The Integrated Carbon Observation System in Europe

Since 1750, land-use change and fossil fuel combustion has led to a 46% increase in the atmospheric carbon dioxide (CO2) concentrations, causing global warming with substantial societal consequences. The Paris Agreement aims to limit global temperature increases to well below 2 degrees C above preindustrial levels. Increasing levels of CO2 and other greenhouse gases (GH6s), such as methane (CH4) and nitrous oxide (N2O), in the atmosphere are the primary cause of climate change. Approximately half of the carbon emissions to the atmosphere are sequestered by ocean and land sinks, leading to ocean acidification but also slowing the rate of global warming. However, there are significant uncertainties in the future global warming scenarios due to uncertainties in the size, nature, and stability of these sinks. Quantifying and monitoring the size and timing of natural sinks and the impact of climate change on ecosystems are important information to guide policy-makers' decisions and strategies on reductions in emissions. Continuous, long-term observations are required to quantify GHG emissions, sinks, and their impacts on Earth systems. The Integrated Carbon Observation System (ICOS) was designed as the European in situ observation and information system to support science and society in their efforts to mitigate climate change. It provides standardized and open data currently from over 140 measurement stations across 12 European countries. The stations observe GHG concentrations in the atmosphere and carbon and GHG fluxes between the atmosphere, land surface, and the oceans. This article describes how ICOS fulfills its mission to harmonize these observations, ensure the related long-term financial commitments, provide easy access to well-documented and reproducible high-quality data and related protocols and tools for scientific studies, and deliver information and GHG-related products to stakeholders in society and policy.Peer reviewe

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

Intravitreal Anti-Vascular Endothelial Growth Factor for Macular Edema due to Complex Retinal Arterial Macroaneurysms

Introduction: Complex retinal arterial macroaneurysms (RAM) are often accompanied by hemorrhage and/or affect the macula. We evaluated the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy using ranibizumab or aflibercept with or without laser photocoagulation in the treatment of macular edema due to RAM. Methods: A case report of two patients with secondary macular edema caused by RAM is presented. The first case was a 76-year-old female treated with two 0.5-mg injections of ranibizumab and additional focal laser photocoagulation. This patient presented a solely intraretinal exudation. The second patient was a 96-year-old female, who received one 2.0-mg injection of aflibercept. She showed sub- and intraretinal edema. We documented the clinical courses of these patients based on fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography. Patients were followed-up for 12 months. Results: Patients were treated successfully using anti-VEGF therapy (ranibizumab or aflibercept) with or without laser photocoagulation. In both cases, we observed a complete regression of the macular edema and an increase in visual acuity. Conclusion: RAM can manifest with heterogeneous findings. Intravitreal anti-VEGF therapy with or without laser photocoagulation may be an effective treatment option in cases of macular edema due to RAM. Aflibercept and ranibizumab seem to be a potent anti-VEGF therapy for RAM. Individualized patient care is needed

Limitations of the radon tracer method (RTM) to estimate regional greenhouse gas (GHG) emissions - A case study for methane in Heidelberg

Correlations of nighttime atmospheric methane (CH4) and 222radon (222Rn) observations in Heidelberg, Germany, were evaluated with the radon tracer method (RTM) to estimate the trend of annual nocturnal CH4 emissions from 1996-2020 in the footprint of the station. After an initial 30ĝ€¯% decrease in emissions from 1996 to 2004, there was no further systematic trend but small inter-annual variations were observed thereafter. This is in accordance with the trend of total emissions until 2010 reported by the EDGARv6.0 inventory for the surroundings of Heidelberg and provides a fully independent top-down verification of the bottom-up inventory changes. We show that the reliability of total nocturnal CH4 emission estimates with the RTM critically depends on the accuracy and representativeness of the 222Rn exhalation rates estimated from soils in the footprint of the site. Simply using 222Rn fluxes as estimated by Karstens et al. (2015) could lead to biases in the estimated greenhouse gas (GHG) fluxes as large as a factor of 2. RTM-based GHG flux estimates also depend on the parameters chosen for the nighttime correlations of CH4 and 222Rn, such as the nighttime period for regressions and the R2 cut-off value for the goodness of the fit. Quantitative comparison of total RTM-based top-down flux estimates with bottom-up emission inventories requires representative high-resolution footprint modelling, particularly in polluted areas where CH4 emissions show large heterogeneity. Even then, RTM-based estimates are likely biased low if point sources play a significant role in the station footprint as their emissions may not be fully captured by the RTM method, for example, if stack emissions are injected above the top of the nocturnal inversion layer or if point-source emissions from the surface are not well mixed into the footprint of the measurement site. Long-term representative 222Rn flux observations in the footprint of a station are indispensable in order to apply the RTM method for reliable quantitative flux estimations of GHG emissions from atmospheric observations

