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International audience; Abstract Objective pulmonary arterial hypertension (PAH) is a leading cause of death in mixed connective tissue disease (MCTD). We aimed to describe PAH in well-characterized MCTD patients. Methods MCTD patients enrolled in the French Pulmonary Hypertension Registry with a PAH diagnosis confirmed by right heart catheterization were included in the study and compared with matched controls: MCTD patients without PAH, systemic lupus erythematous (SLE) patients with PAH, and systemic sclerosis (SSc) patients with PAH. Survival rates were estimated by the Kaplan-Meier method and risk factors for PAH in MCTD patients and risk factors for mortality in MCTD-PAH were sought using multivariate analyses. Results thirty-six patients with MCTD-PAH were included in the study. Comparison with MCTD patients without PAH and multivariate analysis revealed that pericarditis, polyarthritis, thrombocytopenia, interstitial lung disease (ILD), and anti-Sm antibodies were independent predictive factors of PAH/PH in MCTD. Estimated survival rates at 1 year, 5 years, and 10 years, following PAH diagnosis were 83%, 67%, and 56%, respectively. MCTD-PAH presentation and survival did not differ from SLE-PAH and SSc-PAH. Multivariate analysis revealed that tobacco exposure was an independent factor predictive of mortality in MCTD-PAH. Conclusion PAH is a rare and severe complication of MCTD, associated with a 56% 10-year survival. We identified ILD, pericarditis, thrombocytopenia, and anti-Sm antibodies as risk factors for PAH in MCTD and tobacco exposure as predictor of mortality in MCTD-PAH.

The reaction of ozone with sea-salt derived bromide is relevant for marine boundary layer atmospheric chemistry. The oxidation of bromide by ozone is enhanced at aqueous interfaces. Ocean surface water and sea spray aerosol are enriched in organic compounds, which may also have a significant effect on this reaction at the interface. Here, we assess the surface propensity of cationic tetrabutylammonium at the aqueous liquid-vapor interface by liquid microjet X-ray photoelectron spectroscopy (XPS) and the effect of this surfactant on ozone uptake to aqueous bromide solutions. The results clearly indicate that the positively charged nitrogen group in tetrabutylammonium (TBA), along with its surface activity, leads to an enhanced interfacial concentration of both bromide and the bromide ozonide reaction intermediate. In parallel, off-line kinetic experiments for the same system demonstrate a strongly enhanced ozone loss rate in the presence of TBA, which is attributed to an enhanced surface reaction rate. We used liquid jet XPS to obtain detailed chemical composition information from the aqueous-solution-vapor interface of mixed aqueous solutions containing bromide or bromide and chloride with and without TBA surfactant. Core level spectra of Br 3d, C 1s, Cl 2p, N 1s, and O 1s were used for this comparison. A model was developed to account for the attenuation of photoelectrons by the carbon-rich layer established by the TBA surfactant. We observed that the interfacial density of bromide is increased by an order of magnitude in solutions with TBA. The salting-out of TBA in the presence of 0.55 M sodium chloride is apparent. The increased interfacial bromide density can be rationalized by the association constants for bromide and chloride to form ion-pairs with TBA. Still, the interfacial reactivity is not increasing simply proportionally with the increasing interfacial bromide concentration in response to the presence of TBA. The steady state concentration of the bromide ozonide intermediate increases by a smaller degree, and the lifetime of the intermediate is 1 order of magnitude longer in the presence of TBA. Thus, the influence of cationic surfactants on the reactivity of bromide depends on the details of the complex environment at the interface. ISSN:2472-3452

International audience; Rationale: The relationship between the initial treatment strategy and survival in pulmonary arterial hypertension (PAH) remains uncertain. Objectives: To evaluate the long-term survival of patients with PAH categorized according to the initial treatment strategy. Methods: A retrospective analysis of incident patients with idiopathic, heritable, or anorexigen-induced PAH enrolled in the French Pulmonary Hypertension Registry (January 2006 to December 2018) was conducted. Survival was assessed according to the initial strategy: monotherapy, dual therapy, or triple-combination therapy (two oral medications and a parenteral prostacyclin). Measurements and Main Results: Among 1,611 enrolled patients, 984 were initiated on monotherapy, 551 were initiated on dual therapy, and 76 were initiated on triple therapy. The triple-combination group was younger and had fewer comorbidities but had a higher mortality risk. The survival rate was higher with the use of triple therapy (91% at 5 yr) as compared with dual therapy or monotherapy (both 61% at 5 yr) (P < 0.001). Propensity score matching of age, sex, and pulmonary vascular resistance also showed significant differences between triple therapy and dual therapy (10-yr survival, 85% vs. 65%). In high-risk patients (n = 243), the survival rate was higher with triple therapy than with monotherapy or dual therapy, whereas there was no difference between monotherapy and double therapy. In intermediate-risk patients (n = 1,134), survival improved with an increasing number of therapies. In multivariable Cox regression, triple therapy was independently associated with a lower risk of death (hazard ratio, 0.29; 95% confidence interval, 0.11-0.80; P = 0.017). Among the 148 patients initiated on a parenteral prostacyclin, those on triple therapy had a higher survival rate than those on monotherapy or dual therapy. Conclusions: Initial triple-combination therapy that includes parenteral prostacyclin seems to be associated with a higher survival rate in PAH, particularly in the youngest high-risk patients.

Resorcinol and orcinol are simple members of the family of phenolic compounds present in particulate matter in the atmosphere; they are amphiphilic in nature and thus surface active in aqueous solution. Here, we used X-ray photoelectron spectroscopy to probe the concentration of resorcinol (benzene-1,3-diol) and orcinol (5-methylbenzene-1,3-diol) at the liquid-vapor interface of aqueous solutions. Qualitatively consistent surface propensity and preferential orientation was obtained by molecular dynamics simulations. Auger electron yield near-edge X-ray absorption fine structure (NEXAFS) spectroscopy was used to probe the hydrogen bonding (HB) structure, indicating that the local structure of water molecules near the surface of the resorcinol and orcinol solutions tends towards a larger fraction of tetrahedrally coordinated molecules than observed at the liquid-vapor interface of pure water. The order parameter obtained from the molecular dynamics simulations confirm these observations. This effect is being discussed in terms of the formation of an ordered structure of these molecules at the surface leading to patterns of hydrated OH groups with distances among them that are relatively close to those in ice. These results suggest that the self-assembly of phenolic species at the aqueous solution-air interface could induce freezing similar to the case of fatty alcohol monolayers and, thus, be of relevance for ice nucleation in the atmosphere. We also attempted at looking at the changes of the O 1b(1), 3a(2) and 1b(2) molecular orbitals of liquid water, which are known to be sensitive to the HB structure as well, in response to the presence of resorcinol and orcinol. However, these changes remained negligible within uncertainty for both experimentally obtained valence spectra and theoretically calculated density of states., Environmental Science: Atmospheres, 2 (6), ISSN:2634-3606

International audience; Iodine chemistry is implicated in atmospheric chemistry and can form several oxides such as HOI, I2, IO, OIO, and finally I2O5 or HIO3, which may nucleate as nanoparticles relevant for cloud formation in remote environments. These oxides can be formed through reaction with oxidants or other halogen compounds in the gas phase or the particle phase. Most of the iodide oxidation processes have been suggested to be enhanced at interfaces, similar to other halogen species, either due to the surface propensity of intermediates or the iodine species itself. However, no data are available about the surface concentration of iodine species other than iodide. After two decades of research into the surface propensity of iodide and bromide, the picture emerges that their surface propensity is not as extreme as initially thought. Liquid jet X-ray photoelectron spectroscopy (XPS) experiments have been carried out at the SIM beamline at the Swiss Light Source. Acquisition of kinetic energy dependent (thus at different probing depth) I3d, I4d core level and valence level spectra has been done for iodide, iodate and iodic acid. This allows to retrieve the surface propensity of these iodine species at the aqueous solution – air interface. Theoretical computations were performed to calculate the spectra using the so-called Frozen Embedding Method where DFT SAOP is coupled with CVS-EOM-IP-CCSD/d-aug-dy-all.ac2vz via a molecular mean-field X2C including the Gaunt interaction. The computation of the iodide core binding energies in the aqueous have been determined and compared to experimental measurements.

