Assessing inter-sectoral climate change risks: the role of ISIMIP

The aims of the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) are to provide a framework for the intercomparison of global and regional-scale risk models within and across multiple sectors and to enable coordinated multi-sectoral assessments of different risks and their aggregated effects. The overarching goal is to use the knowledge gained to support adaptation and mitigation decisions that require regional or global perspectives within the context of facilitating transformations to enable sustainable development, despite inevitable climate shifts and disruptions. ISIMIP uses community-agreed sets of scenarios with standardized climate variables and socio-economic projections as inputs for projecting future risks and associated uncertainties, within and across sectors. The results are consistent multi-model assessments of sectoral risks and opportunities that enable studies that integrate across sectors, providing support for implementation of the Paris Agreement under the United Nations Framework Convention on Climate Change

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

A Retrospective Chart Review on the Effect of Cisplatin Related Kidney Damage When Used With Mannitol Diuresis Versus Saline Diuresis

Class of 2015 AbstractObjectives: To compare and evaluate effects on kidney function of mannitol dieresis versus saline diuresis on kidney function with cisplatin therapy. Methods: Patient charts documented between January 2010 and July 2013 were obtained and reviewed from a database of a university associated medical center. The patient’s lowest creatinine clearance (CrCl) and potassium levels during any time in therapy were compared against the baseline. Statistical testing for primary and secondary outcomes was calculated using the Independent-Samples T-Test. Results: A total of 140 patients were reviewed – 68 patients were included in the mannitol arm, 72 in the saline arm. All baseline characteristics reviewed were not statistically different between groups except for sex, which was skewed towards males in the saline arm of the study. Baseline CrCl was 97.14 ml/min in the mannitol arm, and 93.69 ml/min in the saline arm (p=0.91). The average change in CrCl was found to be -16.72 ml/min (95% CI, -21.85 to -11.59) in the mannitol arm, -14.00 ml/min (95% CI, -18.82 to -9.20) in the saline arm; this was not statistically different (p=0.41). There was an average change of -0.31 mmol/L in blood potassium levels in mannitol patients, and a change of 0.014 mmol/L in saline patients; this was found to be significantly different (p<0.01). Conclusions: In this single-center retrospective study, there appeared to be no benefit in using mannitol diuresis over saline diuresis. The use of mannitol incurs additional cost and place additional restrictions on administration.This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, [email protected]

Reduced Cerebral Arterial Spin-Labeled Perfusion in Children With Neurofibromatosis Type 1

BACKGROUND AND PURPOSE: Neurofibromatosis type 1 is associated with increased risk for stroke, cerebral vasculopathy, and neurocognitive deficits, but underlying hemodynamic changes in asymptomatic children remain poorly understood. We hypothesized that children with neurofibromatosis type 1 have decreased cerebral blood flow. MATERIALS AND METHODS: Arterial spin-labeled CBF was measured in 14 children with neurofibromatosis type 1 (median age, 9.7 years; mean, 10.2 years; range, 22 months to 18 years) and compared with age-matched control subjects on 3T MR imaging. Three-dimensional pseudocontinuous spin-echo arterial spin-labeled technique was used. Measurements were obtained at cortical gray matter of bilateral cerebral hemispheres and centrum semiovale by use of the ROI method. Comparison by Mann-Whitney test was used, with Bonferroni-adjusted P values ≤.004 judged as significant. RESULTS: We identified 7 of 12 areas with significantly diminished arterial spin-labeled CBF in patients with neurofibromatosis type 1 compared with control subjects. These areas included the anterior cingulate gyrus (P = .001), medial frontal cortex (P = .004), centrum semiovale (P = .004), temporo-occipital cortex (P = .002), thalamus (P = .001), posterior cingulate gyrus (P = .002), and occipital cortex (P = .001). Among patients with neurofibromatosis type 1, there were no significant differences in these regions on the basis of the presence of neurofibromatosis type 1 spots or neurocognitive deficits. CONCLUSIONS: Reduced cerebral perfusion was seen in children with neurofibromatosis type 1, particularly in the posterior circulation and the vascular borderzones of the middle and posterior cerebral arteries

Reduced Cerebral Arterial Spin-Labeled Perfusion in Children With Neurofibromatosis Type 1

BACKGROUND AND PURPOSE: Neurofibromatosis type 1 is associated with increased risk for stroke, cerebral vasculopathy, and neurocognitive deficits, but underlying hemodynamic changes in asymptomatic children remain poorly understood. We hypothesized that children with neurofibromatosis type 1 have decreased cerebral blood flow. MATERIALS AND METHODS: Arterial spin-labeled CBF was measured in 14 children with neurofibromatosis type 1 (median age, 9.7 years; mean, 10.2 years; range, 22 months to 18 years) and compared with age-matched control subjects on 3T MR imaging. Three-dimensional pseudocontinuous spin-echo arterial spin-labeled technique was used. Measurements were obtained at cortical gray matter of bilateral cerebral hemispheres and centrum semiovale by use of the ROI method. Comparison by Mann-Whitney test was used, with Bonferroni-adjusted P values ≤.004 judged as significant. RESULTS: We identified 7 of 12 areas with significantly diminished arterial spin-labeled CBF in patients with neurofibromatosis type 1 compared with control subjects. These areas included the anterior cingulate gyrus (P = .001), medial frontal cortex (P = .004), centrum semiovale (P = .004), temporo-occipital cortex (P = .002), thalamus (P = .001), posterior cingulate gyrus (P = .002), and occipital cortex (P = .001). Among patients with neurofibromatosis type 1, there were no significant differences in these regions on the basis of the presence of neurofibromatosis type 1 spots or neurocognitive deficits. CONCLUSIONS: Reduced cerebral perfusion was seen in children with neurofibromatosis type 1, particularly in the posterior circulation and the vascular borderzones of the middle and posterior cerebral arteries

Intellectual Outcome in Molecular Subgroups of Medulloblastoma.

Purpose To evaluate intellectual functioning and the implications of limiting radiation exposure in the four biologically distinct subgroups of medulloblastoma: wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4. Patients and Methods A total of 121 patients with medulloblastoma (n = 51, Group 4; n = 25, Group 3; n = 28, SHH; and n = 17, WNT), who were treated between 1991 and 2013 at the Hospital for Sick Children (Toronto, Ontario, Canada), Children’s National Health System (Washington, DC), or the Lucile Packard Children’s Hospital (Palo Alto, CA), had intellectual assessments. First, we compared intellectual trajectories between subgroups. Next, we evaluated the effect of treatment with reduced-dose craniospinal irradiation (CSI) plus a tumor bed boost versus treatments that deliver higher CSI doses and/or larger boost volumes to the brain (all other treatments) within subgroups. Linear mixed modeling was used to determine the stability or change in intelligence scores over time. Results Intellectual outcomes declined comparably in each subgroup except for processing speed; SHH declined less than Group 3 ( P = .04). SHH had the lowest incidence of cerebellar mutism and motor deficits. Treatment with reduced-dose CSI plus a tumor bed boost was associated with preserved intellectual functioning in WNT and Group 4 patients considered together (ie, subgroups containing patients who are candidates for therapy de-escalation), and not in Group 3 or SHH. Across all subgroups, patients in the all other treatments group declined over time (all P &lt; .05). Conclusion SHH patients appear to have the most distinct functional (ie, motor deficits and mutism) outcomes and a unique processing speed trajectory. Only WNT and Group 4 patients seem to benefit from limiting radiation exposure. Our findings highlight the value of conducting subgroup-specific analyses, and can be used to inform novel biologically based treatment protocols for patients with medulloblastoma. </jats:sec