On air temperature fluctuations immediately above a glacier surface

Developing remote sensing techniques for measuring meteorological parameters in surface layers of snow field

EUS-guided rendezvous technique for difficult cannulation of an intradiverticular papilla

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Cm-Wavelength Total Flux and Linear Polarization Properties of Radio-Loud BL Lacertae Objects

Results from a long-term program to quantify the range of behavior of the cm-wavelength total flux and linear polarization variability properties of a sample of 41 radio-loud BL Lac objects using weekly to tri-monthly observations with the University of Michigan 26-m telescope operating at 14.5, 8.0, and 4.8 GHz are presented; these observations are used to identify class-dependent differences between these BL Lacs and QSOs in the Pearson-Readhead sample. The BL Lacs are found to be more highly variable in total flux density than the QSOs, exhibiting changes that are often nearly-simultaneous and of comparable amplitude at 14.5 and 4.8 GHz in contrast to the behavior in the QSOs and supporting the existence of class-dependent differences in opacity within the parsec-scale jet flows. Structure function analyses of the flux observations quantify that a characteristic timescale is identifiable in only 1/3 of the BL Lacs. The time-averaged fractional linear polarizations are only on the order of a few percent and are consistent with the presence of tangled magnetic fields within the emitting regions. In many sources a preferred long-term orientation of the EVPA is present; when compared with the VLBI structural axis, no preferred position angle difference is identified. The polarized flux typically exhibits variability with timescales of months to a few years and shows the signature of a propagating shock during several resolved outbursts. The observations indicate that the source emission is predominately due to evolving source components and support the occurrence of more frequent shock formation in BL Lac parsec-scale flows than in QSO jets. The differences in variability behavior and polarization between BL Lacs and QSOs can be explained by differences in jet stability.Comment: 1 LaTex (aastex) file, 21 postscript figure files, 2 external LaTex table files. To appear in the Astrophysical Journa

Long-Term water stress and drought assessment of Mediterranean oak savanna vegetation using thermal remote sensing

Drought is a devastating natural hazard that is difficult to define, detect and quantify. The increased availability of both meteorological and remotely sensed data provides an opportunity to develop new methods to identify drought conditions and characterize how drought changes over space and time. In this paper, we applied the surface energy balance model, SEBS (Surface Energy Balance System), for the period 2001 2018, to estimate evapotranspiration and other energy fluxes over the dehesa area of the Iberian Peninsula, with a monthly temporal resolution and 0.05° pixel size. A satisfactory agreement was found between the fluxes modeled and the measurements obtained for 3 years by two flux towers located over representative sites (RMSD = 21 W m-2 and R2 = 0.76, on average, for all energy fluxes and both sites). The estimations of the convective fluxes (LE and H) showed higher deviations, with RMSD = 26 W m-2 on average, than Rn and G, with RMSD = 15 W m-2. At both sites, annual evapotranspiration (ET) was very close to total precipitation, with the exception of a few wet years in which intense precipitation events that produced high runoff were observed. The analysis of the anomalies of the ratio of ET to reference ET (ETo) was used as an indicator of agricultural drought on monthly and annual scales. The hydrological years 2004/2005 and 2011/2012 stood out for their negative values. The first one was the most severe of the series, with the highest impact observed on vegetation coverage and grain production. On a monthly scale, this event was also the longest and most intense, with peak negative values in January February and April May 2005, explaining its great impact on cereal production (up to 45 % reduction). During the drier events, the changes in the grasslands and oak trees ground cover allowed for a separate analysis of the strategies adopted by the two strata to cope with water stress. These results indicate that the drought events characterized for the period did not cause any permanent damage to the vegetation of dehesa systems. The approach tested has proven useful for providing insight into the characteristics of drought events over this ecosystem and will be helpful to identify areas of interest for future studies at finer resolutions

