What can patient-reported experience measures tell us about the variation in patients' experience of prostate cancer care? A cross-sectional study using survey data from the National Prostate Cancer Audit in England.

OBJECTIVES: A national survey aimed to measure how men with prostate cancer perceived their involvement in and decisions around their care immediately after diagnosis. This study aimed to describe any differences found by socio-demographic groups. DESIGN: Cross-sectional study of men who were diagnosed with and treated for prostate cancer. SETTING: The National Prostate Cancer Audit patient-reported experience measures (PREMs) survey in England. PARTICIPANTS: Men diagnosed in 2014-2016, with non-metastatic prostate cancer, were surveyed. Responses from 32 796 men were individually linked to records from a national clinical audit and to administrative hospital data. Age, ethnicity, deprivation and disease risk classification were used to explore variation in responses to selected questions. PRIMARY AND SECONDARY OUTCOME MEASURES: Responses to five questions from the PREMs survey: the proportion responding to the highest positive category was compared across the socio-demographic characteristics above. RESULTS: When adjusted for other factors, older men were less likely than men under the age of 60 to feel side effects had been explained in a way they could understand (men 80+: relative risk (RR)=0.92, 95% CI 0.84 to 1.00), that their views were considered (RR=0.79, 95% CI 0.73 to 0.87) or that they were involved in decisions (RR=0.92, 95% CI 0.85 to 1.00). The latter was also apparent for men who were not white (black men: RR=0.89, 95% CI 0.82 to 0.98; Asian men: RR=0.85, 95% CI 0.75 to 0.96) and, to a lesser extent, for more deprived men. CONCLUSIONS: The observed discrepancies highlight the need for more focus on initiatives to improve the experience of ethnic minority patients and those older than 60 years. The findings also argue for further validation of discriminatory instruments to help cancer care providers fully understand the variation in the experience of their patients.

Prostagram magnetic resonance imaging in a screening population: Prostate Imaging-Reporting and Data System or Likert?

OBJECTIVE: To compare biopsy recommendation rates and accuracy of the Prostate Imaging-Reporting and Data System, version 2 (PI-RADSv2) with the Likert scale for detection of clinically significant and insignificant prostate cancer in men screened within the Imperial Prostate 1 Prostate Cancer Screening Trial Using Imaging (IP1-PROSTAGRAM). PATIENTS AND METHODS: Men aged 50-69 years were screened with Prostagram MRI. Scans were prospectively reported using both PI-RADSv2 (excluding dynamic contrast-enhanced sequence score) and 5-point Likert scores by expert uro-radiologists. Systematic and targeted transperineal biopsy was recommended if the scan was scored ≥ 3, based on either reporting system. The proportion of patients recommended for biopsy and detection rates for Grade Groups (GGs) 1 and ≥ 2 were compared. Receiver operating characteristic (ROC) analysis was performed to compare performance. RESULTS: A total of 406 men underwent Prostagram MRI. The median (interquartile range) age and prostate-specific antigen level were 57 (53-61) years and 0.91 (0.56-1.74) ng/mL, respectively. At MRI score ≥ 3, more patients were recommended for biopsy based on Likert criteria (94/406; 23%, 95% confidence interval [CI] 19.2%-27.6%) compared to PI-RADSv2 (72/406; 18%, 95% CI 14.2%-21.9%; P = 0.03). For MRI scores ≥ 4, PI-RADSv2 and Likert scales led to 43/406 (11%, 95% CI 7.9%-14.1%) and 35/406 (9%, 95% CI 6.2%-11.9%) men recommended for biopsy (P = 0.40). For GG ≥ 2 detection, PIRADSv2 and Likert detected 22% (95% CI 11.4%-30.8%, 14/72) and 16% (95% CI 9.5%-25.3%, 15/94), respectively (P = 0.56). For GG1 cancers detection these were 11% (95% CI 4.3%-19.6%, seven of 72) vs 11% (95% CI 4.7%-17.8%, nine of 94; P = 1.00). The accuracy of PI-RADSv2 and Likert scale was similar (area under the ROC curve 0.64 vs 0.65, P = 0.95). CONCLUSIONS: In reporting non-contrast-enhanced Prostagram MRI in a screening population, the PI-RADSv2 and Likert scoring systems were equally accurate; however, Likert scale use led to more men undergoing biopsy without a subsequent increase in significant cancer detection rates. To improve reporting of Prostagram MRI, either the PI-RADSv2 or a modified Likert scale or a standalone scoring system should be developed.

