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Integration of geophysical, hydrogeological and geospatial analysis for groundwater a...
Gaurav Kumar
Dewashish Kumar

Gaurav Kumar

and 2 more

June 22, 2021
Integrated study combining electrical resistivity tomography, geology, hydrogeomorphology, and weighted overlay analysis of various surface and subsurface thematic layers proved to be a very useful tool for evaluating the heterogeneous hard aquifer systems for groundwater assessment and development. A comprehensive study was carried out at representative and varied geological settings viz., Chotanagpur Granite-Gneiss Complex (CGGC), Ranchi has been accomplished from geology and geophysical datasets. The electrical resistivity tomography results revealed potential target zones at three sites in the study area up to a maximum of 170 m depth with a large variation in aquifer resistivity ranging from 80 to 800 Ω.m. These significant findings depicted a good correlation and are validated with the lithology in the surrounding of the resistivity tomography results. Nevertheless, the weighted overlay technique act as an essential tool for spatial analysis and interpretation of potential groundwater zones in the study area as well as validated the geophysical depth models whereas in-depth study on geology and hydrogeomorphology provides a detailed hydrogeological scenario throughout the study area for the long-term sustainability of the groundwater resources both at a local and in regional scale in the typical hard rock aquifer system.
A rare cause of respiratory distress in pediatric palliative care: Thoracic Duplicati...
Nilgün Harputluoğlu
Tanju Çelik

Nilgün Harputluoğlu

and 3 more

June 22, 2021
Gastrointestinal duplication cysts are actually rare congenital anomalies that can accompany various anomalies and are most frequently seen in the small intestine. Gastrointestinal duplication may accompany anomalies such as vertebral anomalies, spinal cord malformations. Depending on the location, symptoms such as chest pain, shortness of breath, cough, asthma-like symptoms, hemoptysis, cyanosis, vomiting, difficulty swallowing, weight loss, hematemesis and melena can be observed. To our knowledge, we report a rare case that has not been reported in pediatric palliative care. We present a case operated for diaphragmatic hernia in the neonatal period. A 3-month-old patient with respiratory distress who was followed up in pediatric palliative care was reoperated and pathologically diagnosed as gastrointestinal duplication cyst. Thoracic cysts can have a wide variety of etiology. The correct diagnosis can be made by performing further examinations and appropriate surgery.
Impact of pharmacist intervention on glycemic control of type 2 diabetes patients in...
Kamelia Sadeghi
Karanesh Dass

Kamelia Sadeghi

and 3 more

June 22, 2021
Objective: Diabetes is one of the most common chronic disease that requires comparatively more care to achieve optimal therapeutic outcomes. The aim of this study was to study the impact of pharmacist intervention on glycemic control of type 2 diabetes patients in a tertiary care hospital. The objectives were: To assess the parameters of glycemic control namely FBS, PPBS, and HbA1c; To provide patient education to one group of patients while other group of patients get standard care; To assess the impact of the educational intervention on blood sugar levels and HbA1c. Materials and methods: It was hospital based prospective interventional study carried out in the general medicine out-patient department of St. Philomena’s hospital, a tertiary care hospital, in Bangalore, India. The patients recruited were divided equally and randomly into control and intervention groups. Patients in the interventional group received patient informational leaflets, and education in addition to standard treatment, while the control group patients received only standard treatment. Parameters of glycemic control namely FBS, PPBS, and HbA1c of the patients were measured at baseline and at the end of the follow up period of 3 months and compared using appropriate statistical tests. Result: 50 patients having HbA1c value of >8% were included in the study. FBS, PPBS, and HbA1c values of all patients were measured at baseline and compared to the values obtained at the end of the follow up period, and was found to be statistically significant (p < 0.05). The difference in the baseline and follow up values between the control and intervention groups was also compared and found to be statistically significant (p< 0.05). Conclusion: It was observed from our study that pharmacist led educational intervention program for the management of type 2 diabetes had a positive impact in lowering the levels of glycemic parameter.
Dependence on parameters for nonlinear equations -- abstract principles and applicati...
Michał Bełdziński
Marek Galewski

Michał Bełdziński

and 2 more

June 22, 2021
We provide parameter dependent version of the Browder–Minty Theorem in case when the solution is unique utilizing different types of monotonicity and compactness assumptions related to condition (S)2. Potential equations and the convergence of their Euler action functionals is also investigated. Applications towards the dependence on parameters for both potential and non-potenial nonlinear Dirichlet boundary problems are given.
Analysis of Livable Environment of Traditional Villages in Hot Summer and Cold Winter...

