Cervical artery dissection in patients >= 60 years Often painless, few mechanical triggers

Objective: In a cohort of patients diagnosed with cervical artery dissection (CeAD), to determine the proportion of patients aged >= 60 years and compare the frequency of characteristics (presenting symptoms, risk factors, and outcome) in patients aged = 60 years. Methods: We combined data from 3 large cohorts of consecutive patients diagnosed with CeAD (i. e., Cervical Artery Dissection and Ischemic Stroke Patients-Plus consortium). We dichotomized cases into 2 groups, age >= 60 and Results: Among 2,391 patients diagnosed with CeAD, we identified 177 patients (7.4%) aged >= 60 years. In this age group, cervical pain (ORadjusted 0.47 [0.33-0.66]), headache (ORadjusted 0.58 [0.42-0.79]), mechanical trigger events (ORadjusted 0.53 [0.36-0.77]), and migraine (ORadjusted 0.58 [0.39-0.85]) were less frequent than in younger patients. In turn, hypercholesterolemia (ORadjusted 1.52 [1.1-2.10]) and hypertension (ORadjusted 3.08 [2.25-4.22]) were more frequent in older patients. Key differences between age groups were confirmed in secondary analyses. In multivariable, adjusted analyses, favorable outcome (i. e., modified Rankin Scale score 0-2) was less frequent in the older age group (ORadjusted 0.45 [0.25, 0.83]). Conclusion: In our study population of patients diagnosed with CeAD, 1 in 14 was aged >= 60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk ofmissed CeAD diagnosis in older patients.Peer reviewe

A global observational analysis to understand changes in air quality during exceptionally low anthropogenic emission conditions

This global study, which has been coordinated by the World Meteorological Organization Global Atmospheric Watch (WMO/GAW) programme, aims to understand the behaviour of key air pollutant species during the COVID-19 pandemic period of exceptionally low emissions across the globe. We investigated the effects of the differences in both emissions and regional and local meteorology in 2020 compared with the period 2015-2019. By adopting a globally consistent approach, this comprehensive observational analysis focuses on changes in air quality in and around cities across the globe for the following air pollutants PM2.5, PM10, PMC (coarse fraction of PM), NO2, SO2, NOx, CO, O-3 and the total gaseous oxidant (O-X = NO2 + O-3) during the pre-lockdown, partial lockdown, full lockdown and two relaxation periods spanning from January to September 2020. The analysis is based on in situ ground-based air quality observations at over 540 traffic, background and rural stations, from 63 cities and covering 25 countries over seven geographical regions of the world. Anomalies in the air pollutant concentrations (increases or decreases during 2020 periods compared to equivalent 2015-2019 periods) were calculated and the possible effects of meteorological conditions were analysed by computing anomalies from ERA5 reanalyses and local observations for these periods. We observed a positive correlation between the reductions in NO2 and NOx concentrations and peoples' mobility for most cities. A correlation between PMC and mobility changes was also seen for some Asian and South American cities. A clear signal was not observed for other pollutants, suggesting that sources besides vehicular emissions also substantially contributed to the change in air quality. As a global and regional overview of the changes in ambient concentrations of key air quality species, we observed decreases of up to about 70% in mean NO2 and between 30% and 40% in mean PM2.5 concentrations over 2020 full lockdown compared to the same period in 2015-2019. However, PM2.5 exhibited complex signals, even within the same region, with increases in some Spanish cities, attributed mainly to the long-range transport of African dust and/or biomass burning (corroborated with the analysis of NO2/CO ratio). Some Chinese cities showed similar increases in PM2.5 during the lockdown periods, but in this case, it was likely due to secondary PM formation. Changes in O-3 concentrations were highly heterogeneous, with no overall change or small increases (as in the case of Europe), and positive anomalies of 25% and 30% in East Asia and South America, respectively, with Colombia showing the largest positive anomaly of similar to 70%. The SO2 anomalies were negative for 2020 compared to 2015-2019 (between similar to 25 to 60%) for all regions. For CO, negative anomalies were observed for all regions with the largest decrease for South America of up to similar to 40%. The NO2/CO ratio indicated that specific sites (such as those in Spanish cities) were affected by biomass burning plumes, which outweighed the NO2 decrease due to the general reduction in mobility (ratio of similar to 60%). Analysis of the total oxidant (OX = NO2 + O-3) showed that primary NO2 emissions at urban locations were greater than the O-3 production, whereas at background sites, O-X was mostly driven by the regional contributions rather than local NO2 and O-3 concentrations. The present study clearly highlights the importance of meteorology and episodic contributions (e.g., from dust, domestic, agricultural biomass burning and crop fertilizing) when analysing air quality in and around cities even during large emissions reductions. There is still the need to better understand how the chemical responses of secondary pollutants to emission change under complex meteorological conditions, along with climate change and socio-economic drivers may affect future air quality. The implications for regional and global policies are also significant, as our study clearly indicates that PM2.5 concentrations would not likely meet the World Health Organization guidelines in many parts of the world, despite the drastic reductions in mobility. Consequently, revisions of air quality regulation (e.g., the Gothenburg Protocol) with more ambitious targets that are specific to the different regions of the world may well be required.Peer reviewe

