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Ozone depletion over the polar regions is monitored each year by satellite and ground-based instruments. In this study, the vortex-averaged ozone loss over the last three decades is evaluated for both polar regions using the passive ozone tracer of the chemical transport model TOMCAT/SLIMCAT and total ozone observations from Système d'Analyse par Observation Zénithale (SAOZ) ground-based instruments and Multi-Sensor Reanalysis (MSR2). The passive tracer method allows us to determine the evolution of the daily rate of column ozone destruction, and the magnitude of the cumulative loss at the end of the winter. Three metrics are used to estimate the linear trend since 2000 and to assess the current situation of ozone recovery over both polar regions: 1) The maximum ozone loss at the end of the winter; 2) the onset day of ozone loss at a specific threshold and 3) the ozone loss residuals computed from the differences between annual ozone loss and ozone loss values regressed with respect to sunlit volume of polar stratospheric clouds (VPSC). This latter metric is based on linear and parabolic regressions for ozone loss in the Northern and Southern Hemispheres, respectively. In the Antarctic, metrics 1, and 3, yield trends of -2.3 and -1.8 % dec-1 for the 2000–2021 period, significant at 1 and 2 standard error (σ), respectively. For metric 2, various thresholds were considered, all of them showing a time delay for when they are reached. The trends are significant at the 2σ level and vary from 3.5 to 4.2 day dec-1 between the various thresholds. In the Arctic, metric 1 exhibits large interannual variability and no significant trend is detected; this result is highly influenced by the record ozone losses in 2011 and 2020. Metric 2 is not applied in the Northern Hemisphere due to the difficulty of finding a threshold value in a consistent number of winters. Metric 3 shows a negative trend in Arctic ozone loss residuals of -1.7 ±1 % dec-1, significant at 1σ level. This is therefore the first quantitative detection of ozone recovery in the Arctic springtime lower stratosphere.

After the decrease of ozone-depleting substances (ODSs) as a consequence of the Montreal Protocol, it is still challenging to detect a recovery in the total column amount of ozone (total ozone) at northern high latitudes. To assess regional total ozone changes in the “ozone-recovery” period (2000–2020) at northern high latitudes, this study investigates trends from ground-based total ozone measurements at three stations in Norway (Oslo, Andøya, and Ny-Ålesund). For this purpose, we combine measurements from Brewer spectrophotometers, ground-based UV filter radiometers (GUVs), and a SAOZ (Système d'Analyse par Observation Zénithale) instrument. The Brewer measurements have been extended to work under cloudy conditions using the global irradiance (GI) technique, which is also presented in this study. We derive trends from the combined ground-based time series with the multiple linear regression model from the Long-term Ozone Trends and Uncertainties in the Stratosphere (LOTUS) project. We evaluate various predictors in the regression model and found that tropopause pressure and lower-stratospheric temperature contribute most to ozone variability at the three stations. We report significantly positive annual trends at Andøya (0.9±0.7 % per decade) and Ny-Ålesund (1.5±0.1 % per decade) and no significant annual trend at Oslo (0.1±0.5 % per decade) but significantly positive trends in autumn at all stations. Finally we found positive but insignificant trends of around 3 % per decade in March at all three stations, which may be an indication of Arctic springtime ozone recovery. Our results contribute to a better understanding of regional total ozone trends at northern high latitudes, which is essential to assess how Arctic ozone responds to changes in ODSs and to climate change.

Objective: Antibiotics are largely overprescribed for acute rhinosinusitis in primary care, mainly due to the lack of diagnostic tests to confirm or rule out bacterial infection. The study objective was to assess the on-site applicability and safety of the newly developed JGG endoscope® for the diagnosis of acute bacterial rhinosinusitis in primary care. Design: Five Swiss primary care centres and one university-affiliated ENT unit participated in this single-arm pilot study. Participants: Adults with acute suspected bacterial rhinosinusitis. The newly developed JGG endoscope®, which is attached to a pocket otoscope, was used to inspect after local anaesthesia the nasal cavity and middle meatus and to gain material for bacterial culture from paranasal sinuses draining ostium. Main outcome measures: Applicability and safety. Results: The visualisation of the middle meatus was successful in 16 of 21 patients (13 in both sides and three in one side), and unclear or unsuccessful in five patients. Sample collection from the middle meatus was successful in 10 patients (six on both and four on one side) and unclear or unsuccessful in the remaining patients. Only one culture-confirmed bacterial rhinosinusitis and 11 PCR-confirmed viral infections were identified from collected samples. After a 2-week follow-up, no serious adverse events were observed. Conclusions: The on-site use of the JGG endoscope® in daily primary care routine is feasible and safe and was well accepted by the trial physicians and patients (assessed with structured questionnaires). The JGG endoscope® may support general practitioners to differentiate between bacterial and viral rhinosinusitis.

This paper reports on consolidated ground-based validation results of the atmospheric NO2 data produced operationally since April 2018 by the TROPOspheric Monitoring Instrument (TROPOMI) on board of the ESA/EU Copernicus Sentinel-5 Precursor (S5P) satellite. Tropospheric, stratospheric, and total NO2 column data from S5P are compared to correlative measurements collected from, respectively, 19 Multi-Axis Differential Optical Absorption Spectroscopy (MAX-DOAS), 26 Network for the Detection of Atmospheric Composition Change (NDACC) Zenith-Scattered-Light DOAS (ZSL-DOAS), and 25 Pandonia Global Network (PGN)/Pandora instruments distributed globally. The validation methodology gives special care to minimizing mismatch errors due to imperfect spatio-temporal co-location of the satellite and correlative data, e.g. by using tailored observation operators to account for differences in smoothing and in sampling of atmospheric structures and variability and photochemical modelling to reduce diurnal cycle effects. Compared to the ground-based measurements, S5P data show, on average, (i) a negative bias for the tropospheric column data, of typically −23 % to −37 % in clean to slightly polluted conditions but reaching values as high as −51 % over highly polluted areas; (ii) a slight negative median difference for the stratospheric column data, of about −0.2 Pmolec cm−2, i.e. approx. −2 % in summer to −15 % in winter; and (iii) a bias ranging from zero to −50 % for the total column data, found to depend on the amplitude of the total NO2 column, with small to slightly positive bias values for columns below 6 Pmolec cm−2 and negative values above. The dispersion between S5P and correlative measurements contains mostly random components, which remain within mission requirements for the stratospheric column data (0.5 Pmolec cm−2) but exceed those for the tropospheric column data (0.7 Pmolec cm−2). While a part of the biases and dispersion may be due to representativeness differences such as different area averaging and measurement times, it is known that errors in the S5P tropospheric columns exist due to shortcomings in the (horizontally coarse) a priori profile representation in the TM5-MP chemical transport model used in the S5P retrieval and, to a lesser extent, to the treatment of cloud effects and aerosols. Although considerable differences (up to 2 Pmolec cm−2 and more) are observed at single ground-pixel level, the near-real-time (NRTI) and offline (OFFL) versions of the S5P NO2 operational data processor provide similar NO2 column values and validation results when globally averaged, with the NRTI values being on average 0.79 % larger than the OFFL values.

