Observations on the Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clinical Studies on Healthy Volunteers and Intensive Care Patients

Patients treated in intensive care units require sedation and analgesia. However, sedative drugs also have potential adverse effects, and there is no single ideal sedativeanalgesic drug for these patients. Dexmedetomidine is an apha2-adrenoceptor agonist licenced for sedation of intensive care patients and patients undergoing surgery and other invasive procedures. Several routes of parenteral administration (intravenous, intramuscular, subcutaneous and intranasal) have been utilized. In the present series of studies, the pharmacokinetics and pharmacodynamics of intranasally administered dexmedetomidine as well as the gastrointestinal effects of intravenous dexmedetomidine were determined in healthy volunteers. Pharmacokinetics of dexmedetomidine during long lasting, high-dose infusions were characterized in intensive care patients. The bioavailability of intranasal dexmedetomidine was relatively good (65%), but interindividual variation was large. Dexmedetomidine significantly inhibited gastric emptying and gastrointestinal transit. In intensive care patients, the elimination half-life of dexmedetomidine was somewhat longer than reported for infusions of shorter duration and in less ill patients or healthy volunteers. Dexmedetomidine appeared to have linear pharmacokinetics up to the studied dose rate of 2.5 μg/kg/h. Dexmedetomidine clearance was decreasing with age and its volume of distribution was increased in hypoalbuminaemic patients, resulting in a longer elimination half-life and context-sensitive half-time. Intranasally administered dexmedetomidine was efficacious and well tolerated, making it appropriate for clinical situations requiring light sedation. The clinical significance of the gastrointestinal inhibitory effects of dexmedetomidine should be further evaluated in intensive care patients. The possibility of potentially altered potency and effect duration should be taken into account when administering dexmedetomidine to elderly or hypoalbuminaemic patients.

Metrics for solar wind prediction models: Comparison of empirical, hybrid, and physics-based schemes with 8 years of L1 observations

Space weather effects on technological systems originate with energy carried from the Sun to the terrestrial environment by the solar wind. In this study, we present results of modeling of solar corona-heliosphere processes to predict solar wind conditions at the L1 Lagrangian point upstream of Earth. In particular we calculate performance metrics for (1) empirical, (2) hybrid empirical/physics-based, and (3) full physics-based coupled corona-heliosphere models over an 8-year period (1995–2002). L1 measurements of the radial solar wind speed are the primary basis for validation of the coronal and heliosphere models studied, though other solar wind parameters are also considered. The models are from the Center for Integrated Space-Weather Modeling (CISM) which has developed a coupled model of the whole Sun-to-Earth system, from the solar photosphere to the terrestrial thermosphere. Simple point-by-point analysis techniques, such as mean-square-error and correlation coefficients, indicate that the empirical coronal-heliosphere model currently gives the best forecast of solar wind speed at 1 AU. A more detailed analysis shows that errors in the physics-based models are predominately the result of small timing offsets to solar wind structures and that the large-scale features of the solar wind are actually well modeled. We suggest that additional “tuning” of the coupling between the coronal and heliosphere models could lead to a significant improvement of their accuracy. Furthermore, we note that the physics-based models accurately capture dynamic effects at solar wind stream interaction regions, such as magnetic field compression, flow deflection, and density buildup, which the empirical scheme cannot.

Evaluation of the model representation of the evolution of convective systems using satellite observations of outgoing longwave radiation

We introduce a technique for assessing the diurnal development of convective storm systems based on outgoing longwave radiation fields. Using the size distribution of the storms measured from a series of images, we generate an array in the lengthscale-time domain based on the standard score statistic. It demonstrates succinctly the size evolution of storms as well as the dissipation kinematics. It also provides evidence related to the temperature evolution of the cloud tops. We apply this approach to a test case comparing observations made by the Geostationary Earth Radiation Budget instrument to output from the Met Office Unified Model run at two resolutions. The 12km resolution model produces peak convective activity on all lengthscales significantly earlier in the day than shown by the observations and no evidence for storms growing in size. The 4km resolution model shows realistic timing and growth evolution although the dissipation mechanism still differs from the observed data.

