Traitement du PTI et de l’AHAI au cours du DICV : revue systématique de la littérature

INTRODUCTION: Ten to 15% of common variable immunodeficiencies (CVID) develop auto-immune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Treatment is based on immunosuppressants, which produce blocking effects in the CVID. Our objective was to assess their risk-benefit ratio in these immunocompromised patients. METHODS: We identified 17 articles detailing the treatment of AIHA and/or ITP in patients suffering from CVID through a systematic review of the MEDLINE database. RESULTS: The increased infectious risk with corticosteroids does not call into question their place in the first line of treatment of ITP and AIHA in CVID. High-doses immunoglobulin therapy remain reserved for ITP with a high risk of bleeding. In second-line treatment, rituximab appears to be effective, with a lower infectious risk than the splenectomy. Immunosuppressants (azathioprine, methotrexate, mycophenolate, cyclophosphamide, vincristine, ciclosporine) are moderately effective and often lead to severe infections, meaning that their use is justified only in resistant cases and steroid-sparing. Dapsone, danazol and anti-D immunoglobulins have an unfavorable risk-benefit ratio. The place of TPO receptor agonists is still to be defined. The establishment of immunoglobulin replacement in the place of immunosuppressants (except for short-term corticotherapy) or splenectomy appears to be essential to limit the risk of infections, including in the absence of previous infections. CONCLUSION: The presence of CVID does not mean that it is necessary to give up on corticosteroids as a first-line treatment and rituximab as a second-line treatment for AIHA and ITP, but it should be in addition to immunoglobulin replacement. A splenectomy should be reserved as a third-line treatment

Evolution of trace gases and particles emitted by a chaparral fire in California

Biomass burning (BB) is a major global source of trace gases and particles. Accurately representing the production and evolution of these emissions is an important goal for atmospheric chemical transport models. We measured a suite of gases and aerosols emitted from an 81 hectare prescribed fire in chaparral fuels on the central coast of California, US on 17 November 2009. We also measured physical and chemical changes that occurred in the isolated downwind plume in the first ~4 h after emission. The measurements were carried out onboard a Twin Otter aircraft outfitted with an airborne Fourier transform infrared spectrometer (AFTIR), aerosol mass spectrometer (AMS), single particle soot photometer (SP2), nephelometer, LiCor CO_2 analyzer, a chemiluminescence ozone instrument, and a wing-mounted meteorological probe. Our measurements included: CO_2; CO; NO_x; NH_3; non-methane organic compounds; organic aerosol (OA); inorganic aerosol (nitrate, ammonium, sulfate, and chloride); aerosol light scattering; refractory black carbon (rBC); and ambient temperature, relative humidity, barometric pressure, and three-dimensional wind velocity. The molar ratio of excess O_3 to excess CO in the plume (ΔO_3/ΔCO) increased from −5.13 (±1.13) × 10^(−3) to 10.2 (±2.16) × 10^(−2) in ~4.5 h following smoke emission. Excess acetic and formic acid (normalized to excess CO) increased by factors of 1.73 ± 0.43 and 7.34 ± 3.03 (respectively) over the same time since emission. Based on the rapid decay of C_2H_4 we infer an in-plume average OH concentration of 5.27 (±0.97) × 10^6 molec cm^(−3), consistent with previous studies showing elevated OH concentrations in biomass burning plumes. Ammonium, nitrate, and sulfate all increased over the course of 4 h. The observed ammonium increase was a factor of 3.90 ± 2.93 in about 4 h, but accounted for just ~36% of the gaseous ammonia lost on a molar basis. Some of the gas phase NH_3 loss may have been due to condensation on, or formation of, particles below the AMS detection range. NO_x was converted to PAN and particle nitrate with PAN production being about two times greater than production of observable nitrate in the first ~4 h following emission. The excess aerosol light scattering in the plume (normalized to excess CO_2) increased by a factor of 2.50 ± 0.74 over 4 h. The increase in light scattering was similar to that observed in an earlier study of a biomass burning plume in Mexico where significant secondary formation of OA closely tracked the increase in scattering. In the California plume, however, ΔOA/ΔCO_2 decreased sharply for the first hour and then increased slowly with a net decrease of ~20% over 4 h. The fraction of thickly coated rBC particles increased up to ~85% over the 4 h aging period. Decreasing OA accompanied by increased scattering/particle coating in initial aging may be due to a combination of particle coagulation and evaporation processes. Recondensation of species initially evaporated from the particles may have contributed to the subsequent slow rise in OA. We compare our results to observations from other plume aging studies and suggest that differences in environmental factors such as smoke concentration, oxidant concentration, actinic flux, and RH contribute significantly to the variation in plume evolution observations

