High Sedimentation Rate Research Articles

Risk Factors of Hospital-Acquired Pneumonia Among Hospitalized Patients With Cardiac Diseases.

Background To our knowledge, no studies have been done in Saudi Arabia to determine the risk factors of hospital-acquired pneumonia (HAP) among hospitalized cardiac patients. This study aimed to assess these risk factors. Methods A retrospective study was done at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Five hundred hospitalized patients diagnosed with pre-existing cardiovascular disease (CVD) were included. A checklist was used to collect data about patients' demographic characteristics; BMI; smoking and alcohol abuse; type of cardiac disease; other chronic diseases; exposure to immunosuppressives; chemotherapyand radiotherapy in the last six months; glucocorticoiduse; application of ventilator; initial, follow-up chest X-ray results; pneumonia vaccination status; nasogastric tube use; general anesthesia received; use of loop diuretics; presence of pulmonary diseases; levels of WBC, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP); results of blood and respiratory cultures; number of hospitalizations and intensive care unit (ICU) admissions in the last six months; and Richmond Agitation and Sedation Scale (RASS) score. Results The prevalence of pneumonia was 7%. Females; patients with autoimmune diseaseswho were exposed to immunosuppressives or glucocorticoids; those with an initial or second abnormal chest X-ray; patients who used nasogastric tube, had pulmonary disease, and had high levels of WBC, ESR, or CRP; and patients hospitalized for more than two times had a significantly higher percentage of having pneumonia. Abnormal second chest X-ray, high ESR, and more than two times of hospitalization within the last six months were the risk factors of pneumonia on multivariate logistic regression analysis. Conclusion Better prevention and intervention programs are needed to assess the risk factors of pneumonia among admitted cardiac patients.

Evaluating the Archaeological Efficacy of Bathymetric LiDAR across Oceanographic Contexts: A Case Study from Apalachee Bay, Florida

This study presents preliminary results from recent bathymetric LiDAR-guided surveys of submerged archaeological landscapes in the Apalachee Bay off the coast of Florida. We show how bathymetric LiDAR can re-identify previously recorded archaeological sites and identify new cultural deposits at shallow depths and help aid SCUBA surveys of submerged environments. While most prior archaeological applications of bathymetric LiDAR have focused on shipwrecks and historic era sites, our case study demonstrates that bathymetric LiDAR is capable of detecting Holocene and Pleistocene era archaeological sites as well. Detecting and eventually characterizing these ancient deposits will greatly expand our understanding of settlement trends when sea levels were lower and may provide insights into how some of the earliest coastal populations adapted to this novel and changing environment. Our SCUBA surveys also elucidate the impact of local environmental conditions of the applicability of deploying bathymetric LiDAR; specifically, eel grass cover does not hinder LiDAR capabilities, while high rates of sedimentation greatly reduce success in identifying archaeological deposits. Overall, our results show promise in the future of applying remote sensing to study shallow submerged archaeological landscapes, which can help improve our understanding of human–environment dynamics prior to and during periods of sea level change.

New constraints on the closure of the Betic Seaway and the western Mediterranean palaeoclimate during the Messinian Salinity Crisis from the Campo Coy Basin (SE Spain)

The Campo Coy Basin (SE Spain) exposes >1 km of sedimentary succession with a variety of rocks including a thick evaporitic succession previously associated with the Messinian time. These evaporites were supposedly deposited in a restricted Mediterranean-Atlantic seaway connecting the Lorca and Guadix-Baza basins, although no chronological or geochemical data existed. Here we use palaeomagnetism together with vertebrate and foraminifera biostratigraphy to constrain the age of the Campo Coy succession between <9 Ma and 4.7 Ma. We use geochemistry (δ34S, δ18O and 87Sr/86Sr values) of the gypsum deposits to evaluate their marine or continental origin. In addition, we describe the underlying and overlying lithostratigraphic units to reconstruct the palaeogeographic evolution of this region. Our results show that the sediments were deposited in a continental environment, indicating that the Betic Seaway was already closed in this region during the late Tortonian and that the neighbouring marine basins of Guadix-Baza and Lorca were disconnected during that time. The δ34S, δ18O and 87Sr/86Sr values of the gypsum indicate recycling from the Triassic sulphates. Sedimentary facies of the evaporites point to an environment dominated by a saline lake with continental sabkha episodes developed during the driest periods. Well-defined and laterally continuous evaporitic cyclicity suggests an orbital forcing and high sedimentation rates preceding the Messinian Salinity Crisis (MSC). Alluvial deposits are contemporaneous with the MSC indicating a dry continental environment in this region during the Mediterranean restriction. Overlaying lacustrine carbonates are rich in small vertebrate fauna including African species that migrated to Europe during the MSC. These carbonates have low δ18O and δ13C values characteristic for freshwater input in an open lake just after the Zanclean flood, suggesting that a wet climate followed the MSC.