Evaluating the structure and magnitude of the ash plume during the initial phase of the 2010 Eyjafjallajökull eruption using lidar observations and NAME simulations

The Eyjafjallajökull volcano in Iceland erupted explosively on 14 April 2010, emitting a plume of ash into the atmosphere. The ash was transported from Iceland toward Europe where mostly cloud-free skies allowed ground-based lidars at Chilbolton in England and Leipzig in Germany to estimate the mass concentration in the ash cloud as it passed overhead. The UK Met Office's Numerical Atmospheric-dispersion Modeling Environment (NAME) has been used to simulate the evolution of the ash cloud from the Eyjafjallajökull volcano during the initial phase of the ash emissions, 14–16 April 2010. NAME captures the timing and sloped structure of the ash layer observed over Leipzig, close to the central axis of the ash cloud. Relatively small errors in the ash cloud position, probably caused by the cumulative effect of errors in the driving meteorology en route, result in a timing error at distances far from the central axis of the ash cloud. Taking the timing error into account, NAME is able to capture the sloped ash layer over the UK. Comparison of the lidar observations and NAME simulations has allowed an estimation of the plume height time series to be made. It is necessary to include in the model input the large variations in plume height in order to accurately predict the ash cloud structure at long range. Quantitative comparison with the mass concentrations at Leipzig and Chilbolton suggest that around 3% of the total emitted mass is transported as far as these sites by small (<100 μm diameter) ash particles.

Comprehensive ground-based and in situ observations of substorm expansion phase onset

In this paper, we present comprehensive ground-based and space-based in situ geosynchronous observations of a substorm expansion phase onset on 1 October 2005. The Double Star TC-2 and GOES-12 spacecraft were both located within the substorm current wedge during the substorm expansion phase onset, which occurred over the Canadian sector. We find that an onset of ULF waves in space was observed after onset on the ground by extending the AWESOME timing algorithm into space. Furthermore, a population of low-energy field-aligned electrons was detected by the TC-2 PEACE instrument contemporaneous with the ULF waves in space. These electrons appear to be associated with an enhancement of field-aligned Poynting flux into the ionosphere which is large enough to power visible auroral displays. The observations are most consistent with a near-Earth initiation of substorm expansion phase onset, such as the Near-Geosynchronous Onset (NGO) substorm scenario. A lack of data from further downtail, however, means other mechanisms cannot be ruled out.

Southern annular mode dynamics in observations and models, Part I: The influence of climatological zonal wind biases in a comprehensive GCM

A common bias among global climate models (GCMs) is that they exhibit tropospheric southern annular mode (SAM) variability that is much too persistent in the Southern Hemisphere (SH) summertime. This is of concern for the ability to accurately predict future SH circulation changes, so it is important that it be understood and alleviated. In this two-part study, specifically targeted experiments with the Canadian Middle Atmosphere Model (CMAM) are used to improve understanding of the enhanced summertime SAM persistence. Given the ubiquity of this bias among comprehensive GCMs, it is likely that the results will be relevant for other climate models. Here, in Part I, the influence of climatological circulation biases on SAM variability is assessed, with a particular focus on two common biases that could enhance summertime SAM persistence: the too-late breakdown of the Antarctic stratospheric vortex and the equatorward bias in the SH tropospheric midlatitude jet. Four simulations are used to investigate the role of each of these biases in CMAM. Nudging and bias correcting procedures are used to systematically remove zonal-mean stratospheric variability and/or remove climatological zonal wind biases. The SAM time-scale bias is not alleviated by improving either the timing of the stratospheric vortex breakdown or the climatological jet structure. Even in the absence of stratospheric variability and with an improved climatological circulation, the model time scales are biased long. This points toward a bias in internal tropospheric dynamics that is not caused by the tropospheric jet structure bias. The underlying cause of this is examined in more detail in Part II of this study.

Observations of diurnal and spatial variability of radiative forcing by equatorial deep convective clouds

From geostationary satellite observations of equatorial Africa and the equatorial east Atlantic during May and June 2000 we explore the radiative forcing by deep convective cloud systems in these regions. Deep convective clouds (DCCs) are associated with a mean radiative forcing relative to non–deep convective areas of −39 W m−2 over the Atlantic Ocean and of +13 W m−2 over equatorial Africa (±10 W m−2 in both cases). We show that over land the timing of the daily cycle of convection relative to the daily cycle in solar illumination and surface temperature significantly affects the mean radiative forcing by DCCs. Displacement of the daily cycle of DCC coverage by 2 hours changes their overall radiative effect by ∼10 W m−2, with implications for the simulation of the radiative balance in this region. The timing of the minimum DCC cover over land, close to noon local time, means that the mean radiative forcing is nearly maximized.

