Sudden death due to isolated acute infarction of the His bundle

AbstractA 29 year old black man considered to be in good health died suddenly and unexpectedly. At postmortem examination there were no significant gross abnormalities, all drug screens were normal and sicklemia was not present. Special studies of the cardiac conduction system demonstrated isolated acute infarction of the His bundle, with no similar evidence of myocardial infarction anywhere else in the heart. The atrioventricular (AV) node artery was moderately narrowed, but its branch supplying the His bundle was occluded >95% by focal fibromuscular dysplasia. There were no other significant coronary lesions or other abnormalities in the heart

Development of a low-maintenance measurement approach to continuously estimate methane emissions: a case study

The chemical breakdown of organic matter in landfills represents a significant source of methane gas (CH4). Current estimates suggest that landfills are responsible for between 3% and 19% of global anthropogenic emissions. The net CH4 emissions resulting from biogeochemical processes and their modulation by microbes in landfills are poorly constrained by imprecise knowledge of environmental constraints. The uncertainty in absolute CH4 emissions from landfills is therefore considerable. This study investigates a new method to estimate the temporal variability of CH4 emissions using meteorological and CH4 concentration measurements downwind of a landfill site in Suffolk, UK from July to September 2014, taking advantage of the statistics that such a measurement approach offers versus shorter-term, but more complex and instantaneously accurate, flux snapshots. Methane emissions were calculated from CH4 concentrations measured 700 m from the perimeter of the landfill with observed concentrations ranging from background to 46.4 ppm. Using an atmospheric dispersion model, we estimate a mean emission flux of 709 μg m−2 s−1 over this period, with a maximum value of 6.21 mg m−2 s−1, reflecting the wide natural variability in biogeochemical and other environmental controls on net site emission. The emissions calculated suggest that meteorological conditions have an influence on the magnitude of CH4 emissions. We also investigate the factors responsible for the large variability observed in the estimated CH4 emissions, and suggest that the largest component arises from uncertainty in the spatial distribution of CH4 emissions within the landfill area. The results determined using the low-maintenance approach discussed in this paper suggest that a network of cheaper, less precise CH4 sensors could be used to measure a continuous CH4 emission time series from a landfill site, something that is not practical using far-field approaches such as tracer release methods. Even though there are limitations to the approach described here, this easy, low-maintenance, low-cost method could be used by landfill operators to estimate time-averaged CH4 emissions and their impact downwind by simultaneously monitoring plume advection and CH4 concentrations

CH4 emission estimates from an active landfill site inferred from a combined approach of CFD modelling and in situ FTIR measurements

Globally, the waste sector contributes to nearly a fifth of anthropogenic methane emitted to the atmosphere and is the second largest source of methane in the UK. In recent years great improvements to reduce those emissions have been achieved by installation of methane recovery systems at landfill sites and subsequently methane emissions reported in national emission inventories have been reduced. Nevertheless, methane emissions of landfills remain uncertain and quantification of emission fluxes is essential to verify reported emission inventories and to monitor changes in emissions. Here we present a new approach for methane emission quantification from a complex source like a landfill site by applying a Computational Fluid Dynamics (CFD) model to calibrated in situ measurements of methane as part of a field campaign at a landfill site near Ipswich, UK, in August 2014. The methane distribution for different meteorological scenarios is calculated with the CFD model and compared to methane mole fractions measured by an in situ Fourier Transform Infrared (FTIR) spectrometer downwind of the prevailing wind direction. Assuming emissions only from the active site, a mean daytime flux of 0.83 mg m−2 s−1, corresponding to 53.26 kg h−1, was estimated. The addition of a secondary source area adjacent to the active site, where some methane hotspots were observed, improved the agreement between the simulated and measured methane distribution. As a result, the flux from the active site was reduced slightly to 0.71 mg m−2 s−1 (45.56 kg h−1), at the same time an additional flux of 0.32 mg m−2 s−1 (30.41 kg h−1) was found from the secondary source area. This highlights the capability of our method to distinguish between different emission areas of the landfill site, which can provide more detailed information about emission source apportionment compared to other methods deriving bulk emissions

