Air Quality Forecast by Statistical Methods: Application to Portugal and Macao

Air pollution is a major concern issue for most countries in the world. In Portugal and Macao, the values of nitrogen dioxide (NO₂), particulate matter (PM) and ozone (O₃) are frequently above the concentration thresholds accepted as “good air quality.” Portugal follows the European Union (EU) legislation (Directive 2008/50/EC) on air quality and Macao the air quality guidelines (AQG) from the WHO. Air quality forecasts are very important mitigation tools because of their ability to anticipate pollution events, and issue early warnings, allowing to take preventive measures and reduce impacts, by avoiding exposure. The work presented here refers to the statistical forecast of air pollutants for three regions: Greater Lisbon Area, Madeira Autonomous Region (both located in Portugal), and Macao Special Administrative Region (in Southern China). The presented statistical approach combines Classification and Regression Tree (CART) and multiple regression (MR) analysis to obtain optimized regression models. This consolidated methodology is now in operation for more than a decade in Portugal, and is subject to regular updates that reflect the ongoing research and the changes in the air quality monitoring network. Recently, the same methodology was applied to Macao in collaboration with the Macao Meteorological and Geophysical Bureau (SMG). Here, a statistical approach for air quality forecasting is described that has been proven to be successful, being able to forecast PM₁₀, PM_2.5, NO₂, and O₃ concentrations, for the next day, with a good performance. In general, all the models have shown a good agreement between the observed and forecasted concentrations (with R² from 0.50 to 0.89), and were able to follow the concentration evolution trend. For some cases, there is a slight delay in the prediction trend. Moreover, the results obtained for pollution episodes have proven that statistical forecast can be an effective way of protecting public health.

Nutritional status and functional status of the pancreatic cancer patients and the impact of adjacent symptoms

RATIONALE & AIMS

Pancreatic cancer (PC) is the third most common type of gastrointestinal tract cancer in Europe and the fourth leading cause of death by cancer. Its initial stage is asymptomatic Therefore, the diagnosis tends to be late leading to locally advanced stages that presuppose late and debilitating symptoms, which consequently makes the Nutritional Status (NS) get worse. The weight loss (WL), malnutrition, and oncologic cachexia, which are quite prevalent in PC patients, reflect a poor prognosis. We aimed to track and evaluate the NS and Functional Status (FS) of PC patients (hospitalized patients - HP and Day Hospital patients - DHP) and associate NS with symptoms with nutritional impact and FS.

METHODS

Observational cohort study in PC patients from Garcia de Orta Hospital. NS was tracked and evaluated using Nutritional Risk Screening (NRS-2002) and Patient-Generated Subjective Global Assessment (PG-SGA). To assess FS we used the Eastern Cooperative Oncology Group (ECOG), Karnofsky Performance Scale Index (KPSI) and Handgrip Dynamometer (HGD).

RESULTS

41 PC patients (30-HP and 11-DHP). 29 patients in stage IV of the tumor. 24 with a WL >10% in the last 6 months. 37 manifest symptoms with nutritional impact. 30 to 34 malnourished according to the GLIM criteria and PG-SGA, respectively. 11 in ECOG level 2 and corresponding KPSI, 10 in level 3 and 8 in level 4. 28 patients had a value of HGD below the 10th percentile. NRS-2002, PG-SGA and GLIM criteria were positively correlated with the symptoms (p < 0.01), % WL (p < 0.01) and ECOG (p < 0.01) and negatively correlated with HGS (p < 0.05 - NRS-2002; p < 0.01 - PG-SGA and GLIM criteria).

CONCLUSIONS

PC patients manifest debilitating symptoms with nutritional impact, namely severe WL and anorexia, which in turn lead to deterioration of the NS and FS. It is an oncology population with high nutritional risk and a higher prevalence of malnutrition, associated with severe % WL and symptoms and a sharp decline in FS.

P–073 High-intensity interval training modulates the effects of hypertension on inflammatory mediators in testis in adult spontaneously hypertensive rats

Study question

Is the high-intensity interval training (HIIT) able to prevent the increase of the inflammatory proteins in the testis of spontaneously hypertensive rats (SHR)?

Summary answer

HIIT for 8 weeks inhibits the increase of the tumor necrosis factor alpha (TNFα) and the interleukin 6 (IL6) in the testis of SHR.

What is known already

Hypertension increases the inflammatory cytokines of the cardiovascular system, causing damage in the microcirculation and in the testes. Hypertension is a cause of low fertility in men and exercises are indicated to decrease blood pressure and improve overall health. HIIT is characterized by short periods of exercise, with an intensity equal to or greater than the anaerobic threshold, separated by recovery periods. HIIT can be indicated for cardiac patients, as this type of training improves the cardiac autonomic nervous system and lipemic control in both hypertensive and normotensive individuals.

