First continuous ground-based observations of long period oscillations in strato-/mesospheric wind profiles

Direct measurements of middle-atmospheric wind oscillations with periods between 5 and 50 days in the altitude range between mid-stratosphere (5 hPa) and upper mesosphere (0.02 hPa) have been made using a novel ground-based Doppler wind radiometer. The oscillations were not inferred from measurements of tracers, as the radiometer offers the unique capability of near-continuous horizontal wind profile measurements. Observations from four campaigns at high, mid and low latitudes with an average duration of 10 months have been analyzed. The dominant oscillation has mostly been found to lie in the extra-long period range (20–40 days), while the well-known atmospheric normal modes around 5, 10 and 16 days have also been observed. Comparisons of our results with ECMWF operational analysis model data revealed remarkably good agreement below 0.3 hPa but discrepancies above.

The HARPS search for southern extra-solar planets XXXVII. Five new long-period giant planets and a system update

We describe radial-velocity time series obtained by HARPS on the 3.60 m telescope in La Silla (ESO, Chile) over ten years and report the discovery of five new giant exoplanets in distant orbits; these new planets orbit the stars HD 564, HD 30669, HD 108341, and BD -114672. Their periods range from 492 to 1684 days, semi-major axes range from 1.2 to 2.69 AU, and eccentricities range from 0 to 0.85. Their minimum mass ranges from 0.33 to 3.5 MJup. We also refine the parameters of two planets announced previously around HD 113538, based on a longer series of measurements. The planets have a period of 663 ± 8 and 1818 ± 25 days, orbital eccentricities of 0.14 ± 0.08 and 0.20 ± 0.04, and minimum masses of 0.36 ± 0.04 and 0.93 ± 0.06 MJup. Finally, we report the discovery of a new hot-Jupiter planet around an active star, HD 103720; the planet has a period of 4.5557 ± 0.0001 days and a minimum mass of 0.62 ± 0.025 MJup. We discuss the fundamental parameters of these systems and limitations due to stellar activity in quiet stars with typical 2 m s-1 radial velocity precision.

IDH/MGMT-driven molecular classification of low-grade glioma is a strong predictor for long-term survival

BACKGROUND Low-grade gliomas (LGGs) are rare brain neoplasms, with survival spanning up to a few decades. Thus, accurate evaluations on how biomarkers impact survival among patients with LGG require long-term studies on samples prospectively collected over a long period. METHODS The 210 adult LGGs collected in our databank were screened for IDH1 and IDH2 mutations (IDHmut), MGMT gene promoter methylation (MGMTmet), 1p/19q loss of heterozygosity (1p19qloh), and nuclear TP53 immunopositivity (TP53pos). Multivariate survival analyses with multiple imputation of missing data were performed using either histopathology or molecular markers. Both models were compared using Akaike's information criterion (AIC). The molecular model was reduced by stepwise model selection to filter out the most critical predictors. A third model was generated to assess for various marker combinations. RESULTS Molecular parameters were better survival predictors than histology (ΔAIC = 12.5, P< .001). Forty-five percent of studied patients died. MGMTmet was positively associated with IDHmut (P< .001). In the molecular model with marker combinations, IDHmut/MGMTmet combined status had a favorable impact on overall survival, compared with IDHwt (hazard ratio [HR] = 0.33, P< .01), and even more so the triple combination, IDHmut/MGMTmet/1p19qloh (HR = 0.18, P< .001). Furthermore, IDHmut/MGMTmet/TP53pos triple combination was a significant risk factor for malignant transformation (HR = 2.75, P< .05). CONCLUSION By integrating networks of activated molecular glioma pathways, the model based on genotype better predicts prognosis than histology and, therefore, provides a more reliable tool for standardizing future treatment strategies.

