Studio di marcatori biologici prognostici nel linfoma di Hodgkin

Recent reports showed that early-interim PET-scan is the only tool predicting treatment outcome in advanced-stage classical Hodgkin lymphoma (asCHL). We evaluated the prognostic impact of a series of immunohistochemical markers, mentioned in literature as prognostic factors, on tissue microarrays assembled from biopsies of 220 patients: STAT1, SAP, TOP2A, PCNA and CD20, both in neoplastic (HRSC) and microenvironment cells (MC); RRM2, MAD2, CDC2, BCL2, P53, BCL11A and EBER in HRSC; ALDH1A1, TIA-1, granzyme B, perforin, FOXP3, and PD-1 in MC. All patients had been treated with standard ABVD ± Rx therapy. Interim-PET after 2 ABVD courses was evaluated according to the criteria indicated by Gallamini in his study (Journal of Clinical Oncology, 2007). The survival analysis has been performed in a subset of 138 patients whose complete clinical information were available: the mean age was 33.3 years (14-79), the stage III-IVB in 98 and IIB in 40, and the mean follow-up 38.1 months (7.6-71.9). Histopathology review showed: NS-I 75, NS-II 22, MC 20, DL 3, and CHL/nos 18 cases. Interim-PET was positive in 30 patients, while treatment failure was recorded in 32. In univariate analysis the factors related to treatment outcome were BCL2 on HRSC (cut-off value 50%), STAT1/SAP on MC, and PET (Log-rank 6.9, 7.9 and 93.9 respectively). The combined expression of STAT1 and SAP was scored in three levels depending on the architectural pattern: score 0 for expression of both with a diffuse/rosetting pattern; score 1 for discordant combination of diffuse/rosetting and scattered patterns; score 2 for both markers with a scattered pattern; the 3y-PFS were 87.4%, 69.9% and 61.9% respectively. In multivariate analysis PET, BCL2 and STAT1/SAP remained significant (HR: 24.8, 4.6, 7.5 and 5.6, respectively; p<.01). The proposed model is able to predict treatment response in AsCHL, even if with a lower efficacy than PET. However, unlike PET, it can be applied upfront therapy.

L'evoluzione della tutela cautelare nel processo amministrativo

L’effettività della tutela cautelare, intesa come tutela tempestiva, adeguata e piena, è stata la linea cardine dell’evoluzione della giustizia amministrativa, che, nel corso di un periodo durato più di un secolo, grazie all’opera della giurisprudenza e della dottrina, si è strutturata oggi su un vero processo. Approdo recente, e allo stesso tempo, simbolo di questa evoluzione, è sicuramente il Codice del processo amministrativo emanato con il d. lgs. 2 luglio 2010, n. 104. La ricerca, di cui questo contributo costituisce un resoconto, è iniziata contestualmente all’entrata in vigore del nuovo testo, e quindi è stata anche l’occasione per vederne le prime applicazioni giurisprudenziali. In particolare la lettura del Codice, prescindendo da una mera ricognizione di tutto il suo lungo articolato, è stata fatta alla luce di una ponderazione, nell’attualità, non solo del principio di effettività, ma anche del principio di strumentalità che lega tradizionalmente la fase cautelare con la fase di merito. I risultati della ricerca manifestano la volontà del legislatore di confermare questo rapporto strumentale, per fronteggiare una deriva incontrollata verso una cautela dagli effetti alle volte irreversibili, quale verificatasi nell’applicazione giurisprudenziale, ma contestualmente evidenziano la volontà di estendere la portata della tutela cautelare. Guardando a cosa sia diventata oggi la tutela cautelare, si è assistito ad un rafforzamento degli effetti conformativi, tipici delle sentenze di merito ma che si sono estesi alla fase cautelare. I giudici, pur consapevoli che la tutela cautelare non sia una risposta a cognizione piena, bensì sommaria, intendono comunque garantire una tutela tempestiva ed effettiva, anche per il tramite di tecniche processuali particolari, come quella del remand, cui, all’interno della ricerca, viene dedicato ampio spazio. Nella sua ultima parte la ricerca si è focalizzata, sempre volendo guardare in maniera globale agli effetti della tutela cautelare, sul momento dell’esecuzione e quindi sul giudizio di ottemperanza.