June 22, 2021
Historical settlements can reflect the harmonious coexistence between ancient people and the local climate & geographical environment. In ancient times, many villages were formed during the period of war. To escape from the war, ancient people moved to places with good climate and suitable environment, and continued to improve their quality of life during the development and construction. The site selection, layout planning, architectural layout and material selection of these settlements have valuable scientific design concepts. Wind environment factors have significant influence on the construction of villages. However, the research about the influence of outdoor wind environment in traditional villages’ livable environment is still insufficient. In this paper, a village called Guzhu Village located in typical hot summer and cold winter zone in Jiangxi Province of China is selected to analyze the local climate environment. Computational fluid dynamics (CFD) simulation technology is used to study the selection of places for living in terms of outdoor wind environment. The results of the simulations confirm the habitability of the villages and the need to preserve such treasure.
A case report of lead fracture presenting as high ventricular premature complex burde...
Saurabh Deshpande
Ameya Udyavar

Saurabh Deshpande

and 1 more

June 22, 2021
A document by Saurabh Deshpande. Click on the document to view its contents.
Is a Laboratory Evaluations Required in Every Case Admitting to the Pediatric Emergen...
Songul Tomar Güneysu
Okşan Derinoz Guleryuz

Songül Tomar Güneysu

and 4 more

June 21, 2021
ABSTRACT Background: Epistaxis is a mostly self-limiting condition common among children and is rarely severe. In this study, it was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who applied to the Pediatric Emergency Department (PED) with epistaxis, and to determine in which cases a laboratory test should be used. Method: Admitted to Gazi University Faculty of Medicine, PED which provides trauma care and is a tertiary hospital, between January 1, 2019 and December 31, 2019, 452 patients aged 0-18 years who presented with epistaxis to any reason or secondary to systemic disease were analyzed retrospectively. Results: The annual incidence was found 1.23%. The median age was 63 months, 258 of the cases (57.1%) were male. It was found that the cases most frequently applied to the hospital in the autumn months (37.6%). Sixty of the patients (13.3%) had a chronic disease and 54 (11.9%) had a history of drug use. Bleeding time was less than 5 minutes in 75.2% and 84.4% of the bleeding was unilateral. Nasal bleeding is local in 73.4%; 4.7% of them developed due to systemic reasons. The most common cause of epistaxis; while they were trauma at the first 10 years of age, they were idiopathic causes after the age of 10 years. In 434 (96%) of the patients, epistaxis spontaneously stopped and there was no need for additional treatment. Conclusion: As a result of this study, it was concluded that laboratory tests should be performed in cases with chronic disease history, bilateral bleeding, active bleeding and nontraumatic epistaxis. The situation that causes epistaxis in the childhood age group should be determined with a good history and physical examination, laboratory tests should not be used in every patient. Key Words: pediatric emergency, epistaxis, laboratory examinations, complete blood count
The Burden of Influenza among Kenyan Pregnant and postpartum Women and their Infants,...
Nancy Otieno
Bryan Nyawanda