Study design, size, duration

Male Wistar-Kyoto rats without hypertension and SHRs were divided into 3 groups (n = 4): WKY (Wistar-Kyoto); SHR; and SHR-HIIT (SHRs that performed HIIT). The HIIT was realized in treadmill for 5 days/week for 8 weeks. HIIT started with 5 times of 4 minutes of 100% of the maximum exhaust speed, with active rest intervals of 3 minutes at 60%. There was an increase of once every week until reaching 7 times each session.

Participants/materials, setting, methods

Samples from testicles were used for immunostainig IL6 and TNFα. After the blocking, the sections were subjected to reaction of specific antibodies IL6 (1:50, E–4, sc–28343) and TNFα (1:50, 52B83, sc–257) at 4ºC overnight, and with secondary antibodies m-IgGK (1:200, IgG-HRP, sc–516) at room temperature for 2 hours. Diaminobenzidine (1:50) was used against Harris stained with Hematoxylin and evaluated in the photomicroscope. Data were analyzed by One-Way ANOVA followed by Tukey post test (P &lt; 0.05).

Main results and the role of chance

The immunostainig of IL6 was higher in SHR (10.23 ± 0.47) than in SHR-HIIT (8.69 ± .44) group (P = 0,0237). From the same perspective, immunoexpression of TNFα was higher in SHR (10.10 ± 0.42) than WKY (8.24 ± 0.24) and SHR-HIIT (7.82 ± 0.39) groups (P = 0.0018).

Limitations, reasons for caution

As a limitation of the study, we have no measurement of fertility parameters to affirm that the HIIT improve the fertility because of the reduction of inflammatory mediators.

Wider implications of the findings: The hypertension drugs have a negative effect on fertility. HIIT can be suggested as a treatment for hypertension as an alternative to medication, since HIIT can inhibit the increase of the inflammatory mediators in testis and its consequences to the reproduction. Financial support by São Paulo Research foundation, FAPESP (2018/22682–0).

Trial registration number

2018/22682–0

Plant Compartments and Developmental Stages Modulate the Balance between Niche-Based and Neutral Processes in Soybean Microbiome

Understanding the dynamics of plant-associated microbial communities within agriculture is well documented. However, the ecological processes that assemble the plant microbiome are not well understood. This study elucidates the relative dominance of assembly processes across plant compartments (root, stem, and leaves) and developmental stages (emergence, growth, flowering, and maturation). Bacterial community composition and assembly processes were assessed using 16S rRNA gene amplicon sequencing. Null models that couple phylogenetic community composition and species distribution models were used to evaluate ecological assembly processes of bacterial communities. All models highlighted that the balance between the assembly process was modulated by compartments and developmental stages. Dispersal limitation dominated amongst the epiphytic communities and at the maturation stage. Homogeneous selection dominated assembly across plant compartments and development stages. Overall, both sets of models were mostly in agreement in predicting the prevailing assembly processes. Our results show, for the first time, that even though niche-based processes dominate in the plant environment, the relative influence of dispersal limitation in community assembly is important.

Sensor Noise in LISA Pathfinder: In-Flight Performance of the Optical Test Mass Readout

We report on the first subpicometer interferometer flown in space. It was part of ESA's Laser Interferometer Space Antenna (LISA) Pathfinder mission and performed the fundamental measurement of the positional and angular motion of two free-falling test masses. The interferometer worked immediately, stably, and reliably from switch on until the end of the mission with exceptionally low residual noise of 32.0_{-1.7}^{+2.4}  fm/sqrt[Hz], significantly better than required. We present an upper limit for the sensor performance at millihertz frequencies and a model for the measured sensitivity above 200 mHz.

Bioaerosols in the Athens Metro: Metagenetic insights into the PM10 microbiome in a naturally ventilated subway station

To date, few studies have examined the aerosol microbial content in Metro transportation systems. Here we characterised the aerosol microbial abundance, diversity and composition in the Athens underground railway system. PM₁₀ filter samples were collected from the naturally ventilated Athens Metro Line 3 station "Nomismatokopio". Quantitative PCR of the 16S rRNA gene and high throughput amplicon sequencing of the 16S rRNA gene and internal transcribed spacer (ITS) region was performed on DNA extracted from PM₁₀ samples. Results showed that, despite the bacterial abundance (mean = 2.82 × 10⁵ 16S rRNA genes/m³ of air) being, on average, higher during day-time and weekdays, compared to night-time and weekends, respectively, the differences were not statistically significant. The average PM₁₀ mass concentration on the platform was 107 μg/m³. However, there was no significant correlation between 16S rRNA gene abundance and overall PM₁₀ levels. The Athens Metro air microbiome was mostly dominated by bacterial and fungal taxa of environmental origin (e.g. Paracoccus, Sphingomonas, Cladosporium, Mycosphaerella, Antrodia) with a lower contribution of human commensal bacteria (e.g. Corynebacterium, Staphylococcus). This study highlights the importance of both outdoor air and commuters as sources in shaping aerosol microbial communities. To our knowledge, this is the first study to characterise the mycobiome diversity in the air of a Metro environment based on amplicon sequencing of the ITS region. In conclusion, this study presents the first microbial characterisation of PM₁₀ in the Athens Metro, contributing to the growing body of microbiome exploration within urban transit networks. Moreover, this study shows the vulnerability of public transport to airborne disease transmission.

