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One of the proposed ways to reduce the climate impact of civil aviation is rerouting aircraft to minimise the formation of warming contrails. As this strategy may increase fuel consumption, it would only be beneficial if the climate impact reduction from the avoided contrails exceeds the negative impact of any additional carbon dioxide (CO2) emitted by the rerouted flight. In this study, we calculate the surface temperature response of almost half a million flights that crossed the North Atlantic sector in 2019 and compare it to the temperature response of hypothetical rerouted flights. The climate impacts of contrails and CO2 are assessed through the perspective of CO2-equivalence metrics, represented here as nine combinations of different definitions and time horizons. We estimate that the total emitted CO2 and the persistent contrails formed will have warmed the climate by 17.2 µK in 2039, 13.7 µK in 2069, and 14.1 µK in 2119. Under an idealised scenario where 1 % additional carbon dioxide is enough to reroute all contrail-forming flights and avoid contrail formation completely, total warming would decrease by 4.9 (−28 %), 2.6 (−19 %), and 1.9 (−13 %) µK in 2039, 2069, and 2119, respectively. In most rerouting cases, the results based on the nine different CO2-equivalence metrics agree that rerouting leads to a climate benefit, assuming that contrails are avoided as predicted. But the size of that benefit is very dependent on the choice of CO2-equivalence metrics, contrail efficacy and CO2 penalty. Sources of uncertainty not considered here could also heavily influence the perceived benefit. In about 10 % of rerouting cases, the climate damage resulting from contrail avoidance indicated by CO2-equivalence metrics integrated over a 100-year time horizon is not predicted by metrics integrated over a 20-year time horizon. This study highlights, using North Atlantic flights as a case study, the implications of the choice of CO2-equivalence metrics for contrail avoidance, but the choice of metric implies a focus on a specific climate objective, which is ultimately a political decision.

Abstract Background The effect of plasma hepcidin concentrations on the long-term risk of developing adverse cardiovascular outcomes in people with type 2 diabetes mellitus (T2DM) is unclear. Methods We followed for a median of 55.6 months 213 outpatients with established T2DM (45.5% women, mean age 69 ± 10 years; BMI 28.7 ± 4.7 kg/m2; median diabetes duration 11 years). Baseline plasma ferritin and hepcidin concentrations were measured with an electrochemiluminescence immunoassay and mass spectrometry-based assay, respectively. The primary study outcome was a composite of all-cause mortality or incident nonfatal cardiovascular events (inclusive of myocardial infarction, permanent atrial fibrillation, ischemic stroke, or new hospitalization for heart failure). Results 42 patients developed the primary composite outcome over a median follow-up of 55.6 months. After stratifying patients by baseline hepcidin tertiles [1st tertile: median hepcidin 1.04 (IQR 0.50–1.95) nmol/L, 2nd tertile: 3.81 (IQR 3.01-4-42) nmol/L and 3rd tertile: 7.72 (IQR 6.37–10.4) nmol/L], the risk of developing the primary composite outcome in patients in the 3rd tertile was double that of patients in the 1st and 2nd tertile combined (unadjusted hazard ratio [HR] 2.32, 95%CI 1.27–4.26; p = 0.007). This risk was not attenuated after adjustment for age, sex, adiposity measures, smoking, hypertension, statin use, antiplatelet medication use, plasma hs-C-reactive protein and ferritin concentrations (adjusted HR 2.53, 95%CI 1.27–5.03; p = 0.008). Conclusions In outpatients with T2DM, higher baseline hepcidin concentrations were strongly associated with an increased long-term risk of overall mortality or nonfatal cardiovascular events, even after adjustment for established cardiovascular risk factors, plasma ferritin concentrations, medication use, and other potential confounders.