Nancy Otieno

and 10 more

June 21, 2021
Objective: To describe the burden of influenza among pregnant women and their young infants. Design: Prospective cohort study. Setting: Rural western Kenya. Population: Pregnant women below 31 weeks of gestation and their infants aged 6 months and below Methods: We conducted weekly follow-up until 6 months postpartum to identify acute respiratory illnesses (ARI). We collected nasal/nasopharyngeal and oropharyngeal swabs from mothers/infants with ARI and tested for influenza A and B using polymerase chain reaction. We calculated incidence of laboratory-confirmed influenza per 1,000 person-months. Main outcome measure: Incidence of medically attended influenza illness among pregnant women and its impact on birth outcomes. Results: During June 2015–May 2020, we enrolled 3,026 pregnant women at a median gestational age of 16 weeks (interquartile range [IQR], 13, 18) and followed 2,550 infants. Incidence of laboratory-confirmed influenza during pregnancy (10.3 episodes per 1,000 person-months [95% CI 8.6–11.8]) was 2-fold higher than in the postpartum period (4.0 [95% CI 2.6–5.5]; p<0.01), and significantly higher among HIV-infected pregnant women (15.6 [95% CI 11.0–20.6] vs. 9.1 [95% CI 7.5–10.8]; p<0.01). Incidence among young infants was 4.4 (95% CI 3.0–5.9) and similar among HIV-exposed and HIV-unexposed infants. Conclusion: Our findings suggest a substantial burden of influenza illnesses during pregnancy, with a higher burden among HIV-infected mothers. Kenyan authorities should consider the value of vaccinating pregnant women, especially if HIV-infected. Funding: This work was supported by funding [Grant number GH002133] from the U.S. CDC, through the Influenza Division. Keywords: Burden, influenza, pregnant women, infants
Is Ischemia-Modified Albumin a Biomarker in Wagner Classification in Diabetic Foot Ul...
Sezai ÖZKAN
cihan ADANAS

Sezai ÖZKAN

and 2 more

June 21, 2021
Background: We aimed to determine the relationship of ischemia-modified albumin (IMA) with diabetic foot ulcers and its predictive value in the Wagner classification. Methods: Our cross-sectional study was conducted in 120 diabetic foot patients and 60 healthy individuals with similar body mass index and age. Patients with a diabetic foot were classified according to the Wagner classification. Biochemical parameters, C-reactive protein (CRP) and IMA levels were measured in all patients and healthy volunteers. Screening performance characteristics of CRP and IMA were calculated according to Wagner classes and the presence of osteomyelitis. Results: CRP and IMA levels in the patient group were significantly higher than the control group. The highest IMA levels were detected in Wagner grade 5. CRP had higher sensitivity and specificity than IMA in the discrimination of other grades, except for grade 4-5 separation. For Wagner grade 4-5 distinction, IMA had 84.6% sensitivity and 94.7% specificity. Conclusion: IMA may play a role in the pathogenesis of diabetic foot ulcers and had a higher predictive value in discrimination of the Wagner grade 4 and 5. In the management of diabetic foot patients, it may be recommended that IMA is evaluated by clinicians.
Safe implementation of index telephone clinic appointments for patients with suspecte...
Kasun Wanigasooriya
Diwakar Sarma

Kasun Wanigasooriya

and 13 more

June 21, 2021
Aims: The COVID-19 pandemic led to hospitals in the United Kingdom substituting face-to-face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the impact of virtual two-week wait (2-ww) lower gastrointestinal (LGI) consultations on stakeholders at a district general hospital in England. Methods: Patients undergoing index outpatient 2-ww LGI clinic assessment between 01/06/2019-31/10/2019 (FtF group) and 01/06/2020-31/10/2020 (VC group) were identified. Relevant data were obtained using electronic patient records. Compliance with national cancer waiting time targets (WTT) was assessed. Environmental and financial impact analyses were performed. Results: In total, 1531 patients were analysed (median age=70, male=852, 55.6%). Of these, 757 (49.4%) were assessed virtually via telephone; the remainder were seen FtF (n=774, 50.6%). Ninety two (6%, VC=44, FtF=48) patients had malignant pathology and 64 (4.2%) had colorectal cancer (CRC); of these, 46 (71.9%, VC=26, FtF=20) underwent treatment with curative intent. The median waiting times to index appointment, investigation and diagnosis were significantly lower following VC assessment (p<0.001). The cancer detection rates (p=0.749), treatments received (p=0.785) and median time to index treatment for CRC patients (p=0.156) were similar. A significantly higher proportion of patients were seen within two weeks of referral in the VC group (p<0.001). VC appointments saved patients a total of 9288 miles, 0.7 metric tonnes of CO2 emissions and £7482.97. Taxpayers saved £80,242.00 from VCs. No adverse events or complaints were reported in the VC group. Conclusion: Virtual 2-ww LGI clinics were effective, safe and were associated with tangible environmental and financial benefits for stakeholders.
Influence of Aging in Outcomes of Patients Undergoing Percutaneous Nephrolithotomy fo...
Murat Sahan
Serkan Yarımoğlu