Deposition of cenomanian – Turonian organic-rich units on the mid-Norwegian margin: Controlling factors and regional implications

On the mid-Norwegian margin, extensive rifting and subsequent deposition of thick Cretaceous and Cenozoic sediments have buried the traditional Upper Jurassic organic-rich shales too deep. Consequently, these organic-rich shales are overmature and spent in the deep basins on the mid-Norwegian margin. The absence of well-control, variable seismic quality and in particularly, the great burial depth, makes it difficult to identify alternative Upper Jurassic and Lower Cretaceous organic-rich units. By combining high-resolution 2D seismic data, well logs, and Rock-Eval data, this study documents the presence of alternative organic-rich units in the Cretaceous succession on the Halten Terrace and the Vøring Basin. Multiple seismic horizons which correspond to regional flooding surfaces and define a series of seismic sequences have been mapped across the study area. The regionally extensive upper Cenomanian horizon is associated with wireline log signals and Rock-Eval parameters which imply the presence of a potential source rock unit. Source rock evaluation indicate that this unit contains mainly kerogen Type III on the Halten Terrace, suggesting an organofacies with significant contribution from terrestrial sources. In the Vøring Basin, the unit is sparsely drilled but appears to be mature, thus displaying a relatively limited potential. One well from the Vigrid Syncline demonstrate somewhat higher potential, with Rock-Eval data indicating a kerogen Type II composition. As such, more prolific units seems to exist in the Vøring Basin, albeit exhibiting a patchy distribution. We speculate that the deposition and preservation of this upper Cenomanian organic-rich unit record the development of an extended oxygen minimum zone attributable to increased primary production and sluggish water circulation, linked to the global Oceanic Anoxic Event 2 (OAE 2). However, local physiographic conditions, such as high sedimentation rates, erosion by gravity flows and periodically oxygenated conditions hindered preservation of a significant quantities of organic matter, thus limiting the thickness and quality of the upper Cenomanian organic-rich unit on the mid-Norwegian margin.

Shallow-Water Benthic Communities on Soft Bottoms of a Sub-Arctic Fjord (Southern Barents Sea, Russia) along a Gradient of Ecological Factors

Kola Bay is the most developed coastal area in the Russian part of the Barents Sea, but despite a long history of research, information about the local shallow-water benthic communities is lacking. For this reason, in this fjord area, we investigated the soft-bottom zoobenthos to determine its distribution and the factors influencing its abundance, biomass, and diversity. An analysis of 24 samples collected by divers at eight stations located at 7–8 and 10–15 m depths revealed 127 benthic taxa with an average abundance and biomass of 12,190 ± 4740 ind. m−2 and 30 ± 8 g m−2, respectively. The most severe abiotic conditions (high rates of sedimentation and eutrophication) were found at the head of the bay while the highest densities of predator red king crabs were registered in the middle part. The total benthic abundance and biomass, as well as the abundances of infauna, mobile taxa, subsurface deposit feeders, and surface deposit feeders, decreased towards the central part of the bay, reflecting gradients in the environmental conditions. In the inner part of the bay, we registered two communities: Cossura pygodactylata + Ciliatocardium ciliatum and Arctica islandica + Laonice cirrata, while the benthos of the middle part was less structured. Redundancy analysis indicated that the faunal abundances were influenced mainly by predator density (negative association) and the organic matter content (positive association). The total benthic biomass was negatively linked to water temperature due to the predominance of cold-water species in the area and a close positive association of this factor with crab abundance. In contrast, the highest diversity was registered at the warmer sites, which may have been a reflection of the borealization process in the Arctic. Our results contribute towards the proper management and conservation of the local benthic ecosystem and provide reference data for future monitoring programs and coastal management guidelines.

