Search

Carbon monoxide (CO) concentrations in the troposphere are decreasing globally, with Africa as an exception. Yet, the region is understudied, with a deficit of ground-based observations and highly uncertain CO emission inventories. This paper reports multiyear observational CO data from the Mt. Kenya Global Atmosphere Watch (GAW) station, as well as summertime CO isotope observations from both Mt. Kenya and Nairobi, Kenya. The CO variability at Mt. Kenya is characterized by slightly increased concentrations during dry periods and a strong influence of short-term pollution events. While some data gaps and differences in instrumentation complicate decadal-scale trend analysis, a small long-term increase is resolved. High-pollution events are consistent with isotopic signal from downwind savanna fires. The isotope fingerprint of CO in Nairobi indicates an overwhelming dominance (near 100 %) of primary emissions from fossil fuel combustion with implications for air pollution policy. In contrast, the isotope signature of CO intercepted at the large-footprint Mt. Kenya region suggests that at least 70 % is primary sourced, with a predominance likely from savanna fires in Africa. Taken together, this study provides quantitative constraints of primary vs. secondary CO in the eastern Africa region and in urban Nairobi, with implications for satellite-based emission inventories as well as for chemical transport and climate modeling.

The precise measurement of the amount fraction of atmospheric nitrous oxide (N2O) is required to understand global emission trends. Analysis of the site-specific stable isotopic composition of N2O provides a means to differentiate emission sources. The availability of accurate reference materials of known N2O amount fractions and isotopic composition is critical for achieving these goals. We present the development of nitrous oxide gas reference materials for underpinning measurements of atmospheric composition and isotope ratio. Uncertainties target the World Metrological Organisation Global Atmosphere Watch (WMO-GAW) compatibility goal of 0.1 nmol mol−1 and extended compatibility goal of 0.3 nmol mol−1, for atmospheric N2O measurements in an amount fraction range of 325–335 nmol mol−1. We also demonstrate the stability of amount fraction and isotope ratio of these reference materials and present a characterisation study of the cavity ring-down spectrometer used for analysis of the reference materials.

Atmospheric nitrous oxide (N2O) levels have been continuously growing since preindustrial times. Mitigation requires information about sources and sinks on the regional and global scales. Isotopic composition of N2O in the atmosphere could contribute valuable constraints. However, isotopic records of N2O in the unpolluted atmosphere remain too scarce for large-scale N2O models. Here, we report the results of discrete air samples collected weekly to biweekly over a 5-year period at the high-altitude research station Jungfraujoch, located in central Switzerland. High-precision N2O isotopic measurements were made using a recently developed preconcentration and laser spectroscopy technique. The measurements of discrete samples were accompanied by in situ continuous measurements of N2O mixing ratios. Our results indicate a pronounced seasonal pattern with minimum N2O mixing ratios in late summer, associated with a maximum in δ15Nbulk and a minimum in intramolecular 15N site preference (δ15NSP). This pattern is most likely due to stratosphere–troposphere exchange (STE), which delivers N2O-depleted but 15N-enriched air from the stratosphere into the troposphere. Variability in δ15NSP induced by changes in STE may be masked by biogeochemical N2O production processes in late summer, which are possibly dominated by a low-δ15NSP pathway of N2O production (denitrification), providing an explanation for the observed seasonality of δ15NSP. Footprint analyses and atmospheric transport simulations of N2O for Jungfraujoch suggest that regional emissions from the planetary boundary layer contribute to seasonal variations of atmospheric N2O isotopic composition at Jungfraujoch, albeit more clearly for δ15NSP and δ18O than for δ15Nbulk. With the time series of 5 years, we obtained a significant interannual trend for δ15Nbulk after deseasonalization (-0.052±0.012 ‰ a−1), indicating that the atmospheric N2O increase is due to isotopically depleted N2O sources. We estimated the average isotopic signature of anthropogenic N2O sources with a two-box model to be -8.6±0.6 ‰ for δ15Nbulk, 34.8±3 ‰ for δ18O and 10.7±4 ‰ for δ15NSP. Our study demonstrates that seasonal variation of N2O isotopic composition in the background atmosphere is important when determining interannual trends. More frequent, high-precision and interlaboratory-compatible measurements of atmospheric N2O isotopocules, especially for δ15NSP, are needed to better constrain anthropogenic N2O sources and thus the contribution of biogeochemical processes to N2O growth on the global scale.

Carbon monoxide (CO) and nitrous oxide (N2O) are two key parameters in the observation of the atmosphere, relevant to air quality and climate change, respectively. For CO, various analytical techniques have been in use over the last few decades. In contrast, N2O was mainly measured using gas chromatography (GC) with an electron capture detector (ECD). In recent years, new spectroscopic methods have become available which are suitable for both CO and N2O. These include infrared (IR) spectroscopic techniques such as cavity ring-down spectroscopy (CRDS), off-axis integrated cavity output spectroscopy (OA-ICOS) and Fourier transform infrared spectroscopy (FTIR). Corresponding instruments became recently commercially available and are increasingly used at atmospheric monitoring stations. We analysed results obtained through performance audits conducted within the framework of the Global Atmosphere Watch (GAW) quality management system of the World Meteorology Organization (WMO). These results reveal that current spectroscopic measurement techniques have clear advantages with respect to data quality objectives compared to more traditional methods for measuring CO and N2O. Further, they allow for a smooth continuation of historic CO and N2O time series. However, special care is required concerning potential water vapour interference on the CO amount fraction reported by near-IR CRDS instruments. This is reflected in the results of parallel measurement campaigns, which clearly indicate that drying the sample air leads to an improved accuracy of CO measurements with such near-IR CRDS instruments.

