AEROgui: A graphical user interface for the optical properties of aerosols

Atmospheric aerosols have an uncertain effect on climate and serious impacts on human health. The uncertainty in the aerosols' role on climate has several sources. First, aerosols have great spatial and temporal variability. The spatial variability arises from the fact that aerosols emitted in a certain place can travel thousands of kilometers, swept by the winds to modify the destination region's climate. The spatial variability also means that aerosols are inhomogeneously distributed in the vertical direction, which can lead to a differential effect on the energy balance depending on the aerosols' altitude. On the other hand, aerosols experience physical and chemical transformations in the time they spend in the atmosphere, commonly known as aging, which modifies its optical properties. These factors make necessary the use of two approaches for the study of the aerosol impact on climate: global aerosol models and satellite- and ground-based measurements. The disagreement between the estimates of the two approaches is the main cause of the climate uncertainty. One way to reduce climate uncertainty is to create new tools to simulate more realistic aerosol scenarios. We present a graphical user interface to obtain aerosol optical properties: extinction, scattering, and absorption coefficients; single-scattering albedo; asymmetry parameter; and aerosol optical depth. The tool can be used to obtain the optical properties of the external and internal mixture of several aerosol components. Interface outputs have successfully been compared to a black carbon plume and to aging mineral dust

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Description of the response to galcanezumab in 7 patients with refractory cluster headache. A review and a case series.

Introduction and objectives: Cluster headache is the most frequent trigeminoautonomic headache, which, together with the high impact it produces on the patient's quality of life, has led to an in-depth study of its pathophysiology, thus discovering the role of the peptide related to the gene of calcitonin and consequently test the clinical response to the functional blockade of this molecule with anti-CGRP monoclonal antibodies. We present the data of 7 patients in this regard. Materials and methods: We describe and interpret the frequency of daily attacks of 7 patients through clinical interview, before the start, at 3, and at 6 months of treatment with galcanezumab. They are patients with refractory cluster headache, with more than 5 preventive treatments that they have used previously. Results: Five (5) of the 7 patients (71.4%) presented a reduction in the number of attacks greater than or equal to 50% at 3 months. At 6 months, 4 of the 6 patients (66%) continue to experience a reduction in the number of attacks, 1 of them maintains unpainful and 3 of them present a reduction equal to or greater than 75% in attacks. Two patients suffered side effects that in one case led to discontinuation of treatment. Conclusions: The response to treatment has been good, especially considering the repeatedly refractory profile of the pathology in our sample. Despite this, we accept the limitations of the study, mainly in terms of sample size and follow-up.We provide our data on the early response to galcanezumab in patients with refractory cluster headache, which adds to the evidence that suggests that anti-CGRP monoclonal antibodies may be a valid tool and safe in the treatment of this type of patient. Resumen: Introducción y Objetivos: La cefalea en racimos es la cefalea trigeminoautonómica más frecuente, lo que, unido al alto impacto que produce en la calidad de vida del paciente, ha motivado un estudio en profundidad de su fisiopatología, descubriendo así el papel del péptido relacionado con el gen de la calcitonina y en consecuencia probar la respuesta clínica al bloqueo funcional de esta molécula con anticuerpos monoclonales anti-CGRP. Presentamos los datos de 7 pacientes al respecto. Materiales y métodos: Describimos e interpretamos la frecuencia de ataques diarios de 7 pacientes mediante entrevista clínica, antes del inicio, a los 3 y 6 meses de tratamiento con galcanezumab. Son pacientes con cefalea en racimos refractaria, con más de 5 tratamientos preventivos que han utilizado previamente. Resultados: 5 de los 7 pacientes (71,4%) presentaron una reducción del número de ataques mayor o igual al 50% a los 3 meses. A los 6 meses, 4 de los 6 pacientes (66%) continúan experimentando una reducción en el número de ataques, 1 de ellos se mantiene sin dolor y 3 de ellos presentan una reducción igual o superior al 75% en los ataques. 2 pacientes sufrieron efectos secundarios que en un caso llevaron a la suspensión del tratamiento. Conclusiones: La respuesta al tratamiento ha sido buena, especialmente teniendo en cuenta el perfil repetidamente refractario de la patología en nuestra muestra. A pesar de ello, aceptamos las limitaciones del estudio, principalmente en cuanto al tamaño muestral y al seguimiento

Extreme, wintertime Saharan dust outbreak in the Iberian Peninsula: lidar monitoring and evaluation of dust forecast models during the February 2017 event

An unprecedented extreme Saharan dust event was registered in winter time from 20 to 23 February 2017 over the Iberian Peninsula (IP). We report on aerosol optical properties observed under this extreme dust intrusion through passive and active remote sensing techniques. For that, AERONET (AErosol RObotic NETwork) and EARLINET (European Aerosol Research LIdar NETwork) databases are used. The sites considered are: Barcelona (41.38°N, 2.17°E), Burjassot (39.51°N, 0.42°W), Cabo da Roca (38.78°N, 9.50°W), Évora (38.57°N, 7.91°W), Granada (37.16°N, 3.61°W) and Madrid (40.45°N, 3.72°W). Large aerosol optical depths (AOD) and low Ångström exponents (AE) are observed. An AOD of 2.0 at 675¿nm is reached in several stations. A maximum peak of 2.5 is registered in Évora. During and around the peak of AOD, AEs close to 0 and even slightly negative are measured. With regard to vertically-resolved aerosol optical properties, particle backscatter coefficients as high as 15¿Mm-1¿sr-1 at 355¿nm are recorded at the lidar stations. Layer-mean lidar ratios are found in the range 40–55¿sr at 355¿nm and 34–61¿sr at 532¿nm during the event. The particle depolarization ratios are found to be constant inside the dust layer, and consistent from one site to another. Layer-mean values vary in the range 0.19–0.31. Another remarkable aspect of the event is the limited vertical distribution of the dust plume which never exceeds 5¿km. The extreme aspect of the event also presented a nice case for testing the ability of two dust forecast models, BSC-DREAM8b and NMMB/BSC-Dust, to reproduce the arrival, the vertical distribution and the intensity of the dust plume over a long-range transport region. In the particular case of the February 2017 dust event, we found a large underestimation in the forecast of the extinction coefficient provided by BSC-DREAM8b at all heights independently of the site. In contrast NMMB/BSC-Dust forecasts presented a better agreement with the observations, especially in southwestern part of the IP. With regard to the forecast skill as a function of lead time, no clear degradation of the prognostic is appreciated at 24, 48 and 72¿h for Évora and Granada stations (South). However the prognostic does degrade (bias increases and/or correlation decreases) for Barcelona (North), which is attributed to the fact that Barcelona is at a greater distance from the source region and to the singularity of the event.Peer Reviewe

Overview of the Chemistry-Aerosol Mediterranean Experiment/Aerosol Direct Radiative Forcing on the Mediterranean Climate (ChArMEx/ADRIMED) summer 2013 campaign

The Chemistry-Aerosol Mediterranean Experiment (ChArMEx; http://charmex.lsce.ipsl.fr) is a collaborative research program federating international activities to investigate Mediterranean regional chemistry-climate interactions. A special observing period (SOP-1a) including intensive airborne measurements was performed in the framework of the Aerosol Direct Radiative Impact on the regional climate in the MEDiterranean region (ADRIMED) project during the Mediterranean dry season over the western and central Mediterranean basins, with a focus on aerosol-radiation measurements and their modeling. The SOP-1a took place from 11 June to 5 July 2013. Airborne measurements were made by both the ATR-42 and F-20 French research aircraft operated from Sardinia (Italy) and instrumented for in situ and remote-sensing measurements, respectively, and by sounding and drifting balloons, launched in Minorca. The experimental setup also involved several ground-based measurement sites on islands including two ground-based reference stations in Corsica and Lampedusa and secondary monitoring sites in Minorca and Sicily. Additional measurements including lidar profiling were also performed on alert during aircraft operations at EARLINET/ACTRIS stations at Granada and Barcelona in Spain, and in southern Italy. Remote-sensing aerosol products from satellites (MSG/SEVIRI, MODIS) and from the AERONET/PHOTONS network were also used. Dedicated meso-scale and regional modeling experiments were performed in relation to this observational effort. We provide here an overview of the different surface and aircraft observations deployed during the ChArMEx/ADRIMED period and of associated modeling studies together with an analysis of the synoptic conditions that determined the aerosol emission and transport. Meteorological conditions observed during this campaign (moderate temperatures and southern flows) were not favorable to producing high levels of atmospheric pollutants or intense biomass burning events in the region. However, numerous mineral dust plumes were observed during the campaign, with the main sources located in Morocco, Algeria and Tunisia, leading to aerosol optical depth (AOD) values ranging between 0.2 and 0.6 (at 440 nm) over the western and central Mediterranean basins. One important point of this experiment concerns the direct observations of aerosol extinction onboard the ATR-42, using the CAPS system, showing local maxima reaching up to 150 M m-1 within the dust plume. Non-negligible aerosol extinction (about 50 M m-1) has also been observed within the marine boundary layer (MBL). By combining the ATR-42 extinction coefficient observations with absorption and scattering measurements, we performed a complete optical closure revealing excellent agreement with estimated optical properties. This additional information on extinction properties has allowed calculation of the dust single scattering albedo (SSA) with a high level of confidence over the western Mediterranean. Our results show a moderate variability from 0.90 to 1.00 (at 530 nm) for all flights studied compared to that reported in the literature on this optical parameter. Our results underline also a relatively low difference in SSA with values derived near dust sources. In parallel, active remote-sensing observations from the surface and onboard the F-20 aircraft suggest a complex vertical structure of particles and distinct aerosol layers with sea spray and pollution located within the MBL, and mineral dust and/or aged North American smoke particles located above (up to 6-7 km in altitude). Aircraft and balloon-borne observations allow one to investigate the vertical structure of the aerosol size distribution showing particles characterized by a large size (> 10 μm in diameter) within dust plumes. In most of cases, a coarse mode characterized by an effective diameter ranging between 5 and 10 μm, has been detected above the MBL. In terms of shortwave (SW) direct forcing, in situ surface and aircraft observations have been merged and used as inputs in 1-D radiative transfer codes for calculating the aerosol direct radiative forcing (DRF). Results show significant surface SW instantaneous forcing (up to -90 W m-2 at noon). Aircraft observations provide also original estimates of the vertical structure of SW and LW radiative heating revealing significant instantaneous values of about 5° K per day in the solar spectrum (for a solar angle of 30°) within the dust layer. Associated 3-D modeling studies from regional climate (RCM) and chemistry transport (CTM) models indicate a relatively good agreement for simulated AOD compared with observations from the AERONET/PHOTONS network and satellite data, especially for long-range dust transport. Calculations of the 3-D SW (clear-sky) surface DRF indicate an average of about -10 to -20 W m-2 (for the whole period) over the Mediterranean Sea together with maxima (-50 W m-2) over northern Africa. The top of the atmosphere (TOA) DRF is shown to be highly variable within the domain, due to moderate absorbing properties of dust and changes in the surface albedo. Indeed, 3-D simulations indicate negative forcing over the Mediterranean Sea and Europe and positive forcing over northern Africa. Finally, a multi-year simulation, performed for the 2003 to 2009 period and including an ocean-atmosphere (O-A) coupling, underlines the impact of the aerosol direct radiative forcing on the sea surface temperature, O-A fluxes and the hydrological cycle over the Mediterranean

3D genomics across the tree of life reveals condensin II as a determinant of architecture type.

We investigated genome folding across the eukaryotic tree of life. We find two types of three-dimensional (3D) genome architectures at the chromosome scale. Each type appears and disappears repeatedly during eukaryotic evolution. The type of genome architecture that an organism exhibits correlates with the absence of condensin II subunits. Moreover, condensin II depletion converts the architecture of the human genome to a state resembling that seen in organisms such as fungi or mosquitoes. In this state, centromeres cluster together at nucleoli, and heterochromatin domains merge. We propose a physical model in which lengthwise compaction of chromosomes by condensin II during mitosis determines chromosome-scale genome architecture, with effects that are retained during the subsequent interphase. This mechanism likely has been conserved since the last common ancestor of all eukaryotes

High levels of postmigration HIV acquisition within nine European countries

Objective: We aimed to estimate the proportion of postmigration HIV acquisition among HIV-positive migrants in Europe. Design: To reach HIV-positive migrants, we designed a cross-sectional study performed in HIV clinics. Methods: The study was conducted from July 2013 to July 2015 in 57 clinics (nine European countries), targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4+ cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression. Results: Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country and HIV diagnosis year. Conclusion: A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved

HIV testing history and access to treatment among migrants living with HIV in Europe

Introduction: Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. Methods: A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. Results: A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load <50 copies/mL. Conclusions: Migrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society