We assess the effect of the COVID-19 pandemic on global fossil fuel consumption and CO2 emissions over the two-year horizon 2020Q1-2021Q4. We apply a global vector autoregressive (GVAR) model, which ...captures complex spatial-temporal interdependencies across countries associated with the international propagation of economic impact due to the virus spread. The model makes use of a unique quarterly data set of coal, natural gas, and oil consumption, output, exchange rates and equity prices, including global fossil fuel prices for 32 major CO2 emitting countries spanning the period 1984Q1–2019Q4. We produce forecasts of coal, natural gas and oil consumption, conditional on GDP growth scenarios based on alternative IMF World Economic Outlook forecasts that were made before and after the outbreak. We also simulate the effect of a relative price change in fossil fuels, due to global scale carbon pricing, on consumption and output. Our results predict fossil fuel consumption and CO2 emissions to return to their pre-crisis levels, and even exceed them, within the two-year horizon despite the large reductions in the first quarter following the outbreak. Our forecasts anticipate more robust growth for emerging than for advanced economies. The model predicts recovery to the pre-crisis levels even if another wave of pandemic occurs within a year. Our counterfactual carbon pricing scenario indicates that an increase in coal prices is expected to have a smaller impact on GDP than on fossil fuel consumption. Thus, the COVID-19 pandemic would not provide countries with a strong reason to delay climate change mitigation efforts.
Morphological and functional analysis of the microcirculation are objective outcome measures that are recommended for use in the presence of clinical signs of altered peripheral blood flow (such as ...Raynaud phenomenon), which can occur in systemic sclerosis (SSc) and other autoimmune rheumatic diseases. Several advanced non-invasive tools are available for monitoring the microcirculation, including nailfold videocapillaroscopy, which is the best-studied and most commonly used method for distinguishing and quantifying microvascular morphological alterations in SSc. Nailfold videocapillaroscopy can also be used alongside laser Doppler techniques to assist in the early diagnosis and follow-up of patients with dermatomyositis or mixed connective tissue disease. Power Doppler ultrasonography, which has been used for many years to evaluate the vascularity of synovial tissue in rheumatoid arthritis, is another promising tool for the analysis of skin and nailbed capillary perfusion in other autoimmune rheumatic diseases. Other emerging methods include raster-scanning optoacoustic mesoscopy, which offers non-invasive high-resolution 3D visualization of capillaries and has been tested in psoriatic arthritis and SSc. The principle functions and operative characteristics of several non-invasive tools for analysing microvascular changes are outlined in this Review, and the clinical roles of validated or tested imaging methods are discussed for autoimmune rheumatic diseases.
Symposium 4 SMITH, Vanessa
Journal of clinical rheumatology and immunology (Online),
11/2023, Volume:
23, Issue:
Supp01
Journal Article
Peer reviewed
Open access
Interstitial lung disease (ILD) is a fibrotic disease of the lung parenchyma. It can occur in different connective tissue diseases, including rheumatoid arthritis (RA). Smoking, male gender and ...longstanding RA are possible risk factors for developing ILD
1
. Being a common extra-articular manifestation of RA, it can contribute to decreased quality of life, chronic disability, high utilization of healthcare resources, and may also lead to substantial morbidity and mortality for affected patients
1
. Hence, early identification and management is of paramount importance to improve patient outcomes.
Clinical presentation, chest X-ray, pulmonary function testing and high-resolution computed tomography are common tools for investigation and they also allows assessment of subtype and disease extent
2
. The histopathologic and radiographic features of RA-ILD are heterogeneous. The most frequent patterns of RA-ILD are usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). Distinguishing the patterns is useful in predicting prognosis and would also affect subsequent management approach
2
.
Traditionally treatment initiated for RA-ILD was generally empirical. Corticosteroids were often used as first-line agents and immunosuppressants maybe added
2
. However, these treatments are not specific and mainly target inflammation instead of fibrosis. With the advance in medicine, antifibrotic is now indicated for treating fibrosing ILD with progressive phenotype. FVC decline can be slowed in patients with connective tissue disease associated progressive ILD
3
.
In this lecture, Prof. Vanessa Smith will share the current knowledge and evidence in RA-ILD. The approach on identifying and screening ILD in RA patients would be presented. The management strategy and options would also be reviewed.