Abundance-based model evaluations with observations provide critical tests for the simulated mean state in models of intercontinental pollution transport, and under certain conditions may also offer constraints on model responses to emission changes. We compile multiyear measurements of peroxy acetyl nitrate (PAN) available from five mountaintop sites and apply them in a proof-of-concept approach that exploits an ensemble of global chemical transport models (HTAP1) to identify an observational emergent constraint. In April, when the signal from anthropogenic emissions on PAN is strongest, simulated PAN at northern midlatitude mountaintops correlates strongly with PAN source–receptor relationships (the response to 20 % reductions in precursor emissions within northern midlatitude continents; hereafter, SRRs). This finding implies that PAN measurements can provide constraints on PAN SRRs by limiting the SRR range to that spanned by the subset of models simulating PAN within the observed range. In some cases, regional anthropogenic volatile organic compound (AVOC) emissions, tracers of transport from different source regions, and SRRs for ozone also correlate with PAN SRRs. Given the large observed interannual variability in the limited available datasets, establishing strong constraints will require matching meteorology in the models to the PAN measurements. Application of this evaluation approach to the chemistry–climate models used to project changes in atmospheric composition will require routine, long-term mountaintop PAN measurements to discern both the climatological SRR signal and its interannual variability.

Until recently, atmospheric carbon dioxide (CO2) and methane (CH4) measurements were made almost exclusively using nondispersive infrared (NDIR) absorption and gas chromatography with flame ionisation detection (GC/FID) techniques, respectively. Recently, commercially available instruments based on spectroscopic techniques such as cavity ring-down spectroscopy (CRDS), off-axis integrated cavity output spectroscopy (OA-ICOS) and Fourier transform infrared (FTIR) spectroscopy have become more widely available and affordable. This resulted in a widespread use of these techniques at many measurement stations. This paper is focused on the comparison between a CRDS "travelling instrument" that has been used during performance audits within the Global Atmosphere Watch (GAW) programme of the World Meteorological Organization (WMO) with instruments incorporating other, more traditional techniques for measuring CO2 and CH4 (NDIR and GC/FID). We demonstrate that CRDS instruments and likely other spectroscopic techniques are suitable for WMO/GAW stations and allow a smooth continuation of historic CO2 and CH4 time series. Moreover, the analysis of the audit results indicates that the spectroscopic techniques have a number of advantages over the traditional methods which will lead to the improved accuracy of atmospheric CO2 and CH4 measurements.

In situ and simultaneous measurement of the three most abundant isotopologues of methane using mid-infrared laser absorption spectroscopy is demonstrated. A field-deployable, autonomous platform is realized by coupling a compact quantum cascade laser absorption spectrometer (QCLAS) to a preconcentration unit, called trace gas extractor (TREX). This unit enhances CH4 mole fractions by a factor of up to 500 above ambient levels and quantitatively separates interfering trace gases such as N2O and CO2. The analytical precision of the QCLAS isotope measurement on the preconcentrated (750 ppm, parts-per-million, µmole mole−1) methane is 0.1 and 0.5 ‰ for δ13C- and δD-CH4 at 10 min averaging time. Based on repeated measurements of compressed air during a 2-week intercomparison campaign, the repeatability of the TREX–QCLAS was determined to be 0.19 and 1.9 ‰ for δ13C and δD-CH4, respectively. In this intercomparison campaign the new in situ technique is compared to isotope-ratio mass spectrometry (IRMS) based on glass flask and bag sampling and real time CH4 isotope analysis by two commercially available laser spectrometers. Both laser-based analyzers were limited to methane mole fraction and δ13C-CH4 analysis, and only one of them, a cavity ring down spectrometer, was capable to deliver meaningful data for the isotopic composition. After correcting for scale offsets, the average difference between TREX–QCLAS data and bag/flask sampling–IRMS values are within the extended WMO compatibility goals of 0.2 and 5 ‰ for δ13C- and δD-CH4, respectively. This also displays the potential to improve the interlaboratory compatibility based on the analysis of a reference air sample with accurately determined isotopic composition.

