A gas-phase standard delivery system for direct breath analysis

Applications for direct breath analysis by mass spectrometry (MS) are rapidly expanding. One of the more recent mass spectrometry-based approaches is secondary electrospray ionization coupled to high-resolution mass spectrometry (SESI-HRMS). Despite increasing usage, the SESI methodology still lacks standardization procedures for quality control and absolute quantification. In this study, we designed and evaluated a custom-built standard delivery system tailored for direct breath analysis. The system enables the simultaneous introduction of multiple gas-phase standard compounds into ambient MS setups in the lower parts-per-million (ppm) to parts-per-billion (ppb) range. To best mimic exhaled breath, the gas flow can be heated (37 °C–40 °C) and humidified (up to 98% relative humidity). Inter-laboratory comparison of the system included various SESI-HRMS setups, i.e. an Orbitrap and a quadrupole time-of-flight mass spectrometer (QTOF), and using both single- as well as multi-component standards. This revealed highly stable and reproducible performances with between-run variation 95%) for the single-compound standard acetone, while compound-specific performances were obtained for the multi-component standard. Similarly, the sensitivity varied for different compounds within the multi-component standard across all SESI-Orbitrap and -QTOF setups, yielding limits of detections from 3.1 ppb (for p-xylene) to 0.05 ppb (for 1,8-cineol). Routinely applying the standard system throughout several weeks, allowed us to monitor instrument stability and to identify technical outliers in exhaled breath measurements. Such routine deployment of standards would significantly improve data quality and comparability, which is especially important in longitudinal and multi-center studies. Furthermore, performance validation of the system demonstrated its suitability for reliable absolute quantification while it illustrated compound-dependent behavior for SESI

Tropospheric water vapor: a comprehensive high-resolution data collection for the transnational Upper Rhine Graben region

Tropospheric water vapor is one of the most important trace gases of the Earth\u27s climate system, and its temporal and spatial distribution is critical for the genesis of clouds and precipitation. Due to the pronounced dynamics of the atmosphere and the nonlinear relation of air temperature and saturated vapor pressure, it is highly variable, which hampers the development of high-resolution and three-dimensional maps of regional extent. With their complementary high temporal and spatial resolutions, Global Navigation Satellite Systems (GNSS) meteorology and Interferometric Synthetic Aperture Radar (InSAR) satellite remote sensing represent a significant alternative to generally sparsely distributed radio sounding observations. In addition, data fusion with collocation and tomographical methods enables the construction of detailed maps in either two or three dimensions. Finally, by assimilation of these observation-derived datasets with dynamical regional atmospheric models, tropospheric water vapor fields can be determined with high spatial and continuous temporal resolution. In the following, a collection of basic and processed datasets, obtained with the above-listed methods, is presented that describes the state and course of atmospheric water vapor for the extent of the GNSS Upper Rhine Graben Network (GURN) region. The dataset contains hourly 2D fields of integrated water vapor (IWV) and 3D fields of water vapor density (WVD) for four multi-week, variable season periods between April 2016 and October 2018 at a spatial resolution of (2.1 km)$^2$. Zenith total delay (ZTD) from GNSS and collocation and refractivities are provided as intermediate products. InSAR (Sentinel-1A/B)-derived double differential slant total delay phases (ddSTDPs) and GNSS-based ZTDs are available for March 2015 to July 2019. The validation of data assimilation with five independent GNSS stations for IWV shows improving Kling–Gupta efficiency (KGE) scores for all seasons, most notably for summer, with collocation data assimilation (KGE = 0.92) versus the open-cycle simulation (KGE = 0.69). The full dataset can be obtained from https://doi.org/10.1594/PANGAEA.936447 (Fersch et al., 2021)

Tropospheric water vapor: a comprehensive high-resolution data collection for the transnational Upper Rhine Graben region

