Reliable prediction of clinical outcome in patients with chronic HCV infection and compensated advanced hepatic fibrosis: a validated model using objective and readily available clinical parameters.

OBJECTIVE Reliable tools to predict long-term outcome among patients with well compensated advanced liver disease due to chronic HCV infection are lacking. DESIGN Risk scores for mortality and for cirrhosis-related complications were constructed with Cox regression analysis in a derivation cohort and evaluated in a validation cohort, both including patients with chronic HCV infection and advanced fibrosis. RESULTS In the derivation cohort, 100/405 patients died during a median 8.1 (IQR 5.7-11.1) years of follow-up. Multivariate Cox analyses showed age (HR=1.06, 95% CI 1.04 to 1.09, p<0.001), male sex (HR=1.91, 95% CI 1.10 to 3.29, p=0.021), platelet count (HR=0.91, 95% CI 0.87 to 0.95, p<0.001) and log10 aspartate aminotransferase/alanine aminotransferase ratio (HR=1.30, 95% CI 1.12 to 1.51, p=0.001) were independently associated with mortality (C statistic=0.78, 95% CI 0.72 to 0.83). In the validation cohort, 58/296 patients with cirrhosis died during a median of 6.6 (IQR 4.4-9.0) years. Among patients with estimated 5-year mortality risks <5%, 5-10% and >10%, the observed 5-year mortality rates in the derivation cohort and validation cohort were 0.9% (95% CI 0.0 to 2.7) and 2.6% (95% CI 0.0 to 6.1), 8.1% (95% CI 1.8 to 14.4) and 8.0% (95% CI 1.3 to 14.7), 21.8% (95% CI 13.2 to 30.4) and 20.9% (95% CI 13.6 to 28.1), respectively (C statistic in validation cohort = 0.76, 95% CI 0.69 to 0.83). The risk score for cirrhosis-related complications also incorporated HCV genotype (C statistic = 0.80, 95% CI 0.76 to 0.83 in the derivation cohort; and 0.74, 95% CI 0.68 to 0.79 in the validation cohort). CONCLUSIONS Prognosis of patients with chronic HCV infection and compensated advanced liver disease can be accurately assessed with risk scores including readily available objective clinical parameters.

On the seasonal variations of salinity of the tropical Atlantic mixed layer

The physical processes controlling the mixed layer salinity (MLS) seasonal budget in the tropical Atlantic Ocean are investigated using a regional configuration of an ocean general circulation model. The analysis reveals that the MLS cycle is generally weak in comparison of individual physical processes entering in the budget because of strong compensation. In evaporative regions, around the surface salinity maxima, the ocean acts to freshen the mixed layer against the action of evaporation. Poleward of the southern SSS maxima, the freshening is ensured by geostrophic advection, the vertical salinity diffusion and, during winter, a dominant contribution of the convective entrainment. On the equatorward flanks of the SSS maxima, Ekman transport mainly contributes to supply freshwater from ITCZ regions while vertical salinity diffusion adds on the effect of evaporation. All these terms are phase locked through the effect of the wind. Under the seasonal march of the ITCZ and in coastal areas affected by river (7°S:15°N), the upper ocean freshening by precipitations and/or runoff is attenuated by vertical salinity diffusion. In the eastern equatorial regions, seasonal cycle of wind forced surface currents advect freshwaters, which are mixed with subsurface saline water because of the strong vertical turbulent diffusion. In all these regions, the vertical diffusion presents an important contribution to the MLS budget by providing, in general, an upwelling flux of salinity. It is generally due to vertical salinity gradient and mixing due to winds. Furthermore, in the equator where the vertical shear, associated to surface horizontal currents, is developed, the diffusion depends also on the sheared flow stability.

Modeling postglacial vegetation dynamics of temperate forests on the Olympic Peninsula (WA, USA) with special regard to snowpack

Past and future forest composition and distribution in temperate mountain ranges is strongly influenced by temperature and snowpack. We used LANDCLIM, a spatially explicit, dynamic vegetation model, to simulate forest dynamics for the last 16,000 years and compared the simulation results to pollen and macrofossil records at five sites on the Olympic Peninsula (Washington, USA). To address the hydrological effects of climate-driven variations in snowpack on simulated forest dynamics, we added a simple snow accumulation-and-melt module to the vegetation model and compared simulations with and without the module. LANDCLIM produced realistic present-day species composition with respect to elevation and precipitation gradients. Over the last 16,000 years, simulations driven by transient climate data from an atmosphere-ocean general circulation model (AOGCM) and by a chironomid-based temperature reconstruction captured Late-glacial to Late Holocene transitions in forest communities. Overall, the reconstruction-driven vegetation simulations matched observed vegetation changes better than the AOGCM-driven simulations. This study also indicates that forest composition is very sensitive to snowpack-mediated changes in soil moisture. Simulations without the snow module showed a strong effect of snowpack on key bioclimatic variables and species composition at higher elevations. A projected upward shift of the snow line and a decrease in snowpack might lead to drastic changes in mountain forests composition and even a shift to dry meadows due to insufficient moisture availability in shallow alpine soils.