The amplitude and rate of ozone depletion in the Arctic is monitored every year since 1994 by comparison between SAOZ UV-Vis ground-based network from NDACC and Multi-Sensor Reanalysis 2 (MSR-2) total ozone measurements over 8 stations in the Arctic and 3-D chemical transport model simulations in which ozone is considered as a passive tracer. The passive ozone method allows determining the cumulative loss at the end of the winter. The amplitude of the destruction varies between 0-10% in relatively warm and short vortex duration years to 25-38% in colder and longer ones, which the record winters estimated in 2010/2011 and 2019/2020.In this study, the interannual variability of 10-days average rate of 2021/2022 winter will be analyzed and compared to previous years. In addition, SAOZ NO2 data will be used to evaluate re-noxification in the Arctic. The long-term ozone loss series estimated from measurements will be compared to REPROBUS and SLIMCAT CTM simulations. Relationship with illuminated Polar Stratospheric Clouds will be also presented.

Even though ozone-depleting substances have been substantially reduced due to the Montreal Protocol, it is still not possible to state with confidence that the total column amount of ozone (total ozone) recovers globally. A special focus lies on high latitudes, as they experienced strong stratospheric ozone depletion in the 1980s and 1990s. Especially at northern high latitudes, it is still challenging to detect significant total ozone trends. It is therefore important to use carefully homogenized and stable long-term ozone measurements and advanced trend models to derive ozone trends at northern high latitudes.This study uses ground-based total ozone measurements in Norway and the Arctic to investigate total ozone trends at northern high latitudes. We present combined total ozone time series from Brewer Spectrophotometers at Oslo (60°N) and Andøya (69°N) in Norway, from 2000 to 2020. In addition, measurements from a SAOZ instrument and a Brewer at Ny-Ålesund in Svalbard are used. The combined Brewer time series consist of direct sun (DS) and global irradiance (GI) Brewer measurements and are complemented with measurements from ground-based ultraviolet radiometers (GUV). This makes it possible to obtain measurements during cloudy conditions and in winter and spring, where DS measurements cannot be retrieved due to large solar zenith angles and reduced direct sunlight.We present total ozone trends at the three measurement stations using the LOTUS (Long-term Ozone Trends and Uncertainties in the Stratosphere) multilinear regression model. We test various explanatory variables and select a set of predictors to obtain the best possible regression fit. We found that besides the commonly used predictors QBO, ENSO, and solar cycle, tropopause pressure and stratospheric temperature are also important to improve the fit. We finally present annual total ozone trends and trends for different months at each station. Despite that the annual trends were generally found to be insignificant, we detected significant trends in some months.We believe that our study contributes to a better understanding of long-term ozone changes at northern high latitudes, which is essential to assess how Arctic ozone responds to changes in ozone depleting substances and to climate change.

The Zeppelin Observatory (78.90° N, 11.88° E) is located on the Zeppelin Mountain at 472 m above sea level on Spitsbergen, the largest island of the Svalbard archipelago. Established in 1989, the observatory is part of the “Ny-Ålesund Research Station” and an important atmospheric measurement site, one of only a few in the high Arctic and as a part of several European and global monitoring programs and research infrastructures, notably the European Monitoring and Evaluation Programme (EMEP), the Arctic Monitoring and Assessment Programme (AMAP), the Global Atmosphere Watch (GAW), the Aerosols, Clouds, and Trace gases Research InfraStructure (ACTRIS), the Advanced Global Atmospheric Gases Experiment (AGAGE) network, and the Integrated Carbon Observation System (ICOS). The observatory is jointly operated by the Norwegian Polar Institute (NPI), Stockholm University and the Norwegian Institute for Air Research (NILU). Here we detail the establishment of the Zeppelin Observatory including historical measurements of atmospheric composition in the European Arctic leading to its construction. We present a history of the measurements at the observatory and review the current state of the European Arctic atmosphere, including results from trends in greenhouse gases, chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs), other traces gases, persistent organic pollutants (POPs) and heavy metals, aerosols and Arctic haze, and atmospheric transport phenomena.

Ozone depletion over Polar Regions is monitored each year by satellite and ground-based instruments. The first signs of healing of the ozone layer linked to the decrease of ozone destructive substances (ODSs) were observed in Antarctica using different metrics (ozone mean values, ozone mass deficit, area of the ozone hole) and simple or sophisticated models. Chemistry climate models predict that climate change will not affect expected ozone recovery over Antarctica but will accelerate recovery in the Arctic due to the possible enhancement of the Brewer Dobson circulation. However, ozone loss observations by SAOZ UV-Vis spectrometers do not show a clear sign of recovery in the latter region. In addition, a record of 38% ozone loss in 2010/2011 and 2019/2020 was estimated.In this study, the vortex-averaged ozone loss in the last three decades will be evaluated for both Polar Regions using the passive ozone tracer of two chemical transport models (REPROBUS and SLIMCAT CTMs) and total ozone observations from SAOZ and satellite observations (IASI/METOP and Multi-Sensor Reanalysis (MSR-2)).The tracer method allows us to determine the evolution of the daily rate of ozone destruction, and the amplitude of the cumulative loss at the end of the winter. The cumulative ozone destruction in the Artic varies between 0-10% in relatively warm winters with short vortex duration to up to 25-38% in colder winters with longer vortex persistence, while in Antarctica it is mostly stable, around 50%.Interannual variability of 10-days average rate will be analyzed and compared between both hemispheres as well as the timing to reach different thresholds of absolute ozone loss values. Finally, linear trend of ozone loss and temperature since 2000 will be estimated in both Polar Regions in order to evaluate possible ozone recovery.

