First sequence-confirmed case of infection with the new influenza A(H1N1) strain in Germany

Here, we report on the first sequence-confirmed case of infection with the new influenza A(H1N1) virus in Germany. Two direct contacts of the patient were laboratory-confirmed as cases and demonstrate a chain of direct human-to-human transmission

Intercomparison of erythemal broadband radiometers calibrated by seven UV calibration facilities in Europe and the USA

International audienceA bi-lateral intercomparison of erythemal broadband radiometers was performed between seven UV calibration facilities. The owners calibrations were compared relative to the characterisation and calibration performed at PMOD/WRC in Davos, Switzerland. The calibration consisted in the determination of the spectral and angular response of the radiometer, followed by an absolute calibration performed outdoors relative to a spectroradiometer which provided the absolute reference. The characterization of the detectors in the respective laboratories are in good agreement: The determination of the angular responses have deviations below ±4% and the spectral responses agree within ±20%. A "blind" intercomparison of the erythemally weighted irradiances derived by the respective institutes and PMOD/WRC showed consistent measurements to within ±2% for the majority of institutes. One institute showed slightly larger deviation of 10%. The differences found between the different instrument calibrations are all within the combined uncertainty of the calibration

A two-parameter wind speed algorithm for Ku-band altimeters

Globally distributed crossovers of altimeter and scatterometer observations clearly demonstrate that ocean altimeter backscatter correlates with both the near-surface wind speed and the sea state. Satellite data from TOPEX/Poseidon and NSCAT are used to develop an empirical altimeter wind speed model that attenuates the sea-state signature and improves upon the present operational altimeter wind model. The inversion is defined using a multilayer perceptron neural network with altimeter-derived backscatter and significant wave height as inputs. Comparisons between this new model and past single input routines indicates that the rms wind error is reduced by 10%–15% in tandem with the lowering of wind error residuals dependent on the sea state. Both model intercomparison and validation of the new routine are detailed, including the use of large independent data compilations that include the SeaWinds and ERS scatterometers, ECMWF wind fields, and buoy measurements. The model provides consistent improvement against these varied sources with a wind-independent bias below 0.3 m s?1. The continuous form of the defined function, along with the global data used in its derivation, suggest an algorithm suitable for operational application to Ku-band altimeters. Further model improvement through wave height inclusion is limited due to an inherent multivaluedness between any single realization of the altimeter measurement pair [?o, HS] and observed near-surface winds. This ambiguity indicates that HS is a limited proxy for variable gravity wave properties that impact upon altimeter backscatter

Influence of clouds on the spectral actinic flux density in the lower troposphere (INSPECTRO): overview of the field campaigns

Ultraviolet radiation is the key factor driving tropospheric photochemistry. It is strongly modulated by clouds and aerosols. A quantitative understanding of the radiation field and its effect on photochemistry is thus only possible with a detailed knowledge of the interaction between clouds and radiation. The overall objective of the project INSPECTRO was the characterization of the three-dimensional actinic radiation field under cloudy conditions. This was achieved during two measurement campaigns in Norfolk (East Anglia, UK) and Lower Bavaria (Germany) combining space-based, aircraft and ground-based measurements as well as simulations with the one-dimensional radiation transfer model UVSPEC and the three-dimensional radiation transfer model MYSTIC. During both campaigns the spectral actinic flux density was measured at several locations at ground level and in the air by up to four different aircraft. This allows the comparison of measured and simulated actinic radiation profiles. In addition satellite data were used to complete the information of the three dimensional input data set for the simulation. A three-dimensional simulation of actinic flux density data under cloudy sky conditions requires a realistic simulation of the cloud field to be used as an input for the 3-D radiation transfer model calculations. Two different approaches were applied, to derive high- and low-resolution data sets, with a grid resolution of about 100 m and 1 km, respectively. The results of the measured and simulated radiation profiles as well as the results of the ground based measurements are presented in terms of photolysis rate profiles for ozone and nitrogen dioxide. During both campaigns all spectroradiometer systems agreed within ±10% if mandatory corrections e.g. stray light correction were applied. Stability changes of the systems were below 5% over the 4 week campaign periods and negligible over a few days. The J(O1D) data of the single monochromator systems can be evaluated for zenith angles less than 70°, which was satisfied by nearly all airborne measurements during both campaigns. The comparison of the airborne measurements with corresponding simulations is presented for the total, downward and upward flux during selected clear sky periods of both campaigns. The compliance between the measured (from three aircraft) and simulated downward and total flux profiles lies in the range of ±15%.© Author(s) 2008. This work is distributed under the Creative Commons Attribution 3.0 License

A Quaternary ZnCdSeTe Nanotip Photodetector

The authors report the growth of needle-like high density quaternary Zn0.87Cd0.13Se0.98Te0.02nanotips on oxidized Si(100) substrate. It was found that average length and average diameter of the nanotips were 1.3 μm and 91 nm, respectively. It was also found that the as-grown ZnCdSeTe nanotips exhibit mixture of cubic zinc-blende and hexagonal wurtzite structures. Furthermore, it was found that the operation speeds of the fabricated ZnCdSeTe nanotip photodetector were fast with turn-on and turn-off time constants both less than 2 s

Increasing uptake of self-management education programmes for type 2 diabetes in primary care: the Embedding research programme including an RCT

Background Self-management education and support programmes help people with type 2 diabetes to manage their diabetes better. However, most people do not attend these programmes. Objective Increase type 2 diabetes self-management programme attendance. Design Workstream 1: develop intervention (mixed methods). Workstream 2: refine intervention and trial design (feasibility study). Workstream 3: evaluate effectiveness (18-month wait-list cluster randomised controlled trial with ethnography component; baseline: months −3 to 0; step one: months 1–9; step two: months 10–18; minimum clinically significant difference in glycated haemoglobin: 1.1 mmol/mol; target sample size: 66 practices). Workstream 4: health economics analysis; 12-month observational follow-up of trial population; qualitative substudy. Setting Primary care practices and providers of self-management programmes (East Midlands, Thames Valley and South Midlands, Yorkshire and Humber). Participants Workstream 1: 103 stakeholders. Workstream 2: 6 practices. Workstreams 3–4: 64 practices (92,977 people with type 2 diabetes). Qualitative substudy: 30 participants. Intervention Embedding Package (marketing strategy for self-management programmes; user-friendly referral pathway; new/amended professional roles; resources toolkit) delivered through an online portal for practices and providers (‘toolkit’; 88 live accounts; average of 19 page views/week); people working with practices and providers to embed self-management programmes into routine practice (‘embedders’). Additionally, a patient digital support programme (MyDESMOND) was developed. The comparator was usual care. Main outcome measures Patient-level glycated haemoglobin (primary outcome, continuous, mmol/mol) and referrals to, and attendance at, self-management programmes (main secondary outcomes; binary yes/no variables) compared between control (wait-list: baseline and step one; immediate: baseline) and intervention (wait-list: step two; immediate: steps one and two) conditions. Data sources Existing interviews, published literature, workshops, patient-level practice data, patient self-completed questionnaire, patient-level provider data, ethnographic data and one-to-one interviews. Results Workstreams 1 and 2: intervention and trial successfully developed then refined. Workstream 3: glycated haemoglobin was not significantly different (p = 0.503) between intervention and control conditions (adjusted mean difference −0.10 mmol/mol, 95% confidence interval −0.38 to 0.18; −0.01%, 95% confidence interval −0.03% to 0.02%). Both patient-level referral to, and attendance at, structured self-management education programmes were lower or similar during the intervention than control conditions. There was no significant difference in most other secondary outcomes. Prespecified analyses indicated that glycated haemoglobin was statistically significantly lower (p = 0.004) among ethnic minority individuals during intervention than control conditions (−0.64 mmol/mol, 95% confidence interval −1.08 to −0.20; −0.06%, 95% confidence interval −0.10 to −0.02). This difference was not clinically significant and self-management programme attendance did not improve. Ethnography analyses found that the intervention’s attractiveness and usefulness were not self-evident to practices and providers, much of the activity was led by the embedders, and embedders covering multiple localities were not best placed to adapt the intervention to local contexts. Workstream 4: the intervention cost £0.52 per patient. There was no evidence of a difference in costs (−£33, 95% confidence interval −£2195 to +£2171) or quality-adjusted life-years (+0.002, 95% confidence interval −0.100 to +0.098) in the base-case analysis. The trial plus 12-month observational follow-up data showed that glycated haemoglobin was statistically significantly lower (−0.56 mmol/mol, 95% confidence interval −0.71 to −0.42; −0.05, 95% confidence interval −0.06% to −0.04%; p < 0.001) and self-management programme attendance higher (adjusted odds ratio 1.13, 95% confidence interval 1.02 to 1.25; p = 0.017) in intervention than control conditions, although it should be noted that the difference was not clinically significant. The qualitative substudy indicated that virtual programmes have a place in future self-management programme delivery, with highly positive feedback, particularly around financial and logistical benefits. Limitations The COVID-19 pandemic affected this research. A delayed start to the feasibility study prevented all learnings being taken into the wait-list trial, particularly around implementing the intervention at provider, not practice level. Practice engagement with the intervention was limited and variable. National Health Service commissioning restructures in England meant that, for many localities, changes to the provision of diabetes self-management programme commissioning included funding and capacity to co-ordinate and promote uptake in a similar way to the Embedding Package. With the wait-list design, a proxy primary outcome for self-management programme attendance was used, which may have affected the sensitivity of results. Finally, baseline structured self-management education programme attendance was higher than expected, and data sources were between 39% and 66% complete. Conclusions There were difficulties implementing the intervention, which probably contributed to the trial showing that, overall, the Embedding Package was unlikely to have affected glycated haemoglobin, self-management programme referrals and attendance or most other secondary outcomes. Future work Focus should be on which organisation(s)/role(s) can best drive change around embedding type 2 diabetes self-management programmes into routine care, and the role of blended face-to-face and virtual programmes. Trial registration This trial is registered as Current Controlled Trials ISRCTN23474120. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme (NIHR award ref: RP-PG-1212-20004) and is published in full in Programme Grants for Applied Research; Vol. 13, No. 2. See the NIHR Funding and Awards website for further award information