Simple and objective method for routine detection of the macular pigment xanthophyll

A new simple method for two-dimensional determination of optical density of macular pigment xanthophyll (ODx) in clinical routine is based on a single blue-reflection fundus image. Individual different vignetting is corrected by a shading function. For its construction, nodes are automatically found in structureless image regions. The influence of stray light in elderly crystalline lenses is compensated by a correction function that depends on age. The reproducibility of parameters in a one-wavelength reflection method determined for three subjects (47, 61, and 78 years old) was: maxODx = 6.3%, meanODx = 4.6%, volume = 6%, and area = 6% already before stray-light correction. ODx was comparable in pseudophakic and in an eye with a crystalline lens of the same 11 subjects after stray-light correction. Significant correlation in ODx was found between the one-wavelength reflection method and the two-wavelength autofluorescence method for pseudophakic and cataract eyes of 19 patients suffering from dry age-related macular degeneration (AMD) (R(2) = 0.855). In pseudophakic eyes, maxODx was significantly lower for dry AMD (n = 45) (ODx = 0.491±0.102 ODU) than in eyes with healthy fundus (n = 22) (ODx = 0.615±0.103 ODU) (p = 0.000033). Also in eyes with crystalline lens, maxODx was lower in AMD (n = 125) (ODx = 0.610±0.093 ODU) than in healthy subjects (n = 45) (ODx = 0.674±0.098 ODU) (p = 0.00019). No dependence on age was found in the pseudophakic eyes both of healthy subjects and AMD patients

"Der Reha-Gedanke muss bei dieser Erkrankung völlig neu gedacht werden" Eine qualitative Analyse von Erfahrungen Betroffener mit stationärer Rehabilitation bei Long/Post-COVID