Relative humidity with respect to ice (RHi) is a key variable in the formation of cirrus clouds and contrails. We document its probability density function (PDF) using long-term Measurements of Ozone, Water Vapour, Carbon Monoxide and Nitrogen Oxides by In-Service Airbus Aircraft (MOZAIC) and the In-service Aircraft for a Global Observing System (IAGOS) observations over the period 1995–2022 in the upper troposphere (UT) and the lower stratosphere (LS) between 325 and 175 hPa. The characteristics of the RHi PDF differ in the UT and in the LS of the high-latitude regions (HLs) and mid-latitude regions (MLs) of the Northern Hemisphere. In the LS, this PDF decreases exponentially with increasing RHi. In the UT, it first increases exponentially in subsaturated conditions and then decreases exponentially in supersaturated conditions. Because of these different behaviors, the PDF for the combined UT and LS is bimodal. In contrast to the HLs and the MLs, the RHi PDF in the tropical troposphere decreases exponentially with increasing RHi. The different forms of PDF, in the tropics and in the higher-latitude regions, lead to a global PDF of RHi in subsaturated tropospheric conditions that is almost uniform. These findings invite caution when using MOZAIC and IAGOS measurements to calibrate large-scale simulations of RHi. The variability in RHi properties associated with that of temperature also has implications for the formation of contrails. We examined the impact of switching fuel (from kerosene to bioethanol or liquid hydrogen) on the frequency of contrail formation using the Schmidt–Appleman criterion. We show that bioethanol and, to a larger extent, liquid hydrogen would produce more contrails. The impact of a potential change from kerosene to these alternative fuels decreases with decreasing pressure but increases when moving from the higher latitudes of the Northern Hemisphere to the tropics. Finally, we emphasize that investigations of the impact on contrail occurrence frequency as a result of switching from fossil kerosene to more sustainable fuels must be carried out in various meteorological conditions.

Integrating knowledge regarding habitat characteristics and animal behaviour into conservation programs has the potential to impact the results of management and conservation efforts. This study aimed to explore the relationship between spatial and environmental data on the nesting activity of the European pond turtle, Emys orbicularis. Additionally, it sought to analyse the abundance, activity pattern, and behaviour of potential nest predators of E. orbicularis. Natural predated nests of the European pond turtle were utilized to characterise nesting habitat features, while artificial nests and camera traps were deployed to identify potential predators and their behaviour. Artificial nests and camera traps were established in areas with evidence of track detection or historical observations indicating past instances of nest predation. The nest site distribution of the European pond turtle showed a positive relationship with north-south oriented canals, the presence of vegetative components on embankments (shrubs, grass, emergent vegetation), finer-grained soil components (silt and clay), and soil moisture. Camera trapping of artificial nests revealed mammals (Meles meles and Vulpes vulpes) and a bird (Pica pica) as predators engaging in digging and destroying behaviour. P. pica detection was notably higher in mowed vegetation areas. Results indicate that natural nest distribution and predation on artificial nests may be influenced by their distribution concerning human-controlled vegetation and foraging activities of common nest predators. Protecting nesting sites in predator-frequented habitats, combined with landscape management targeting vegetation control along embankments, could mitigate nest predation and enhance hatchling recruitment.

Abstract Disease-modifying therapies (DMT) administered to patients with multiple sclerosis (MS) can influence immune responses to SARS-CoV-2 and vaccine efficacy. However, data on the detailed phenotypic, functional and metabolic characteristics of antigen (Ag)-specific cells following the third dose of mRNA vaccine remain scarce. Here, using flow cytometry and 45-parameter mass cytometry, we broadly investigate the phenotype, function and the single-cell metabolic profile of SARS-CoV-2-specific T and B cells up to 8 months after the third dose of mRNA vaccine in a cohort of 94 patients with MS treated with different DMT, including cladribine, dimethyl fumarate, fingolimod, interferon, natalizumab, teriflunomide, rituximab or ocrelizumab. Almost all patients display functional immune response to SARS-CoV-2. Different metabolic profiles characterize antigen-specific-T and -B cell response in fingolimod- and natalizumab-treated patients, whose immune response differs from all the other MS treatments.

In this work pyrolysis of palm oil and lignin has been investigated using a two-stage process at 550 °C, with a first step configuration of continuous condensation for vapors and separation of gases, and a second step with distillation of vapors. Experiments were realized as pyrolysis of palm oil, palmitic acid, and Kraft lignin, as well as co-pyrolysis of palm oil/lignin, palmitic acid/lignin and palmitic acid/guaiacol. It has been shown that the addition of lignin improves the quality of palm oil pyrolysis bio-oil, thanks to the conversion of fatty acids coproduct to fatty acid methyl esters (FAME). The production of methyl esters in the reaction environment using palm oil and lignin was studied by conducting experiments with palmitic acid and lignin, as well as palmitic acid and guaiacol (the main product obtained from lignin pyrolysis). The results highlighted that during pyrolysis, the production of FAME is a consequence of a direct esterification reaction on palmitic acid. The formation of FAMEs during pyrolysis presents a promising avenue to optimize the utilization of palm oil by generating FAMEs as supplementary fuel products, Furthermore, it is possible to consider the application of the studied process for the conversion of free fatty acids into FAME.