Direct peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary study

Background and aims: Endoscopic sphincterotomy (ES) with stone extraction is the standard treatment for choledocholithiasis. After stone retrieval, balloon-occluded cholangiography is generally performed to confirm bile duct clearance but can miss residual stones particularly in patients with residual small-sized stones, a large bile duct or pneumobilia. In addition, difficult common bile duct (CBD) stones requiring advanced endoscopic techniques for retrieval are a potential risk factor for choledocholithiasis recurrence. Methods: We performed a retrospective evaluation of a prospectively maintained procedures database. From July 2016 to December 2017, all patients with difficult CBD stones who underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillary balloon dilation-assisted stone retrieval and subsequent direct per-oral cholangioscopy (DPOC) using standard gastroscopes to confirm CBD clearance were analyzed. Results: Thirty-six patients who underwent ERCP and DPOC were included. Technical success, defined as deep intubation of CBD with hepatic hilum visualization, was achieved in 31 of 36 patients (86%). During DPOC, residual CBD stones were visualized and removed in 7 of 31 patients (22.5%). After a mean of 241 +/- 56 days of follow-up post-DPOC, no serious adverse events were reported, and there was no evidence or suspicion of recurrent choledocholithiasis. Conclusions: Direct per-oral cholangioscopy immediately following difficult CBD stone removal was safe, feasible and accurate. In this setting, DPOC at the time of ERCP appears to be a very useful tool to achieve complete clearance of choledocholithiasis.info:eu-repo/semantics/publishedVersio

Association of Patients’ Epidemiological Characteristics and Comorbidities with Severity and Related Mortality Risk of SARS-CoV-2 Infection: Results of an Umbrella Systematic Review and Meta-Analysis

The objective of this study was to assess the association between patients’ epidemiological characteristics and comorbidities with SARS-CoV-2 infection severity and related mortality risk. An umbrella systematic review, including a meta-analysis examining the association between patients’ underlying conditions and severity (defined as need for hospitalization) and mortality of COVID-19, was performed. Studies were included if they reported pooled risk estimates of at least three underlying determinants for hospitalization, critical disease (ICU admission, mechanical ventilation), and hospital mortality in patients diagnosed with SARS-CoV-2 infection. Evidence was summarized as pooled odds ratios (pOR) for disease outcomes with 95% confidence intervals (95% CI). Sixteen systematic reviews investigating the possible associations of comorbidities with severity or death from COVID-19 disease were included. Hospitalization was associated with age > 60 years (pOR 3.50; 95% CI 2.97–4.36), smoking habit (pOR 3.50; 95% CI 2.97–4.36), and chronic pulmonary disease (pOR 2.94; 95% CI 2.14–4.04). Chronic pulmonary disease (pOR 2.82; 95% CI 1.92–4.14), cerebrovascular disease (pOR 2.74; 95% CI 1.59–4.74), and cardiovascular disease (pOR 2.44; 95% CI 1.97–3.01) were likely to be associated with increased risk of critical COVID-19. The highest risk of mortality was associated with cardiovascular disease (pOR 3.59; 95% CI 2.83–4.56), cerebrovascular disease (pOR 3.11; 95% CI 2.35–4.11), and chronic renal disease (pOR 3.02; 95% CI 2.61–3.49). In conclusion, this umbrella systematic review provides a comprehensive summary of meta-analyses examining the impact of patients’ characteristics on COVID-19 outcomes. Elderly patients and those cardiovascular, cerebrovascular, and chronic renal disease should be prioritized for pre-exposure and post-exposure prophylaxis and early treatment

Sub-milliarcsecond Imaging of Quasars and AGN

We have used the VLBA at 15 GHz to image the structure of 132 strong compact AGN and quasars with a resolution better than one milliarcsecond and a dynamic range typically exceeding 1000 to 1. These observations were made as part of a program to investigate the sub-parsec structure of quasars and AGN and to study the changes in their structure with time. Many of the sources included in our study, particularly those located south of +35 degrees, have not been previously imaged with milliarcsecond resolution. Each of the sources has been observed at multiple epochs. In this paper we show images of each of the 132 sources which we have observed. For each source we present data at the epoch which had the best quality data. The milliarcsecond jets generally appear one-sided but two-sided structure is often found in lower luminosity radio galaxies and in high luminosity quasars with gigahertz peaked spectra. Usually the structure is unresolved along the direction perpendicular to the jet, but a few sources have broad plumes. In some low luminosity radio galaxies, the structure appears more symmetric at 2 cm than at long wavelengths. The apparent long wavelength symmetry in these sources is probably due to absorption by intervening material. A few sources contain only a single component with any secondary feature at least a thousand times weaker. We find no obvious correlation of radio morphology and the detection of gamma-ray emission by EGRET.Comment: 19 pages, 3 tables, 3 figures. Figure 2 (132 contour diagrams) is long and is omitted here. Figure 2 may be viewed at http://www.cv.nrao.edu/2cmsurvey/ In press, Astronomical Journal, April 199

