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The Program for International Student Assessment (PISA) 2012 utilized data from 63 countries and economies to generate research questions that centered on the contribution of mathematics self-efficacy, opportunity to learn (OTL), and how their interplay affected students' mathematical performance. This study reveals that in a majority of the surveyed countries/economies, students' OTL can enhance the positive relationship between mathematics self-efficacy and mathematical performance. Path analysis further demonstrates that in 61 out of the 63 countries/economies, students' OTL positively affect their mathematics self-efficacy, which subsequently enhances mathematical performance. It was observed that students with more OTL typically exhibit higher math performance, but this effect is explained by the mediating influence of having more mathematics self-efficacy.

Measuring opportunities to learn (OTL) is crucial for evaluating education quality and equity, but obtaining accurate and comprehensive OTL data at a large scale remains challenging. We attempt to address this issue by investigating measurement concerns in data collection and sampling. With the primary goal of estimating group-level OTLs for large populations of classrooms and the secondary goal of estimating classroom-level OTLs, we propose forming a teacher panel and using an online log-type survey to collect content and time data on sampled days throughout the school year. We compared various sampling schemes in a simulation study with real daily log data from 66 fourth-grade math teachers. The findings from this study indicate that sampling 1 day per week or 1 day every other week provided accurate group-level estimates, while sampling 1 day per week yielded satisfactory classroom-level estimates. The proposed approach aids in effectively monitoring large-scale classroom OTL.

The recent PISA mathematics results delivered disappointing news for the United States of America (USA). These results underscored the education system's continuing inequalities. An important question concerns to what extent and to which part of the educational system do these sources of inequality occur? In this paper we use PISA 2012 data merged with district- and school-level variables derived from five additional national databases to explore the way socio-economic status (SES) and race are related to inequalities in student performance as well as to inequalities in other components of schooling at both the system and student-levels, such as the academic 'zeitgeist' of the school, the nature of the mathematics curriculum and characteristics of both the teacher and the student. The results demonstrated how race and SES had significant relationships not only to student performance but to other aspects of schooling as well. Those relationships occurred at both the system- and within-school levels but differed in their implications. The policy implications of the research could help determine where the greatest effort could be made to provide all children of all racial and social classes equal opportunities to learn.

Abstract Despite the favorable effects of immunotherapies in multiple types of cancers, its complete success in CNS malignancies remains challenging. Recently, a successful clinical trial of cytokine-induced killer (CIK) cell immunotherapy in patients with glioblastoma (GBM) has opened a new avenue for adoptive cellular immunotherapies in CNS malignancies. Prompt from these findings, herein, we investigated whether dendritic cells (DC) in combination with cytokine-induced killer cells (DC-CIK) could also provide an alternative and more effective way to improve the efficacy of GBM treatment. The analysis showed that DC-CIK cells exerted a significant cytotoxic effect on the glioblastoma cell lines, especially with the phenotype of stem-like cells (GSCs). In addition, the increased specific lysis of these cells subsequent to DC-CIK co-culture was confirmed with confocal fluorescence microscope. The direct interactions between tumor and effector cells were found to be highly effective in GBM organoids (GBOs). Moreover, a significant increase in apoptosis and elevated levels of IFN-γ (and not TNF-α) secretion were observed as a targeting mechanism of DC-CIK cells against GBM cell models. Overall, we provide important preliminary evidence that DC-CIK cells may have potential in the treatment of CNS malignancies, particularly glioblastoma.

The paper presents selected acoustic power amplifiers from among those currently available. The results of a series of measurements characteris ing the amplifiers are presented. The measured amplitude and phase characteristics as a function of frequency for four selected amplifiers are analysed. The spectra of the output signal in the band from 4 kHz to 30 kHz are presented. The usefulness of the selected amplifiers in an underwater communication system is assessed.

Ensuring universal and stable underwater communication in shallow waters for various environmental conditions is a difficult scientific and engineering task. This applies in particular to underwater communication systems that use acoustic waves in very shallow underwater channels, where multipath propagation permanently occurs. The article provides assumptions for a system working with incoherent M-ary Frequency-Shift Keying (MFSK) modulation, along with guidelines for eliminating the impact of the multipath phenomenon. The results of experimental tests carried out in a lake for two seasons and, therefore, different sound velocity profiles are presented. For comparison purposes, three transducers placed at different depths, including at the bottom of the reservoir, were used to receive the transmitted signals.

Abstract The basic idea of modulating the immune system to better recognize and fight tumor cells has led to the successful introduction of adoptive cellular immunotherapy (ACT). ACT-based treatment regimens, in which the patient's own immune cells are isolated and subsequently expanded (ex vivo) and reinfused, have also contributed significantly to the development of a personalized treatment strategy. Complementing this, the unprecedented advances in ACTs as chimeric antigen receptor (CAR)-T cell therapies and their derivatives such as CAR-NK, CAR-macrophages, CAR-γδT and CAR-NKT have further maximized the therapeutic outcomes. Herein, we provide a comprehensive overview of the development of ACTs in multiple myeloma (MM) and outline how they have evolved from an experimental form to a mainstay of standard clinical settings. Besides, we provide insights into cytokine-induced killer cell (CIK) therapy, an alternative form of ACT that (as CIK or CAR-CIK) has enormous potential in the clinical spectrum of MM. We also summarize the results of the major preclinical and clinical studies of adoptive cell therapy in MM and address the current challenges (such as cytokine release syndrome (CRS) and neurotoxicity) that limit its complete success in the cancer landscape.

Conventional letter- or number-based grading systems, though ubiquitous at all levels of education, do not optimize the learning experience. The philosophy of "ungrading" includes a variety of approaches that decenter or even remove numeric or letter scoring of student work in favor of descriptive feedback, opportunities for revision, self-assessment and reflection, and assessment toward mastery. This paper presents one of the few published descriptions of the use of ungrading approaches in geoscience courses at the undergraduate and graduate level. We showcase four approaches, detailing the courses and ungrading structures used, positive outcomes and challenges, and tools that might allow others to apply these methods. We describe (a) mastery and specifications grading, chosen to promote mastery of course materials in mid- and upper-level courses for college majors; (b) labor-based grading used to promote depth of student learning by focusing on revision; (c) collaborative grading utilizing self-assessment and reflection chosen to promote meta-cognition and growth mindset; and, (d) partial ungrading as a means to begin the ungrading process. Importantly, our experiences have led us to recognize the equity that ungrading approaches create, enabling students from different backgrounds, including students of color and disabled students, to find stronger support and build greater competence and confidence in geoscience classes.