A global observational analysis to understand changes in air quality during exceptionally low anthropogenic emission

This global study, which has been coordinated by the World Meteorological Organization Global Atmospheric Watch (WMO/GAW) programme, aims to understand the behaviour of key air pollutant species during the COVID-19 pandemic period of exceptionally low emissions across the globe. We investigated the effects of the differences in both emissions and regional and local meteorology in 2020 compared with the period 2015–2019. By adopting a globally consistent approach, this comprehensive observational analysis focuses on changes in air quality in and around cities across the globe for the following air pollutants PM2.5, PM10, PMC (coarse fraction of PM), NO2, SO2, NOx, CO, O3 and the total gaseous oxidant (OX = NO2 + O3) during the pre-lockdown, partial lockdown, full lockdown and two relaxation periods spanning from January to September 2020. The analysis is based on in situ ground-based air quality observations at over 540 traffic, background and rural stations, from 63 cities and covering 25 countries over seven geographical regions of the world. Anomalies in the air pollutant concentrations (increases or decreases during 2020 periods compared to equivalent 2015–2019 periods) were calculated and the possible effects of meteorological conditions were analysed by computing anomalies from ERA5 reanalyses and local observations for these periods. We observed a positive correlation between the reductions in NO2 and NOx concentrations and peoples’ mobility for most cities. A correlation between PMC and mobility changes was also seen for some Asian and South American cities. A clear signal was not observed for other pollutants, suggesting that sources besides vehicular emissions also substantially contributed to the change in air quality. As a global and regional overview of the changes in ambient concentrations of key air quality species, we observed decreases of up to about 70% in mean NO2 and between 30% and 40% in mean PM2.5 concentrations over 2020 full lockdown compared to the same period in 2015–2019. However, PM2.5 exhibited complex signals, even within the same region, with increases in some Spanish cities, attributed mainly to the long-range transport of African dust and/or biomass burning (corroborated with the analysis of NO2/CO ratio). Some Chinese cities showed similar increases in PM2.5 during the lockdown periods, but in this case, it was likely due to secondary PM formation. Changes in O3 concentrations were highly heterogeneous, with no overall change or small increases (as in the case of Europe), and positive anomalies of 25% and 30% in East Asia and South America, respectively, with Colombia showing the largest positive anomaly of ~70%. The SO2 anomalies were negative for 2020 compared to 2015–2019 (between ~25 to 60%) for all regions. For CO, negative anomalies were observed for all regions with the largest decrease for South America of up to ~40%. The NO2/CO ratio indicated that specific sites (such as those in Spanish cities) were affected by biomass burning plumes, which outweighed the NO2 decrease due to the general reduction in mobility (ratio of ~60%). Analysis of the total oxidant (OX = NO2 + O3) showed that primary NO2 emissions at urban locations were greater than the O3 production, whereas at background sites, OX was mostly driven by the regional contributions rather than local NO2 and O3 concentrations. The present study clearly highlights the importance of meteorology and episodic contributions (e.g., from dust, domestic, agricultural biomass burning and crop fertilizing) when analysing air quality in and around cities even during large emissions reductions. There is still the need to better understand how the chemical responses of secondary pollutants to emission change under complex meteorological conditions, along with climate change and socio-economic drivers may affect future air quality. The implications for regional and global policies are also significant, as our study clearly indicates that PM2.5 concentrations would not likely meet the World Health Organization guidelines in many parts of the world, despite the drastic reductions in mobility. Consequently, revisions of air quality regulation (e.g., the Gothenburg Protocol) with more ambitious targets that are specific to the different regions of the world may well be required.Peer reviewedFinal Published versio

