Incremental Decrease Research Articles

Representing Irrigation Processes in the Land Surface‐Hydrological Model and a Case Study in the Yangtze River Basin, China

AbstractIrrigation is the dominant section of human water use, exerting essential impacts on hydrological processes and water resources. To more realistically simulate irrigation processes in water‐rich regions, an irrigation scheme is incorporated into a land surface‐hydrological model. It calculates the irrigation water requirement according to meteorological conditions, cropping area and growing stage, and root‐zone soil moisture, and determines the irrigation water withdrawal based on the available water resources as well as describing water extraction and irrigation processes in the model. The coupled model is applied to the Yangtze River Basin (YRB) in China, and verified using the observed daily river discharge from 1987 to 1990, evapotranspiration and irrigation amounts from 1999 to 2003. The results first show that the model can well reproduce hydrological processes within the basin, and the simulated irrigation largely agrees with the observation, in terms of annual irrigation and its spatial pattern. Second, inclusion of irrigation processes allows the model to better estimate evapotranspiration, with relative biases decreased from about −10% to −3%. It is also found that in comparison to arid/semi‐arid areas, although presenting a less effect on river discharge and groundwater, the irrigation in the YRB significantly alters hydrological processes through water redistribution. The irrigation‐induced evapotranspiration increment and runoff decrease indicate a shift in the surface water and energy balance, implying a potential effect on the atmosphere. Therefore, representing irrigation processes properly is important, particularly for understanding the coupling effect of the nature‐human system and improving the hydrological prediction accuracy.

When Too Much of a Good Thing Becomes Harmful: A Cluster of Aspergillosis in Premature Extremely Low Birthweight Neonates

<h3>Background</h3> The movement of premature Extremely Low Birthweight (ELBW) neonates imposes risk for brain hemorrhage. In response to this concern, the babies in the Neonatal Intensive Care Unit (NICU) were enrolled in the newly adopted Intraventricular Hemorrhage (IVH) Prevention Bundle, where infants were immobilized in supine position for the first seventy-two hours of life. Four neonates from the NICU were diagnosed with Primary Cutaneous Aspergillus (PCA) infection after exposure to this life-saving protocol. <h3>Methods</h3> An internal multi-disciplinary team was convened to investigate these four cases. The case definition included infants who were enrolled in the IVH protocol starting in 2016. A review of the NICU's environment-of-care (EOC) elements was performed. This included retrospective air-quality culture surveillance data for molds available from 2016 to July 2017, internal incubator conditions, NICU construction and renovation activities, linen management, and the cleaning and disinfection of the infant immobilization/positioning device. During this investigation, air and surface samples were also collected to test for molds. <h3>Results</h3> The air sampling results were consistent with our facility's normal thresholds for air quality surveillance and the surface samples from linen, incubator, and all associated-IVH supplies were negative for molds. High humidity induced condensation was observed inside the incubators. Infection Control Risk Assessments were reviewed and were determined to be appropriate for unit-based construction activities. Subsequent mitigation strategies were instituted to include improvement in linen management, incremental decrease in humidity to reduce condensation, and more frequent patient re-positioning and incubator linen replacements. No additional cases were detected after the 4th case to-date. <h3>Conclusions</h3> The use of prevention bundles is an important component in improving healthcare-associated outcomes. In the case of the IVH prevention bundle for premature ELBW neonates in this NICU, careful attention and fine adjustments to the infant's environment-of-care needs were essential to the successful application of this life-saving protocol.

Analysis of climate changes in the forest fund lands of Boyarka Forest Research Station

The relevance of the study is conditioned upon the predicted changes in the area, as well as the significant narrowing of the zone of optimal growth of Scots pine. These forecasts are based on obtaining data on the ongoing climate changes. A constant decrease in precipitation, along with a gradual increase in temperature levels, will lead to consequences such as uncontrolled changes in ecosystems. Such a substantial change in abiotic factors caused by human activity plays a key role in the formation of forest coenoses. The main purpose of this study was to analyse the change in the average annual temperature, as well as the monthly amount of precipitation observed in the forest communities in the Separated Subdivision of the National University of Life and Environmental Sciences of Ukraine “Boyarka Forest Research Station”. The analysis is performed over decades to obtain data on the level of temperature change in relation to the previous period. This also includes a comparison of monthly precipitation for 2021 relative to 1991-2020, which is set as normal. To obtain indicators of the average annual temperature, the average value method is used, followed by calculating the value of the average annual temperature for each decade. To find the deviation in total precipitation, the method of estimating the moisture conditions according to total precipitation is used. Therewith, the value of a substantial deviation is taken at 20% relative to the precipitation rate. According to the study results, it was established that in 2001-2010 the average annual temperature changed by 0.83°C relative to the previous decade, and in 2011-2020 by 0.74°C relative to the previous period. Such dynamics indicate a gradual increase in the average annual temperature, which is reflected in the forecasts of the world community. During the estimation of moisture conditions, separate months of 2021 with a critical level of precipitation in relation to the normal period were selected. In March, the amount of precipitation was 43% of normal, in June – 32%, in September – 40%, and in October – only 4.3% of normal. The value in November was observed at 63% of the norm. Such a decrease in the amount of precipitation in relation to a gradual increase in the average annual temperature poses a threat of a decrease in the hydrological level of moisture. This leads to a decrease in the radial increment of tree stands, and a gradual shift in the growing area of Scots pine. The obtained analysis results will further be used to conduct dendrochronological studies of tree rings of Scots pine (Pinus sylvestris L.) in the tree stands of the Separated Subdivision of the National University of Life and Environmental Sciences of Ukraine “Boyarka Forest Research Station”

Outcomes of Expedited Discharge After Isolated Coronary Artery Bypass Grafting

Expedited discharge after coronary artery bypass grafting (CABG) has been postulated as a possible solution for reducing hospitalization costs. This study aimed to evaluate the impact of expedited postoperative discharge on readmissions and costs in patients undergoing isolated CABG. Adults (≥18 years) who underwent isolated CABG were identified using the 2016-to-2019 Nationwide Readmission Database. Patients were classified as expedited or routine, with expedited patients being discharged on or before postoperative day 4. Those who experienced perioperative complications were excluded. The Nationwide Readmissions Database. Patients ≥18 years old who underwent isolated CABG. Of an estimated 187,591 patients meeting study criteria, 37.2% (n=69,861) experienced expedited discharge. Expedited patients experienced lower index hospitalization costs ($28,543 v $34,114, p < 0.001), and were less likely to experience 30-day nonelective readmission (4.6% v 7.3%, p < 0.001) and 90-day nonelective readmission (5.6% v 8.7%, p < 0.001). After adjustment, expedited discharge remained independently associated with reduced odds of both 30-day (adjusted odds ratio [AOR]: 0.78, 95% CI: 0.71-0.85) and 90-day (AOR: 0.80, 95% CI: 0.74-0.87) nonelective readmission. In addition, expedited discharge was associated with an incremental decrease in index hospitalization costs (β: -5,661, 95% CI: -5,894 to -5,429). Expedited discharge immensely decreases costs of care for patients undergoing isolated CABG, as well as readmission risks. Expedited discharge may be considered a strategy to both improve postoperative patient care and reduce hospitalization costs within the United States healthcare system.

Implementing 1.5 mm internal diameter columns into analytical workflows

The use of smaller column diameters in liquid chromatography (LC) is often associated with capillary LC. Although there are many analytical benefits gained by adapting this format, routine use continues to be challenging due to column fragility and extra column dispersion. Bridging the gap between routinely used 2.1 mm columns and capillary bore columns allows for a sequential but far from insignificant increase in performance without the need for specialized equipment associated with very low dispersion LC systems. Moreover, an incremental decrease in column internal diameter (i.d.) allows for similar mass load (avoiding column overload that may be observed in much larger decreases in i.d. without trapping) and thus an increase in measured signal. As such, 1.5 mm i.d. columns provide an alternative intermediate dimension between the more regularly used 2.1 mm i.d. columns and 1 mm i.d. columns. These columns balance an increase in sensitivity compared to 2.1 mm i.d. columns (theoretically doubling the time-domain peak area in mass sensitive detectors for the same mass load), while mitigating the efficiency losses due to extra-column dispersion effects that are commonly observed with 1.0 mm i.d. columns. Here, the use of 1.5 mm i.d. columns was applied to LC/UV analysis of small molecules and LC/MS methods for the analysis of monoclonal antibodies. With equivalent mass load on column, the 1.5 mm i.d. columns provide two-to-threefold improvement in analyte peak area signal for small molecules as well as intact, subunit, and peptide levels of antibody analysis. Peak height was also increased using the 1.5 mm i.d. column, although the scale of increase varies between isocratic and gradient modes, likely due to differences in system dispersion effects and variation in electrospray ionization efficiency at different flow rates.