Murat Sahan

and 4 more

June 21, 2021
Objective: To evaluate the effect of age on the success and complications of percutaneous nephrolithotomy (PCNL) in staghorn renal stones. Materials and Methods: The files of 182 patients who underwent single-access PCNL for staghorn renal stones between 2012 and 2017 were retrospectively analyzed. The patients were divided into two groups according to their age: those aged<65 years were defined as Group-1 and those aged≥65 years as Group-2. The demographic characteristics and perioperative and postoperative results were compared between the two groups. Results: Of the patients with staghorn renal stones,139 were in Group-1 and 43 were in Group-2. The mean age of the patients was 43.9±10.6 years for Group-1 and 67.8±2.1 years for Group-2(p=0.001). The amount of hemoglobin drop was statistically significantly higher in Group-1 (p=0.001). However, blood transfusion rate was higher in Group-2 than in Group-1 (18.6% and 7.2%, respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in Group-2(p=0.139). According to the evaluation of the overall complication rates,34.5% of the patients in Group-1 and 46.5% of those in Group-2 developed complications(p=0.206). According to the Clavien scoring system, the rate of minor complications was found to be 22.3% in Group-1 and 41.9% in Group-2,and the difference was statistically significant (p=0.012). The major complication rates were determined as 4.7% and 12.2% for Group-1 and Group-2, respectively (p=0.155). The number of patients with Clavien grade-2 complications was statistically higher in the elderly patient group (p=0.019). Conclusions: PCNL can be used as an effective and safe treatment method in the treatment of complex stones in elderly patients.
Therapeutic Drug Monitoring of Vancomycin in Patients with Altered Pharmacokinetics:...
Parisa Ghasemiyeh
Afsaneh Vazin

Parisa Ghasemiyeh

and 2 more

June 21, 2021
Introduction: Vancomycin is a glycopeptide antibiotic that is considered as the drug of choice against many Gram-positive bacterial infections, especially Methicillin-resistant Staphylococcus aureus (MRSA). Also, it is a hydrophilic drug with predominantly renal elimination. Given the vancomycin narrow therapeutic index, therapeutic drug monitoring (TDM) is essential to achieve an optimum clinical response and avoid vancomycin-induced adverse drug reactions including nephrotoxicity and ototoxicity. Although different studies are available on vancomycin pharmacokinetic assessment and vancomycin TDM, still there are controversies regarding the selection among different pharmacokinetic parameters including trough concentration (Cmin), the daily area under the curve to minimum inhibitory concentration (AUC24h/MIC) ratio, AUC of intervals (AUCτ), elimination constant (k), vancomycin clearance (ClV) and methods of their calculations for TDM purposes. Methods: In this review, different pharmacokinetic parameters for vancomycin TDM have been discussed in detail along with corresponding advantages and disadvantages, based on the literature review. Determination of vancomycin concentration at steady state (Css) during 24h continuous injection are mentioned. Also, vancomycin pharmacokinetic assessments are discussed in detail in patients with altered pharmacokinetic parameters including those with renal and/or hepatic failure, critically ill patients, patients with burn injuries, intravenous (IV) drug users, obese and morbidly obese patients, those with cancer, patients undergoing organ transplantation, and vancomycin administration during pregnancy and lactation. Results and Discussion: An individualized dosing regimen is required to guarantee the optimum therapeutic results and minimize severe adverse reactions such as acute kidney injury (AKI) in these special groups of patients with altered pharmacokinetic parameters. Also, according to the pharmacoeconomic data on vancomycin TDM, pharmacokinetic assessments would be cost-effective in the mentioned groups of patients with altered pharmacokinetics and associated with shorter hospitalization period, faster clinical stability status, and shorter courses of inpatient vancomycin administration.
Cardiac Angiosarcoma:A case report and review of the literature
Limin Luo
weipeng zhao

