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Purpose of Review Attention deficit hyperactivity disorder (ADHD) shows high heritability in formal genetic studies. In our review article, we provide an overview on common and rare genetic risk variants for ADHD and their link to clinical practice. Recent findings The formal heritability of ADHD is about 80% and therefore higher than most other psychiatric diseases. However, recent studies estimate the proportion of heritability based on singlenucleotide variants (SNPs) at 22%. It is a matter of debate which genetic mechanisms explain this huge difference. While frequent variants in first mega-analyses of genome-wideassociation study data containing several thousand patients give the first genome-wide results, explaining only little variance, the methodologically more difficult analyses of rare variants are still in their infancy. Some rare genetic syndromes show higher prevalence for ADHD indicating a potential role for a small number of patients. In contrast, polygenic risk scores (PRS) could potentially be applied to every patient. We give an overview how PRS explain different behavioral phenotypes in ADHD and how they could be used for diagnosis and therapy prediction. Summary Knowledge about a patient’s genetic makeup is not yet mandatory for ADHD therapy or diagnosis. PRS however have been introduced successfully in other areas of clinical medicine, and their application in psychiatry will begin within the next years. In order to ensure competent advice for patients, knowledge of the current state of research is useful forpsychiatrists.

Purpose of Review We will describe the success of recent genome-wide association studies that identify genetic variants associated with depression and outline the strategies used to reduce heterogeneity and increase sample size. Recent Findings The CONVERGE consortium identified two genetic associations by focusing on a sample of Chinese women with recurrent severe depression. Three other loci have been found in Europeans by combining cohorts with clinical diagnosis and measures of depressive symptoms to increase sample size. 23andMe identified 15 loci associated with depression using self-report of clinical diagnosis in a study of over 300,000 individuals. Summary The first genetic associations with depression have been identified, and this number is now expected to increase linearly with sample size, as seen in other polygenic disorders. These loci provide invaluable insights into the biology of depression and exciting opportunities to develop new biomarkers and therapeutic targets.

The Advanced Baseline Imager (ABI) is the primary Earth observing sensor on the new generation Geostationary Operational Environmental Satellites (GOES-R) series, and provides significant spectral, spatial and temporal observational enhancements compared to the legacy GOES satellites. ABI also provides enhanced capabilities for operational sensor calibration and image navigation and registration (INR) to enable observations of the Earth with high spectral fidelity as well as creating images that are accurately mapped and co-registered over time. Unlike earlier GOES Imagers, ABI has onboard calibration capability for all sixteen bands in the reflective and emissive bands. The calibration process includes periodic and routine views of the internal reflective and blackbody targets as well as views of space and the moon. Improvements in INR are made possible by having a Global Positioning System (GPS) on board the spacecraft and routine measurements of stars through the sensor’s boresight for orbit and attitude determination through a Kalman filter. This paper describes how the sensor data are processed into calibrated and geolocated radiances that enable the generation of imagery and higher level products for both meteorological and non-meteorological Earth science applications. Some examples of ABI images and calibration are presented to demonstrate the capabilities and applications of the sensor.

A number of approaches have been developed to generate true color images from the Advanced Baseline Imager (ABI) on the Geostationary Operational Environmental Satellite (GOES)‐16. GOES‐16 is the first of a series of four spacecraft with the ABI onboard. These approaches are complicated since the ABI does not have a green (0.55 μm) spectral band. Despite this limitation, representative true color images can be built. A methodology for generating color images from the ABI is discussed, along with corresponding examples from the Earth Polychromatic Imaging Camera on Deep Space Climate Observatory. Key Points The Advanced Baseline Imager (ABI) is significantly improved over the legacy Geostationary Operational Environmental Satellite imager All approaches to generate true color images from the ABI first need to generate the green band True color RGB natural and enhanced image comparisons are shown between the ABI and the EPIC on the Deep Space Climate Observatory

IntroductionPrimary Ciliary Dyskinesia (PCD) is a rare genetic disease, affecting ~400 children in England. Ciliary structural defects cause abnormal function, impairing mucociliary clearance. Mucus build-up and infection cause lung disease, including bronchiectasis. Little is known about disease progression in PCD. CT imaging identifies structural lung damage and alongside lung function could be used to measure disease severity. This study compared CT changes over time to identify disease progression in children with PCD linked to spirometry, infection, and ciliary defect.Methods278 children with confirmed PCD diagnosis were screened. Inclusion criteria were referrals between 2013–2022 and having two sequential lung CT scans according to an internal hospital guideline, ensuring children were scanned at similar ages. CTs were analysed using the Brody score. Demographic, anthropometric, ciliary defect, lung function, infection and treatment data were collected for patients using hospital records.Results61 children (30 male) had two CTs, mean age at first, 9.1 years, and second, 14.8 years. There was no significant change over time in total CT lung scores, median (IQR) 16 (6–26) and 14 (7.9–24.7), or lung function, mean ppFEV172.9% and 73.4%, ppFVC 81.1% and 83.1%. Dependent lobes scored higher, as expected. The sub-category score for bronchiectasis did increase over time, however 3 of the other sub-categories improved (mucus plugging, peribronchial thickening, parenchymal changes). CT score and lung function showed significant negative correlation at both CT time points (r2=0.25, p<0.0001 at second). Increased CT scores were associated with increased chronic infections, at second CT. CT changes, anthropometrics and lung function did not differ significantly between ciliary defects.ConclusionThis large, longitudinal CT study in PCD showed no changes in total CT score or lung function in children aged 5 and over, contrasting with sparse and inconclusive evidence in the literature. This was a single-centre study, using a CT score derived from cystic fibrosis, which may have introduced bias and scoring limitations resulting in participants showing less progressed disease. Our findings suggest CT is a useful modality, alongside spirometry, to monitor disease progression. However, larger multicentre longitudinal studies, using a PCD-specific score, are required to validate this claim.

IntroductionThe relationship between neutrophilic inflammation and microbiome dysbiosis, two central features of bronchiectasis pathophysiology, is not fully understood. We used novel full length 16s rRNA sequencing, which provides detailed characterisation of bacterial communities at species level, to investigate the relationship between microbiome composition and markers of neutrophilic inflammation in bronchiectasis airways.MethodsThe neutrophil serine protease Proteinase-3 (PR3) and the neutrophil granule protein Olfactomedin-4 (OLFM4), were measured by ELISA in sputum supernatant from patients enrolled in the pan-European, multicentre EMBARC-BRIDGE study. Results were linked to sputum levels of neutrophil elastase (NE), a known bronchiectasis severity marker, and to relative abundance of taxa at species level in sputum measured by full length 16s rRNA sequencing.Results143 patients were included. Mean age was 65 yrs (± 16) and 48% were female. Sputum PR3 and OLFM4 were strongly correlated (rs=0.73, p<0.001). Both were moderately correlated with NE (rs=0.54 and rs=0.4 respectively, p<0001). Median PR3 and OLFM4 were significantly higher in patients with Pseudomonas aeruginosa infection (p=0.002 and p<0.001), mucus plugging on chest computed tomography (p=0.006 and p=0.045) and hospitalisation for severe exacerbation (p=0.07 and p=0.05). Patients were grouped into high and low biomarker levels based around the median concentration. Table 1 shows bacterial species with highest relative abundance in samples grouped by high and low PR3, OLFM4 and NE. Linear discriminant analysis Effect Size (LEfSe) showed that the proteobacteria Haemophilus influenzae and P. aeruginosa were the most differentially abundant species defining patients with high PR3, OLFM4 and NE. In patients with low sputum PR3 and OLFM4, Rothia mucilaginosa was the most differentially abundant species; whereas unclassified Streptococcus differentiated those with low NE. Alpha diversity, measured using the Shannon index, was lower among patients with high PR3 (p<0.001), OLFM4 (p<0.001) and NE (p=0.034). Beta diversity analysed by PERMANOVA revealed distinct clusters defined by high and low PR3, OLFM4 and NE levels.Abstract S27 Table 1Relative abundance (%) of Haemophilus influenzae, Pseudomonas aeruginosa, Rothia mucilaginosa and unclassified Streptococcus in bronchiectasis patients with high (above the median concentration) and low (below the median concentration) sputum proteinase-3 (PR3), olfactomedin-4 (OLFM4) and neutrophil elastase (NE). PR3 OLFM4 NE Median sputum concentration (ng/ml) 425.6 640.24 747.5 Bacterial Species PR3 high PR3 low OLFM4 high OLFM4 low NE high NE low Haemophilus influenzae 27.91% 3.58% 27.23% 3.47% 18.55% 15.48% Pseudomonas aeruginosa 9.04% 0.29% 8.92% 0.09% 8.54% 2.02% Rothia mucilaginosa 3.90% 8.73% 3.88% 8.95% 5.59% 6.51% Unclassified Streptococcus 11.04% 15.21% 12.73% 13.17% 8.37% 16.97% High sputum PR3, OLFM4 and NE levels are associated with microbiome dysbiosis, characterised by predominance of proteobacteria and reduced alpha diversity. PR3 and OLFM4 were more strongly associated with dysbiosis than NE and warrant further investigation as biomarkers in bronchiectasis.

GOES‐16 and GOES‐17 are the first of NOAA's Geostationary Operational Environmental Satellite (GOES)‐R series of satellites. Each GOES‐R satellite has a magnetometer mounted on the end (outboard) and one part‐way down a long boom (inboard). This paper demonstrates the relative accuracy and stability of the measurements on a daily and long‐term basis. The GOES‐16 and GOES‐17 magnetic field observations from 2017 to 2020 have been compared to simultaneous magnetic field observations from each other and from the previous GOES‐NOP series satellites (GOES‐13, GOES‐14 and GOES‐15). These comparisons provide assessments of relative accuracy and stability. We use a field model to facilitate the inter‐satellite comparisons at different longitudes. GOES‐16 inboard and outboard magnetometers data suffer daily variations which cannot be explained by natural phenomena. Long‐term‐averaged GOES‐16 outboard (OB) data has daily variations of ±3 nT from average values with one‐sigma uncertainty of ±1.5 nT. Long‐term averaged GOES‐17OB magnetometer data have minimal daily variations. Daily average of the difference between the GOES‐16 outboard or GOES‐17 outboard measurements and the measurements made by another GOES satellite are computed. The long‐term averaged results show the GOES‐16OB and GOES‐17OB measurements have long‐term stability (±2 nT or less) and match measurements from magnetometers on other GOES within limits stated herein. The GOES‐17OB operational offset (zero field value) was refined using the GOES‐17 satellite rotated 180° about the Earth pointing axis (known as a yaw flip).

The hyperarid Atacama Desert coast receives scarce moisture inputs mainly from the Pacific Ocean in the form of marine advective fog. The collected moisture supports highly specialized ecosystems, where the bromeliad Tillandsia landbeckii is the dominant species. The fog and low clouds (FLCs) on which these ecosystems depend are affected in their interannual variability and spatial distribution by global phenomena, such as ENSO. Yet, there is a lack of understanding of how ENSO influences recent FLCs spatial changes and their interconnections and how these variations can affect existing Tillandsia stands. In this study, we analyze FLCs occurrence, its trends and the influence of ENSO on the interannual variations of FLCs presence by processing GOES satellite images (1995–2017). Our results show that ENSO exerts a significant influence over FLCs interannual variability in the Atacama at ~ 20°S. Linear regression analyses reveal a relation between ENSO3.4 anomalies and FLCs with opposite seasonal effects depending on the ENSO phase. During summer (winter), the ENSO warm phase is associated with an increase (decrease) of the FLCs occurrence, whereas the opposite occurs during ENSO cool phases. In addition, the ONI Index explains up to ~ 50 and ~ 60% variance of the interannual FLCs presence in the T. landbeckii site during summer and winter, respectively. Finally, weak negative (positive) trends of FLCs presence are observed above (below) 1000 m a. s. l. These results have direct implications for understanding the present and past distribution of tillandsia ecosystems under the extreme conditions characterizing our study area.

