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BirdLife International´s Important Bird and Biodiversity Areas (IBA) Programme has identified, documented and mapped over 13,000 sites of international importance for birds. IBAs have been influential with governments, multilateral agreements, businesses and others in: (1) informing governments’ efforts to expand protected area networks (in particular to meet their commitments through the Convention on Biological Diversity); (2) supporting the identification of Ecologically or Biologically Significant Areas (EBSAs) in the marine realm, (3) identifying Wetlands of International Importance under the Ramsar Convention; (4) identifying sites of importance for species under the Convention on Migratory Species and its sister agreements; (5) identifying Special Protected Areas under the EU Birds Directive; (6) applying the environmental safeguards of international finance institutions such as the International Finance Corporation; (7) supporting the private sector to manage environmental risk in its operations; and (8) helping donor organisations like the Critical Ecosystems Partnership Fund (CEPF) to prioritise investment in site-based conservation. The identification of IBAs (and IBAs in Danger: the most threatened of these) has also triggered conservation and management actions at site level, most notably by civil society organisations and local conservation groups. IBA data have therefore been widely used by stakeholders at different levels to help conserve a network of sites essential to maintaining the populations and habitats of birds as well as other biodiversity. The experience of IBA identification and conservation is shaping the design and implementation of the recently launched Key Biodiversity Areas (KBA) Partnership and programme, as IBAs form a core part of the KBA network.

Vulval intraepithelial neoplasia is a skin disorder affecting the vulva that, if left untreated, can become cancerous. Currently, the standard treatment for patients with vulval intraepithelial neoplasia is surgery, but this approach does not guarantee cure and can be disfiguring, causing physical and psychological problems, particularly in women of reproductive age. We aimed to assess the activity, safety, and feasibility of two topical treatments—cidofovir and imiquimod—as an alternative to surgery in female patients with vulval intraepithelial neoplasia. We recruited female patients (age 16 years or older) from 32 centres to an open-label, randomised, phase 2 trial. Eligibility criteria were biopsy-proven vulval intraepithelial neoplasia grade 3 and at least one lesion that could be measured accurately. We randomly allocated patients to topical treatment with either 1% cidofovir (supplied as a gel in a 10 g tube, to last 6 weeks) or 5% imiquimod (one 250 mg sachet for every application), to be self-applied three times a week for a maximum of 24 weeks. Randomisation (1:1) was done by stratified minimisation via a central computerised system, with stratification by hospital, disease focality, and presentation stage. The primary endpoint was a histologically confirmed complete response at the post-treatment assessment visit 6 weeks after the end of treatment (a maximum of 30 weeks after treatment started). Analysis of the primary endpoint was by intention to treat. Secondary outcomes were toxic effects (to assess safety) and adherence to treatment (to assess feasibility). We present results after all patients had reached the primary endpoint assessment point at 6 weeks; 2-year follow-up of complete responders continues. This trial is registered with Current Controlled Trials, ISRCTN 34420460. Between Oct 21, 2009, and Jan 11, 2013, 180 participants were enrolled to the study; 89 patients were randomly allocated cidofovir and 91 were assigned imiquimod. At the post-treatment assessment visit, a complete response had been achieved by 41 (46%; 90% CI 37·0–55·3) patients allocated cidofovir and by 42 (46%; 37·2–55·3) patients assigned imiquimod. After 6 weeks of treatment, 156 (87%) patients (78 in each group) had adhered to the treatment regimen. Five patients in the cidofovir group and seven in the imiquimod group either withdrew or were lost to follow-up before the first 6-week safety assessment. Adverse events of grade 3 or higher were reported in 31 (37%) of 84 patients allocated cidofovir and 39 (46%) of 84 patients assigned imiquimod; the most frequent grade 3 and 4 events were pain in the vulva, pruritus, fatigue, and headache. Cidofovir and imiquimod were active, safe, and feasible for treatment of vulval intraepithelial neoplasia and warrant further investigation in a phase 3 setting. Both drugs are effective alternatives to surgery for female patients with vulval intraepithelial neoplasia after exclusion of occult invasive disease. Cancer Research UK.