Airborne and Ground-Based Measurements of the Trace Gases and Particles Emitted by Prescribed Fires in the United States

We have measured emission factors for 19 trace gas species and particulate matter (PM2.5) from 14 prescribed fires in chaparral and oak savanna in the southwestern US, as well as conifer forest understory in the southeastern US and Sierra Nevada mountains of California. These are likely the most extensive emission factor field measurements for temperate biomass burning to date and the only published emission factors for temperate oak savanna fuels. This study helps to close the gap in emissions data available for temperate zone fires relative to tropical biomass burning. We present the first field measurements of the biomass burning emissions of glycolaldehyde, a possible precursor for aqueous phase secondary organic aerosol formation. We also measured the emissions of phenol, another aqueous phase secondary organic aerosol precursor. Our data confirm previous observations that urban deposition can impact the NOx emission factors and thus subsequent plume chemistry. For two fires, we measured both the emissions in the convective smoke plume from our airborne platform and the unlofted residual smoldering combustion emissions with our ground-based platform. The smoke from residual smoldering combustion was characterized by emission factors for hydrocarbon and oxygenated organic species that were up to ten times higher than in the lofted plume, including high 1,3-butadiene and isoprene concentrations which were not observed in the lofted plume. This should be considered in modeling the air quality impacts for smoke that disperses at ground level. We also show that the often ignored unlofted emissions can significantly impact estimates of total emissions. Preliminary evidence suggests large emissions of monoterpenes in the residual smoldering smoke. These data should lead to an improved capacity to model the impacts of biomass burning in similar temperate ecosystems

Trace Gas and Particle Emissions from Open Biomass Burning in Mexico

We report airborne measurements of emission factors (EF) for trace gases and PM(2.5) made in southern Mexico in March of 2006 on 6 crop residue fires, 3 tropical dry forest fires, 8 savanna fires, 1 garbage fire, and 7 mountain pine-oak forest fires. The savanna fire EF were measured early in the local dry season and when compared to EF measured late in the African dry season they were at least 1.7 times larger for NO(x), NH(3), H(2), and most non-methane organic compounds. Our measurements suggest that urban deposition and high windspeed may also be associated with significantly elevated NOx EF. When considering all fires sampled, the percentage of particles containing soot increased from 15 to 60% as the modified combustion efficiency increased from 0.88 to 0.98. We estimate that about 175 Tg of fuel was consumed by open burning of biomass and garbage and as biofuel (mainly wood cooking fires) in Mexico in 2006. Combining the fuel consumption estimates with our EF measurements suggests that the above combustion sources account for a large fraction of the reactive trace gases and more than 90% of the total primary, fine carbonaceous particles emitted by all combustion sources in Mexico

The influence of Depth of Cut, Feed Rate, and Step-over on Surface Roughness of Polycarbonate Material in Subtractive Rapid Prototyping

Rapid prototyping is fast and automatic three dimensions physical modeling that uses computer aided design model as the input. One of the important requirements in various products is the surface quality. Therefore, the aim of this research is to study and then develop a model that shows the influence of depth of cut, feed rate, and step-over on the vertical and horizontal surface roughness of polycarbonate material in subtractive rapid prototyping. The subtractive rapid prototyping process is performed by using Roland MDX 40 machine assisted by CAM Modela Player 4.0 software. This research implements response surface methodology to develop the model and then followed by the residual tests. The result shows that the increase of the depth of cut and the interaction between the step-over and the depth of cut will increase the horizontal surface roughness. Meanwhile, the vertical surface roughness will be affected mostly by the step-over. This research provides an insight on how to rapid prototype the polycarbonate material in order to achieve the surface requirement. The result of this research is the basis for achieving the main purpose of subtractive rapid prototyping which are maximum material rate removal and the minimum surface roughness

Measurements of reactive trace gases and variable O3 formation rates in some South Carolina biomass burning plumes