Evaluation of two cloud parametrization schemes using ARM and Cloudnet observations

Ground-based remote-sensing observations from Atmospheric Radiation Measurement (ARM) and Cloud-Net sites are used to evaluate the clouds predicted by a weather forecasting and climate model. By evaluating the cloud predictions using separate measures for the errors in frequency of occurrence, amount when present, and timing, we provide a detailed assessment of the model performance, which is relevant to weather and climate time-scales. Importantly, this methodology will be of great use when attempting to develop a cloud parametrization scheme, as it provides a clearer picture of the current deficiencies in the predicted clouds. Using the Met Office Unified Model, it is shown that when cloud fractions produced by a diagnostic and a prognostic cloud scheme are compared, the prognostic cloud scheme shows improvements to the biases in frequency of occurrence of low, medium and high cloud and to the frequency distributions of cloud amount when cloud is present. The mean cloud profiles are generally improved, although it is shown that in some cases the diagnostic scheme produced misleadingly good mean profiles as a result of compensating errors in frequency of occurrence and amount when present. Some biases remain when using the prognostic scheme, notably the underprediction of mean ice cloud fraction due to the amount when present being too low, and the overprediction of mean liquid cloud fraction due to the frequency of occurrence being too high.

Validation of a priori CME arrival predictions made using real-time heliospheric imager observations

Between December 2010 and March 2013, volunteers for the Solar Stormwatch (SSW) Citizen Science project have identified and analyzed coronal mass ejections (CMEs) in the near real-time Solar Terrestrial Relations Observatory Heliospheric Imager observations, in order to make “Fearless Forecasts” of CME arrival times and speeds at Earth. Of the 60 predictions of Earth-directed CMEs, 20 resulted in an identifiable Interplanetary CME (ICME) at Earth within 1.5–6 days, with an average error in predicted transit time of 22 h, and average transit time of 82.3 h. The average error in predicting arrival speed is 151 km s−1, with an average arrival speed of 425km s−1. In the same time period, there were 44 CMEs for which there are no corresponding SSW predictions, and there were 600 days on which there was neither a CME predicted nor observed. A number of metrics show that the SSW predictions do have useful forecast skill; however, there is still much room for improvement. We investigate potential improvements by using SSW inputs in three models of ICME propagation: two of constant acceleration and one of aerodynamic drag. We find that taking account of interplanetary acceleration can improve the average errors of transit time to 19 h and arrival speed to 77 km s−1.

Digital spiral analysis for objective assessment of fine motor timing variability in Parkinson's disease

OBJECTIVES: To develop a method for objective assessment of fine motor timing variability in Parkinson’s disease (PD) patients, using digital spiral data gathered by a touch screen device. BACKGROUND: A retrospective analysis was conducted on data from 105 subjects including65 patients with advanced PD (group A), 15 intermediate patients experiencing motor fluctuations (group I), 15 early stage patients (group S), and 10 healthy elderly subjects (HE) were examined. The subjects were asked to perform repeated upper limb motor tasks by tracing a pre-drawn Archimedes spiral as shown on the screen of the device. The spiral tracing test was performed using an ergonomic pen stylus, using dominant hand. The test was repeated three times per test occasion and the subjects were instructed to complete it within 10 seconds. Digital spiral data including stylus position (x-ycoordinates) and timestamps (milliseconds) were collected and used in subsequent analysis. The total number of observations with the test battery were as follows: Swedish group (n=10079), Italian I group (n=822), Italian S group (n = 811), and HE (n=299). METHODS: The raw spiral data were processed with three data processing methods. To quantify motor timing variability during spiral drawing tasks Approximate Entropy (APEN) method was applied on digitized spiral data. APEN is designed to capture the amount of irregularity or complexity in time series. APEN requires determination of two parameters, namely, the window size and similarity measure. In our work and after experimentation, window size was set to 4 and similarity measure to 0.2 (20% of the standard deviation of the time series). The final score obtained by APEN was normalized by total drawing completion time and used in subsequent analysis. The score generated by this method is hence on denoted APEN. In addition, two more methods were applied on digital spiral data and their scores were used in subsequent analysis. The first method was based on Digital Wavelet Transform and Principal Component Analysis and generated a score representing spiral drawing impairment. The score generated by this method is hence on denoted WAV. The second method was based on standard deviation of frequency filtered drawing velocity. The score generated by this method is hence on denoted SDDV. Linear mixed-effects (LME) models were used to evaluate mean differences of the spiral scores of the three methods across the four subject groups. Test-retest reliability of the three scores was assessed after taking mean of the three possible correlations (Spearman’s rank coefficients) between the three test trials. Internal consistency of the methods was assessed by calculating correlations between their scores. RESULTS: When comparing mean spiral scores between the four subject groups, the APEN scores were different between HE subjects and three patient groups (P=0.626 for S group with 9.9% mean value difference, P=0.089 for I group with 30.2%, and P=0.0019 for A group with 44.1%). However, there were no significant differences in mean scores of the other two methods, except for the WAV between the HE and A groups (P<0.001). WAV and SDDV were highly and significantly correlated to each other with a coefficient of 0.69. However, APEN was not correlated to neither WAV nor SDDV with coefficients of 0.11 and 0.12, respectively. Test-retest reliability coefficients of the three scores were as follows: APEN (0.9), WAV(0.83) and SD-DV (0.55). CONCLUSIONS: The results show that the digital spiral analysis-based objective APEN measure is able to significantly differentiate the healthy subjects from patients at advanced level. In contrast to the other two methods (WAV and SDDV) that are designed to quantify dyskinesias (over-medications), this method can be useful for characterizing Off symptoms in PD. The APEN was not correlated to none of the other two methods indicating that it measures a different construct of upper limb motor function in PD patients than WAV and SDDV. The APEN also had a better test-retest reliability indicating that it is more stable and consistent over time than WAV and SDDV.

Light microscope observations on the epididymis of paca (Agouti paca)

The features of paca epididymis, based on its appearance in light microscope, is described in this paper. The cellular population of the epithelial lining comprises principal cells, basal cells, apical cells, narrows cells, and hallo cells. The epididymis is divided in five distinct and continuous regions, Zone I, or initial segment, and zone II, are both localized into the head. Zone III comprises the distal head and all the body. Zones IV and V are restricted to the tail, in the proximal and distal cauda epididymis respectively. Each zone can be readily distinguished on the basis of morphological characteristics. The height of epididymal epithelium is greater in zone I. There is a progressive increase in the diameter of the tubular lumen through the different areas, with the maximum in the zone V. The presence of a high epithelium, and the virtual absence of sperm in zone I suggest fast transit of spermatozoa in this region. Zone V comprises the distal tail, has smaller epithelial lining, greater luminal diameter, shorter stereocilia than the other zones, and contains spermatozoa packed inside the lumen, that characterizes this zone as a place of sperm storage. The findings are compared with other reports in rodents and other domestic animals, to contribute to the understanding of epididymal morphophysiology. © 2013 Firenze University Press.

Historical Observations of Humpback And Blue Whales in the North Atlantic Ocean: Clues to Migratory Routes and Possibly Additional Feeding Grounds

The seasonal distributions of humpback and blue whales (Megaptera novaeangliae and Balaenoptera musculus, respectively) in the North Atlantic Ocean are not fully understood. Although humpbacks have been studied intensively in nearshore or coastal feeding and breeding areas, their migratory movements between these areas have been largely inferred. Blue whales have only been studied intensively along the north shore of the Gulf of St. Lawrence, and their seasonal occurrence and movements elsewhere in the North Atlantic are poorly known. We investigated the historical seasonal distributions of these two species using sighting and catch data extracted from American 18th and 19th century whaling logbooks. These data suggest that humpback whales migrated seasonally from low-latitude calving/ breeding grounds over a protracted period, and that some of them traveled far offshore rather than following coastal routes. Also, at least some humpbacks apparently fed early in the summer west of the Mid-Atlantic Ridge, well south of their known present-day feeding grounds. In assessing the present status of the North Atlantic humpback population, it will be important to determine whether such offshore feeding does in fact occur. Blue whales were present across the southern half of the North Atlantic during the autumn and winter months, and farther north in spring and summer, but we had too few data points to support inferences about these whales’ migratory timing and routes.

Planetary transit candidates in the CoRoT LRa01 field

Context. CoRoT is a pioneering space mission whose primary goals are stellar seismology and extrasolar planets search. Its surveys of large stellar fields generate numerous planetary candidates whose lightcurves have transit-like features. An extensive analytical and observational follow-up effort is undertaken to classify these candidates. Aims. We present the list of planetary transit candidates from the CoRoT LRa01 star field in the Monoceros constellation toward the Galactic anti-center direction. The CoRoT observations of LRa01 lasted from 24 October 2007 to 3 March 2008. Methods. We acquired and analyzed 7470 chromatic and 3938 monochromatic lightcurves. Instrumental noise and stellar variability were treated with several filtering tools by different teams from the CoRoT community. Different transit search algorithms were applied to the lightcurves. Results. Fifty-one stars were classified as planetary transit candidates in LRa01. Thirty-seven (i.e., 73% of all candidates) are "good" planetary candidates based on photometric analysis only. Thirty-two (i.e., 87% of the "good" candidates) have been followed-up. At the time of writing twenty-two cases were solved and five planets were discovered: three transiting hot-Jupiters (CoRoT-5b, CoRoT-12b, and CoRoT-21b), the first terrestrial transiting planet (CoRoT-7b), and another planet in the same system (CoRoT-7c, detected by radial velocity survey only). Evidence of another non-transiting planet in the CoRoT-7 system, namely CoRoT-7d, was recently found as well.

Importance of vegetation, topography and flow paths for water transit times of base flow in alpine headwater catchments

The mean transit time (MTT) of water in a catchment gives information about storage, flow paths, sources of water and thus also about retention and release of solutes in a catchment. To our knowledge there are only a few catchment studies on the influence of vegetation cover changes on base flow MTTs. The main changes in vegetation cover in the Swiss Alps are massive shrub encroachment and forest expansion into formerly open habitats. Four small and relatively steep headwater catchments in the Swiss Alps (Ursern Valley) were investigated to relate different vegetation cover to water transit times. Time series of water stable isotopes were used to calculate MTTs. The high temporal variation of the stable isotope signals in precipitation was strongly dampened in stream base flow samples. MTTs of the four catchments were 70 to 102 weeks. The strong dampening of the stable isotope input signal as well as stream water geochemistry points to deeper flow paths and mixing of waters of different ages at the catchments' outlets. MTTs were neither related to topographic indices nor vegetation cover. The major part of the quickly infiltrating precipitation likely percolates through fractured and partially karstified deeper rock zones, which increases the control of bedrock flow paths on MTT. Snow accumulation and the timing of its melt play an important role for stable isotope dynamics during spring and early summer. We conclude that, in mountainous headwater catchments with relatively shallow soil layers, the hydrogeological and geochemical patterns (i.e. geochemistry, porosity and hydraulic conductivity of rocks) and snow dynamics influence storage, mixing and release of water in a stronger way than vegetation cover or topography do.

Optimal sequence timing of CT angiography and perfusion CT in patients with stroke

OBJECTIVE Standard stroke CT protocols start with non-enhanced CT followed by perfusion-CT (PCT) and end with CTA. We aimed to evaluate the influence of the sequence of PCT and CTA on quantitative perfusion parameters, venous contrast enhancement and examination time to save critical time in the therapeutic window in stroke patients. METHODS AND MATERIALS Stroke CT data sets of 85 patients, 47 patients with CTA before PCT (group A) and 38 with CTA after PCT (group B) were retrospectively analyzed by two experienced neuroradiologists. Parameter maps of cerebral blood flow, cerebral blood volume, time to peak and mean transit time and contrast enhancements (arterial and venous) were compared. RESULTS Both readers rated contrast of brain-supplying arteries to be equal in both groups (p=0.55 (intracranial) and p=0.73 (extracranial)) although the extent of venous superimposition of the ICA was rated higher in group B (p=0.04). Quantitative perfusion parameters did not significantly differ between the groups (all p>0.18), while the extent of venous superimposition of the ICA was rated higher in group B (p=0.04). The time to complete the diagnostic CT examination was significantly shorter for group A (p<0.01). CONCLUSION Performing CTA directly after NECT has no significant effect on PCT parameters and avoids venous preloading in CTA, while examination times were significantly shorter.