Pemphigus herpetiformis: analysis of the autoantibody profile during the disease course with changes in the clinical phenotype

Pemphigus herpetiformis (PH) is a rare dapsone-responsive variant of pemphigus, characterized by annular and vesiculopustular cutaneous lesions. Most PH serum samples contain autoantibodies against desmoglein (Dsg)1, but not Dsg3, and the presence of the latter is almost invariably associated with mucosal involvement, as predicted based on the 'Dsg compensation theory'. We describe a patient with features characteristic of PH with histologically eosinophilic spongiosis who repeatedly tested positive for anti-Dsg3 but not anti-Dsg1 autoantibodies by ELISA. To investigate whether the peculiar clinical phenotype was due to a distinct immunological profile, the patient's serum was tested by ELISA and immunoblotting using recombinant forms of Dsg3. Serum samples were found to have low and high reactivity against the EC1 and the EC4 domains of Dsg3, respectively, whereas the autoantibodies belonged predominantly to the IgG1 and IgG4 subclasses. The overall immunological profile was typical of pemphigus vulgaris. The patient finally developed isolated oral erosions 22 months after initial presentation, without significant changes in the autoantibody profile and of the targeted antigenic sites. Our patient presented features characteristic of PH. Although circulating anti-Dsg3 antibodies were present, the patient had only cutaneous involvement for a long period. Our findings indicate that the proposed Dsg compensation theory cannot always explain the clinical phenotype, changes in which may occur without apparent modification of the autoantibody profile and antibody specificity. Hence, additional factors, such as Fcgamma-dependent neutrophil activation, may critically affect the clinical presentation of pemphigus.

Interest in a national research network in surgery in Switzerland

Networks are known to improve performance and create synergies. A research network can provide a significant advantage for all parties involved in research in surgery by systematically tracking the outcome of a huge number of patients over a long period of time. The aim of the present study was to investigate the experiences of surgeons with respect to research activities, to evaluate the opinions of surgeons with regard to the development of a national network for research in the field of surgery in Switzerland and to obtain data on how such a network should be designed.

What has ageing to do with periodontal health and disease?

Periodontitis is a multi-factorial disease and in most cases also a disease with a chronic progression. Exposure to factors which contribute to periodontitis occurs over a long period, so that at the time of diagnosis it may be difficult to identify and evaluate what co-factors have contributed to its development. These include exposure to bacteria and viruses, inflammation, genetic factors, health behaviours and a variety of social factors, socio-economic status, behavioural and nutritional habits, the ability to cope with stress and the ability of the immune system to fight infections. Many patients in their 50s also experience other conditions such as heart disease, diabetes mellitus, or rheumatoid arthritis and recent reports on the associations and potential biological mechanisms by which periodontitis can be linked to other systemic diseases suggest that the patient with periodontitis is a challenged individual. Neither individuals nor their oral health care providers are currently prepared for the challenges in oral health care as the expectation of successful ageing with remaining and aesthetically functional teeth is increasing. The scientific evidence is, however, growing, and while the opportunities to prepare for successful ageing exist they must be included in the educational process of both current and future oral health care providers and their patients.

Seismic stratigraphy of the Blue Hole (Lighthouse Reef, Belize), a late Holocene climate and storm archive

Five seismic units may be identified in the similar to 8 m thick Holocene sediment package at the bottom of the Blue Hole, a 120 m deep sinkhole located in the atoll lagoon of Lighthouse Reef, Belize. These units may be correlated with the succession of an existing 5.85-m-long sediment core that reaches back to 1385 kyrs BP. The identification of seismic units is based on the fact that uniform, fine-grained background sediments show weak reflections while alternating background and coarser-grained event (storm) beds exhibit strong reflections in the seismic profiles. The main source of sediments is the marginal atoll reef and adjacent lagoon area to the east and north. Northeasterly winds and storms transport sediment into the Blue Hole, as seen in the eastward increase in sediment thickness, i.e., the eastward shallowing of the Blue Hole. Previous assumptions of much thicker Holocene sediment packages in the Blue Hole could not be confirmed. So far, close to 6-m-long cores were retrieved from the Blue Hole but the base of the sedimentary succession remains to be recovered. The nature of the basal sediments is unknown but mid-Holocene and possibly older, Pleistocene sinkhole deposits can be expected. The number of event beds identified in the Blue Hole (n = 37) during a 1.385 kyr-long period and the number of cyclones listed in historical databases suggest that only strong hurricanes (categories 4 and 5) left event beds in the Blue Hole sedimentary succession. Storm beds are numerous during 13-0.9 kyrs BP and 0.8-0.5 kyrs BP.

