Fearing that, without reform, the National Health Service (NHS) could consume infinitely more resources, she took the opportunity – in an HIS public annual review meeting with the government – to ...give Ministers a warning about a possible parallel with the fate of the world's only seven-masted schooner, the Thomas W. Lawson. Denise passionately believed in investing more in child and adolescent mental health services. Earlier in her career as consultant psychiatrist at the Florence St Day Hospital and Leverndale Hospital, Glasgow, where she served from 1987 to 2011, she was largely based in the Gorbals, one of the most deprived communities in Glasgow.
Cloud droplet chemical composition is a key observable property that can aid understanding of how aerosols and clouds interact. As part of the Clouds, Aerosols and Monsoon Processes – Philippines ...Experiment (CAMP2Ex), three case studies were analyzed involving collocated airborne sampling of relevant clear and cloudy air masses associated with maritime warm convection. Two of the cases represented a polluted marine background, with signatures of transported East Asian regional pollution, aged over water for several days, while the third case comprised a major smoke transport event from Kalimantan fires.
Sea salt was a dominant component of cloud droplet composition, in spite of fine particulate enhancement from regional anthropogenic sources. Furthermore, the proportion of sea salt was enhanced relative to sulfate in rainwater and may indicate both a propensity for sea salt to aid warm rain production and an increased collection
efficiency of large sea salt particles by rain in subsaturated environments. Amongst cases, as precipitation became more significant, so too did the variability in the sea salt to (non-sea salt) sulfate ratio. Across cases, nitrate and ammonium were fractionally greater in cloud water than fine-mode aerosol particles; however, a strong
covariability in cloud water nitrate and sea salt was suggestive of prior uptake of nitrate on large salt particles.
A mass-based closure analysis of non-sea salt sulfate compared the cloud water air-equivalent mass concentration to the concentration of aerosol particles serving as cloud condensation nuclei for droplet activation. While sulfate found in cloud was generally constrained by the sub-cloud aerosol concentration, there was significant
intra-cloud variability that was attributed to entrainment – causing evaporation of sulfate-containing droplets –and losses due to precipitation. In addition, precipitation tended to promote mesoscale variability in the sub-cloud aerosol through a combination of removal, convective downdrafts, and dynamically driven convergence. Physical
mechanisms exerted such strong control over the cloud water compositional budget that it was not possible to isolate any signature of chemical production/loss using in-cloud observations. The cloud-free environment surrounding the non-precipitating smoke case indicated sulfate enhancement compared to convective mixing quantified by a stable gas tracer; however, this was not observed in the cloud water (either through use of ratios
or the mass closure), perhaps implying that the warm convective cloud timescale was too short for chemical production to be a leading-order budgetary term and because precursors had already been predominantly exhausted.
Closure of other species was truncated by incomplete characterization of coarse aerosol (e.g., it was found that only 10 %–50% of sea salt mass found in cloud was captured during clear-air sampling) and unmeasured gasphase abundances affecting closure of semi-volatile aerosol species (e.g., ammonium, nitrate and organic) and soluble volatile organic compound contributions to total organic carbon in cloud water.
Abstract Background Abstracts presented at the British Association of Paediatric Surgeons annual congress have the potential to influence practice. However, it is not known what percentage of ...accepted abstracts actually go on to withstand peer review and be published in the literature. Methods Abstract books were reviewed for the period 1999 to 2008. A MEDLINE search using keywords from title and authors' names was used to identify subsequent publication. Categorical analysis for variation and trend with P < .05 was accepted as significant. Data were expressed as median (interquartile range). Results During the 10-year period, 862 abstracts were presented orally and were derived from 36 countries, with a median of 18 (17-19) countries represented each year. Of these, 375 (43%) abstracts originated from 25 United Kingdom (UK) institutions with most (45%) from London and specifically the Institute of Child Health/Great Ormond Street Hospital (n = 118, 14%). The annual median number of presentations was 81 (74-97). This fell during the first half of the decade but is now rising with a significant increase in the UK proportion ( P = .001). Thirty (27-35) abstracts per year (overall, n = 302) were subsequently published with the proportion (36% 33%-39%) remaining remarkably consistent over the period. Abstracts were published in a range of 26 journals, but most (69%) were published in the Journal of Pediatric Surgery. Conclusions The publication rate of the British Association of Paediatric Surgeons congress and hence entry into the “evidence base” as published material is consistent at just over one third of submissions. Whether this represents a waste of scientific endeavor or further refinement of quality is a moot point.
Three choices of control variables for meteorological variational analysis (3DVAR or 4DVAR) are associated with horizontal wind: (1) streamfunction and velocity potential, (2) eastward and northward ...velocity, and (3) vorticity and divergence. This study shows theoretical and numerical differences of these variables in practical 3DVAR data assimilation through statistical analysis and numerical experiments. This paper demonstrates that (a) streamfunction and velocity potential could potentially introduce analysis errors; (b) A 3DVAR using velocity or vorticity and divergence provides a natural scale dependent influence radius in addition to the covariance; (c) for a regional analysis, streamfunction and velocity potential are retrieved from the background velocity field with Neumann boundary condition. Improper boundary conditions could result in further analysis errors; (d) a variational data assimilation or an inverse problem using derivatives as control variables yields smoother analyses, for example, a 3DVAR using vorticity and divergence as controls yields smoother wind analyses than those analyses obtained by a 3DVAR using either velocity or streamfunction/velocity potential as control variables; and (e) statistical errors of higher order derivatives of variables are more independent, e.g., the statistical correlation between
U
and
V
is smaller than the one between streamfunction and velocity potential, and thus the variables in higher derivatives are more appropriate for a variational system when a cross-correlation between variables is neglected for efficiency or other reasons. In summary, eastward and northward velocity, or vorticity and divergence are preferable control variables for variational systems and the former is more attractive because of its numerical efficiency. Numerical experiments are presented using analytic functions and real atmospheric observations.
Aerosol-cloud interactions are the largest source of uncertainty in quantifying anthropogenic radiative forcing. The large uncertainty is, in part, due to the difficulty of predicting cloud ...microphysical parameters, such as the cloud droplet number concentration (
). Even though rigorous first-principle approaches exist to calculate
, the cloud and aerosol research community also relies on empirical approaches such as relating
to aerosol mass concentration. Here we analyze relationships between
and cloud water chemical composition, in addition to the effect of environmental factors on the degree of the relationships. Warm, marine, stratocumulus clouds off the California coast were sampled throughout four summer campaigns between 2011 and 2016. A total of 385 cloud water samples were collected and analyzed for 80 chemical species. Single- and multispecies log-log linear regressions were performed to predict
using chemical composition. Single-species regressions reveal that the species that best predicts
is total sulfate (
). Multispecies regressions reveal that adding more species does not necessarily produce a better model, as six or more species yield regressions that are statistically insignificant. A commonality among the multispecies regressions that produce the highest correlation with
was that most included sulfate (either total or non-sea-salt), an ocean emissions tracer (such as sodium), and an organic tracer (such as oxalate). Binning the data according to turbulence, smoke influence, and in-cloud height allowed for examination of the effect of these environmental factors on the composition-
correlation. Accounting for turbulence, quantified as the standard deviation of vertical wind speed, showed that the correlation between
with both total sulfate and sodium increased at higher turbulence conditions, consistent with turbulence promoting the mixing between ocean surface and cloud base. Considering the influence of smoke significantly improved the correlation with
for two biomass burning tracer species in the study region, specifically oxalate and iron. When binning by in-cloud height, non-sea-salt sulfate and sodium correlated best with
at cloud top, whereas iron and oxalate correlated best with
at cloud base.
Otelixizumab is a monoclonal antibody (mAb) directed to human CD3ε, a protein forming part of the CD3/T-cell receptor (TCR) complex on T lymphocytes. This study investigated the temporal interaction ...between varying concentrations of otelixizumab, binding to human CD3 antigen, and expression of CD3/TCR complexes on lymphocytes in vitro, free from the confounding influence of changing lymphocyte frequencies observed in vivo. A static in vitro culture system was established in which primary human peripheral blood mononuclear cells (PBMCs) were incubated over an extended time course with titrated concentrations of otelixizumab. At each time point, free, bound, and total CD3/TCR expression on both CD4+ and CD8+ T cells and the amount of free otelixizumab antibody in the supernatant were measured. The pharmacokinetics of free otelixizumab in the culture supernatants was saturable, with a shorter apparent half-life at low concentration. Correspondingly, a rapid, otelixizumab concentration-, and time-dependent reduction in CD3/TCR expression was observed. These combined observations were consistent with the phenomenon known as target-mediated drug disposition (TMDD). A mechanistic, mathematical pharmacokinetic/pharmacodynamic (PK/PD) model was then used to characterize the free otelixizumab-CD3 expression-time relationship. CD3/TCR modulation induced by otelixizumab was found to be relatively fast compared with the re-expression rate of CD3/TCR complexes following otelixizumab removal from supernatants. In summary, the CD3/TCR receptor has been shown to have a major role in determining otelixizumab disposition. A mechanistic PK/PD model successfully captured the PK and PD in vitro data, confirming TMDD by otelixizumab.
Stroke is a common cause of death and disability in both men and women. Differences in the incidence, presenting features and outcome after stroke have been reported between men and women. The global ...lifetime risk of stroke of approximately 25% is similar in men and women, although in women, the first cardiovascular event is more likely to be stroke than in men. Concerningly, there are reports of underuse of some treatments in women, although these differences may be diminishing over time. In addition, there are specific clinical challenges that can arise in women with stroke, such as stroke in people taking hormonal therapy, and stroke during pregnancy and stroke in the post-partum period. This review will cover these areas highlighting important differences and areas for future research. We found there are important differences in incidence of stroke, which differ by age. Further, there is concerning evidence that some treatments such as intravenous thrombolysis are underused in women. While there may be some differences in the relative effectiveness of treatments such as antiplatelet therapy and blood pressure reduction between men and women, for most aspects of stroke care, benefit is clear in both men and women and the emphasis must be on more equitable access. There is limited evidence to inform decision making during pregnancy and the post-partum period, but guidelines now exist and further research is needed in these areas.
This study characterizes the hygroscopic and chemical nature of aerosols originating from ten locations (4 outdoors and 6 indoors) around the Gol-E-Gohar (GEG) iron ore mine (Iran), including an ...assessment of how hygroscopic growth alters particulate deposition in the respiratory system. Aerosols collected on filters in three diameter (Dp) ranges (total suspended particulates TSP, Dp ≤ 10 μm PM10, and Dp ≤ 2.5 μm PM2.5) were analyzed for chemical and hygroscopic characteristics. The water-soluble aerosol composition is dominated by species associated with directly emitted crustal matter such as chloride, sodium, calcium, and sulfate. There was minimal contribution from organic acids and other secondarily formed species such as inorganic salts. Aerosol growth factors at 90% relative humidity varied between 1.39 and 1.72 and exceed values reported for copper mines in the United States where similar data are available. Values of the hygroscopicity parameter kappa (0.19–0.45) were best related to the mass fraction of chloride among all the studied species. Kappa values were generally similar when comparing the three types of samples (TSP, PM2.5, PM10) at each site and also when comparing each of the ten sampling sites. Accounting for hygroscopic growth yields an increase in the deposition fraction for aerosols with a dry Dp between 0.2 and 2 μm based on International Commission on Radiological Protection model calculations, with more variability when examining each of the three individual head airway regions.
•Cl, Na, Ca, and SO4 dominated composition at an iron ore mine in Iran.•Hygroscopic growth factors (90% RH) varied from 1.39 to 1.72 across 10 sites.•Kappa values varied from 0.19 to 0.45 and best related to chloride mass fraction.•Total deposition fraction increases for dry Dp between 0.2 and 2 μm after humidification.
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