Purpose: Wagner syndrome is an autosomal genetic vitreoretinopathy characterized by chorioretinal atrophy, avascular vitreous veils, reduced visual acuity and early retinal detachment in advanced cases. Management of Wagner syndrome usually results in observation then management of occurring complications. Observations: We report the case of a 9-year-old girl presenting with supposed Wagner syndrome that we managed with prophylactic encircling band and retinopexy in both eyes. The genetic testing revealed a new variant in the intron 7 non canonical splice acceptor site, c.4004-12_4004-6delins17, that was also present in her father. Conclusions and Importance: The VCAN variant found in this proband and her father has not been described yet but shows high predictions of pathogenicity. The previous reported variants in VCAN intron 7 and the associated phenotype for both cases allowed us to attribute this variant to Wagner syndrome. In Wagner syndrome, management is usually curative. After prophylactic surgery in our case, the zones of retinal delamination were well supported by the scleral buckle, releasing the vitreoretinal tractions, and the additional laser focalized on the temporal zones of dehiscence secured the retina. An encircling band may be a good way to prevent RD in patients with Wagner syndrome at risk.

Not available.

Legionella is the pathogen that causes Legionnaires’ disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to assess the effectiveness and efficiency of different Legionella monitoring and control strategies to inform government requirements to prevent community-acquired Legionnaires’ disease in non-hospital buildings. This simulation model was built using comprehensive data from multiple scientific and field-based sources. It is a tool for estimating the relative economic and human costs of monitoring and control efforts targeting either L. pneumophila or Legionella species and was designed to analyze the potential application of each approach to specific building classes across Italy. The model results consistently showed that targeting L. pneumophila is not only sufficient but preferable in optimizing total cost (direct and economic) for similar human health benefits, even when stress-tested with extreme inputs. This cost–benefit analytical tool allows the user to run different real-life scenarios with a broad range of epidemiological and prevalence assumptions across different geographies in Italy. With appropriate modifications, this tool can be localized and applied to other countries, states, or provinces.

Penetrating trauma is usually divided into stab and gunshot wounds (GSW). When considering GSW, the initial assessment involves the identification of all the wounds, to understand the projectile's trajectory as well as to determine which anatomic structures might have been damaged [1]. Rarely, the projectile might not leave the victim's body and embolize to a different region through large blood vessels. Known as Missile Embolism (ME), this uncommon complication can compromise multiple body segments, resulting in severe injuries, whether it occurs through an artery or a vein, such as pulmonary embolism, cardiac-valve incompetence, limb-threatening ischemia, coronary infarct, and stroke [2,3]. This is a case report of an 18-year-old male patient who suffered a gunshot wound and was submitted to an exploratory laparotomy which identified a laceration of the inferior vena cava. Further exams concluded that the bullet was embolized to the right hepatic vein. ME treatment will depend mostly on the bullet's placement; if located in the left circulation or arterial vessels, retrieval is the preferred treatment. It can be executed through surgical exploration or endovascular procedure [3,4,8] Venous ME has several treatment options, including conservative management if the patient remains asymptomatic [3–7]. Cases of paradoxical embolization might be managed as arterial ME [3,4].

Bamboo is already a convenient construction resource, as it offers an efficient structural performance. As this plant has native varieties adapted to different climates and soils of Brazil, bamboo silviculture can be intensified to supply the national industry. Three bamboo species from Brazil (Dendrocalamus asper, Bambusa tuldoides, and Phyllostachys aurea) were analyzed for the flexural load capacity applied on the internal and external surfaces. Specimens were prepared without knots and with knots centered at the middle of each sample. In total, 240 samples were tested in terms of static bending and dynamic bending (impact). The results showed a higher flexural elasticity and a higher proportional limit strength of knotted P. aurea. The presence of knots provided higher values of ultimate strength in P. aurea, even reducing the bamboo flexibility. Also, P. aurea exhibited the best characteristic of flexural dynamic energy absorption among the three bamboo species under evaluation.

