533 research outputs found

    Satellite-based detection of volcanic sulphur dioxide from recent eruptions in Central and South America

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    Volcanic eruptions can emit large amounts of rock fragments and fine particles (ash) into the atmosphere, as well as several gases, including sulphur dioxide (SO<sub>2</sub>). These ejecta and emissions are a major natural hazard, not only to the local population, but also to the infrastructure in the vicinity of volcanoes and to aviation. Here, we describe a methodology to retrieve quantitative information about volcanic SO<sub>2</sub> plumes from satellite-borne measurements in the UV/Visible spectral range. The combination of a satellite-based SO<sub>2</sub> detection scheme and a state-of-the-art 3D trajectory model enables us to confirm the volcanic origin of trace gas signals and to estimate the plume height and the effective emission height. This is demonstrated by case-studies for four selected volcanic eruptions in South and Central America, using the GOME, SCIAMACHY and GOME-2 instruments

    Nationwide Real-world Cohort Study of First-line Tyrosine Kinase Inhibitor Treatment in Epidermal Growth Factor Receptor-mutated Non-small-cell Lung Cancer

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    Most trials regarding tyrosine kinase inhibitors in patients with advanced epidermal growth factor receptor-mutated non-small-cell lung cancer comprised selected series from Asian populations. We found that Western European patients with epidermal growth factor receptor-mutated non-small-cell lung cancer who received first-line treatment with regular tyrosine kinase inhibitors have a median overall survival of 20.2 months in our large nationwide real-world cohort. In patients with brain metastasis, erlotinib showed superior results compared with gefitinib and was similar to afatinib. Background: Only a few randomized trials directly compared the relative efficacy of tyrosine kinase inhibitors (TKIs) in patients with advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), and most trials comprised selected series from Asian populations. Therefore, the aim of this study was to assess the overall survival (OS) of advanced EGFR-mutated NSCLC in a large white population and to evaluate variation between different TKIs and identify predictors of survival. Patients and Methods: Information about clinical characteristics, treatment, and survival for 873 patients with stage IV EGFR + NSCLC, diagnosed from 2015 through 2017, was derived from the Netherlands Cancer Registry. OS was evaluated by actuarial analysis and multivariable Cox regression. Prognostic factors are reported as hazard ratios and 95% confidence intervals. Results: A total of 596 (68%) patients received first-line treatment with regular TKIs, providing a median survival of 20.2 months. Forty-five percent of patients were 70 years and older, and 54% of patients had distant metastasis in multiple organs. In the multivariate analysis, survival was significantly worse for men, and patients with higher age, poorer performance, and >= 3 organs with metastasis. Compared with erlotinib, OS was worse for gefitinib users (adjusted hazard ratio, 1.30; 95% confidence interval, 1.02-1.64), predominantly in patients with brain metastasis. Conclusion: Dutch patients with EGFR-mutated NSCLC who received first-line treatment with regular TKIs have a median OS of 20.2 months in a nationwide real-world cohort. In patients with brain metastasis, erlotinib showed superior results compared with gefitinib and was similar to afatinib. (C) 2020 Elsevier Inc. All rights reserved

    High-flow nasal cannula oxygen therapy for admitted COPD-patients:A retrospective cohort study

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    BACKGROUND: The use of High-flow nasal cannula (HFNC) is increasing in admitted COPD-patients and could provide a step in between non-invasive ventilation (NIV) and standard oxygen supply. Recent studies demonstrated that HFNC is capable of facilitating secretion removal and reduce the work of breathing. Therefore, it might be of advantage in the treatment of acute exacerbations of COPD (AECOPD). No randomized trials have assessed this for admitted COPD-patients on a regular ward and only limited data from non-randomized studies is available. OBJECTIVES: The aim of our study was to identify the reasons to initiate treatment with HFNC in a group of COPD-patients during an exacerbation, further identify those most likely to benefit from HFNC treatment and to find factors associated with treatment success on the pulmonary ward. MATERIAL AND METHODS: This retrospective study included COPD-patients admitted to the pulmonary ward and treated with HFNC from April 2016 until April 2019. Only patients admitted with severe acute exacerbations were included. Patients who had an indication for NIV-treatment where treated with NIV and were included only if they subsequently needed HFNC, e.g. when they did not tolerate NIV. Known asthma patients were excluded. RESULTS: A total of 173 patients were included. Stasis of sputum was the indication most reported to initiate HFNC-treatment. Treatment was well tolerated in 83% of the patients. Cardiac and vascular co-morbidities were significantly associated with a smaller chance of successful treatment (Respectively OR = 0.435; p = 0.013 and OR = 0.493;p = 0.035). Clinical assessment judged HFNC-treatment to be successful in 61% of the patients. Furthermore, in-hospital treatment with NIV was associated with a higher chance of HFNC failure afterwards (OR = 0.439; p = 0.045). CONCLUSION: This large retrospective study showed that HFNC-treatment in patients with an AECOPD was initiated most often for sputum stasis as primary reason. Factors associated with improved outcomes of HFNC-treatment was the absence of vascular and/or cardiac co-morbidities and no need for in-hospital NIV-treatment