A new guard ring for ionizing radiation tolerance enhancement in single-photon avalanche diodes

A new guard ring is studied to improve radiation tolerance of single-photon avalanche diodes (SPAD) designed in 180 nm high voltage Complementary Metal-Oxide-Semiconductor (CMOS) technology. The radiation tolerance enhancement is obtained due to the reduction of the electric field inside Shallow Trench Isolation (STI), which reduces radiation-induced positive oxide charge density inside the STI by almost one order of magnitude. TCAD simulations show that, after 1 Mrad (SiO2) of X-ray radiation with a cathode voltage of 24.4 V, the increase in dark count rate at room temperature compared to pre-irradiation is 1438 counts per second (cps) and 311 cps for the conventional structure and new structure respectively, which shows a 78.3 % decrease in DCR increment for the new structure as compared to the conventional one. Moreover, the fill factor and photon detection probability of the new structure decreases by 0.3 % and 6 % compared to the conventional structure, which is negligible.

Adherence to Healthy and Unhealthy Plant-Based Diets and Risk of Breast Cancer Overall and by Hormone Receptor and Histologic Subtypes Among Postmenopausal Women

ObjectivesPrevious studies on vegan and vegetarian diets have reported beneficial effects on health outcomes by reducing low-grade systemic inflammation. However, few studies have assessed the incremental decrease of animal foods and how the quality of plant foods (healthy and less healthy) is linked with favorable health outcomes. There is still limited data on breast cancer (BC) in this regard. We aimed to assess the association between long-term adherence to a plant-based diet and BC risk among postmenopausal women. MethodsWomen from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale) cohort (n = 65,574, mean age = 52.8 years) were followed from 1993 to 2014. Incident BC cases were identified, validated, and classified into receptor and histological subtypes. Scores for healthful (hPDI) and unhealthful (uPDI) plant-based diets were developed using self-reported dietary intake at baseline (1993) and during follow-up (2005), and studied as a continuous variable and in quintiles. Multivariable Cox regression models were used to estimate BC hazard ratios (HR) and 95% confidence intervals (CI). ResultsOver a mean follow-up of 21 years, there were 3,968 incident BC cases. Adherence to hPDI was associated with lower BC risk (HRQ5 vs. Q1, 0.86; 95% CI, 0.77–0.95, Ptrend < 0.001), whereas adherence to uPDI was associated with increased BC risk (HRQ5 vs. Q1, 1.20; 95% CI, 1.08–1.33, Ptrend < 0.001). Adherence to hPDI was inversely associated with ER-positive, PR-positive, PR-negative, and ER/PR positive BC, and both ductal and lobular carcinomas (HR1-SD increase, 0.92; 95% CI, 0.89–0.96, 0.93; 95% CI, 0.89–0.97, 0.94; 95% CI, 0.89–0.99, 0.93; 95% CI, 0.89–0.97, 0.92; 95% CI, 0.89–0.96, and 0.92; 95% CI, 0.85–1.00, respectively). Adherence to uPDI was associated with increased ER-positive BC and lobular carcinoma (HR1-SD increase, 1.05; 95% CI, 1.01–1.08 and 1.12; 95% CI, 1.04–1.22, respectively). ConclusionsOur findings support that adherence to a healthy plant-based diet may reduce the risk of BC. In contrast, an unhealthy plant-based diet may increase BC risk, further emphasizing the importance of diet quality regarding cancer prevention. Funding SourcesMinistère de l’enseignement supérieur de la recherche et de l’innovation.

Handgrip Strength Values Depend on Tumor Entity and Predict 180-Day Mortality in Malnourished Cancer Patients

Background: Cancer-related malnutrition is a prevalent condition associated with a loss of muscle mass and impaired functional status, leading to immunodeficiency, impaired quality of life and adverse clinical outcomes. Handgrip strength (HGS) is a practical measure to assess muscle strength in individual patients during clinical practice. However, HGS reference values refer to populations of healthy people, and population-specific values, such as those in the population of cancer patients, still need to be defined. Methods: Within a secondary analysis of a previous randomized controlled nutritional trial focusing on hospitalized cancer patients at risk for malnutrition, we investigated sex-specific HGS values stratified by age and tumor entity. Additionally, we examined the association between HGS and 180-day all-cause mortality. Results: We included data from 628 cancer patients, which were collected from eight hospitals in Switzerland. Depending on the age of patients, HGS varied among female patients from 7 kg to 26 kg and among male patients from 20.5 kg to 44 kg. An incremental decrease in handgrip strength by 10 kg resulted in a 50% increase in 180-day all-cause mortality (odds ratio 1.52 (95%CI 1.19 to 1.94), p = 0.001). Conclusion: Our data provide evidence of the prognostic implications of HGS measurement in cancer patients and validate the prognostic value of handgrip strength in regard to long-term mortality. In addition, our results provide expected HGS values in the population of hospitalized malnourished cancer patients, which may allow better interpretation of values in individual patients.

