotherapy as per WHO and national policy in the 1990s. Since 2000, there has been a staggered deployment of artesunate-amodiaquine after parasitological confirmation; this was adopted nationally in 2006.</p> <p>Methods</p> <p>Data were extracted from clinic registers for the period between January 1996 and December 2010, analysed and modelled.</p> <p>Results</p> <p>Over the 15-year study period, the risk of malaria decreased about 32-times (from 0.4 to 0.012 episodes person-year), while anti-malarial treatments decreased 13-times (from 0.9 to 0.07 treatments person-year) and consultations for fever decreased 3-times (from 1.8 to 0.6 visits person-year). This was paralleled by changes in the age profile of malaria patients so that the risk of malaria is now almost uniformly distributed throughout life, while in the past malaria used to concern more children below 16 years of age.</p> <p>Conclusions</p> <p>This study provides direct evidence of malaria risk receding between 1996-2010 and becoming equal throughout life where transmission used to be moderate. Infection rates are no longer enough to sustain immunity. Temporally, this coincides with deploying artemisinin combinations on parasitological confirmation, but other contributing causes are unclear.</p

Comparative assimilation of Topex/poseidon and ERS altimetric data and of TAO temperature data in the tropical Pacific Ocean during 1994-1998, and the mean sea-surface height issue

International audienceFive years of Topex/Poseidon (T/P) and ERS sea level anomaly (SLA) data (1994–1998) are assimilated every 10 days into a primitive equation model of the tropical Pacific ocean. The data assimilation technique used here is a reduced-order Kalman filter derived from the Singular Evolutive Extended Kalman (SEEK) filter [J. Mar. Syst. 16(3–4) (1998) 323] with an error covariance matrix parameterised by a subset of multivariate 3D global empirical orthogonal functions (EOFs). The assimilation run is compared to the free run and to independent data from the TAO network. The impact of sea-surface height (SSH) assimilation on surface and subsurface temperature and currents is estimated in the equatorial band. In a second stage, temperature data from the TAO array are assimilated in the same conditions as in the first stage. The comparison between the results of the two assimilation experiments is made mainly with a view to gaining insights into the mean sea-surface height (MSSH) for the assimilation of altimeter data, and more generally, into the question of biases. XBT observations and TAO array data are then used to build a physically more consistent mean sea-surface height for assimilation of SLA data. Results from the assimilation of altimeter data referenced to this new MSSH show significant improvements

Report of the 1988 2-D Intercomparison Workshop, chapter 3

Several factors contribute to the errors encountered. With the exception of the line-by-line model, all of the models employ simplifying assumptions that place fundamental limits on their accuracy and range of validity. For example, all 2-D modeling groups use the diffusivity factor approximation. This approximation produces little error in tropospheric H2O and CO2 cooling rates, but can produce significant errors in CO2 and O3 cooling rates at the stratopause. All models suffer from fundamental uncertainties in shapes and strengths of spectral lines. Thermal flux algorithms being used in 2-D tracer tranport models produce cooling rates that differ by as much as 40 percent for the same input model atmosphere. Disagreements of this magnitude are important since the thermal cooling rates must be subtracted from the almost-equal solar heating rates to derive the net radiative heating rates and the 2-D model diabatic circulation. For much of the annual cycle, the net radiative heating rates are comparable in magnitude to the cooling rate differences described. Many of the models underestimate the cooling rates in the middle and lower stratosphere. The consequences of these errors for the net heating rates and the diabatic circulation will depend on their meridional structure, which was not tested here. Other models underestimate the cooling near 1 mbar. Suchs errors pose potential problems for future interactive ozone assessment studies, since they could produce artificially-high temperatures and increased O3 destruction at these levels. These concerns suggest that a great deal of work is needed to improve the performance of thermal cooling rate algorithms used in the 2-D tracer transport models