Minor inheritance inhibits the calibration of the 10Be production rate from the AD 1717 Val Ferret rock avalanche, European Alps

To calibrate the in situ 10Be production rate, we collected surface samples from nine large granitic boulders within the deposits of a rock avalanche that occurred in AD 1717 in the upper Ferret Valley, Mont Blanc Massif, Italy. The 10Be concentrations were extremely low and successfully measured within 10% analytical uncertainty or less. The concentrations vary from 4829 ± 448 to 5917 ± 476 at g−1. Using the historical age exposure time, we calculated the local and sea level-high latitude (i.e. ≥60°) cosmogenic 10Be spallogenic production rates. Depending on the scaling schemes, these vary between 4.60 ± 0.38 and 5.26 ± 0.43 at g−1 a−1. Although they correlate well with global values, our production rates are clearly higher than those from more recent calibration sites. We conclude that our 10Be production rate is a mean and an upper bound for production rates in the Massif region over the past 300 years. This rate is probably influenced by inheritance and will yield inaccurate (e.g. too young) exposure ages when applied to surface-exposure studies in the area. Other independently dated rock-avalanche deposits in the region that are approximately 103 years old could be considered as possible calibration sites.

Time to initiation of antiretroviral therapy among patients with HIV-associated tuberculosis in Cape Town, South Africa

We studied the time interval between starting tuberculosis treatment and commencing antiretroviral treatment (ART) in HIV-infected patients (n = 1433; median CD4 count 71 cells per microliter, interquartile range: 32-132) attending 3 South African township ART services between 2002 and 2008. The overall median delay was 2.66 months (interquartile range: 1.58-4.17). In adjusted analyses, delays varied between treatment sites but were shorter for patients with lower CD4 counts and those treated in more recent calendar years. During the most recent period (2007-2008), 4.7%, 19.7%, and 51.1% of patients started ART within 2, 4, and 8 weeks of tuberculosis treatment, respectively. Operational barriers must be tackled to permit further acceleration of ART initiation as recommended by 2010 WHO ART guidelines.

An ice-core based history of Siberian forest fires since AD 1250

Forest fires play a key role in the global carbon cycle and thus, can affect regional and global climate. Although fires in extended areas of Russian boreal forests have a considerable influence on atmospheric greenhouse gas and soot concentrations, estimates of their impact on climate are hampered by a lack of data on the history of forest fires. Especially regions with strong continental climate are of high importance due to an intensified development of wildfires. In this study we reconstruct the fire history of Southern Siberia during the past 750 years using ice-core based nitrate, potassium, and charcoal concentration records from Belukha glacier in the continental Siberian Altai. A period of exceptionally high forest-fire activity was observed between AD 1600 and 1680, following an extremely dry period AD 1540-1600. Ice-core pollen data suggest distinct forest diebacks and the expansion of steppe in response to dry climatic conditions. Coherence with a paleoenvironmental record from the 200 km distant Siberian lake Teletskoye shows that the vegetational shift AD 1540-1680, the increase in fire activity AD 1600-1680, and the subsequent recovery of forests AD 1700 were of regional significance. Dead biomass accumulation in response to drought and high temperatures around AD 1600 probably triggered maximum forest-fire activity AD 1600-1680. The extreme dry period in the 16th century was also observed at other sites in Central Asia and is possibly associated with a persistent positive mode of the Pacific Decadal Oscillation (PDO). No significant increase in biomass burning occurred in the Altai region during the last 300 years, despite strongly increasing temperatures and human activities. Our results imply that precipitation changes controlled fire-regime and vegetation shifts in the Altai region during the past 750 years. We conclude that high sensitivity of ecosystems to occasional decadal-scale drought events may trigger unprecedented environmental reorganizations under global-warming conditions.

On the variability of return periods of European winter precipitation extremes over the last three centuries

We investigate the changes of extreme European winter (December-February) precipitation back to 1700 and show for various European regions that return periods of extremely wet and dry winters are subject to significant changes both before and after the onset of anthropogenic influences. Generally, winter precipitation has become more extreme. We also examine the spatial pattern of the changes of the extremes covering the last 300 years where data quality is sufficient. Over central and Eastern Europe dry winters occurred more frequently during the 18th and the second part of the 19th century relative to 1951–2000. Dry winters were less frequent during both the 18th and 19th century over the British Isles and the Mediterranean. Wet winters have been less abundant during the last three centuries compared to 1951–2000 except during the early 18th century in central Europe. Although winter precipitation extremes are affected by climate change, no obvious connection of these changes was found to solar, volcanic or anthropogenic forcing. However, physically meaningful interpretation with atmospheric circulation changes was possible.