The amplitude of ozone depletion in the Arctic is monitored every year since 1990 by comparison between total ozone measurements of SAOZ / NDACC UV-Vis spectrometers deployed in the Arctic and 3-D chemical transport model simulations in which ozone is considered as a passive tracer.When SAOZ measurements are missing for various reasons, lack of sunlight, station closed or instrument failure, they are replaced since 2017 by IASI/Metop overpasses above the station. These measurements in the thermal Infrared are available all year around, at all latitudes even in the polar night. IASI data have been compared to SAOZ and to 3-D CTM REPROBUS and the agreement is better than 3% at the latitude of the polar circle.The method allows determining the evolution of the daily rate of the ozone destruction and the amplitude of the cumulative loss at the end of the winter. The amplitude of the destruction varies between 0-10% in relatively warm and short vortex duration years up to 25-39% in colder and longer ones.Since a strong and large vortex centred at the North Pole, PSCs and activated chlorine are still present at all levels in the lower stratosphere on January 9, 2020, there is a good probability that a significant O3 loss may happen in 2020. But since, as shown by the unprecedented depletion of 39% in 2010/11, the loss depends on the vortex duration, strength and possible re-noxification, it is difficult to predict in advance the amplitude of the cumulative loss at the end of the winter.Shown in this presentation will be the evolution of ozone loss and re-noxification in the Arctic vortex during the winter 2019/20 compared to previous winters and REPROBUS and SLIMCAT CTM simulations.

Objectives The number of dinucleotide repeats (GT) n modulate expression of heme oxygenase 1 ( HMOX1 ), a stress response gene. Multiple repeats might affect chronic obstructive pulmonary disease (COPD) susceptibility. We aimed to investigate the association of this polymorphism with COPD and its interaction with occupational exposures (vapor, gas, dust, or fumes). Methods This population-based cross-sectional study included 4703 Danes, aged 45–84 years. HMOX1 (GT) n was genotyped and grouped as short: ≤26, medium: 27–32 and long: ≥33 alleles. COPD was defined by the lower limit of normal (2.5 th FEV 1 /FVC and FEV 1 centiles). Occupational exposure was defined as ever exposed to vapor, gas, dust, or fume in expert-selected jobs. Associations were analyzed by adjusted mixed logistic regression. Results The population included 6% with COPD, 48% who had smoked ≥10 pack-years, and 46% with occupational exposure. HMOX1 was genotyped in 4423 participants. The adjusted odds ratio (OR) for the association between HMOX1 long allele and COPD was 1.75 [95% confidence interval (CI) 1.18–2.60]. An interaction was evident between HMOX1 long allele and occupational exposure, OR 2.38 (95% CI 1.04–5.46), versus HMOX1 short/medium without exposure. Analyses were replicated in another cohort, aged 20–44 years, N=1168, including 3% with COPD, 25% who had smoked ≥10 pack-years and 20% with occupational exposure. No associations were seen between COPD and HMOX1 long allele here. Conclusions Long alleles in HMOX1 alone and in interaction with occupational exposure seem to be associated with COPD. Failure to replicate data may be due to premature age for COPD development and low occupational exposure prevalence. We propose this long allele may be a genetic contributor to the COPD pathogenesis.

Combining information from several channels of the Norwegian Institute for Air Research (NILU-UV) irradiance meter, one may determine the total ozone column (TOC) amount. A NILU-UV instrument has been deployed and operated on two locations at Troll research station in Jutulsessen, Queen Maud Land, Antarctica, for several years. The method used to determine the TOC amount is presented, and the derived TOC values are compared with those obtained from the Ozone Monitoring Instrument (OMI) located on NASA’s AURA satellite. The findings show that the NILU-UV TOC amounts correlate well with the results of the OMI and that the NILU-UV instruments are suitable for monitoring the long-term change and development of the ozone hole. Because of the large footprint of OMI, NILU-UV is a more suitable instrument for local measurements. © 2020 Optical Society of America. Users may use, reuse, and build upon the article, or use the article for text or data mining, so long as such uses are for non-commercial purposes and appropriate attribution is maintained. All other rights are reserved

Ozone vertical profiles derived from nadir measurements of the GOME instrument on board the ERS-2 satellite, by means of the FURM algorithm of the University of Bremen, are validated against measurements with the stratospheric ozone lidar at the ALOMAR facility in North-Norway. A set of 43 measurements, taken in the period August 1996 to September 1999 with a maximum distance between the ground-based site and the GOME pixel centre of 650 km, is used. The comparison shows a satisfactory agreement within less than ± 7% in the altitude range 15 to 30 km, independent of the season of the year. At lower altitudes, average deviations of the GOME profiles from lidar measurements of up to - 15% occur in spring, the reason for which has to be found in the FURM algorithm, while the agreement is within ± 5% in both winter and summer/autumn months. At altitudes above 30 km, significant seasonally varying discrepancies occur, being largest in winter ( - 40% on average at 40 km altitude) and smallest in summer (less than - 10%). The source of these deviations is most likely related to a radiance and irradiance calibration problem in the GOME data below 300 nm, which are used to derive ozone at the highest altitudes. The validation also shows that it is very important to choose the right ozone climatology for initialisation. Satisfactory results in spring 1997, when the polar stratospheric vortex was very stable, are only achieved, if a winter (vortex) profile is used.Key words. Atmospheric composition and structure (middle atmosphere-composition and chemistry; instruments and techniques; general or miscellaneous)

BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification separates the spirometric 1-4 staging from the ABCD groups defined by symptoms and exacerbations. Little is known about how this new classification predicts mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to establish the predictive ability of the GOLD 2017 classification, compared with earlier classifications, for all-cause and respiratory mortality, both when using its main ABCD groups and when further subdividing according to spirometric 1-4 staging.METHODS: In this nationwide cohort study, we enrolled patients with COPD with data available in the Danish registry for COPD. To be included in this registry, individuals must have been outpatients in hospital-based pulmonary clinics in Denmark. Eligible patients were aged 30 years or older; had received a primary diagnosis of COPD (International Classification of Diseases [ICD]-10 J44.X) or acute respiratory failure (ICD-10 J96.X) in combination with COPD (ICD-10 J44.X) as a secondary diagnosis; and had complete data on FEV1, body-mass index, modified Medical Research Council dyspnoea scale score, and smoking status. We categorised eligible patients with complete data according to the 2007, 2011, and 2017 GOLD classifications at the first contact with an outpatient clinic. For the GOLD 2017 classification, we further subdivided the patients by spirometry into 16 subgroups (1A to 4D). We calculated adjusted hazard ratios (HRs) for all-cause and respiratory mortality and compared the predictive ability of the three GOLD classifications (2007, 2011, and 2017) using receiver operating curves.FINDINGS: We enrolled 33 765 patients with COPD, who were outpatients in Danish hospitals between Jan 1, 2008, and Nov 30, 2013, in the main cohort assessed for all-cause mortality. 22 621 of these patients had data available on cause-specific mortality (respiratory) and were included in a subcohort followed from Jan 1, 2008, to Dec 31, 2011. For the GOLD 2017 classification, 3 year mortality increased with increasing exacerbations and dyspnoea from group A (all-cause mortality 10·0%, respiratory mortality 3·0%) to group D (all-cause mortality 36·9%, respiratory mortality 18·0%). However, 3 year mortality was higher for group B patients (all-cause mortality 23·8%, respiratory mortality 9·7%) than for group C patients (all-cause mortality 17·4%, respiratory mortality 6·4%). Compared with group A, adjusted HRs for all-cause mortality ranged from 2·05 (95% CI 1·87-2·26) for group B, to 1·47 (1·31-1·65) for group C, and to 3·01 (2·75-3·30) for group D. Area under the curve for all-cause mortality was 0·61 (95% CI 0·60-0·61) for GOLD 2007, 0·61 (0·60-0·62) for GOLD 2011, and 0·63 (0·53-0·73) for GOLD 2017. Area under the curve for respiratory mortality was 0·64 (0·62-0·65) for GOLD 2007, 0·63 (0·62-0·64) for GOLD 2011, and 0·65 (0·53-0·78) for GOLD 2017. The GOLD 2017 classification based on ABCD groups only did not predict mortality better than the earlier 2007 and 2011 GOLD classifications. However, when 16 subgroups (1A to 4D) were defined, the new classification predicted mortality more accurately than the previous systems (pINTERPRETATION: We showed that the new GOLD 2017 ABCD classification does not predict all-cause and respiratory mortality more accurately than the previous GOLD systems from 2007 and 2011.FUNDING: Danish Lung Association, Program for Clinical Research Infrastructure.

International audience; After the well-reported record loss of Arctic stratospheric ozone of up to 38% in the winter 2010–2011, further large depletion of 27% occurred in the winter 2015–2016. Record low winter polar vortex temperatures, below the threshold for ice polar stratospheric cloud (PSC) formation, persisted for one month in January 2016. This is the first observation of such an event and resulted in unprecedented dehydration/denitrification of the polar vortex. Although chemistry–climate models (CCMs) generally predict further cooling of the lower stratosphere with the increasing atmospheric concentrations of greenhouse gases (GHGs), significant differences are found between model results indicating relatively large uncertainties in the predictions. The link between stratospheric temperature and ozone loss is well understood and the observed relationship is well captured by chemical transport models (CTMs). However, the strong dynamical variability in the Arctic means that large ozone depletion events like those of 2010–2011 and 2015–2016 may still occur until the concentrations of ozone-depleting substances return to their 1960 values. It is thus likely that the stratospheric ozone recovery, currently anticipated for the mid-2030s, might be significantly delayed. Most important in order to predict the future evolution of Arctic ozone and to reduce the uncertainty of the timing for its recovery is to ensure continuation of high-quality ground-based and satellite ozone observations with special focus on monitoring the annual ozone loss during the Arctic winter.

Extreme winter events that damage vegetation are considered an important climatic cause of arctic browning-a reversal of the greening trend of the region-and possibly reduce the carbon uptake of northern ecosystems. Confirmation of a reduction in CO2 uptake due to winter damage, however, remains elusive due to a lack of flux measurements from affected ecosystems. In this study, we report eddy covariance fluxes of CO2 from a peatland in northern Norway and show that vegetation CO2 uptake was delayed and reduced in the summer of 2014 following an extreme winter event earlier that year. Strong frost in the absence of a protective snow cover-its combined intensity unprecedented in the local climate record-caused severe dieback of the dwarf shrub species Calluna vulgaris and Empetrum nigrum. Similar vegetation damage was reported at the time along similar to 1000 km of coastal Norway, showing the widespread impact of this event. Our results indicate that gross primary production (GPP) exhibited a delayed response to temperature following snowmelt. From snowmelt up to the peak of summer, this reduced carbon uptake by 14 (0-24) g Cm-2 (similar to 12% of GPP in that period)-similar to the effect of interannual variations in summer weather. Concurrently, remotely-sensed NDVI dropped to the lowest level in more than a decade. However, bulk photosynthesis was eventually stimulated by the warm and sunny summer, raising total GPP. Species other than the vulnerable shrubs were probably resilient to the extreme winter event. The warm summer also increased ecosystem respiration, which limited net carbon uptake. This study shows that damage from a single extreme winter event can have an ecosystem-wide impact on CO2 uptake, and highlights the importance of including winter-induced shrub damage in terrestrial ecosystem models to accurately predict trends in vegetation productivity and carbon sequestration in the Arctic and sub-Arctic.