POS0230 INTESTINAL MICROBIOTA CHANGES TNF-INHIBITORS INDUCED IN IBD-RELATED SPONDYLOARTHRITIS

Background:the close relationship between joints and gut inflammation has long been known and several data suggest that the dysbiosis could represents the link between Spondyloarthritis (SpA) and Inflammatory Bowel Diseases (IBD). To date, the manipulation of the intestinal microbiota is considered the key to the cure or control of the natural history of several pathologies sustained or favored by dysbiosis. The introduction of biologic drugs, in particular Tumor Necrosis Factor inhibitors (TNFi), revolutionized the management of both these diseases, thanks to the strong inhibition of inflammation and partially indirectly with mechanisms not yet fully clarified. While the impact of conventional drugs on gut microbiota is well known poor data are available about TNFi.Objectives:to investigate the impact of TNFi on gut microbiota.Methods:we included CD or UC patients fulfilling criteria for axial or peripheral SpA (ASAS 2009) on a typical Mediterranean diet, naïve to biologics needing TNFi. Clinical history, physical examination, instrumental examinations, biochemical examination including C-reactive protein (CRP), erhytrocyte sedimentation rate (ESR), HLA-B27 and fecal calprotectin at the baseline and after 6 months were performed. TNFi included infliximab and adalimumab. Fecal samples were collected by patients themselves by 24 hours before the start of the therapy. The processing was performed through metagenomic NGS (next generation sequencing) including the amplification of the V3 and V4 regions of the 16S (V3 and V4) and sequencing on the Illumina MiSeq platform. All patients received the treatment at least until week 24. Clinical disease indices included Visual Analogue Scale (VAS)-pain and Visual Analgue Scale(VAS)-disease activity for all patients, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for axial involvement, clinical disease activity index (CDAI) and Health Assessment Questionnaire-Disability Index (HAQ-DI) for peripheral involvement, Harvey-Bradshaw Index for CD (HBI), or partial Mayo (pMAYO) score for UC, were assessed at baseline and at the end of the study. The study was approved by the ethics committee (approval code 0056924).Results:we evaluated 20 patients affected by enteropatic arthritis, naïve for biologic drugs, treated with TNFi. After six months of therapy we observed a significant increase in Lachnospiracae family (Δ +10.3, p 0.04) and in Coprococcus genus (Δ +2.8, p 0.003). We also observed a decrease trend in Proteobacteria (Δ -8.0 p 0.095) and Gammaproteobacteria (Δ -9, p 0.093) and an increase trend in Clostridia (Δ +8.2 p 0.083). We didn't find differences between TNFi responders (SpA improvement or IBD remission achieved) and not responders in terms of alpha and beta-diversity.Conclusion:the decrease of Proteobacteria and the increase of Lachnospiraceae and Coprococcus is consistent with the hypothesis that TNFi therapy, by decreasing inflammation, tends to restore the intestinal eubiosis. However further studies on larger cohort incuding the evaluation of gut virota and micobiota will be necessary to definitively clarify the effects of TNFi on the composition and function of the gut microbiota.References:[1]Bazin T et al. Sci Rep. 2018;8(1):5446.[2]Aden K et al. Gastroenterology. 2019;157(5):1279-1292.e11.Table 1.Comparison between clinical variables between baseline and T6 (six months)Clinical variablesT0T6P_valueFecal Calprotectin(μg/g)- median (IQR)207.5(125.5-446.2)81(50-197.2)0.004CRP(mg/L)- median(IQR)8.2(4.8-20.8)2.9(1-4)0.001ESR(mm/h)- median(IQR)21.5(10.8-34)11(7.8-21)0.003VAS_pain- median(IQR)50(38.8-60)35(10-42.5)0.001VAS_disease- median(IQR)50(38.8-50)37.5(25-42.5)0.006HAQ- mediana(IQR)0.6(0.1-0.8)0.2(0.1-0.6)0.004BASDAI_score- median(IQR)5.2(4.1-5.6)2.8(2.5-4.3)0.013CDAI_activity- median(IQR)13(10.5-16)7(5.2-11)0.004IBD activity n(%) - 011 (55%)20 (100%)0.174IBD activity n(%) - 16 (30%)0 (0%)IBD activity n(%) - 22 (10%)0 (0%)IBD activity n(%) - 31 (5%)0 (0%)Disclosure of Interests:None declared