[This corrects the article DOI: 10.1371/journal.pbio.3001427.].

Background Organs and tissues need to be vascularized during development. Similarly, vascularization is required to engineer thick tissues. How vessels are formed during organogenesis is not fully understood, and vascularization of engineered tissues remains a significant challenge. Methods and Results Here, we show that the extracellular matrix protein nephronectin is required for vascularization during zebrafish development as well as adult fin regeneration and is sufficient to promote mammalian vessel formation and maturation. Nephronectin a morphants and mutants exhibit diminished axial vein sprouting and posterior intersegmental vessel growth. Notably, the angiogenesis‐associated integrins itgav and itgb3.1 are coexpressed with nephronectin a in the region of the caudal vein plexus and posterior somites; nephronectin binds to integrin alpha‐V/integrin beta‐3.1 (ITGAV/ITGB3.1), and itgav morphants phenocopy nephronectin a mutants. In addition, nephronectin a mutants showed decreased vessel maturation compared with wild‐type siblings during caudal fin regeneration in adult zebrafish. Moreover, nephronectin promotes mammalian endothelial cell migration and tube formation in 2D and 3‐dimensional in vitro tissue culture. Further, nephronectin enhances vascular endothelial growth factor‐induced periaortic vascular capillary interconnectivity, vessel diameter, and vessel stability. Conclusions Collectively, our results identify nephronectin as a proangiogenic factor during embryonic development, which can be used to improve the vascularization of engineered tissues.

The use of nanotechnology in medicine and healthcare is known as nanomedicine. These nanoparticles exhibit significant potential in medicine, including in imaging techniques and diagnostic tools, tissue-engineered constructs, drug delivery systems, pharmaceutical therapeutics, and implants. The association with neurosurgery had been less well established compared to other organ systems but has recently offered the promising future potential for a wide range of utilities, including CNS drug delivery, neuro-regeneration, neuro oncology, neuroimaging, and neuromodulation. This review summarizes the current developments in nanotechnology and nanomedicine that may yield future neurosurgery applications. A literature review was carried out with a focus on the use of nanotechnology and nanoparticles in the field of neurosurgery and its future implications. Although most therapeutic strategies involving nanotechnology discussed are still in an early experimental stage, it is expected that research on such frontline field will bring a major impact in several neurosurgical areas, opening new opportunities for the treatment of CNS neoplasms, neurodegenerative processes as well as vascular and traumatic injuries.

ABSTRACT Background Cytokine‐induced killer (CIK) cell therapy has proven successful in clinical trials regarding glioblastoma. Equally important are the hints suggesting peroxisome proliferator‐activated receptors (PPARs) ligands being co‐expressed in the central nervous system (CNS). This provides a rationale about investigating the possible synergistic effect of CIK cells and PPARs. Methodology We investigated neuroblastoma and glioblastoma cell lines with mature CIK cells and the PPARγ antagonist GW‐9662 to assess the effects on cell viability, candidate gene expression (Wnt/β‐catenin signalling, DNMT1) and global methylation levels (5‐methylcytosine, LINE‐1). Results Using a clinical applicable PPAR‐γ inhibitor, we showed that (1) PPARγ‐antagonist GW‐9662 suppressed tumor cell growth in both neuroblastoma and glioblastoma cells, (2) PPARγ inhibition had restricted effect on the expression of Wnt/β‐catenin associated genes, (3) inhibition of PPARγ led to downregulation of DNMT1 expression, supporting their hypothesized interaction in cancer, (4) a partial modulation of global LINE‐1 methylation levels was observed, indicating their role in epigenetic processes, and (5) Combining PPARγ inhibition with CIK cell immunotherapy enhanced cell lysis significantly. Conclusion We provide evidence that PPAR ligands in combination with CIK cell immunotherapy could be a valuable option for malignant CNS tumors.

Abstract Approximately 1–2 per 100,000 young athletes die from sudden cardiac death (SCD) and extreme exercise may be associated with myocardial scar and arrhythmias. Racehorses have a high prevalence of atrial fibrillation (AF) and SCD but the presence of myocardial scar and inflammation has not been evaluated. Cardiac tissues from the left (LAA) and right (RAA) atrial appendages, left ventricular anterior (LVAPM) and posterior (LVPPM) papillary muscles, and right side of the interventricular septum (IVS-R) were harvested from racehorses with sudden cardiac death (SCD, n = 16) or other fatal injuries (OFI, n = 17), constituting the athletic group (ATH, n = 33), and compared to sedentary horses (SED, n = 10). Horses in the ATH group had myocyte hypertrophy at all sites; increased fibrosis at all sites other than the LAA; increased fibroblast infiltration but a reduction in the overall extracellular matrix (ECM) volume in the RAA, LVAPM, and IVS-R compared to SED horses. In this horse model, athletic conditioning was associated with myocyte hypertrophy and a reduction in ECM. There was an excess of fibrocyte infiltration and focal fibrosis that was not present in non-athletic horses, raising the possibility of an exercise-induced pro-fibrotic substrate.

Previous research has shown that stratospheric aerosol causes only a small temperature change per unit forcing because they produce stronger cooling in the tropical Indian Ocean and the western Pacific Ocean than in the global mean. The enhanced temperature change in this so-called “warm-pool” region activates strongly negative local and remote feedbacks, which dampen the global mean temperature response. This paper addresses the question of why stratospheric aerosol forcing affects warm-pool temperatures more strongly than CO2 forcing, using idealized MPI-ESM simulations. We show that the aerosol's enhanced effective forcing at the top of the atmosphere (TOA) over the warm pool contributes to the warm-pool-intensified temperature change but is not sufficient to explain the effect. Instead, the pattern of surface effective forcing, which is substantially different from the effective forcing at the TOA, is more closely linked to the temperature pattern. Independent of surface temperature changes, the aerosol heats the tropical stratosphere, accelerating the Brewer–Dobson circulation. The intensified Brewer–Dobson circulation exports additional energy from the tropics to the extratropics, which leads to a particularly strong negative forcing at the tropical surface. These results show how forced circulation changes can affect the climate response by altering the surface forcing pattern. Furthermore, they indicate that the established approach of diagnosing effective forcing at the TOA is useful for global means, but a surface perspective on the forcing must be adopted to understand the evolution of temperature patterns.

