Aerosol and Cloud Microphysical Characteristics of Rifts and Gradients in Maritime Stratocumulus Clouds

A cloud rift is characterized as a large-scale, persistent area of broken, low-reflectivity stratocumulus clouds usually surrounded by a solid deck of stratocumulus. A rift observed off the coast of California was investigated using an instrumented aircraft to compare the aerosol, cloud microphysical, and thermodynamic properties in the rift with those of the surrounding solid stratocumulus deck. The microphysical characteristics in the solid stratocumulus deck differ substantially from those of a broken, cellular rift where cloud droplet concentrations are a factor of 2 lower than those in the solid cloud. Furthermore, cloud condensation nuclei (CCN) concentrations were found to be about 3 times greater in the solid-cloud area compared with those in the rift. Although drizzle was observed near cloud top in parts of the solid stratocumulus cloud, the largest drizzle rates were associated with the broken clouds within the rift area and with extremely large effective droplet sizes retrieved from satellite data. Minimal thermodynamic differences between the rift and solid cloud deck were observed. In addition to marked differences in particle concentrations, evidence of a mesoscale circulation near the solid cloud–rift boundary is presented. This mesoscale circulation may provide a mechanism for maintaining a rift, but further study is required to understand the initiation of a rift and the conditions that may cause it to fill. A review of results from previous studies indicates similar microphysical characteristics in rift features sampled serendipitously. These observations indicate that cloud rifts are depleted of aerosols through the cleansing associated with drizzle and are a manifestation of natural processes occurring in marine stratocumulus

Aerosol and Cloud Microphysical Characteristics of Rifts and Gradients in Maritime Stratocumulus Clouds

A cloud rift is characterized as a large-scale, persistent area of broken, low reflectivity stratocumulus clouds usually surrounded by a solid deck of stratocumulus. A rift observed off the coast of Monterey Bay, California on 16 July 1999 was studied to compare the aerosol and cloud microphysical properties in the rift with those of the surrounding solid stratus deck. Variables measured from an instrumented aircraft included temperature, water vapor, and cloud liquid water. These measurements characterized the thermodynamic properties of the solid deck and rift areas. Microphysical measurements made included aerosol, cloud drop and drizzle drop concentrations and cloud condensation nuclei (CCN) concentrations. The microphysical characteristics in a solid stratus deck differ substantially from those of a broken, cellular rift where cloud droplet concentrations are a factor of 2 lower than those in the solid cloud. Further, CCN concentrations were found to be about 3 times greater in the solid cloud area compared with those in the rift and aerosol concentrations showed a similar difference as well. Although drizzle was observed near cloud top in parts of the solid stratus cloud, the largest drizzle rates were associated with the broken clouds within the rift area. In addition to marked differences in particle concentrations, evidence of a mesoscale circulation near the solid cloud rift boundary is presented. This mesoscale circulation provides a mechanism for maintaining a rift, but further study is required to understand the initiation of a rift and the conditions that may cause it to fill

An Evaluation of Bylaw and Policy Changes on Pharmacy Robberies in British Columbia

On 15 September 2015, the College of Pharmacists of British Columbia (BC) implemented a set of by-law and security policy changes in an effort to reduce robberies and burglaries in BC pharmacies. Prior to these by-law and security policy changes, pharmacy robberies were increasing in BC for approximately 5 years. After implementation, pharmacy robberies decreased significantly. In this paper, we evaluate the potential impact of the by-law and security policy changes on pharmacy robberies in four regions within BC. We find strong evidence supporting that the reduction in pharmacy robberies is a result of this by-law and accompanying security policy changes. Specifically, there was an immediate and substantial drop in pharmacy robberies within Vancouver, with a change in trend (now decreasing instead of increasing) for the Interior and Lower Mainland less Vancouver. These results should be considered support for maintaining these by-laws and security policy changes in BC and potential implementation in other areas of Canada experiencing similar issues

