TROPOMI/S5P total ozone column data: global ground-based validation and consistency with other satellite missions

In this work, the TROPOMI near real time (NRTI) and offline (OFFL) total ozone column (TOC) products are presented and compared to daily ground-based quality-assured Brewer and Dobson TOC measurements deposited in the World Ozone and Ultraviolet Radiation Data Centre (WOUDC). Additional comparisons to individual Brewer measurements from the Canadian Brewer Network and the European Brewer Network (Eubrewnet) are performed. Furthermore, twilight zenith-sky measurements obtained with ZSL-DOAS (Zenith Scattered Light Differential Optical Absorption Spectroscopy) instruments, which form part of the SAOZ network (Système d'Analyse par Observation Zénitale), are used for the validation. The quality of the TROPOMI TOC data is evaluated in terms of the influence of location, solar zenith angle, viewing angle, season, effective temperature, surface albedo and clouds. For this purpose, globally distributed ground-based measurements have been utilized as the background truth. The overall statistical analysis of the global comparison shows that the mean bias and the mean standard deviation of the percentage difference between TROPOMI and ground-based TOC is within 0 –1.5 % and 2.5 %–4.5 %, respectively. The mean bias that results from the comparisons is well within the S5P product requirements, while the mean standard deviation is very close to those limits, especially considering that the statistics shown here originate both from the satellite and the ground-based measurements.This research has been supported by the European Space Agency “Preparation and Operations of the Mission Performance Centre (MPC) for the Copernicus Sentinel-5 Precursor Satellite” (contract no. 4000117151/16/1-LG)

Multicountry Prospective Clinical Evaluation of Two Enzyme-Linked Immunosorbent Assays and Two Rapid Diagnostic Tests for Diagnosing Dengue Fever

We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks

The Diagnostic Sensitivity of Dengue Rapid Test Assays Is Significantly Enhanced by Using a Combined Antigen and Antibody Testing Approach

Dengue is a serious public health concern with around 3 billion people at risk of infection. Severe forms of the infection can be fatal and with no licensed vaccine or effective therapeutic currently available, early detection is important to assist with the clinical management of symptoms. Isolation of the virus and the detection of viral RNA using RT-PCR are commonly used methods for early diagnosis but are time-consuming, expensive and require skilled operation. Rapid immunochromatographic tests (ICT) are relatively simple, inexpensive and easy to perform at or near the point of care. Here, we report on the clinical performance of a new rapid ICT for the non-structural protein 1 (NS1) of dengue virus, a marker of acute infection. At two clinical study sites, NS1 was detected in 60–70% of laboratory-confirmed dengue cases and specificity of the test was >95%. We have also shown that a combined testing approach for both circulating NS1 antigen and antibody responses to the glycoprotein E of the virus can significantly improve diagnostic sensitivity compared to the detection of NS1 alone. Importantly, the combined antigen and antibody testing approach also provides an expanded window of detection from as early as day 1 post-onset of illness

Aortic calcification and arterial stiffness burden in a chronic kidney disease cohort with high cardiovascular risk: baseline characteristics of the IMpact of phosphate reduction on vascular end-points in chronic kidney disease trial

Chronic kidney disease (CKD) is associated with excess cardiovascular morbidity and mortality compared to the general population. Hyperphosphataemia, associated with vascular calcification and arterial stiffness, may play a key role in the pathogenesis of cardiovascular disease (CVD) associated with CKD, although phosphate reduction strategies have not consistently proven to beneficially affect clinically relevant outcomes. The IMpact of Phosphate Reduction On Vascular End-points in CKD (IMPROVE-CKD) study is an international, multi-centre, randomized, placebo-controlled trial investigating the effect of the phosphate binder lanthanum carbonate on intermediate cardiovascular markers in patients with stage 3b-4 CKD. The primary end-point is change in carotid-femoral pulse wave velocity (PWV, SphygmoCor) after 96 weeks. Secondary outcomes include change in abdominal aortic calcification (AAC, computed tomography), serum phosphate and fibroblast growth factor 23 (FGF-23). In total, 278 participants were recruited and randomized, mean age 63 ± 13 years, 69% male, 45% diabetes, 32% CVD, 33% stage 3b CKD and 67% stage 4 CKD. Mean estimated glomerular filtration rate and serum phosphate were 26.6 ± 8.3 mL/min/1.72 m and 1.25 ± 0.20 mmol/L, respectively. Median (interquartile range) intact and c-terminal FGF-23 levels were 133.0 (89.1-202) pg/mL and 221.1 (154.3-334.1) RU/mL, respectively. Mean PWV was 10.8 ± 3.6 m/s and 81% had AAC (median Agatston score 1,535 [63-5,744] Hounsfield units). PWV ≥10 m/s was associated with older age, diabetes, CVD, presence of AAC, higher systolic blood pressure (BP), larger waist circumference and higher alkaline phosphatase. AAC was associated with older age, male sex, diabetes, CVD, higher diastolic BP, dyslipidaemia (and use of statins), smoking, larger waist circumference and increased PWV. In conclusion, IMPROVE-CKD participants had high baseline risk for cardiovascular events, as suggested by high baseline PWV and AAC values

Effect of lanthanum carbonate on serum calciprotein particles in patients with stage 3-4 CKD-results from a placebo-controlled randomized trial

Background: Calciprotein particles (CPP) are colloidal aggregates of calcium phosphate and the mineral-binding protein fetuin-A, and are potential mediators of cardiovascular disease in chronic kidney disease (CKD). Emerging evidence suggests non-calcium-containing phosphate binders may reduce serum CPP in patients with kidney failure who require dialysis; however, it is unclear whether similar interventions are effective in patients with earlier stages of CKD. Methods: The IMpact of Phosphate Reduction On Vascular End-points in CKD (IMPROVE-CKD) was a multicentre, placebo-controlled, randomized trial of lanthanum carbonate on cardiovascular markers in 278 participants with stage 3b/4 CKD. In this pre-specified exploratory analysis, primary (CPP-I) and secondary CPP (CPP-II) were measured in a sub-cohort of participants over 96 weeks. Treatment groups were compared using linear mixed-effects models and the relationship between serum CPP and pulse wave velocity (PWV) and abdominal aortic calcification (AAC) was examined. Results: A total of 253 participants had CPP data for baseline and at least one follow-up timepoint and were included in this analysis. The mean age was 62.4 ± 12.6 years, 32.0% were female and the mean estimated glomerular filtration rate (eGFR) was 26.6 ± 8.3 mL/min/1.73 m2. Baseline median serum CPP-I was 14.9 × 104 particles/mL [interquartile range (IQR) 4.6–49.3] and median CPP-II was 3.3 × 103 particles/mL (IQR 1.4–5.4). There was no significant difference between treatment groups at 96 weeks in CPP-I [22.8% (95% confidence interval −39.2, 36.4), P = 0.65] or CPP-II [−18.3% (95% confidence interval −40.0, 11.2), P = 0.20] compared with a placebo. Serum CPP were not correlated with baseline PWV or AAC, or with the progression of either marker. Conclusions: Lanthanum carbonate was not associated with a reduction of CPP at 96 weeks when compared with a placebo in a CKD cohort

Validation of the IASI FORLI/EUMETSAT ozone products using satellite (GOME-2), ground-based (Brewer–Dobson, SAOZ, FTIR) and ozonesonde measurements

International audienceThis paper assesses the quality of IASI (Infrared Atmospheric Sounding Interferometer)/Metop-A (IASI-A) and IASI/Metop-B (IASI-B) ozone (O3) products (total and partial O3 columns) retrieved with the Fast Optimal Retrievals on Layers for IASI Ozone (FORLI-O3; v20151001) software for 9 years (2008–July 2017) through an extensive intercomparison and validation exercise using independent observations (satellite, ground-based and ozonesonde). Compared with the previous version of FORLI-O3 (v20140922), several improvements have been introduced in FORLI-O3 v20151001, including absorbance look-up tables recalculated to cover a larger spectral range, with additional numerical corrections. This leads to a change of  ∼ 4% in the total ozone column (TOC) product, which is mainly associated with a decrease in the retrieved O3 concentration in the middle stratosphere (above 30hPa/25km). IASI-A and IASI-B TOCs are consistent, with a global mean difference of less than 0.3% for both daytime and nighttime measurements; IASI-A is slightly higher than IASI-B. A global difference of less than 2.4% is found for the tropospheric (TROPO) O3 column product (IASI-A is lower than IASI-B), which is partly due to a temporary issue related to the IASI-A viewing angle in 2015. Our validation shows that IASI-A and IASI-B TOCs are consistent with GOME-2 (Global Ozone Monitoring Experiment-2), Dobson, Brewer, SAOZ (Système d'Analyse par Observation Zénithale) and FTIR (Fourier transform infrared) TOCs, with global mean differences in the range of 0.1%–2% depending on the instruments compared. The worst agreement with UV–vis retrieved TOC (satellite and ground) is found at the southern high latitudes. The IASI-A and ground-based TOC comparison for the period from 2008 to July 2017 shows the long-term stability of IASI-A, with insignificant or small negative drifts of 1%–3%decade−1. The comparison results of IASI-A and IASI-B against smoothed FTIR and ozonesonde partial O3 columns vary with altitude and latitude, with the maximum standard deviation being seen for the 300–150hPa column (20%–40%) due to strong ozone variability and large total retrievals errors. Compared with ozonesonde data, the IASI-A and IASI-B O3 TROPO column (defined as the column between the surface and 300hPa) is positively biased in the high latitudes (4%–5%) and negatively biased in the midlatitudes and tropics (11%–13% and 16%–19%, respectively). The IASI-A-to-ozonesonde TROPO comparison for the period from 2008 to 2016 shows a significant negative drift in the Northern Hemisphere of −8.6±3.4%decade−1, which is also found in the IASI-A-to-FTIR TROPO comparison. When considering the period from 2011 to 2016, the drift value for the TROPO column decreases and becomes statistically insignificant. The observed negative drifts of the IASI-A TROPO O3 product (8%–16%decade−1) over the 2008–2017 period might be taken into consideration when deriving trends from this product and this time period

Seven years of IASI ozone retrievals from FORLI: validation with independent total column and vertical profile measurements

International audienceThis paper presents an extensive inter-comparison and validation for the ozone (O3) product measured by the two Infrared Atmospheric Sounding Interferometers (IASI) launched onboard the Metop-A and Metop-B satellites in 2006 and in 2012, respectively. IASI O3 total columns and vertical profiles obtained from Fast Optimal Retrievals on Layers for IASI (FORLI-O3) v20140922 software (running up until recently) are validated against independent observations during the period 2008–2014 on a global scale. On average for the period 2013–2014, IASI-A and IASI-B TOCs retrieved using FORLI are consistent, with IASI-B providing slightly lower values with a global difference of only 0.2±0.8 %. The comparison between IASI-A and IASI-B O3 vertical profiles shows differences within ±2 % over the entire altitude range. Global validation results for seven years of IASI TOCs from FORLI against GOME-2/Metop-A, Dobson and Brewer data show that, on average, IASI overestimates the UV data by 5–6 % with the largest differences found in the Southern high latitudes. The comparison with UV-vis SAOZ measurements shows a mean bias between IASI and SAOZ TOCs of 2–4 % in the mid-latitudes and tropics, and 7 % at the polar circle. Part of the discrepancies found at high latitudes can be attributed to the limited information content in the observations, due to low brightness temperatures. The comparison with ozonesonde vertical profiles (limited to 30 km) shows that on average IASI with FORLI processing underestimates O3 by ~5–15 % in the troposphere while it overestimates O3 by ~10–40 % in the stratosphere depending on the latitude. In the Northern middle latitudes, the bias varies within ±20 % for the entire altitude range. The largest relative differences are found in the tropical tropopause region; this can be explained by the low O3 amounts leading to large relative errors. In this study, we also evaluate an updated version of FORLI-O3 retrieval software (v20151001), using look-up tables recalculated to cover a larger spectral range using the latest HITRAN spectroscopic database (HITRAN 2012), and implementing numerical corrections. The assessement of the new O3 product with the same set of observations as that used for the validation exercise shows a correction of ~4 % for the TOC positive bias when compared to the UV ground-based and satellite observations, bringing the overall global comparison to ~1–2 % on average. This improvement is mainly associated with a decrease in the retrieved O3 concentration in the stratosphere (above 30 hPa/25 km) as shown by the comparison with ozonesonde data

Study protocol for Vascular Access outcome measure for function:a vaLidation study In hemoDialysis (VALID) : A multi-center, multinational validation study to assess the accuracy and feasibility of measuring vascular access function in clinical practice

BACKGROUND: A functioning vascular access (VA) is crucial to providing adequate hemodialysis (HD) and considered a critically important outcome by patients and healthcare professionals. A validated, patient-important outcome measure for VA function that can be easily measured in research and practice to harvest reliable and relevant evidence for informing patient-centered HD care is lacking. Vascular Access outcome measure for function: a vaLidation study In hemoDialysis (VALID) aims to assess the accuracy and feasibility of measuring a core outcome for VA function established by the international Standardized Outcomes in Nephrology (SONG) initiative. METHODS: VALID is a prospective, multi-center, multinational validation study that will assess the accuracy and feasibility of measuring VA function, defined as the need for interventions to enable and maintain the use of a VA for HD. The primary objective is to determine whether VA function can be measured accurately by clinical staff as part of routine clinical practice (Assessor 1) compared to the reference standard of documented VA procedures collected by a VA expert (Assessor 2) during a 6-month follow-up period. Secondary outcomes include feasibility and acceptability of measuring VA function and the time to, rate of, and type of VA interventions. An estimated 612 participants will be recruited from approximately 10 dialysis units of different size, type (home-, in-center and satellite), governance (private versus public), and location (rural versus urban) across Australia, Canada, Europe, and Malaysia. Validity will be measured by the sensitivity and specificity of the data acquisition process. The sensitivity corresponds to the proportion of correctly identified interventions by Assessor 1, among the interventions identified by Assessor 2 (reference standard). The feasibility of measuring VA function will be assessed by the average data collection time, data completeness, feasibility questionnaires and semi-structured interviews on key feasibility aspects with the assessors. DISCUSSION: Accuracy, acceptability, and feasibility of measuring VA function as part of routine clinical practice are required to facilitate global implementation of this core outcome across all HD trials. Global use of a standardized, patient-centered outcome measure for VA function in HD research will enhance the consistency and relevance of trial evidence to guide patient-centered care. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03969225. Registered on 31st May 2019