    Treatment goals and changes over time in older patients with non-curable cancer

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    PURPOSE: To investigate the treatment goals of older patients with non-curable cancer, whether those goals changed over time, and if so, what triggered those changes. METHODS: We performed a descriptive and qualitative analysis using the Outcome Prioritization Tool (OPT) to assess patient goals across four conversations with general practitioners (GPs) over 6 months. Text entries from electronic patient records (hospital and general practice) were then analyzed qualitatively for this period. RESULTS: Of the 29 included patients, 10 (34%) rated extending life and 9 (31%) rated maintaining independence as their most important goals. Patients in the last year before death (late phase) prioritized extending life less often (3 patients; 21%) than those in the early phase (7 patients; 47%). Goals changed for 16 patients during follow-up (12 in the late phase). Qualitative analysis revealed three themes that explained the baseline OPT scores (prioritizing a specific goal, rating a goal as unimportant, and treatment choices related to goals). Another three themes related to changes in OPT scores (symptoms, disease course, and life events) and stability of OPT scores (stable situation, disease-unrelated motivation, and stability despite symptoms). CONCLUSION: Patients most often prioritized extending life as the most important goal. However, priorities differed in the late phase of the disease, leading to changed goals. Triggers for change related to both the disease (e.g., symptoms and course) and to other life events. We therefore recommend that goals should be discussed repeatedly, especially near the end of life. TRIAL REGISTRATION: OPTion study: NTR5419

    Artificial light at night causes diapause inhibition and sex-specific life history changes in a moth

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    Rapidly increasing levels of light pollution subject nocturnal organisms to major alterations of their habitat, the ecological consequences of which are largely unknown. Moths are well-known to be attracted to light at night, but effects of light on other aspects of moth ecology, such as larval development and life-history, remain unknown. Such effects may have important consequences for fitness and thus for moth population sizes. To study the effects of artificial night lighting on development and life-history of moths, we experimentally subjected Mamestra brassicae (Noctuidae) caterpillars to low intensity green, white, red or no artificial light at night and determined their growth rate, maximum caterpillar mass, age at pupation, pupal mass and pupation duration. We found sex-specific effects of artificial light on caterpillar life-history, with male caterpillars subjected to green and white light reaching a lower maximum mass, pupating earlier and obtaining a lower pupal mass than male caterpillars under red light or in darkness. These effects can have major implications for fitness, but were absent in female caterpillars. Moreover, by the time that the first adult moth from the dark control treatment emerged from its pupa (after 110 days), about 85% of the moths that were under green light and 83% of the moths that were under white light had already emerged. These differences in pupation duration occurred in both sexes and were highly significant, and likely result from diapause inhibition by artificial night lighting. We conclude that low levels of nocturnal illumination can disrupt life-histories in moths and inhibit the initiation of pupal diapause. This may result in reduced fitness and increased mortality. The application of red light, instead of white or green light, might be an appropriate measure to mitigate negative artificial light effects on moth life history

    Ontogenetic movements of cod in Arctic fjords and the Barents Sea as revealed by otolith microchemistry

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    The distribution of Atlantic cod (Gadus morhua) in northern Norwegian waters is expanding eastward and northward in the Barents Sea and along western Svalbard. In the Arctic fjords of Svalbard, cod has become abundant, but little is known about the biology, origin, or residence patterns of these populations. To address this issue, we used laser ablation inductively coupled plasma mass spectrometry to quantify the trace elemental composition of cod otoliths at age-0, age-3 and the year of spawning at five distinct locations in northern Norway and western Svalbard. Chemical composition data was used to identify natal sources of cod, their broad-scale migration patterns, and to determine if cod are currently resident in Arctic fjords. Our results suggest that cod collected at Kongsfjord, Isfjord, outside Svalbard, Lofoten, and Porsangerfjord were recruited mainly from the Barents Sea, conforming to the Northeast Arctic cod ecotype. The degree of chemical overlap between Porsangerfjord and Isfjord cod, however, varied with fish age, suggesting individual movements consistent with the Norwegian coastal cod ecotype. Finally, the chemical composition of mature fish at Isfjord, and to a lesser extent Kongsfjord, suggests that cod from the Barents Sea might have recently established residency in these two Arctic fjords.acceptedVersio
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