In October–November 2011 we measured trace gas emission factors from seven prescribed fires in South Carolina (SC), US, using two Fourier transform infrared spectrometer (FTIR) systems and whole air sampling (WAS) into canisters followed by gas-chromatographic analysis. A total of 97 trace gas species were quantified from both airborne and ground-based sampling platforms, making this one of the most detailed field studies of fire emissions to date. The measurements include the first emission factors for a suite of monoterpenes produced by heating vegetative fuels during field fires. The first quantitative FTIR observations of limonene in smoke are reported along with an expanded suite of monoterpenes measured by WAS including α-pinene, β-pinene, limonene, camphene, 4-carene, and myrcene. The known chemistry of the monoterpenes and their measured abundance of 0.4–27.9% of non-methane organic compounds (NMOCs) and ~ 21% of organic aerosol (mass basis) suggests that they impacted secondary formation of ozone (O3), aerosols, and small organic trace gases such as methanol and formaldehyde in the sampled plumes in the first few hours after emission. The variability in the initial terpene emissions in the SC fire plumes was high and, in general, the speciation of the initially emitted gas-phase NMOCs was 13–195% different from that observed in a similar study in nominally similar pine forests in North Carolina ~ 20 months earlier. It is likely that differences in stand structure and environmental conditions contributed to the high variability observed within and between these studies. Similar factors may explain much of the variability in initial emissions in the literature. The ΔHCN/ΔCO emission ratio, however, was found to be fairly consistent with previous airborne fire measurements in other coniferous-dominated ecosystems, with the mean for these studies being 0.90 ± 0.06%, further confirming the value of HCN as a biomass burning tracer. The SC results also support an earlier finding that C3-C4 alkynes may be of use as biomass burning indicators on the time-scale of hours to a day. It was possible to measure the downwind chemical evolution of the plume on four of the fires and significant O3 formation (ΔO3/ΔCO from 10–90%) occurred in all of these plumes within two hours. The slowest O3 production was observed on a cloudy day with low co-emission of NOx. The fastest O3 production was observed on a sunny day when the downwind plume almost certainly incorporated significant additional NOx by passing over the Columbia, SC metropolitan area. Due to rapid plume dilution, it was only possible to acquire high-quality downwind data for two other trace gas species (formaldehyde and methanol) during two of the fires. In all four of these cases, significant increases in formaldehyde and methanol were observed in \u3c2 h. This is likely the first direct observation of post-emission methanol production in biomass burning plumes. Post-emission production of methanol does not always happen in young biomass burning plumes, and its occurrence in this study could have involved terpene precursors to a significant extent

Laboratory measurements of trace gas emissions from biomass burning of fuel types from the southeastern and southwestern United States

Vegetation commonly managed by prescribed burning was collected from five southeastern and southwestern US military bases and burned under controlled conditions at the US Forest Service Fire Sciences Laboratory in Missoula, Montana. The smoke emissions were measured with a large suite of state-of-the-art instrumentation including an open-path Fourier transform infrared (OP-FTIR) spectrometer for measurement of gas-phase species. The OP-FTIR detected and quantified 19 gas-phase species in these fires: CO2, CO, CH4, C2H2, C2H4, C3H6, HCHO, HCOOH, CH3OH, CH3COOH, furan, H2O, NO, NO2, HONO, NH3, HCN, HCl, and SO2. Emission factors for these species are presented for each vegetation type burned. Gas-phase nitrous acid (HONO), an important OH precursor, was detected in the smoke from all fires. The HONO emission factors ranged from 0.15 to 0.60 g kg(-1) and were higher for the southeastern fuels. The fire-integrated molar emission ratios of HONO (relative to NOx) ranged from approximately 0.03 to 0.20, with higher values also observed for the southeastern fuels. The majority of non-methane organic compound (NMOC) emissions detected by OP-FTIR were oxygenated volatile organic compounds (OVOCs) with the total identified OVOC emissions constituting 61 +/- 12% of the total measured NMOC on a molar basis. These OVOC may undergo photolysis or further oxidation contributing to ozone formation. Elevated amounts of gas-phase HCl and SO2 were also detected during flaming combustion, with the amounts varying greatly depending on location and vegetation type. The fuels with the highest HCl emission factors were all located in the coastal regions, although HCl was also observed from fuels farther inland. Emission factors for HCl were generally higher for the southwestern fuels, particularly those found in the chaparral biome in the coastal regions of California

Laboratory Characterization of PM Emissions from Combustion of Wildland Biomass Fuels

[1] Particle emissions from open burning of southwestern (SW) and southeastern (SE) U.S. fuel types during 77 controlled laboratory burns are presented. The fuels include SW vegetation types: ceanothus, chamise/scrub oak, coastal sage scrub, California sagebrush, manzanita, maritime chaparral, masticated mesquite, oak savanna, and oak woodland, as well as SE vegetation types: 1 year, 2 year rough, pocosin, chipped understory, understory hardwood, and pine litter. The SW fuels burned at higher modified combustion efficiency (MCE) than the SE fuels resulting in lower particulate matter mass emission factor. Particle mass distributions for six fuels and particle number emission for all fuels are reported. Excellent mass closure (slope = 1.00, r2 = 0.94) between ions, metals, and carbon with total weight was obtained. Organic carbon emission factors inversely correlated (R2 = 0.72) with average MCE, while elemental carbon (EC) had little correlation with average MCE (R2 = 0.10). The EC/total carbon ratio sharply increased with MCE for MCEs exceeding 0.94. The average levoglucosan and total polycyclic aromatic hydrocarbon (PAH) emissions factors ranged from 25 to 1272 mg/kg fuel and 1.8 to 11.3 mg/kg fuel, respectively. No correlation between average MCE and emissions of PAHs/levoglucosan was found. Additionally, PAH diagnostic ratios were observed to be poor indicators of biomass burning. Large fuel type and regional dependency were observed in the emission rates of ammonium, nitrate, chloride, sodium, and potassium

Laboratory measurements of trace gas emissions from biomass burning of fuel types from the southeastern and southwestern United States

Vegetation commonly managed by prescribed burning was collected from five southeastern and southwestern US military bases and burned under controlled conditions at the US Forest Service Fire Sciences Laboratory in Missoula, Montana. The smoke emissions were measured with a large suite of state-of-the-art instrumentation including an open-path Fourier transform infrared (OP-FTIR) spectrometer for measurement of gas-phase species. The OP-FTIR detected and quantified 19 gas-phase species in these fires: CO<sub>2</sub>, CO, CH<sub>4</sub>, C<sub>2</sub>H<sub>2</sub>, C<sub>2</sub>H<sub>4</sub>, C<sub>3</sub>H<sub>6</sub>, HCHO, HCOOH, CH<sub>3</sub>OH, CH<sub>3</sub>COOH, furan, H<sub>2</sub>O, NO, NO<sub>2</sub>, HONO, NH<sub>3</sub>, HCN, HCl, and SO<sub>2</sub>. Emission factors for these species are presented for each vegetation type burned. Gas-phase nitrous acid (HONO), an important OH precursor, was detected in the smoke from all fires. The HONO emission factors ranged from 0.15 to 0.60 g kg<sup>−1</sup> and were higher for the southeastern fuels. The fire-integrated molar emission ratios of HONO (relative to NO<sub>x</sub>) ranged from approximately 0.03 to 0.20, with higher values also observed for the southeastern fuels. The majority of non-methane organic compound (NMOC) emissions detected by OP-FTIR were oxygenated volatile organic compounds (OVOCs) with the total identified OVOC emissions constituting 61±12% of the total measured NMOC on a molar basis. These OVOC may undergo photolysis or further oxidation contributing to ozone formation. Elevated amounts of gas-phase HCl and SO<sub>2</sub> were also detected during flaming combustion, with the amounts varying greatly depending on location and vegetation type. The fuels with the highest HCl emission factors were all located in the coastal regions, although HCl was also observed from fuels farther inland. Emission factors for HCl were generally higher for the southwestern fuels, particularly those found in the chaparral biome in the coastal regions of California

Laboratory Measurements of Trace Gas Emissions from Biomass Burning of Fuel Types from the Southeastern and Southwestern United States

Vegetation commonly managed by prescribed burning was collected from five southeastern and southwestern US military bases and burned under controlled conditions at the US Forest Service Fire Sciences Laboratory in Missoula, Montana. The smoke emissions were measured with a large suite of state-of-the-art instrumentation including an open-path Fourier transform infrared (OP-FTIR) spectrometer for measurement of gas-phase species. The OP-FTIR detected and quantified 19 gas-phase species in these fires: CO2, CO, CH4, C2H2, C2H4, C3H6, HCHO, HCOOH, CH3OH, CH3COOH, furan, H2O, NO, NO2, HONO, NH3, HCN, HCl, and SO2. Emission factors for these species are presented for each vegetation type burned. Gas-phase nitrous acid (HONO), an important OH precursor, was detected in the smoke from all fires. The HONO emission factors ranged from 0.15 to 0.60 g kg(-1) and were higher for the southeastern fuels. The fire-integrated molar emission ratios of HONO (relative to NOx) ranged from approximately 0.03 to 0.20, with higher values also observed for the southeastern fuels. The majority of non-methane organic compound (NMOC) emissions detected by OP-FTIR were oxygenated volatile organic compounds (OVOCs) with the total identified OVOC emissions constituting 61 +/- 12% of the total measured NMOC on a molar basis. These OVOC may undergo photolysis or further oxidation contributing to ozone formation. Elevated amounts of gas-phase HCl and SO2 were also detected during flaming combustion, with the amounts varying greatly depending on location and vegetation type. The fuels with the highest HCl emission factors were all located in the coastal regions, although HCl was also observed from fuels farther inland. Emission factors for HCl were generally higher for the southwestern fuels, particularly those found in the chaparral biome in the coastal regions of California