Influence of Breast Cancer and Metastases on Incidence of Diabete

Purpose: Diabetes increases the risk of subsequent breast cancer. However, the inverse relationship of breast cancer to incident diabetes development is unclear. In preclinical models increased bone turnover due to bone metastases or endocrine therapies impacts insulin secretion. This analysis was conducted to estimate the incidence of diabetes after breast cancer and the influence of metastases and therapeutic agents. Methods: This retrospective case-control study combined data from a large electronic health data exchange and the Indiana State Cancer Registry on breast cancer patients and controls between 2007 and 2017. Primary exposure was presence of breast cancer and bone or non-bone metastases. The primary outcome was frequency of incident diabetes detected by ICD codes, medication use, or laboratory results, compared between breast cancer cases and controls using conditional or ordinary logistic regressions. Results: 36,083 cases and 36,083 matched controls were detected. Incident diabetes was higher in early stage breast cancer (OR 1.17, 95%CI 1.11-1.23, p<0.0001) and metastatic breast cancer (OR 1.62, 95% CI 1.25-2.09, p=0.0002), compared to controls. Bone metastases conferred higher odds of both pre-existing (OR 1.20, 95% CI 1.03-1.63, p=0.0272) and incident diabetes (OR 1.64, 95% CI 1.19-2.25, p=0.0021). Endocrine therapy was associated with reduced diabetes (OR 0.86, 95% CI 0.79-0.83, p=0.002). Anti-resorptives reduced incident diabetes in those with bone metastases (OR 0.44, 95% CI 0.25-0.78, p=0.005). Conclusion: Breast cancer, especially with metastases, increases subsequent risk of diabetes. As patients with breast cancer live longer, identifying and managing diabetes may impact treatment delivery, cost, survival, and quality of life

Brain responses during delay discounting in youth at high-risk for substance use disorders

Offspring of parents with substance use disorders (SUD) discount future rewards at a steeper rate on the monetary delay discounting task (DD) than typically developing youth. However, brain activation during DD has yet to be studied in drug naïve youth with a family history (FH) of SUD. Here, we investigate brain activation differences in high-risk youth during DD. We recruited substance naïve youth, aged 11–12, into three groups to compare brain activation during DD: (1) High-risk youth (n = 35) with a FH of SUD and externalizing psychiatric disorders, (2) psychiatric controls (n = 25) who had no FH of SUD, but with equivalent externalizing psychiatric disorders as high-risk youth, and (3) a healthy control group (n = 24) with no FH of SUD and minimal psychopathology. A whole-brain voxel wise analysis of the [Delay > Baseline], [Immediate > Baseline], and [Control > Baseline] contrasts identified functional regions of interest, from which extracted parameter estimates were tested for significant group differences. Relative to control youth, high-risk youth showed stronger activation in the left posterior insula and thalamus when making delayed choices, and stronger activation of the parahippocampal gyrus when making both delayed and control choices (ps < 0.05). Activation in the left posterior insula negatively correlated with both subscales of the Emotion Regulation Checklist, and positively correlated with the Stroop interference effect (ps < 0.05). Our findings suggest possible heritable SUD risk neural markers that distinguish drug naïve high-risk youth from psychiatric and healthy controls

Femtosecond diode-based time lens laser for multiphoton microscopy

We demonstrate a near-infrared, femtosecond, diode laser-based source with kW peak power for two-photon microscopy. At a wavelength of 976 nm, the system produces sub-ps pulses operating at a repetition rate of 10 MHz with kilowatt class peak powers suitable for deep tissue two-photon microscopy. The system, integrated with a laser-scanning microscope, images to a depth of 900 &micro;m in a fixed sample of PLP-eGFP labeled mouse brain tissue. This represents a significant development that will lead to more efficient, compact, and accessible laser sources for biomedical imaging. &nbsp;</p

Atezolizumab in Combination With Carboplatin and Survival Outcomes in Patients With Metastatic Triple-Negative Breast Cancer