Cell assemblies are considered fundamental units of brain activity, underlying diverse functions ranging from perception to memory and decision-making. Cell assemblies have historically been theorized as internal representations of specific stimuli or actions. Alternatively, cell assemblies can be defined without reference to an external world, by their endogenous ability to effectively elicit specific responses in downstream (‘reader’) neurons. However, this compelling framework currently lacks experimental support. Here, we provide evidence for assembly– reader communication. Reader activation was genuinely collective, functionally selective, yet flexible, implementing both pattern separation and completion. These processes occurred at the time scale of membrane integration, synaptic plasticity and gamma oscillations. Finally, assembly–reader couplings were selectively modified upon associative learning, indicating that they were plastic and could become bound to behaviorally relevant variables. These results support cell assemblies as an endogenous mechanism for brain function.

Common variable immunodeficiency (CVID) is known to cause infectious, inflammatory, and autoimmune manifestations. Pulmonary hypertension (PH) is an unusual complication of CVID with largely unknown characteristics and mechanisms. We report the clinical, functional, hemodynamics, radiologic and histologic characteristics, and outcomes of CVID-associated PH patients from the French PH Network. Ten patients were identified. The median (range) age at CVID diagnosis was 36.5 (4–49) years and the median delay between CVID and PH diagnosis was 12 (0–30) years. CVID-associated PH affected predominantly women (female-to-male ratio 9:1). Most patients were New York Heart Association functional class III with a severe hemodynamic profile and frequent portal hypertension (n = 6). Pulmonary function tests were almost normal in 70% of patients and showed a mild restrictive syndrome in 30% of patients while the diffusing capacity for carbon monoxide was decreased in all but one patient. High-resolution computed tomography found enlarged mediastinal nodes, mild interstitial infiltration with reticulations and nodules. Two patients had a CIVD-interstitial lung disease, and one presented with bronchiectasis. Pathologic assessment of lymph nodes performed in 5 patients revealed the presence of granulomas (n = 5) and follicular lymphoid hyperplasia (n = 3). At last follow-up (median 24.5 months), 9 patients were alive, and one patient died of Hodgkin disease. PH is a possible complication of CVID whose pathophysiological mechanisms, while still unclear, would be due to the inflammatory nature of CVID. CVID-associated PH presents as precapillary PH with multiple possible causes, acting in concert in some patients: a portal hypertension, a pulmonary vascular remodeling, sometimes a pulmonary parenchymal involvement and occasionally an extrinsic compression by mediastinal lymphadenopathies, which would be consistent with its classification in group 5 of the current PH classification.

A Viewpoint regarding our recently published Letter in this Journal (Gladich et al.