Penestragania apicalis (Osborn & Ball,1898),another invasive Nearctic leafhopper found in Europe

In 2010 the Nearctic leafhopper Penestragania apicalis (Osb.& Ball) was found for the first time in Europe. Altogether there are now 16 known localities in France, Switzerland, Germany and Austria indicating that the species is well established for a rather long period and more widespread in Europe and perhaps worldwide. As in North America it lives on honeylocust (Gleditsia triacanthos L.), overwinters in the egg stage and probably has one or two generations a year, with adults at least from late June until early October. It is yet unclear if it causes relevant damage to the host plant in Europe.

The palaeoecological history of the Praz-Rodet bog (Swiss Jura) based on pollen, plant macrofossils and testate amoebae (Protozoa)

Stratigraphy, radiocarbon dating and analyses of pollen, plant macrofossils and testate amoebae were used to reconstruct the development and ecology of a small raised bog in a karst-dominated landscape in the Swiss Jura Mountains. Special focus was on past vegetation and on the history of Pinus rotundata in relation to anthropogenic and climatic influences. Testate amoebae were used to reconstruc-t past local soil pH and water-table depth. The inferred development of the Praz-Rodet bog typifies a classic hydroseral tefrestrialization of a small basin. Two features are specific for this site. First, the bog was much wetter than today for a long period; according to our hypothesis, this only changed as a consequence of human activities. Second, two hiatuses are present at the coring location (Younger Dryas--early Preboreal, and 4700-2800 cal. yr BP), the former probably caused by low lake productivity due to cold temperatures and the latter by the erosional activity of the adjacent small river. The date of 2800 cal. yr BP for renewed peat accumulation may be related to climatic change (Subboreal-Subatlantic transition). Pollen indicators failed to show one hiatus: an apparently complete pollen sequence is therefore no guarantee of an uninterrupted sediment accumulation. Evidence of early minor human impact on the vegetation in the Joux Valley dates back to c. 6850 calendar years, congruous with the early Neolithic in the Jura Mountains. The history of Pinuis rotindata appears to be more complex than previously believed. Human activity is clearly responsible for the present abundance of this species, but the tree was naturally present on the bog long before the first evidence of important human disturbance of the site (1500 cal. yr BP). It is suggested that, in karst-dominated landscapes, dense forests growing on mineral soils around raised bogs may significantly reduce summer evapotranspiration by acting as windbreaks. Forest clearance results in increased evapotranspiration, causing a lowering of the water table on the bog and a modification of the vegetation cover. This hypothesis has implications for the management of similar small raised bogs in karst-dominated landscape.

Favourable long-term outcome after immediate treatment of neonatal hyperammonemia due to N-acetylglutamate synthase deficiency

INTRODUCTION: N-Acetylglutamate synthase (NAGS) deficiency is a rare urea cycle disorder, which may present in the neonatal period with severe hyperammonemia and marked neurological impairment. CASE REPORT: We report on a Turkish family with a patient who died due to hyperammonemia in the neonatal period. Reduced activity of NAGS and carbamyl phosphate synthetase were found at autopsy. A second child who developed hyperammonemia on the second day of life was immediately treated with arginine hydrochloride, sodium benzoate and protein restriction. After NAGS deficiency was suspected by enzyme analysis, sodium benzoate was replaced by N-carbamylglutamate (NCG). A third child who developed slight hyperammonemia on the third day of life was treated with NCG before enzyme analysis confirmed reduced NAGS activity. Neither of the patients developed hyperammonemia in the following years. After the human NAGS gene was identified, mutation analysis revealed that the older sibling on NCG therapy was homozygous for a 971G>A (W324X) mutation. The parents and the younger sibling were heterozygous. Therapy was continued in the older sibling until now without any adverse effects and favourable neurodevelopment outcome. In the younger sibling, therapy was stopped without any deterioration of urea cycle function. CONCLUSION: NAGS deficiency can be successfully treated with NCG and arginine hydrochloride with favourable outcome. Molecular diagnostic rather than enzyme analysis should be used in patients with suspected NAGS deficiency.

