A case study analysis of the impact of a new free tropospheric turbulence scheme on the dispersion of an atmospheric tracer

Most Lagrangian dispersion models represent free tropospheric turbulence as a homogeneous steady-state process. However, intermittent turbulent mixing in the free troposphere may be a significant source of mixing. We test anew parametrization scheme that represents spatial- and temporal-varying turbulence in the free troposphere in the Met Office’s Numerical Atmospheric-dispersion Modelling Environment. We use semi-idealized emissions of radon-222 (222Rn) from rocks and soil in the United Kingdom to evaluate the impact of using a variable free tropospheric turbulence parameterization on the dispersion of 222Rn. We performed two experiments, the first using the existing steady-state scheme and the second using the newly implemented spatio-temporal-varying scheme, for two case periods July 2018 and April 2021. We find that the turbulence in the varying scheme (represented by the vertical velocity variance) can range by two to three orders of magnitude (10−4to 10−1 m2 s−2) when compared with the steady-state scheme(10−2 m2 s−2). In particular, low-altitude turbulence is enhanced when synoptic conditions are conducive to forming low-level jets. This leads to a greater dispersion in the free troposphere, reducing the mean monthly 222Rn concentration above the boundary layer by 20–40% relative to the steady-state scheme. We conclude that without a space–time-varying free tropospheric turbulence scheme atmospheric dispersion may be significantly underestimated under synoptic conditions that are favourable for low-level jet formation. This underestimation of dispersion may potentially result in inaccurate estimations of local emissions in top-down greenhouse gas inventory studies

Fake anti-malarials: start with the facts.

This meeting report presents the key findings and discussion points of a 1-day meeting entitled 'Fake anti-malarials: start with the facts' held on 28th May 2015, in Geneva, Switzerland, to disseminate the findings of the artemisinin combination therapy consortium's drug quality programme. The teams purchased over 10,000 samples, using representative sampling approaches, from six malaria endemic countries: Equatorial Guinea (Bioko Island), Cambodia, Ghana, Nigeria, Rwanda and Tanzania. Laboratory analyses of these samples showed that falsified anti-malarials (<8 %) were found in just two of the countries, whilst substandard artemisinin-based combinations were present in all six countries and, artemisinin-based monotherapy tablets are still available in some places despite the fact that the WHO has urged regulatory authorities in malaria-endemic countries to take measures to halt the production and marketing of these oral monotherapies since 2007. This report summarizes the presentations that reviewed the public health impact of falsified and substandard drugs, sampling strategies, techniques for drug quality analysis, approaches to strengthen health systems capacity for the surveillance of drug quality, and the ensuing discussion points from the dissemination meeting

Comparing diagnosed observation uncertainties with independent estimates: a case study using aircraft‐based observations and a convection‐permitting data assimilation system

Aircraft can report in situ observations of the ambient temperature by using aircraft meteorological data relay (AMDAR) or these can be derived using mode‐select enhanced tracking data (Mode‐S EHS). These observations may be assimilated into numerical weather prediction models to improve the initial conditions for forecasts. The assimilation process weights the observation according to the expected uncertainty in its measurement and representation. The goal of this paper is to compare observation uncertainties diagnosed from data assimilation statistics with independent estimates. To quantify these independent estimates, we use metrological comparisons, made with in‐situ research‐grade instruments, as well as previous studies using collocation methods between aircraft (mostly AMDAR reports) and other observing systems such as radiosondes. In this study, we diagnose a new estimate of the vertical structure of the uncertainty variances using observation‐minus‐background and observation‐minus‐analysis statistics from a Met Office limited area three‐dimensional variational data assimilation system (3 km horizontal grid‐length, 3‐hourly cycle). This approach for uncertainty estimation is simple to compute but has several limitations. Nevertheless, the resulting diagnosed variances have a vertical structure that is like that provided by the independent estimates of uncertainty. This provides confidence in the uncertainty estimation method, and in the diagnosed uncertainty estimates themselves. In the future, our methodology, along with other results, could provide ways to estimate the uncertainty for the assimilation of aircraft‐based temperature observations

Pseudoaneurysm of the left ventricle following apical approach TAVI

Symptomatic severe aortic stenosis carries a two year survival of only 50%. However many patients are unsuitable for conventional aortic valve replacement as they are considered too high risk due to significant co-morbidities. Transcatheter Aortic Valve Implantation (TAVI) offers a viable alternative for this high risk patient group, either by the femoral or apical route. This article reports a case of a pseudoaneurysm of the left ventricle following an apical approach TAVI in an elderly lady with severe aortic stenosis. To our knowledge pseduoaneuryms of the left ventricle have been reported infrequently in the literature and has yet to be established as a recognised complication of TAVI

Individual common variants exert weak effects on the risk for autism spectrum disorders.

While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm&lt; 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest

Comparison of aircraft-derived observations with in situ research aircraft measurements

Mode Selective Enhanced Surveillance (Mode-S EHS) reports are aircraft-based observations that have value in numerical weather prediction (NWP). These reports contain the aircraft's state vector in terms of its speed, direction, altitude and Mach number. Using the state vector, meteorological observations of temperature and horizontal wind can be derived. However, Mode-S EHS processing reduces the precision of the state vector from 16-bit to 10-bit binary representation. We use full precision data from research grade instruments, on-board the United Kingdom's Facility for Atmospheric Airborne Measurements, to emulate Mode-S EHS reports and to compare with derived observations. We aim to understand the observation errors due to the reduced precision of Mode-S EHS reports. We derive error models to estimate these observation errors. The temperature error increases from 1.25 K to 2.5 K between an altitude of 10 km and the surface due to its dependency on Mach number and also Mode-S EHS precision. For the cases studied, the zonal wind error is around 0.50 ms− 1 and the meridional wind error is 0.25 ms− 1. The wind is also subject to systematic errors that are directionally dependent. We conclude that Mode-S EHS derived horizontal winds are suitable for data assimilation in high-resolution NWP. Temperature reports may be usable when aggregated from multiple aircraft. While these reduced precision, high frequency data provide useful, albeit noisy, observations; direct reports of the higher precision data would be preferable

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty