Influence of lateral and top boundary conditions on regional air quality prediction: A multiscale study coupling regional and global chemical transport models

The sensitivity of regional air quality model to various lateral and top boundary conditions is studied at 2 scales: a 60 km domain covering the whole USA and a 12 km domain over northeastern USA. Three global models (MOZART-NCAR, MOZART-GFDL and RAQMS) are used to drive the STEM-2K3 regional model with time-varied lateral and top boundary conditions (BCs). The regional simulations with different global BCs are examined using ICARTT aircraft measurements performed in the summer of 2004, and the simulations are shown to be sensitive to the boundary conditions from the global models, especially for relatively long-lived species, like CO and O3. Differences in the mean CO concentrations from three different global-model boundary conditions are as large as 40 ppbv, and the effects of the BCs on CO are shown to be important throughout the troposphere, even near surface. Top boundary conditions show strong effect on O3 predictions above 4 km. Over certain model grids, the model’s sensitivity to BCs is found to depend not only on the distance from the domain’s top and lateral boundaries, downwind/upwind situation, but also on regional emissions and species properties. The near-surface prediction over polluted area is usually not as sensitive to the variation of BCs, but to the magnitude of their background concentrations. We also test the sensitivity of model to temporal and spatial variations of the BCs by comparing the simulations with time-varied BCs to the corresponding simulations with time-mean and profile BCs. Removing the time variation of BCs leads to a significant bias on the variation prediction and sometime causes the bias in predicted mean values. The effect of model resolution on the BC sensitivity is also studied

The Influence of Loop Current Perturbations on the Formation and Evolution of Tortugas Eddies in the Southern Straits of Florida

Large cyclonic eddies on the northern edge of the Florida Current are the dominant mesoscale features within the southern Straits of Florida. The most prominent of these features is a quasi-stationary eddy that forms near the Dry Tortugas. Our observations, compiled from 3 years of advanced very high resolution radiometer measurements in the Straits of Florida and Gulf of Mexico, demonstrate a strong relationship between the generation of anticyclonic rings from the Gulf of Mexico Loop Current and the evolution of Tortugas eddies within the southern Straits of Florida. In six cases, Tortugas eddies evolve from cyclonic frontal eddies which form along the boundary of the Loop Current. The eddies remain stationary near the Dry Tortugas until they are impacted by an approaching Loop Current frontal eddy. The length of time an eddy spends near the Dry Tortugas is increased when the Loop Current sheds an anticyclonic ring. The involvement of a Loop Current frontal eddy in the ring-shedding process results in a delay in its, and hence the Tortugas eddy\u27s, downstream propagation. Results suggest that the lifetime of a Tortugas eddy can be as long as 140 days when a ring-shedding event occurs, or as short as 50 days in the absence of any ring-shedding events. Upon entering the Straits of Florida, the Tortugas eddies are deformed by the narrowing topography and shrink to approximately 55% of their original size as they propagated downstream. The shrinking of these eddies is accompanied by an accelerated translation from 5 km/d in the western Straits of Florida to 16 km/d in the east

Impaired Target Site Penetration of Vancomycin in Diabetic Patients following Cardiac Surgery

Soft tissue infections constitute a serious complication following surgery in diabetic patients and frequently require the administration of vancomycin. However, despite antibiotic treatment, mortality of patients with postoperative infections remains high and might be related to an impaired penetration of anti-infective agents to target tissues. Therefore, the present study was designed to measure vancomycin tissue concentrations in six diabetic and six nondiabetic patients after cardiac surgery. Vancomycin was administered as a continuous intravenous infusion at an infusion rate of 80 to 120 mg/h. Vancomycin concentrations in soft tissues and plasma were measured in all patients during steady state as “therapeutic window” concentrations in plasma by microdialysis on day 8 ± 4 after initiation of vancomycin treatment. Vancomycin tissue concentrations in diabetic patients were significantly lower than in nondiabetics (3.7 mg/liter versus 11.9 mg/liter; P = 0.002). The median vancomycin(tissue)/vancomycin(plasma) concentration ratio was 0.1 in diabetic patients and 0.3 in nondiabetics (P = 0.002). Our study demonstrated that vancomycin penetration into target tissues is substantially impaired in diabetic patients versus nondiabetics. Insufficient tissue concentrations could therefore possibly contribute to failure of antibiotic treatment and the development of antimicrobial resistance in diabetic patients

Autoantibody-associated psychiatric symptoms and syndromes in adults: A narrative review and proposed diagnostic approach

Background: Autoimmune-mediated encephalitis is a disease that often encompasses psychiatric symptoms as its first clinical manifestation’s predominant and isolated characteristic. Novel guidelines even distinguish autoimmune psychosis from autoimmune encephalitis. The aim of this review is thus to explore whether a wide range of psychiatric symptoms and syndromes are associated or correlate with autoantibodies. Methods: We conducted a PubMed search to identify appropriate articles concerning serum and/or cerebrospinal fluid (CSF) autoantibodies associated with psychiatric symptoms and syndromes between 2000 and 2020. Relying on this data, we developed a diagnostic approach to optimize the detection of autoantibodies in psychiatric patients, potentially leading to the approval of an immunotherapy. Results: We detected 10 major psychiatric symptoms and syndromes often reported to be associated with serum and/or CSF autoantibodies comprising altered consciousness, disorientation, memory impairment, obsessive-compulsive behavior, psychosis, catatonia, mood dysfunction, anxiety, behavioral abnormalities (autism, hyperkinetic), and sleeping dysfunction. The following psychiatric diagnoses were associated with serum and/or CSF autoantibodies: psychosis and schizophrenia spectrum disorders, mood disorders, minor and major neurocognitive impairment, obsessive-compulsive disorder, autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), anxiety disorders, eating disorders and addiction. By relying on these symptom clusters and diagnoses in terms of onset and their duration, we classified a subacute or subchronic psychiatric syndrome in patients that should be screened for autoantibodies. We propose further diagnostics entailing CSF analysis, electroencephalography and magnetic resonance imaging of the brain. Exploiting these technologies enables standardized and accurate diagnosis of autoantibody-associated psychiatric symptoms and syndromes to deliver early immunotherapy. Conclusions: We have developed a clinical diagnostic pathway for classifying subgroups of psychiatric patients whose psychiatric symptoms indicate a suspected autoimmune origin