Interstitial lung diseases (ILD) encompass a broad group of more than 200 parenchymal pulmonary disorders in which the lung tissue is comprised. Connective tissue disease related ILD comprise almost ...20% of all ILD, rheumatoid arthritis and systemic sclerosis (SSc) making up the largest proportion of CTD-ILD.1 Some CTD-ILD may have an acute course, such as anti-MDA5 positive rapidly progressive amyopathic dermatomyositis related ILD, others may have a chronic course. CTD-ILD are frequently progressive bringing along an as dismal disease course as idiopathic pulmonary fibrosis. Several challenges are related to CTD-ILD. One of the challenges concerning is firstly to think of them. The second challenge is to screen for them. The third challenge is the optimal management. In this way only for SSc related ILD we have generally adopted screening/monitoring strategies as well as several randomised controlled trials to evaluate the efficacy of immune suppressive and antifibrotic drugs.2 Multidisciplinary approach in diagnosis and management of CTD-ILD is paramount. Wijsenbeek M, et al. Interstitial lung diseases. Lancet. 2022 Sep 3;400(10354):769–786. doi: 10.1016/S0140-6736(22)01052-2. Epub 2022 Aug 11. Volkmann ER, et al. Systemic sclerosis. Lancet. 2023 Jan 28;401(10373):304–318. doi: 10.1016/S0140-6736(22)01692-0. Epub 2022 Nov 25.
This paper extends the cross-sectionally augmented panel unit root test (CIPS) proposed by Pesaran (2007) to the case of a multifactor error structure, and proposes a new panel unit root test based ...on a simple average of cross-sectionally augmented Sargan–Bhargava statistics (CSB). The basic idea is to exploit information regarding the m unobserved factors that are shared by k observed time series in addition to the series under consideration. Initially, we develop the tests assuming that m0, the true number of factors, is known and show that the limit distribution of the tests does not depend on any nuisance parameters, so long as k≥m0−1. Small sample properties of the tests are investigated by Monte Carlo experiments and are shown to be satisfactory. Particularly, the proposed CIPS and CSB tests have the correct size for all combinations of the cross section (N) and time series (T) dimensions considered. The power of both tests rises with N and T, although the CSB test performs better than the CIPS test for smaller sample sizes. The various testing procedures are illustrated with empirical applications to real interest rates and real equity prices across countries.
Lean and Green Hand Surgery Van Demark, Robert E.; Smith, Vanessa J.S.; Fiegen, Anthony
The Journal of hand surgery (American ed.),
February 2018, 2018-02-00, 20180201, Volume:
43, Issue:
2
Journal Article
Peer reviewed
Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 ...trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2.8 billion pounds, produced directly by operating rooms. Waste disposal also accounts for up to 20% of a hospital’s annual environmental services budget. Since 1992, waste production by hospitals has increased annually by a rate of at least 15%, due in part to the increased usage of disposables. Reduction in operating room waste would decrease both health care costs and potential environmental hazards. In 2015, the American Association for Hand Surgery along with the American Society for Surgery of the Hand, American Society for Peripheral Nerve Surgery, and the American Society of Reconstructive Microsurgery began the “Lean and Green” surgery project to reduce the amount of waste generated by hand surgery. We recently began our own “Lean and Green” project in our institution. Using “minor field sterility” surgical principles and Wide Awake Local Anesthesia No Tourniquet (WALANT), both surgical costs and surgical waste were decreased while maintaining patient safety and satisfaction. As the current reimbursement model changes from quantity to quality, “Lean and Green” surgery will play a role in the future health care system.
In 2005, natalizumab treatment was identified as a risk factor for PML in multiple sclerosis . CONFLICT OF INTEREST STATEMENT The authors declare no conflict of interest. DATA AVAILABILITY STATEMENT ...Data sharing is not applicable to this article as no new data were created or analyzed in this study.
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease; the clinical manifestations are correlated with continuum multiarticular synovitis, cartilage and bone damage, and defeat of ...joint function, that causes disability. Involvement of internal organs is also frequent. Between the inflammatory cells involved in RA, macrophages play a key role. These cells can polarize in different phenotype and mediate the immune/inflammatory reaction as well as the reparatory phase when possible. The properties of these cells are mediate by the body's environmental factors.
In this systematic review, all English-speaking articles concerning the role of M1 (pro-inflammatory) or M2 (anti-inflammatory) macrophages in RA were systematically reviewed and categorized according to their polarized-function in RA, especially in the synovial tissue. Analyses of the endogenous molecules and the drugs that could modulate M1 and M2 activity in RA were achieved.