Abstract Background Acute myeloid leukemia, constituting a majority of leukemias, grapples with a 24% 5-year survival rate. Recent strides in research have unveiled fresh targets for drug therapies. LIM-only, a pivotal transcription factor within LIM proteins, oversees cell development and is implicated in tumor formation. Among these critical LIM proteins, CSRP1, a Cysteine-rich protein, emerges as a significant player in various diseases. Despite its recognition as a potential prognostic factor and therapeutic target in various cancers, the specific link between CSRP1 and acute myeloid leukemia remains unexplored. Our previous work, identifying CSRP1 in a prognostic model for AML patients, instigates a dedicated exploration into the nuanced role of CSRP1 in acute myeloid leukemia. Methods R tool was conducted to analyze the public data. qPCR was applied to evaluate the expression of CSRP1 mRNA for clinical samples and cell line. Unpaired t test, Wilcoxon Rank Sum test, KM curves, spearman correlation test and Pearson correlation test were included in this study. Results CSRP1 displays notable expression variations between normal and tumor samples in acute myeloid leukemia (AML). It stands out as an independent prognostic factor for AML patients, showing correlations with clinical factors like age and cytogenetics risk. Additionally, CSRP1 correlates with immune-related pathways, immune cells, and immune checkpoints in AML. Furthermore, the alteration of CSRP1 mRNA levels is observed upon treatment with a DNMT1 inhibitor for THP1 cells. Conclusion The CSRP1 has potential as a novel prognostic factor and appears to influence the immune response in acute myeloid leukemia. Additionally, there is an observed association between CSRP1 and DNA methylation in acute myeloid leukemia.

Objective To evaluate the prognostic utility of baseline frailty, measured by the Risk Analysis Index (RAI), for prediction of postoperative mortality among patients with spinal malignancy (SM) undergoing resection. Methods SM surgery cases were queried from the American College of Surgeons – National Surgical Quality Improvement Program database (2011–2020). The relationship between preoperative RAI frailty score and increasing rate of primary endpoint (mortality or discharge to hospice within 30 days, “mortality/hospice”) were assessed. Discriminatory accuracy was assessed by computation of C-statistics (with 95% confidence interval [CI]) in receiver operating characteristic (ROC) curve analysis. Results A total of 2,235 cases were stratified by RAI score: 0–20, 22.7%; 21–30, 11.9%; 31–40, 54.7%; and ≥ 41, 10.7%. The rate of mortality/hospice was 6.5%, which increased linearly with increasing RAI score (p < 0.001). RAI was also associated with increasing rates of major complication, extended length of stay, and nonhome discharge (all p < 0.05). The RAI demonstrated acceptable discriminatory accuracy for prediction of primary endpoint (C-statistic, 0.717; 95% CI, 0.697–0.735). In pairwise ROC comparison, RAI demonstrated superiority versus modified frailty index-5 and chronological age (p < 0.001). Conclusion Preoperative frailty, as measured by RAI, is a robust predictor of mortality/hospice after SM surgery. The frailty score may be applied in clinical settings using a user-friendly calculator, deployed here: https://nsgyfrailtyoutcomeslab.shinyapps.io/spinalMalignancyRAI/.

Abstract Identifying how species respond to system drivers such as weather, climate, habitat, and resource availability is critical for understanding population change. In coastal areas, the transfer of nutrients across the marine and terrestrial interface increases complexity. Nesting populations of bald eagles (Haliaeetus leucocephalus) along the Pacific coast of North America, although terrestrial, are largely dependent on marine resources during the breeding season and therefore represent a good focal species for understanding the linkages of nutrients between terrestrial and marine systems. Due to their location, coastal eagle populations are susceptible to a variety of climate‐induced perturbations, from both land and sea. The northeast Pacific Marine Heatwave (PMH) of 2014–2016 had wide‐ranging impacts on the marine ecosystem and provided an opportunity to explore how marine conditions can impact terrestrial wildlife populations. We used a spatially explicit multistate occupancy modeling framework to analyze >30 years of bald eagle nest occupancy data collected in four large national parks along a coastal interior gradient in Alaska, USA. We assessed occupancy state in relation to weather conditions, salmon abundance, access to alternate prey resources, and the PMH event to help elucidate the factors affecting bald eagle occupancy dynamics over time. We found that occupancy probability was higher in areas where prey resources were concentrated (e.g., near seabird colonies, where bears facilitate access to salmon carcasses). We also found that the probability of reproductive success was higher during warmer, drier springs with higher‐than‐average salmon abundance. After the onset of the PMH, success declined in the areas most dependent on non‐salmon marine resources. These findings confirm the importance of spring weather conditions and access to salmon resources during the critical chick‐rearing period, but also reveal that marine heatwaves may have important secondary effects through a reduction in the overall quantity or quality of prey available to bald eagles. Given ongoing warming at high latitudes and the expectation that marine heatwaves will become more common, our findings are useful for understanding ongoing and future changes in the transfer of nutrients from marine to terrestrial ecosystems and how such changes may impact terrestrial species such as bald eagles.

Abstract Cancer stem cells (CSCs) are widely acknowledged as the drivers of tumor initiation, epithelial‐mesenchymal transition (EMT) progression, and metastasis. Originating from both hematologic and solid malignancies, CSCs exhibit quiescence, pluripotency, and self‐renewal akin to normal stem cells, thus orchestrating tumor heterogeneity and growth. Through a dynamic interplay with the tumor microenvironment (TME) and intricate signaling cascades, CSCs undergo transitions from differentiated cancer cells, culminating in therapy resistance and disease recurrence. This review undertakes an in‐depth analysis of the multifaceted mechanisms underlying cancer stemness and CSC‐mediated resistance to therapy. Intrinsic factors encompassing the TME, hypoxic conditions, and oxidative stress, alongside extrinsic processes such as drug efflux mechanisms, collectively contribute to therapeutic resistance. An exploration into key signaling pathways, including JAK/STAT, WNT, NOTCH, and HEDGEHOG, sheds light on their pivotal roles in sustaining CSCs phenotypes. Insights gleaned from preclinical and clinical studies hold promise in refining drug discovery efforts and optimizing therapeutic interventions, especially chimeric antigen receptor (CAR)‐T cell therapy, cytokine‐induced killer (CIK) cell therapy, natural killer (NK) cell‐mediated CSC‐targeting and others. Ultimately use of cell sorting and single cell sequencing approaches for elucidating the fundamental characteristics and resistance mechanisms inherent in CSCs will enhance our comprehension of CSC and intratumor heterogeneity, which ultimately would inform about tailored and personalized interventions.