Potential vorticity and moisture in extratropical cyclones : climatology and sensitivity experiments

The development of extratropical cyclones can be seen as an interplay of three positive potential vorticity (PV) anomalies: an upper-level stratospheric intrusion, low-tropospheric diabatically produced PV, and a warm anomaly at the surface acting as a surrogate PV anomaly. In the mature stage they become vertically aligned and form a “PV tower” associated with strong cyclonic circulation. This paradigm of extratropical cyclone development provides the basis of this thesis, which will use a climatological dataset and numerical model experiments to investigate the amplitude of the three anomalies and the processes leading in particular to the formation of the diabatically produced low-tropospheric PV anomaly.rnrnThe first part of this study, based on the interim ECMWF Re-Analysis (ERA-Interim) dataset, quantifies the amplitude of the three PV anomalies in mature extratropical cyclones in different regions in the Northern Hemisphere on a climatological basis. A tracking algorithm is applied to sea level pressure (SLP) fields to identify cyclone tracks. Surface potential temperature anomalies ∆θ and vertical profiles of PV anomalies ∆PV are calculated at the time of the cyclones’ minimum SLP and during the intensification phase 24 hours before in a vertical cylinder with a radius of 200 km around the surface cyclone center. To compare the characteristics of the cyclones, they are grouped according to their location (8 regions) and intensity, where the central SLP is used as a measure of intensity. Composites of ∆PV profiles and ∆θ are calculated for each region and intensity class at the time of minimum SLP and during the cyclone intensification phase.rnrnDuring the cyclones’ development stage the amplitudes of all three anomalies increase on average. In the mature stage all three anomalies are typically larger for intense than for weak winter cyclones [e.g., 0.6 versus 0.2 potential vorticity units (PVU) at lower levels, and 1.5 versus 0.5 PVU at upper levels].rnThe regional variability of the cyclones’ vertical structure and the profile evolution is prominent (cyclones in some regions are more sensitive to the amplitude of a particular anomaly than in other regions). Values of ∆θ and low-level ∆PV are on average larger in the western parts of the oceans than in the eastern parts. In addition, a large seasonal variability can be identified, with fewer and weaker cyclones especially in the summer, associated with higher low-tropospheric PV values, but also with a higher tropopause and much weaker surface potential temperature anomalies (compared to winter cyclones).rnrnIn the second part, we were interested in the diabatic low-level part of PV towers. Evaporative sources were identified of moisture that was involved in PV production through condensation. Lagrangian backward trajectories were calculated from the region with high PV values at low-levels in the cyclones. PV production regions were identified along these trajectories and from these regions a new set of backward trajectories was calculated and moisture uptakes were traced along them. The main contribution from surface evaporation to the specific humidity of the trajectories is collected 12-72 hours prior to therntime of PV production. The uptake region for weaker cyclones with less PV in the centre is typically more localized with reduced uptake values compared to intense cyclones. However, in a qualitative sense uptakes and other variables along single trajectories do not vary much between cyclones of different intensity in different regions.rnrnA sensitivity study with the COSMO model comprises the last part of this work. The study aims at investigating the influence of synthetic moisture modification in the cyclone environment in different stages of its development. Moisture was eliminated in three regions, which were identified as important moisture source regions for PV production. Moisture suppression affected the cyclone the most in its early phase. It led to cyclolysis shortly after its genesis. Nevertheles, a new cyclone formed on the other side of a dry box and developed relatively quickly. Also in other experiments, moisture elimination led to strong intensity reduction of the surface cyclone, limited upper-level development, and delayed or missing interaction between the two.rnrnIn summary, this thesis provides novel insight into the structure of different intensity categories of extratropical cyclones from a PV perspective, which corroborates the findings from a series of previous case studies. It reveals that all three PV anomalies are typically enhanced for more intense cyclones, with important regional differences concerning the relative amplitude of the three anomalies. The moisture source analysis is the first of this kind to study the evaporation-condensation cycle related to the intensification of extratropical cyclones. Interestingly, most of the evaporation occurs during the 3 days prior to the time of maximum cyclone intensity and typically extends over fairly large areas along the track of the cyclone. The numerical model case study complements this analysis by analyzing the impact of regionally confined moisture sources for the evolution of the cyclone.

The Combination of Interferon-Beta and HMG-CoA Reductase Inhibition in Multiple Sclerosis: Enthusiasm Lost too Soon?