Limin Luo

and 2 more

June 21, 2021
Primary cardiac tumors are extremely rare.Most primary tumors are benign,and malignant tumors comprise about 15%1.Angiosarcoma is the most common type of primary cardiac malignant tumors.Compared with the left atrium or ventricle,the tumor prefer to occur in the right atrium or ventricle,especially the right atrium.In this case report,we present the case of a 32-year-old female with cardiac angiosarcoma primary to the right atrial appendage(RAA).
Exploring the Geographic Variation of Pediatric Renovascular Hypertension Etiology Th...
Jaineet Chhabra

Jaineet Singh Chhabra, MS

June 22, 2021
Keywords: Pediatric, Renovascular, Hypertension, Evolution, MedicineAbbreviations: renal artery stenosis (RAS), fibromuscular dysplasia (FMD), Takayasu arteritis (TA), ACE insertion/deletion (ACE I/D), renovascular hypertension (RVH), angiotensin I (ang I), angiotensin II (ang II), angiotensin converting enzyme (ACE), midaortic syndrome (MAS), angiotensinogen (AGT)Correspondence: 1130 14th Street, Huntington, WV, 25701, Apartment 133Email: chhabra@marshall.edu 
Clinical characteristics of people with cystic fibrosis and frequent fungal infection
Thomas Poore
Maxene Meier

Thomas Poore

and 8 more

June 21, 2021
Background: Individuals with cystic fibrosis (CF) and fungal airway infection may present with fungal bronchitis, allergic bronchopulmonary aspergillosis (ABPA) or may appear unaffected despite fungal detection. We sought to characterize people with CF with frequent detection of fungi from airway samples and determine clinical outcomes. Methods: This retrospective study included individuals with CF with ≥ 4 lower airway cultures over a 2-year baseline period and ≥ 2 years of follow-up. We defined two groups: ≤ 1 positive fungus culture (rare) or ≥ 2 positive cultures during baseline (frequent). Clinical characteristics and outcomes were determined. Results: Between 2004-2016, 294 individuals met inclusion with 62% classified as rare and 38% as frequent fungi during baseline. Median follow-up was 6 years (range 2-9 years). Aspergillus fumigatus was the most common fungal species detected. Individuals with frequent fungi were older (13.7 vs. 11.7 yrs, p = 0.02) and more likely to have Stenotrophomonas maltophilia (35% vs 17%, p < 0.001) at baseline, but did not differ in lung function or ABPA diagnosis. During follow-up, those with frequent fungi were more likely to have chronic P. aeruginosa and S. maltophilia. Individuals with ABPA and frequent fungi had the highest rates of co-infection and co-morbidities, and a trend towards more rapid lung function decline. Discussion: Fungal infection in CF was associated with frequent P. aeruginosa and S. maltophilia co-infection even in those without ABPA. Individuals with frequent fungi and ABPA had worse outcomes, highlighting the potential contribution of fungi to CF pulmonary disease.
The use of elexacaftor/tezacaftor/ivacaftor in patients with cystic fibrosis post-liv...
Hunter Ragan
Elizabeth Autry

Hunter Ragan

and 7 more

June 21, 2021
Introduction Cystic fibrosis (CF) related liver disease (CFLD) manifests as a wide spectrum of hepatobiliary disease and can progress to need liver transplantation. Elexacaftor/tezacaftor/ivacaftor (elx/tez/iva) is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator which has superior efficacy compared to previously approved modulators. Use of elx/tez/iva, should be approached with caution in individuals with CFLD or following liver transplantation due to possible increases in LFTs and drug-drug interactions with several immunosuppressant medications. Objective The purpose of this case series was to explore if the use of elx/tez/iva is safe and tolerable in patients with CF post-liver transplantation. Methods A retrospective case series including patients prescribed elx/tez/iva following liver transplantation and an immunosuppressive regimen consisting of drug therapy metabolized by P-glycoprotein was completed. Results Ten patients at six CF centers with a median age of 22.1 years (range 14-43.4 years) and median time from transplant of 6.9 years (range 0.6-22 years) were included. Most patients (8, 80%) received a reduced or full dose of elx/tez/iva for a mean duration of 10.4 months (range 7-12 months). Fluctuations in LFTs occurred in all patients (10, 100%) and led to therapy discontinuation in two patients (20%). Elx/tez/iva initiation resulted in elevations in tacrolimus trough concentration in 7 patients (70%). Most patients who tolerated elx/tez/iva had symptomatic and quality of life improvement, increased body-mass-index, and maintained or improved lung function. Conclusion Initiation of elx/tez/iva in patients with CF who received a liver transplantation may be safe with clinical benefits.
Multicentric Castleman Disease in a DOCK8 Deficient Patient with Orf Virus Infection
Elif Tugce Aydin Goker
Deniz Cagdas Ayvaz