Abstract Despite significant progress in the medical field, there is still a pressing need for minimal‐invasive tools to assist with decision‐making, especially in cases of polytrauma. Our team explored the potential of serum‐derived large extracellular vesicles, so called microparticles/microvesicles/ectosomes, to serve as a supportive tool in decision‐making in polytrauma situations. We focused on whether monocyte derived large EVs may differentiate between polytrauma patients with internal organ injury (ISS > 15) and those without. Thus, we compared our EV data to soluble biomarkers such as tumour necrosis factor alpha (TNF alpha) and Interleukin‐8 (IL‐8). From the blood of 25 healthy and 26 patients with polytrauma large EVs were isolated, purified, and characterized. TNF alpha and IL‐8 levels were quantified. We found that levels of these monocyte derived large EVs were significantly higher in polytrauma patients with internal organ damage and correlated with the ISS. Interestingly, we also observed a decline in AnnV+CD14+ large EVs during normal recovery after trauma. Thus, inflammatory serological markers as TNF alpha and as IL‐8 demonstrated an inability to discriminate between polytrauma patients with or without internal organ damage, such as spleen, kidney, or liver lacerations/ruptures. However, TNF and IL‐8 levels were elevated in polytrauma cases overall when contrasted with healthy non‐traumatic controls. These findings suggest that delving deeper into the potential of AnnV+ large EVs derived from monocytes could highly beneficial in the managment of polytrauma, potentially surpassing the efficacy of commonly used serum markers.

Abstract Histone deacetylase inhibitors (HDACis) are a significant category of pharmaceuticals that have developed in the past two decades to treat multiple myeloma. Four drugs in this category have received approval from the U.S. Food and Drug Administration (FDA) for use: Panobinonstat (though canceled by the FDA in 2022), Vorinostat, Belinostat and Romidepsin. The efficacy of this group of drugs is attributed to the disruption of many processes involved in tumor growth through the inhibition of histone deacetylase, and this mode of action leads to significant anti-multiple myeloma (MM) activity. In MM, inhibition of histone deacetylase has many downstream consequences, including suppression of NF-κB signaling and HSP90, upregulation of cell cycle regulators (p21, p53), and downregulation of antiapoptotic proteins including Bcl-2. Furthermore, HDACis have a variety of direct and indirect oxidative effects on cellular DNA. HDAC inhibitors enhance normal immune function, thereby decreasing the proliferation of malignant plasma cells and promoting autophagy. The various biological effects of inhibiting histone deacetylase have a combined or additional impact when used alongside other chemotherapeutic and targeted drugs for multiple myeloma. This helps to decrease resistance to treatment. Combination treatment regimens that include HDACis have become an essential part of the therapy for multiple myeloma. These regimens incorporate drugs from other important classes of anti-myeloma agents, such as immunomodulatory drugs (IMiDs), conventional chemotherapy, monoclonal antibodies, and proteasome inhibitors. This review provides a comprehensive evaluation of the clinical efficacy and safety data pertaining to the currently approved histone deacetylase inhibitors, as well as an explanation of the crucial function of histone deacetylase in multiple myeloma and the characteristics of the different histone deacetylase inhibitors. Moreover, it provides a concise overview of the most recent developments in the use of histone deacetylase inhibitors for treating multiple myeloma, as well as potential future uses in treatment.

Abstract Background Imaging-based assessment of sarcopenia is a well-validated prognostic tool for patients with chronic liver disease. However, little is known about its value in patients with primary sclerosing cholangitis (PSC). This cross-sectional study aimed to investigate the predictive value of the cross-sectional imaging-based skeletal muscle index (SMI) for transplant-free survival (TFS) in patients with PSC. Methods A total of 95 patients with PSC who underwent abdominal cross-sectional imaging between 2008 and 2022 were included in this retrospective study. SMI was measured at the third lumbar vertebra level (L3-SMI). The cut-off values to define sarcopenia were 10% at 12 months, which is used as MELD standard exception (SE) criterion in Eurotransplant (in Germany only until September 2023), was not significantly associated with TFS in the multivariate Cox regression analysis (HR = 1.417; p = 0.330). Substitution of BMI reduction with L3-SMI in the German SE criteria improved the predictive accuracy of TFS compared to the established SE criteria (multivariable Cox regression analysis: HR = 4.007, p

Background and Aims: Data on the prevalence and characteristics of so-called rare HCV genotypes (GTs) in larger cohorts is limited. This study investigates the frequency of rare GT and resistance-associated substitutions and the efficacy of retreatment in a European cohort. Methods: A total of 129 patients with rare GT1-6 were included from the European resistance database. NS3, NS5A, and NS5B were sequenced and clinical parameters and retreatment efficacies were collected retrospectively. Results: Overall 1.5% (69/4,656) of direct-acting antiviral (DAA)-naive and 4.4% (60/1,376) of DAA-failure patients were infected with rare GT. Although rare GTs were almost equally distributed throughout GT1-6 in DAA-naive patients, we detected mainly rare GT4 (47%, 28/60 GT4; of these n = 17, subtype 4r) and GT3 (25%, 15/60 GT3, of these n = 8, subtype 3b) among DAA-failures. A total of 62% (37/60) of DAA failures had not responded to first-generation regimes and the majority was infected with rare GT4 (57%, 21/37). In contrast, among patients with failure to pangenotypic DAA regimens (38%, 23/60), infections with rare GT3 were overrepresented (57%, 13/23). Although NS5A RASs were uncommon in rare GT2, GT5a, and GT6, we observed combined RASs in rare GT1, GT3, and GT4 at positions 28, 30, 31, which can be considered as inherent. DAA failures with completed follow-up of retreatment, achieved a high SVR rate (94%, 45/48 modified intention-to-treat analysis; 92%, 45/49 intention-to-treat). Three patients with GT4f, 4r, or 3b, respectively, had virological treatment failure. Conclusions: In this European cohort, rare HCV GT were uncommon. Accumulation of specific rare GT in DAA-failure patients suggests reduced antiviral activities of DAA regimens. The limited global availability of pangenotypic regimens for first line therapy as well as multiple targeted regimens for retreatment could result in HCV elimination targets being delayed. Impact and implications: Data on the prevalence and characteristics of rare HCV genotypes (GT) in larger cohorts are still scarce. This study found low rates of rare HCV GTs among European HCV-infected patients. In direct-acting antiviral (DAA)-failure patients, rare GT3 subtypes accumulated after pangenotypic DAA treatment and rare GT4 after first generation DAA failure and viral resistance was detected at NS5A positions 28, 30, and 31. The limited global availability of pangenotypic DAA regimens for first line therapy as well as multiple targeted regimens for retreatment could result in HCV elimination targets being delayed.