Event reconstruction for KM3NeT/ORCA using convolutional neural networks

The KM3NeT research infrastructure is currently under construction at two locations in the Mediterranean Sea. The KM3NeT/ORCA water-Cherenkov neutrino de tector off the French coast will instrument several megatons of seawater with photosensors. Its main objective is the determination of the neutrino mass ordering. This work aims at demonstrating the general applicability of deep convolutional neural networks to neutrino telescopes, using simulated datasets for the KM3NeT/ORCA detector as an example. To this end, the networks are employed to achieve reconstruction and classification tasks that constitute an alternative to the analysis pipeline presented for KM3NeT/ORCA in the KM3NeT Letter of Intent. They are used to infer event reconstruction estimates for the energy, the direction, and the interaction point of incident neutrinos. The spatial distribution of Cherenkov light generated by charged particles induced in neutrino interactions is classified as shower-or track-like, and the main background processes associated with the detection of atmospheric neutrinos are recognized. Performance comparisons to machine-learning classification and maximum-likelihood reconstruction algorithms previously developed for KM3NeT/ORCA are provided. It is shown that this application of deep convolutional neural networks to simulated datasets for a large-volume neutrino telescope yields competitive reconstruction results and performance improvements with respect to classical approaches

Event reconstruction for KM3NeT/ORCA using convolutional neural networks

The KM3NeT research infrastructure is currently under construction at two locations in the Mediterranean Sea. The KM3NeT/ORCA water-Cherenkov neutrino detector off the French coast will instrument several megatons of seawater with photosensors. Its main objective is the determination of the neutrino mass ordering. This work aims at demonstrating the general applicability of deep convolutional neural networks to neutrino telescopes, using simulated datasets for the KM3NeT/ORCA detector as an example. To this end, the networks are employed to achieve reconstruction and classification tasks that constitute an alternative to the analysis pipeline presented for KM3NeT/ORCA in the KM3NeT Letter of Intent. They are used to infer event reconstruction estimates for the energy, the direction, and the interaction point of incident neutrinos. The spatial distribution of Cherenkov light generated by charged particles induced in neutrino interactions is classified as shower- or track-like, and the main background processes associated with the detection of atmospheric neutrinos are recognized. Performance comparisons to machine-learning classification and maximum-likelihood reconstruction algorithms previously developed for KM3NeT/ORCA are provided. It is shown that this application of deep convolutional neural networks to simulated datasets for a large-volume neutrino telescope yields competitive reconstruction results and performance improvements with respect to classical approaches

A global observational analysis to understand changes in air quality during exceptionally low anthropogenic emission conditions

