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What are ventilation defects in asthma?

BACKGROUND: Hyperpolarised (3)He MRI provides a way to visualise regional pulmonary functional abnormalities that in asthma are thought to be related to airway morphological abnormalities. However, the exact aetiology of ventilation defects in asthma is not well understood. OBJECTIVE: To better understand the determinants of ventilation defects in asthma, we evaluated well-established clinical as well as (3)He MRI and X-ray CT airway measurements in healthy subjects and subjects with asthma. METHODS: Thirty-four subjects (n=26 subjects with asthma, n=8 healthy volunteers) underwent MRI, spirometry, plethysmography, fraction of exhaled nitric oxide analysis, methacholine challenge and CT for a region-of-interest proximal to ventilation defects. For subjects who consented to CT (n=18 subjects with asthma, n=5 healthy volunteers), we evaluated 3(rd) to 5th generation airway wall area and wall thickness per cent and lumen area. RESULTS: Seventeen subjects with asthma (17/26=65%) had visually obvious evidence of (3)He ventilation defects prior to bronchoprovocation and nine subjects with asthma had no ventilation defects prior to bronchoprovocation (9/26=35%). Subjects with asthma with defects were older (p=0.01) with worse forced expiratory volume in 1 s (FEV1)/forced vital capacity (p=0.0003), airways resistance (p=0.004), fraction of exhaled nitric oxide (p=0.03), greater bronchoprovocation concentration of methacholine that reduced FEV1 by 20% (p=0.008) and wall thickness per cent (p=0.02) compared with subjects with asthma without defects. There was a moderate correlation for wall area per cent with ventilation defect per cent (r=0.43, p=0.04). CONCLUSIONS: Subjects with asthma with (3)He ventilation defects were older with significantly worse airway hyper-responsiveness, inflammation and airway remodelling but similar FEV1 as subjects with asthma without defects; hyperpolarised (3)He ventilation abnormalities were spatially and quantitatively related to abnormally remodelled airways

A Contribution by Ice Nuclei to Global Warming

Ice nuclei (IN) significantly affect clouds via supercooled droplets, that in turn modulate atmospheric radiation and thus climate change. Since the IN effect is relatively strong in stratiform clouds but weak in convective ones, the overall effect depends on the ratio of stratiform to convective cloud amount. In this paper, 10 years of TRMM (Tropical Rainfall Measuring Mission) satellite data are analyzed to confirm that stratiform precipitation fraction increases with increasing latitude, which implies that the IN effect is stronger at higher latitudes. To quantitatively evaluate the IN effect versus latitude, large-scale forcing data from ten field campaigns are used to drive a CRM (cloud-resolving model) to generate longterm cloud simulations. As revealed in the simulations, the increase in the net downward radiative flux at the TOA (top of the atmosphere) from doubling the current IN concentrations is larger at higher latitude, which is attributed to the meridional tendency in the stratiform precipitation fraction. Surface warming from doubling the IN concentrations, based on the radiative balance of the globe, is compared with that from anthropogenic COZ . It is found that the former effect is stronger than the latter in middle and high latitudes but not in the Tropics. With regard to the impact of IN on global warming, there are two factors to consider: the radiative effect from increasing the IN concentration and the increase in IN concentration itself. The former relies on cloud ensembles and thus varies mainly with latitude. In contrast, the latter relies on IN sources (e.g., the land surface distribution) and thus varies not only with latitude but also longitude. Global desertification and industrialization provide clues on the geographic variation of the increase in IN concentration since pre-industrial times. Thus, their effect on global warming can be inferred and then be compared with observations. A general match in geographic and seasonal variations between the inferred and observed warming suggests that IN may have contributed positively to global warming over the past decades, especially in middle and high latitudes

Planning, implementation, and first results of the Tropical Composition, Cloud and Climate Coupling Experiment (TC4)

