The effect of observational constraint on the ranges of
uncertain physical and chemical process parameters was explored in a global
aerosol–climate model. The study uses 1 million variants of the ...Hadley Centre General Environment Model version 3
(HadGEM3) that sample 26 sources of uncertainty, together with over 9000
monthly aggregated grid-box measurements of aerosol optical depth, PM2.5,
particle number concentrations, sulfate and organic mass concentrations.
Despite many compensating effects in the model, the procedure constrains the
probability distributions of parameters related to secondary organic
aerosol, anthropogenic SO2 emissions, residential emissions, sea spray
emissions, dry deposition rates of SO2 and aerosols, new particle
formation, cloud droplet pH and the diameter of primary combustion
particles. Observational constraint rules out nearly 98 % of the model
variants. On constraint, the ±1σ (standard deviation) range
of global annual mean direct radiative forcing (RFari) is reduced by
33 % to −0.14 to −0.26 W m−2, and the 95 % credible interval (CI)
is reduced by 34 % to −0.1 to −0.32 W m−2. For the global annual
mean aerosol–cloud radiative forcing, RFaci, the ±1σ
range is reduced by 7 % to −1.66 to −2.48 W m−2, and the 95 % CI by
6 % to −1.28 to −2.88 W m−2. The tightness of the constraint is
limited by parameter cancellation effects (model equifinality) as well as
the large and poorly defined “representativeness error” associated with
comparing point measurements with a global model. The constraint could also
be narrowed if model structural errors that prevent simultaneous agreement
with different measurement types in multiple locations and seasons could be
improved. For example, constraints using either sulfate or PM2.5
measurements individually result in RFari±1σ ranges
that only just overlap, which shows that emergent constraints based on one
measurement type may be overconfident.
Aspiration pneumonia is one of the leading causes of death in patients with muscular dystrophy; therefore, it is important to predict its occurrence in the clincal setting. We aimed to examine the ...usefulness of repeated saliva swallowing test (RSST), modified water swallowing test (MWST), and flexible endoscopic evaluation of swallowing (FEES) for evaluating the Hyodo score at the bedside, to predict the risk of aspiration pneumonia in patients with Duchenne muscular dystrophy (DMD).
In this retrospective cohort study involving 43 patients, we evaluated the swallowing function using the RSST, MWST, and FEES, and predicted the likelihood of aspiration pneumonia within 2 years after the assessment. The Hyodo score, a scoring system for evaluating the swallowing function determined by the FEES, was used.
Pneumonia was observed in 14 patients (32.6%). The RSST was not significantly useful for predicting the onset of pneumonia. The MWST was reported to have a cutoff value of < 4 points. Significantly more patients in the pneumonia group had an MWST score of < 4 points. The results revealed that the occurrence of pneumonia could be predicted based on a Hyodo cutoff score of ≥ 6. Significantly more patients in the pneumonia group had an MWST score of < 4 or a Hyodo score of ≥ 6.
Combining MWST and FEES is useful for evaluating the bedside swallowing function and predicting the onset of pneumonia.