Analysis of the accuracy of actuation electronics in the laser interferometer space antenna pathfinder

The Laser Interferometer Space Antenna Pathfinder (LPF) main observable, labeled Δg, is the differential force per unit mass acting on the two test masses under free fall conditions after the contribution of all non-gravitational forces has been compensated. At low frequencies, the differential force is compensated by an applied electrostatic actuation force, which then must be subtracted from the measured acceleration to obtain Δg. Any inaccuracy in the actuation force contaminates the residual acceleration. This study investigates the accuracy of the electrostatic actuation system and its impact on the LPF main observable. It is shown that the inaccuracy is mainly caused by the rounding errors in the waveform processing and also by the random error caused by the analog to digital converter random noise in the control loop. Both errors are one order of magnitude smaller than the resolution of the commanded voltages. We developed a simulator based on the LPF design to compute the close-to-reality actuation voltages and, consequently, the resulting actuation forces. The simulator is applied during post-processing the LPF data.

LISA Pathfinder Performance Confirmed in an Open-Loop Configuration: Results from the Free-Fall Actuation Mode

We report on the results of the LISA Pathfinder (LPF) free-fall mode experiment, in which the control force needed to compensate the quasistatic differential force acting on two test masses is applied intermittently as a series of "impulse" forces lasting a few seconds and separated by roughly 350 s periods of true free fall. This represents an alternative to the normal LPF mode of operation in which this balancing force is applied continuously, with the advantage that the acceleration noise during free fall is measured in the absence of the actuation force, thus eliminating associated noise and force calibration errors. The differential acceleration noise measurement presented here with the free-fall mode agrees with noise measured with the continuous actuation scheme, representing an important and independent confirmation of the LPF result. An additional measurement with larger actuation forces also shows that the technique can be used to eliminate actuation noise when this is a dominant factor.

Hands-on Gross Anatomy Instruction Improves Clinical Imaging Skills Among Cardiovascular Fellows

INTRODUCTION

Multi-modality imaging is a crucial component of cardiovascular (CV) fellowship training and requires knowledge of CV anatomy for interpretation. We hypothesized that hands-on anatomy education would improve the imaging interpretation skills of CV fellows.

METHODS

The first-year CV fellowship class completed a hands-on cadaveric anatomy session correlated with clinical imaging. Fellows' ability to identify CV structures on cardiac imaging was assessed using a 30-question assessment tool administered at baseline and 1 week and 6 months post intervention. Advanced CV fellows (second or third year) who had not attended the session were also tested. Scores were expressed as median [interquartile range].

RESULTS

Among 9 first-year fellows, the majority reported no formal anatomy training since medical school (N = 7) and rated their knowledge of CV anatomy as fair or poor (N = 7) prior to the intervention. The median assessment score was higher 1 week after intervention vs baseline (24 [23-25] vs 19 [17-21]; P = .013) and remained higher than baseline at 6 months (26 [26-28] vs 19 [17-21]; P = .009). The 6-month post-intervention score for first-year fellows was not significantly different than that of senior fellows (n = 10) not exposed to the intervention (26 [26-28] vs 26 [23-27]; P = .434).

CONCLUSIONS

Gross anatomy instruction improved first-year CV fellows' interpretation of CV imaging. Anatomic instruction may be a useful adjunct to multi-modality imaging education.

Pectoral nerve block as a single anesthetic technique for breast surgery and sentinel lymph node investigation

Breast cancer surgery is usually performed under general anesthesia or, more recently, combined with conventional regional techniques. Pectoral nerves (PECs) block appears as an analgesic alternative in these procedures, but few studies refer to it as a single anesthetic technique^1-3. In this case report, we describe a 56-year-old female patient, BMI 31kg/m², ASA IV, admitted for elective tumorectomy of the left upper quadrant of the breast and sentinel node investigation. Given the multiple comorbidities and the high anesthetic and surgical risk, the anaesthetic plan consisted in ultrasound guided PECs II block as a single anesthetic technique. The authors report a successful anesthetic and pain management without complications in breast surgery. PECs block, as a single anesthetic technique, may be safe, advantageous and effective with haemodynamic stability and few side effects in high risk cardiac patients.

Detection of wheezes using their signature in the spectrogram space and musical features

In this work thirty features were tested in order to identify the best feature set for the robust detection of wheezes. The features include the detection of the wheezes signature in the spectrogram space (WS-SS) and twenty-nine musical features usually used in the context of Music Information Retrieval. The method proposed to detect the signature of wheezes imposes a temporal Gaussian regularization and a reduction of the false positives based on the (geodesic) morphological opening by reconstruction operator. Our dataset contains wheezes, crackles and normal breath sounds. Four selection algorithms were used to rank the features. The performance of the features was asserted having into account the Matthews correlation coefficient (MCC). All the selection algorithms ranked the WS-SS feature as the most important. A significant boost in performance was obtained by using around ten features. This improvement was independent of the selection algorithm. The use of more than ten features only allows for a small increase of the MCC value.

Beyond the Required LISA Free-Fall Performance: New LISA Pathfinder Results down to 20 μHz

In the months since the publication of the first results, the noise performance of LISA Pathfinder has improved because of reduced Brownian noise due to the continued decrease in pressure around the test masses, from a better correction of noninertial effects, and from a better calibration of the electrostatic force actuation. In addition, the availability of numerous long noise measurement runs, during which no perturbation is purposely applied to the test masses, has allowed the measurement of noise with good statistics down to 20  μHz. The Letter presents the measured differential acceleration noise figure, which is at (1.74±0.05)  fm s^{-2}/sqrt[Hz] above 2 mHz and (6±1)×10  fm s^{-2}/sqrt[Hz] at 20  μHz, and discusses the physical sources for the measured noise. This performance provides an experimental benchmark demonstrating the ability to realize the low-frequency science potential of the LISA mission, recently selected by the European Space Agency.

Detection of explosive cough events in audio recordings by internal sound analysis

We present a new method for the discrimination of explosive cough events, which is based on a combination of spectral content descriptors and pitch-related features. After the removal of near-silent segments, a vector of event boundaries is obtained and a proposed set of 9 features is extracted for each event. Two data sets, recorded using electronic stethoscopes and comprising a total of 46 healthy subjects and 13 patients, were employed to evaluate the method. The proposed feature set is compared to three other sets of descriptors: a baseline, a combination of both sets, and an automatic selection of the best 10 features from both sets. The combined feature set yields good results on the cross-validated database, attaining a sensitivity of 92.3±2.3% and a specificity of 84.7±3.3%. Besides, this feature set seems to generalize well when it is trained on a small data set of patients, with a variety of respiratory and cardiovascular diseases, and tested on a bigger data set of mostly healthy subjects: a sensitivity of 93.4% and a specificity of 83.4% are achieved in those conditions. These results demonstrate that complementing the proposed feature set with a baseline set is a promising approach.

Tourism as a driver of conflicts and changes in fisheries value chains in Marine Protected Areas

Although critical tools for protecting ocean habitats, Marine Protected Areas (MPAs) are sometimes challenged for social impacts and conflicts they may generate. Some conflicts have an economic base, which, once understood, can be used to resolve associated socioenvironmental problems. We addressed how the fish trade in an MPA that combines no-take zones and tourist or resident zones creates incentives for increased fisheries. We performed a value chain analysis following the fish supply and trade through interviews that assessed consumer demand and preference. The results showed a simple and closed value chain driven by tourism (70% of the consumption). Both tourists and local consumers preferred high trophic level species (predators), but the former preferred large pelagics (tuna and dolphinfish) and the latter preferred reef species (barracuda and snapper). Pelagic predators are caught with fresh sardines, which are sometimes located only in the no-take zone. Pelagic species are mainly served as fillet, and the leftover fish parts end up as waste, an issue that, if properly addressed, can help reduce fishing pressure. Whereas some of the target species may be sustainable (e.g., dolphinfish), others are more vulnerable (e.g., wahoo) and should not be intensively fished. We advise setting stricter limits to the number of tourists visiting MPAs, according to their own capacity and peculiarities, in order to avoid conflicts with conservations goals through incentives for increased resource use.

Detection of crackle events using a multi-feature approach

The automatic detection of adventitious lung sounds is a valuable tool to monitor respiratory diseases like chronic obstructive pulmonary disease. Crackles are adventitious and explosive respiratory sounds that are usually associated with the inflammation or infection of the small bronchi, bronchioles and alveoli. In this study a multi-feature approach is proposed for the detection of events, in the frame space, that contain one or more crackles. The performance of thirty-five features was tested. These features include thirty-one features usually used in the context of Music Information Retrieval, a wavelet based feature as well as the Teager energy and the entropy. The classification was done using a logistic regression classifier. Data from seventeen patients with manifestations of adventitious sounds and three healthy volunteers were used to evaluate the performance of the proposed method. The dataset includes crackles, wheezes and normal lung sounds. The optimal detection parameters, such as the number of features, were chosen based on a grid search. The performance of the detection was studied taking into account the sensitivity and the positive predictive value. For the conditions tested, the best results were obtained for the frame size equal to 128 ms and twenty-seven features.

Evaluation of lung ventilation distribution in chronic obstructive pulmonary disease patients using the global inhomogeneity index

The global inhomogeneity (GI) index is a electrical impedance tomography (EIT) parameter that quantifies the tidal volume distribution within the lung. In this work the global inhomogeneity index was computed for twenty subjects in order to evaluate his potential use in the detection and follow up of chronic obstructive pulmonary disease (COPD) patients. EIT data of 17 subjects were acquired: 14 patients with the main diagnoses of COPD and 3 healthy subjects which served as a control group. Two or three datasets of around 30 seconds were acquired at 33 scans/s and analysed for each subject. After reconstruction, a tidal EIT image was computed for each breathing cycle and a GI index calculated from it. Results have shown significant differences in GI values between the two groups (0.745 ± 0.007 for COPD and 0.668 ± 0.006 for lung-healthy subject, p <; 0.005). The GI values obtained for each subject have shown small variance between them, which is a good indication of stability. The results suggested that the GI may be useful for the identification and follow up of ventilation problems in patients with COPD.

Charge-Induced Force Noise on Free-Falling Test Masses: Results from LISA Pathfinder

We report on electrostatic measurements made on board the European Space Agency mission LISA Pathfinder. Detailed measurements of the charge-induced electrostatic forces exerted on free-falling test masses (TMs) inside the capacitive gravitational reference sensor are the first made in a relevant environment for a space-based gravitational wave detector. Employing a combination of charge control and electric-field compensation, we show that the level of charge-induced acceleration noise on a single TM can be maintained at a level close to 1.0  fm s^{-2} Hz^{-1/2} across the 0.1-100 mHz frequency band that is crucial to an observatory such as the Laser Interferometer Space Antenna (LISA). Using dedicated measurements that detect these effects in the differential acceleration between the two test masses, we resolve the stochastic nature of the TM charge buildup due to interplanetary cosmic rays and the TM charge-to-force coupling through stray electric fields in the sensor. All our measurements are in good agreement with predictions based on a relatively simple electrostatic model of the LISA Pathfinder instrument.

Association Between Readmission After Liver Transplant and Adverse Immunosuppressant Reactions: A Prospective Cohort With a 1-Year Follow-up

OBJECTIVE

To measure the association between readmission after liver transplantation and corresponding adverse drug reactions.

METHODS

A total of 48 patients undergoing liver transplantation were prospectively followed for 1 year. Of these, 23 were readmitted and evaluated by a pharmacist for causes of adverse drug reaction. The detection of adverse drug reactions was based on a combination of clinical interviews and physical and laboratory exams. Adverse reactions were defined in accordance with the Naranjo algorithm.

RESULTS

A total of 67.6% of all readmissions were related to adverse drug reactions, with tacrolimus accounting for 80% of the drug reactions. The most common cause of readmission was infection (48.6%), followed by procedure-related reasons (29.7%). Of all patients requiring admission, 39.1% had Model for End-stage Liver Disease (MELD) scores below 21 at the time of transplantation, 17.4% had MELD scores between 21 and 29, and 43.5% had MELD scores above 29. Most (66.7%) of those readmitted more than twice had MELD scores above 29.

CONCLUSION

Adverse drug reactions related to immunosuppressants frequently lead to readmission among liver transplant patients, and in our series tacrolimus was the most frequently associated drug.

Robust features for detection of crackles: an exploratory study

Crackles are adventitious and explosive respiratory sounds that can be classified as fine or coarse. These sounds are usually associated with cardiopulmonary diseases such as the chronic obstructive pulmonary disease. In this work seven different features were tested with the objective to identify the best subset of features that allows a robust detection of coarse crackles. Some of the features used in this study are new, namely those based on the local entropy, on the Teager energy and on the residual fit of a Generalized Autoregressive Conditional Heteroskedasticity process. The best features as a function of the number of features used in classification were identified having into account the Matthews correlation coefficient. The best individual feature was based on the local entropy. A significant improvement in the performance was obtained by using the feature based on local entropy and the feature based on the wavelet packed stationary transform - no stationary transform. The addition of more features only allows a smaller improvement.

Sub-Femto-g Free Fall for Space-Based Gravitational Wave Observatories: LISA Pathfinder Results

We report the first results of the LISA Pathfinder in-flight experiment. The results demonstrate that two free-falling reference test masses, such as those needed for a space-based gravitational wave observatory like LISA, can be put in free fall with a relative acceleration noise with a square root of the power spectral density of 5.2±0.1  fm s^{-2}/sqrt[Hz], or (0.54±0.01)×10^{-15}  g/sqrt[Hz], with g the standard gravity, for frequencies between 0.7 and 20 mHz. This value is lower than the LISA Pathfinder requirement by more than a factor 5 and within a factor 1.25 of the requirement for the LISA mission, and is compatible with Brownian noise from viscous damping due to the residual gas surrounding the test masses. Above 60 mHz the acceleration noise is dominated by interferometer displacement readout noise at a level of (34.8±0.3)  fm/sqrt[Hz], about 2 orders of magnitude better than requirements. At f≤0.5  mHz we observe a low-frequency tail that stays below 12  fm s^{-2}/sqrt[Hz] down to 0.1 mHz. This performance would allow for a space-based gravitational wave observatory with a sensitivity close to what was originally foreseen for LISA.

Influence of torso and arm positions on chest examinations by electrical impedance tomography

Electrical impedance tomography (EIT) is increasingly used in patients suffering from respiratory disorders during pulmonary function testing (PFT). The EIT chest examinations often take place simultaneously to conventional PFT during which the patients involuntarily move in order to facilitate their breathing. Since the influence of torso and arm movements on EIT chest examinations is unknown, we studied this effect in 13 healthy subjects (37  ±  4 years, mean age  ±  SD) and 15 patients with obstructive lung diseases (72  ±  8 years) during stable tidal breathing. We carried out the examinations in an upright sitting position with both arms adducted, in a leaning forward position and in an upright sitting position with consecutive right and left arm elevations. We analysed the differences in EIT-derived regional end-expiratory impedance values, tidal impedance variations and their spatial distributions during all successive study phases. Both the torso and the arm movements had a highly significant influence on the end-expiratory impedance values in the healthy subjects (p  =  0.0054 and p  <  0.0001, respectively) and the patients (p  <  0.0001 in both cases). The global tidal impedance variation was affected by the torso, but not the arm movements in both study groups (p  =  0.0447 and p  =  0.0418, respectively). The spatial heterogeneity of the tidal ventilation distribution was slightly influenced by the alteration of the torso position only in the patients (p  =  0.0391). The arm movements did not impact the ventilation distribution in either study group. In summary, the forward torso movement and the arms' abduction exert significant effects on the EIT waveforms during tidal breathing. We recommend strict adherence to the upright sitting position during PFT when EIT is used.

Joint analysis of BICEP2/keck array and Planck Data

We report the results of a joint analysis of data from BICEP2/Keck Array and Planck. BICEP2 and Keck Array have observed the same approximately 400  deg^{2} patch of sky centered on RA 0 h, Dec. -57.5°. The combined maps reach a depth of 57 nK deg in Stokes Q and U in a band centered at 150 GHz. Planck has observed the full sky in polarization at seven frequencies from 30 to 353 GHz, but much less deeply in any given region (1.2  μK deg in Q and U at 143 GHz). We detect 150×353 cross-correlation in B modes at high significance. We fit the single- and cross-frequency power spectra at frequencies ≥150  GHz to a lensed-ΛCDM model that includes dust and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r), using a prior on the frequency spectral behavior of polarized dust emission from previous Planck analysis of other regions of the sky. We find strong evidence for dust and no statistically significant evidence for tensor modes. We probe various model variations and extensions, including adding a synchrotron component in combination with lower frequency data, and find that these make little difference to the r constraint. Finally, we present an alternative analysis which is similar to a map-based cleaning of the dust contribution, and show that this gives similar constraints. The final result is expressed as a likelihood curve for r, and yields an upper limit r_{0.05}<0.12 at 95% confidence. Marginalizing over dust and r, lensing B modes are detected at 7.0σ significance.

Comparative effect of a new mouthrinse containing chlorhexidine, triclosan and zinc on volatile sulphur compounds: a randomized, crossover, double-blind study

AIM

The aims of this study were to compare the volatile sulphur compounds (VSC)-reducing effect of two commercial mouthrinses using a morning bad breath model and to assess the role of mechanical plaque control (MPC) when performed previously to mouthrinse use.

PATIENTS AND METHODS

Eleven volunteers with good oral health were enrolled in a double-blind, randomized, six-step crossover design study with a 7-day washout period. Two commercial mouthrinses were tested using a saline solution (NaCl 0.9%) as a negative control: one mouthrinse contained 0.05% chlorhexidine, 0.05% cetylpyridinium chloride and 0.14% zinc lactate (CHX-CPC-Zn), while the other contained 0.05% chlorhexidine, 0.15% triclosan and 0.18% zinc pidolate (CHX-triclosan-Zn). A portable sulphide monitor (Halimeter(®) ) was used for VSC quantification. Measurements were made at baseline, and 1, 3 and 5 h after rinsing. Significant differences were detected by analysis of variance.

RESULTS

No significant differences between groups were detected at baseline. We were unable to demonstrate a significant influence of mechanical plaque control on the reduction of VSC levels when performed before mouthrinse use (P = 0.631). Both mouthrinses effectively lowered VSC levels in all test intervals (P < 0.05). No statistically significant differences were found between mouthrinses in any of the test intervals (P = 0.629, 0.069 and 0.598 at 1, 3 and 5 h).

CONCLUSION

This study demonstrated that CHX-CPC-Zn and CHX-triclosan-Zn have significant and similar effects in reducing VSC levels, which persist for at least 5 h. Such effects were independent of previous MPC, which failed to improve on the results of mouthrinse use alone.

