Atmospheric chemistry regimes in intercontinental air traffic corridors:Ozone versus NOx sensitivity

This study focusses on the environmental consequences of aircraft NOx emissions and their role and impact on ozone formation in the upper troposphere and lower stratosphere (UTLS). We use a global chemistry transport/box model approach to quantify the impacts of NOx on UTLS ozone over time scales of hours and over distance scales appropriate to air traffic corridors and aircraft flight paths. An important feature of our study has been to provide a marked contrast to the coarse spatial resolution of the global model studies typically employed to assess the impacts of aviation NOx on UTLS ozone. Real operational aviation routing data are used to quantify the NOx impacts on ozone at 235 locations on 21 flight paths. The NOx impact on ozone in the intercontinental air traffic corridors is strongest in the great circle routes from North America and Europe into Asia and weakest in the trans-polar routes. The NOx impacts identified with the CTM/box model combination are significantly smaller compared with those identified in the current global models typically used to assess aviation NOx impacts. Further research is required to confirm our assessment of those flight paths that appear to show greatest NOx – O3 impacts and those the least and extend our analyses into the tropics and southern hemisphere

Long-term restenosis rate of eversion endarterectomy on the internal carotid artery.

OBJECTIVES: The eversion endarterectomy of the internal carotid artery was introduced in Hungary in 1991. The aim of this study was to define the long-term restenosis rate of this procedure. PATIENTS AND METHODS: Between 1991 and 1993, 171 operations, on 151 patients, were performed by single surgeon: with long-term follow up of 109 patients, which included annual physical and ultrasound examinations. Restenosis rate and plaque morphology were defined. Survival and patency rate were analysed by life-tables. RESULTS: The combined perioperative stroke morbidity and mortality rate was 0.8%. The 5-year patient survival rate was 85%, the recurrent stenosis free rate was 88% at 5 years. Only 9% of the patients had carotid restenosis of more than 70% during this period. Ultrasound plaque morphology showed calcification in one case. Two patients had re-operations, with plaque histology showed myointimal hyperplasia in each case. CONCLUSIONS: Our results for restenosis are compare favourably with the 2-34% restenosis rate reported in the literature. Ultrasound and histological findings suggest that atherosclerosis does not play a significant role in the development of restenosis after the eversion carotid endarterectomy

Cerium‐Copper Oxides Synthesized in a Multi‐Inlet Vortex Reactor as Effective Nanocatalysts for CO and Ethene Oxidation Reactions

In this study, a set of CuCeOx catalysts was prepared via the coprecipitation method using a Multi‐Inlet Vortex Reactor: the Cu wt.% content is 5, 10, 20, 30 and 60. Moreover, pure CeO2 and CuO were synthesized for comparison purposes. The physico‐chemical properties of this set of samples were investigated by complementary techniques, e.g., XRD, N2 physisorption at −196 °C, Scanning Electron Microscopy, XPS, FT‐IR, Raman spectroscopy and H2‐TPR. Then, the CuCeOx catalysts were tested for the CO and ethene oxidation reactions. As a whole, all the prepared samples presented good catalytic performances towards the CO oxidation reaction (1000 ppm CO, 10 vol.% O2/N2): the most promising catalyst was the 20%CuCeOx (complete CO conversion at 125 °C), which exhibited a long‐term thermal stability. Similarly, the oxidative activity of the catalysts were evaluated using a gaseous mixture containing 500 ppm C2H4, 10 vol.% O2/N2. Accordingly, for the ethene oxidation reaction, the 20%CuCeOx catalyst evidenced the best catalytic properties. The elevated catalytic activity towards CO and ethene oxidation was mainly ascribed to synergistic interactions between CeO2 and CuO phases, as well as to the high amount of surface‐chemisorbed oxygen species and structural defects

Research Needs for Effective Transition in Lifelong Care of Congenital Genitourinary Conditions: A Workshop Sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases

Over the last 5 decades, health-care advances have yielded quantum improvements in the life expectancy of individuals with congenital genitourinary conditions (CGCs), leading to a crisis of care. Many individuals with CGC enter adulthood unprepared to manage their condition. Pediatric CGC specialists lack training to manage adulthood-related health-care issues, whereas adult genitourinary specialists lack training within the context of CGCs. To address these challenges, the National Institutes of Diabetes and Digestive and Kidney Diseases convened individuals with CGCs and experts from a variety of fields to identify research needs to improve transitional urology care. This paper outlines identified research needs