Aviation emissions impact both air quality and climate. Using a coupled tropospheric chemistry-aerosol microphysics model we investigate the effects of varying aviation fuel sulfur content (FSC) on ...premature mortality from long-term exposure to aviation-sourced PM2.5 (particulate matter with a dry diameter of < 2.5 µm) and on the global radiation budget due to changes in aerosol and tropospheric ozone. We estimate that present-day non-CO2 aviation emissions with a typical FSC of 600 ppm result in ∼ 3600 95 % CI: 1310–5890 annual premature mortalities globally due to increases in cases of cardiopulmonary disease and lung cancer, resulting from increased surface PM2.5 concentrations. We quantify the global annual mean combined radiative effect (REcomb) of non-CO2 aviation emissions as −13.3 mW m−2; from increases in aerosols (direct radiative effect and cloud albedo effect) and tropospheric ozone. Ultra-low sulfur jet fuel (ULSJ; FSC = 15 ppm) has been proposed as an option to reduce the adverse health impacts of aviation-induced PM2.5. We calculate that swapping the global aviation fleet to ULSJ fuel would reduce the global aviation-induced mortality rate by ∼ 620 95 % CI: 230–1020 mortalities a−1 and increase REcomb by +7.0 mW m−2. We explore the impact of varying aviation FSC between 0 and 6000 ppm. Increasing FSC increases aviation-induced mortality, while enhancing climate cooling through increasing the aerosol cloud albedo effect (CAE). We explore the relationship between the injection altitude of aviation emissions and the resulting climate and air quality impacts. Compared to the standard aviation emissions distribution, releasing aviation emissions at the ground increases global aviation-induced mortality and produces a net warming effect, primarily through a reduced CAE. Aviation emissions injected at the surface are 5 times less effective at forming cloud condensation nuclei, reducing the aviation-induced CAE by a factor of 10. Applying high FSCs at aviation cruise altitudes combined with ULSJ fuel at lower altitudes results in reduced aviation-induced mortality and increased negative RE compared to the baseline aviation scenario.
This study assessed the sensitivity of the West African climate to varying vegetation fractions. The assessment of a such relationship is critical in understanding the interactions between land ...surface and atmosphere. Two sets of convection‐permitting simulations from the UK Met Office Unified Model at 12 km horizontal resolution covering the monsoon period May–September (MJJAS) were used, one with fixed vegetation fraction (MF‐V) and the other with time‐varying vegetation fraction (MV‐V). Vegetation fractions are based on MODIS retrievals between May and September. We focused on three climatic zones over West Africa: Guinea Coast, Sudanian Sahel, and the Sahel while investigating heat fluxes, temperature, and evapotranspiration. Results reveal that latent heat fluxes are the most strongly affected by vegetation fraction over the Sahelian and Sudanian regions while sensible heat fluxes are more impacted over the Guinea Coast and Sudanian Sahel. Also, in MV‐V simulation there is an increase in evapotranspiration mainly over the Sahel and some specific areas in Guinea Coast from June to September. Moreover, it is noticed that high near‐surface temperature is associated with a weak vegetation fraction, especially during May and June. Finally, varying vegetation seems to improve the simulation of surface energy fluxes and in turn impact on climate parameters. This suggests that climate modelers should prioritize the use of varying vegetation options to improve the representation of the West African climate system.
The Japanese surveillance committee conducted a third nationwide surveillance of antimicrobial susceptibility of acute uncomplicated cystitis at 55 facilities throughout Japan between April 2020 and ...September 2021. In this surveillance, we investigated the susceptibility of Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Staphylococcus saprophyticus (S. saprophyticus) for various antimicrobial agents by isolating and culturing bacteria from urine samples. In total, 823 strains were isolated from 848 patients and 569 strains of target bacteria, including E. coli (n = 529, 92.9 %), K. pneumoniae (n = 28, 4.9 %), and S. saprophyticus (n = 12, 2.2 %) were isolated. The minimum inhibitory concentrations of 18 antibacterial agents were determined according to the Clinical and Laboratory Standards Institute manual. In premenopausal patients, there were 31 (10.5 %) and 20 (6.8 %) fluoroquinolone (FQ)-resistant E. coli and extended-spectrum β-lactamase (ESBL)-producing E. coli, respectively. On the other hand, in postmenopausal patients, there were 75 (32.1 %) and 36 (15.4 %) FQ-resistant E. coli and ESBL-producing E. coli, respectively. The rate of FQ-resistant E. coli and ESBL-producing E. coli in post-menopausal women was higher than that for our previous nationwide surveillance (20.7 % and 32.1 %: p = 0.0004, 10.0 % and 15.4 %; p = 0.0259). For pre-menopausal women, there was no significant difference in the rate of FQ-resistant E. coli and ESBL-producing E. coli between this and previous reports, but the frequency of FQ-resistant E. coli and ESBL-producing E. coli exhibited a gradual increase. For appropriate antimicrobial agent selection and usage, it is essential for clinicians to be aware of the high rate of these antimicrobial-resistant bacteria in acute uncomplicated cystitis in Japan.