Elif Tugce Aydin Goker

and 10 more

June 21, 2021
Castleman disease is a rare, heterogeneous disorder that driven by proinflammatory responses. Human herpes virus-8 has a major role in pathogenesis of multicentric Castleman disease. There is also a subgroup of cases, human herpes virus-8 negative, idiopathic multicentric Castleman disease. The role of primary immunodeficiencies in idiopathic Castleman disease are poorly described. DOCK8 deficiency is a combined primary immunodeficiency. It has a broad clinic spectrum including atopy, autoimmunity and cancer. We present a 10-year-old, DOCK8 deficient patient. He had giant lobular capillary hemangiomas on his neck, iliac and gluteal regions and multiple lymphadenopathies. Abdominal lymph node pathology revealed hyaline vascular type Castleman disease and human herpes virus-8 staining was negative. His lesions were shown to be infected with orf virus. Our case is the first case to relate idiopathic multicentric Castleman disease and DOCK8 deficiency; also, very unusual presentation of orf virus infection in humans.
Current Approaches to Management of Bone Sarcoma in Adolescent and Young Adult (AYA)...
Katrina Ingley
Alessandra Maleddu

Katrina Ingley

and 6 more

June 21, 2021
Bone tumors are a group of histologically diverse diseases which occur across all ages. Two of the commonest, osteosarcoma (OS) and Ewing sarcoma (ES), are regarded as characteristic AYA cancers with an incidence peak in AYAs. They are curable for some but associated with unacceptably high rates of treatment failure and morbidity. The introduction of effective new therapeutics for bone sarcomas is slow, and to date, complex biology has been insufficiently characterized to allow more rapid therapeutic exploitation. This review focuses on current standards of care, recent advances that have or may soon change that standard of care and challenges to the expert clinical research community that we suggest must be met.
Tris(methylthio)methane Produced by Mortierella hyalina Affects Sulfur Homeostasis in...
Yu-Heng Tseng
Stefan Bartram

Yu-Heng Tseng

and 7 more

July 06, 2021
Microbial volatiles are important factors in symbiotic interactions with plants. Mortierella hyalina is a beneficial root-colonizing fungus with a garlic-like smell, and promotes growth of Arabidopsis seedlings. GC-MS analysis of the M. hyalina headspace and NMR analysis of the extracted essential oil identified the sulfur-containing volatile tris(methylthio)methane (TMTM) as the major compound. Its incorporation in seedlings was shown by 34S labeling experiment. Under sulfur deficiency, TMTM downregulated sulfur deficiency-responsive genes, prevented glucosinolate (GSL) and glutathione (GSH) diminishment, and sustained plant growth. However, excess TMTM led to accumulation of GSH and GSL and reduced plant growth. Since TMTM is not directly incorporated into cysteine, we propose that the volatile from M. hyalina influences the plant sulfur metabolism by interfering with the GSH metabolism, and alleviates sulfur imbalances under sulfur stress.
Factors associated with successful extubation following the use of systemic dexametha...
Kristin O'Connor
Cameron Hurst