Background: Neurological surgery remains one of the most competitive specialties with a match rate of

Objective: In recent years, frailty has been reported to be an important predictive factor associated with worse outcomes in neurosurgical patients. The purpose of the present systematic review was to analyze the impact of frailty on outcomes of chronic subdural hematoma (cSDH) patients. Methods: We performed a systematic review of literature using the PubMed, Cochrane library, Wiley online library, and Web of Science databases following PRISMA guidelines of studies evaluating the effect of frailty on outcomes of cSDH published until January 31, 2023. Results: A comprehensive literature search of databases yielded a total of 471 studies. Six studies with 4085 patients were included in our final qualitative systematic review. We found that frailty was associated with inferior outcomes (including mortality, complications, recurrence, and discharge disposition) in cSDH patients. Despite varying frailty scales/indices used across studies, negative outcomes occurred more frequently in patients that were frail than those who were not. Conclusions: While the small number of available studies, and heterogenous methodology and reporting parameters precluded us from conducting a pooled analysis, the results of the present systematic review identify frailty as a robust predictor of worse outcomes in cSDH patients. Future studies with a larger sample size and consistent frailty scales/indices are warranted to strengthen the available evidence. The results of this work suggest a strong case for using frailty as a pre-operative risk stratification measure in cSDH patients.

Summary: Midbrain dopaminergic neurons (DANs) are subject to extensive metabotropic regulation, but the repertoire of G protein-coupled receptors (GPCRs) present in these neurons has not been mapped. Here, we isolate DANs from Dat-eGFP mice to generate a GPCR atlas by unbiased qPCR array expression analysis of 377 GPCRs. Combined with data mining of scRNA-seq databases, we identify multiple receptors in DAN subpopulations with 38 of these receptors representing the majority of transcripts. We identify 41 receptors expressed in midbrain DANs but not in non-DAN midbrain cells, including the free fatty acid receptor 4 (FFAR4). Functional expression of FFAR4 is validated by ex vivo Ca2+ imaging, and in vivo experiments support that FFAR4 negatively regulates food and water intake and bodyweight. In addition to providing a critical framework for understanding metabotropic DAN regulation, our data suggest fatty acid sensing by FFAR4 as a mechanism linking high-energy intake to the dopamine-reward pathway.

Abstract Cancer, being the most formidable ailment, has had a profound impact on the human health. The disease is primarily associated with genetic mutations that impact oncogenes and tumor suppressor genes (TSGs). Recently, growing evidence have shown that X‐linked TSGs have specific role in cancer progression and metastasis as well. Interestingly, our genome harbors around substantial portion of genes that function as tumor suppressors, and the X chromosome alone harbors a considerable number of TSGs. The scenario becomes even more compelling as X‐linked TSGs are adaptive to key epigenetic processes such as X chromosome inactivation. Therefore, delineating the new paradigm related to X‐linked TSGs, for instance, their crosstalk with autosome and involvement in cancer initiation, progression, and metastasis becomes utmost importance. Considering this, herein, we present a comprehensive discussion of X‐linked TSG dysregulation in various cancers as a consequence of genetic variations and epigenetic alterations. In addition, the dynamic role of X‐linked TSGs in sex chromosome–autosome crosstalk in cancer genome remodeling is being explored thoroughly. Besides, the functional roles of ncRNAs, role of X‐linked TSG in immunomodulation and in gender‐based cancer disparities has also been highlighted. Overall, the focal idea of the present article is to recapitulate the findings on X‐linked TSG regulation in the cancer landscape and to redefine their role toward improving cancer treatment strategies.

Global storm-resolving models (GSRMs) use strongly refined horizontal grids compared with the climate models typically used in the Coupled Model Intercomparison Project (CMIP) but employ comparable vertical grid spacings. Here, we study how changes in the vertical grid spacing and adjustments to the integration time step affect the basic climate quantities simulated by the ICON-Sapphire atmospheric GSRM. Simulations are performed over a 45 d period for five different vertical grids with between 55 and 540 vertical layers and maximum tropospheric vertical grid spacings of between 800 and 50 m, respectively. The effects of changes in the vertical grid spacing are compared with the effects of reducing the horizontal grid spacing from 5 to 2.5 km. For most of the quantities considered, halving the vertical grid spacing has a smaller effect than halving the horizontal grid spacing, but it is not negligible. Each halving of the vertical grid spacing, along with the necessary reductions in time step length, increases cloud liquid water by about 7 %, compared with an approximate 16 % decrease for halving the horizontal grid spacing. The effect is due to both the vertical grid refinement and the time step reduction. There is no tendency toward convergence in the range of grid spacings tested here. The cloud ice amount also increases with a refinement in the vertical grid, but it is hardly affected by the time step length and does show a tendency to converge. While the effect on shortwave radiation is globally dominated by the altered reflection due to the change in the cloud liquid water content, the effect on longwave radiation is more difficult to interpret because changes in the cloud ice concentration and cloud fraction are anticorrelated in some regions. The simulations show that using a maximum tropospheric vertical grid spacing larger than 400 m would increase the truncation error strongly. Computing time investments in a further vertical grid refinement can affect the truncation errors of GSRMs similarly to comparable investments in horizontal refinement, because halving the vertical grid spacing is generally cheaper than halving the horizontal grid spacing. However, convergence of boundary layer cloud properties cannot be expected, even for the smallest maximum tropospheric grid spacing of 50 m used in this study.

Background: Although hearing aids (HAs) can compensate for reduced audibility, functional outcomes and benefits vary widely across individuals. As part of the Danish ‘Better hEAring Rehabilitation’ (BEAR) project, four distinct auditory profiles differing in terms of audiometric thresholds and supra-threshold hearing abilities were recently identified. Additionally, profile-specific HA-fitting strategies were proposed. The aim of the current study was to evaluate the self-reported benefit of these profile-based HA fittings in a group of new HA users. Methods: A total of 205 hearing-impaired older adults were recruited from two Danish university hospitals. Participants were randomly allocated to one of two treatment groups: (1) NAL-NL2 gain prescription combined with default advanced feature settings (‘reference fitting’) or (2) auditory profile-based fitting with tailored gain prescription and advanced feature settings (‘BEAR fitting’). Two months after treatment, the participants completed the benefit version of the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12-B) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. Results: Overall, participants reported a clear benefit from HA treatment. However, no significant differences in the SSQ12-B or IOI-HA scores between the reference and BEAR fittings were found. Conclusion: First-time users experience clear benefits from HA treatment. Auditory profile-based HA fitting warrants further investigation.

