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Land Surface Temperature (LST) is an important parameter for tracing the impact of changing climatic conditions on our environment. Describing the interface between long- and shortwave radiation fluxes, as well as between turbulent heat fluxes and the ground heat flux, LST plays a crucial role in the global heat balance. Satellite-derived LST is an indispensable tool for monitoring these changes consistently over large areas and for long time periods. Data from the AVHRR (Advanced Very High-Resolution Radiometer) sensors have been available since the early 1980s. In the TIMELINE project, LST is derived for the entire operating period of AVHRR sensors over Europe at a 1 km spatial resolution. In this study, we present the validation results for the TIMELINE AVHRR daytime LST. The validation approach consists of an assessment of the temporal consistency of the AVHRR LST time series, an inter-comparison between AVHRR LST and in situ LST, and a comparison of the AVHRR LST product with concurrent MODIS (Moderate Resolution Imaging Spectroradiometer) LST. The results indicate the successful derivation of stable LST time series from multi-decadal AVHRR data. The validation results were investigated regarding different LST, TCWV and VA, as well as land cover classes. The comparisons between the TIMELINE LST product and the reference datasets show seasonal and land cover-related patterns. The LST level was found to be the most determinative factor of the error. On average, an absolute deviation of the AVHRR LST by 1.83 K from in situ LST, as well as a difference of 2.34 K from the MODIS product, was observed.
Earth observation time series are well suited to monitor global surface dynamics. However, data products that are aimed at assessing large-area dynamics with a high temporal resolution often face various error sources (e.g., retrieval errors, sampling errors) in their acquisition chain. Addressing uncertainties in a spatiotemporal consistent manner is challenging, as extensive high-quality validation data is typically scarce. Here we propose a new method that utilizes time series inherent information to assess the temporal interpolation uncertainty of time series datasets. For this, we utilized data from the DLR-DFD Global WaterPack (GWP), which provides daily information on global inland surface water. As the time series is primarily based on optical MODIS (Moderate Resolution Imaging Spectroradiometer) images, the requirement of data gap interpolation due to clouds constitutes the main uncertainty source of the product. With a focus on different temporal and spatial characteristics of surface water dynamics, seven auxiliary layers were derived. Each layer provides probability and reliability estimates regarding water observations at pixel-level. This enables the quantification of uncertainty corresponding to the full spatiotemporal range of the product. Furthermore, the ability of temporal layers to approximate unknown pixel states was evaluated for stratified artificial gaps, which were introduced into the original time series of four climatologic diverse test regions. Results show that uncertainty is quantified accurately (>90%), consequently enhancing the product's quality with respect to its use for modeling and the geoscientific community.
Introduction The fast, precise, and accurate measurement of the new generation of oral anticoagulants such as dabigatran and rivaroxaban in patients' plasma my provide important information in different clinical circumstances such as in the case of suspicion of overdose, when patients switch from existing oral anticoagulant, in patients with hepatic or renal impairment, by concomitant use of interaction drugs, or to assess anticoagulant concentration in patients' blood before major surgery. Methods Here, we describe a quick and precise method to measure the coagulation inhibitors dabigatran and rivaroxaban using ultra-performance liquid chromatography electrospray ionization-tandem mass spectrometry in multiple reactions monitoring (MRM) mode (UPLC-MRM MS). Internal standards (ISs) were added to the sample and after protein precipitation; the sample was separated on a reverse phase column. After ionization of the analytes the ions were detected using electrospray ionization-tandem mass spectrometry. Run time was 2.5 minutes per injection. Ion suppression was characterized by means of post-column infusion. Results The calibration curves of dabigatran and rivaroxaban were linear over the working range between 0.8 and 800 mu g/L (r > 0.99). Limits of detection (LOD) in the plasma matrix were 0.21 mu g/L for dabigatran and 0.34 mu g/L for rivaroxaban, and lower limits of quantification (LLOQ) in the plasma matrix were 0.46 mu g/L for dabigatran and 0.54 mu g/L for rivaroxaban. The intraassay coefficients of variation (CVs) for dabigatran and rivaroxaban were < 4% and 6%; respectively, the interassay CVs were < 6% for dabigatran and < 9% for rivaroxaban. Inaccuracy was < 5% for both substances. The mean recovery was 104.5% (range 83.8-113.0%) for dabigatran and 87.0%(range 73.6-105.4%) for rivaroxaban. No significant ion suppressions were detected at the elution times of dabigatran or rivaroxaban. Both coagulation inhibitors were stable in citrate plasma at -20 degrees C, 4 degrees C and even at RT for at least one week. A method comparison between our UPLC-MRM MS method, the commercially available automated Direct Thrombin Inhibitor assay (DTI assay) for dabigatran measurement from CoaChrom Diagnostica, as well as the automated anti-Xa assay for rivaroxaban measurement from Chromogenix both performed by ACL-TOP showed a high degree of correlation. However, UPLC-MRM MS measurement of dabigatran and rivaroxaban has a much better selectivity than classical functional assays measuring activities of various coagulation factors which are susceptible to interference by other coagulant drugs. Conclusions Overall, we developed and validated a sensitive and specific UPLC-MRM MS assay for the quick and specific measurement of dabigatran and rivaroxaban in human plasma.
Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) defines COPD as a fixed postbronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) below 0.7. Agedependent cut-off values below the lower fifth percentile (LLN) of this ratio derived from the general population have been proposed as an alternative. We wanted to assess the diagnostic accuracy and prognostic capability of the GOLD and LLN definition when compared to an expert-based diagnosis. Methods: In a prospective cohort study, 405 patients aged ≥ 65 years with a general practitioner’s diagnosis of COPD were recruited and followed up for 4.5 (median; quartiles 3.9; 5.1) years. Prevalence rates of COPD according to GOLD and three LLN definitions and diagnostic performance measurements were calculated. The reference standard was the diagnosis of COPD of an expert panel that used all available diagnostic information, including spirometry and bodyplethysmography. Results: Compared to the expert panel diagnosis, ‘GOLD-COPD’ misclassified 69 (28%) patients, and the three LLNs misclassified 114 (46%), 96 (39%), and 98 (40%) patients, respectively. The GOLD classification led to more false positives, the LLNs to more false negative diagnoses. The main predictors beyond the FEV1/FVC ratio for an expert diagnosis of COPD were the FEV1 % predicted, and the residual volume/total lung capacity ratio (RV/TLC). Adding FEV1 and RV/TLC to GOLD or LLN improved the diagnostic accuracy, resulting in a significant reduction of up to 50% of the number of misdiagnoses. The expert diagnosis of COPD better predicts exacerbations, hospitalizations and mortality than GOLD or LLN. Conclusions: GOLD criteria over-diagnose COPD, while LLN definitions under-diagnose COPD in elderly patients as compared to an expert panel diagnosis. Incorporating FEV1 and RV/TLC into the GOLD-COPD or LLN-based definition brings both definitions closer to expert panel diagnosis of COPD, and to daily clinical practice.
Das Ziel vorliegender Arbeit war die Entwicklung einer HPLC-MS(/MS)-Methode, die im Rahmen der pharmazeutischen Qualitätskontrolle zur direkten Quantifizierung von Aminosäuren (AS) in Infusionslösungen angewendet werden kann. Die Zielset-zung schloss eine Validierung innerhalb der für die Zweckbestimmung vorgesehenen Grenzen ein. Im Rahmen der Methodenentwicklung wurde das ESI-MS/MS-Fragmentierungs-muster von 21 Aminosäuren, von 20 stabil-isotopenmarkierten Aminosäuren, die als interne Standards verwendet wurden, sowie von einigen weiteren Substanzen bestimmt. Nach Kenntnis von Precursor- und Produktionen erstellte man eine SRM-Methode zur spezifischen MS/MS-Analyse. Dabei wurden durch das jeweilige Frag-mentierungsmuster bedingte Interferenzen bei den zu untersuchenden Aminosäuren bestimmt, die bei der zu erarbeitenden HPLC-MS-Methode beachtet werden mussten. Die Methodenentwicklung zur HPLC-MS-Analytik von underivatisierten AS umfasste mit der RP-HPLC unter Verwendung eines Ionenpaarreagenzes (IP) und der hydrophilen Interaktionschromatographie (HILIC) zwei verschiedene chromatographi-sche Ansätze. Bei der Anwendung der RP-HPLC ergaben sich Probleme. Die Verwendung eines IP, im vorliegenden Fall TDFHA (Tridecafluorheptansäure), führte zu langen Equilibrierungs-, Re-Equilibrierungs- und Spülzeiten und damit bei zwar relativ kurzer HPLC-Laufzeit zu einem aber insgesamt hohen Zeitaufwand. Gleich-zeitig war die LC-MS-Anlage auf diese Anwendung fixiert, da das Ionenpaarreagenz das