An Evaluation of Screening Pathways Using a Combination of Magnetic Resonance Imaging and Prostate-specific Antigen: Results from the IP1-PROSTAGRAM Study.

BACKGROUND: The use of prostate-specific antigen (PSA) testing to screen for prostate cancer has been fraught with under- and overdiagnosis. Short, noncontrast magnetic resonance imaging (MRI) might detect more grade group ≥2 cancers with similar rates of biopsy. OBJECTIVE: To evaluate strategies that combined PSA and MRI to select men based in the community for a prostate biopsy. DESIGN, SETTING, AND PARTICIPANTS: IP1-PROSTAGRAM was a prospective, population-based, paired cohort study of 408 men aged 50-69 yr conducted at seven UK primary care practice and two imaging centres (from October 10, 2018 to May 15, 2019). INTERVENTION: All participants underwent screening with a PSA test, MRI (T2-weighted and diffusion), and transrectal ultrasound (b-mode and elastography). If any test was screen positive, a systematic 12-core biopsy was performed. Additional image-fusion targeted biopsies were taken if the MRI or ultrasound was positive. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We conducted an analysis, set out in the statistical plan a priori, comparing 13 different pathways including PSA-alone, MRI-alone, and a range of PSA thresholds and MRI scores. The performance of each pathway was evaluated focusing on the trade-offs between biopsy referral rates and detection of grade group ≥2 cancers. A targeted biopsy was performed only where the PROSTAGRAM MRI showed a lesion score of 3, 4, or 5. RESULTS AND LIMITATIONS: The standard PSA pathway (PSA ≥3 ng/ml + systematic biopsy) would lead to 10% of men being referred for a biopsy and a 1.0% detection rate of grade group ≥2 cancers. Pathways that relied on MRI alone set at a threshold score of 3 for a biopsy led to higher biopsy rates, but with benefit of high cancer detection rates. The pathway that combined an initial low PSA threshold (≥1.0 ng/ml) and MRI score ≥4 accurately identified a high rate of grade group ≥2 cancers (2.5%, 95% confidence interval 1.3-4.6) while recommending fewer patients for a biopsy (7.1%, 95% confidence interval 4.9-10.2). The results are pertinent to only one screening round, the impact of repeat screening rounds is not evaluated, and the required MRI capacity is currently lacking. CONCLUSIONS: Our results highlight the trade-off that exists between reducing excessive numbers of biopsies and maintaining grade group ≥2 cancer detection rates. A pathway that combines PSA ≥1 ng/ml and MRI score ≥4 maintains the detection of grade group ≥2 cancers while recommending fewer men for biopsies and would be the preferred strategy to evaluate in future studies at the first screening round. PATIENT SUMMARY: The IP1-PROSTAGRAM study shows that PROSTAGRAM magnetic resonance imaging in men with a prostate-specific antigen level of ≥1.0 ng/ml could be a promising pathway to evaluate in future screening trials.

Perceived patient burden and acceptability of MRI in comparison to PSA and ultrasound: results from the IP1-PROSTAGRAM study.

BACKGROUND: The IP1-PROSTAGRAM study showed that a short, non-contrast MRI detected more significant cancers with similar rates of biopsy compared to PSA. Herein, we compare the expected and perceived burden of PSA, MRI and ultrasound as screening tests. METHODS: IP1-PROSTAGRAM was a prospective, population-based, paired screening study of 408 men conducted at seven UK primary care practices and two imaging centres. The screening tests were serum PSA, non-contrast MRI and ultrasound. If any test was screen-positive, a prostate biopsy was performed. Participants completed an Expected Burden Questionnaire (EBQ) and Perceived Burden Questionnaire (PBQ) before and after each screening test. RESULTS: The overall level of burden for MRI and PSA was minimal. Few men reported high levels of anxiety, burden, embarrassment or pain following either MRI or PSA. Participants indicated an overall preference for MRI after completing all screening tests. Of 408 participants, 194 (47.5%) had no preference, 106 (26.0%) preferred MRI and 79 (19.4%) preferred PSA. This indicates that prior to screening, participants preferred MRI compared to PSA (+6.6%, 95% CI 4.4-8.4, p = 0.02) and after completing screening, the preference for MRI was higher (+21.1%, 95% CI 14.9-27.1, p < 0.001). The proportion of participants who strongly agreed with repeating the test was 50.5% for ultrasound, 65% for MRI and 68% for PSA. A larger proportion of participants found ultrasound anxiety-inducing, burdensome, embarrassing and painful compared to both MRI and PSA. CONCLUSIONS: Prostagram MRI and PSA are both acceptable as screening tests among men aged 50-69 years. Both tests were associated with minimal amounts of anxiety, burden, embarrassment and pain. The majority of participants preferred MRI over PSA and ultrasound. REGISTRATION: This study was registered on clinicaltrials.gov at https://clinicaltrials.gov/ct2/show/NCT03702439 .