INDIGO : better geomagnetic observatories where we need them

The INDIGO project aims to improve the global coverage of digital observatories by deploying digital magnetometer systems in: i) Observatories where existing analog recording equipment is in need of upgrading. ii) Newly established digital observatories. iii) Existing digital observatories for the purpose of quality control and redundancy. In implementing the project and selecting suitable sites, special attention is paid to parts of the Earth devoid of magnetic observatories, increasing the reliability and long-term operation of existing observatories and cost-effective use of local resources. The Poster reviews the current status of the project. We examine the different steps and initiatives taken since the initiation of INDIGO in 2004 and assess their effectiveness in achieving progress towards our aims of improving global coverage and enhanced data quality

Different Successful Management Strategies for Obstructing Renal Parapelvic Cysts

Parapelvic cysts originate in the renal parenchyma and extend into the renal sinus. A series of 3 patients with symptomatic obstructing parapelvic cysts is described, 2 with acute presentations, and 1 with chronic symptoms. In 2 of the 3 cases, there was a significant delay in establishing a diagnosis. Although one individual was successfully managed by image-guided cyst aspiration, the second patient required repeated aspiration due to cyst re-accumulation. A high index of clinical suspicion and a combination of imaging modalities, including serial ultrasound, excretory-phase CT, and MAG3 renogram, are necessary to establish the diagnosis and monitor response to treatment

The Influence of Murine Genetic Background in Adeno-Associated Virus Transduction of the Mouse Brain

Adeno-associated virus (AAV) vectors have become an important tool for delivering therapeutic genes for a wide range of neurological diseases. AAV serotypes possess differential cellular tropism in the central nervous system. Although several AAV serotypes or mutants have been reported to transduce the brain efficiently, conflicting data occur across studies with the use of various rodent strains from different genetic backgrounds. Herein, we performed a systematic comparison of the brain transduction properties among five AAV serotypes (AAV2, 5, 7, 8, and 9) in two common rodent strains (C57BL/6J and FVB/N), following local intrastriatal injection of AAV vectors encoding enhanced green fluorescent protein (EGFP) driven by the CBh promoter. Important differences were found regarding overall cellular tropism and transduction efficiency, including contralateral transduction among the AAV serotypes and between the mouse strains. We have further found loss of NeuN-immunoreactivity and microglial activation from AAV transduction in the different mouse strains. The important strain-specific differences from our study suggest that the genetic background of the mouse may affect AAV serotype transduction properties in the brain. These data can provide valuable information about how to choose an effective AAV vector for clinical application and interpret the data obtained from preclinical studies and clinical trials

Optimal Cyanobacterial Pigment Retrieval from Ocean Colour Sensors in a Highly Turbid, Optically Complex Lake

To date, several algorithms for the retrieval of cyanobacterial phycocyanin (PC) from ocean colour sensors have been presented for inland waters, all of which claim to be robust models. To address this, we conducted a comprehensive comparison to identify the optimal algorithm for retrieval of PC concentrations in the highly optically complex waters of Lake Balaton (Hungary). MEdium Resolution Imaging Spectrometer (MERIS) top-of-atmosphere radiances were first atmospherically corrected using the Self-Contained Atmospheric Parameters Estimation for MERIS data v.B2 (SCAPE-M_B2). Overall, the Simis05 semi-analytical algorithm outperformed more complex inversion algorithms, providing accurate estimates of PC up to ±7 days from the time of satellite overpass during summer cyanobacteria blooms (RMSElog 0.66, p < 0.001). In-depth analysis of the Simis05 algorithm using in situ measurements of inherent optical properties (IOPs) revealed that the Simis05 model overestimated the phytoplankton absorption coefficient [aph(λ)] by a factor of ~2. However, these errors were compensated for by underestimation of the mass-specific chlorophyll absorption coefficient [a*chla(λ)]. This study reinforces the need for further validation of algorithms over a range of optical water types in the context of the recently launched Ocean Land Colour Instrument (OLCI) onboard Sentinel-3