Importance: Agents targeting programmed death ligand 1 (PD-L1) have demonstrated efficacy in triple-negative breast cancer (TNBC) when combined with chemotherapy and are now the standard of care in patients with PD-L1-positive metastatic disease. In contrast to microtubule-targeting agents, the effect of combining platinum compounds with programmed cell death 1 (PD-1)/PD-L1 immunotherapy has not been extensively determined. Objective: To evaluate the efficacy of atezolizumab with carboplatin in patients with metastatic TNBC. Design, Setting, and Participants: This phase 2 randomized clinical trial was conducted in 6 centers from August 2017 to June 2021. Interventions: Patients with metastatic TNBC were randomized to receive carboplatin area under the curve (AUC) 6 alone or with atezolizumab, 1200 mg, every 3 weeks until disease progression or unacceptable toxic effects with a 3-year duration of follow-up. Main Outcome and Measures: The primary end point was investigator-assessed progression-free survival (PFS). Secondary end points included overall response rate (ORR), clinical benefit rate (CBR), and overall survival (OS). Other objectives included correlation of response with tumor PD-L1 levels, tumor-infiltrating lymphocytes (TILs), tumor DNA- and RNA-sequenced biomarkers, TNBC subtyping, and multiplex analyses of immune markers. Results: All 106 patients with metastatic TNBC who were enrolled were female with a mean (range) age of 55 (27-79) years, of which 12 (19%) identified as African American/Black, 1 (1%) as Asian, 73 (69%) as White, and 11 (10%) as unknown. Patients were randomized and received either carboplatin (n = 50) or carboplatin and atezolizumab (n = 56). The combination improved PFS (hazard ratio [HR], 0.66; 95% CI, 0.44-1.01; P = .05) from a median of 2.2 to 4.1 months, increased ORR from 8.0% (95% CI, 3.2%-18.8%) to 30.4% (95% CI, 19.9%-43.3%), increased CBR at 6 months from 18.0% (95% CI, 9.8%-30.1%) to 37.5% (95% CI, 26.0%-50.6%), and improved OS (HR, 0.60; 95% CI, 0.37-0.96; P = .03) from a median of 8.6 to 12.6 months. Subgroup analysis showed PD-L1-positive tumors did not benefit more from adding atezolizumab (HR, 0.62; 95% CI, 0.23-1.65; P = .35). Patients with high TILs (HR, 0.12; 95% CI, 0.30-0.50), high mutation burden (HR, 0.50; 95% CI, 0.23-1.06), and prior chemotherapy (HR, 0.59; 95% CI, 0.36-0.95) received greater benefit on the combination. Patients with obesity and patients with more than 125 mg/dL on-treatment blood glucose levels were associated with better PFS (HR, 0.35; 95% CI, 0.10-1.80) on the combination. TNBC subtypes benefited from adding atezolizumab, except the luminal androgen receptor subtype. Conclusions and Relevance: In this randomized clinical trial, the addition of atezolizumab to carboplatin significantly improved survival of patients with metastatic TNBC regardless of PD-L1 status. Further, lower risk of disease progression was associated with increased TILs, higher mutation burden, obesity, and uncontrolled blood glucose levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03206203

Protocol of a randomized trial of acceptance and commitment therapy for fatigue interference in metastatic breast cancer

Fatigue interference with activities, mood, and cognition is one of the most prevalent and distressing concerns of metastatic breast cancer patients. To date, there are no evidence-based interventions for reducing fatigue interference in metastatic breast cancer and other advanced cancer populations. In pilot studies, Acceptance and Commitment Therapy (ACT) has shown potential for reducing symptom-related suffering in cancer patients. The current Phase II trial seeks to more definitively examine the efficacy of telephone-based ACT for women with metastatic breast cancer who are experiencing fatigue interference. In this trial, 250 women are randomly assigned to either the ACT intervention or an education/support control condition. Women in both conditions attend six weekly 50-min telephone sessions. The primary aim of this study is to test the effect of telephone-based ACT on fatigue interference. Secondary outcomes include sleep interference, engagement in daily activities, and quality of life. Outcomes are assessed at baseline, 2 weeks post-intervention, and 3 and 6 months post-intervention. This trial also examines whether increases in psychological flexibility, defined as full awareness of the present moment while persisting in behaviors aligned with personal values, account for the beneficial effect of ACT on fatigue interference. After demonstrating ACT's efficacy, the intervention can be widely disseminated to clinicians who care for metastatic breast cancer patients. Our findings will also inform future ACT trials with various cancer populations and functional outcomes