Traditional techniques for measuring the mole fractions of greenhouse gases in the well-mixed atmosphere have required dry sample gas streams (dew point < −25 °C) to achieve the inter-laboratory compatibility goals set forth by the Global Atmosphere Watch programme of the World Meteorological Organisation (WMO/GAW) for carbon dioxide (±0.1 ppm in the Northern Hemisphere and ±0.05 ppm in the Southern Hemisphere) and methane (±2 ppb). Drying the sample gas to low levels of water vapour can be expensive, time-consuming, and/or problematic, especially at remote sites where access is difficult. Recent advances in optical measurement techniques, in particular cavity ring down spectroscopy, have led to the development of greenhouse gas analysers capable of simultaneous measurements of carbon dioxide, methane and water vapour. Unlike many older technologies, which can suffer from significant uncorrected interference from water vapour, these instruments permit accurate and precise greenhouse gas measurements that can meet the WMO/GAW inter-laboratory compatibility goals (WMO, 2011a) without drying the sample gas. In this paper, we present laboratory methodology for empirically deriving the water vapour correction factors, and we summarise a series of in-situ validation experiments comparing the measurements in humid gas streams to well-characterised dry-gas measurements. By using the manufacturer-supplied correction factors, the dry-mole fraction measurements have been demonstrated to be well within the GAW compatibility goals up to a water vapour concentration of at least 1%. By determining the correction factors for individual instruments once at the start of life, this water vapour concentration range can be extended to at least 2% over the life of the instrument, and if the correction factors are determined periodically over time, the evidence suggests that this range can be extended up to and even above 4% water vapour concentrations.

Long-term time series of the atmospheric composition are essential for environmental research and thus require compatible, multi-decadal monitoring activities. The current data quality objectives of the World Meteorological Organization (WMO) for carbon monoxide (CO) in the atmosphere are very challenging to meet with the measurement techniques that have been used until recently. During the past few years, new spectroscopic techniques came to market with promising properties for trace gas analytics. The current study compares three instruments that have recently become commercially available (since 2011) with the best currently available technique (Vacuum UV Fluorescence) and provides a link to previous comparison studies. The instruments were investigated for their performance regarding repeatability, reproducibility, drift, temperature dependence, water vapour interference and linearity. Finally, all instruments were examined during a short measurement campaign to assess their applicability for long-term field measurements. It could be shown that the new techniques perform considerably better compared to previous techniques, although some issues, such as temperature influence and cross sensitivities, need further attention.

Quasicontinuous measurements of carbon monoxide (CO) recorded over three years at Mount Waliguan (WLG), a global baseline station in remote western China, were examined using back trajectory analysis. The data include a revision to correct the working reference scale to the WMO2000 scale and corrections for drift in the reference gases. Between July 2004 and June 2007, CO exhibited large fluctuations and the 5 %, 50 % and 95 %-percentiles of relevant CO mixing ratios were 102 ppb, 126 ppb and 194 ppb. Approximately 50 % of all observed data were selected as CO background data using a mathematical procedure of robust local regression, with the remainder affected by regional-scale pollution. The monthly mean background CO mixing ratios showed a minimum in summer and a maximum in late winter, although all seasons were affected by short-term enhancements that exceeded background levels. The CO data were compared to values observed at the high alpine research station at Jungfraujoch, Switzerland. Smaller seasonal amplitudes were observed at WLG compared to the Jungfraujoch due to lower winter and spring CO levels, however, episodic enhancements of polluted air were greater at WLG. The air parcels arriving at WLG came predominately from the west, except in summer when advection from the east and southeast prevailed. Transport from the east or southeast typically brought polluted air to the site, having passed over populated urban areas upwind. A large number of elevated CO mixing ratios could also be associated with advection from the northwest of WLG via the central Xinjiang Uygur Autonomous Region (XUAR) and the Ge'ermu urban area where growing industrial activities as well as crops residue burning provide sources of CO. Air masses passing over northwestern Gansu were associated with relatively high CO values suggesting an anthropogenic influence, which was likely due to anthropogenic emissions from northwestern China (based on back-trajectory and potential source contribution analysis and on the INTEX-B: intercontinental Chemical Transport Experiment-Phase B). Background conditions were observed most frequently in air parcels from remote Tibet west of WLG. The probability that air parcels pass over regions of clean or polluted regions was further identified using potential source contribution function (PSCF) analysis.

Despite the importance of carbon monoxide (CO) for the overall oxidative capacity of the atmosphere, there is still considerable uncertainty in ambient measurements of CO. To address this issue, an inter-comparison between four different measurement techniques was made over a period of two months at the high-alpine site Jungfraujoch (JFJ), Switzerland. The measurement techniques were Non-dispersive Infrared Absorption (NDIR), Vacuum UV Resonance Fluorescence (VURF), gas chromatographic separation with a mercuric oxide reduction detector (GC/HgO), and gas chromatographic separation followed by reduction on a nickel catalyst and analysis by a flame ionization detector (GC/FID). The agreement among all techniques was better than 2% for one-hourly averages, which confirmed the suitability of the NDIR method for CO measurements even at remote sites. The inter-comparison added to the validation of the 12-year record (1996–2007) of continuous CO measurements at JFJ. To date this is one of the longest time series of continuous CO measurements in the free troposphere over Central Europe. This data record was further investigated with a focus on trend analysis. A significant negative trend was observed at JFJ showing a decrease of 21.4±0.3% over the investigated period, or an average annual decrease of 1.78%/yr (2.65±0.04 ppb/yr). These results were compared with emission inventory data reported to the Long-range Transboundary Air Pollution (LRTAP) Convention. It could be shown that long range transport significantly influences the CO levels observed at JFJ, with air masses of non-European origin contributing at least one third of the observed mole fractions.