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study.

ObjectivePost-stroke cognitive impairment (PSCI) is resistant to treatment. Recent studies have widely applied repetitive transcranial magnetic stimulation (rTMS) to treat various brain dysfunctions, such as post-stroke syndromes. Nonetheless, a protocol for PSCI has not been established. Therefore, this study is aimed to evaluate the therapeutic effect of our high-frequency rTMS protocol for PSCI during the chronic phase of stroke.MethodsIn this prospective study, ten patients with PSCI were enrolled and received high-frequency rTMS on the ipsilesional dorsolateral prefrontal cortex (DLPFC) for 10 sessions (5 days per week for 2 weeks). Cognitive and affective abilities were assessed at baseline and 2 and 14 weeks after rTMS initiation. To investigate the therapeutic mechanism of rTMS, the mRNA levels of pro-inflammatory cytokines (interleukin (IL)-6, IL-1β, transforming growth factor beta [TGF-β], and tumor necrosis factor alpha [TNF-α]) in peripheral blood samples were quantified using reverse transcription polymerase chain reaction, and cognitive functional magnetic resonance imaging (fMRI) was conducted at baseline and 14 weeks in two randomly selected patients after rTMS treatment.ResultsThe scores of several cognitive evaluations, i.e., the Intelligence Quotient (IQ) of Wechsler Adult Intelligence Scale, auditory verbal learning test (AVLT), and complex figure copy test (CFT), were increased after completion of the rTMS session. After 3 months, these improvements were sustained, and scores on the Mini-Mental Status Examination and Montreal Cognitive Assessment (MoCA) were also increased (p < 0.05). While the Geriatric Depression Scale (GeDS) did not show change among all patients, those with moderate-to-severe depression showed amelioration of the score, with marginal significance. Expression of pro-inflammatory cytokines was decreased immediately after the ten treatment sessions, among which, IL-1β remained at a lower level after 3 months. Furthermore, strong correlations between the decrease in IL-6 and increments in AVLT (r = 0.928) and CFT (r = 0.886) were found immediately after the rTMS treatment (p < 0.05). Follow-up fMRI revealed significant activation in several brain regions, such as the medial frontal lobe, hippocampus, and angular area.ConclusionsHigh-frequency rTMS on the ipsilesional DLPFC may exert immediate efficacy on cognition with the anti-inflammatory response and changes in brain network in PSCI, lasting at least 3 months.

THE IMPACT OF EARTHWORKS ON OLDER TREES IN HISTORICAL PARKS

The publication aims to investigate the quantitative impact of linear earthworks in urban parks, e.g. during roads’ and pavements’ modernization in the old trees’ root zones, on the increment in their external parameters (e.g. trunk circumference). Pilot studies (Warsaw, Poland) were carried out 2003–2019 in two historical parks: Ursynów and Królikarnia. The dataset of trees’ parameters is based on detailed dendrological inventories. Test groups consisted of trees exposed to damage and not exposed to damage (Ursynów) and the control group – trees growing in unchanged site conditions (Królikarnia). Among the three most abundant species of dendroflora, Norway maples (Acer platanoides L.) show the most visible difference (&gt;1.8 cm) between the normal and the inhibited growth in trunk circumference. Two other species – black locusts (Robinia pseudoacacia L.) and small-leaved limes (Tilia cordata Mill.) – also revealed statistically significant differences in the increment of the trunk circumference (respectively: &gt;1.3 cm and &gt;1.4 cm). In general, the reaction of affected trees was a significant reduction of circumference increments from 2.6 to 4.0 times concerning trees not exposed to damage. The verification made with the resistograph in 2019 confirmed a statistically significant decrease in radial increments of trees remaining in the impact zone of the earthworks.

