Annual and Seasonal Surface Circulation Over the Mid Atlantic Bight Continental Shelf Derived From a Decade of High Frequency Radar Observations

A decade (2007–2016) of hourly 6‐km‐resolution maps of the surface currents across the Mid‐Atlantic Bight (MAB) generated by a regional‐scale High Frequency Radar network are used to reveal new insights into the spatial patterns of the annual and seasonal mean surface flows. Across the 10‐year time series, temporal means and interannual and intra‐annual variability are used to quantify the variability of spatial surface current patterns. The 10‐year annual mean surface flows are weaker and mostly cross‐shelf near the coast, increasing in speed and rotating to more alongshore directions near the shelfbreak, and increasing in speed and rotating to flow off‐shelf in the southern MAB. The annual mean surface current pattern is relatively stable year to year compared to the hourly variations within a year. The 10‐year seasonal means exhibit similar current patterns, with winter and summer more cross‐shore while spring and fall transitions are more alongshore. Fall and winter mean speeds are larger and correspond to when mean winds are stronger and cross‐shore. Summer mean currents are weakest and correspond to a time when the mean wind opposes the alongshore flow. Again, intra‐annual variability is much greater than interannual, with the fall season exhibiting the most interseasonal variability in the surface current patterns. The extreme fall seasons of 2009 and 2011 are related to extremes in the wind and river discharge events caused by different persistent synoptic meteorological conditions, resulting in more or less rapid fall transitions from stratified summer to well‐mixed winter conditions

Rilonacept and Anakinra in Recurrent Pericarditis: A Systematic Review and Meta-Analysis

Interleukin 1 (IL-1) has been indicated as a mediator of recurrent pericarditis. Rilonacept, a soluble IL-1 receptor chimeric fusion protein neutralizing interleukin 1 alpha (IL-1α) and interleukin 1 beta (IL-1β), has demonstrated promising results in a phase II study in recurrent or refractory pericarditis. Anakinra is a recombinant inhibitor of the IL-1 receptor with a demonstrated reduction in the incidence of recurrent pericarditis. Definite pharmacological management of pericarditis is key to preventing recurrences, mostly treatment options for recurrent pericarditis refractory to conventional drugs. Here we critically discuss the existing therapy options for recurrent pericarditis, with a focus on new pharmacological approaches: rilonacept and anakinra. A systematic search was conducted across online databases such as PubMed, Cochrane, Google Scholar, ScienceDirect, CINAHL, Scopus, and Embase to obtain clinical trials that assess the effectiveness of anti-interleukin 1 therapy such as anakinra and rilonacept in the management of recurrent pericarditis. Our study concluded that anti-interleukin 1 therapy significantly improved both the quality of life and the clinical outcomes of the study population. These outcomes were most prominent with the use of rilonacept and anakinra in the trial treatment. Rilonacept and anakinra are valuable options in case of recurrent pericarditis refractory to conventional drugs

Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy

Objective: To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus (ANT) for treatment of localization-related epilepsy. Methods: This long-term follow-up is a continuation of a previously reported trial of 5-vs 0-V ANT stimulation. Long-term follow-up began 13 months after device implantation with stimulation parameters adjusted at the investigators\u27 discretion. Seizure frequency was determined using daily seizure diaries. Results: The median percent seizure reduction from baseline at 1 year was 41%, and 69% at 5 years. The responder rate (≥50% reduction in seizure frequency) at 1 year was 43%, and 68% at 5 years. In the 5 years of follow-up, 16% of subjects were seizure-free for at least 6 months. There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages. The Liverpool Seizure Severity Scale and 31-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by 1 year and at 5 years (p \u3c 0.001). Conclusion: Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population. Classification of evidence: This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years