A sensitive search was developed in Pubmed, Web of Science, Ovid Med-Line, Embase Database and Science Direct Database (la both from Elsevier) to identify articles to increase the highlighting on the role of macrophages M1 and M2 in RA using the following terms: ((M1 AND M2) AND Rheumatoid Arthritis). All selected papers were read and discussed by two independent reviewers. The selection process was based on title, abstract and full text level. Relevant data were extracted and analyzed using a standardized template designed for this review.
In total 39 resulting articles were selected and categorized according to description of M1/M2's role in RA. Data from humans, mice and rats were subcategorized, thus in every section were highlighted the contribute, in peripheral blood and synovial tissue, of both polarized macrophages; section for endogenous molecules and drugs that favor the switch from M1 to M2 macrophages were carried out. The most evinced relevant results, were that in RA blood and in the synovial tissue, there isn't a clear distinction phase with M1 or M2 macrophages (by membrane marker analysis); rather there is M1 and M2 subset disequilibrium and by deeply analyses of mRNA gene and cytokine produced, it emerged that a non-coherent expression inner marker match with membrane molecules, and also the tissue section can define the marker expressed.
This systematic review emphasizes that the rigid classical subdivision of M1 and M2 macrophages, as well as the different samples' results comparison, might be questionable. In addition, it is suggested, when taking samples from RA patients, to carefully consider their therapies in order to analyze the M1 and M2 macrophages behavior without drug influence.
In line with the advances in M1 and M2 knowledge, and the progression in the single-cell methodologies by identification of individual cell molecular markers, therapeutic approaches seem possible to favor the anti-inflammatory macrophage response in RA (e.g. M2 polarization).
•There are no differences in the circulating monocyte populations among RA and HD.•M1/M2 polarization changes through the disease activity phases.•In RA synovial tissue there are both mature macrophages and mixed M1/M2 phenotypes.•Molecular milieu modulates M1/M2 polarization in animal models and humans.•Animal RA models are still unable to reproduce the human disease comparably.
Glial fibrillary acidic protein (GFAP) is the main astrocytic intermediate filament (IF). GFAP splice isoforms show differential expression patterns in the human brain. GFAPδ is preferentially ...expressed by neurogenic astrocytes in the subventricular zone (SVZ), whereas GFAP(+1) is found in a subset of astrocytes throughout the brain. In addition, the expression of these isoforms in human brain material of epilepsy, Alzheimer and glioma patients has been reported. Here, for the first time, we present a comprehensive study of GFAP isoform expression in both wild-type and Alzheimer Disease (AD) mouse models. In cortex, cerebellum, and striatum of wild-type mice, transcripts for Gfap-α, Gfap-β, Gfap-γ, Gfap-δ, Gfap-κ, and a newly identified isoform Gfap-ζ, were detected. Their relative expression levels were similar in all regions studied. GFAPα showed a widespread expression whilst GFAPδ distribution was prominent in the SVZ, rostral migratory stream (RMS), neurogenic astrocytes of the subgranular zone (SGZ), and subpial astrocytes. In contrast to the human SVZ, we could not establish an unambiguous GFAPδ localization in proliferating cells of the mouse SVZ. In APPswePS1dE9 and 3xTgAD mice, plaque-associated reactive astrocytes had increased transcript levels of all detectable GFAP isoforms and low levels of a new GFAP isoform, Gfap-ΔEx7. Reactive astrocytes in AD mice showed enhanced GFAPα and GFAPδ immunolabeling, less frequently increased vimentin and nestin, but no GFAPκ or GFAP(+1) staining. In conclusion, GFAPδ protein is present in SVZ, RMS, and neurogenic astrocytes of the SGZ, but also outside neurogenic niches. Furthermore, differential GFAP isoform expression is not linked with aging or reactive gliosis. This evidence points to the conclusion that differential regulation of GFAP isoforms is not involved in the reorganization of the IF network in reactive gliosis or in neurogenesis in the mouse brain.
When Louis Antoine de Bougainville reached Tahiti in 1768, he was struck by the way in which 'All these people came crying out tayo, which means friend, and gave a thousand signs of friendship; they ...all asked nails and ear-rings of us.' Reading the archive of early contact in Oceania against European traditions of thinking about intimacy and exchange, Vanessa Smith illuminates the traditions and desires that led Bougainville and other European voyagers to believe that the first word they heard in the Pacific was the word for friend. Her book encompasses forty years of encounters from the arrival of the Dolphin in Tahiti in June 1767, through Cook's and Bligh's voyages, to early missionary and beachcomber settlement in the Marquesas. It unpacks both the political and emotional significances of ideas of friendship for late eighteenth-century European, and particularly British, explorations of Oceania.
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