In this study we present the seasonal variability of ozone production efficiencies (EN), defined as the net number of ozone molecules produced per molecule of nitrogen oxides (nitrogen oxide (NO) + nitrogen dioxide (NO2)=NOx) oxidized to NOz (total reactive nitrogen (NOy)–NOx) determined from field measurements of a seven-year period (1998–2004) at the Swiss high-alpine research station Jungfraujoch (JFJ), 3580 m a.s.l. This dataset is a unique long-term data series of nitrogen levels in the free troposphere over Central Europe and hence it offers an excellent opportunity to perform such an analysis and provide further evidence to the photochemical origin of the ozone spring maximum at locations of the northern hemisphere distant from nearby pollution sources. Experimentally derived daily EN values have been selected for 571 days out of the 2557 days from 1998 to 2004, from which an average ozone production efficiency of 18.8±1.3 molecules of O3 produced per molecule of NOx oxidized was calculated. This value indicates the great potential and importance of photochemical ozone production in the free troposphere. The monthly means of experimentally derived daily EN values show a seasonal variation with lower values from May to August, which can be probably attributed to more efficient vertical transport of polluted air masses from the atmospheric boundary layer up to JFJ. In agreement, theoretically derived monthly EN values show similar seasonal variation. The ratio NOy/CO, a parameter to assess the aging process that has occurred in an air parcel, was used as a criterion to disaggregate the 571 selected days between undisturbed and disturbed free tropospheric (FT). The monthly means of experimentally derived EN values for the undisturbed FT conditions show a distinct seasonal cycle with higher values in the cold season from November to April. The EN values for undisturbed FT conditions are particularly higher than the respective monthly EN values for disturbed FT conditions from February to October. It should be noted that the monthly EN values of March (EN=35.8) and April (EN=34.9) are among the highest values throughout the year for undisturbed FT conditions at JFJ. These results highlight the key and possibly the dominant role for photochemistry in the observed build-up of tropospheric ozone in the winter-spring transition period.

An automated, ground-based instrument was used to measure gas-phase hydroperoxides at the Jungfraujoch High Altitude Research Station as part of the Free Tropospheric EXperiment (FREETEX) during February/March 2003. A nebulising reflux concentrator sampled ambient air twice hourly, prior to on-site analysis by HPLC speciation, coupled with post-column peroxidase derivatisation and fluorescence detection. Hydrogen peroxide (H2O2) concentrations reached up to 1330 pptv over the 13-day period with a mean of 183±233 pptv (± one standard deviation). Methyl hydroperoxide (CH3OOH) reached up to 379 pptv with a mean of 51±55 pptv. No other organic hydroperoxides were detected. The lack of an explicit diurnal cycle suggests that hydroperoxide concentrations are chiefly influenced by transport processes rather than local photochemistry at this mountainous site. There was some evidence that elevated concentrations of H2O2 existed in air-masses originating from the south-west, suggesting higher concentrations of HOx due to more active photochemistry. Air which had been recently polluted exhibited low H2O2 concentration due to a combination of suppression of HO2 by NOx and deposition. The concentrations of H2O2 sampled here are consistent with previous box modelling studies of hydroperoxides, except in periods influenced by the boundary layer, where agreement required a depositional sink.

Results of continuous nitrogen oxide (NO), nitrogen dioxide (NO2), peroxyacetyl nitrate (PAN) and total reactive nitrogen (NOy) measurements along with seasonal field campaigns of nitric acid (HNO3) and particulate nitrate (NO3-) measurements are presented for a two-year period at the high-alpine research station Jungfraujoch (JFJ), 3580 m asl. The NOy mixing ratio and partitioning is shown to strongly depend on meteorological conditions. Knowledge of these meteorological transport processes allows discrimination between undisturbed (i.e. clean) and disturbed (i.e. influenced by regional pollution sources) free tropospheric (FT) conditions at the JFJ. Median NOy concentrations during undisturbed FT periods ranged from 350 pptv (winter, December to February) to 581 pptv (spring, March to May). PAN was found to be the dominant NOy species during spring and summer, whereas NO2 was most abundant during autumn and winter. Particulate nitrate was found to contribute significantly to total NOy during thermally induced vertical transport. Föhn events, synoptical lifting (e.g. fronts) and thermally induced vertical transport resulted in mixing ratios up to 10 times higher at the JFJ compared to undisturbed FT conditions. Furthermore this meteorological variability of the NOy concentration and partitioning often dominated the seasonal variability. As a consequence the use of filters at the JFJ (and other mountainous sites) is crucial for the interpretation of data from such measurement sites. This study presents a further development of meteorological filters for the high-alpine site Jungfraujoch, which also could be modified and adapted to other mountainous measurement sites.