Abstract Hepatitis B virus (HBV)-transgenic mice exhibit competent innate immunity and are therefore an ideal model for considering intrinsic or cell-based mechanisms in HBV pathophysiology. A highly replicative model that has been little used, let alone characterized, is the Tg1.4HBV-s-rec strain derived from cross breeding of HBV-transgenic mouse models that either accumulate (Alb/HBs, Tg[Alb1-HBV]Bri44) or lack (Tg1.4HBV-s-mut) the hepatitis B surface antigen (HBsAg). Tg1.4HBV-s-rec hepatocytes secreted HBsAg, Hepatitis B extracellular antigen (HBeAg) and produced HBV virions. Transmission electron microscopy visualised viral particles (Tg1.4HBV-s-rec), nuclear capsid formations (Tg1.4HBV-s-mut and Tg1.4HBV-s-rec) and endoplasmic reticulum malformations (Alb/HBs). Viral replication in Tg1.4HBV-s-rec and Tg1.4HBV-s-mut differed in HBsAg expression and interestingly in the distribution of HBV core antigen (HBcAg) and HBV × protein. While in Tg1.4HBV-s-mut hepatocytes, the HBcAg was located in the cytoplasm, in Tg1.4HBV-s-rec hepatocytes, the HBcAg appeared in the nuclei, suggesting a more productive replication. Finally, Tg1.4HBV-s-rec mice showed symptoms of mild hepatitis, with reduced liver function and elevated serum transaminases, which appeared to be related to natural killer T cell activation. In conclusion, the study of Alb/HBs, Tg1.4HBV-s-mut and their F1 progeny provides a powerful tool to elucidate HBV pathophysiology, especially in the early HBeAg-positive phases of chronic infection and chronic hepatitis.

Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy. It is often caused by mutations of genes encoding for sarcomeric or sarcomere-associated proteins. Despite its clinical importance, divergent definitions are published by major cardiology societies. Some regard HCM as a specific genetic disease, whereas others define it as a broad ‘spectrum of the thick heart’. The present narrative review aimed to assess both definitions from a pathoanatomical perspective. As a conjoint interdisciplinary and translational approach is needed to further increase knowledge and improve the understanding of HCM, the PubMed database was searched using several advanced search algorithms to explore the perspectives of the (forensic) pathologist, clinician, and basic researcher regarding the difference between the definitions of HCM. This discrepancy between definitions can impact critical data, such as prevalence and mortality rate, and complicate the understanding of the disease. For example, due to the different definitions, research findings regarding molecular changes from studies applying the narrow definition cannot be simply extended to the ‘spectrum’ of HCM.

We report on strong field ionization of S- and R-propylene oxide in circularly polarized two-color laser fields. We find that the relative helicity of the two single-color laser fields affects the photoelectron circular dichroism (PECD). Further, we observe that PECD is modulated as a function of the subcycle release time of the electron. Our experimental observations are successfully described by a heuristic model based on electrons in chiral initial states, which are selectively liberated by the laser field and, after tunneling, interact with an achiral Coulomb potential.

Societal Impact Statement Grasses are significant drivers of fires and are the primary food source for cattle in Madagascar's Central Highlands. However, their extent and importance to animals and people in the past remain poorly understood. Clarifying the history of Malagasy grasslands is necessary for building climate resilient food systems and supporting carbon stores that also conserve biodiversity. We generated chemical data for grasses that grow in open habitats in central Madagascar, which will help improve our understanding of the ecological and economic importance of modern grassy ecosystems, reconstruct the regional history of grasses, and anticipate how vegetation may respond to changing climate and rising atmospheric carbon dioxide levels. Summary Stable carbon isotope (δ13C) data for Malagasy grasses are needed to establish expected values for C3 and C4 grasses from particular regions in Madagascar, and possible differences among different grass lineages, or species with different distributions or adaptations. These data, in turn, may help inform how widespread grasses were in the past, and the importance of grasses to endemic and domesticated animals as well as people over time. We analysed both δ13C and weight %C:N from 63 Poaceae species that grow in open grassy biomes in Madagascar's Central Highlands and explored how these values relate to multiple variables, including encounter frequency, distribution, lineage, adaptations to grazing and fire and the typical floral assemblage in which each species occurs. Of the species sampled, 56 are C4 and seven are C3. There are no differences in δ13C or weight %C:N among either C3 or C4 species with different distributions or adaptations, from different assemblages, or that are frequently or infrequently encountered. However, there are differences in both δ13C and weight %C:N among C4 lineages, and the single C3 arundinoid (Styppeiochloa hitchcockii) has larger weight %C:N than C3 Paniceae. Our results provide a foundation for evaluating reliance on C4 resources by people, as well as domesticated and endemic animals both today and in the past. We encourage gathering additional comparative data for co‐occurring individual plants from the same open grassy biome localities, as well as other species, habitats and regions in Madagascar.

Abstract Glioblastoma multiforme (GBM) is probably the only tumor in which a unique epigenetic alteration, namely methylation of the MGMT gene, possesses direct clinical relevance. Now with the emergence of aberrant N6 methyladenosine (m6A) modifications (the most common epigenetic modification of mRNA, closely linked to the autophagy process) in cancer, the epi-transcriptomic landscape of GBM pathobiology has been expanded. Considering this, herein, we systematically analyzed m6A regulators, assessed their correlation with autophagy-related genes (ATG), and established a long non-coding RNAs (lncRNA)-dependent prognostic signature (m6A-autophagy-lncRNAs) for GBM. Our analysis identified a novel signature of five long non-coding RNAs (lncRNAs: ITGA6-AS1, AC124248.1, NFYC-AS1, AC025171.1, and AC005229.3) associated with survival of GBM patients, and four among them clearly showed cancer-associated potential. We further validated and confirmed the altered expression of two lncRNAs (AC124248.1, AC005229.3) in GBM associated clinical samples using RT-PCR. Concerning the prognostic ability, the obtained signature determined high-/low-risk groups in GBM patients and showed sensitivity to anticancer drugs. Collectively, the m6A-autophagy-lncRNAs signature presented in the study is clinically relevant and is the first attempt to systematically predict the potential interaction between the three key determinants (m6A, autophagy, lncRNA) in cancer, particularly in GBM.