Fenton chemistry, involving the reaction between Fe

Precipitation is mostly formed via the ice phase in mixed phase clouds, and ice clouds are very relevant for Earths’ climate. Freezing or prevention of freezing is common to everyday life, e.g. for food and drug storage, icing and de-icing, etc. However, the ice nucleation process is not well understood, since it occurs on the size scale of clusters of molecules and time scales of molecular fluctuations. In this study, we have taken a step toward nanoscale observation of particles that nucleate ice by developing a new ice nucleation instrument, referred as the INXcell, which couples an ice nucleation environmental cell to the scanning transmission X-ray microscope (STXM) at the Swiss Light Source. We employ near-edge X-ray absorption fine-structure spectroscopy (NEXAFS) to map in situ chemical composition of ice nucleating particles with 35 × 35 nm2 spatial resolution. The main technical challenge was control of temperature, T, and thus relative humidity, RH, while maintaining X-ray transparency. In the INXcell, X-rays are focused onto a sample through a temperature-controlled aperture, which was modified to host a jet of nitrogen cooled down to 170 K. The cold jet impinges on the back surface of a sample exposed to water vapor to control sample temperature and thus RH. We used our unique spectroscopic and ice nucleation capability and investigated the heterogeneous freezing ability of ferrihydrite particles with and without coatings of citric acid. Ferrihydrite is an amorphous or poorly crystalline iron oxyhydroxide abundant in mineral dust and is difficult to identify with conventional XRD analysis. We confirmed that ferrihydrite could nucleate ice via immersion freezing and deposition ice nucleation, depending on whether or not the particles first take up water, respectively. When coating ferrihydrite with citric acid, mimicking organic coatings that aerosol particles obtain throughout their atmospheric lifetime, we observed a reduction in the efficiency to nucleate ice following freezing point depression. Spectroscopic identification of the coated ferrihydrite structure emplyed the iron and carbon X-ray absorption L-edges and K-edge, respectively. We also investigated feldspar particles coated with xanthan gum, a surrogate for a highly ice active mineral with a highly viscous organic coating. We observed that deposition ice nucleation occurred only below the RH dependent glass transition of xanthan gum. Using a newly developed stochastic freezing model (SFM) based on solution water activity, we reproduced average conditions and data scatter of the RH and T at which ice formed. Additionally, we ran our model with atmospheric idealized air parcel trajectories and found overall that deposition ice nucleation was the dominant heterogeneous freezing mechanism. Homogeneous ice nucleation subsequent to water uptake out-performed immersion freezing.

The phenotype of pulmonary arterial hypertension (PAH) patients carryingWe report the genetic analysis findings, characteristics and outcomes of patients with heritable PAH carryingTwenty patients and eight unaffected relatives were identified. The median (min-max) age at diagnosis was 17 years (2-53), with a female-to-male ratio of 1.5. At diagnosis, most of the patients (74%) were in functional class III or IV with severe hemodynamic compromise, including a median pulmonary vascular resistance (PVR) of 14.0 (4.2-31.5) Wood units (WU). An associated congenital heart disease (CHD) was found in 7 PAH patients (35%). Patients with CHD-associated PAH were significantly younger at diagnosis than PAH patients without CHD. Four patients (20%) suffered from recurrent haemoptysis requiring repeated arterial embolisations. Thirteen out of 16 patients (81%) of whom imaging was available displayed chest computed tomography abnormalities, including dilated, tortuous pulmonary vessels, ground-glass opacities as well as bronchial and non-bronchial arteries anomalies. After a median follow-up of 47 months (1-591 months), 10 patients underwent lung transplantation and one patient benefited from a heart-lung transplantation due to associated CHD. Histopathologic analysis of lung explants showed a congested lung architecture with severe pulmonary arterial remodelling, subpleural vessel dilation and numerous haemorrhagic foci.PAH due to

Resorcinol and orcinol are simple members of the family of phenolic compounds present in particulate matter in the atmosphere; they are amphiphilic in nature and thus surface active in aqueous solution. Here, we used X-ray photoelectron spectroscopy to probe the concentration of resorcinol (benzene-1,3-diol) and orcinol (5-methylbenzene-1,3-diol) at the liquid-vapor interface of aqueous solutions. Qualitatively consistent surface propensity and preferential orientation was obtained by molecular dynamics simulations. Auger electron yield near-edge X-ray absorption fine structure (NEXAFS) spectroscopy was used to probe the hydrogen bonding (HB) structure, indicating that the local structure of water molecules near the surface of the resorcinol and orcinol solutions tends towards a larger fraction of tetrahedrally coordinated molecules than observed at the liquid-vapor interface of pure water. The order parameter obtained from the molecular dynamics simulations confirm these observations. This effect is being discussed in terms of the formation of an ordered structure of these molecules at the surface leading to patterns of hydrated OH groups with distances among them that are relatively close to those in ice. These results suggest that the self-assembly of phenolic species at the aqueous solution-air interface could induce freezing similar to the case of fatty alcohol monolayers and, thus, be of relevance for ice nucleation in the atmosphere. We also attempted at looking at the changes of the O 1b