Persistent acceleration in global sea-level rise since the 1960s

Previous studies reconstructed twentieth-century global mean sea level (GMSL) from sparse tide-gauge records to understand whether the recent high rates obtained from satellite altimetry are part of a longer-term acceleration. However, these analyses used techniques that can only accurately capture either the trend or the variability in GMSL, but not both. Here we present an improved hybrid sea-level reconstruction during 1900–2015 that combines previous techniques at time scales where they perform best. We find a persistent acceleration in GMSL since the 1960s and demonstrate that this is largely (~76%) associated with sea-level changes in the Indo-Pacific and South Atlantic. We show that the initiation of the acceleration in the 1960s is tightly linked to an intensification and a basin-scale equatorward shift of Southern Hemispheric westerlies, leading to increased ocean heat uptake, and hence greater rates of GMSL rise, through changes in the circulation of the Southern Ocean

IL-21 signaling is essential for optimal host resistance against Mycobacterium tuberculosis infection

IL-21 is produced predominantly by activated CD4(+) T cells and has pleiotropic effects on immunity via the IL-21 receptor (IL-21R), a member of the common gamma chain (gamma(c)) cytokine receptor family. We show that IL-21 signaling plays a crucial role in T cell responses during Mycobacterium tuberculosis infection by augmenting CD8(+) T cell priming, promoting T cell accumulation in the lungs, and enhancing T cell cytokine production. In the absence of IL-21 signaling, more CD4(+) and CD8(+) T cells in chronically infected mice express the T cell inhibitory molecules PD-1 and TIM-3. We correlate these immune alterations with increased susceptibility of IL-21R(-/-) mice, which have increased lung bacterial burden and earlier mortality compared to WT mice. Finally, to causally link the immune defects with host susceptibility, we use an adoptive transfer model to show that IL-21R(-/-) T cells transfer less protection than WT T cells. These results prove that IL-21 signaling has an intrinsic role in promoting the protective capacity of T cells. Thus, the net effect of IL-21 signaling is to enhance host resistance to M. tuberculosis. These data position IL-21 as a candidate biomarker of resistance to tuberculosis.This work was supported by National Institutes of Health Grants R21 AI100766, R01 AI106725, and P01 AI073748

ICAR: endoscopic skull‐base surgery

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Lawson criterion for ignition exceeded in an inertial fusion experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion

Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia

Vampires in the village Žrnovo on the island of Korčula: following an archival document from the 18th century

Središnja tema rada usmjerena je na raščlambu spisa pohranjenog u Državnom arhivu u Mlecima (fond: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) koji se odnosi na događaj iz 1748. godine u korčulanskom selu Žrnovo, kada su mještani – vjerujući da su se pojavili vampiri – oskvrnuli nekoliko mjesnih grobova. U radu se podrobno iznose osnovni podaci iz spisa te rečeni događaj analizira u širem društvenom kontekstu i prate se lokalna vjerovanja.The main interest of this essay is the analysis of the document from the State Archive in Venice (file: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) which is connected with the episode from 1748 when the inhabitants of the village Žrnove on the island of Korčula in Croatia opened tombs on the local cemetery in the fear of the vampires treating. This essay try to show some social circumstances connected with this event as well as a local vernacular tradition concerning superstitions

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Differential associations of amyloid and tau (from PET) with brain volumes (from MRI) by cognitive status

Background: Alzheimer’s disease pathology (AD) is an important cause of neurodegeneration and brain atrophy. Non-AD mechanisms can also cause neurodegeneration alone or in conjunction with AD. Harboring combination of AD and non-AD pathologies leads to greater cognitive impairment and dementia. Here, we examined the hypothesis that the association of amyloid and tau burden from positron emission tomography (PET) with brain volumes from magnetic resonance imaging (MRI) is weaker in those with dementia compared to those with mild cognitive impairment (MCI) or normal cognition. Method: We used data from participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) who had either florbetapir amyloid PET (N=1320) of flortaucipir tau PET (N=833, 535 of whom had both). We examined the association between volumes of brain structures (FreeSurfer-v7) and standardized uptake value ratios (SUVr) for amyloid (summary cortical region, normalized to whole cerebellum) and tau (meta-temporal region, normalized to inferior cerebellar gray matter) separately, using linear regressions adjusting for age, sex, and education. We report results in overall groups and by cognitive status (normal, MCI, dementia). We display semi-partial correlations (sr, thresholded at Puncorrected<0.05), as measures of effect size. Result: Table-1 summarizes participant characteristics. The effect of amyloid on brain volumes was modest in the overall cohort, with associations strongest for inferior/middle temporal, inferior parietal, entorhinal, hippocampus, and amygdala regions (sr∼-0.2, P<0.001 all). In those with dementia, however, there were no distinct associations between amyloid and brain atrophy (Figure-1). For tau, associations in the overall cohort were similarly strongest for inferior/middle temporal, inferior parietal, entorhinal, hippocampus, and amygdala regions (sr∼-0.3, P<0.001 all). In those with dementia, associations remained strong for inferior/middle temporal regions (sr∼-0.3, P<0.001) but tau was not associated with hippocampus volumes (left, sr=-0.05, P=0.6; right, sr=-0.12, P=0.14, Figure-2); this divergence is further highlighted in select regions (inferior temporal and hippocampus) in Figure-3. Conclusion: We found that the relationship between amyloid and tau burden and atrophy was stronger in the overall cohort than in participants with dementia. This was particularly the case for medial temporal lobe structures. The effect of non-AD pathologies on medial temporal lobe atrophy is a potential explanation for the observed results

Understanding global sea levels: past, present and future

The coastal zone has changed profoundly during the 20th century and, as a result, society is becoming increasingly vulnerable to the impact of sea-level rise and variability. This demands improved understanding to facilitate appropriate planning to minimise potential losses. With this in mind, the World Climate Research Programme organised a workshop (held in June 2006) to document current understanding and to identify research and observations required to reduce current uncertainties associated with sea-level rise and variability. While sea levels have varied by over 120 m during glacial/interglacial cycles, there has been little net rise over the past several millennia until the 19th century and early 20th century, when geological and tide-gauge data indicate an increase in the rate of sea-level rise. Recent satellite-altimeter data and tide-gauge data have indicated that sea levels are now rising at over 3 mm year−1. The major contributions to 20th and 21st century sea-level rise are thought to be a result of ocean thermal expansion and the melting of glaciers and ice caps. Ice sheets are thought to have been a minor contributor to 20th century sea-level rise, but are potentially the largest contributor in the longer term. Sea levels are currently rising at the upper limit of the projections of the Third Assessment Report of the Intergovernmental Panel on Climate Change (TAR IPCC), and there is increasing concern of potentially large ice-sheet contributions during the 21st century and beyond, particularly if greenhouse gas emissions continue unabated. A suite of ongoing satellite and in situ observational activities need to be sustained and new activities supported. To the extent that we are able to sustain these observations, research programmes utilising the resulting data should be able to significantly improve our understanding and narrow projections of future sea-level rise and variabilit