Metastatic uveal melanoma (mUM) is a rare type of melanoma with poor outcomes. The first systemic treatment to significantly prolong overall survival (OS) in patients with mUM was tebentafusp, a bispecific protein that can redirect T-cells to gp-100 positive cells. However, the objective response rate according to Response Evaluation Criteria in Solid Tumors (RECIST) may underestimate the clinical impact of tebentafusp. As metabolic response assessed by PET Response Criteria in Solid Tumors (PERCIST) has been reported to better correlate with clinical outcome, we here compared the patterns of radiological and morphological responses in HLA-A*02:01-positive patients with mUM treated with tebentafusp. In the 19 enrolled patients, RECIST showed an overall response rate (ORR) of 10%, median progression-free survival of 2.8 months (95% CI 2.5-8.4), and median OS (mOS) of 18.8 months. In 10 patients, where both RECIST and PERCIST evaluation was available, the ORR was 10% for both; however, the PFS was longer for PERCIST compared to RECIST, 3.1 and 2.4 months, respectively. A poor agreement between the criteria was observed at all assessments (Cohen's kappa ≤0), yet they differed significantly only at the first on-treatment imaging ( P  = 0.037). Elevated baseline LDH and age were associated with an increased risk for RECIST progression, while lymphocyte decrease after the first infusions correlated to reduced risk of RECIST progression. Detectable ctDNA at baseline did not correlate with progression. Early response to tebentafusp may be incompletely captured by conventional imaging, leading to a need to consider both tumor morphology and metabolism., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Risk assessment of pesticide impacts on remote ecosystems makes use of model-estimated degradation in air. Recent studies suggest these degradation rates to be overestimated, questioning current pesticide regulation. Here, we investigated the concentrations of 76 pesticides in Europe at 29 rural, coastal, mountain, and polar sites during the agricultural application season. Overall, 58 pesticides were observed in the European atmosphere. Low spatial variation of 7 pesticides suggests continental-scale atmospheric dispersal. Based on concentrations in free tropospheric air and at Arctic sites, 22 pesticides were identified to be prone to long-range atmospheric transport, which included 15 substances approved for agricultural use in Europe and 7 banned ones. Comparison between concentrations at remote sites and those found at pesticide source areas suggests long atmospheric lifetimes of atrazine, cyprodinil, spiroxamine, tebuconazole, terbuthylazine, and thiacloprid. In general, our findings suggest that atmospheric transport and persistence of pesticides have been underestimated and that their risk assessment needs to be improved.

Background: Targeted therapy (TT) of BRAF V600 mutated unresectable melanoma with inhibitors of the MAPK pathway achieves response rates of up to 76%, but most patients develop secondary resistance. Albeit TT is strikingly efficacious during the first days of treatment, even in advanced cases, long-term survival is highly unlikely, especially in patients with unfavorable baseline characteristics like elevated lactate dehydrogenase (LDH). In patients treated with anti-PD-1 immune checkpoint inhibitors, elevated baseline metastatic growth rate (MGR) was the most important prognostic factor. Here, we aimed at investigating the prognostic impact of MGR in patients with unresectable melanoma receiving TT., Methods: Clinical records of 242 patients with at least one measurable target lesion (TL) receiving TT at seven skin cancer centers were reviewed. Baseline MGR was determined measuring the largest TL at baseline and at one earlier timepoint., Results: Overall survival (OS) and progression-free survival (PFS) were significantly impaired in patients with an MGR > 3.9 mm/month (median OS: 11.4 vs. 35.5 months, P < 0.0001; median PFS: 4.8 vs. 9.2 months, P < 0.0001). Multivariable analysis of OS and PFS revealed that the prognostic impact of elevated MGR was independent of LDH, presence of brain and liver metastases, tumor burden, and line of treatment. The prognostic significance of elevated MGR was highest in patients with normal LDH., Conclusions: Baseline MGR is an important independent prognostic marker for OS and PFS in melanoma patients treated with TT. Its implementation in clinical routine is easy and could facilitate the prognostic stratification., Competing Interests: Declaration of Competing Interest N.B.W. has participated in advisory board meetings for Novartis, Pierre Fabre, and Sanofi, and received speaker fees from Sanofi, outside the submitted work. A.Oe. has received consultant fees from MSD and Bristol-Myers Squibb; has participated in advisory board meetings for MSD and Bristol-Myers Squibb. T.A. received institutional grants from SkylineDx, Neracare, Novartis, Sanofi, and consulting fees from Novartis, Neracare, BMS, CeCaVa and Chemosat, outside the submitted work. A.F. served as a consultant to Novartis, MSD, BMS, Pierre-Fabre and Immunocore; received travel support from Novartis, BMS, Pierre-Fabre, and received speaker fees from Novartis, BMS and MSD and reports institutional research grants from BMS Stiftung Immunonkologie, outside the submitted work. U.L. has received consultancy fees from MSD, Novartis, and Roche; has participated in advisory board meetings for MSD, Novartis, and Roche; has received honoraria from MSD, Novartis, and Roche. P.T. has received honoraria and/or consultancy fees from Bristol-Myers Squibb, Curevac, Merck, MSD, Novartis, Pierre Fabre, Roche, and Sanofi; has received travel support from Bristol-Myers Squibb and Pierre-Fabre. J.M. has received consultancy fees from Merck/Pfizer, MSD, Amgen, Novartis, Bristol-Myers Squibb, and Pierre Fabre; has participated in advisory board meetings for Merck/Pfizer, MSD, Amgen, Novartis, Bristol-Myers Squibb, and Pierre Fabre; has received travel support from Ultrasun, L′Oreal, MSD, Bristol-Myers Squibb, and Pierre Fabre. C.L. has received consultancy fees from, has participated in advisory board meetings for, has received speaker’s fees, and/or has received travel reimbursements from Roche, Pierre Fabre, Novartis, Bristol-Myers Squibb, Merck, MSD, Biontech, Almiral Hermal, Kyowa Kirin, Sun Pharma and Sanofi. C.G. has received personal fees from CeCaVa, MSD, NeraCare and Philogen. F.M. has received speaker’s fees from, has received travel support from, and has participated in advisory board meeting for Novartis, Roche, Bristol-Myers Squibb, MSD and Pierre Fabre; has received research funding from Novartis and Roche. T.K.E. has received consultancy fees from Philogen, Bristol-Myers Squibb, Novartis, Roche, Merck, and Sanofi; has participated in advisory board meetings for CureVac, Philogen, Bristol-Myers Squibb, Novartis, Roche, and Sanofi. L.F. has received grant funding from the Swiss National Science Foundation, Swiss Cancer League, Hookipa Pharma and Novartis Foundation; has participated in advisory board meetings for Novartis and Bristol-Myers Squibb. M.M.L., K.K., L.R., M.F., N.R., R.S., C.Z., C.E., S.K., B.K., W.H., and A.C. have no conflicts of interest to disclose., (Copyright © 2023. Published by Elsevier Ltd.)