Kristin O'Connor

and 3 more

June 21, 2021
Objectives The aim of our study was to identify, in mechanically ventilated neonates <30 weeks GA with clinical evidence of bronchopulmonary dysplasia (BPD), factors likely to be predictive of a first course of systemic dexamethasone leading to extubation within 14 days and remaining extubated for at least 7 days. Methods We studied a retrospective cohort of neonates (23+0-29+6 weeks GA), with evidence of BPD, prescribed their first course of systemic dexamethasone to aid in extubation from mechanical ventilation. The data collected only pertained to the first course of dexamethasone for any given neonate, with the primary outcome of interest of successful extubation within 14 days (i.e., extubated within 14 days of starting dexamethasone and remaining extubated for at least seven days). Binary logistic regression was employed. Results A total of 287 neonates were included. Each additional week of GA at birth led to a 1.53 increase in the odds of successful extubation (95% CI 1.122-2.096, p<0.01). Higher average fraction of inspired oxygen (FiO2) requirements in the preceding 24 hours resulted in a 0.94 decrease in the odds of successful extubation (p<0.05) and higher mean airway pressure (MAP) resulted in 0.76 decrease in odds of successful extubation (p<0.01). Conclusions Mechanically ventilated neonates born at <30 week GA, with evidence of BPD requiring dexamethasone to facilitate extubation, had a lower likelihood of successful extubation by day 14 if at the time of commencing steroids they were less mature at birth, had higher MAPs and higher oxygen requirements.
Phase I randomized, placebo-controlled, cross-over dose-finding pharmacokinetic study...
Heather Greenlee
Katherine Crew

Heather Greenlee

and 9 more

June 21, 2021
Aim: To determine the safety of Coenzyme Q10 (CoQ10) in breast cancer patients receiving doxorubicin treatment. Methods: Phase I randomized, placebo-controlled, cross-over, dose-finding pharmacokinetic study among women with stage I-III breast cancer receiving 4 cycles of doxorubicin plus cyclophosphamide. The study was designed to test the maximum tolerated dose of CoQ10 using up to 1200 mg/day. Eligible patients were randomized to Arm A (CoQ10 after Cycle 3, followed by placebo after Cycle 4) or Arm B (placebo after cycle 3, followed by CoQ10 after cycle 4). CoQ10 concentrations and total antioxidant capacity (TAC) were measured before and after chemotherapy cycles. Non-compartmental pharmacokinetic parameters of doxorubicin and its active metabolites were measured with and without CoQ10. Paired t-tests assessed intra-patient differences in pharmacokinetic parameters, serum CoQ10 concentrations, TAC and adverse events. Results: Six patients received 300 mg/day of CoQ10 [Arm A (n=3), Arm B (n=3)]. One patient received 600 mg/day of CoQ10 but was discontinued due to non-adherence. Serum CoQ10 concentrations were increased in patients receiving 300 mg/day (mean±SD change: CoQ10, 1.6±0.9 ug/mL; placebo, -0.01±0.3 ug/mL; P=0.01). There were no clinically significant pharmacokinetic interactions between 300 mg/day CoQ10 and doxorubicin and no differences in TAC or adverse events during treatment and nontreatment periods. The trial was closed early due to slow accrual. Conclusions: 300 mg/day of CoQ10 with doxorubicin did not change doxorubicin pharmacokinetics and was not associated with treatment-related adverse events. Future studies should evaluate the long-term effects of CoQ10 at 300 mg/day and safety studies should examine higher doses.
How does the suspended sediment yield change in the North Caucasus during the Anthrop...
atsyplenkov@gmail.com
Valentin Golosov

Anatolii Tsyplenkov

and 2 more

June 21, 2021
Quantifying and understanding catchment sediment yields is crucial both from a scientific and environmental management perspective. To deepen the understanding of land use impacts and climate change on sediment load, we explore mechanisms of the suspended sediment yield formation in the Northern Caucasus during the Anthropocene. We examine how sediment flux of various river basins with different land-use/landcover and glacier cover changes during the 1925-2018 period. Our analysis is based on observed mean annual suspended sediment discharges (SSD, kg·s−1) and annual fluxes (SSL, t·yr−1) from 33 Roshydromet gauging stations (Russia). SSL series have been analyzed to detect statistically significant changes during the 1925-2018 period. The occurrence of abrupt change points in SSD was investigated using cumulative sum (CUSUM) charts. We found that SSL has decreased by −1.81% per year on average at most gauges. However, the decline was not linear. Several transition years are expected in the region: increasing trends from the 1950s and decreasing trends from 1988-1994. Correlation analyses showed that variation in SSL trend values is mainly explained by gauging station altitude, differences in land use (i.e., the fraction of cropland), and catchment area. Nonetheless, more accurate quantifications of SSL trend values and more refined characterizations of the catchments regarding (historical) land use, soil types/lithology, weather conditions, and topography may reveal other tendencies.
Operational monitoring of floodplain vegetation using remote sensing
Gertjan Geerling

Gertjan Geerling

and 6 more

June 21, 2021
Gertjan Geerling1,3, Ellis Penning1, Christine Rogers1, Cindy van de Vries - Safavi Nic1, Valesca Harezlak1, Stanford Wilson2, Gennadii Donchyts11Deltares, Delft, The Netherlands2Rijkswaterstaat-WVL, Lelystad, the Netherlands3Deptartment of Environmental Science, Radboud University, Nijmegen, the NetherlandsCorresponding author: Gertjan Geerling email: gertjan.geerling@deltares.nlAcknowledgementsThis research was funded by the research programme of the Dutch National Water Authority (KPP-Corporate Innovation Programme and the KPP- Innovative Monitoring). We thank the valuable discussions with the Floodplain Management Team of the National Water Authority (RWS-ON) and all other contributing stakeholders.AbstractIn deltas, rivers are often embanked and have a limited discharge capacity. In case these rivers also have a fixed riverbed for navigation, vegetation succession in the floodplains will reach climax stages. This leads to increasing hydraulic roughness that lowers the discharge capacity and prompts the river manager to intervene in the floodplain vegetation. The Dutch river manager depended on a 6-year map cycle of manually digitized aerial photographs for assessment of the state of hydraulic resistance. As the amount of agriculture in floodplains is receding in favor of nature rehabilitation projects, the vegetation dynamics increase. At the same time, the bigger floods were anticipated in the future. Therefore, more up-to-date floodplain vegetation maps with a short processing time were needed for about 500 kms of river in the Netherlands. We present an operational web-based monitoring tool that analyses sentinel-2 data on the fly though Google Earth Engine to provide an overview of the current state of the vegetation in the entire floodplain area of the Dutch river systems Rhine and Meuse. It is the first satellite-based application in an operational setting for the Dutch National River Manager (Rijkswaterstaat). The tool compares a map of allowable vegetation with the remotely sensed current situation for a quick scan of hotspots and can create reports on the cadastral (landowner) level. We describe the results of the image classifications and the role of this tool in the full process of the Dutch flood risk management process.Keywords: river management, vegetation, vegetation succession, remote sensing, open data, google earth engine
Nitrite as a causal factor for nitrate-dependent anaerobic corrosion of metallic iron...
Takao  Iino
Nobuaki Shono

Takao Iino

and 6 more

June 21, 2021
Microbially influenced corrosion (MIC) may contribute significantly to overall corrosion risks, especially in the gas and petroleum industries. In this study, we isolated four Prolixibacter strains, which belong to the phylum Bacteroidetes, and examined their nitrate-respiration- and Fe0-corroding activities, together with two previously isolated Prolixibacter strains. Four of the six Prolixibacter strains reduced nitrate under anaerobic conditions, while the other two strains did not. The anaerobic growth of the four nitrate-reducing strains was enhanced by nitrate, which was not observed in the two nitrate-non-reducing strains. When the nitrate-reducing strains were grown anaerobically in the presence of Fe0 or carbon steel, the corrosion of the materials was enhanced by more than 20-fold compared to that in aseptic controls. This enhancement was not observed in cultures of the nitrate-non-reducing strains. The oxidation of Fe0 in the anaerobic cultures of nitrate-reducing strains occurred concomitantly with the reduction of nitrite. Since nitrite chemically oxidized Fe0 under anaerobic and aseptic conditions, the corrosion of Fe0- and carbon-steel by the nitrate-reducing Prolixibacter strains was deduced to be mainly enhanced via the biological reduction of nitrate to nitrite, followed by the chemical oxidation of Fe0 to Fe2+ and Fe3+ coupled to the reduction of nitrite.
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