Gerät stark verschmutzte und dadurch andere Analysen erheblich störte. Zudem waren die Retentionszeiten der Analyten trotz langer Equilibrierungszeiten schlecht reproduzierbar, so dass eine solche Methode im Rahmen der pharmazeutischen Qualitätskontrolle schwer validierbar wäre. Weiterführende Untersuchungen erfolgten daher nicht. In nachfolgenden Studien mit der HILIC wurden verschiedene Einflussparameter (Anteil organischer Phase im Fließmittel, pH-Wert des Fließmittels, Temperatur der Säule, Pufferkonzentration im Fließmittel, Gradientenelution) auf die Trennung der AS an einer ZIC®-HILIC-Säule untersucht. Durch Optimierung der Parameter wurde so eine HILIC-HPLC-Methode entwickelt, bei der 21 AS und 20 ihrer isotopen-markierten Referenz-AS innerhalb von 20 min eluierten. Diejenigen AS, bei denen im Rahmen der Fragmentierungsstudien Interferenzen aufgrund gleicher bzw. ähnlicher Massen der Precursor- bzw. Produktionen aufgetreten waren, wurden chroma-tographisch getrennt. Gleichzeitig hat sich die SIM-Analyse als anwendbar erwiesen. Die Anwendung des spezifischeren SRM-Modus und damit der Tandem-Massenspektrometrie war nicht erforderlich. Im Rahmen der nachfolgenden Studien zur Validierung ergab sich, dass die entwickelte Methode über einen weiten Bereich eine lineare Abhängigkeit zwischen Konzentrations- und Messwerten zeigte. Für drei der 21 AS (NAcCys, NAcTyr, Pro) wurde die quadratische Regression mit dem Anpassungstest nach Mandel als geeig-neteres Regressionsmodell ermittelt. Bei Untersuchungen zur Wiederfindung wurde ein Einfluss der Matrix-Lösung der Infusionslösung festgestellt, der zu Abweichungen hinsichtlich des Quotienten AreaAS / AreaIS führte, so dass eine Quantifizierung innerhalb der geforderten Grenzen bei Kalibrierung über reine Standardlösungen nicht möglich war. Die Validierung wurde daher nachfolgend in der Matrixlösung durchgeführt. Dabei wurde gezeigt, dass mit der entwickelten HILIC-HPLC-MS-Methode Aminosäuren in Infusionslösungen mit hoher Präzision und Richtigkeit bestimmt werden können. Neun der 21 untersuchten AS konnten im Bereich von 30% - 350%, zehn weitere im Bereich von 50% - 350% innerhalb der zur Gehaltsbestimmung von pharmazeutischen Formulierungen vorgeschriebenen Grenzen (Wiederfindung Einzelbestimmung: 98% -102.0%, Mittelwert einer Dreifachbestimmung: 98.5% – 101.5%) quantifiziert werden. Für His und Phe gelang allerdings keine Quantifizierung innerhalb der Akzeptanzkriterien, wobei der Grund hierfür in weiteren Studien geklärt werden müsste. Mit der entwickelten Methode ist damit eine gleichzeitige Quantifizierung verschiedener AS-Infusionslösungsformulierungen möglich, die sich bei gleicher Matrix in der Konzentration an AS unterscheiden. Beispielsweise seien hier die Formulierungen „Aminoplasmal® E 5% / 10% /15%“ genannt, die mit der validierten Methode erfassbar sind. Die Probenvorbereitung beschränkt sich dabei auf den Zusatz der IS-Formulierung zur Infusionslösung und einen Verdünnungsschritt. Die Quanti-fizierung erfolgt über eine 5-Punkt-Kalibriergerade, die aus einer AS- und IS-Standardmischung, nach Zusatz der einfach herzustellenden Elektrolyt-Matrix, erstellt wird. Die Analysenzeit der HPLC-MS-Methode beträgt einschließlich Equilibrie-rungszeit 35 min und ist damit deutlich kürzer als die 120 min, die bei der nach wie vor zur AS-Analytik allgemein gebräuchlichen Ionenaustauschchromatographie mit Ninhydrin-Nachsäulenderivatisierung anzusetzen sind.
BACKGROUND: Climate change will probably alter the spread and transmission intensity of malaria in Africa. OBJECTIVES: In this study, we assessed potential changes in the malaria transmission via an integrated weather disease model.
METHODS: We simulated mosquito biting rates using the Liverpool Malaria Model (LMM). The input data for the LMM were bias-corrected temperature and precipitation data from the regional model (REMO) on a 0.5 degrees latitude longitude grid. A Plasmodium falciparum infection model expands the LMM simulations to incorporate information on the infection rate among children. Malaria projections were carried out with this integrated weather disease model for 2001 to 2050 according to two climate scenarios that include the effect of anthropogenic land-use and land-cover changes on climate.
RESULTS: Model-based estimates for the present climate (1960 to 2000) are consistent with observed data for the spread of malaria in Africa. In the model domain, the regions where malaria is epidemic are located in the Sahel as well as in various highland territories. A decreased spread of malaria over most parts of tropical Africa is projected because of simulated increased surface temperatures and a significant reduction in annual rainfall. However, the likelihood of malaria epidemics is projected to increase in the southern part of the Sahel. In most of East Africa, the intensity of malaria transmission is expected to increase. Projections indicate that highland areas that were formerly unsuitable for malaria will become epidemic, whereas in the lower-altitude regions of the East African highlands, epidemic risk will decrease.
CONCLUSIONS: We project that climate changes driven by greenhouse-gas and land-use changes will significantly affect the spread of malaria in tropical Africa well before 2050. The geographic distribution of areas where malaria is epidemic might have to be significantly altered in the coming decades.
Background: International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the association between the recognition of current depression/anxiety by the general practitioner (GP) and the quality of life and the patients' prognosis.
Methods/Design: In this multicenter, prospective, observational study 3,950 patients with HF are recruited by general practices in Germany. The patients fill out questionnaires at baseline and 12-month follow-up. At baseline the GPs are interviewed regarding the somatic and psychological comorbidities of their patients. During the follow-up assessment, data on hospitalization and mortality are provided by the general practice. Based on baseline data, the patients are allocated into three observation groups: HF patients with depression and/or anxiety recognized by their GP (P+/+), those with depression and/or anxiety not recognized (P+/-) and patients without depression and/or anxiety (P-/-). We will perform multivariate regression models to investigate the influence of the recognition of depression and/or anxiety on quality of life at 12 month follow-up, as well as its influences on the prognosis (hospital admission, mortality).
Discussion: We will display the frequency of GP-acknowledged depression and anxiety and the frequency of installed therapeutic strategies. We will also describe the frequency of depression and anxiety missed by the GP and the resulting treatment gap. Effects of correctly acknowledged and missed depression/anxiety on outcome, also in comparison to the outcome of subjects without depression/anxiety will be addressed. In case results suggest a treatment gap of depression/anxiety in patients with HF, the results of this study will provide methodological advice for the efficient planning of further interventional research.
Central Asia consists of the five former Soviet States Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, therefore comprising an area of similar to 4 Mio km(2). The continental climate is characterized by hot and dry summer months and cold winter seasons with most precipitation occurring as snowfall. Accordingly, freshwater supply is strongly depending on the amount of accumulated snow as well as the moment of its release after snowmelt. The aim of the presented study is to identify possible changes in snow cover characteristics, consisting of snow cover duration, onset and offset of snow cover season within the last 28 years. Relying on remotely sensed data originating from medium resolution imagers, these snow cover characteristics are extracted on a daily basis. The resolution of 500-1000 m allows for a subsequent analysis of changes on the scale of hydrological sub-catchments. Long-term changes are identified from this unique dataset, revealing an ongoing shift towards earlier snowmelt within the Central Asian Mountains. This shift can be observed in most upstream hydro catchments within Pamir and Tian Shan Mountains and it leads to a potential change of freshwater availability in the downstream regions, exerting additional pressure on the already tensed situation.