The Tropical Composition, Cloud and Climate Coupling Experiment (TC4), was based in Costa Rica and Panama during July and August 2007. The NASA ER-2, DC-8, and WB-57F aircraft flew 26 science flights during TC4. The ER-2 employed 11 instruments as a remote sampling platform and satellite surrogate. The WB-57F used 25 instruments for in situ chemical and microphysical sampling in the tropical tropopause layer (TTL). The DC-8 used 25 instruments to sample boundary layer properties, as well as the radiation, chemistry, and microphysics of the TTL. TC4 also had numerous sonde launches, two ground-based radars, and a ground-based chemical and microphysical sampling site. The major goal of TC4 was to better understand the role that the TTL plays in the Earth's climate and atmospheric chemistry by combining in situ and remotely sensed data from the ground, balloons, and aircraft with data from NASA satellites. Significant progress was made in understanding the microphysical and radiative properties of anvils and thin cirrus. Numerous measurements were made of the humidity and chemistry of the tropical atmosphere from the boundary layer to the lower stratosphere. Insight was also gained into convective transport between the ground and the TTL, and into transport mechanisms across the TTL. New methods were refined and extended to all the NASA aircraft for real-time location relative to meteorological features. The ability to change flight patterns in response to aircraft observations relayed to the ground allowed the three aircraft to target phenomena of interest in an efficient, well-coordinated manner

Aluminium and fluoride in drinking water in relation to later dementia risk

BACKGROUND: Environmental risk factors for dementia are poorly understood. Aluminium and fluorine in drinking water have been linked with dementia but uncertainties remain about this relationship. AIMS: In the largest longitudinal study in this context, we set out to explore the individual effect of aluminium and fluoride in drinking water on dementia risk and, as fluorine can increase absorption of aluminium, we also examine any synergistic influence on dementia. METHOD: We used Cox models to investigate the association between mean aluminium and fluoride levels in drinking water at their residential location (collected 2005–2012 by the Drinking Water Quality Regulator for Scotland) with dementia in members of the Scottish Mental Survey 1932 cohort who were alive in 2005. RESULTS: A total of 1972 out of 6990 individuals developed dementia by the linkage date in 2012. Dementia risk was raised with increasing mean aluminium levels in women (hazard ratio per s.d. increase 1.09, 95% CI 1.03–1.15, P < 0.001) and men (1.12, 95% CI 1.03–1.21, P = 0.004). A dose-response pattern of association was observed between mean fluoride levels and dementia in women (1.34, 95% CI 1.28–1.41, P < 0.001) and men (1.30, 95% CI 1.22–1.39, P < 0.001), with dementia risk more than doubled in the highest quartile compared with the lowest. There was no statistical interaction between aluminium and fluoride levels in relation with dementia. CONCLUSIONS: Higher levels of aluminium and fluoride were related to dementia risk in a population of men and women who consumed relatively low drinking-water levels of both. DECLARATION OF INTEREST: NONE

Contemplating Synergistic Algorithms for the NASA ACE Mission

ACE is a proposed Tier 2 NASA Decadal Survey mission that will focus on clouds, aerosols, and precipitation as well as ocean ecosystems. The primary objective of the clouds component of this mission is to advance our ability to predict changes to the Earth's hydrological cycle and energy balance in response to climate forcings by generating observational constraints on future science questions, especially those associated with the effects of aerosol on clouds and precipitation. ACE will continue and extend the measurement heritage that began with the A-Train and that will continue through Earthcare. ACE planning efforts have identified several data streams that can contribute significantly to characterizing the properties of clouds and precipitation and the physical processes that force these properties. These include dual frequency Doppler radar, high spectral resolution lidar, polarimetric visible imagers, passive microwave and submillimeter wave radiometry. While all these data streams are technologically feasible, their total cost is substantial and likely prohibitive. It is, therefore, necessary to critically evaluate their contributions to the ACE science goals. We have begun developing algorithms to explore this trade space. Specifically, we will describe our early exploratory algorithms that take as input the set of potential ACE-like data streams and evaluate critically to what extent each data stream influences the error in a specific cloud quantity retrieval

Overview of NASA Technology Development for In-Situ Resource Utilization (ISRU)