Real-World Effectiveness, Tolerability and Safety of Cyclosporine A 0.1% Cationic Emulsion in Severe Keratitis and Dry Eye Treatment.

IntroductionThe PERSPECTIVE study evaluated, in routine clinical practice, the effectiveness, tolerability and safety of cyclosporine A (CsA) 0.1% cationic emulsion (CE) in controlling severe keratitis in adults with dry eye who remained insufficiently controlled despite artificial tear (AT) use.MethodsA prospective, multicenter, observational study was conducted at 44 ophthalmology clinics across Finland, Germany, Norway, Sweden and the UK. Adults treated with ATs for severe keratitis and dry eye received CsA 0.1% CE therapy (1 drop in both eyes at bedtime) and were followed up at weeks 4, 12 and 24 and at month 12. Primary endpoint was mean [standard deviation (SD)] change from baseline in corneal fluorescein staining (CFS; Oxford Grade Scale) at month 12 following CsA 0.1% CE initiation. Secondary endpoints examined ocular sign and symptom severity and adverse events (AEs).ResultsThe full analysis set included 472 adults (75.9% female). Mean (SD) age was 61.9 (15.41) years. Mean (SD) CFS score was significantly reduced from baseline [2.56 (1.10)] at month 12 [1.10 (SD 1.13); P < 0.0001]. CFS score reductions were statistically significant from week 4, with further incremental decreases reported at study visits through month 12 (P < 0.0001). Severity of eyelid and conjunctival erythema was significantly reduced from baseline at week 4 and maintained through month 12 (P < 0.001). Tear film breakup time increased significantly from baseline at all study visits through month 12 (P < 0.001). Ocular symptom severity was significantly reduced from baseline at all study visits through month 12 (P < 0.001). Overall, 101 treatment-related AEs were reported. Most were mild/moderate (83.6%) and resolved by month 12 (73.3%).ConclusionsIn routine clinical practice, CsA 0.1% CE provided statistically significant reductions in dry eye signs and symptoms. Improvements were seen at week 4 and maintained over 12 months. Treatment tolerability was good and consistent with previous CsA 0.1% CE clinical studies.Trial registrationEU PAS register number: EUPAS 22376.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-022-00487-x.

Survival and Outcomes of Newly Diagnosed Multiple Myeloma Patients Stratified by Transplant Status 2007-2018: Retrospective Analysis from the Canadian Myeloma Research Group Database

BackgroundConsiderable progress has been made in therapeutic options for multiple myeloma (MM). Understanding the current landscape of MM treatment options and associated outcomes in the real world is important in providing key insights into clinical and knowledge gaps which could be targeted for further optimization. MethodsThe Canadian Myeloma Research Group Database (CMRG-DB) is a prospectively maintained disease-specific database with >7000 patients. The objective of this study was to describe the trends in the treatment landscape and outcomes including early mortality, time to next treatment, and overall survival (OS) in each line of treatment stratified by autologous stem cell transplant (ASCT) receipt among newly-diagnosed MM patients in Canada between 2007 and 2018. ResultsA total of 5154 patients were identified among which 3030 patients (58.8%) received an upfront ASCT and 2124 (41.2%) did not. At diagnosis, the median age was 64 years and 58.6% were males. Bortezomib and lenalidomide were most frequently used (>50%) in first and second-line treatment respectively among both the ASCT and non-ASCT cohort. The median OS was 122.0 months (95% Cl 115.0-135.0 months) and 54.3 months (95% CI 50.8-58.8 months) for the ASCT and non-ASCT cohort respectively with an incremental decrease in OS in each subsequent line of treatment. ConclusionWe present the largest study to date in the Canadian landscape showing the characteristics, therapy usage, and outcomes among MM patients. This information will be critical in benchmarking current outcomes and provide key insight into areas of unmet needs and gaps for improvement of MM patients nationally.

Fully Biobased Photothermal Films and Coatings for Indoor Ultraviolet Radiation and Heat Management.

Sustainable materials are needed to mitigate against the increase in energy consumption resulting from population growth and urbanization. Here, we report fully biobased nanocomposite films and coatings that display efficient photothermal activity and selective absorption of ultraviolet (UV) radiation. The nanocomposites with 20 wt % of lignin nanoparticles (LNPs) embedded in a chitosan matrix displayed an efficient UV blocking of 97% at 400 nm along with solar energy-harvesting properties. The reflectance spectra of the nanocomposite films revealed the importance of well-dispersed nanoparticles in the matrix to achieve efficient UV-blocking properties. Finally, yet importantly, we demonstrate the nanocomposites with 20 wt % LNPs as photothermal glass coatings for passive cooling of indoor temperature by simply tailoring the coating thickness. Under simulated solar irradiation of 100 mW/cm2, the 20 μm coating achieved a 58% decrease in the temperature increment in comparison to the system with uncoated glass. These renewable nanocomposite films and coatings are highly promising sustainable solutions to facilitate indoor thermal management and improve human health and well-being.

Strength deterioration mechanism of bentonite modified loess after wetting\u2013drying cycles

The employment of bentonite modified loess (BML) is a common method of constructing the anti-seepage lining of landfills in the loess region of China, and its long-term secure performance is threatened by wetting–drying (W–D) cycles. Taking the remolded loess (RL) and BML with 15% in mass of bentonite as research objects, the W–D cycles test, scanning electron microscope test and direct shear test were carried out to analyze the effects of W–D cycles on the microstructure and shear strength of samples. The regression equations between strength and micro-pore structure parameters were established by the multivariate linear stepwise regression method. The damage mechanism of BML after W–D cycles was studied by establishing damage degree models based on pore area ratio and cohesion. Results indicate that the water absorption and expansion of bentonite effectively block the intergranular pores, resulting in more medium and small pores and more pronounced surface contact of particles. After W–D cycles, the particle arrangement of samples before and after bentonite modification tends to be loose. Both the pore area ratio and fractal dimension increase and tend to stabilize after five cycles. The BML exhibits lower pore area ratio and greater fractal dimension while its cohesion and internal friction angle show more significant decrease after W–D cycles than those of RL. The damage variables based on pore area ratio and cohesion well describe the W–D induced damage of loess before and after modification from macro- and micro-scale perspectives. The damage degree of samples increases with W–D cycles, but the increment decreases.

Offloading Effects on Impact Forces and Patellofemoral Joint Loading During Running in Females

BackgroundStructure-specific loading is being increasingly recognized as playing a role in running related injuries. The use of interventions targeted at reducing patellofemoral joint loads have shown effectiveness in reducing symptoms of patellofemoral pain. Use of bodyweight support (BWS) has the potential to reduce loading on the patellofemoral joint during running to augment rehabilitation efforts. Research Question:How is patellofemoral joint loading different when using a harness-based BWS system during running? MethodsTwenty-five healthy females free from lower extremity injury were included. Participants completed four running trials on an instrumented treadmill with varying amounts of BWS using a commercially available harness system. Kinematic data from a 3D motion capture system and kinetic data from the treadmill were combined in a computer model to estimate measures of patellofemoral joint loading, knee kinematics, ground reaction force, and stride frequency. ResultsPeak patellofemoral joint stress and time-integral were reduced when running under BWS conditions compared to control conditions. Incremental decreases in patellofemoral loading were not observed with incremental increases in BWS. Peak knee flexion angle was reduced in all BWS conditions compared to control but was not different between BWS conditions. Knee flexion excursion was reduced in only the high BWS condition. Peak ground reaction force and stride frequency incrementally decreased with increased amounts of BWS. SignificanceHarness-based BWS systems may provide a simple means to reduce patellofemoral joint loading to assist in rehabilitation efforts, such as addressing patellofemoral pain.

Population-based normative data for the Scoliosis Research Society 22r, EQ-5D, and VAS questionnaires among individuals aged 20 to 69 years.

AimsTo provide normative data that can assess spinal-related disability and the prevalence of back or leg pain among adults with no spinal conditions in the UK using validated questionnaires.MethodsA total of 1,000 participants with equal sex distribution were included and categorized in five age groups: 20 to 29, 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years. Individuals with spinal pathologies were excluded. Participants completed the Scoliosis Research Society-22 (SRS-22r), visual analogue scale (VAS) for back/leg pain, and the EuroQol five-dimension index (EQ-5D/VAS) questionnaires, and disclosed their age, sex, and occupation. They were also categorized in five professional groups: doctors, nurses, allied health professionals, office workers, and manual workers.ResultsThe mean age of all participants was 43.8 years (20 to 69). There was no difference in the SRS-22r, EQ-5D, or VAS scores among male and female participants (p > 0.05). There was incremental decrease in SRS-22r total scores as the age increased. The mean EQ-5D index score (0.84) ranged little across the age groups (0.72 to 0.91) but reduced gradually with increasing age. There was difference between the SRS-22r total score (4.51), the individual domain scores, and the EQ-5D score (index: 0.94 and VAS: 89) for the doctors’ group compared to all other occupational categories (p < 0.001). Doctors had a younger mean age of participants, which may explain their improved spinal health. There was no difference in the total or sub-domain SRS-22r and EQ-5D scores between the other four occupational groups.ConclusionThis study provides the first normative data for the SRS-22r, EQ-5D, and VAS for back/leg pain questionnaires among adults in the UK. We recorded an excellent correlation between the three assessment tools with individuals who reported less back and leg pain having better quality of life and greater function. The participants’ age, rather than their sex or profession, appears to be the major determinant for spinal health and quality of life.Cite this article: Bone Jt Open 2022;3(2):130–134.