Tropospheric water vapor is one of the most important trace gases of the Earth's climate system, and its temporal and spatial distribution is critical for the genesis of clouds and precipitation. Due to the pronounced dynamics of the atmosphere and the nonlinear relation of air temperature and saturated vapor pressure, it is highly variable, which hampers the development of high-resolution and three-dimensional maps of regional extent. With their complementary high temporal and spatial resolutions, Global Navigation Satellite Systems (GNSS) meteorology and Interferometric Synthetic Aperture Radar (InSAR) satellite remote sensing represent a significant alternative to generally sparsely distributed radio sounding observations. In addition, data fusion with collocation and tomographical methods enables the construction of detailed maps in either two or three dimensions. Finally, by assimilation of these observation-derived datasets with dynamical regional atmospheric models, tropospheric water vapor fields can be determined with high spatial and continuous temporal resolution. In the following, a collection of basic and processed datasets, obtained with the above-listed methods, is presented that describes the state and course of atmospheric water vapor for the extent of the GNSS Upper Rhine Graben Network (GURN) region. The dataset contains hourly 2D fields of integrated water vapor (IWV) and 3D fields of water vapor density (WVD) for four multi-week, variable season periods between April 2016 and October 2018 at a spatial resolution of (2.1 km)2. Zenith total delay (ZTD) from GNSS and collocation and refractivities are provided as intermediate products. InSAR (Sentinel-1A/B)-derived double differential slant total delay phases (ddSTDPs) and GNSS-based ZTDs are available for March 2015 to July 2019. The validation of data assimilation with five independent GNSS stations for IWV shows improving Kling–Gupta efficiency (KGE) scores for all seasons, most notably for summer, with collocation data assimilation (KGE = 0.92) versus the open-cycle simulation (KGE = 0.69). The full dataset can be obtained from https://doi.org/10.1594/PANGAEA.936447 (Fersch et al., 2021)

Lung structural and functional impairments in young children with cystic fibrosis diagnosed following newborn screening - A nationwide observational study.

BACKGROUND Non-invasive and sensitive clinical endpoints are needed to monitor onset and progression of early lung disease in children with cystic fibrosis (CF). We compared lung clearance index (LCI), FEV1, functional and structural lung magnetic resonance imaging (MRI) outcomes in Swiss children with CF diagnosed following newborn screening. METHODS Lung function (LCI, FEV1) and unsedated functional and structural lung MRI was performed in 79 clinically stable children with CF (3 - 8 years) and 75 age-matched healthy controls. Clinical information was collected throughout childhood. RESULTS LCI, ventilation and perfusion defects, and structural MRI scores were significantly higher in children with CF compared with controls, but FEV1 was not different between groups. Lung MRI outcomes correlated significantly with LCI (morphology score (r = 0.56, p < 0.001); ventilation defects (r = 0.43, p = 0.001); perfusion defects (r = 0.64, p < 0.001), but not with FEV1. Lung MRI outcomes were more sensitive to detect impairments in children with CF (abnormal ventilation and perfusion outcomes in 47 %, morphology score in 30 %) compared with lung function (abnormal LCI in 21 % and FEV1 in 4.8 %). Pulmonary exacerbations, respiratory hospitalizations, and increase in patient-reported cough was associated with higher LCI and higher structural and functional MRI outcomes. CONCLUSIONS The LCI and lung MRI outcomes non-invasively detect even mild early lung disease in young children with CF diagnosed following newborn screening. Pulmonary exacerbations and early respiratory symptoms were risk factors for structural and functional impairment in childhood

Correction to: Reldesemtiv in Patients with Spinal Muscular Atrophy: a Phase 2 Hypothesis-Generating Study (Neurotherapeutics, (2021), 18, 2, (1127-1136), 10.1007/s13311-020-01004-3)

This article has been updated to add the author Richard S. Finkel. The original article has been corrected

Sources of mycosporine-like amino acids in planktonic Chlorella-bearing ciliates (Ciliophora)

Mycosporine-like amino acids (MAAs) are a family of secondary metabolites known to protect organisms exposed to solar UV radiation. We tested their distribution among several planktonic ciliates bearing Chlorella isolated from an oligo-mesotrophic lake in Tyrol, Austria. In order to test the origin of these compounds, the MAAs were assessed by high performance liquid chromatography in both the ciliates and their symbiotic algae.Considering all Chlorella-bearing ciliates, we found: (i) seven different MAAs (mycosporine-glycine, palythine, asterina-330, shinorine, porphyra-334, usujirene, palythene); (ii) one to several MAAs per species and (iii) qualitative and quantitative seasonal changes in the MAAs (e.g. in Pelagodileptus trachelioides). In all species tested, concentrations of MAAs were always <1% of ciliate dry weight.Several MAAs were also identified in the Chlorella isolated from the ciliates, thus providing initial evidence for their symbiotic origin. In Uroleptus sp., however, we found evidence for a dietary source of MAAs.Our results suggest that accumulation of MAAs in Chlorella-bearing ciliates represents an additional benefit of this symbiosis and an adaptation for survival in sunlit, UV-exposed waters