This pilot study conducted in Switzerland aims to assess the implementation, execution, and performance of low-dose CT lung cancer screening (LDCT-LCS). With lung cancer being the leading cause of cancer-related deaths in Switzerland, the study seeks to explore the potential impact of screening on reducing mortality rates. However, initiating a lung cancer screening program poses challenges and depends on country-specific factors. This prospective study, initiated in October 2018, enrolled participants meeting the National Lung Cancer Study criteria or a lung cancer risk above 1.5% according to the PLCOm2012 lung cancer risk-model. LDCT scans were assessed using Lung-RADS. Enrollment and follow-up are ongoing. To date, we included 112 participants, with a median age of 62 years (IQR 57-67); 42% were female. The median number of packs smoked each year was 45 (IQR 38-57), and 24% had stopped smoking before enrollment. The mean PLCOm2012 was 3.7% (±2.5%). We diagnosed lung cancer in 3.6% of participants (95%, CI:1.0-12.1%), with various stages, all treated with curative intent. The recall rate for intermediate results (Lung-RADS 3,4a) was 15%. LDCT-LCS in Switzerland, using modified inclusion criteria, is feasible. Further analysis will inform the potential implementation of a comprehensive lung cancer screening program in Switzerland.

Objective: To investigate aspects of image quality, feasibility and patient comfort in dedicated spiral breast computed tomography (B-CT) in a large patient cohort., Methods: This retrospective study was approved by the institutional review board. 2418 B-CT scans from 1222 women examined between 04/16/2019 and 04/13/2022 were analyzed. Patients evaluated their comfort during the examination, radiographers carrying out the scans evaluated the patient's mobility and usability of the B-CT device, whereas radiologists assessed lesion contrast, detectability of calcifications, breast coverage and overall image quality. For semi-quantitative assessment, a Likert-Scale was used and statistical significance and correlations were calculated using ANOVAs and Spearman tests., Results: Comfort, mobility and usability of the B-CT were rated each with either "no" or "negligible" complaints in >99%. Image quality was rated with "no" or "negligible complaints" in 96.7%. Lesion contrast and detectability of calcifications were rated either "optimal" or "good" in 92.6% and 98.4%. "Complete" and "almost complete" breast coverage were reported in 41.9%, while the pectoral muscle was found not to be covered in 56.0%. Major parts of the breast were not covered in 2.1%. Some variables were significantly correlated, such as age with comfort (ρ = -0.168, p < .001) and mobility (ρ = -0.172, p < .001) as well as patient weight with lesion contrast (ρ = 0.172, p < .001) and breast coverage (ρ = -0.109, p < .001)., Conclusions: B-CT provides high image quality and contrast of soft tissue lesions as well as calcifications, while covering the pre-pectoral areas of the breast remains challenging. B-CT is easy to operate for the radiographer and comfortable for the majority of women., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to evaluate the diagnostic performance of the maximum intensity projection (MIP) reformations of breast computed tomography (B-CT) images as a stand-alone method for the detection and characterization of breast imaging findings., Materials and Methods: A total of 160 women undergoing B-CT between August 2018 and December 2020 were retrospectively included; 80 patients with known breast imaging findings were matched with 80 patients without imaging findings according to age and amount of fibroglandular tissue (FGT). A total of 71 benign and 9 malignant lesions were included. Images were evaluated using 15-mm MIP in 3 planes by 2 radiologists with experience in B-CT. The presence of lesions and FGT were evaluated, using the BI-RADS classification. Interreader agreement and descriptive statistics were calculated., Results: The interreader agreement of the 2 readers for finding a lesion (benign or malignant) was 0.86 and for rating according to BI-RADS classification was 0.82. One of 9 cancers (11.1%) was missed by both readers due to dense breast tissue. BI-RADS 1 was correctly applied to 73 of 80 patients (91.3%) by reader 1 and to 74 of 80 patients (92.5%) by reader 2 without recognizable lesions. BI-RADS 2 or higher with a lesion in at least one of the breasts was correctly applied in 69 of 80 patients (86.3%) by both readers. For finding a malignant lesion, sensitivity was 88.9% (95% confidence interval [CI], 51.75%-99.72%) for both readers, and specificity was 99.3% (95% CI, 96.4%-100%) for reader 1 and 100% (95% CI, 