Abstract Background Bone marrow (BM) transplantation is a life-saving therapy for hematological diseases, and the BM harbors also highly useful (progenitor) cell types for novel cell therapies manufacture. Yet, the BM collection technique is not standardized. Methods Benchmarking our collection efficiency to BM collections worldwide (N = 1248), we noted a great variability of total nucleated cell (TNC) yields in BM products (HPC-M) with superior performance of our center, where we have implemented a small volume aspirate policy. Thus, we next prospectively aimed to assess the impact of BM collection technique on HPC-M quality. For each BM collection (N = 20 donors), small volume (3 mL) and large volume (10 mL) BM aspirates were sampled at 3 time points and analyzed for cell composition. Results Compared to large volume aspirates, small volume aspirates concentrated more TNCs, immune cells, platelets, hematopoietic stem/progenitor cells, mesenchymal stromal cells (MSCs), and endothelial progenitors. Inversely, the hemoglobin concentration was higher in large volume aspirates indicating more hemoglobin loss. Manufacturing and dosing scenarios showed that small volume aspirates save up to 42% BM volume and 44% hemoglobin for HPC-M donors. Moreover, MSC production efficiency can be increased by more than 150%. Conclusions We propose to consider small volume BM aspiration as standard technique for BM collection.

Optimizing natural killer (NK) cell alloreactivity could further improve outcome after allogeneic hematopoietic cell transplantation (alloHCT). The donor’s Killer-cell Immunoglobulin-like Receptor (KIR) genotype may provide important information in this regard. In the past decade, different models have been proposed aiming at maximizing NK cell activation by activating KIR-ligand interactions or minimizing inhibitory KIR-ligand interactions. Alternative classifications intended predicting outcome after alloHCT by donor KIR-haplotypes. In the present study, we aimed at validating proposed models and exploring more classification approaches. To this end, we analyzed samples stored at the Collaborative Biobank from HLA-compatible unrelated stem cell donors who had donated for patients with acute myeloid leukemia (AML) or myelodysplastic neoplasm (MDS) and whose outcome data had been reported to EBMT or CIBMTR. The donor KIR genotype was determined by high resolution amplicon-based next generation sequencing. We analyzed data from 5,017 transplants. The median patient age at alloHCT was 56 years. Patients were transplanted for AML between 2013 and 2018. Donor-recipient pairs were matched for HLA-A, -B, -C, -DRB1, and -DQB1 (79%) or had single HLA mismatches. Myeloablative conditioning was given to 56% of patients. Fifty-two percent of patients received anti-thymocyte-globulin-based graft-versus-host disease prophylaxis, 32% calcineurin-inhibitor-based prophylaxis, and 7% post-transplant cyclophosphamide-based prophylaxis. We tested several previously reported classifications in multivariable regression analyses but could not confirm outcome associations. Exploratory analyses in 1,939 patients (39%) who were transplanted from donors with homozygous centromeric (cen) or telomeric (tel) A or B motifs, showed that the donor cen B/B-tel A/A diplotype was associated with a trend to better event-free survival (HR 0.84, p=.08) and reduced risk of non-relapse mortality (NRM) (HR 0.65, p=.01). When we further dissected the contribution of B subtypes, we found that only the cen B01/B01-telA/A diplotype was associated with a reduced risk of relapse (HR 0.40, p=.04) while all subtype combinations contributed to a reduced risk of NRM. This exploratory finding has to be validated in an independent data set. In summary, the existing body of evidence is not (yet) consistent enough to recommend use of donor KIR genotype information for donor selection in routine clinical practice.

Background & Aims: Hepatitis B surface antigen (HBsAg) drives hepatocarcinogenesis. Factors and mechanisms involved in this progression remain poorly defined, hindering the development of effective therapeutic strategies. Therefore, the mechanisms involved in the HBsAg-induced transformation of normal liver into hepatocellular carcinoma (HCC) were investigated. Methods: Hemizygous Tg(Alb1HBV)44Bri/J mice were examined for HBsAg-induced carcinogenic events. Gene set-enrichment analysis identified significant signatures in HBsAg-transgenic mice that correlated with endoplasmic reticulum (ER) stress, unfolded protein response, autophagy and proliferation. These events were investigated by western blotting, immunohistochemical and immunocytochemical staining in 2-, 8- and 12-month-old HBsAg-transgenic mice. The results were verified in HBsAg-overexpressing Hepa1-6 cells and validated in human HBV-related HCC samples. Results: Increased BiP expression in HBsAg-transgenic mice indicated induction of the unfolded protein response. In addition, early-phase autophagy was enhanced (increased BECN1 and LC3B) and late-phase autophagy blocked (increased p62) in HBsAg-transgenic mice. Finally, HBsAg altered lysosomal acidification via ATF4- and ATF6-mediated downregulation of lysosome-associated membrane protein 2 (LAMP2) expression. In patients, HBV-related HCC and adjacent tissues showed increased BiP, p62 and downregulated LAMP2 compared to uninfected controls. In vitro, the use of ER stress inhibitors reversed the HBsAg-related suppression of LAMP2. Furthermore, HBsAg promoted hepatocellular proliferation as indicated by Ki67, cleaved caspase-3 and AFP staining in paraffin-embedded liver sections from HBsAg-transgenic mice. These results were further verified by colony formation assays in HBsAg-expressing Hepa1-6 cells. Interestingly, inhibition of ER stress in HBsAg-overexpressing Hepa1-6 cells suppressed HBsAg-mediated cell proliferation. Conclusions: These data showed that HBsAg directly induces ER stress, impairs autophagy and promotes proliferation, thereby driving hepatocarcinogenesis. In addition, this study expanded the understanding of HBsAg-mediated intracellular events in carcinogenesis. Impact and implications: Factors and mechanisms involved in hepatocarcinogenesis driven by hepatitis B surface antigen (HBsAg) are poorly defined, hindering the development of effective therapeutic strategies. This study showed that HBsAg-induced endoplasmic reticulum stress suppressed LAMP2, thereby mediating autophagic injury. The present data suggest that restoring LAMP2 function in chronic HBV infection may have both antiviral and anti-cancer effects. This study has provided insights into the role of HBsAg-mediated intracellular events in carcinogenesis and thereby has relevance for future drug development.

Background: Major depressive disorder (MDD) is a leading cause of disability. To understand why depression develops, it is important to distinguish between early neural markers of vulnerability that precede the onset of MDD and features that develop during depression. Recent neuroimaging findings suggest that reduced global and regional intracortical myelination (ICM), especially in the lateral prefrontal cortex, may be associated with depression, but it is unknown whether it is a precursor or a consequence of MDD. The study of offspring of affected parents offers the opportunity to distinguish between precursors and consequences by examining individuals who carry high risk at a time when they have not experienced depression. Methods: We acquired 129 T1-weighted and T2-weighted scans from 56 (25 female) unaffected offspring of parents with depression and 114 scans from 63 (34 female) unaffected offspring of parents without a history of depression (ages 9 to 16 years). To assess scan quality, we calculated test-retest reliability. We used the scan ratios to calculate myelin maps for 68 cortical regions. We analyzed data using mixed-effects modeling. Results: ICM did not differ between high and low familial risk youths in global (B = 0.06, SE = 0.03, p = .06) or regional (B = 0.05, SE = 0.03, p = .08) analyses. Our pediatric sample had high ICM reliability (intraclass correlation coefficient = 0.79; 95% CI, 0.55–0.88). Conclusions: Based on our results, reduced ICM does not appear to be a precursor of MDD. Future studies should examine ICM in familial high-risk youths across a broad developmental period.