<p><strong>ZUSAMMENFASSUNG</strong></p><p><strong>Hintergrund:</strong> Bis Ende 2022 haben in Deutschland etwa 70.000 Menschen mit Long COVID bzw. einem Post-COVID-Syndrom (PCS) eine stationäre medizinische Rehabilitation in Anspruch genommen. Bisherige Untersuchungen zur Wirksamkeit von Rehabilitation bei PCS sind u.a. aufgrund der Heterogenität des Krankheitsbildes, der Variabilität angebotener Maßnahmen sowie uneinheitlicher Endpunkte nur begrenzt aussagekräftig. Damit bleibt unklar, ob bzw. inwieweit etablierte Reha-Maßnahmen für z.B. pulmologische, kardiologische, psychosomatische oder neurologische Erkrankungen bei PCS geeignet sind. </p><p><strong>Ziel:</strong> Identifizierung von Barriere-und Förderfaktoren für den Erfolg stationärer medizinischer Rehabilitation aus der Perspektive PCS-Betroffener.</p><p><strong>Methoden:</strong> Strukturierende und zusammenfassende qualitative Inhaltsanalyse frei formulierter Antworten aus einer retrospektiven Online-Befragung im Januar/Februar 2023, ergänzt durch deskriptive Darstellungen standardisierter Angaben.</p><p><strong>Ergebnisse:</strong> Von 1191 Teilnehmer*innen (TN) der Befragung nutzten 733 offene Antwortformate, um ihre Erfahrungen und die Auswirkungen einzelner Maßnahmen auf ihren Allgemeinzustand ergänzend zu explizieren. Als zentrale Barrierefaktoren des Reha-Erfolgs wurde das Vorliegen einer Post-Exertionellen Malaise (PEM) bzw. deren unzureichende Berücksichtigung während der Rehabilitation benannt. 366 (50%) der 733 Betroffenen berichteten von Verschlechterungen ihres Gesundheitszustandes, insbesondere infolge von Kraft- und Ausdauertraining sowie zu umfangreicher Behandlungspläne. Als Förderfaktoren wurden die Anerkennung und Akzeptanz der individuellen Leistungsgrenzen, eine auf individuelle Einschränkungen zugeschnittene, flexible und abgestimmte Behandlungsplanung sowie die Unterstützung in der Krankheitsbewältigung beschrieben. Bei Vorliegen einer PEM kann eine Reha aus Sicht der Befragten dann hilfreich sein, wenn das zentrale Ziel in der Vermeidung einer Verschlechterung des Gesundheitszustands infolge Überanstrengung sowie im Erlernen entsprechender Verhaltensstrategien (Pacing) liegt. Viele TN wiesen auf die Notwendigkeit einer disziplinübergreifenden Maßnahme hin, um alle relevanten Symptome adressieren zu können. </p><p><strong>Diskussion & Fazit:</strong> Die Ergebnisse sind nicht statistisch repräsentativ, zeigen jedoch, dass für PCS-Betroffene mit PEM bereits die Erfüllung von Mindestanforderungen an Rehabilitationsmaßnahmen zu einer Überlastung und Verschlimmerung führen kann. Eine zuverlässige Prüfung auf PEM und Reha-Fähigkeit vor bzw. zu Beginn der Rehabilitation ist daher notwendig, um die Sicherheit für Betroffene zu gewährleisten. Gängige, fachspezifische Reha-Konzepte scheinen nur bedingt geeignet, um der Symptomatik und der Heterogenität des Krankheitsbildes gerecht zu werden. Ziele und Inhalte sollten individuell angepasst werden und Maßnahmen zu Pacing und Krankheitsbewältigung im Vordergrund stehen. Um Studien zur Wirksamkeit von Rehabilitation adäquat einordnen zu können, sollten dort auch Risiken und Nebenwirkungen offengelegt werden. </p><p><strong>Schlüsselwörter:</strong> Long COVID, Post-COVID-Syndrom, Rehabilitation, Qualitative Forschung, Patient-Reported Outcomes, Gemeinsame Entscheidungsfindung</p><p><strong>Background:</strong> In Germany, an estimated number of 70,000 people diagnosed with LONG COVID or Post-COVID-Syndrome (PCS) received inpatient medical rehabilitation by the end of 2022. Due to the heterogeneity of the clinical picture, the variability of measures and inconsistent endpoints, previous studies on the effectiveness of rehabilitation are only of limited value. It therefore remains unclear whether and to what extent established rehabilitation measures for e.g. pulmonary, cardiological or neurological diseases are suitable for patients with PCS.</p><p><strong>Objectives:</strong> Identification of barriers and facilitators for the success of inpatient medical rehabilitation from the perspective of patients with PCS</p><p><strong>Methods:</strong> Structuring and summarizing qualitative content analysis of open answers from a retrospective online survey in January 2023, supplemented by descriptive results of standardized answers.</p><p><strong>Results:</strong> Of 1191 participants in the survey, 733 used open response formats to additionally explain their experiences and the effects of individual measures on their general condition. The presence of a post-exertional-malaise (PEM) or its insufficient consideration during rehabilitation was described as a central barrier. 366 (50%) of the 733 participants reported that their state of health had deteriorated, mainly as a result of strength or endurance training and too extensive treatment plans. The recognition and acceptance of individual performance limits, flexible and coordinated treatment planning tailored to individual limitations, and support in coping with the disease were described as supportive factors. From the perspective of the participants, learning strategies to avoid a deterioration in the state of health due to overexertion, the so-called pacing, should be a central treatment goal for patients affected by PEM. </p><p>The need for individual and interdisciplinary treatment was expressed in order to address all relevant symptoms.</p><p><strong>Discussion & Conclusion:</strong> The results are not statistically representative, but show that for PCS patients with PEM, even minimum requirements for rehabilitation measures can lead to overload and aggravation. Therefore, a reliable test for PEM and rehabilitation ability before the start of rehabilitation is necessary to ensure safety for those affected. Common, subject-specific rehabilitation concepts appear to be only partially suitable for dealing with the symptoms and the heterogeneity of the disease.  Aims and measures should be individually adapted, and the focus should be on pacing, disease coping and management.</p><p>To adequately classify studies on the effectiveness of rehabilitation, risks and side effects should be disclosed.</p><p><strong>Keywords:</strong> long COVID, post-COVID-syndrome, rehabilitation, qualitative research, patient-reported outcomes, shared decision-making</p&gt

A novel approach to pathogen reduction in platelet concentrates using short-wave ultraviolet light

Background: Transfusion of platelet concentrates (PCs) is the basic treatment for severe platelet disorders. PCs carry the risk of pathogen transmission, especially bacteria. Pathogen reduction (PR) by addition of photochemical reagents and irradiation with visible or ultraviolet (UV) light can significantly reduce this risk. We present a novel approach for PR in PCs employing UVC light alone. Study design and methods: UVC PR was evaluated by bacteria and virus infectivity assays. PC quality was investigated by measuring pH, lactate, glucose, hypotonic shock response, platelet aggregation, CD62P expression, and annexin V binding as in vitro parameters. The impact of UVC PR on the platelet proteome was assessed by differential in-gel electrophoresis and compared with changes caused by UVB and gamma-irradiation, respectively. Results: Vigorous agitation of loosely placed PCs generated thin fluid layers that allow penetration of UVC light for inactivation of the six bacteria and six of the seven virus species tested. HIV-1 was only moderately inactivated. UVC light at the dose used (0.4 J/cm) had a minor impact on in vitro parameters and on storage stability of treated PCs. Proteome analysis revealed a common set of 92 (out of 793) protein spots being affected by all three types of irradiation. Specific alterations were most pronounced for gamma-irradiation (45 spots), followed by UVB (11 spots) and UVC (2 spots). Conclusion: UVC irradiation is a potential new method for pathogen reduction in PCs. The data obtained until now justify further development of this process