Abrupt reversal in emissions and atmospheric abundance of HCFC-133a (CF3CH2Cl)

Hydrochlorofluorocarbon HCFC-133a (CF3CH2Cl) is an anthropogenic compound whose consumption for emissive use is restricted under the Montreal Protocol. A recent study showed rapidly increasing atmospheric abundances and emissions. We report that, following this rise, the at- mospheric abundance and emissions have declined sharply in the past three years. We find a Northern Hemisphere HCFC-133a increase from 0.13 ppt (dry air mole fraction in parts-per-trillion) in 2000 to 0.50 ppt in 2012–mid-2013 followed by an abrupt reversal to 0.44 ppt by early 2015. Global emissions derived from these observations peaked at 3.1 kt in 2011, followed by a rapid decline of 0.5 kt yr−2 to 1.5 kt yr−1 in 2014. Sporadic HCFC-133a pollution events are detected in Europe from our high-resolution HCFC-133a records at three European stations, and in Asia from sam- ples collected in Taiwan. European emissions are estimated to be <0.1 kt yr−1 although emission hotspots were identi- fied in France

Abundance and sources of atmospheric halocarbons in the Eastern Mediterranean

A wide range of anthropogenic halocarbons is released to the atmosphere, contributing to stratospheric ozone depletion and global warming. Using measurements of atmospheric abundances for the estimation of halocarbon emissions on the global and regional scale has become an important top-down tool for emission validation in the recent past, but many populated and developing areas of the world are only poorly covered by the existing atmospheric halocarbon measurement network. Here we present 6 months of continuous halocarbon observations from Finokalia on the island of Crete in the Eastern Mediterranean. The gases measured are the hydrofluorocarbons (HFCs), HFC-134a (CH2FCF3), HFC-125 (CHF2CF3), HFC-152a (CH3CHF2) and HFC-143a (CH3CF3) and the hydrochlorofluorocarbons (HCFCs), HCFC-22 (CHClF2) and HCFC-142b (CH3CClF2). The Eastern Mediterranean is home to 250 million inhabitants, consisting of a number of developed and developing countries, for which different emission regulations exist under the Kyoto and Montreal protocols. Regional emissions of halocarbons were estimated with Lagrangian atmospheric transport simulations and a Bayesian inverse modeling system, using measurements at Finokalia in conjunction with those from Advanced Global Atmospheric Gases Experiment (AGAGE) sites at Mace Head (Ireland), Jungfraujoch (Switzerland) and Monte Cimone (Italy). Measured peak mole fractions at Finokalia showed generally smaller amplitudes for HFCs than at the European AGAGE sites except for periodic peaks of HFC-152a, indicating strong upwind sources. Higher peak mole fractions were observed for HCFCs, suggesting continued emissions from nearby developing regions such as Egypt and the Middle East. For 2013, the Eastern Mediterranean inverse emission estimates for the four analyzed HFCs and the two HCFCs were 13.9 (11.3–19.3) and 9.5 (6.8–15.1) Tg CO2eq yr−1, respectively. These emissions contributed 16.8 % (13.6–23.3 %) and 53.2 % (38.1–84.2 %) to the total inversion domain, which covers the Eastern Mediterranean as well as central and western Europe. Greek bottom-up HFC emissions reported to the UNFCCC were higher than our top-down estimates, whereas for Turkey our estimates agreed with UNFCCC-reported values for HFC-125 and HFC-143a, but were much and slightly smaller for HFC-134a and HFC-152a, respectively. Sensitivity estimates suggest an improvement of the a posteriori emission estimates, i.e., a reduction of the uncertainties by 40–80 % in the entire inversion domain, compared to an inversion using only the existing central European AGAGE observations

Simulation-Based Training of the Rapid Evaluation and Management of Acute Stroke (STREAM)-A Prospective Single-Arm Multicenter Trial

Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2-3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period. Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the door-to-needle time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire. Interventions: We are applying a multi-level intervention in cooperation with three STREAM multipliers from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2-3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings