An Evaluaton of Real-Time Troposphere Products Based on mult-GNSS Precise Point Posi)oning

When employing observations from multiple Global Navigation Satellite System (GNSS) the performance of real-time (RT) GNSS meteorology can be improved. In this paper, we describe an operational RT system for extracting zenith tropospheric delay (ZTD) using a modified version of the PPP-wizard. Multi-GNSS, including GPS, GLONASS and Galileo, observation streams are processed using a RT PPP strategy based on RT satellite orbit/clock products from CNES. A continuous experiment for 30 days is conducted, in which the RT observation streams of 20 globally distributed stations are processed. The initialization time and accuracy of the RT troposphere products using single/multi-system observations are evaluated. The effect of RT PPP ambiguity resolution is also evaluated. The results reveal that the RT troposphere products based on single system observations can fulfill the requirements of meteorological application, in which the GPS-only solution is better than the GLONASS-only solution in both initialization and accuracy. The performance can also be improved by applying RT PPP ambiguity resolution and utilizing multi-GNSS observations. Specifically, we notice that the ambiguity resolution is more effective in improving the accuracy, whereas the initialization process can be better accelerated by multi-GNSS observations. Combining all systems, RT troposphere products with an average accuracy of about 8 mm in ZTD can be achieved after an initialization process of approximately 9 minutes, which supports the application of multi-GNSS observations and ambiguity resolution for RT meteorological applications

The cooperative IGS RT-GIMs: a reliable estimation of the global ionospheric electron content distribution in real time

The Real-Time Working Group (RTWG) of the International GNSS Service (IGS) is dedicated to providing high-quality data and high-accuracy products for Global Navigation Satellite System (GNSS) positioning, navigation, timing and Earth observations. As one part of real-time products, the IGS combined Real-Time Global Ionosphere Map (RT-GIM) has been generated by the real-time weighting of the RT-GIMs from IGS real-time ionosphere centers including the Chinese Academy of Sciences (CAS), Centre National d'Etudes Spatiales (CNES), Universitat Politècnica de Catalunya (UPC) and Wuhan University (WHU). The performance of global vertical total electron content (VTEC) representation in all of the RT-GIMs has been assessed by VTEC from Jason-3 altimeter for 3 months over oceans and dSTEC-GPS technique with 2¿d observations over continental regions. According to the Jason-3 VTEC and dSTEC-GPS assessment, the real-time weighting technique is sensitive to the accuracy of RT-GIMs. Compared with the performance of post-processed rapid global ionosphere maps (GIMs) and IGS combined final GIM (igsg) during the testing period, the accuracy of UPC RT-GIM (after the improvement of the interpolation technique) and IGS combined RT-GIM (IRTG) is equivalent to the rapid GIMs and reaches around 2.7 and 3.0 TECU (TEC unit, 1016¿el¿m-2) over oceans and continental regions, respectively. The accuracy of CAS RT-GIM and CNES RT-GIM is slightly worse than the rapid GIMs, while WHU RT-GIM requires a further upgrade to obtain similar performance. In addition, a strong response to the recent geomagnetic storms has been found in the global electron content (GEC) of IGS RT-GIMs (especially UPC RT-GIM and IGS combined RT-GIM). The IGS RT-GIMs turn out to be reliable sources of real-time global VTEC information and have great potential for real-time applications including range error correction for transionospheric radio signals, the monitoring of space weather, and detection of natural hazards on a global scale. All the IGS combined RT-GIMs generated and analyzed during the testing period are available at https://doi.org/10.5281/zenodo.5042622 (Liu et al., 2021b).his research has been supported by the China Scholarship Council (CSC). The contribution from UPC- IonSAT authors was partially supported by the European Union- funded project PITHIA-NRF (grant no. 101007599) and by the ESSP/ICAO-funded project TEC4SpaW. The work of An- drzej Krankowski is supported by the National Centre for Research and Development, Poland, through grant ARTEMIS (grant nos. DWM/PL-CHN/97/2019 and WPC1/ARTEMIS/2019)Peer ReviewedPostprint (published version

Ten Years of Surveillance for Invasive Streptococcus pneumoniae during the Era of Antiretroviral Scale-Up and Cotrimoxazole Prophylaxis in Malawi

OBJECTIVE: To document trends in invasive pneumococcal disease (IPD) in a central hospital in Malawi during the period of national scale-up of antiretroviral therapy (ART) and cotrimoxazole prophylaxis. METHODS: Between 1 January 2000 and 31 December 2009 almost 100,000 blood cultures and 40,000 cerebrospinal fluid (CSF) cultures were obtained from adults and children admitted to the Queen Elizabeth Central Hospital, Blantyre, Malawi with suspected severe bacterial infection. RESULTS: 4,445 pneumococcal isolates were obtained over the 10 year period. 1,837 were from children: 885 (19.9%) from blood and 952 (21.4%) from CSF. 2,608 were from adults: 1,813 (40.8%) from blood and 795 (17.9%) from CSF. At the start of the surveillance period cotrimoxazole resistance was 73.8% and at the end was 92.6%. Multidrug resistance (MDR) was present in almost one third of isolates and was constant over time. Free ART was introduced in Malawi in 2004. From 2005 onwards there was a decline in invasive pneumococcal infections with a negative correlation between ART scale-up and the decline in IPD (Pearson's correlation r = -0.91; p<0.001). CONCLUSION: During 2004-2009, national ART scale-up in Malawi was associated with a downward trend in IPD at QECH. The introduction of cotrimoxazole prophylaxis in HIV-infected groups has not coincided with a further increase in pneumococcal cotrimoxazole or multidrug resistance. These data highlight the importance of surveillance for high disease burden infections such as IPD in the region, which will be vital for monitoring pneumococcal conjugate vaccine introduction into national immunisation programmes

The ANTENATAL multicentre study to predict postnatal renal outcome in fetuses with posterior urethral valves: objectives and design

Abstract Background Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease. A major issue in the management of PUV is prenatal prediction of postnatal renal function. Fetal ultrasound and fetal urine biochemistry are currently employed for this prediction, but clearly lack precision. We previously developed a fetal urine peptide signature that predicted in utero with high precision postnatal renal function in fetuses with PUV. We describe here the objectives and design of the prospective international multicentre ANTENATAL (multicentre validation of a fetal urine peptidome-based classifier to predict postnatal renal function in posterior urethral valves) study, set up to validate this fetal urine peptide signature. Methods Participants will be PUV pregnancies enrolled from 2017 to 2021 and followed up until 2023 in >30 European centres endorsed and supported by European reference networks for rare urological disorders (ERN eUROGEN) and rare kidney diseases (ERN ERKNet). The endpoint will be renal/patient survival at 2 years postnatally. Assuming α = 0.05, 1–β = 0.8 and a mean prevalence of severe renal outcome in PUV individuals of 0.35, 400 patients need to be enrolled to validate the previously reported sensitivity and specificity of the peptide signature. Results In this largest multicentre study of antenatally detected PUV, we anticipate bringing a novel tool to the clinic. Based on urinary peptides and potentially amended in the future with additional omics traits, this tool will be able to precisely quantify postnatal renal survival in PUV pregnancies. The main limitation of the employed approach is the need for specialized equipment. Conclusions Accurate risk assessment in the prenatal period should strongly improve the management of fetuses with PUV

An Evaluation of the Accuracy of Real-Time Zenith Total Delay Estimates

The continuous evolution of Global Navigation Satellite Systems (GNSS) meteorology has lead to an increased use of associated observations for operational meteorology worldwide. In order to enhance short-term weather forecasts meteorological institutions use modern low-latency Numerical Weather Prediction (NWP) models which assimilate GNSS-derived Zenith Total Delay (ZTD) estimates. For such NWP models a number of GNSS processing strategies allow the provision of these ZTDs with the required accuracy (up to a few millimetres) and latency (hourly). However, meteorological now-casting applications, e.g. for storm tracking, require higher update rates for the ZTDs of 10 or even 5 min, which can be achieved, but only at a loss in accuracy. Using the IGS Real-Time Service orbit and clock products together with an appropriate GNSS software, it is possible to estimate the ZTDs in real-time. Available software packages either use GNSS processing strategies based on differenced or un-differenced observations, such as Precise Point Positioning (PPP). While PPP has clear advantages for efficiently processing data streams from large GNSS networks this strategy is more affected by inaccuracies in the real-time products than when using differenced observations. On the other hand, recent advances in PPP integer ambiguity resolution nowadays provide this strategy with the benefits of ambiguity-fixed solutions. In this study, we present an evaluation of the accuracy of real-time ZTD estimates obtained from several GNSS processing systems through comparison to those obtained from a near real-time and a post-processing system

False positive morphologic diagnoses at the anomaly scan: marginal or real problem, a population-based cohort study.

This work was funded as part of the Hospital Clinical Research Programme, in 2010, by the French Health Ministry.International audienceBACKGROUND: Congenital malformations occur in 3-4% of live births. Their prenatal detection is performed by ultrasound screening. Any announcement about a suspected malformation is a source of stress for the parents, and misdiagnosis during ultrasound screening can lead to expensive and sometimes iatrogenic medical interventions. In this study, we aim to determine the false-positive rate, first overall and then by anatomical system, of ultrasound screening for congenital malformations in the second and third trimesters of pregnancy. METHODS: Our sample includes all children born between 1 January, 2006, and 31 December, 2009, in the French region of Auvergne, whose mother had a prenatal ultrasound diagnosis of a congenital malformation during the second or third trimester of pregnancy confirmed by a follow-up ultrasound examination by an expert consultant ultrasonographer. The study included 526 fetuses, divided in 3 groups: false positives, diagnostic misclassifications, and true positives. The rates of false positives and diagnostic misclassifications were calculated for the sample as a whole and then by anatomical system. RESULTS: Overall, the false-positive rate was 8.8% and the rate of diagnostic misclassification 9.2%. The highest false-positive rates were found for renal and gastrointestinal tract malformations, and the highest diagnostic misclassification rates for cerebral and cardiac malformations. The diagnostic misclassification rate was significantly higher than the false-positive rate for cardiac malformations. CONCLUSION: The false-positive rate during prenatal ultrasound is not insignificant; these misdiagnoses cause psychological stress for the parents and overmedicalisation of the pregnancy and the child

The Status of GNSS Data Processing Systems to Estimate Integrated Water Vapour for Use in Numerical Weather Prediction Models

Modern Numerical Weather Prediction (NWP) models make use of the GNSS-derived Zenith Total Delay (ZTD) or Integrated Water Vapour (IWV) estimates to enhance the quality of their forecasts. Usually, the ZTD is assimilated into the NWP models on 3-hourly to 6-hourly intervals but with the advancement of NWP models towards higher update rates e.g. 1-hourly cycling in the Rapid update Cycle (RUC) NWP, it has become of high interest to estimate ZTD on sub-hourly intervals. In turn, this imposes requirements related to the timeliness and accuracy of the ZTD estimates and has lead to a development of various strategies to process GNSS observations to obtain ZTD with different latencies and accuracies. Using present GNSS products and tools, ZTD can be estimated in realtime (RT), near real-time (NRT) and post-processing (PP) modes. The aim of this study is to provide an overview and accuracy assessment of various RT, NRT, and PP IWV estimation systems and comparing their achieved accuracy with the user requirements for GNSS meteorology. The NRT systems are based on Bernese GPS Software 5.0 and use a double-differencing strategy whereas the PP system is based on the Bernese GNSS Software 5.2 using the precise point positioning (PPP) strategy. The RT systems are based on the BKG Ntrip Client 2.7 and the PPP-Wizard both using PPP. The PPP-Wizard allows integer ambiguity resolution at a single station and therefore the effect of fixing integer ambiguities on ZTD estimates will also be presented

Assessing the Status of GNSS Data Processing Systems to Estimate Integrated Water Vapour for Use in Numerical Weather Prediction models

Modern Numerical Weather Prediction (NWP) models make use of the GNSS derived Zenith Total Delay (ZTD) or Integrated Water Vapour (IWV) estimates to enhance the quality of their forecasts. Usually, the ZTD is assimilated into the NWP models on hourly intervals but with the advancement of NWP models towards higher update rates, it has become necessary to estimate the ZTD on sub-hourly intervals. In turn, this imposes requirements related to the timeliness and accuracy of the ZTD estimates and has lead to a development of various strategies to process GNSS observations to obtain ZTD with different latencies and accuracies. Using present GNSS products and tools, ZTD can be estimated in real-time (RT), near real-time (NRT) and post-processing (PP) modes. The aim of this study is to provide an overview and accuracy assessment of various RT, NRT, and PP IWV estimation systems and comparing their achieved accuracy with the user requirements for GNSS meteorology. The NRT and PP systems are based on the Bernese GNSS Software v5.2 using a double-difference network and Precise Point Positioning (PPP) strategy, and the RT systems are based on BKG Ntrip Client 2.7 and PPP-Wizard both using PPP. One of the RT systems allows integer ambiguity resolution with PPP and therefore the effect of fixing integer ambiguities on ZTD estimates will also be presented

Laryngotracheoesophageal cleft, a rare differential diagnosis of esophageal atresia

International audienc