Aufgrund der sich umkehrenden Alterspyramide in Deutschland leiden bereits jetzt immer mehr Menschen an Gelenkknorpelschäden. Doch nicht nur das Alter, sondern auch Unfälle und Sportverletzungen und Übergewicht können zu irreversiblen Knorpeldefekten führen. Obwohl es diverse Behandlungsmöglichkeiten gibt, können die bisherige Methoden nicht als dauerhafte Heilung betrachtet werden. Im Rahmen des internationalen Forschungsprojektes BIO-CHIP sollte eine vielsprechende Behandlungsmethode mit neuartigen Arzneimitteln untersucht werden.
Als Ausgangsmaterial des Arzneimittels, ein hergestelltes Knorpelimplantat, dienen patienteneigene Knorpelzellen aus der Nase. Diese werden isoliert, vermehrt und letztlich auf einer Matrix zu einem Knorpelimplantat kultiviert. Wesentliche Voraussetzung für die Implantatfreigabe stellt neben toxikologischen und biologischen Unbedenklichkeitstests die Beurteilung der Viabilität dar. Diese wurde bisher anhand von Histologieschnitten von der Pathologie durchgeführt.
Ziel der vorliegenden Arbeit war die Entwicklung und Validierung eines standardisierten und objektiven Viabilitätstests für die Chondrozyten innerhalb der Knorpelmatrix. Hierfür wurde die LDH als Marker für irreversibel geschädigte Zellen verwendet. Die LDH Konzentration konnte mit dem CyQuant LDH-Assay durch die Messung der Absorption gemessen werden. Es konnte nachgewiesen werden, dass LDH die erforderliche Stabilität und Nachweisbarkeit im Medium besitzt. Mithilfe der Lyse, analog zum Herstellungsprozess, gezüchteter Mini-Knorpelimplantate, konnten die maximal erreichbaren LDH Konzentrationen ermittelt werden. Mithilfe dieser Konzentrationen wurde eine Eichkurve generiert. Diese dient als Beurteilung der Viabilität zukünftig gemessener Absorptionen des Überstandmediums.
Das entwickelte Verfahren erfordert keine invasiven Eingriffe am Implantat und zeichnet sich durch eine einfache Durchführung aus, da nur der Überstand gemessen werden muss. Die durchgeführte Validierung der Methode bescheinigte eine hohe Robustheit, Linearität, Genauigkeit und Präzision.
Background: Persistent pain after inguinal herniorrhaphy is a disabling condition with a lack of evidence-based pharmacological treatment options. This randomized placebo-controlled trial investigated the efficacy of a capsaicin 8% cutaneous patch in the treatment of severe persistent inguinal postherniorrhaphy pain. Methods: Forty-six patients with persistent inguinal postherniorrhaphy pain were randomized to receive either a capsaicin 8% patch or a placebo patch. Pain intensity (Numerical Rating Scale [NRS 0-10]) was evaluated under standardized conditions (at rest, during movement, and during pressure) at baseline and at 1, 2 and 3 months after patch application. Skin punch biopsies for intraepidermal nerve fiber density (IENFD) measurements were taken at baseline and 1 month after patch application. Quantitative sensory testing was performed at baseline and at 1, 2, and 3 months after patch application. The primary outcome was comparisons of summed pain intensity differences (SPIDs) between capsaicin and placebo treatments at 1, 2 and 3 months after patch application (significance level P<0.01). Results: The maximum difference in SPID, between capsaicin and placebo treatments, was observed at 1 month after patch application, but the pain reduction was not significant (NRS, mean difference [95% CI]: 5.0 [0.09 to 9.9]; P=0.046). No differences in SPID between treatments were observed at 2 and 3 months after patch application. Changes in IENFD on the pain side, from baseline to 1 month after patch application, did not differ between capsaicin and placebo treatment: 1.9 [-0.1 to 3.9] and 0.6 [-1.2 to 2.5] fibers/mm, respectively (P=0.32). No significant changes in sensory function, sleep quality or psychological factors were associated with capsaicin patch treatment. Conclusions: The study did not demonstrate significant differences in pain relief between capsaicin and placebo treatment, although a trend toward pain improvement in capsaicin treated patients was observed 1 month after patch application.