IntroductionA multitude of findings from cell cultures and animal studies are available to support the anti-cancer properties of cannabidiol (CBD). Since CBD acts on multiple molecular targets, its clinical adaptation, especially in combination with cancer immunotherapy regimen remains a serious concern.MethodsConsidering this, we extensively studied the effect of CBD on the cytokine-induced killer (CIK) cell immunotherapy approach using multiple non-small cell lung cancer (NSCLC) cells harboring diverse genotypes.ResultsOur analysis showed that, a) The Transient Receptor Potential Cation Channel Subfamily V Member 2 (TRPV2) channel was intracellularly expressed both in NSCLC cells and CIK cells. b) A synergistic effect of CIK combined with CBD, resulted in a significant increase in tumor lysis and Interferon gamma (IFN-g) production. c) CBD had a preference to elevate the CD25+CD69+ population and the CD62L_CD45RA+terminal effector memory (EMRA) population in NKT-CIK cells, suggesting early-stage activation and effector memory differentiation in CD3+CD56+ CIK cells. Of interest, we observed that CBD enhanced the calcium influx, which was mediated by the TRPV2 channel and elevated phosphor-Extracellular signal-Regulated Kinase (p-ERK) expression directly in CIK cells, whereas ERK selective inhibitor FR180204 inhibited the increasing cytotoxic CIK ability induced by CBD. Further examinations revealed that CBD induced DNA double-strand breaks via upregulation of histone H2AX phosphorylation in NSCLC cells and the migration and invasion ability of NSCLC cells suppressed by CBD were rescued using the TRPV2 antagonist (Tranilast) in the absence of CIK cells. We further investigated the epigenetic effects of this synergy and found that adding CBD to CIK cells decreased the Long Interspersed Nuclear Element-1 (LINE-1) mRNA expression and the global DNA methylation level in NSCLC cells carrying KRAS mutation. We further investigated the epigenetic effects of this synergy and found that adding CBD to CIK cells decreased the Long Interspersed Nuclear Element-1 (LINE-1) mRNA expression and the global DNA methylation level in NSCLC cells carrying KRAS mutation.ConclusionsTaken together, CBD holds a great potential for treating NSCLC with CIK cell immunotherapy. In addition, we utilized NSCLC with different driver mutations to investigate the efficacy of CBD. Our findings might provide evidence for CBD-personized treatment with NSCLC patients.

Atmospheric boundary layers (ABLs) exhibit transient processes on various time scales that range from a few days down to seconds, with a scale separation of the large-scale forcing and the small-scale turbulent response. One of the standing challenges in modeling and simulation of ABLs is a physically based representation of complex multiscale boundary layer dynamics. In this study, an idealized time-dependent ABL, the so-called Ekman–Stokes boundary layer (ESBL), is considered as a simple model for the near-surface flow in the mid latitudes and polar regions. The ESBL is driven by a prescribed temporal modulation of the bulk–surface velocity difference. A stochastic one-dimensional turbulence (ODT) model is applied to the ESBL as standalone tool that aims to resolve all relevant scales of the flow along a representative vertical coordinate. It is demonstrated by comparison with reference data that ODT is able to capture relevant features of the time-dependent boundary layer flow. The model predicts a parametric enhancement of the bulk–surface coupling in the event of a boundary layer resonance when the flow is forced with the local Coriolis frequency. The latter reproduces leading order effects of the critical latitudes. The model results suggest that the bulk flow decouples from the surface for high forcing frequencies due to a relative increase in detached residual turbulence.

Explosive volcanic eruptions emitting large amounts of sulfur can alter the temperature of the lower stratosphere and change the circulation of the middle atmosphere. The dynamical response of the stratosphere to strong volcanic eruptions has been the subject of numerous studies. The impact of volcanic eruptions on the mesosphere is less well understood because of a lack of large eruptions in the satellite era and only sparse observations before that period. Nevertheless, some measurements indicated an increase in mesospheric mid-latitude temperatures after the 1991 Pinatubo eruption. The aim of this study is to uncover potential dynamical mechanisms that may lead to such a mesospheric temperature response. We use the Upper-Atmospheric ICOsahedral Non-hydrostatic (UA-ICON) model to simulate the atmospheric response to an idealized strong volcanic injection of 20 Tg S into the stratosphere (about twice as much as the eminent 1991 Pinatubo eruption). Two experiments with differently parameterized effects of sub-grid-scale orography are compared to test the impact of different atmospheric background states. The simulations show a significant warming of the polar summer mesopause of up to 15–21 K in the first November after the eruption. We argue that this is mainly due to intrahemispheric dynamical coupling in the summer hemisphere and is potentially enhanced by interhemispheric coupling with the winter stratosphere. This study focuses on the first austral summer after the eruption because mesospheric temperature anomalies are especially relevant for the properties of noctilucent clouds, whose season peaks around January in the Southern Hemisphere.

The World Health Organisation develops and promotes international standards for pharmaceutical products, in support of efforts to increase access to quality-assured medicines for all, and to safeguard patients from substandard and falsified medicines. The International Pharmacopoeia is a key output of this work. Its focus, processes to establish texts for inclusion or revision, response to COVID-19 and the collaboration with other Pharmacopoeias shall be discussed in this review. Pharmacopoeias provide public standards (written norms as well as physical reference standards), which ensure the quality of medicines by defining the attributes that are essential to their safety and efficacy. They consist of analytical methods to test for the identity, purity and content of pharmaceutical products, together with acceptance criteria to evaluate test results, and information about storage, labelling and production. Pharmacopoeias greatly facilitate the development of multi-source medicines (generics) by defining minimum quality standards that a group of medicines must meet in order to be considered of commensurate safety, quality and effectiveness as the originator product(s). The added value of The International Pharmacopoeia lies in its focus on monographs of particular relevance to lowand middle-income countries which may not have sufficient resources to develop national pharmacopoeias. In a globalised world, where medicines and health products are frequently sourced from several countries with differing regulatory standards and requirements, and when the response to Public Health Emergencies of International Concern, like the COVID-19 pandemic, necessitates swift and equitable access to urgently needed quality-assured therapeutics, such a resource is indispensable.