The vertical features of the variations in the atmospheric ozone density, temperature and wind velocity observed at Ny-Alesund, Svalbard were studied by applying the principal component analysis to the ozonesounding data collected during the 1992–2016 period. Two data sets corresponding to intra-seasonal (IS) variations, which are composed by harmonics with lower than 1 year periods and inter-annual (IA) variations, characterised by larger periods, were extracted and analysed separately. The IS variations in all the three parameters were found to be composed mainly by harmonics typical for the Madden-Julian Oscillation (from 30- to 60-day periods) and, while the first four principal components (PCs) associated with the temperature and wind contributed about 90% to the IS variations, the ozone IS oscillations appeared to be a higher dimensional object for which the first 15 PCs presented almost the same extent of contribution. The IA variations in the three parameters were consisted of harmonics that correspond to widely registered over the globe Quasi-Biennial, El Nino-Southern, North Atlantic and Arctic Oscillations respectively, and the IA variations turned out to be negligible below the tropopause that characterises the Svalbard troposphere as comparatively closed system with respect to the long-period global variations. The behaviour of the first and second PCs associated with IS ozone variations in the time of particular events, like the strong ozone depletion over Arctic in the spring 2011 and solar eclipses was discussed and the changes in the amplitude-frequency features of these PCs were assumed as signs of the atmosphere response to the considered phenomena.

Longitudinal outcomes following stress or trauma diagnoses are receiving attention, yet population-based studies are few. The aims of the present cohort study were to examine the cumulative incidence of traumatic events and psychiatric diagnoses following diagnoses of severe stress and adjustment disorders categorized using International Classification of Diseases, Tenth Revision, codes and to examine associations of these diagnoses with all-cause mortality and suicide. Data came from a longitudinal cohort of all Danes who received a diagnosis of reaction to severe stress or adjustment disorders (International Classification of Diseases, Tenth Revision, code F43.x) between 1995 and 2011, and they were compared with data from a general-population cohort. Cumulative incidence curves were plotted to examine traumatic experiences and psychiatric diagnoses during the study period. A Cox proportional hazards regression model was used to examine the associations of the disorders with mortality and suicide. Participants with stress diagnoses had a higher incidence of traumatic events and psychiatric diagnoses than did the comparison group. Each disorder was associated with a higher rate of all-cause mortality than that seen in the comparison cohort, and strong associations with suicide were found after adjustment. This study provides a comprehensive assessment of the associations of stress disorders with a variety of outcomes, and we found that stress diagnoses may have long-lasting and potentially severe consequences.

Occupational exposures have been shown to be risk factors for chronic obstructive pulmonary disease (COPD) among never-smokers. In a Danish population-based cohort, we analysed this association and the population attributable fraction. The study population (N=1575) was aged 45-84, COPD was defined by lung function measurements and the method of lower limit of normal (LLN), and occupational exposure was assessed by questionnaire and expert judgement. Furthermore, the estimates additionally were provided according to the Global Initiative for Chronic Obstructive Lung Diseases. More than a threefold increased risk (LLN OR=3.69 (95% CI 1.36 to 10.04) was found for occupational exposure to vapour, gas, dust and fumes (predominantly organic dust) in this never-smoking population, with a corresponding 48% (95% CI 30% to 65%) population attributable fraction among never-smokers.

Background: Dinucleotide repeats (GT)n in the 5’prime promoter region of the heme oxygenase 1 (HMOX1) gene modulate the gene expression. Long repeats might affect occurrence of COPD. We aimed to investigate associations of the HMOX1 polymorphism of (GT)n repeats to occurrence of COPD.Methods: This population based cohort included 4703 Danes aged 45-84 of Northern European descents. COPD was defined by LLN: 2.5th FEV1/FVC and FEV1 centiles. The occupational exposures were defined as years with vapour, gas, dust or fume (VGDF) exposure. The HMOX1 repeat was genotyped by fragment analysis and capillary electrophoresis and grouped according to short (S): ≤26, medium (M): 27-32 and long (L): ≥33 GT repeat alleles in an L dominant genetic model. Associations were analysed with mixed random effect logistic regression adjusted for smoking, sex, occupational exposure, age and general practitioner practice. Currently, analyses are attempted replicated in a younger Danish cohort aged 20-44.Results: A HMOX1 (GT)n genotype was present in 4423 participants and distributed as S/S 12%, S/M 42%, M/M 35%, S/L 4%, M/L 7% and L/L 0.1%. The crude association between COPD and at least one long GT repeat (S/L, M/L, L/L) GT genotype was significant, p

The report use ozone measurement data retrieved in the Arctic with balloon borne ozone sondes for the last 20-30 years. Four stations with the best data series have been selected. Using a Monte Carlo method the yearly period is subtracted from the data and the remains, the anomalies, are correlated towards the area of the Polar Front, the temperature rise of the Nortern Hemisphere and the North Atlantic Oscillation (NAO) and towards one another. It was found that the NAO correlates negatively with ozone anomalies for all four stations albeit the correlations are weak. Besides, the polar front area correlates weakly positive with the ozone anomalies for three out of the four stations. These results, together with the observation that the ozone-anomalies have a brief decorrelation time, indicate that most of the variability in the anomalies should be found in local conditions.

Ozone soundings from 9 Nordic stations have been homogenized and interpolated to standard pressure levels. The different stations have very different data coverage; the longest period with data is from the end of the 1980ies to 2014. At each pressure level the homogenized ozone time-series have been analyzed with a model which includes both low-frequency variability in form of a polynomial, an annual cycle with harmonics, the possibility for low-frequency variability in the annual amplitude and phasing, and either white noise or noise given by a first order autoregressive process. The fitting of the parameters is performed with a Bayesian approach not only giving the mean values but also confidence intervals. The results show that all stations agree on a well-defined annual cycle in the free troposphere with a relatively confined maximum in the early summer. Regarding the low-frequency variability it is found that Scoresbysund, Ny Aalesund, Sodankylae, Eureka, and Orland show similar, significant signals with a maximum near 2005 followed by a decrease. This change is characteristic for all pressure levels in the free troposphere. A significant change in the annual cycle was found for Ny Aalesund, Scoresbysund and Sodankylae. The changes at these stations are in agreement with the interpretation that the early summer maximum is appearing earlier in the year. The results are shown to be robust to the different settings of the model parameters such as the order of the polynomial, number of harmonics in the annual cycle, and the type of noise.