Prolonged inflammation following critical illness may impair long-term survival: a hypothesis with potential therapeutic implications

Despite successful intensive care a substantial portion of critically ill patients dies after discharge from the intensive care unit or hospital. Observational studies investigating long-term survival of critically ill patients reported that most deaths occur during the first months or year after discharge. Only limited data on the causes of impaired quality of life and post-intensive care unit deaths exist in the current literature. In this manuscript we hypothesize that the acute inflammatory response which characteristically accompanies critical illness is ensued by a prolonged imbalance or activation of the immune system. Such a chronic low-grade inflammatory response to critical illness may be sub-clinical and persist for a variable period of time after discharge from the intensive care unit and hospital. Chronic inflammation is a well-recognized risk factor for long-term morbidity and mortality, particularly from cardiovascular causes, and may thus partly contribute to the impaired quality of life as well as increased morbidity and mortality following intensive care unit and hospital discharge of critically ill patients. Assuming that critical illness is indeed followed by a prolonged inflammatory response, important implications for treatment would arise. An interesting and potentially beneficial therapy could be the administration of immune-modulating drugs during the time after intensive care unit or hospital discharge until chronic inflammation has subsided. Statins are well-investigated and effective drugs to attenuate chronic inflammation and could potentially also improve long-term outcome of critically ill patients after intensive care unit or hospital discharge. Future studies evaluating the course of inflammation during and after critical illness as well as its response to statin therapy are required.

Millennial and sub-millennial scale climatic variations recorded in polar ice cores over the last glacial period

Since its discovery in Greenland ice cores, the millennial scale climatic variability of the last glacial period has been increasingly documented at all latitudes with studies focusing mainly on Marine Isotopic Stage 3 (MIS 3; 28–60 thousand of years before present, hereafter ka) and characterized by short Dansgaard-Oeschger (DO) events. Recent and new results obtained on the EPICA and NorthGRIP ice cores now precisely describe the rapid variations of Antarctic and Greenland temperature during MIS 5 (73.5–123 ka), a time period corresponding to relatively high sea level. The results display a succession of abrupt events associated with long Greenland InterStadial phases (GIS) enabling us to highlight a sub-millennial scale climatic variability depicted by (i) short-lived and abrupt warming events preceding some GIS (precursor-type events) and (ii) abrupt warming events at the end of some GIS (rebound-type events). The occurrence of these sub-millennial scale events is suggested to be driven by the insolation at high northern latitudes together with the internal forcing of ice sheets. Thanks to a recent NorthGRIP-EPICA Dronning Maud Land (EDML) common timescale over MIS 5, the bipolar sequence of climatic events can be established at millennial to sub-millennial timescale. This shows that for extraordinary long stadial durations the accompanying Antarctic warming amplitude cannot be described by a simple linear relationship between the two as expected from the bipolar seesaw concept. We also show that when ice sheets are extensive, Antarctica does not necessarily warm during the whole GS as the thermal bipolar seesaw model would predict, questioning the Greenland ice core temperature records as a proxy for AMOC changes throughout the glacial period.

Eculizumab in atypical hemolytic uremic syndrome: long-term clinical course and histological findings

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy associated with defective regulation of the alternative complement pathway. The prognosis for patients with aHUS is poor, and plasma exchange represents the first-line therapy. Eculizumab is a humanized monoclonal anti-C5 antibody that prevents the activation of the terminal complement pathway. Here, we report the case of a 9-year-old girl with frequent relapsing aHUS due to heterozygous factor H mutation who was initially treated with plasma exchange three times per week with 150% plasma exchange volume. This treatment frequently caused allergic reactions and school absences. Because any reduction in the frequency of plasma exchange immediately induced relapses of the aHUS, treatment with eculizumab, 600 mg every 2 weeks, was started and plasma exchange completely stopped. On this drug regimen the patient showed no evidence of disease activity during a period of more than 24 months. Renal function improved, proteinuria disappeared, the number of antihypertensive medications could be decreased, and the quality of life increased substantially. The inhibition of the terminal complement pathway by eculizumab was also confirmed by renal biopsy, which showed the absence of thrombotic microangiopathy 2 months after the initiation of eculizumab therapy. This case illustrates the long-term favorable outcome of aHUS with eculizumab treatment.