Soil water infiltration is an important component of the hydrological cycle, and it is best evaluated when the raindrop impacts the ground surface. For this reason, it is affected by changes in land use and land cover and by the characteristics and physical–hydric properties of the soil. This study aimed to evaluate soil water infiltration in areas occupied by annual crops (soybean and corn) and pastures in two watersheds of the Teles Pires River-MT, using simulated rainfall, physical models, and principal component analysis. Infiltration rates were evaluated based on simulated rainfall with an average intensity of 75 mm h−1, with four repetitions per region (upper, middle, and lower) of the hydrographic sub-basins of the Caiabi and Renato rivers, and soil use with cover, without cover, and disturbed. Soil tillage provided higher water infiltration rates into the soil, especially in pasture areas in the two hydrographic sub-basins. There were significant adjustments to the mathematical models based on the infiltration rate data for all land use and land cover conditions. The soil attributes that most interfered with the infiltration rate were microporosity, bulk density, and total porosity in the crop areas of the middle Caiabi and microporosity, clay content, total porosity, and silt content in the areas farming at the source of the Renato River. The Horton and Philip models presented the best adjustments in the hydrographic sub-basins of the Caiabi and Renato Rivers, which are recommended for estimating the water infiltration rate into the soil in different uses, coverages, and regions.

The standard surgical treatment for early-stage cervical cancer includes hysterectomy and bilateral oophorectomy along the removal of parametrial tissue to achieve surgical radicality. However, in recent years, the role of simple hysterectomy for cervical cancer with favorable prognostic characteristics has been re-evaluated. One of the challenges in early-stage cervical cancer is identifying predictive factors for neoplastic parametrial infiltration and lymph node metastases that cannot be detected during the preoperative assessment. We hypothesized that histological tumor growth patterns may be associated with these features and could thus be useful for the management of apparent early-stage cervical cancer. We identified 3 different histological patterns: the comedo-like, the infiltrative, and the expansive. We analyzed a series of clinic-pathological characteristics to determine the association of eachpatternwith aggressive features. Furthermore, we estimated odd ratios (ORs) in univariate and multivariate analyses for parametrial infiltration and lymph node metastasis. We found that comedo-like pattern is associated to advanced FIGO stages, larger tumor size, lymphovascular space invasion, deeper invasion depth, parametrium involvement, and lymph node metastases. By univariate analysis, comedo-like pattern was statistically associated with both parametrial involvement (OR: 19.3, CI 5.47–68.6, p-value = < 0.001) and lymph node metastases (OR: 4.98, CI 1.71–14.5, p-value = 0.003). By multivariate analysis, the association between comedo-like pattern and parametrial involvement was confirmed (OR: 8.76, CI 2.34–32.75, p-value = 0.01). The specific growth pattern of cervical cancer, assessed in a conization specimen before hysterectomy, can be useful to tailor surgical radicality. [ABSTRACT FROM AUTHOR]

To classify actinic cheilitis (AC) from clinical criteria. Information and clinical images and histopathological slides from 32 cases compatible with the clinicopathological diagnosis of AC were reviewed between the years 2014 and 2021. Men (84.4%), white (78.1%), married (53.1%), with a median age of 60 years, incomplete elementary school (37.5%), no family history of cancer (78.1%) or comorbidities (50%), with lesions on the lower lip (100%) were the most affected. Most patients came from the prevention service (87.5%) of the dentistry department, had sun exposure (56.3%), were smokers (34.4%) and alcoholics (56.3%). Erosed or ulcerated lesions (56.3%), single (87.5%), up to 1 cm in diameter (59.4%), homogeneous in appearance (56.3%), absence of epithelial dysplasia (87.5%), clinically classified as grade IV (18.8%), submitted to surgical treatment and follow-up (84.4%) with a partial response rate to treatment (56.3%) predominated. Only one case had recurrence (3.1%), new primary lesion (3.1%), or malignant transformation (3.1%) and most patients had follow-up ≥6 months. The classification of AC from clinical criteria has potential, as it contributes to the follow-up of patients with this oral potentially malignant disorder and the early detection of lip cancer [ABSTRACT FROM AUTHOR]