Recent studies support the notion that statins, widely prescribed cholesterol-lowering agents, may target key elements in the immunological cascade leading to inflammation and tissue damage in the pathogenesis of multiple sclerosis (MS). Compelling experimental and observational clinical studies highlighted the possibility that statins may also exert immunomodulatory synergy with approved MS drugs, resulting in several randomized clinical trials testing statins in combination with interferon-beta (IFN-?). Some data, however, suggest that this particular combination may not be clinically beneficial, and might actually have a negative effect on the disease course in some patients with MS. In this regard, a small North American trial indicated that atorvastatin administered in combination with IFN-? may increase disease activity in relapsing-remitting MS. Although other trials did not confirm this finding, the enthusiasm for studies with statins dwindled. This review aims to provide a comprehensive overview of the completed clinical trials and reports of the interim analyses evaluating the combination of IFN-? and statins in MS. Moreover, we try to address the evident question whether usage of this combination routinely requires caution, since the number of IFN-?-treated MS patients receiving statins for lowering of cholesterol is expected to grow.

The Clearing Storm: A Re-Assessment of the Climate for Collaboration between Academic and Student Affairs

There is increasing recognition among those in higher education that it is no longer adequate to train students in a specific field or industry. Instead, the push is more towards producing well-rounded students. In order to do so, all of a university’s resources must come together and the climate on campus must be one that supportscollaboration. This report is a re-examination of the climate for collaboration on the campus of a private liberal arts university in the Mid-Atlantic region of the United States. It is a follow up to a similar investigation conducted on the same campus by Victor Arcelus(2008) five years earlier. In the interim, the university had re-configured its organizational structure, combining separate academic and student affairs divisions into a single unit overseen by the Provost. Additionally, the university had experienced turnover in several key leadership positions, including those of the President and the chief academic and student affairs officers. The purpose of this investigation, therefore, was to gauge the immediate impact of these changes on conditions for collaboration, which when present, advance student learning and development. Through interviews with six men and women, information was collected on the perceived climate for collaboration between academic and student affairs personnel.Analysis of the interview transcripts revealed that, depending on the position of the interviewee within the university, conditions on campus were seen as either improved or largely unchanged as a result of the transition in leadership and the structural merger of the two divisions.

Cardiorenal End Points in a Trial of Aliskiren for Type 2 Diabetes

BACKGROUND: This study was undertaken to determine whether use of the direct renin inhibitor aliskiren would reduce cardiovascular and renal events in patients with type 2 diabetes and chronic kidney disease, cardiovascular disease, or both. METHODS: In a double-blind fashion, we randomly assigned 8561 patients to aliskiren (300 mg daily) or placebo as an adjunct to an angiotensin-converting-enzyme inhibitor or an angiotensin-receptor blocker. The primary end point was a composite of the time to cardiovascular death or a first occurrence of cardiac arrest with resuscitation; nonfatal myocardial infarction; nonfatal stroke; unplanned hospitalization for heart failure; end-stage renal disease, death attributable to kidney failure, or the need for renal-replacement therapy with no dialysis or transplantation available or initiated; or doubling of the baseline serum creatinine level. RESULTS: The trial was stopped prematurely after the second interim efficacy analysis. After a median follow-up of 32.9 months, the primary end point had occurred in 783 patients (18.3%) assigned to aliskiren as compared with 732 (17.1%) assigned to placebo (hazard ratio, 1.08; 95% confidence interval [CI], 0.98 to 1.20; P=0.12). Effects on secondary renal end points were similar. Systolic and diastolic blood pressures were lower with aliskiren (between-group differences, 1.3 and 0.6 mm Hg, respectively) and the mean reduction in the urinary albumin-to-creatinine ratio was greater (between-group difference, 14 percentage points; 95% CI, 11 to 17). The proportion of patients with hyperkalemia (serum potassium level, ≥6 mmol per liter) was significantly higher in the aliskiren group than in the placebo group (11.2% vs. 7.2%), as was the proportion with reported hypotension (12.1% vs. 8.3%) (P<0.001 for both comparisons). CONCLUSIONS: The addition of aliskiren to standard therapy with renin-angiotensin system blockade in patients with type 2 diabetes who are at high risk for cardiovascular and renal events is not supported by these data and may even be harmful. (Funded by Novartis; ALTITUDE ClinicalTrials.gov number, NCT00549757.).

Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency

BACKGROUND: Individual adaptation of processed patient's blood volume (PBV) should reduce number and/or duration of autologous peripheral blood progenitor cell (PBPC) collections. STUDY DESIGN AND METHODS: The durations of leukapheresis procedures were adapted by means of an interim analysis of harvested CD34+ cells to obtain the intended yield of CD34+ within as few and/or short as possible leukapheresis procedures. Absolute efficiency (AE; CD34+/kg body weight) and relative efficiency (RE; total CD34+ yield of single apheresis/total number of preapheresis CD34+) were calculated, assuming an intraapheresis recruitment if RE was greater than 1, and a yield prediction models for adults was generated. RESULTS: A total of 196 adults required a total of 266 PBPC collections. The median AE was 7.99 x 10(6), and the median RE was 1.76. The prediction model for AE showed a satisfactory predictive value for preapheresis CD34+ only. The prediction model for RE also showed a low predictive value (R2 = 0.36). Twenty-eight children underwent 44 PBPC collections. The median AE was 12.13 x 10(6), and the median RE was 1.62. Major complications comprised bleeding episodes related to central venous catheters (n = 4) and severe thrombocytopenia of less than 10 x 10(9) per L (n = 16). CONCLUSION: A CD34+ interim analysis is a suitable tool for individual adaptation of the duration of leukapheresis. During leukapheresis, a substantial recruitment of CD34+ was observed, resulting in a RE of greater than 1 in more than 75 percent of patients. The upper limit of processed PBV showing an intraapheresis CD34+ recruitment is higher than in a standard large-volume leukapheresis. Therefore, a reduction of individually needed PBPC collections by means of a further escalation of the processed PBV seems possible.

Characterizing the effects of turbulence on sediment oxygen and sediment nitrate demand using flow-through reactors

Onondaga Lake has received the municipal effluent and industrial waste from the city of Syracuse for more than a century. Historically, 75 metric tons of mercury were discharged to the lake by chlor-alkali facilities. These legacy deposits of mercury now exist primarily in the lake sediments. Under anoxic conditions, methylmercury is produced in the sediments and can be released to the overlying water. Natural sedimentation processes are continuously burying the mercury deeper into the sediments. Eventually, the mercury will be buried to a depth where it no longer has an impact on the overlying water. In the interim, electron acceptor amendment systems can be installed to retard these chemical releases while the lake naturally recovers. Electron acceptor amendment systems are designed to meet the sediment oxygen demand in the sediment and maintain manageable hypolimnion oxygen concentrations. Historically, designs of these systems have been under designed resulting in failure. This stems from a mischaracterization of the sediment oxygen demand. Turbulence at the sediment water interface has been shown to impact sediment oxygen demand. The turbulence introduced by the electron amendment system can thus increase the sediment oxygen demand, resulting in system failure if turbulence is not factored into the design. Sediment cores were gathered and operated to steady state under several well characterized turbulence conditions. The relationship between sediment oxygen/nitrate demand and turbulence was then quantified and plotted. A maximum demand was exhibited at or above a fluid velocity of 2.0 mm•s-1. Below this velocity, demand decreased rapidly with fluid velocity as zero velocity was approached. Similar relationships were displayed by both oxygen and nitrate cores.

[11C]Choline PET/CT for targeted salvage lymph node dissection in patients with biochemical recurrence after primary curative therapy for prostate cancer. Preliminary results of a prospective study

INTRODUCTION: In this prospective study we set out to investigate the diagnostic value of [(11)C]choline-PET/CT in patients with suspected lymph node metastases before salvage lymph node dissection. PATIENTS AND METHODS: 15 consecutive patients with rising PSA underwent [(11)C]choline-PET/CT and consecutive open salvage pelvic/retroperitoneal extended lymph node dissection due to uptake of [(11)C]choline in at least 1 lymph node. Mean age was 62.1 (range 53-73). RESULTS: [(11)C]choline-PET/CT results were compared with the histopathology reports and clinical follow-up (mean 13.7 months, range 6-24). Mean time to progression was 23.6 months (range 4-81). [(11)C]choline uptake was observed in nodes along the external and internal and common iliac arteries and in the paraaortic region. A positive histology was reported in 8/15 patients. Only one patient had a PSA nadir of <0.1 ng/ml after salvage surgery. Another patient had stable disease with a PSA of 0.5 ng/ml. Three patients developed bone metastases during follow-up. CONCLUSIONS: This interim analysis indicates that [(11)C]choline-PET/CT may be a useful technique in detection of lymph node metastases when rising PSA occurs after definite prostate cancer therapy. The presented cohort is limited in size, but there is still strong evidence that the patients benefit from [(11)C]choline-PET/CT and consecutive salvage lymph node dissection is rather small.