We created a registry of Danish-born citizens of Denmark with incident International Classification of Diseases (10th ed.; ICD-10) severe stress and adjustment disorder diagnoses between 1995 and 2011. A unique personal identifier was used to retrieve and merge data on demographic characteristics and diagnoses (ICD-10 codes F43.x). Here we report on the incidence of these disorders and the demographic characteristics of the subset of the Danish population who have received 1 of these diagnoses: 111,844 adults and children received a first diagnosis between 1995 and 2011. More women than men (60.1% vs. 39.9%) received a diagnosis. Diagnoses increased during the late teens through early 30s. Adjustment disorder was the most common diagnosis (65.7% of adults and 64% of children). Reaction to severe stress unspecified was the second most common (19.8% of adults and 23.8% of children), and there was a large increase in both, as well as acute stress reaction diagnoses, in 2007 (3,717-5,141, 1,248-2,520, and 348-1,024 in 2006 to 2007, respectively). Findings regarding gender and age of onset are similar to other westernized countries. This registry can be used for future research programs, contributing to the study of stress and trauma.

PURPOSE To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis.METHODS Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid). Signs, symptoms, C-reactive protein (CRP), and reference standard tests were prospectively recorded in 175 Danish patients aged 18 to 65 years seeking care for suspected acute rhinosinusitis. For each reference standard, we developed 2 clinical decision rules: a point score based on a logistic regression model and an algorithm based on a CART model. We identified low-, moderate-, and high-risk groups for acute rhinosinusitis or acute bacterial rhinosinusitis for each clinical decision rule.RESULTS The point scores each had between 5 and 6 predictors, and an area under the receiver operating characteristic curve (AUROCC) between 0.721 and 0.767. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a 16%, 49%, and 73% likelihood of acute bacterial rhinosinusitis, respectively. CART models had an AUROCC ranging from 0.783 to 0.827. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a likelihood of acute bacterial rhinosinusitis of 6%, 31%, and 59% respectively.CONCLUSIONS We have developed a series of clinical decision rules integrating signs, symptoms, and CRP to diagnose acute rhinosinusitis and acute bacterial rhinosinusitis with good accuracy. They now require prospective validation and an assessment of their effect on clinical and process outcomes.

Women have a different clinical expression of chronic obstructive pulmonary disease (COPD) [1] and are more prone to developing COPD than men with similar exposures. These findings have been ascribed variously to a different susceptibility to tobacco smoke and anatomic, hormonal and behavioural differences [2]. Women have been shown to perform work with lower exposures than men within the same occupation and industry [3]. Despite these obvious and important gender differences, few studies have focused on occupational COPD in women. The population attributable fraction (PAF) for COPD due to occupational exposure to vapour, gases, dust and fumes (VGDF), irrespective of sex, is ∼15% [4, 5]. However, to our knowledge, no estimates have been published that focus solely on women. We thus analysed cross-sectional data among 1626 Danish women aged 45–84 years in relation to occupational COPD. The analyses add important information to our previously published population-based study [6]., The PAF of occupational COPD among Danish women http://ow.ly/CEmy308XEgl

In this paper, we review data on the risk of infectious diseases in chronic obstructive pulmonary disease (COPD), including the efficacy of antibiotics for prevention and treatment of acute COPD exacerbations, with a focus on more recent studies. Studies indicate that immunological mechanisms in COPD are impaired, leading to increased susceptibility to infection. Exacerbations are often infectious in origin (viral and/or bacterial) although pathogens may also be present in the lungs of person with stable COPD. The detailed mechanisms of exacerbations remain under investigation. Despite great variations in design and operational definitions of outcome, studies consistently find that patients with COPD are at an increased risk of respiratory infections. Patients with COPD do not appear to be at an increased risk of infections outside the respiratory system, but only a small number of studies have addressed this. The role of antibiotics in the management of acute exacerbations of COPD is disputed. However, findings from recent studies suggest that antibiotics are effective, although primarily in patients admitted to the hospital, thus representing patients with more severe exacerbations. Still, the question of antibiotic efficacy for different clinically well-defined subgroups of COPD exacerbation as well as the choice of the most appropriate antibiotic for these subgroups is uncertain. Antibiotics may also be efficacious in exacerbation prevention. Recent studies on the efficacy of macrolides for the prevention of COPD exacerbations demonstrated promising results. Nevertheless, questions on the risk-benefit ratio of macrolides, efficacy in subgroups of COPD patients, and long-term effects remain unanswered.

We examined rates of first hospitalization for COPD, rates of 5-year mortality among patients hospitalized for COPD, and comparisons of mortality between COPD patients and a matched cohort free of COPD. We computed standardized rates of first COPD hospitalization. Using Cox regression, we compared 180- and 181-day to 5-year mortality among COPD patients with the comparison cohort. We used medical databases in Denmark (population 5.4 million) from 1997 to 2006. We included patients 40 years or older with first hospitalization for COPD (64,499) and an age- and gender-matched comparison cohort of persons without COPD hospitalization (322,495). We examined the incidence of COPD hospitalization and risks and rates of mortality in the 5 years after hospitalization. Standardized rates of first hospitalization for COPD declined from 276 per 100,000 person-years in 1999 to 231 per 100,000 person-years in 2006. Within 180 days of hospitalization, 16% of COPD patients and 2.4% of persons in the matched cohort died (adjusted hazard ratio = 7.00, 95% CI = 6.79-7.22). Between 181 days and 5 years, 46% of COPD patients who survived the first 180 days and 19% of persons in the comparison cohort died (adjusted hazard ratio = 2.91, 95% CI = 2.86-2.95). COPD and comorbid diseases interacted to increase mortality in the first 180 days, but not thereafter. COPD continues to be a major public health problem causing substantial mortality in the 5 years after hospitalization, particularly in the first 180 days and in patients with comorbid diseases.

The objective of this study was to evaluate the association between changes revealed by computerized tomography scan (CT) and symptoms, signs, and bacteriological diagnoses in a general practice population who had been diagnosed with acute maxillary sinusitis (AMS). This study was designed as a prospective cohort study in Danish general practice in cooperation with the otorhinolaryngology and neuroradiology departments at Aalborg County Hospital. One hundred and seventy-four patients, aged 18-65 years, suspected of having AMS were included. The strongest associations were with purulent nasal discharge, preceding upper respiratory tract infection, maxillary toothache and oedema over the maxillary sinuses. Self-reported previous sinusitis was negatively associated with sinus infection. There was a strong association between increasing values of C-reactive protein (CRP) and erythrocyte sedimentation rate and changes on the CT scan. CT scans contributed only little to the final diagnosis, whereas increased CRP values and elevated erythrocyte sedimentation rates were more reliable indicators of inflammation in the sinuses.