97.20%-100.00%) for reader 2., Conclusions: Evaluation of B-CT images using the MIP reformations may help to reduce the reading time with high diagnostic performance and confidence., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Checkpoint inhibitors revolutionized the treatment of metastatic melanoma patients. Although tumor burden and lactate dehydrogenase (LDH) are associated with overall survival (OS), the impact of tumor growth kinetics remains elusive and in part contradictory. The aims of this study were to develop a novel simple and rapid method that estimates pretreatment metastatic growth rate (MGR) and to investigate its prognostic impact in melanoma patients treated with antiprogrammed death receptor-1 (PD-1) antibodies., Methods: MGR was assessed in three independent cohorts of a total of 337 unselected consecutive metastasized stage IIIB-IV melanoma patients (discovery cohort: n=53, confirmation cohort: n=126, independent multicenter validation cohort: n=158). MGR was computed during the pretreatment period before initiation of therapy with anti-PD-1 antibodies nivolumab or pembrolizumab by measuring the increase of the longest diameter of the largest target lesion. Tumor doubling time served as quality control. Kaplan-Meier analysis and univariable as well as multivariable Cox regression were used to examine the prognostic impact of MGR., Results: Pretreatment MGR >3.9 mm/month was associated with impaired OS in the discovery cohort (HR 6.19, 95% CI 2.92 to 13.10, p<0.0001), in the confirmation cohort (HR 3.62, 95% CI 2.19 to 5.98, p<0.0001) and in the independent validation cohort (HR 2.57, 95% CI 1.56 to 4.25, p=0.00023). Prior lines of systemic treatment did not influence the significance of MGR. Importantly, the prognostic impact of MGR was independent of total tumor burden, diameter of the largest metastasis, number of prior lines of systemic treatment, LDH, as well as liver and brain metastasis (discovery and confirmation cohorts: both p<0.0001). Superiority of MGR compared with these variables was confirmed in the independent multicenter validation cohort (HR 2.92, 95% CI 1.62 to 5.26, p=0.00036)., Conclusions: High pretreatment MGR is an independent strong prognostic biomarker associated with unfavorable survival of melanoma patients receiving anti-PD-1 antibodies. Further investigations are warranted to assess the predictive impact of MGR in distinct systemic therapeutic regimens., Competing Interests: Competing interests: NBW reports a consulting/advisory role for Sanofi and has received travel support from AbbVie and Amgen outside the submitted work. RL has received research funding from Bristol-Myers Squibb, Pierre Fabre and Roche, honoraria and travel support from Merck Sharp & Dohme and travel support from Amgen. AO is a consultant/advisory board member for MSD and Bristol-Myers Squibb. AF has received speaker’s honoraria from Bristol-Myers Squibb, MSD, Roche, and Novartis, is advisory board member for Roche and Novartis and received travel support from Roche, Novartis, and Bristol-Myers Squibb. UL is a consultant/advisory board member for and has received honoraria from MSD, Novartis, and Roche. MG is an advisory board member of Novartis and has received grants from Novartis outside the submitted work. CB has received speaker's honoraria and consultancy fees from Amgen, Bristol-Myers Squibb, Merck, MSD, Novartis, Pierre Fabre, Regeneron, Roche, and Sanofi-Aventis outside the submitted work, and has received travel support from Bristol-Myers Squibb. ER has received honoraria from and has a consultancy or advisory role for Amgen, Bayer, Bristol-Myers Squibb, MSD, Merck, Novartis, Pierre Fabre, Roche and Sanofi, reports speakers' bureau for Amgen, Bristol-Myers Squibb, MSD, Merck, Novartis, Pierre Fabre and Sanofi, received research funding (at the institution) from Amgen, Bristol-Myers Squibb, MSD, Novartis, Pierre Fabre and Roche, is a member of the research funding steering committee of Novartis, and received travel accommodations and/or expenses from Amgen, Bristol-Myers Squibb, MSD, Merck, Novartis, Pierre Fabre, Roche and Sanofi. JM has intermittent project focused consultant or advisory relationships with Merck/Pfizer, Merck Sharp & Dohme, Amgen, Novartis, Bristol-Myers Squibb and Pierre Fabre, and has received travel support from Ultrasun, L’Oreal, Merck Sharp & Dohme, Bristol-Myers Squibb and Pierre Fabre outside of the submitted work. PT has received honoraria and/or consultancy fees from Bristol-Myers Squibb, Curevac, Merck, MSD, Novartis, Pierre Fabre, Roche, and Sanofi outside the submitted work, and has received travel support from Bristol-Myers Squibb and Pierre-Fabre. CL is a consultant/advisory board member for