A Bargaining Model of Holdouts and Takings

The holdout problem is commonly cited as the justification for eminent domain, but the nature of the problem is not well understood. This paper models the holdout problem in a bargaining framework, where a developer seeks to acquire several parcels of land for a large-scale development. We show that in the absence of eminent domain, holdouts are inevitable, threatening costly delay. However, if the developer has the power to use eminent domain to acquire the land from holdouts, all sellers will bargain, thus avoiding delay. An offsetting cost is that owners may negotiate prices below their true value, possibly resulting in excessive transfer of land to the developer.

Metastatic lung cancer in a new mouse model inheriting p53 and latent K-ras mutations

Lung cancer is a devastating disease with very poor prognosis. The design of better treatments for patients would be greatly aided by mouse models that closely resemble the human disease. The most common type of human lung cancer is adenocarcinoma with frequent metastasis. Unfortunately, current models for this tumor are inadequate due to the absence of metastasis. Based on the molecular findings in human lung cancer and metastatic potential of osteosarcomas in mutant p53 mouse models, I hypothesized that mice with both K-ras and p53 missense mutations might develop metastatic lung adenocarcinomas. Therefore, I incorporated both K-rasLA1 and p53RI72HΔg alleles into mouse lung cells to establish a more faithful model for human lung adenocarcinoma and for translational and mechanistic studies. Mice with both mutations ( K-rasLA1/+ p53R172HΔg/+) developed advanced lung adenocarcinomas with similar histopathology to human tumors. These lung adenocarcinomas were highly aggressive and metastasized to multiple intrathoracic and extrathoracic sites in a pattern similar to that seen in lung cancer patients. This mouse model also showed gender differences in cancer related death and developed pleural mesotheliomas in 23.2% of them. In a preclinical study, the new drug Erlotinib (Tarceva) decreased the number and size of lung lesions in this model. These data demonstrate that this mouse model most closely mimics human metastatic lung adenocarcinoma and provides an invaluable system for translational studies. ^ To screen for important genes for metastasis, gene expression profiles of primary lung adenocarcinomas and metastases were analyzed. Microarray data showed that these two groups were segregated in gene expression and had 79 highly differentially expressed genes (more than 2.5 fold changes and p<0.001). Microarray data of Bub1b, Vimentin and CCAM1 were validated in tumors by quantitative real-time PCR (QPCR). Bub1b , a mitotic checkpoint gene, was overexpressed in metastases and this correlated with more chromosomal abnormalities in metastatic cells. Vimentin, a marker of epithelial-mesenchymal transition (EMT), was also highly expressed in metastases. Interestingly, Twist, a key EMT inducer, was also highly upregulated in metastases by QPCR, and this significantly correlated with the overexpression of Vimentin in the same tumors. These data suggest EMT occurs in lung adenocarcinomas and is a key mechanism for the development of metastasis in K-ras LA1/+ p53R172HΔg/+ mice. Thus, this mouse model provides a unique system to further probe the molecular basis of metastatic lung cancer.^

Adaptation of the Bolivia community postabortion care model in Egypt and Peru

La implementación del modelo de la comunidad del PAC en los tres países demuestra que el modelo es adaptable a diferentes niveles, en diferentes configuraciones y en una variedad de contextos socioculturales. Con el fin de efectuar cambios positivos, es importante para crear comunidades fuertes y unidas como fuerza motriz del cambio en el tratamiento de temas relacionados con las complicaciones del aborto involuntario e incompleto

Modelled global ocean temperature from 6 ka to present

We compare the ocean temperature evolution of the Holocene as simulated by climate models and reconstructed from marine temperature proxies. This site provides informations about the Holocene temperature trends as simulated by the models. We use transient simulations from a coupled atmosphere-ocean general circulation model, as well as an ensemble of time slice simulations from the Paleoclimate Modelling Intercomparison Project. The general pattern of sea surface temperature (SST) in the models shows a high latitude cooling and a low latitude warming. The proxy dataset comprises a global compilation of marine alkenone- and Mg/Ca-derived SST estimates. Independently of the choice of the climate model, we observe significant mismatches between modelled and estimated SST amplitudes in the trends for the last 6000 years. Alkenone-based SST records show a similar pattern as the simulated annual mean SSTs, but the simulated SST trends underestimate the alkenone-based SST trends by a factor of two to five. For Mg/Ca, no significant relationship between model simulations and proxy reconstructions can be detected. We tested if such discrepancies can be caused by too simplistic interpretations of the proxy data. We tested different seasons and depths in the model to compare the proxy data trends, and can reconcile only part of the mismatches on a regional scale. We therefore considered the additional environmental factor changes in the planktonic organisms' habitat depth and a time-shift in the recording season to diagnose whether invoking those environmental factors can help reconciling the proxy records and the model simulations. We find that invoking shifts in the living season and habitat depth can remove some of the model-data discrepancies in SST trends. Regardless whether such adjustments in the environmental parameters during the Holocene are realistic, they indicate that when modeled temperature trends are set up to allow drastic shifts in the ecological behavior of planktonic organisms, they do not capture the full range of reconstructed SST trends. Our findings indicate that climate model and reconstructed temperature trends are to a large degree only qualitatively comparable, thus providing a challenge for the interpretation of proxy data as well as the models' sensitivity to orbital forcing.

EPICA Dome C Ice Core 800KYr deuterium data and temperature estimates

A high-resolution deuterium profile is now available along the entire European Project for Ice Coring in Antarctica Dome C ice core, extending this climate record back to marine isotope stage 20.2, ~800,000 years ago. Experiments performed with an atmospheric general circulation model including water isotopes support its temperature interpretation. We assessed the general correspondence between Dansgaard-Oeschger events and their smoothed Antarctic counterparts for this Dome C record, which reveals the presence of such features with similar amplitudes during previous glacial periods. We suggest that the interplay between obliquity and precession accounts for the variable intensity of interglacial periods in ice core records. Temperature was estimated after correction for sea-water isotopic composition (Bintanja et al, 2005) and for ice sheet elevation (Parrenin et al, 2007) on EDC3 age scale (Parrenin et al, 2007).

A coupled model for carbon and radiocarbon evolution during the last deglaciation, link to model results

Changes in the ventilation of the Southern Ocean are thought to play an important role on deglacial carbon and radiocarbon evolution, but have not been tested within a coupled climate-carbon model. Here, we present such a simulation based on a simple scenario of transient deglacial sinking of brines - sea-ice salt rejections - around Antarctica, which modulates Southern Ocean ventilation. This experiment is able to reproduce deglacial atmospheric changes in carbon and radiocarbon but also ocean radiocarbon records measured in the Atlantic, Southern and Pacific Oceans. Simulated for the first time in a fully coupled climate-carbon model including radiocarbon, our modeling results suggest that the deglacial changes in atmospheric carbon dioxide and radiocarbon were achieved by means of a breakdown in the glacial brine-induced stratification of the Southern Ocean.

Glacial-interglacial bioproductivity of the Mexican Margin

Sedimentary accumulation of biogenic components (organic carbon, opal, and biogenic barium) on the northwestern Mexican margin declined during every glacial interval of the past 140 kyr, indicating decreases in upwelling-induced productivity during cold periods. The glacial-interglacial contrasts in upwelling on this margin are attributed to reversals in land-ocean thermal contrast, the waxing and waning of the Laurentide Ice Sheet, and consequent responses of the western hemisphere wind fields. This scenario is consistent with three independent lines of evidence: terrestrial paleoclimatic data, general circulation model results, and our marine records. This pattern of glacial-interglacial variability in upwelling off NW Mexico is opposite to that observed in other low-latitude and midlatitude upwelling areas, such as the eastern equatorial Pacific. These results add to a growing pool of observations that the response of oceanic upwelling to glacial climatic forcing has been regionally variable.

Sea-surface temperature reconstruction of sediments from the North Pacific and North Atlantic

Holocene climate variability is investigated in the North Pacific and North Atlantic realms, using alkenone-derived sea-surface temperature (SST) records as well as a millennial scale simulation with a coupled atmosphere-ocean general circulation model (AOGCM). The alkenone SST data indicate a temperature increase over almost the entire North Pacific from 7 cal kyr BP to the present. A dipole pattern with a continuous cooling in the northeastern Atlantic and a warming in the eastern Mediterranean Sea and the northern Red Sea is detected in the North Atlantic realm. Similarly, SST variations are opposite in sign between the northeastern Pacific and the northeastern Atlantic. A 2300 year long AOGCM climate simulation reveals a similar SST seesaw between the northeastern Pacific and the northeastern Atlantic on centennial time scales. Our analysis of the alkenone SST data and the model results suggests fundamental inter-oceanic teleconnections during the Holocene.