During the last two decades, important advances have been made in the investigation of gravity waves. However, more efforts are needed to study certain aspects of gravity waves. In the real atmosphere, gravity waves occur with different properties at different altitudes and, most often, simultaneously. In this case, when there is more than one dominant wave, the determination of gravity wave characteristics, such as the vertical wavelength and the phase velocity, is difficult. The interpretation of temperature perturbation plots versus the altitude and time as well as the application of the Fourier spectral analysis can produce errors. Exact knowledge of the wave characteristics is important both for determination of other characteristics, for example, the horizontal wave components, and for study of wave climatology. The wavelet analysis of vertical temperature profiles allows one to examine the wave's location in space. Up to now, gravity waves have been studied mainly by continuous wavelet transformation to determine dominant waves. We apply wavelet analysis to a time series of temperature profiles, observed by the ALOMAR ozone lidar at Andoya, Norway, and by the U. Bonn lidar system at ESRANGE, Sweden, both for determination of the dominant waves and for specifying the vertical wavelengths and the vertical component of the phase velocities. For this purpose, the wavelet amplitude spectra and the wavelet phase spectra are filtered and Hovmoller diagrams for dominant wavelengths are constructed. The advantage of this type of diagrams is that they give clear evidence for the localization of the dominant waves in space and time and for the development of their phase fronts.

Ozone profiles retrieved from Global Ozone Monitoring Experiment (GOME, flying on ERS-2 satellite) spectra from July 1995 to June 2003 by means of 2 independent neural network (NN) schemes have been validated with ozone lidar measurements performed at different stations belonging to the network for the detection of atmospheric composition changes (NDACC). The retrieval and the whole validation have been carried out by using the performances and resources of the European project Enabling Grid for E-sciencE (EGEE) and of a local Grid at the European Space Research Institute of the European Space Agency (ESRIN/ESA). Roughly 1800 collocated profiles have been found, in tropical, mid-latitude and high-latitude regions; for each lidar station the differences between GOME and lidar profiles have been evaluated and the global performance of the proposed NN approaches has been critically discussed. The results indicate the potentialities for obtaining reliable ozone field analysis on global scale, including detailed altitude resolved trend analysis.

Ozone soundings from 9 Nordic stations with rather different data coverage have been homogenized followed by an interpolation to standard tropospheric pressure levels. A Bayesian model was applied which included a low-frequency variability, an annual cycle with harmonics, the possibility for variability in seasonal amplitude and phasing, and noise. Regarding the low-frequency variability it was found that only Scoresbysund, Ny Aalesund and Sodankyla showed statistical significant changes with a maximum near 2007 followed by a decrease. We hypothesize that this decrease could be explained by an observed decrease in nitrogen oxide in Europe.

The aim was to explore the impact of occupation on chronic obstructive pulmonary disease (COPD) in a cross-sectional population-based study among subjects aged 45 to 84 years. In a stratified sampling 89 general practitioners practices (GPP) in Denmark recruited 3106 males and 1636 females through the Danish Civil Registration System. COPD was defined by spirometry by the 2.5(th)-centile Lower Limit of Normal of FEV1 and FEV1/FVC. Information about smoking, occupational exposure and the respective occupations were obtained from questionnaires. Occupations followed the Danish adaptation of The International Standard Classification of Occupations, revision 1988 (DISCO-88). Exposure to vapour, gas, dust (organic and inorganic), and fume (VGDF) in each occupation (yes/no) was evaluated by two independent specialist in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0

Elisabeth Svensson,1 Timothy L Lash,1,2 Patricia A Resick,3 Jens Georg Hansen,1 Jaimie L Gradus4–61Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; 2Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; 4National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; 5Department of Psychiatry, 6Department of Epidemiology, Boston University, Boston, MA, USAAims: To assess the validity of reaction to severe stress and adjustment disorder diagnoses registered in the Danish Psychiatric Central Research Register (DPCRR), to examine the documentation of stressful and traumatic events in the medical records, and to investigate the occurrence of stress diagnoses among persons not registered in the DPCRR.Methods: Among 101,633 patients diagnosed with International Classification of Diseases, 10th Edition (ICD-10) F43 diagnoses between 1995 and 2011, we selected 50 patients from two hospitals (100 total), comprising one above and one below median age for each diagnosis for five time periods, and reviewed their medical records. We calculated the positive predictive value, comparing registration in the DPCRR with the original medical records, and captured data on stressful life events. Two general practitioners were queried about 50 patients without a stress diagnosis in the DPCRR, regarding whether they had ever received a stress diagnosis.Results: The positive predictive value was 58% for acute stress reaction, 83% for posttraumatic stress disorder, 94% for adjustment disorder, 71% for other reactions to severe stress, and 68% for reaction to severe stress, unspecified. In 80% of the records, a stressful or traumatic event was noted. Of 100 patients without an F43 diagnosis in the DPCRR, seven had a stress diagnosis.Conclusion: The DPCRR represents a valid and comprehensive resource for research on reaction to severe stress and adjustment disorders, particularly for posttraumatic stress disorder and adjustment disorder.Keywords: validity (epidemiology), stress disorders, traumatic, Denmark

Introduction: In COPD the population attributable fraction due to occupational exposure is about 15%, although longitudinal data from occupational exposure in population-based studies are sparse. Aims and objectives: The aim was to explore the impact of occupational exposure on the development of COPD in a longitudinal population-based study. Methods: A stratified sampling was conducted among 155 general practitioners. The 4-year follow-up included 1837 men and 914 women with a follow-up rate of 58%. Information about smoking, occupations and years of occupational exposures were obtained from questionnaires. Occupations were coded according to the Danish adaptation of The International Standard Classification of Occupations, revision 1988. Exposures to vapour, gas, dust, and fume (VGDF) in each occupation were evaluated by two independent specialists in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0, th centile lower limit of normal of FEV 1 and FEV 1 /FVC and analysed in a mixed Poisson regression. Results: At least 1 occupation with VGDF exposure was reported by 46% in their lifetime. The adjusted COPD incidence rate ratio (IRR) was associated with occupational exposure especially for low VGDF and organic dust exposure; IRR=3.71 (95% CI 1.17 to 11.8) and IRR=3.24 (95% CI 1.07 to 9.83), respectively, although no clear exposure-response relation was revealed. Additional adjustment for asthma status strengthens the association. However, by defining COPD according to the GOLD criteria no significant association was identified. Conclusion: Occupational exposure seems to increase the incidence of COPD.