and has received advisory board fees, speaker's fees and/or travel reimbursements from Roche, Pierre Fabre, Novartis, Bristol-Myers Squibb, Merck, MSD, Biontech, Almiral Hermal, Kyowa Kirin, Sun Pharma and Sanofi. VAN has received speaker’s honoraria and consultancy fees from Amgen, Bristol-Myers Squibb, GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Roche, and Takeda outside of the submitted work. CGe has received personal speaker/advisory board fees from Amgen, Beiersdorf, BMS, MSD, Novartis, Pierre Fabre, Roche, Sun Pharma and Sanofi Genzyme. FM has received travel support or/and speaker’s fees or/and advisor’s honoraria by Novartis, Roche, BMS, MSD and Pierre Fabre, and research funding from Novartis and Roche. SD has received travel support from MSD. AC has received consultancy fees from AbbVie, BMS, Almirall, Amgen, Eli Lilly, Galderma, Janssen, Kyowa Kirin, Leo, Novartis, and Sanofi. LF reports grants from the Swiss National Science Foundation, Swiss Cancer League, Hookipa Pharma and Novartis Foundation as well as an advisory role for Novartis and Bristol-Myers Squibb. CGa has received grants and personal fees from Bristol-Myers Squibb, Roche, Novartis and personal fees from Amgen, MSD and Philogen outside the submitted work. TE is a consultant/advisory board member for Philogen, Bristol-Myers Squibb, Novartis, Roche and Sanofi. No other disclosures were reported., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Brown adipose tissue (BAT) is a specialized form of adipose tissue, able to increase energy expenditure by heat generation in response to various stimuli. Recently, its pathological activation has been implicated in the pathogenesis of cancer cachexia. To establish a causal relationship, we retrospectively investigated the longitudinal changes in BAT and cancer in a large FDG-PET/CT cohort., Methods: We retrospectively analyzed 13 461 FDG-PET/CT examinations of n = 8 409 patients at our institution from the winter months of 2007-2015. We graded the activation strength of BAT based on the anatomical location of the most caudally activated BAT depot into three tiers, and the stage of the cancer into five general grades. We validated the cancer grading by an interreader analysis and correlation with histopathological stage. Ambient temperature data (seven-day average before the examination) was obtained from a meteorological station close to the hospital. Changes of BAT, cancer, body mass index (BMI) and temperature between the different examinations were examined with Spearman's test and a mixed linear model for correlation, and with a causal inference algorithm for causality., Results: We found n = 283 patients with at least two examinations and active BAT in at least one of them. There was no significant interaction between the changes in BAT activation, cancer burden or BMI. Temperature changes exhibited a strong negative correlation with BAT activity (ϱ = -0.57, p<0.00001). These results were confirmed with the mixed linear model. Causal inference revealed a link of Temperature ➜ BAT in all subjects and also of BMI ➜ BAT in subjects who had lost weight and increased cancer burden, but no role of cancer and no causal links of BAT ➜ BMI., Conclusions: Our data did not confirm the hypothesis that BAT plays a major role in cancer-mediated weight loss. Temperature changes are the main driver of incidental BAT activity on FDG-PET scans., Competing Interests: The authors have declared that no competing interests exist.

Recent research focusing on brown adipose tissue (BAT) function emphasizes its importance in systemic metabolic homeostasis. We show here that genetic and pharmacological inhibition of the mevalonate pathway leads to reduced human and mouse brown adipocyte function in vitro and impaired adipose tissue browning in vivo. A retrospective analysis of a large patient cohort suggests an inverse correlation between statin use and active BAT in humans, while we show in a prospective clinical trial that fluvastatin reduces thermogenic gene expression in human BAT. We identify geranylgeranyl pyrophosphate as the key mevalonate pathway intermediate driving adipocyte browning in vitro and in vivo, whose effects are mediated by geranylgeranyltransferases (GGTases), enzymes catalyzing geranylgeranylation of small GTP-binding proteins, thereby regulating YAP1/TAZ signaling through F-actin modulation. Conversely, adipocyte-specific ablation of GGTase I leads to impaired adipocyte browning, reduced energy expenditure, and glucose intolerance under obesogenic conditions, highlighting the importance of this pathway in modulating brown adipocyte functionality and systemic metabolism., (Copyright © 2018 Elsevier Inc. All rights reserved.)