Abstract Purpose The goal of the present study was to clarify the clinical characteristics and laboratory results of parkinsonian symptoms among patients with and without camptocormia. Methods ...Seventy-eight Parkinson's disease (PD) patients with camptocormia and 78 PD patients without camptocormia underwent a neurological examination, a blood test, and spinal magnetic resonance imaging (MRI). PD with camptocormia group and PD with non-camptocormia group were matched on age, age at PD onset, and sex. Principal results Camptocormia group had significantly higher prevalence of compression fractures, more severe parkinsonian symptoms, and a greater incidence of dementia than those without camptocormia. Serum creatine kinase levels in camptocormia group significantly elevated compared with non-camptocormia group. There were higher prevalence of abnormal findings in spine MRI including compression fractures and paravertebral muscle changes in camptocormia group compared with non-camptocormia group. Major conclusions Camptocormia is associated with a greater prevalence of compression fractures and associated with greater UPDRS part II, part III score, axial score, and lower MMSE in this cross-sectional study. Thus, it can be concluded that camptocormia in PD is predominantly myopathic.
Objective and methods Dysferlin encoded by DYSF deficiency leads to two main phenotypes, limb girdle muscular dystrophy (LGMD) 2B and Miyoshi myopathy. To reveal in detail the mutational and clinical ...features of LGMD2B in Japan, we observed 40 Japanese patients in 36 families with LGMD2B in whom dysferlin mutations were confirmed. Results and conclusions Three mutations (c.1566C>G, c.2997G>T and c.4497delT) were relatively more prevalent. The c.2997G>T mutation was associated with late onset, proximal dominant forms of dysferlinopathy, a high probability that muscle weakness started in an upper limb and lower serum creatine kinase (CK) levels. The clinical features of LGMD2B are as follows: (1) onset in the late teens or early adulthood, except patients homozygous for the c.2997G>T mutation; (2) lower limb weakness at onset; (3) distal change of lower limbs on muscle CT at an early stage; (4) impairment of lumbar erector spinal muscles on muscle CT at an early stage; (5) predominant involvement of proximal upper limbs; (6) preservation of function of the hands at late stage; (7) preservation of strength in neck muscles at late stage; (8) lack of facial weakness or dysphagia; (9) avoidance of scoliosis; (10) hyper-Ckaemia; (11) preservation of cardiac function; and (12) a tendency for respiratory function to decline with disease duration. It is important that the late onset phenotype is found with prevalent mutations.
To investigate the presence of microorganisms related to urethritis in the oral cavity of male patients with urethritis and the efficacies of antimicrobials for urethritis on microorganisms in the ...oral cavity.
Ninety-two male patients with urethritis and 17 male controls participated to this study at 12 urology clinics in Japan between March 2014 and March 2015. The first voided urine (FVU) and oral wash fluid (OWF) specimens were collected from the participants. The microorganisms in both FVU and OWF specimens were detected by nucleic acid amplification tests at the first and follow-up visit. The efficacies of antimicrobials were evaluated after 1–4 weeks treatment completion.
In a total of 92 male patients with urethritis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum, Trichomonas vaginalis and Gardnerella vaginalis were detected from OWF specimens of 12%, 3%, 9%, 0%, 12%, 3%, 3% and 15% patients, respectively. From control males, no microorganism was detected from OWF specimens. Among 46 patients who could be evaluated for antimicrobial efficacies at the follow-up visit, 5 in FVU specimens failed by azithromycin (AZM), and 10 failed in OWF specimens (7 by AZM, 2 by tetracycline, 1 by spectinomycin; p = 0.002). Especially, a high prevalence of G. vaginalis remained positive after treatment for urethritis in the oral cavity.
Microorganisms related to urethritis were detected in the oral cavity of male patients with urethritis. Antimicrobials that focused on urethritis, especially AZM regimen seem to be less effective for microorganisms in the oral cavity.
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