Cox proportional hazards deep neural network identifies peripheral blood complete remission to be at least equivalent to morphologic complete remission in predicting outcomes of patients treated with azacitidine - a prospective cohort study by the AGMT

The current gold standard of response assessment in patients with myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myeloid leukemia (AML) is morphologic complete remission (CR) and CR with incomplete count recovery (CRi), both of which require an invasive BM evaluation. Outside of clinical trials, BM evaluations are only performed in ~50% of patients during follow-up, pinpointing a clinical need for response endpoints that do not necessitate BM assessments. We define and validate a new response type termed "peripheral blood complete remission" (PB-CR) that can be determined from the differential blood count and clinical parameters without necessitating a BM assessment. We compared the predictive value of PB-CR with morphologic CR/CRi in 1441 non-selected, consecutive patients diagnosed with MDS (n = 522; 36.2%), CMML (n = 132; 9.2%), or AML (n = 787; 54.6%), included within the Austrian Myeloid Registry (aMYELOIDr; NCT04438889). Time-to-event analyses were adjusted for 17 covariates remaining in the final Cox proportional hazards (CPH) model. DeepSurv, a CPH neural network model, and permutation-based feature importance were used to validate results. 1441 patients were included. Adjusted median overall survival for patients achieving PB-CR was 22.8 months (95%CI 18.9-26.2) versus 10.4 months (95%CI 9.7-11.2) for those who did not; HR = 0.366 (95%CI 0.303-0.441; p < .0001). Among patients achieving CR, those additionally achieving PB-CR had a median adjusted OS of 32.6 months (95%CI 26.2-49.2) versus 21.7 months (95%CI 16.9-27.7; HR = 0.400 [95%CI 0.190-0.844; p = .0161]) for those who did not. Our deep neural network analysis-based findings from a large, prospective cohort study indicate that BM evaluations solely for the purpose of identifying CR/CRi can be omitted

A method to generate near real time UV-Index maps of Austria

International audienceA method is presented that combines individual ground based ultraviolet (UV) measurements from the Austrian UVB monitoring network and area-wide data of the distribution of clouds derived from satellite images to generate a UV-Index map all over the region. The Austrian UVB Monitoring network provides near real time ground based measurements of surface UV irradiance from fifteen selected locations throughout and in the vicinity of Austria. The amount of ultraviolet radiation passing through the atmosphere as measured by the UVB detectors is indicated in units of the UV-Index, the internationally agreed unit for erythemally weighted solar UV irradiance. Together with clear sky model calculations the measured UV-Index is used to determine the cloud modification factor (CMF), a scaling factor giving the reduction of radiation due to the presence of clouds. Moreover satellite images from MSG (Meteosat Second Generation) with a time resolution of 15 min and a spatial resolution of 0.05° are received. From the satellite images the CMFs for the area of Austria are obtained using an algorithm provided by Jean Verdebout. Then both independent data sets of cloud modification factors are checked for consistency by comparing satellite derived and ground based values at the positions of the monitoring stations. If necessary the satellite derived cloud modification factors are corrected by about ±20% according to the results of the ground based measurements. Afterwards realistic UV-Index maps of the whole area are generated by scaling model derived UV-Indexes with the corresponding cloud modification factors. Since all the data is available in almost real time, the calculated UV-Index maps are available in the web at http://www.uv-index.at/ with a time delay of about 30 min

Twilight tropospheric and stratospheric photodissociation rates derived from balloon borne radiation measurements

International audienceA new ligthweight multichannel moderate bandwidth filter instrument designed to be flown on balloons, is described. The instrument measures the radiation field within the short UV (center wavelength at 312 nm) and long UV (center wavelength at 340 nm). The angular and spectral characteristics of the instrument are discussed and the calibration procedure outlined. Measurements made during a stratospheric balloon flight at twilight conditions from Gap-Tallard, France, are presented and compared with state-of-the-art radiative transfer model simulations. The model simulations and the measurements agree within ±10% (±20%) for solar zenith angles smaller than 93° (90°) for the 340 (312) nm channel. Based on the model simulations of the measured radiation, actinic flux spectra are reconstructed. These are used to calculate various photodissociation rates