This global study, which has been coordinated by the World Meteorological Organization Global Atmospheric Watch (WMO/GAW) programme, aims to understand the behaviour of key air pollutant species during the COVID-19 pandemic period of exceptionally low emissions across the globe. We investigated the effects of the differences in both emissions and regional and local meteorology in 2020 compared with the period 2015–2019. By adopting a globally consistent approach, this comprehensive observational analysis focuses on changes in air quality in and around cities across the globe for the following air pollutants PM2.5, PM10, PMC (coarse fraction of PM), NO2, SO2, NOx, CO, O3 and the total gaseous oxidant (OX = NO2 + O3) during the pre-lockdown, partial lockdown, full lockdown and two relaxation periods spanning from January to September 2020. The analysis is based on in situ ground-based air quality observations at over 540 traffic, background and rural stations, from 63 cities and covering 25 countries over seven geographical regions of the world. Anomalies in the air pollutant concentrations (increases or decreases during 2020 periods compared to equivalent 2015–2019 periods) were calculated and the possible effects of meteorological conditions were analysed by computing anomalies from ERA5 reanalyses and local observations for these periods. We observed a positive correlation between the reductions in NO2 and NOx concentrations and peoples’ mobility for most cities. A correlation between PMC and mobility changes was also seen for some Asian and South American cities. A clear signal was not observed for other pollutants, suggesting that sources besides vehicular emissions also substantially contributed to the change in air quality. As a global and regional overview of the changes in ambient concentrations of key air quality species, we observed decreases of up to about 70% in mean NO2 and between 30% and 40% in mean PM2.5 concentrations over 2020 full lockdown compared to the same period in 2015–2019. However, PM2.5 exhibited complex signals, even within the same region, with increases in some Spanish cities, attributed mainly to the long-range transport of African dust and/or biomass burning (corroborated with the analysis of NO2/CO ratio). Some Chinese cities showed similar increases in PM2.5 during the lockdown periods, but in this case, it was likely due to secondary PM formation. Changes in O3 concentrations were highly heterogeneous, with no overall change or small increases (as in the case of Europe), and positive anomalies of 25% and 30% in East Asia and South America, respectively, with Colombia showing the largest positive anomaly of ~70%. The SO2 anomalies were negative for 2020 compared to 2015–2019 (between ~25 to 60%) for all regions. For CO, negative anomalies were observed for all regions with the largest decrease for South America of up to ~40%. The NO2/CO ratio indicated that specific sites (such as those in Spanish cities) were affected by biomass burning plumes, which outweighed the NO2 decrease due to the general reduction in mobility (ratio of ~60%). Analysis of the total oxidant (OX = NO2 + O3) showed that primary NO2 emissions at urban locations were greater than the O3 production, whereas at background sites, OX was mostly driven by the regional contributions rather than local NO2 and O3 concentrations. The present study clearly highlights the importance of meteorology and episodic contributions (e.g., from dust, domestic, agricultural biomass burning and crop fertilizing) when analysing air quality in and around cities even during large emissions reductions. There is still the need to better understand how the chemical responses of secondary pollutants to emission change under complex meteorological conditions, along with climate change and socio-economic drivers may affect future air quality. The implications for regional and global policies are also significant, as our study clearly indicates that PM2.5 concentrations would not likely meet the World Health Organization guidelines in many parts of the world, despite the drastic reductions in mobility. Consequently, revisions of air quality regulation (e.g., the Gothenburg Protocol) with more ambitious targets that are specific to the different regions of the world may well be required.World Meteorological Organization Global Atmospheric Watch programme is gratefully acknowledged for initiating and coordinating this study and for supporting this publication. We acknowledge the following projects for supporting the analysis contained in this article: Air Pollution and Human Health for an Indian Megacity project PROMOTE funded by UK NERC and the Indian MOES, Grant reference number NE/P016391/1; Regarding project funding from the European Commission, the sole responsibility of this publication lies with the authors. The European Commission is not responsible for any use that may be made of the information contained therein. This project has received funding from the European Commission’s Horizon 2020 research and innovation program under grant agreement No 874990 (EMERGE project). European Regional Development Fund (project MOBTT42) under the Mobilitas Pluss programme; Estonian Research Council (project PRG714); Estonian Research Infrastructures Roadmap project Estonian Environmental Observatory (KKOBS, project 2014-2020.4.01.20-0281). European network for observing our changing planet project (ERAPLANET, grant agreement no. 689443) under the European Union’s Horizon 2020 research and innovation program, Estonian Ministry of Sciences projects (grant nos. P180021, P180274), and the Estonian Research Infrastructures Roadmap project Estonian Environmental Observatory (3.2.0304.11-0395). Eastern Mediterranean and Middle East—Climate and Atmosphere Research (EMME-CARE) project, which has received funding from the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 856612) and the Government of Cyprus. INAR acknowledges support by the Russian government (grant number 14.W03.31.0002), the Ministry of Science and Higher Education of the Russian Federation (agreement 14.W0331.0006), and the Russian Ministry of Education and Science (14.W03.31.0008). We are grateful to to the following agencies for providing access to data used in our analysis: A.M. Obukhov Institute of Atmospheric Physics Russian Academy of Sciences; Agenzia Regionale per la Protezione dell’Ambiente della Campania (ARPAC); Air Quality and Climate Change, Parks and Environment (MetroVancouver, Government of British Columbia); Air Quality Monitoring & Reporting, Nova Scotia Environment (Government of Nova Scotia); Air Quality Monitoring Network (SIMAT) and Emission Inventory, Mexico City Environment Secretariat (SEDEMA); Airparif (owner & provider of the Paris air pollution data); ARPA Lazio, Italy; ARPA Lombardia, Italy; Association Agr´e´ee de Surveillance de la Qualit´e de l’Air en ˆIle-de- France AIRPARIF / Atmo-France; Bavarian Environment Agency, Germany; Berlin Senatsverwaltung für Umwelt, Verkehr und Klimaschutz, Germany; California Air Resources Board; Central Pollution Control Board (CPCB), India; CETESB: Companhia Ambiental do Estado de S˜ao Paulo, Brazil. China National Environmental Monitoring Centre; Chandigarh Pollution Control Committee (CPCC), India. DCMR Rijnmond Environmental Service, the Netherlands. Department of Labour Inspection, Cyprus; Department of Natural Resources Management and Environmental Protection of Moscow. Environment and Climate Change Canada; Environmental Monitoring and Science Division Alberta Environment and Parks (Government of Alberta); Environmental Protection Authority Victoria (Melbourne, Victoria, Australia); Estonian Environmental Research Centre (EERC); Estonian University of Life Sciences, SMEAR Estonia; European Regional Development Fund (project MOBTT42) under the Mobilitas Pluss programme; Finnish Meteorological Institute; Helsinki Region Environmental Services Authority; Haryana Pollution Control Board (HSPCB), IndiaLondon Air Quality Network (LAQN) and the Automatic Urban and Rural Network (AURN) supported by the Department of Environment, Food and Rural Affairs, UK Government; Madrid Municipality; Met Office Integrated Data Archive System (MIDAS); Meteorological Service of Canada; Minist`ere de l’Environnement et de la Lutte contre les changements climatiques (Gouvernement du Qu´ebec); Ministry of Environment and Energy, Greece; Ministry of the Environment (Chile) and National Weather Service (DMC); Moscow State Budgetary Environmental Institution MOSECOMONITORING. Municipal Department of the Environment SMAC, Brazil; Municipality of Madrid public open data service; National institute of environmental research, Korea; National Meteorology and Hydrology Service (SENAMHI), Peru; New York State Department of Environmental Conservation; NSW Department of Planning, Industry and Environment; Ontario Ministry of the Environment, Conservation and Parks, Canada; Public Health Service of Amsterdam (GGD), the Netherlands. Punjab Pollution Control Board (PPCB), India. R´eseau de surveillance de la qualit´e de l’air (RSQA) (Montr´eal); Rosgydromet. Mosecomonitoring, Institute of Atmospheric Physics, Russia; Russian Foundation for Basic Research (project 20–05–00254) SAFAR-IITM-MoES, India; S˜ao Paulo State Environmental Protection Agency, CETESB; Secretaria de Ambiente, DMQ, Ecuador; Secretaría Distrital de Ambiente, Bogot´a, Colombia. Secretaria Municipal de Meio Ambiente Rio de Janeiro; Mexico City Atmospheric Monitoring System (SIMAT); Mexico City Secretariat of Environment, Secretaría del Medio Ambiente (SEDEMA); SLB-analys, Sweden; SMEAR Estonia station and Estonian University of Life Sciences (EULS); SMEAR stations data and Finnish Center of Excellence; South African Weather Service and Department of Environment, Forestry and Fisheries through SAAQIS; Spanish Ministry for the Ecological Transition and the Demographic Challenge (MITECO); University of Helsinki, Finland; University of Tartu, Tahkuse air monitoring station; Weather Station of the Institute of Astronomy, Geophysics and Atmospheric Science of the University of S˜ao Paulo; West Bengal Pollution Control Board (WBPCB).http://www.elsevier.com/locate/envintam2023Geography, Geoinformatics and Meteorolog