In-Situ Resource Utilization (ISRU) encompasses a broad range of systems that enable the production and use of extraterrestrial resources in support of future exploration missions. It has the potential to greatly reduce the dependency on resources transported from Earth (e.g., propellants, life support consumables), thereby significantly improving the ability to conduct future missions. Recognizing the critical importance of ISRU for the future, NASA is currently conducting technology development projects in two of its four mission directorates. The Advanced Exploration Systems Division in the Agency's Human Exploration and Operations Mission Directorate has initiated a new project for ISRU Technology focused on component, subsystem, and system maturation in the areas of water volatiles resource acquisition, and water volatiles and atmospheric processing into propellants and other consumable products. The Space Technology Mission Directorate is supporting development of ISRU component technologies in the areas of Mars atmosphere acquisition, including dust management, and oxygen production from Mars atmosphere for propellant and life support consumables. Together, these two coordinated projects are working towards a common goal of demonstrating ISRU technology and systems in preparation for future flight applications

Major-Element Abundances on the Surface of Mercury: Results from the MESSENGER Gamma-Ray Spectrometer

Orbital gamma-ray measurements obtained by the MESSENGER spacecraft have been analyzed to determine the abundances of the major elements Al, Ca, S, Fe, and Na on the surface of Mercury. The Si abundance was determined and used to normalize those of the other reported elements. The Na analysis provides the first abundance estimate of 2.9 plus or minus 0.1 wt% for this element on Mercury's surface. The other elemental results (S/Si = 0.092 plus or minus 0.015, Ca/Si = 0.24 plus or minus 0.05, and Fe/Si = 0.077 plus or minus 0.013) are consistent with those previously obtained by the MESSENGER X-Ray Spectrometer, including the high sulfur and low iron abundances. Because of different sampling depths for the two techniques, this agreement indicates that Mercury's regolith is, on average, homogenous to a depth of tens of centimeters. The elemental results from gamma-ray and X-ray spectrometry are most consistent with petrologic models suggesting that Mercury's surface is dominated by Mg-rich silicates. We also compare the results with those obtained during the MESSENGER flybys and with ground-based observations of Mercury's surface and exosphere

Occurrence of cytomegalovirus hepatitis in liver transplant patients

The differential diagnosis of liver dysfunction after orthotopic liver transplantation can be difficult. Cytomegalovirus (CMV) hepatitis is one possibility. This report reviews our experience with 17 cases of pathologically proven CMV hepatitis following liver transplantation and demonstrates the need for percutaneous liver biopsies to establish the diagnosis. There were seven pediatric patients (ages 2–11 years, five males, two females) and ten adult patients (ages 17–53 years, eight males, two females). The most common symptoms were prolonged fever (15 patients, with a mean duration of 22 ± 5.5 days), elevation in total bilirubin (14 patients), and elevation in liver enzymes (15 patients); all symptoms were also found in rejection. Leukopenia and thrombocytopenia, reported to frequently occur with CMV infection, were found in only three and five patients, respectively. Twelve patients with the above symptoms underwent percutaneous biopsy on one or more occasions to differentiate CMV hepatitis from rejection. The diagnosis was made at retransplantation in five patients. CMV hepatitis followed treatment for acute rejection in 14 patients and occurred without additional immunosuppression in three patients. All patients were maintained on cyclosporine and prednisone. Acute rejection episodes were treated with a 5‐day tapering dose of steroids (17 courses in 12 patients), OKT3 monoclonal antibody [Ortho (4 patients)] antithymocyte globulin [Upjohn (2 patients)], and azathioprine (1 patient). CMV was isolated from urine (nine patients), blood (nine patients), throat (seven patients), lungs (two patients), and other organs (two patients). CMV was cultured from the liver biopsy specimens in five of the seven attempts in pediatric patients. When the diangosis was confirmed in the absence of rejection, immunosuppression was routinely lowered. When rejection occurred concomitantly with CMV hepatitis, therapy had to be individualized. Retrospectively, three patients treated for rejection were noted at retransplantation to have only CMV hepatitis, and all three paients died. A high index of suspicion and the judicioususe of liver bopsies is essential in order to differentiate CMV hepatitis from other causes of posttransplant liver dysfunction. Copyright © 1988 Wiley‐Liss, Inc., A Wiley Compan