Direct mail from primary care and targeted recruitment strategies achieved a representative uptake of prostate cancer screening.

BACKGROUND AND OBJECTIVES: Prostate cancer screening studies has previously not been able to reflect a diverse group of participants. We evaluated a range of recruitment strategies and their ability to recruit from the Black population and areas of deprivation. METHODS: IP1-PROSTAGRAM was a prospective, population-based, paired screening study of 408 participants conducted at seven UK primary care practices and two imaging centres. All participants underwent screening with a prostate specific antigen (PSA) test, magnetic resonance imaging (MRI), and transrectal ultrasound. A number of recruitment strategies were embedded including direct mail, media campaigns, and a targeted recruitment strategy to increase participation among harder-to-reach groups. RESULTS: A total of 1,316 expressions of interest were received (20th September 2018 to 15th May 2019). The direct mail strategy generated 317 expressions of interest from 1707 invitation letters. Overall 387 expressions of interest were received following the targeted strategy and 612 from media campaigns. The recruitment target was met 19 months ahead of the schedule. Of the 411 participants, ethnicity was White (38.0%), Black (32.4%), Asian (23.0%), and Other/Mixed (4.4%) ethnic groups. This higher recruitment of Black men was driven by the targeted recruitment strategy. A comparison of recruitment methods showed marked differences between ethnicities recruited (P < 0.001). The proportion of Black participants recruited by direct mail (8%) was similar to the prevalence of Black local population (9%) whereas, targeted recruitment was 88% (115) and media recruitment 1.7% (1). The Index of Multiple Deprivation (IMD) distribution was similar to the local population with marginal higher recruitment from more deprived areas; proportion increasing from 26% to 40% from least to most deprived IMD quintiles (Quintiles 4/5 vs. 1/2). Direct mail recruited a close-to-normal distribution for deprivation with targeted recruitment trending towards recruiting from most deprived areas. CONCLUSION: Direct mail and targeted strategies designed to engage a diverse population can achieve a representative uptake from Black participants and those from a lower socioeconomic group.

Elevated Seawater Temperature and Infection with Neoparamoeba perurans Exacerbate Complex Gill Disease in Farmed Atlantic Salmon (Salmo salar) in British Columbia, Canada.

Gill disorders and diseases are emergent health concerns affecting marine-farmed salmon, for which the causal factors are poorly understood in British Columbia (BC), Canada. This study sought to describe and compare spatial and temporal patterns of infection with Neoparamoeba perurans, the causal agent of amoebic gill disease, and visually assessed gill health scores in farmed Atlantic salmon. Gill tissue obtained during the Fisheries and Oceans Canada's Fish Health Audit and Intelligence Program (DFO-FHAIP) between 2016 and 2020 were screened for N. perurans by qPCR. Semi-quantitative visual gill health assessments were conducted during the audits, and farms were assigned clinical AGD status based on microscopic visualization of N. perurans together with histopathological lesions. Seawater temperature and salinity data were collected from all active farms in the region during the study period. Trends in gill scores and associations with N. perurans infections were described and tested using an ordinal logistic mixed model. The amoeba was detected in 21% of 345 audited farms and in 12% of 1925 fish samples. Most (56%, n = 1898) samples had no visible gill damage (score = 0), and 23% had scores ≥ 2 (high). Distinct patterns of spatial and temporal variability in the rates of high gill scores and N. perurans infections are demonstrated. The model supported the statistically significant relationship observed between seawater temperature and the proportion of samples with elevated gill scores. The model also revealed a direct relationship between salinity and gill score but only in the presence of N. perurans. While the data suggest that histopathological lesions contributed to the gill scores, temperature and, to a lesser extent, salinity were significant risk factors of increased gill score. The results are discussed in the context of recently frequent thermal anomalies in the northeastern Pacific Ocean.

DTU-DADS-Aqua: A simulation framework for modelling waterborne spread of highly infectious pathogens in marine aquaculture.

Simulation models are useful tools to predict and elucidate the effects of factors influencing the occurrence and spread of epidemics in animal populations, evaluate the effectiveness of different control strategies and ultimately inform decision-makers about mitigations to reduce risk. There is a paucity of simulation models to study waterborne transmission of viral and bacterial pathogens in marine environments. We developed a stochastic, spatiotemporal hybrid simulation model (DTU-DADS-Aqua) that incorporates a compartmental model for infection spread within net-pens, an agent-based model for infection spread between net-pens within and between sites and uses seaway distance to inform farm-site hydroconnectivity. The model includes processes to simulate infection transmission and control over surveillance, detection and depopulation measures. Different what-if scenarios can be explored according to the input data provided and user-defined parameter values, such as daily surveillance and depopulation capacities or increased animal mortality that triggers diagnostic testing to detect infection. The latter can be easily defined in a software application, in which results are summarized after each simulation. To demonstrate capabilities of the model, we simulated the spread of infectious salmon anaemia virus (ISAv) for realistic scenarios in a transboundary population of farmed Atlantic salmon (Salmo salar L.) in New Brunswick, Canada and Maine, United States. We assessed the progression of infection in the different simulated outbreak scenarios, allowing for variation in the control strategies adopted for ISAv. Model results showed that improved disease detection, coupled with increasing surveillance visits to farm-sites and increased culling capacity for depopulation of infected net-pens reduced the number of infected net-pens and outbreak duration but the number of ISA-infected farm sites was minimally affected. DTU-DADS-Aqua is a flexible modelling framework, which can be applied to study different infectious diseases in the aquatic environment, allowing the incorporation of alternative transmission and control dynamics. The framework is open-source and available at https://github.com/upei-aqua/DTU-DADS-Aqua.

Antimicrobial Use Surveillance Indicators for Finfish Aquaculture Production: A Review.

Quantification and tracking of antimicrobial use (AMU) are key factors for the development of responsible antimicrobial stewardship programs and comparison between countries. Global finfish aquaculture growth and increased AMU creates the potential for exchange of antimicrobial resistance between aquatic and terrestrial environments, making AMU surveillance imperative for this industry. The objective of this review is to collate current literature on AMU surveillance indicators and their application to commercial finfish aquaculture production. A systematic search strategy was applied to five databases: Medline, Embase, Agricola, CAB abstracts, and Biosis. To be included, studies must report on at least one AMU surveillance indicator for use in animals. There is no single, standardized indicator suitable to report finfish aquaculture AMU. The type and availability of finfish aquaculture data presents unique considerations for AMU reporting. Ultimately, the indicator used should be fit-for-purpose to satisfy the objective of the surveillance program, motivation for comparison and provide useful information to the industry stakeholders. Finfish aquaculture total annual slaughter weight allows estimation of biomass for the population correction unit (PCU) to report annual total mg of active antimicrobial ingredient per PCU. These data are commonly reported by finfish aquaculture-producing countries, allowing for international comparisons. However, this precludes the ability to compare to terrestrial livestock where the PCU is based on animal numbers and an average treatment weight, which are not available for finfish aquaculture. The mg per adjusted PCU indicator provides an interesting alternative that incorporates the length of the marine grow-out phase for finfish, but is subject to the same limitations. The number of defined daily doses animal per animal-days-at-risk is useful but also limited by a lack of a defined average treatment weight. The concept of average treatment weight remains challenging for the industry as it does not accurately reflect the timing of actual AMU to fish in the system. The term "average biomass" is more reflective of the intent of AMU surveillance indicators. Defining an average treatment weight, or average biomass, will require industry engagement, which is crucial if AMU reporting is to be deemed credible and provide value back to the finfish aquaculture industry.

Additional Treatments to the Local tumour for metastatic prostate cancer-Assessment of Novel Treatment Algorithms (IP2-ATLANTA): protocol for a multicentre, phase II randomised controlled trial.

INTRODUCTION: Survival in men diagnosed with de novo synchronous metastatic prostate cancer has increased following the use of upfront systemic treatment, using chemotherapy and other novel androgen receptor targeted agents, in addition to standard androgen deprivation therapy (ADT). Local cytoreductive and metastasis-directed interventions are hypothesised to confer additional survival benefit. In this setting, IP2-ATLANTA will explore progression-free survival (PFS) outcomes with the addition of sequential multimodal local and metastasis-directed treatments compared with standard care alone. METHODS: A phase II, prospective, multicentre, three-arm randomised controlled trial incorporating an embedded feasibility pilot. All men with new histologically diagnosed, hormone-sensitive, metastatic prostate cancer, within 4 months of commencing ADT and of performance status 0 to 2 are eligible. Patients will be randomised to Control (standard of care (SOC)) OR Intervention 1 (minimally invasive ablative therapy to prostate±pelvic lymph node dissection (PLND)) OR Intervention 2 (cytoreductive radical prostatectomy±PLND OR prostate radiotherapy±pelvic lymph node radiotherapy (PLNRT)). Metastatic burden will be prespecified using the Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease (CHAARTED) definition. Men with low burden disease in intervention arms are eligible for metastasis-directed therapy, in the form of stereotactic ablative body radiotherapy (SABR) or surgery. Standard systemic therapy will be administered in all arms with ADT±upfront systemic chemotherapy or androgen receptor agents. Patients will be followed-up for a minimum of 2 years. PRIMARY OUTCOME: PFS. Secondary outcomes include predictive factors for PFS and overall survival; urinary, sexual and rectal side effects. Embedded feasibility sample size is 80, with 918 patients required in the main phase II component. Study recruitment commenced in April 2019, with planned follow-up completed by April 2024. ETHICS AND DISSEMINATION: Approved by the Health Research Authority (HRA) Research Ethics Committee Wales-5 (19/WA0005). Study results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03763253; ISCRTN58401737.

Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography: The IP1-PROSTAGRAM Study.

IMPORTANCE: Screening for prostate cancer using prostate-specific antigen (PSA) testing can lead to problems of underdiagnosis and overdiagnosis. Short, noncontrast magnetic resonance imaging (MRI) or transrectal ultrasonography might overcome these limitations. OBJECTIVE: To compare the performance of PSA testing, MRI, and ultrasonography as screening tests for prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: This prospective, population-based, blinded cohort study was conducted at 7 primary care practices and 2 imaging centers in the United Kingdom. Men 50 to 69 years of age were invited for prostate cancer screening from October 10, 2018, to May 15, 2019. INTERVENTIONS: All participants underwent screening with a PSA test, MRI (T2 weighted and diffusion), and ultrasonography (B-mode and shear wave elastography). The tests were independently interpreted without knowledge of other results. Both imaging tests were reported on a validated 5-point scale of suspicion. If any test result was positive, a systematic 12-core biopsy was performed. Additional image fusion-targeted biopsies were performed if the MRI or ultrasonography results were positive. MAIN OUTCOMES AND MEASURES: The main outcome was the proportion of men with positive MRI or ultrasonography (defined as a score of 3-5 or 4-5) or PSA test (defined as PSA ≥3 µg/L) results. Key secondary outcomes were the number of clinically significant and clinically insignificant cancers detected if each test was used exclusively. Clinically significant cancer was defined as any Gleason score of 3+4 or higher. RESULTS: A total of 2034 men were invited to participate; of 411 who attended screening, 408 consented to receive all screening tests. The proportion with positive MRI results (score, 3-5) was higher than the proportion with positive PSA test results (72 [17.7%; 95% CI, 14.3%-21.8%] vs 40 [9.9%; 95% CI, 7.3%-13.2%]; P < .001). The proportion with positive ultrasonography results (score, 3-5) was also higher than the proportion of those with positive PSA test results (96 [23.7%; 95% CI, 19.8%-28.1%]; P < .001). For an imaging threshold of score 4 to 5, the proportion with positive MRI results was similar to the proportion with positive PSA test results (43 [10.6%; 95% CI, 7.9%-14.0%]; P = .71), as was the proportion with positive ultrasonography results (52 [12.8%; 95% CI, 9.9%-16.5%]; P = .15). The PSA test (≥3 ng/mL) detected 7 clinically significant cancers, an MRI score of 3 to 5 detected 14 cancers, an MRI score of 4 to 5 detected 11 cancers, an ultrasonography score of 3 to 5 detected 9 cancer, and an ultrasonography score of 4 to 5 detected 4 cancers. Clinically insignificant cancers were diagnosed by PSA testing in 6 cases, by an MRI score of 3 to 5 in 7 cases, an MRI score of 4 to 5 in 5 cases, an ultrasonography score of 3 to 5 in 13 cases, and an ultrasonography score of 4 to 5 in 7 cases. CONCLUSIONS AND RELEVANCE: In this cohort study, when screening the general population for prostate cancer, MRI using a score of 4 or 5 to define a positive test result compared with PSA alone at 3 ng/mL or higher was associated with more men diagnosed with clinically significant cancer, without an increase in the number of men advised to undergo biopsy or overdiagnosed with clinically insignificant cancer. There was no evidence that ultrasonography would have better performance compared with PSA testing alone.

Development of simulation models for transmission of Salmonid Rickettsial Septicaemia between salt water fish farms in Chile.

This study aimed at estimating parameters representing between-farm transmission of Salmonid Rickettsial Septicaemia (SRS) in Chile, and developing and validating simulation models to predict weekly spread of SRS between farms in Los Lagos (Region 10), using InterSpread Plus. The model parameters were estimated by analyses of the historical SRS outbreak data. The models incorporated time and distance-dependent transmission kernels, representing the probabilities of waterborne spread of SRS between farms. Seven candidate transmission kernels were estimated, with varying maximum distance of between-farm SRS spread (15-60 km). Farms were categorized by size (small; medium; large) and species (Coho salmon; Atlantic salmon; rainbow trout). The time that it took a farm to recover from infection was parameterized to be shortest for small Coho farms (median: 7 weeks), followed by medium and large Coho farms (median: 25 weeks), Atlantic salmon farms (median: 42 weeks, any size) and rainbow trout farms (median: 43 weeks, any size). The relative infectiousness parameters of rainbow trout farms were 1.5-6.3 times that of Coho or Atlantic salmon, or those of large farms was 1.3-4.2 times that of small or medium farms. The models predicted SRS prevalence in Region 10 between 2013 and 2015 (79 weeks) with 76.5%-93.0% overall accuracy. The model with a transmission kernel of <20 km (P20) achieved a maximum overall accuracy (93.0%). Within each neighbourhood, the accuracy of P20 varied between 32.4% and 88.1%; 13/20 neighbourhoods had a reasonable temporal agreement between the simulated and actual dynamics of SRS (within 5th-95th percentiles), but 5/20 neighbourhoods underestimated and 2/20 overestimated the SRS spread. The model could be used for evaluation of semi-global control policies in Region 10, while addition of other factors such as seasonality, ocean currents, and movement of infected fish may improve the model performance at a finer scale.

Real-time organic aerosol chemical speciation in the indoor environment using extractive electrospray ionization mass spectrometry.

Understanding the sources and composition of organic aerosol (OA) in indoor environments requires rapid measurements, since many emissions and processes have short timescales. However, real-time molecular-level OA measurements have not been reported indoors. Here, we present quantitative measurements, at a time resolution of five seconds, of molecular ions corresponding to diverse aerosol-phase species, by applying extractive electrospray ionization mass spectrometry (EESI-MS) to indoor air analysis for the first time, as part of the highly instrumented HOMEChem field study. We demonstrate how the complex spectra of EESI-MS are screened in order to extract chemical information and investigate the possibility of interference from gas-phase semivolatile species. During experiments that simulated the Thanksgiving US holiday meal preparation, EESI-MS quantified multiple species, including fatty acids, carbohydrates, siloxanes, and phthalates. Intercomparisons with Aerosol Mass Spectrometer (AMS) and Scanning Mobility Particle Sizer suggest that EESI-MS quantified a large fraction of OA. Comparisons with FIGAERO-CIMS shows similar signal levels and good correlation, with a range of 100 for the relative sensitivities. Comparisons with SV-TAG for phthalates and with SV-TAG and AMS for total siloxanes also show strong correlation. EESI-MS observations can be used with gas-phase measurements to identify co-emitted gas- and aerosol-phase species, and this is demonstrated using complementary gas-phase PTR-MS observations.

Global airborne sampling reveals a previously unobserved dimethyl sulfide oxidation mechanism in the marine atmosphere.

Dimethyl sulfide (DMS), emitted from the oceans, is the most abundant biological source of sulfur to the marine atmosphere. Atmospheric DMS is oxidized to condensable products that form secondary aerosols that affect Earth's radiative balance by scattering solar radiation and serving as cloud condensation nuclei. We report the atmospheric discovery of a previously unquantified DMS oxidation product, hydroperoxymethyl thioformate (HPMTF, HOOCH2SCHO), identified through global-scale airborne observations that demonstrate it to be a major reservoir of marine sulfur. Observationally constrained model results show that more than 30% of oceanic DMS emitted to the atmosphere forms HPMTF. Coincident particle measurements suggest a strong link between HPMTF concentration and new particle formation and growth. Analyses of these observations show that HPMTF chemistry must be included in atmospheric models to improve representation of key linkages between the biogeochemistry of the ocean, marine aerosol formation and growth, and their combined effects on climate.

Budgets of Organic Carbon Composition and Oxidation in Indoor Air.

The chemical composition of indoor air at the University of Colorado, Boulder art museum was measured by a suite of gas- and particle-phase instruments. Over 80% of the total observed organic carbon (TOOC) mass (100 µg m-3) consisted of reduced compounds (carbon oxidation state, OSC < -0.5) with high volatility (log10 C* > 7) and low carbon number (nC < 6). The museum TOOC was compared to other indoor and outdoor locations, which increased according to the following trend: remote < rural ≤ urban < indoor ≤ megacity. The museum TOOC was comparable to a university classroom and 3× less than residential environments. Trends in the total reactive flux were remote < indoor < rural < urban < megacity. High volatile organic compound (VOC) concentrations compensated low oxidant concentrations indoors to result in an appreciable reactive flux. Total hydroxyl radical (OH), ozone (O3), nitrate radical (NO3), and chlorine atom (Cl) reactivities for each location followed a similar trend to TOOC. High human occupancy events increased all oxidant reactivities in the museum by 65-125%. The lifetimes of O3, NO3, OH, and Cl reactivities were 13 h, 15 h, 23 days, and 189 days, respectively, corresponding to over 88% of indoor VOC oxidant reactivity being consumed outdoors after ventilation.

Influences of Primary Emission and Secondary Coating Formation on the Particle Diversity and Mixing State of Black Carbon Particles.

The mixing state of black carbon (BC) affects its environmental fate and impacts. This work investigates particle diversity and mixing state for refractory BC (rBC) containing particles in an urban environment. The chemical compositions of individual rBC-containing particles were measured, from which a mixing state index and particle diversity were determined. The mixing state index (χ) varied between 26% and 69% with the average of 48% in this study and was slightly enhanced with the photochemical age of air masses, indicating that most of the rBC-containing particles cannot be simply explained by fully externally and internally mixed model. Clustering of single particle measurements was used to investigate the potential effects of different primary emissions and atmospheric processes on rBC-containing particle diversity and mixing state. The average particle species diversity and the bulk population species diversity both increased with primary traffic emissions and elevated nitrate concentrations in the morning but gradually decreased with secondary organic aerosol (SOA) formation in the afternoon. The single particle clustering results illustrate that primary traffic emissions and entrainment of nitrate-containing rBC particles from the residual layer to the surface could lead to more heterogeneous aerosol compositions, whereas substantial fresh SOA formation near vehicular emissions made the rBC-containing particles more homogeneous. This work highlights the importance of considering particle diversity and mixing state for investigating the chemical evolution of rBC-containing particles and the potential effects of coating on BC absorption enhancement.

Time-Resolved Measurements of Indoor Chemical Emissions, Deposition, and Reactions in a University Art Museum.

A 6-week study was conducted at the University of Colorado Art Museum, during which volatile organic compounds (VOCs), carbon dioxide (CO2), ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), other trace gases, and submicron aerosol were measured continuously. These measurements were then analyzed using a box model to quantify the rates of major processes that transformed the composition of the air. VOC emission factors were quantified for museum occupants and their activities. The deposition of VOCs to surfaces was quantified across a range of VOC saturation vapor concentrations ( C*) and Henry's Law constants ( H) and determined to be a major sink for VOCs with C* < 108 µg m-3 and H > 102 M atm-1. The reaction rates of VOCs with O3, OH radicals, and nitrate (NO3) radicals were quantified, with unsaturated and saturated VOCs having oxidation lifetimes of >5 and >15 h, making deposition to surfaces and ventilation the dominant VOC sinks in the museum. O3 loss rates were quantified inside a museum gallery, where reactions with surfaces, NO, occupants, and NO2 accounted for 62%, 31%, 5%, and 2% of the O3 sink. The measured concentrations of acetic acid, formic acid, NO2, O3, particulate matter, sulfur dioxide, and total VOCs were below the guidelines for museums.

Substantial Seasonal Contribution of Observed Biogenic Sulfate Particles to Cloud Condensation Nuclei.

Biogenic sources contribute to cloud condensation nuclei (CCN) in the clean marine atmosphere, but few measurements exist to constrain climate model simulations of their importance. The chemical composition of individual atmospheric aerosol particles showed two types of sulfate-containing particles in clean marine air masses in addition to mass-based Estimated Salt particles. Both types of sulfate particles lack combustion tracers and correlate, for some conditions, to atmospheric or seawater dimethyl sulfide (DMS) concentrations, which means their source was largely biogenic. The first type is identified as New Sulfate because their large sulfate mass fraction (63% sulfate) and association with entrainment conditions means they could have formed by nucleation in the free troposphere. The second type is Added Sulfate particles (38% sulfate), because they are preexisting particles onto which additional sulfate condensed. New Sulfate particles accounted for 31% (7 cm-3) and 33% (36 cm-3) CCN at 0.1% supersaturation in late-autumn and late-spring, respectively, whereas sea spray provided 55% (13 cm-3) in late-autumn but only 4% (4 cm-3) in late-spring. Our results show a clear seasonal difference in the marine CCN budget, which illustrates how important phytoplankton-produced DMS emissions are for CCN in the North Atlantic.