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

The Future of the Binners\u27 Project. Below the Radar podcast

In August of 2019, The Binners\u27 Project faced a new change. After 5 years, co-founder Anna Godefroy stepped back and The Binners\u27 Project welcomed Landon Hoyt as their new director. As a follow up to one of the first episodes of Below the Radar, we welcomed Anna back to the studio for a conversation with Landon and our host, Am Johal. Together, we talk about the ways in which The Binners\u27 Project helped to provide economic opportunities and reduce the stigma of waste-pickers, and what\u27s next for the group. To learn more about The Binners’ Project, you can check out their website at www.binnersproject.org. You can also take a listen to our previous interview with The Binners’ Project

Binners’ Project: an Origin Story. Below the Radar podcast

The Binners’ Project is a Vancouver-based initiative dedicated to advocating for waste-pickers in the city. Am Johal interviews Binners’ Project staff members Davin Boutang and Anna Godefroy about their beginnings and evolution as an organization. They discuss their Universal Carts Initiative, the Coffee Cup Revolution and how the project has grown in its capacity to create opportunities for binners, destigmatizing the work they do in diverting waste from landfills

Binning & the Informal Economy: A Panel Discussion

Binning: a tough — often invisible — job that is doing a great service to our communities and the planet. Every year, throughout Vancouver, binners divert millions of bottles and cans from landfills. That\u27s why, for the last three years, our team at Binners\u27 Project has been working to make it more sustainable for everyone involved. Binners\u27 Project team leads, Davin Boutang, Michael Leland, and Anna Godefroy, are joined by two special guests who will help them share the ins and outs of binning, the Binners\u27 Project, and, of course, give you a sneak peek at the plan for 2018