Prostate cancer: to screen or not to screen?

Unfortunately, interim analyses of the long-awaited ERSPC and PLCO trial data have generated conflicting conclusions. Here, two European authors speculate as to the reasons underlying this contradiction, while highlighting clinically relevant points that are supported by both studies. Particular attention is paid to the potential consequences of overdiagnosis and overtreatment.

Regulations on E-Commerce Consumer Protection Rules in China and Europe Compared – Same Same but Different?

This article provides a comprehensive overview of the regulations on e-commerce protection rules in China and the European Union. It starts by giving a general overview of different approaches towards consumer protection in e-commerce. This article then scrutinizes the current legal system in China by mainly focusing on SAIC’s “Interim Measures for the Administration of Online Commodity Trading and Relevant Service Activities”. The subsequent chapter covers the supervision of consumer protection in e-commerce in China, which covers both the regulatory objects of online commodity trading and the applied regulatory mechanisms. While the regulatory objects include operating agents, operating objects, operating behavior, electronic contracts, intellectual property and consumer protection, the regulatory mechanisms for e-commerce in China combines market mechanism and industry self-discipline under the government’s administrative regulation. Further, this article examines the current European legal system in online commodity trading. It outlines the aim and the scope of EU legislation in the respective field. Subsequently, the paper describes the European approach towards the supervision of consumer protection in e-commerce. As there is no central EU agency for consumer protection in e-commerce transactions, the EU stipulates a framework for Member States’ institutions, thereby creating a European supervisory network of Member States’ institutions and empowers private consumer organisations to supervise the market on their behalf. Moreover, the EU encourages the industry to self- or co-regulate e-commerce by providing incentives. Consequently, this article concludes that consumer protection may be achieved by different means and different systems. However, even though at first glance the Chinese and the European system appear to differ substantially, a closer look reveals tendencies of convergence between the two systems.

Moodle & Co. auf dem Weg zur Personal Learning Environment

Ausgehend von der typischen IT‐Infrastruktur für E‐Learning an Hochschulen auf der einen Seite sowie vom bisherigen Stand der Forschung zu Personal Learning Environments (PLEs) auf der anderen Seite zeigt dieser Beitrag auf, wie bestehende Werkzeuge bzw. Dienste zusammengeführt und für die Anforderungen der modernen, rechnergestützten Präsenzlehre aufbereitet werden können. Für diesen interdisziplinären Entwicklungsprozess bieten sowohl klassische Softwareentwicklungsverfahren als auch bestehende PLE‐Modelle wenig Hilfestellung an. Der Beitrag beschreibt die in einem campusweiten Projekt an der Universität Potsdam verfolgten Ansätze und die damit erzielten Ergebnisse. Dafür werden zunächst typische Lehr‐/Lern‐bzw. Kommunikations‐Szenarien identifiziert, aus denen Anforderungen an eine unterstützende Plattform abgeleitet werden. Dies führt zu einer umfassenden Sammlung zu berücksichtigender Dienste und deren Funktionen, die gemäß den Spezifika ihrer Nutzung in ein Gesamtsystem zu integrieren sind. Auf dieser Basis werden grundsätzliche Integrationsansätze und technische Details dieses Mash‐Ups in einer Gesamtschau aller relevanten Dienste betrachtet und in eine integrierende Systemarchitektur überführt. Deren konkrete Realisierung mit Hilfe der Portal‐Technologie Liferay wird dargestellt, wobei die eingangs definierten Szenarien aufgegriffen und exemplarisch vorgestellt werden. Ergänzende Anpassungen im Sinne einer personalisierbaren bzw. adaptiven Lern‐(und Arbeits‐)Umgebung werden ebenfalls unterstützt und kurz aufgezeigt.

Simulating the temperature and precipitation signal in an Alpine ice core

Accumulation and delta O-18 data from Alpine ice cores provide information on past temperature and precipitation. However, their correlation with seasonal or annual mean temperature and precipitation at nearby sites is often low. This is partly due to the irregular sampling of the atmosphere by the ice core (i.e. ice cores almost only record precipitation events and not dry periods) and the possible incongruity between annual layers and calendar years. Using daily meteorological data from a nearby station and reanalyses, we replicate the ice core from the Grenzgletscher (Switzerland, 4200m a.s.l.) on a sample-by-sample basis by calculating precipitation-weighted temperature (PWT) over short intervals. Over the last 15 yr of the ice core record, accumulation and delta O-18 variations can be well reproduced on a sub-seasonal scale. This allows a wiggle-matching approach for defining quasi-annual layers, resulting in high correlations between measured quasi-annual delta O-18 and PWT. Further back in time, the agreement deteriorates. Nevertheless, we find significant correlations over the entire length of the record (1938-1993) of ice core delta O-18 with PWT, but not with annual mean temperature. This is due to the low correlations between PWT and annual mean temperature, a characteristic which in ERA-Interim reanalysis is also found for many other continental mid-to-high-latitude regions. The fact that meteorologically very different years can lead to similar combinations of PWT and accumulation poses limitations to the use of delta O-18 from Alpine ice cores for temperature reconstructions. Rather than for reconstructing annual mean temperature, delta O-18 from Alpine ice cores should be used to reconstruct PWT over quasi-annual periods. This variable is reproducible in reanalysis or climate model data and could thus be assimilated into conventional climate models.

The HeartQoL: Part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Background: Evaluation of health-related quality of life (HRQL) is important in improving the quality of patient care. The aim of this study was to determine the psychometric properties of the HeartQoL in patients with ischemic heart disease (IHD), specifically angina, myocardial infarction (MI), or ischemic heart failure. Methods: Data for the interim validation of the HeartQoL questionnaire were collected in (a) a cross-sectional survey and (b) a prospective substudy of patients undergoing either a percutaneous coronary intervention (PCI) or referred to cardiac rehabilitation (CR) and were then analyzed to determine the reliability, validity, and responsiveness of the HeartQoL questionnaire. Results: We enrolled 6384 patients (angina, n = 2111, 33.1%; MI, n = 2351, 36.8%; heart failure, n = 1922, 30.1%) across 22 countries speaking 15 languages in the cross-sectional study and 730 patients with IHD in the prospective substudy. The HeartQoL questionnaire comprises 14-items with physical and emotional subscales and a global score (range 0–3 (poor to better HRQL). Cronbach’s α was consistently ≥0.80; convergent validity correlations between similar HeartQoL and SF-36 subscales were significant (r ≥ 0.60, p < 0.001); discriminative validity was confirmed with predictor variables: health transition, anxiety, depression, and functional status. HeartQoL score changes following either PCI or CR were significant (p < 0.001) with effect sizes ranging from 0.37–0.64. Conclusion: The HeartQoL questionnaire is reliable, valid, and responsive to change allowing clinicians and researchers to (a) assess baseline HRQL, (b) make between-diagnosis comparisons of HRQL, and (c) evaluate change in HRQL in patients with angina, MI, or heart failure with a single IHD-specific HRQL instrument.

A 20-day period standing oscillation in the northern winter stratosphere

Observations of the ozone profile by a ground-based microwave radiometer in Switzerland indicate a dominant 20-day oscillation in stratospheric ozone, possibly related to oscillations of the polar vortex edge during winter. For further understanding of the nature of the 20-day oscillation, the ozone data set of ERA Interim meteorological reanalysis is analyzed at the latitude belt of 47.5° N and in the time from 1979 to 2010. Spectral analysis of ozone time series at 7 hPa indicates that the 20-day oscillation is maximal at two locations: 7.5° E, 47.5° N and 60° E, 47.5° N. Composites of the stream function are derived for different phases of the 20-day oscillation of stratospheric ozone at 7 hPa in the Northern Hemisphere. The streamline at Ψ = −2 × 107 m2 s−1 is in the vicinity of the polar vortex edge. The other streamline at Ψ = 4 × 107 m2 s1 surrounds the Aleutian anticyclone and goes to the subtropics. The composites show 20-day period standing oscillations at the polar vortex edge and in the subtropics above Northern Africa, India, and China. The 20-day period standing oscillation above Aral Sea and India is correlated to the strength of the Aleutian anticyclone.