Constraints on magma processes, subsurface conditions, and total volatile flux at Bezymianny Volcano in 2007–2010 from direct and remote volcanic gas measurements

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Exhaled Nitric Oxide is Not a Biomarker for Pulmonary Tuberculosis.

To reduce transmission of tuberculosis (TB) in resource-limited countries where TB remains a major cause of mortality, novel diagnostic tools are urgently needed. We evaluated the fractional concentration of exhaled nitric oxide (FeNO) as an easily measured, noninvasive potential biomarker for diagnosis and monitoring of treatment response in participants with pulmonary TB including multidrug resistant-TB in Lima, Peru. In a longitudinal study however, we found no differences in baseline median FeNO levels between 38 TB participants and 93 age-matched controls (13 parts per billion [ppb] [interquartile range (IQR) = 8-26] versus 15 ppb [IQR = 12-24]), and there was no change over 60 days of treatment (15 ppb [IQR = 10-19] at day 60). Taking this and previous evidence together, we conclude FeNO is not of value in either the diagnosis of pulmonary TB or as a marker of treatment response

Interactions of the Totten Glacier with the Southern Ocean through multiple glacial cycles (IN2017-V01): Post-survey report

The authors wish to thank the CSIRO Marine National Facility (MNF) for its support in the form of sea time on RV Investigator, support personnel, scientific equipment and data management. All data and samples acquired on the voyage are made publicly available in accordance with MNF Policy. All raw and processed data acquired by MNF equipment on MNF voyages will be archived by MNF data support staff in the enduring CSIRO Data Access Portal, https://data.csiro.au. Metadata records will be made publicly available at http://www.marlin.csiro.au. Processed data and data products will be made publicly available through Data Trawler http://www.cmar.csiro.au/data/trawler/index.cfm, the MNF web data access tool http://www.cmar.csiro.au/data/underway/, and/or from national or world data centres most suitable for the dissemination of particular data types.Other Australian Program Support Smaller projects have attracted funding to support research activities post-cruise these include the following: 1. Australian and New Zealand IODP Committee (ANZIC) Special Analytical Support Grant. Project Title: Using ancient phytoplankton communities and genes to illuminate future ocean responses. Researchers involved: L. Armand, L. Armbrecht, M. Ostrowski, & S. George. 2. Australian Antarctic Division Australian Antarctic Science Grant (#4320). Project Title: Characterising East Antarctic seabed habitats. Researchers involved: Post, A.L., & Smith, J. 3. Australian Antarctic Division Australian Antarctic Science Grant (#4419). Project Title: Response of the Totten Glacier to past climate warming. Researchers involved: Noble, T., Armand, L., Chase, Z., & Halpin, J.The Sabrina Sea Floor Survey was a major marine geoscience expedition to the Antarctic margin which took place between 14 January and 7 March 2017. It sailed on the Australian Marine National Facility vessel RV Investigator. This document describes survey activities, data collected on the ship and important metadata. Some preliminary results are included and the location of samples and data sets reported for future use. The report also provides information on data ownership and acknowledgement for future use and publication. It is intended as an aid to future research and use of results and has not been rigorously edited and peer-reviewed.Australian Research Council (DP170100557), Australian Antarctic Science Grant Program (AAS #4333), Italian Antarctic program support PNRA TYTAN Project (PdR 14_00119), Spanish Ministry of Economy and Competitivity (MINECO) (CTM2015-60451-C2-1-P & CTM2015-60451-C2-2-P), United States National Science Foundation's Polar Program - Antarctic Integrated System Science. #1143834, 1143836, 1143837, 1143843, 1313826

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Constraints on magma processes, subsurface conditions, and total volatile flux at Bezymianny Volcano in 2007–2010 from direct and remote volcanic gas measurements

AbstractDirect and remote measurements of volcanic gas composition, SO2 flux, and eruptive SO2 mass from Bezymianny Volcano were acquired between July 2007 and July 2010. Chemical composition of fumarolic gases, plume SO2 flux from ground and air-based ultraviolet remote sensing (FLYSPEC), and eruptive SO2 mass from Ozone Monitoring Instrument (OMI) satellite observations were used along with eruption timing to elucidate magma processes and subsurface conditions, and to constrain total volatile flux. Bezymianny Volcano had five explosive magmatic eruptions between May 2007 and June 2010. The most complete volcanic gas datasets were acquired for the October 2007, December 2009, and May 2010 eruptions. Gas measurements collected prior to the October 2007 eruption have a relatively high ratio of H2O/CO2 (81.2), a moderate ratio of CO2/S (5.47), and a low ratio of S/HCl (0.338), along with moderate SO2 and CO2 fluxes of 280 and 980t/d, respectively, and high H2O and HCl fluxes of ~45,000 and ~440t/d, respectively. These results suggest degassing of shallow magma (consistent with observations of lava extrusion) along with potential minor degassing of a deeper magma source. Gas measurements collected prior to the December 2009 eruption are characterized by relatively low H2O/CO2 (4.13), moderate CO2/S (6.84), and high S/HCl (18.7) ratios, along with moderate SO2 and CO2 fluxes of ~220 and ~1000t/d, respectively, and low H2O and HCl fluxes of ~1700 and ~7t/d, respectively. These trends are consistent with degassing of a deeper magma source. Fumarole samples collected ~1.5months following the May 2010 eruption are characterized by high H2O/CO2 (63.0), low CO2/S (0.986), and moderate S/HCl (6.09) ratios. These data are consistent with degassing of a shallow, volatile-rich magma source, likely related to the May eruption. Passive and eruptive SO2 measurements are used to calculate a total annual SO2 mass of 109kt emitted in 2007, with passive emissions comprising ~87–95% of the total. Total annual volatile masses for the study period are estimated to range from 1.1×106 to 18×106t/year. Annual CO2 masses are ~8 to 40 times larger than can be explained by degassing of dissolved CO2 within eruptive magma, suggesting that the eruptive magma contained a significant quantity of exsolved volatiles sourced either from the eruptive melt or unerupted magma at depth. Variable total volatile fluxes ranging from ~3000t/d in 2009 to ~49,000t/d in 2007 are attributed to variations in the depth of gas exsolution and separation from the melt under open-system degassing conditions. We propose that exsolved volatiles are quickly transported to the surface from ascending magma via permeable flow through a bubble and/or fracture network within the conduit and thus retain their equilibrium composition at the time of segregation from melt. The composition of surface CO2 and H2O emissions from 2007 to 2009 are compared with modeled exsolved fluid compositions for a magma body ascending from entrapment depths to estimate depth of fluid exsolution and separation from the melt. We find that at the time of sample collection magma had already begun ascent from the mid-crustal storage region and was located at maximum depths of ~3.7km in August 2007, approximately 2months prior to the next magmatic eruption, and ~4.6km in July of 2009 approximately five months prior to the next magmatic eruption. These findings suggest that the exsolved gas composition at Bezymianny Volcano may be used to detect magma ascent prior to eruption

Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Background: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality

Implementing stakeholder engagement to explore alternative models of consent: An example from the PREP-IT trials

Introduction: Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent. Methods: The PREP-IT program consists of two multi-center cluster randomized crossover trials that engaged patient advisors to determine an optimal model of consent. Patient advisors and stakeholders met regularly and reached consensus on decisions related to the trial design including the model for consent. Patient advisors provided valuable insight on how key decisions on trial design and conduct would be received by participants and the impact these decisions will have. Results: Patient advisors, together with stakeholders, reviewed the pros and cons and the requirements for the traditional model of consent, deferred consent, and waiver of consent. Collectively, they agreed upon a deferred consent model, in which patients may be approached for consent after their fracture surgery and prior to data collection. The consent rate in PREP-IT is 80.7%, and 0.67% of participants have withdrawn consent for participation. Discussion: Involvement of patient advisors in the development of an optimal model of consent has been successful. Engagement of patient advisors is recommended for other large trials where the traditional model of consent may not be optimal