Hidden haemosporidian infections in Ruffs (Philomachus pugnax) staging in Northwest Europe en route from Africa to Arctic Europe

In their African freshwater wintering habitats, shorebirds show a high prevalence of blood parasites, whereas no parasites are detected elsewhere along the migration route. We looked at two genera of haemosporidian parasites, Haemoproteus and Plasmodium, in the long-distance migrating Ruff (Philomachus pugnax) along a geographical/seasonal gradient to verify the infection pattern and examine possible hidden organ infections at European staging areas. We amplified parasite DNA from blood of 53 healthy birds wintering in Mali, 53 samples of seven organ tissues (spleen, liver, kidneys, heart, lungs, brain, and pectoral muscle) from healthy individuals caught during spring migration, and 18 weak birds found sick in summer in The Netherlands. We confirm that Ruffs wintering in Africa carried blood infections and that some infections developed into hidden organ infections during spring migration. Moreover, sick birds either had new infections (in one juvenile) or relapses (in an adult harboring an African lineage). Our results suggest that some parasites develop latency. This strategy may be beneficial for the parasite as it may take control over reappearance in the blood to help further transmission.

Multiannual observations of acetone, methanol, and acetaldehyde in remote tropical atlantic air: implications for atmospheric OVOC budgets and oxidative capacity

Oxygenated volatile organic compounds (OVOCs) in the atmosphere are precursors to peroxy acetyl nitrate (PAN), affect the tropospheric ozone budget, and in the remote marine environment represent a significant sink of the hydroxyl radical (OH). The sparse observational database for these compounds, particularly in the tropics, contributes to a high uncertainty in their emissions and atmospheric significance. Here, we show measurements of acetone, methanol, and acetaldehyde in the tropical remote marine boundary layer made between October 2006 and September 2011 at the Cape Verde Atmospheric Observatory (CVAO) (16.85° N, 24.87° W). Mean mixing ratios of acetone, methanol, and acetaldehyde were 546 ± 295 pptv, 742 ± 419 pptv, and 428 ± 190 pptv, respectively, averaged from approximately hourly values over this five-year period. The CAM-Chem global chemical transport model reproduced annual average acetone concentrations well (21% overestimation) but underestimated levels by a factor of 2 in autumn and overestimated concentrations in winter. Annual average concentrations of acetaldehyde were underestimated by a factor of 10, rising to a factor of 40 in summer, and methanol was underestimated on average by a factor of 2, peaking to over a factor of 4 in spring. The model predicted summer minima in acetaldehyde and acetone, which were not apparent in the observations. CAM-Chem was adapted to include a two-way sea-air flux parametrization based on seawater measurements made in the Atlantic Ocean, and the resultant fluxes suggest that the tropical Atlantic region is a net sink for acetone but a net source for methanol and acetaldehyde. Inclusion of the ocean fluxes resulted in good model simulations of monthly averaged methanol levels although still with a 3-fold underestimation in acetaldehyde. Wintertime acetone levels were better simulated, but the observed autumn levels were more severely underestimated than in the standard model. We suggest that the latter may be caused by underestimated terrestrial biogenic African primary and/or secondary OVOC sources by the model. The model underestimation of acetaldehyde concentrations all year round implies a consistent significant missing source, potentially from secondary chemistry of higher alkanes produced biogenically from plants or from the ocean. We estimate that low model bias in OVOC abundances in the remote tropical marine atmosphere may result in up to 8% underestimation of the global methane lifetime due to missing model OH reactivity. Underestimation of acetaldehyde concentrations is responsible for the bulk (∼70%) of this missing reactivity.

Diversity of cloacal microbial community in migratory shorebirds that use the Tagus estuary as stopover habitat and their potential to harbor and disperse pathogenic microorganisms

The diversity of the cloacal microbial community in migratory shorebirds, caught at the Tagus estuary, Portugal, was assessed by cultivation (R2A and Nutrient Agar media) and denaturing gradient gel electrophoresis profiling (DGGE) to provide a better understanding of the birds' potential to harbor and disperse pathogens. Three different bird species belonging to four different populations were studied: common redshank (Tringa totanus), black-winged stilt (Himantopus himantopus) and nominate and Icelandic populations of black-tailed godwit (Limosa limosa). DGGE profiling and partial 16S RNA gene sequences of 240 isolates, and 26 DGGE bands resulting in 58 clones, were analyzed. Most isolates were members of the phylum Firmicutes and Actinobacteria and only a small portion belonged to the Proteobacteria and Deinococcus-Thermus phyla. Potentially pathogenic strains carried by the birds were found such as Helicobacter and Staphylococcus in all bird species, and Clostridium, Mycobacterium, Rhodococcus, Legionella and Corynebacterium in black-winged stilts. Unexpectedly, bacteria from the phylum Deinococcus-Thermus were isolated in shorebirds and were present in all the bird species studied.