The Advanced Baseline Imager (ABI) on board the Geostationary Operational Environmental Satellite-R (GOES-R) is America’s next-generation geostationary advanced imager. GOES-R launched on 19 November 2016. The ABI is a state-of-the-art 16-band radiometer, with spectral bands covering the visible, near-infrared, and infrared portions of the electromagnetic spectrum. Many attributes of the ABI—such as spectral, spatial, and temporal resolution; radiometrics; and image navigation/registration—are much improved from the current series of GOES imagers. This paper highlights and discusses the expected improvements of each of these attributes. From ABI data many higher-level-derived products can be generated and used in a large number of environmental applications. The ABI’s design allows rapid-scan and contiguous U.S. imaging automatically interleaved with full-disk scanning. In this paper the expected instrument attributes are covered, as they relate to signal-to-noise ratio, image navigation and registration, the various ABI scan modes, and other parameters. There will be several methods for users to acquire GOES-R imagery and products depending on their needs. These include direct reception of the imagery via the satellite downlink and an online-accessible archive. The information from the ABI on the GOES-R series will be used for many applications related to severe weather, tropical cyclones and hurricanes, aviation, natural hazards, the atmosphere, the ocean, and the cryosphere. The ABI on the GOES-R series is America’s next-generation geostationary advanced imager and will dramatically improve the monitoring of many phenomena at finer time and space scales.

IntroductionPrimary ciliary dyskinesia (PCD) is a rare genetic disorder resulting in progressive lung disease due to recurrent respiratory infections. A recent international consensus statement regarding infection prevention and control in PCD1 gave some framework for management of infection, but did not give specific suggestions regarding antimicrobial agents of choice, length of treatment or surveillance post treatment. The clinical leads of the NHS-England commissioned paediatric PCD service (PCD leads) agreed to prioritise this and develop best practice guidelines for antimicrobial management in paediatric PCD.MethodsConsensus guidelines were developed by a multi-stage processDevelopment of a framework of antimicrobial management based on current practice and available evidence.Critical appraisal of the framework by the PCD leads and an expert pharmacist resulting in preliminary statementsA two-stage modified Delphi survey of the PCD leads followed by a review by an expert microbiologist to generate the final statements.Statements were rejected if they failed to achieve 75% consensus or if they were independently rejected by either the pharmacist or microbiologist.ResultsTwenty-seven statements under the following headings were examined and put forward to the Delphi process.Respiratory microbiological samples for surveillanceManaging first isolation of Pseudomonas aeruginosa (PA)Management of regrowth and chronic isolation of PAManagement of Staphylococcus aureus Management of Moraxella catarrhalis and Haemophilus influenzae Management of Streptococcus pneumoniae Antibiotic prophylaxisManagement of a chest exacerbation while awaiting a positive culture reportFull consensus was achieved in 16 statements and partial (75–99%) consensus in 8. Two statements regarding ‘Management of Streptococcus pneumoniae’ were rejected based on expert microbiological review. The consensus statements regarding first isolation of Pseudomonas aeruginosa is shown in table 1 as an example.Abstract S23 Table 1Managing first isolation of Pseudomonas aeruginosa (PA) 1. Typing (100 % ) We suggest that clonal type of PA is determined by variable number of tandem repeats (VNTR typing) when PA is isolated for the first time, in discussion with microbiology team 2. Treatment – drug and duration of therapy (100 % ) • If child is well and there are no contra-indications: Ciprofloxacin p.o. 3–4 weeks plus nebulised Colistimethate sodium for 4 weeks is recommended. Until specific studies are done in PCD, we recommend using dosages as specified in the British National Formulary for children (BNFc). • If unwell and/or contra-indication to above: Consider i.v. antipseudomonal antibiotics, ideally a combination of two different classes. Suggested duration – 10 days to 14 days. In addition, prescribe nebulised Colistimethate sodium for 4 weeks as above. 3. Monitoring following treatment (88 % ) • Monitor for the regrowth of PA using surveillance sputum samples (2- 3 sputum samples over a period of 2 -4 weeks) done at least 2 -4 weeks after completion of treatment. • In sputum non-producers, given the lower sensitivity of cough swabs, consider more frequent sampling or longer period of surveillance. Consider the use of induced sputum for monitoring regrowth. ConclusionsA standardised approach to antimicrobial respiratory management in children with PCD was developed which is likely to reduce variations in practice and improve their outcomes. A Delphi method was used successfully, and consensus statements were developed based on best practice. Scientific evidence is lacking and further research needs to be done.ReferenceMarthin JK, et al. ERJ Open Res, 2021;7:00301–2021