Being oneself through time: bases of self-continuity across 55 cultures

Self-continuity – the sense that one’s past, present, and future are meaningfully connected – is considered a defining feature of personal identity. However, bases of self-continuity may depend on cultural beliefs about personhood. In multilevel analyses of data from 7287 adults from 55 cultural groups in 33 nations, we tested a new tripartite theoretical model of bases of self-continuity. As expected, perceptions of stability, sense of narrative, and associative links to one’s past each contributed to predicting the extent to which people derived a sense of self-continuity from different aspects of their identities. Ways of constructing self-continuity were moderated by cultural and individual differences in mutable (vs. immutable) personhood beliefs – the belief that human attributes are malleable. Individuals with lower mutability beliefs based self-continuity more on stability; members of cultures where mutability beliefs were higher based self-continuity more on narrative. Bases of self-continuity were also moderated by cultural variation in contextualized (vs. decontextualized) personhood beliefs, indicating a link to cultural individualism-collectivism. Our results illustrate the cultural flexibility of the motive for self-continuity

Multiple breath washout quality control in the clinical setting

BACKGROUND Multiple breath washout (MBW) is increasingly used in the clinical assessment of patients with cystic fibrosis (CF). Guidelines for MBW quality control (QC) were developed primarily for retrospective assessment and central overreading. We assessed whether real-time QC of MBW data during the measurement improves test acceptability in the clinical setting. METHODS We implemented standardized real-time QC and reporting of MBW data at the time of the measurement in the clinical pediatric lung function laboratory in Bern, Switzerland in children with CF aged 4-18 years. We assessed MBW test acceptability before (31 tests; 89 trials) and after (32 tests; 96 trials) implementation of real-time QC and compared agreement between reviewers. Further, we assessed the implementation of real-time QC at a secondary center in Zurich, Switzerland. RESULTS Before implementation of real-time QC in Bern, only 58% of clinical MBW tests were deemed acceptable following retrospective QC by an experienced reviewer. After implementation of real-time QC, MBW test acceptability improved to 75% in Bern. In Zurich, after implementation of real-time QC, test acceptability improved from 38% to 70%. Further, the agreement between MBW operators and an experienced reviewer for test acceptability was 84% in Bern and 93% in Zurich. CONCLUSION Real-time QC of MBW data at the time of measurement is feasible in the clinical setting and results in improved test acceptability. This article is protected by copyright. All rights reserved

Comparison of challenges for health occupations based on the examples of handicapped carers and qualified medical employees

Im internationalen Vergleich zeichnet sich das deutsche Berufsbildungssystem insbesondere für die Gesundheitsberufe, die als nicht-ärztliche Heilberufe klassifiziert sind, durch einige Besonderheiten aus. Hierdurch bedingt sind große methodische Anforderungen, die einerseits diesen Unterschieden gerecht werden, und andererseits eine vergleichende Analyse von Berufsgruppen ermöglichen. In Deutschland wie auch in vielen anderen Ländern werden intensive Debatten geführt, die sich mit den zu erwartenden Veränderungen in der Gesundheitsversorgung, der demografischen Bevölkerungsentwicklung und den Anforderungen an die Berufstätigen im Gesundheits- und Sozialwesen auseinandersetzen. In der Konsequenz hat dies Auswirkungen auf das Berufsbild und das berufliche Selbstverständnis der beteiligten Akteure/-innen, deren zukünftige Aufgaben (Qualifikationsprofil) sowie auf die interdisziplinäre Zusammenarbeit im Gesundheitswesen. Um diese Anforderungen zu erfüllen, ist der Stand des Berufsbildungssystems und des Ausbildungsniveaus zu prüfen und ggf. anzupassen. Dieser Beitrag greift diese Fragen am Beispiel der Berufe Heilerziehungspfleger/-innen und Medizinische/-r Fachangestellte/-r vergleichend zwischen Deutschland und Österreich, der Schweiz und Großbritannien auf. Dies erfolgt dabei in einer doppelten Perspektive: zum einen wird auf Basis des jeweiligen Qualifikationsprofils und Aufgabenspektrums in Deutschland eine Gegenüberstellung mit den Berufen in den ausgewählten Ländern vorgenommen; zum anderen werden bereits absehbare Änderungen im Qualifikationsprofil dieser Berufe mit dem Fokus auf Gesundheitsförderung/Prävention und Beratung in der Berufsbildungsstruktur, Fort-/Weiterbildung und berufsbezogene Diskussion analysiert

Gesundheitsberufe als heterogene Zielgruppe in der wissenschaftlichen Weiterbildung

Vortrag auf DGWF-Jahrestagung 2016. 15.09.2016, Wien