Pembrolizumab as first-line treatment for metastatic uveal melanoma

Background: No standard treatment has been defined for metastatic uveal melanoma (mUM). Although clinical trials testing Nivolumab/Pembrolizumab for cutaneous melanoma did not include mUM, anti PD-1 agents are commonly used for this disease. Patients and methods: In this prospective observational cohort single arm study, we investigated efficacy and safety of Pembrolizumab as first-line therapy for mUM. The efficacy was evaluated in terms of progression-free survival (PFS), response rate and overall survival (OS). Toxicity was also assessed. Results: Seventeen patients were enrolled. A median of 8 cycles were administered (range 2\u201328). Two patients achieved partial response (11.7%), 6 a disease stabilization (35.3%), whereas 9 (53%) had a progression. No complete response was observed. PFS of the overall population was 3.8 months. PFS was 9.7 months for patients with an interval higher than 5 years from diagnosis of primary tumor to metastatic disease and 2.6 months for patients with an interval lower than 5 years [p = 0.039, HR 0.2865 (95% CI 0.0869\u20130.9443)]. Median OS was not reached. The two responding patients were still on treatment with Pembrolizumab at the time of data analysis. Survival was 12.8 months for patients with clinical benefit, while OS for progressive patients was 3.1 months. PD-L1 expression and genomic abnormalities predictive of relapse after diagnosis of primary tumor were not associated with PFS. Toxicity was mild, without grade 3\u20134 side effects. Conclusions: The efficacy of Pembrolizumab does not seem particularly different when compared to other agents for mUM, but responding patients had a remarkable disease control

How does study quality affect the results of a diagnostic meta-analysis?

Background: The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods: This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results: Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion: Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited

BepiColombo’s Cruise Phase: Unique Opportunity for Synergistic Observations

The investigation of multi-spacecraft coordinated observations during the cruise phase of BepiColombo (ESA/JAXA) are reported, with a particular emphasis on the recently launched missions, Solar Orbiter (ESA/NASA) and Parker Solar Probe (NASA). Despite some payload constraints, many instruments onboard BepiColombo are operating during its cruise phase simultaneously covering a wide range of heliocentric distances (0.28 AU–0.5 AU). Hence, the various spacecraft configurations and the combined in-situ and remote sensing measurements from the different spacecraft, offer unique opportunities for BepiColombo to be part of these unprecedented multipoint synergistic observations and for potential scientific studies in the inner heliosphere, even before its orbit insertion around Mercury in December 2025. The main goal of this report is to present the coordinated observation opportunities during the cruise phase of BepiColombo (excluding the planetary flybys). We summarize the identified science topics, the operational instruments, the method we have used to identify the windows of opportunity and discuss the planning of joint observations in the future

BepiColombo's Cruise Phase : Unique Opportunity for Synergistic Observations

The investigation of multi-spacecraft coordinated observations during the cruise phase of BepiColombo (ESA/JAXA) are reported, with a particular emphasis on the recently launched missions, Solar Orbiter (ESA/NASA) and Parker Solar Probe (NASA). Despite some payload constraints, many instruments onboard BepiColombo are operating during its cruise phase simultaneously covering a wide range of heliocentric distances (0.28 AU-0.5 AU). Hence, the various spacecraft configurations and the combined in-situ and remote sensing measurements from the different spacecraft, offer unique opportunities for BepiColombo to be part of these unprecedented multipoint synergistic observations and for potential scientific studies in the inner heliosphere, even before its orbit insertion around Mercury in December 2025. The main goal of this report is to present the coordinated observation opportunities during the cruise phase of BepiColombo (excluding the planetary flybys). We summarize the identified science topics, the operational instruments, the method we have used to identify the windows of opportunity and discuss the planning of joint observations in the future.Peer reviewe

Clustered mutations in the <i>GRIK2</i> kainate receptor subunit gene underlie diverse neurodevelopmental disorders

Kainate receptors (KARs) are glutamate-gated cation channels with diverse roles in the central nervous system. Bi-allelic loss of function of the KAR-encoding gene GRIK2 causes a nonsyndromic neurodevelopmental disorder (NDD) with intellectual disability and developmental delay as core features. The extent to which mono-allelic variants in GRIK2 also underlie NDDs is less understood because only a single individual has been reported previously. Here, we describe an additional eleven individuals with heterozygous de novo variants in GRIK2 causative for neurodevelopmental deficits that include intellectual disability. Five children harbored recurrent de novo variants (three encoding p.Thr660Lys and two p.Thr660Arg), and four children and one adult were homozygous for a previously reported variant (c.1969G&gt;A [p.Ala657Thr]). Individuals with shared variants had some overlapping behavioral and neurological dysfunction, suggesting that the GRIK2 variants are likely pathogenic. Analogous mutations introduced into recombinant GluK2 KAR subunits at sites within the M3 transmembrane domain (encoding p.Ala657Thr, p.Thr660Lys, and p.Thr660Arg) and the M3-S2 linker domain (encoding p.Ile668Thr) had complex effects on functional properties and membrane localization of homomeric and heteromeric KARs. Both p.Thr660Lys and p.Thr660Arg mutant KARs exhibited markedly slowed gating kinetics, similar to p.Ala657Thr-containing receptors. Moreover, we observed emerging genotype-phenotype correlations, including the presence of severe epilepsy in individuals with the p.Thr660Lys variant and hypomyelination in individuals with either the p.Thr660Lys or p.Thr660Arg variant. Collectively, these results demonstrate that human GRIK2 variants predicted to alter channel function are causative for early childhood development disorders and further emphasize the importance of clarifying the role of KARs in early nervous system development.</p