Using perimetric data to estimate ganglion cell loss for detecting progression of glaucoma: a comparison of models.

PURPOSE: Models relating perimetric sensitivities to ganglion cell numbers have been proposed for combining structural and functional measures from patients with glaucoma. Here we compared seven models for ability to differentiate progressing and stable patients, testing the hypothesis that the model incorporating local spatial scale would have the best performance. METHODS: The models were compared for the United Kingdom Glaucoma Treatment Study (UKGTS) data for the right eyes of 489 patients recently diagnosed with glaucoma. The SITA 24-2 program was utilised for perimetry and Stratus OCT fast scanning protocol for thickness of circumpapillary retinal nerve fibre layer (RNFL). The first analysis defined progression in terms of decline in RNFL thickness. The highest and lowest quintiles (22 subjects per group) were identified for change in thickness of inferior temporal (IT), superior temporal (ST), and global RNFL (µm year-1 ); a two-way anova was used to look for differences between the models in ability to discriminate the two quintiles. The second analysis defined a 'progression group' as those who were flagged by the UKGTS criteria as having progressive loss in perimetric sensitivity, and a 'no progression' group as those with rate of change in Mean Deviation (MD) closest to 0 dB year-1 (87 subjects per group). The third analysis characterised variability of retinal ganglion cell (RGC) models for the two groups in the second analysis, using the standard deviation of residuals from linear regression of ganglion cell number over time to compute Coefficient of Variation (CoV). RESULTS: The first analysis produced a negative result because the three anovas found no effect of model or interaction of model and group (F6,294 < 3.1, p > 0.08). There was an effect of group only for the anova with the ST sector (F6,294 = 12.2, p < 0.001). The second analysis also produced a negative result, because ROC areas were in the range 0.69-0.72 for all models. The third analysis found that even when variability in MD was low, the CoV was so large that test-retest variation could include 100% loss of ganglion cells. CONCLUSIONS: Two very different approaches for testing the hypothesis both gave a negative result. For all seven ganglion cell models, rates of ganglion cell loss were highly affected by fluctuations in height of the hill of vision. Methods for reducing effects of between-visit variability are needed in order to assess progression by relating perimetric sensitivities and ganglion cell numbers.

Retrospective analysis of antibiotic treatments against piscirickettsiosis in farmed Atlantic salmon Salmo salar in Chile.

Piscirickettsiosis is the most prevalent salt-water infectious disease in farmed salmonids in Chile. Antimicrobials are used to treat this disease; however, there is growing concern about the poor response to therapeutants on some fish farms. The objective of this study was to assess whether factors such as type of antibiotic used, average fish weight, temperature at the beginning of the treatment, and mortality at the time of treatment administration affect the probability of treatment failure against piscirickettsiosis. Pen-level treatment and production information for the first treatment event from 2014 pens on 118 farms was used in a logistic mixed model to assess treatment failure. We defined a failed treatment as when the average mortality 3 wk after the treatment was above 0.1%. Farm and company were included in the model as random effects. We found that the antibiotic product, mortality level before the treatment, and fish weight at the start of the treatment all had a significant effect on treatment outcome. Our results suggest that antibiotic treatment success is higher if the treatment is administered when mortality associated with piscirickettsiosis is relatively low. We discuss the effect of weight on treatment success and its potential relationships with husbandry practices and drug pharmacokinetics.

Treatment of diplomonad intestinal parasites with magnesium sulphate at a commercial rainbow trout (Oncorhynchus mykiss) facility.

Rainbow trout (average weight of 2 g) in fresh water experienced high mortality and were infected with a diplomonad intestinal parasite. Tanks of fish experienced an immediate reduction in mortality after an in-feed treatment with 3% Epsom salts for 2 d. Treatments had to be applied several times, but in each case there was a similar reduction in mortality.

Traitement des parasites intestinaux diplomonades à l'aide de sulfate de magnésium dans une installation commerciale de truites arc-en-ciel(Oncorhynchus mykiss). Des truites arc-en-ciel (poids moyen de 2 g) élevées en eau douce ont connu une mortalité élevée et ont été infectées par un parasite intestinal diplomonade. Une réduction immédiate de la mortalité a été observée dans les bassins de poissons après un traitement dans l'alimentation de 3 % de sel d'Epsom pendant 2 jours. Les traitements ont dû être appliqués plusieurs fois, mais, dans chaque instance, il s'est produit une réduction semblable de la mortalité.(Traduit par Isabelle Vallières).