Microcirculation disorders in patients with severe COVID-19 and development of bacterial sepsis

It is believed that microcirculation dysfunction in sepsis primarily caused by damage of the endothelium by infectious agents and pro-inflammatory cytokines. Mechanisms of impaired microcirculation in the severe course of COVID-19 and sepsis likely to be similar. However, there are few reports studied microcirculation disorders in patients with COVID-19, and their results are sometimes contradictory. Objective. To assess the microcirculation of patients with severe Covid-19 and the development of bacterial sepsis using nail bed microscopy and laser Doppler flowmetry. Materials and methods. 16 intensive care unit COVID-19 patients subsequently diagnosed with bacterial sepsis were examined. Patients underwent vital capillaroscopy and an occlusive test using laser Doppler flowmetry. The average rate of capillary blood flow, the size of the perivascular zone, the density of capillaries, the presence of intravascular aggregates, the increase in the amplitude of the maximum post-occlusive blood flow and the average value of postocclusive blood flow relative to the initial one were valuated. Additionally, the level of serum proadrenomedullin was evaluated. Studies were performed on the day of admission and in dynamics. Results. By the capillaroscopy analysis, microcirculation disorders were detected in the form of a decrease in the linear speed of capillary blood flow (&lt;400 μm/s), an extention of the perivascular zone (&gt;100 μm), the circulation of microaggregates; the absence of postocclusive hyperemia was determined by an occlusive test. Secondary bacterial infection led to an even greater aggravation of microcirculation disorders: an increase of the perivascular zone, the progression of intravascular aggregation resulting in microthrombosis with a decrease of the density of the capillary network (according to capillaroscopy), as well as a sharp decrease of amplitude maximal increment of blood flow of post-осclusive circulation at the time of an occlusive sample. We also revealed a trend of negative correlation between the level of serum proadrenomedullin and the maximum increase in blood flow during the occlusive test. Conclusion. The secondary bacterial infection in patients with COVID-19 leads to a significant aggravation of microcirculation disorders with the development of perfusion deficiency and interstitial edema. The increased plasma proadrenomedullin level supports the concept of the significant role of endothelial dysfunction in the pathogenesis of severe COVID-10 and bacterial sepsis.

Association of ergothioneine with neurodegeneration and cerebrovascular disease in cognitive impairment and dementia

AbstractBackgroundErgothioneine (ET) is a dietary amino‐thione with strong antioxidant properties and therapeutic potential for neurodegenerative and vascular diseases (Halliwell et al., 2018; Smith et al., 2020). Decreased blood concentrations of ET have been found in patients with mild cognitive impairment (Cheah et al., 2016), but its status in neurodegenerative and vascular dementias are currently unclear. We thus investigated the association of plasma ET levels with (1) cognitive impairment and dementia, (2) cerebrovascular disease (CeVD), namely white matter hyperintensities (WMH), cortical infarcts and lacunes and (3) brain atrophy.MethodA cross‐sectional study was conducted in a total of 496 participants in an ongoing longitudinal study, including 88 subjects with no cognitive impairment (NCI), 201 subjects with cognitive impairment but no dementia (CIND), 207 dementia patients of whom 160 had Alzheimer’s Disease and 47 vascular dementia (VaD). All subjects underwent collection of blood samples, neuropsychological assessment, and neuroimaging. Plasma ET levels were measured with a high sensitivity liquid chromatography tandem‐mass spectrometry (LC‐MS/MS) method.ResultPlasma ET concentrations were lowest in dementia (p&lt;0.001 vs. NCI and CIND), with intermediate levels in CIND (p&lt;0.001 vs. NCI). In multivariate analyses, lower levels of ET were significantly associated with CIND (OR, 0.20; 95% CI, 0.07–0.56; p&lt;0.01) and dementia (OR, 0.06; 95% CI, 0.02–0.20; p&lt;0.001) after adjustment for demographics and risk factors. There was a positive correlation between plasma ET and MMSE scores (r=0.341, p&lt;0.001). Lower ET levels were also strongly associated with WMH (OR, 0.44; 95% CI, 0.123–0.85); p&lt;0.01) and brain atrophy markers (cortical atrophy: OR, 0.42; 95% CI, 0.20–0.92; central atrophy: OR, 0.46; 95% CI, 0.22–0.93; medial temporal atrophy: OR, 0.45; 95% CI, 0.24–0.99, p&lt;0.05 for all).ConclusionThe incremental decreases in ET levels along the clinical continuum suggest that ET may be associated with disease severity and is a potential biomarker for early detection of cognitive impairment. Deficiency of ET may contribute towards neurodegeneration‐ and CeVD‐associated cognitive impairments by exacerbating the deleterious effects of oxidative stress in these conditions.

Plasmonic photothermal biosensor for visual detection of tyrosinase and dopamine based on manganese dioxide nanosheets-mediated etching of gold nanorods

As a crucial enzyme involved in melanogenesis, tyrosinase plays an important role in the diagnosis of melanoma. Herein, a novel and simple photothermal quantitative method based on manganese dioxide nanosheets-mediated etching of gold nanorods was established for tyrosinase activity assay with a simple household thermometer as the readout. Gold nanorods were etched by manganese dioxide nanosheets in acid condition at room temperature with a fast and stable etching efficiency. With the etching of gold nanorods, the photothermal conversion efficiency decreased gradually with the change of the aspect ratio of gold nanorods, leading to the decrease of the temperature increment of the solution by degrees. The gold nanorods have an unparalleled photothermal conversion efficiency, and the increment of temperature caused by the photothermal effect of gold nanorods has a span as wide as nearly 17 °C within one minute of laser irradiation. A household thermometer, instead of a spectrometer or any other professional and costly instruments, was used as a signal reader to achieve the visual quantitative detection, which makes this method possible for point-of-care testing. The photothermal platform was used successfully for the determination of tyrosinase and its substrate dopamine with wider linear ranges from 1.0 to 70 U/mL and 2.0–150 μM and detection limits as low as 0.34 U/mL and 0.92 μM, respectively. Moreover, the inhibition efficiency of kojic acid on tyrosinase activity was investigated, proving the photothermal quantitative method will be a potential platform for screening inhibitors of tyrosinase.

Method to optimize the volume of nitrogen gas injected into the trapped annulus to mitigate thermal-expanded pressure in oil and gas wells

Trapped annular pressure caused by thermal-expand liquid greatly threatens well integrity, so its mitigation is very necessary and essential. Nitrogen gas has been proved as an effective and low-cost mitigation measure for thermal-expanded annular pressure, but few methods are available to design the injection volume while this is vital for its mitigation reliability. Hence, this paper aims to develop a design method of the optimal injection volume of nitrogen gas to mitigate trapped annular pressure. The design method is based on volume consistency law and volume compensation effect. The proposed design method takes annular pressure increment and optimal injection volume as mitigation aim. A solving process is proposed according to volume increment and error iteration. An index is defined to evaluate mitigation efficiency. The results indicate the mitigation would fail once the injection volume is lower than the optimal injection volume, but over-surplus injection volume reduces mitigation efficiency. Optimal injection volume increases as production time and rate increase. The mitigation efficiency decreases and optimal injection volume increases as water depth increases. The optimal volume increases as the geothermal gradient increases. More nitrogen gas is needed as the mitigation aim of annular pressure increment decreases. The optimal injection volume increases as the expand-compress ratio increase while mitigation efficiency changes little. This design method can be applied in deep-water and HPHT wells. Detailed production data should be obtained and the geothermal temperature should be measured accurately. The extra injection volume is recommended to overcome the unexpected change of production plan and error of geothermal temperature measurement. The mitigation aim should consider the change of well barriers’ strengths. The expand-compress ratio of annular liquid should be adjusted to prevent too large optimal injection volume. Compared with field experience or qualitative analysis, this method can provide an optimal injection volume as reference for the mitigation of thermal-expanded annular pressure, which can enhance the long-term reliability of mitigation by injecting nitrogen gas, thus promoting the popularization.