Methane emissions from oil and gas platforms in the North Sea

Since 1850 the concentration of atmospheric methane (CH4), a potent greenhouse gas, has more than doubled. Recent studies suggest that emission inventories may be missing sources and underestimating emissions. To investigate whether offshore oil and gas platforms leak CH4 during normal operation, we measured CH4 mole fractions around eight oil and gas production platforms in the North Sea which were neither flaring gas nor offloading oil. We use the measurements from summer 2017, along with meteorological data, in a Gaussian plume model to estimate CH4 emissions from each platform. We find CH4 mole fractions of between 11 and 370 ppb above background concentrations downwind of the platforms measured, corresponding to a median CH4 emission of 6.8 g CH4 s−1 for each platform, with a range of 2.9 to 22.3 g CH4 s−1. When matched to production records, during our measurements individual platforms lost between 0.04 % and 1.4 % of gas produced with a median loss of 0.23 %. When the measured platforms are considered collectively (i.e. the sum of platforms' emission fluxes weighted by the sum of the platforms' production), we estimate the CH4 loss to be 0.19 % of gas production. These estimates are substantially higher than the emissions most recently reported to the National Atmospheric Emission Inventory (NAEI) for total CH4 loss from United Kingdom platforms in the North Sea. The NAEI reports CH4 losses from the offshore oil and gas platforms we measured to be 0.13 % of gas production, with most of their emissions coming from gas flaring and offshore oil loading, neither of which was taking place at the time of our measurements. All oil and gas platforms we observed were found to leak CH4 during normal operation, and much of this leakage has not been included in UK emission inventories. Further research is required to accurately determine total CH4 leakage from all offshore oil and gas operations and to properly include the leakage in national and international emission inventories

The VENUSS prognostic model to predict disease recurrence following surgery for non-metastatic papillary renal cell carcinoma: development and evaluation using the ASSURE prospective clinical trial cohort

Abstract: Background: The current World Health Organization classification recognises 12 major subtypes of renal cell carcinoma (RCC). Although these subtypes differ on molecular and clinical levels, they are generally managed as the same disease, simply because they occur in the same organ. Specifically, there is a paucity of tools to risk-stratify patients with papillary RCC (PRCC). The purpose of this study was to develop and evaluate a tool to risk-stratify patients with clinically non-metastatic PRCC following curative surgery. Methods: We studied clinicopathological variables and outcomes of 556 patients, who underwent full resection of sporadic, unilateral, non-metastatic (T1–4, N0–1, M0) PRCC at five institutions. Based on multivariable Fine-Gray competing risks regression models, we developed a prognostic scoring system to predict disease recurrence. This was further evaluated in the 150 PRCC patients recruited to the ASSURE trial. We compared the discrimination, calibration and decision-curve clinical net benefit against the Tumour, Node, Metastasis (TNM) stage group, University of California Integrated Staging System (UISS) and the 2018 Leibovich prognostic groups. Results: We developed the VENUSS score from significant variables on multivariable analysis, which were the presence of VEnous tumour thrombus, NUclear grade, Size, T and N Stage. We created three risk groups based on the VENUSS score, with a 5-year cumulative incidence of recurrence equalling 2.9% in low-risk, 15.4% in intermediate-risk and 54.5% in high-risk patients. 91.7% of low-risk patients had oligometastatic recurrent disease, compared to 16.7% of intermediate-risk and 40.0% of high-risk patients. Discrimination, calibration and clinical net benefit from VENUSS appeared to be superior to UISS, TNM and Leibovich prognostic groups. Conclusions: We developed and tested a prognostic model for patients with clinically non-metastatic PRCC, which is based on routine pathological variables. This model may be superior to standard models and could be used for tailoring postoperative surveillance and defining inclusion for prospective adjuvant clinical trials