Northern peatlands hold large amounts of organic carbon (C) in their soils and are as such important in a climate change context. Blanket bogs, i.e. nutrient-poor peatlands restricted to maritime climates, may be extra vulnerable to global warming since they require a positive water balance to sustain their moss dominated vegetation and C sink functioning. This study presents a 4.5 year record of land-atmosphere carbon dioxide (CO2) exchange from the Andoya blanket bog in northern Norway. Compared with other peatlands, the Andoya peatland exhibited low flux rates, related to the low productivity of the dominating moss and lichen communities and the maritime settings that attenuated seasonal temperature variations. It was observed that under periods of high vapour pressure deficit, net ecosystem exchange was reduced, which was mainly caused by a decrease in gross primary production. However, no persistent effects of dry conditions on the CO2 exchange dynamics were observed, indicating that under present conditions and within the range of observed meteorological conditions the Andoya blanket bog retained its C uptake function. Continued monitoring of these ecosystem types is essential in order to detect possible effects of a changing climate. (Less)

We discuss the quality of the two available SCIAMACHY limb ozone profile products. They were retrieved with the University of Bremen IFE's algorithm version 1.61 (hereafter IFE), and the official ESA offline algorithm (hereafter OL) versions 2.4 and 2.5. The ozone profiles were compared to a suite of correlative measurements from ground-based lidar and microwave, sondes, SAGE II and SAGE III (Stratospheric Aerosol and Gas Experiment). To correct for the expected Envisat pointing errors, which have not been corrected implicitly in either of the algorithms, we applied a constant altitude shift of -1.5 km to the SCIAMACHY ozone profiles. The IFE ozone profile data between 16 and 40 km are biased low by 3-6%. The average difference profiles have a typical standard deviation of 10% between 20 and 35 km. We show that more than 20% of the SCIAMACHY official ESA offline (OL) ozone profiles version 2.4 and 2.5 have unrealistic ozone values, most of these are north of 15° S. The remaining OL profiles compare well to correlative instruments above 24 km. Between 20 and 24 km, they underestimate ozone by 15±5%.

This paper provides a summary of the current state of telecommunications for eight Arctic nations and a common vision for a Wireless Arctic Network to unite the Arctic Circumpolar Community. It presents detailed requirements based on the North

The idea behind this thesis is to present how ARS and especially acute maxillary sinusitis in adults is diagnosed and treated in general practice. The study extends over many years, beginning with the first survey in 1991. Based on doctors' answers, we then investigated the diagnostic values ​​of the symptoms, signs and examinations which the doctors reported using. All patients over 18 years suspected of acute maxillary sinusitis were included consecutively and only once and, after a clinical examination with the GP, they were offered the opportunity to enter into the prospective study referred to acute CT scan and by changes in the CT, immediately referred to sinus puncture. Both examinations were conducted at Aalborg Hospital. The disease was found most frequently in younger and 2/3 were women. The reason for this gender difference is unknown. We have assessed the diagnostic values of the symptoms, objective findings and investigations ​​using 3 different reference standards: sinus puncture, microbiological diagnosis and CT scan described in three articles. In all examinations, it appeared that the usual signs and symptoms of acute maxillary sinusitis occur almost equally often and with a few exceptions in patients, with and without pus in the sinus cavities. Pain in the sinus cavities occurring in 95% of patients, and only elevated levels of CRP and ESR are significantly and independently associated with pus in the sinus cavities. This finding is surprising, because they are two nonspecific markers. CRP tested by near-patient testing has, within the investigations period, been introduced in general practice, and from 1999 the doctors also get reimbursed for performing the test. We have on this background originally defined a clinical criterion with pain over the sinuses accompanied by elevated values ​​of CRP and/or ESR giving a sensitivity of 0.82, specificity 0.57, ppv 0.68 and npv 0.74. But looking at the ROC curve we suggest that a more clinical relevant diagnose will be based on use of CRP alone, as the test can be made easily and fast while the patient is in the clinic compared to the use of ESR. The disease is over-diagnosed in general practice. In only 53% of patients, who the GP suspected of having acute sinusitis, was there detected pus or mucopus at the sinus puncture, furthermore the patients' statements that they had had sinusitis was significantly negatively associated with current acute maxillary sinusitis. Almost all patients are prescribed topical treatment to the nose in the form of vasoconstrictor, and 50-70% also antibiotics. The most common bacteria that can be isolated are S. pneumoniae and H. influenzae. For many years the first drug of choice has been penicillin V, and treatment with penicillin V has followed Scandinavian recommendations. However, the resistance patterns in respect of H. influenzae have changed over the years and if the dominant flora is H. influenzae, then oral penicillin is not sufficient anymore, and should be replaced by amoxicillin with or without clavulanate. It is reported that the MIC of penicillin V is too high, such that oral dosage cannot provide sufficiently high concentrations. However, in daily clinical practice the doctor does not have the possibility to decide whether the infection is caused by either S. pneumoniae or H. influenzae, unless a sinus puncture is performed and it is not considered as a standard procedure. The recommended treatment is therefore starting with penicillin V, and at treatment failure switching to amoxicillin with or without clavulanate. It is well known that URTI's can exacerbate a chronic pulmonary disease - like asthma - in allergic patients, but this influence is also demonstrated as described in article 6 where ARS in adults without any sign of chronic lung disease or allergy is accompanied by a temporary reduction lung function. Future research should focus on the use of CRP in general practice, analysing cost-effectiveness of the use of CRP patient outcome in relation to antibiotic treatment, clarification of ARS as a female disease, and a detailed exploration of the relationship between URTI's and impaired lung function in lung-healthy patients.