Avian malaria infections in western European mosquitoes

In the complex life cycle of avian malaria parasites (Plasmodium sp.), we still have a poor understanding on the vector-parasite relationships. This study described the community of potential avian malaria vectors in four Portuguese reedbeds. We tested if their geographical distribution differed, and investigated on their Plasmodium infections. The mosquitoes' feeding preferences were evaluated using CO(2), mice, and birds as baits. The most abundant species were Culex pipiens, Culex theileri, and Ochlerotatus caspius (and, in one site, Coquillettidia richiardii). Plasmodium lineages SGS1 and SYAT05 were found in unengorged Cx. pipiens and Cx. theileri, respectively, suggesting that these mosquitoes were competent vectors of those lineages. The species' abundance was significantly different among sites, which may help to explain the observed differences in the prevalence of SGS1. At the study sites, SGS1 was detected in the most abundant mosquito species and reached a high prevalence in the most abundant passerine species. Probably, this parasite needs abundant hosts in all phases of its cycle to keep a good reservoir of infection in all its stages. Cq. richiardii showed an opportunistic feeding behavior, while Cx. pipiens appeared to be more mammophilic than previously described, perhaps because the used avian bait was not its preferential target. In one of the study sites, mosquitoes seem to be attracted to the Spotless Starling Sturnus unicolor, an abundant bird species that may be an important local reservoir of avian malaria infections. To our knowledge, this is the first report of detection of avian Plasmodium DNA from European mosquitoes.

Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis

OBJECTIVE

To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens.

DESIGN AND PATIENTS

Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that were selected from all the ankle MR examinations performed during the past year. Data derived from these MR examinations were the following: the size of the enthesophyte; its location in relation to the plantar fascia (PF) and flexor muscles; and the thickness and signal of the PF. The corresponding radiographs of the ankles were evaluated at a different time by the same observers for the presence or absence of plantar enthesophytes and, when present, their measurements. A third observer reviewed all the discordant observations of MR imaging and radiographic examinations. Two observers analyzed 22 calcaneal specimens with plantar enthesophytes at an anthropology museum to determine the orientation of each plantar enthesophyte. MR imaging of a cadaveric foot with a plantar enthesophyte with subsequent sagittal sectioning was performed to provide further anatomic understanding.

RESULTS

With regard to MR imaging, the mean size of the plantar enthesophytes was 4.41 mm (SD 2.4). Twenty (50%) enthesophytes were located above the PF, 16 (40%) between the fascia and abductor digiti minimi, flexor digitorum brevis and abductor hallucis muscles, and only one (3%) was located within the PF. In three (8%) cases the location was not determined. The size of enthesophytes seen with MR imaging and radiographs was highly correlated (P<0.01). The interobserver agreement for all measurements was good (Pearson >0.8, kappa >0.9). Eleven of the 22 bone specimens had plantar enthesophytes oriented in the direction of the abductor digiti minimi and 11 oriented in the direction of the flexor digitorum brevis and PF. The cadaveric sections revealed different types of enthesophytes.

CONCLUSIONS

Plantar calcaneal enthesophytes arise in five different locations: at the insertion sites of abductor digiti minimi and flexor digitorum brevis muscles; between the PF and these muscles; and, less frequently, within the PF and at the insertion site of the short plantar ligament.

Breeding plumage honestly signals likelihood of tapeworm infestation in females of a long-distance migrating shorebird, the bar-tailed godwit

The indicator mechanism for sexual selection proposed by Hamilton and Zuk (i.e. that sexually selected ornaments signal parasite resistance) has received rather little observational support, and none in the case of long-distance migrant birds. Here we present a test by examining the association between helminth infestations and breeding plumage quality in bar-tailed godwits Limosa lapponica taymyrensis during their spring staging period in the Wadden Sea, The Netherlands. After a non-stop flight from West Africa, these shorebirds refuel in the Wadden Sea in preparation for a second flight to the central Siberian Arctic breeding grounds. Earlier studies have shown that only relatively heavy and well ornamented birds carry out a "top-up" moult during stopover, in which part of the contour feathers recently grown in West Africa are replaced by even fresher ones. Active body moult was therefore taken as the primary indicator of ornament quality. Of 78 birds collected between 1992 and 1997, 42% carried helminths, including four species of digenean trematodes (flukes), three species of cestodes (tapeworms) and an acanthocephalan (spiny-headed worm). Faecal samples examined for helminth eggs in another 92 birds in 1998 and 2000 showed similar rates of infestation. Actively moulting bar-tailed godwits were confirmed to be heavier and to show more extensive breeding plumage than non-moulting birds. In females, but not in males, active moult was associated with fewer cestodes and acanthocephalans. Also, breeding plumage and presence of cestodes were negatively associated in females. We argue that the quality of the breeding plumage reliably indicates parasite resistance in female godwits. The repeatability of plumage scores of females between years is consistent with such resistance having a heritable component. In contrast, male ornaments may demonstrate other qualities, e.g. an ability to combine adequate fuelling and flight performances with moult during the time-stress of migration.