© 2018 Springer Science+Business Media, LLC, part of Springer Nature The high-frequency telescope for LiteBIRD is designed with refractive and reflective optics. In order to improve sensitivity, this paper suggests the new optical configurations of the HFT which have approximately 7 times larger focal planes than that of the original design. The sensitivities of both the designs are compared, and the requirement of anti-reflection (AR) coating on the lens for the refractive option is derived. We also present the simulation result of a sub-wavelength AR structure on both surfaces of silicon, which shows a band-averaged reflection of 1.1–3.2% at 101–448 GHz.

We present constraints on cosmological parameters using maps from the last Planck data release (PR4). In particular, we detail an upgraded version of the cosmic microwave background likelihood, HiLLiPoP, based on angular power spectra and relying on a physical modelling of the foreground residuals in the spectral domain. This new version of the likelihood retains a larger sky fraction (up to 75%) and uses an extended multipole range. Using this likelihood, along with low-l measurements from LoLLiPoP, we derive constraints on \\(\\Lambda\\)CDM parameters that are in good agreement with previous Planck 2018 results, but with 10% to 20% smaller uncertainties. We demonstrate that the foregrounds can be accurately described in spectra domain with only negligible impact on \\(\\Lambda\\)CDM parameters. We also derive constraints on single-parameter extensions to \\(\\Lambda\\)CDM including \\(A_L\\), \\(\\Omega_K\\), \\(N_{eff}\\), and \\(\\sum m_{\\nu}\\). Noteworthy results from this updated analysis include a lensing amplitude value of \\(A_L = 1.039 \\pm 0.052\\), which aligns more closely with theoretical expectations within the \\(\\Lambda\\)CDM framework. Additionally, our curvature measurement, \\(\\Omega_K = -0.012 \\pm 0.010\\), now demonstrates complete consistency with a flat universe, and our measurement of \\(S_8\\) is closer to the measurements derived from large-scale structure surveys (at the 1.6\\(\\sigma\\) level). We also add constraints from PR4 lensing, making the combination the most constraining data set that is currently available from Planck. Additionally we explore adding baryon acoustic oscillation data, which tightens limits on some particular extensions to the standard cosmology.

The Quadratic Maximum Likelihood estimator can be used to reconstruct the Cosmic Microwave Background (CMB) power spectra with minimal error bars. Still, it requires an accurate estimate of the datasets noise covariance matrix in order to be corrected for spurious bias. We describe an extension of this method to cross-correlation, thus removing noise bias and mitigating the impact of systematic effects, providing they are uncorrelated. This estimator is tested on two simulation surveys at large and intermediate angular scales, respectively corresponding to satellite and ground-based CMB experiments. The analysis focuses on polarization maps, over a wide range of noise levels from 0.1 to 50 muK.arcmin. We show how this estimator minimizes the increase of variance due to polarization leakage between E and B modes. We compare this method with the pure pseudo-spectrum formalism which is computationally faster but less optimal, especially on large angular scales.

The utility of routine TEE to exclude LAA thrombus prior to AF ablation in patients treated with NOAC therapy is unclear. This single center retrospective study sought to investigate the incidence of left atrial appendage (LAA) thrombus in patients undergoing routine transesophageal echocardiography (TEE) prior to atrial fibrillation (AF) ablation treated with warfarin or non-vitamin K oral anticoagulant (NOAC) therapy. We included 937 routine pre-AF ablation TEE procedures performed in patients treated with warfarin (n=517) or NOAC (n=420). Patients were anticoagulated without interruption for at least 4 consecutive weeks prior to the TEE. Patients treated with warfarin had lower LAA velocity and underwent TEE earlier in the study period than patients treated with NOAC ( P <0.05). The incidence of LAA thrombus was higher in patients treated with warfarin (1.55%, 8/517) compared to patients treated with NOAC (0.24%, 1/420, P = 0.0473 for difference). No LAA thrombus was identified in NOAC treated patients with a CHA2 DS2 -VASC score <5 and in warfarin treated patients with a CHA2 DS2 -VASC score <2. TEE related complications occurred in 3/937 procedures (0.3%). In conclusion, LAA thrombus is detected rarely during pre-AF ablation TEE. Treatment with a NOAC is associated with a lower incidence of pre AF-ablation LAA thrombus compared to warfarin.

The polarization of the cosmic microwave background (CMB) can be used to search for parity-violating processes like that predicted by a Chern-Simons coupling to a light pseudoscalar field. Such an interaction rotates \\(E\\) modes into \\(B\\) modes in the observed CMB signal by an effect known as cosmic birefringence. Even though isotropic birefringence can be confused with the rotation produced by a miscalibration of the detectors' polarization angles the degeneracy between both effects is broken when Galactic foreground emission is used as a calibrator. In this work, we use realistic simulations of the High-Frequency Instrument of the Planck mission to test the impact that Galactic foreground emission and instrumental systematics have on the recent birefringence measurements obtained through this technique. Our results demonstrate the robustness of the methodology against the miscalibration of polarization angles and other systematic effects, like intensity-to-polarization leakage, beam leakage, or cross-polarization effects. However, our estimator is sensitive to the \\(EB\\) correlation of polarized foreground emission. Here we propose to correct the bias induced by dust \\(EB\\) by modeling the foreground signal with templates produced in Bayesian component-separation analyses that fit parametric models to CMB data. Acknowledging the limitations of currently available dust templates like that of the Commander sky model, high-precision CMB data and a characterization of dust beyond the modified blackbody paradigm are needed to obtain a definitive measurement of cosmic birefringence in the future.

The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization’s methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical “full-time faculty” (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs–reported median work relative value unit productivity approximated MGMA and FPSC benchmark data, we conclude that more rigorous standardization of academic faculty effort assignment will be needed to improve the value of work relative value unit measurements of faculty productivity.

We present a cross-spectra based approach for the analysis of CMB data at large angular scales to constrain the reionization optical depth \\(\\tau\\), the tensor to scalar ratio \\(r\\) and the amplitude of the primordial scalar perturbations \\(A_s\\). With respect to the pixel-based approach developed so far, using cross-spectra has the unique advantage to eliminate spurious noise bias and to give a better handle over residual systematics, allowing to efficiently combine the cosmological information encoded in cross-frequency or cross-dataset spectra. We present two solutions to deal with the non-Gaussianity of the \\(\\hat{C}_\\ell\\) estimator distributions at large angular scales: the first one relies on an analytical parametrization of the estimator distribution, while the second one is based on modification of the Hamimache\\&Lewis likelihood approximation at large angular scales. The modified HL method (oHL) is powerful and complete. It allows to deal with multipole and mode correlations for a combined temperature and polarization analysis. We validate our likelihoods on numerous simulations that include the realistic noise levels of the \\wmap, \\planck-LFI and \\planck-HFI experiments, demonstrating their validity over a broad range of cross-spectra configurations.

We search for the signature of parity-violating physics in the cosmic microwave background, called cosmic birefringence, using the Planck data release 4. We initially find a birefringence angle of \\(\\beta=0.30\\pm0.11\\) (68% C.L.) for nearly full-sky data. The values of \\(\\beta\\) decrease as we enlarge the Galactic mask, which can be interpreted as the effect of polarized foreground emission. Two independent ways to model this effect are used to mitigate the systematic impact on \\(\\beta\\) for different sky fractions. We choose not to assign cosmological significance to the measured value of \\(\\beta\\) until we improve our knowledge of the foreground polarization.