A 170 year spring phenology index of plants in eastern China

Extending phenological records into the past is essential for the understanding of past ecological change and evaluating the effects of climate change on ecosystems. A growing body of historical phenological information is now available for Europe, North America, and Asia. In East Asia, long-term phenological series are still relatively scarce. This study extracted plant phenological observations from old diaries in the period 1834–1962. A spring phenology index (SPI) for the modern period (1963–2009) was defined as the mean flowering time of three shrubs (first flowering of Amygdalus davidiana and Cercis chinensis, 50% of full flowering of Paeonia suffruticosa) according to the data availability. Applying calibrated transfer functions from the modern period to the historical data, we reconstructed a continuous SPI time series across eastern China from 1834 to 2009. In the recent 30 years, the SPI is 2.1–6.3 days earlier than during any other consecutive 30 year period before 1970. A moving linear trend analysis shows that the advancing trend of SPI over the past three decades reaches upward of 4.1 d/decade, which exceeds all previously observed trends in the past 30 year period. In addition, the SPI series correlates significantly with spring (February to April) temperatures in the study area, with an increase in spring temperature of 1°C inducing an earlier SPI by 3.1 days. These shifts of SPI provide important information regarding regional vegetation-climate relationships, and they are helpful to assess long term of climate change impacts on biophysical systems and biodiversity.

Early-Holocene afforestation processes in the lower subalpine belt of the Central Swiss Alps as inferred from macrofossil and pollen records

To reconstruct the vegetation history of the Upper Engadine, continuous sediment cores covering the past 11 800 years from Lej da Champfer and Lej da San Murezzan (Upper Engadine Valley, c. 1800 m a.s.l., southeastern Switzerland) have been analysed for pollen and plant macrofossils. The chronologies of the cores are based on 16 and 22 radiocarbon dates, respectively. The palaeobotanical records of both lakes are in agreement for the Holocene, but remarkable differences exist between the sites during the period 11 100 to 10 500 cal. BP, when Lej da Champfer was affected by re-sedimentation processes. Macrofossil data suggest that Holocene afforestation began at around 11400 cal. BP. A climatic deterioration, the Preboreal Oscillation, stopped and subsequently delayed the establishment of trees until c. 11000 cal. BP, when first Betula, then Pinus sylvestrislmugo, then Larix 300 years later, and finally Pinus cembra expanded within the lake catchment. Treeline was at c. 1500 m during the Younger Dryas (12 542- 11 550 cal. BP) in the Central Alps. Our results, along with other macrofossil studies from the Alps, suggest a nearly simultaneous afforestation (e.g., by Pinus sylvestris in the lower subalpine belt) between 1500 and 2340 m a.s.l. at around 11 400 to 11 300 cal. BP. We suggest that forest-limit species (e.g., Pinus cembra, Larix decidua) could expand faster at today's treeline (c. 2350 m a.s.l.), than 550 m lower. Earlier expansions at higher altitudes probably resulted from reduced competition with low-altitude trees (e.g. Pinus sylvestris) and herbaceous species. Comparison with other proxies such as oxygen isotopes, residual A14C, glacier fluctuations, and alpine climatic cooling phases suggests climatic sensitivity of vegetation during the early Holocene.

Herbivores limit the population size of big-leaf mahogany trees in an Amazonian forest

The Janzen–Connell hypothesis proposes that specialized herbivores maintain high numbers of tree species in tropical forests by restricting adult recruitment so that host populations remain at low densities. We tested this prediction for the large timber tree species, Swietenia macrophylla, whose seeds and seedlings are preyed upon by small mammals and a host-specific moth caterpillar Steniscadia poliophaea, respectively. At a primary forest site, experimental seed additions to gaps – canopy-disturbed areas that enhance seedling growth into saplings – over three years revealed lower survival and seedling recruitment closer to conspecific trees and in higher basal area neighborhoods, as well as reduced subsequent seedling survival and height growth. When we included these Janzen–Connell effects in a spatially explicit individual-based population model, the caterpillar's impact was critical to limiting Swietenia's adult tree density, with a > 10-fold reduction estimated at 300 years. Our research demonstrates the crucial but oft-ignored linkage between Janzen–Connell effects on offspring and population-level consequences for a long-lived, potentially dominant tree species.

Recent developments for surgical aortic valve replacement: the concept of sutureless valve technology

Aortic stenosis has become the most frequent type of valvular heart disease in Europe and North America and presents in the large majority of patients as calcified aortic stenosis in adults of advanced age. Surgical aortic valve replacement has been recognized to be the definitive therapy which improves considerably survival for severe aortic stenosis since more than 40 years. In the most recent period, operative mortality of isolated aortic valve replacement for aortic stenosis varies between 1–3% in low-risk patients younger than 70 years and between 4 and 8% in selected older adults. Long-term survival following aortic valve replacement is close to that observed in a control population of similar age. Numerous observational studies have consistently demonstrated that corrective surgery in symptomatic patients is invariably followed by a subjective improvement in quality of life and a substantial increase in survival rates. More recently, transcatheter aortic valve implantation (TAVI) has been demonstrated to be feasible in patients with high surgical risk using either a retrograde transfemoral or transsubclavian approach or an antegrade, transapical access. Reported 30-day mortality ranges between 5 and 15%) and is acceptable when compared to the risk predicted by the logistic EuroSCORE (varying between 20 and 35%) and the STS Score, although the EuroScore has been shown to markedly overestimate the effective operative risk. One major concern remains the high rate of paravalvular regurgitation which is observed in up to 85% of the patients and which requires further follow-up and critical evaluation. In addition, long-term durability of these valves with a focus on the effects of crimping remains to be addressed, although 3-5 year results are promising. Sutureless biological valves were designed to simplify and significantly accelerate the surgical replacement of a diseased valve and allow complete excision of the calcified native valve. Until now, there are 3 different sutureless prostheses that have been approved. The 3f Enable valve from ATS-Medtronic received CE market approval in 2010, the Perceval S from Sorin during Q1 of 2011 and the intuity sutureless prosthesis from Edwards in 2012. All these devices aim to facilitate valve surgery and therefore have the potential to decrease the invasivness and to shorten the conventional procedure without compromise in term of excision of the diseased valve. This review summarizes the history and the current knowledge of sutureless valve technology.

Mycobacterium microti infection in the cat: a case report, literature review and recent clinical experience

OVERVIEW: Mycobacterium microti infection is infrequently described in cats in the veterinary literature. It can be one of a large number of possible differential diagnoses in a feline patient with dermal nodules and non-healing draining ulcers, and can occasionally spread to involve the lungs and/or other areas of the body. CASE SUMMARY: This report describes the clinical signs, eventual diagnosis and variable response to treatment in a cat in Switzerland with recurrent cutaneous M microti infection. Only after several diagnostic and therapeutic attempts, over more than 2 years, was the species of Mycobacterium finally identified and targeted therapy given. PRACTICAL RELEVANCE: For any cat in which there is even a low suspicion of mycobacterial infection, the authors recommend that an aggressive diagnostic approach is taken. Tissue specimens should be collected and frozen early on, and, as soon as acid-fast bacilli are detected, samples should be sent to a mycobacterial reference laboratory for definitive identification. LITERATURE REVIEW: A review of the literature relating to the aetiopathogenesis, diagnosis and management of M microti infection in cats and dogs is included. This is supplemented with clinical and therapeutic experience gained from this case and other, unpublished cases managed over the past 15 years by one of the authors (DGM).

Outcome at two years of age in a Swiss national cohort of extremely preterm infants born between 2000 and 2008

Background While survival rates of extremely preterm infants have improved over the last decades, the incidence of neurodevelopmental disability (ND) in survivors remains high. Representative current data on the severity of disability and of risk factors associated with poor outcome in this growing population are necessary for clinical guidance and parent counselling. Methods Prospective longitudinal multicentre cohort study of preterm infants born in Switzerland between 240/7 and 276/7 weeks gestational age during 2000–2008. Mortality, adverse outcome (death or severe ND) at two years, and predictors for poor outcome were analysed using multilevel multivariate logistic regression. Neurodevelopment was assessed using Bayley Scales of Infant Development II. Cerebral palsy was graded after the Gross Motor Function Classification System. Results Of 1266 live born infants, 422 (33%) died. Follow-up information was available for 684 (81%) survivors: 440 (64%) showed favourable outcome, 166 (24%) moderate ND, and 78 (11%) severe ND. At birth, lower gestational age, intrauterine growth restriction and absence of antenatal corticosteroids were associated with mortality and adverse outcome (p < 0.001). At 360/7 weeks postmenstrual age, bronchopulmonary dysplasia, major brain injury and retinopathy of prematurity were the main predictors for adverse outcome (p < 0.05). Survival without moderate or severe ND increased from 27% to 39% during the observation period (p = 0.02). Conclusions In this recent Swiss national cohort study of extremely preterm infants, neonatal mortality was determined by gestational age, birth weight, and antenatal corticosteroids while neurodevelopmental outcome was determined by the major neonatal morbidities. We observed an increase of survival without moderate or severe disability.

Magnetic field exposure and neurodegenerative diseases--recent epidemiological studies

OBJECTIVES: To analyse the results of recent studies not yet included in a 2003 report of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) on occupational exposure to low-frequency electromagnetic fields as potential risk factor for neurodegenerative diseases. METHODS: A literature search was conducted in the online databases of PubMed, ISI Web of Knowledge, DIMDI and COCHRANE, as well as in specialised databases and journals. Eight studies published between January 2000 and July 2005 were included in the review. RESULTS: The findings of these studies contribute to the evidence of an association between occupational magnetic field exposure and the risk of dementia. Regarding amyotrophic lateral sclerosis, the recent results confirm earlier observations of an association with electric and electronic work and welding. Its relationship with magnetic field exposure remains unsolved. There are only few findings pointing towards an association between magnetic field exposure and Parkinson's disease. CONCLUSIONS: The epidemiological evidence for an association between occupational exposure to low-frequency electromagnetic fields and the risk of dementia has increased during the last five years. The impact of potential confounders should be evaluated in further studies.