Fluvial responses to late Holocene hydroclimate variability in the midcontinental United States

Long-term relationships between mean-state climatic conditions and flood frequencies in the midcontinental United States (US) are not well established because instrumental records of fluvial processes are limited to the current warm period (CWP; the last ca. 150 years) and continuous paleo-flood records are exceedingly rare. Here, we investigate climate-flood relationships in the midcontinental US by reconstructing flood frequencies at Half Moon Pond, a 1600-year-old oxbow lake on the lower White River, Indiana (watershed = ca, 29,000 km2). We used sediment accumulation rates and clastic fluxes constrained by high-resolution radiocarbon (14C) dating. Frequent flooding, as indicated by high sedimentation rates and clastic fluxes to Half Moon Pond, occurred leading up to and during the Medieval Climate Anomaly (MCA; 950–1250 CE) when paleoclimate records suggest the predominance of ocean-atmosphere mean states resembling the negative phases of the Pacific Decadal Oscillation (-PDO-like) and Pacific North American Mode (-PNA-like). Reductions in sedimentation rates and clastic fluxes, indicating reduced flooding, subsequently occurred during the transition out of the MCA and into the Little Ice Age (LIA; 1250–1830 CE) as ocean-atmosphere conditions shifted to + PDO-like and +PNA-like mean states. Sedimentation rates and clastic fluxes increased again after ca. 1800 CE, indicating increased flooding during the CWP as ocean-atmosphere conditions returned to -PDO-like and -PNA-like mean states. The White River trends were notably antiphased with sedimentation-rate-based flood frequencies for the lower Ohio River (500,000 km2 watershed) prior to 1830 CE. This antiphased relationship is consistent with flooding in moderate to small watersheds in the Midwest being sensitive to the occurrence of rainstorm events, which were more frequent leading up to and during the MCA, and flooding in large watersheds being more sensitive to large spring melts associated with extensive snowpacks, which characterized the LIA. That both the White and Ohio rivers experienced their most frequent flooding during the CWP suggests deforestation and changing land use practices increased flooding on Midwestern watersheds across scales despite a current climatic mean state that in the past only resulted in increased flooding on moderate to small watersheds. Continued increased in midcontinental rainfall are therefore likely to enhance the occurrence of floods in Midwestern watersheds across different geographic scales.

Flow Velocity and Sediment Transport Analysis at Intake of Asahan I Hydroelectric Power Plant

Asahan I Hydroelectric Power Plant is located in the upper reaches of the Asahan River, Ambarhalim Village, Toba Samosir Regency, North Sumatra. The high rate of sedimentation is one of the problems that must be overcome so that the operational continuity of hydroelectric power plant can run well. Flow velocity needs to be known to control sedimentation around hydroelectric power plant intakes as a consideration for the safe limit of dredger placement. The method used to analyze flow velocity included conventional flow continuity methods and finite element mathematical models using the SRH-2D software. The results of the conventional method analysis of flood conditions Flood Water Level = +903.50 m obtained the flow velocity at the intake of 0.34 m/s, the transition channel 0.37 m/s and the condition of full capacity Q = 100.00 m³/s is 3.78 m/s and analysis using SRH-2D obtained speed flow <4 m/s. Both of these conditions make it possible to carry out sediment dredging in the hydroelectric power plant intake.

Disease patterns among Saudi children undergoing colonoscopy for lower gastrointestinal bleeding: Single tertiary care center experience.

: The yield of colonoscopy in cases presenting with lower gastrointestinal bleeding (LGIB) in previously published studies varies according to several factors, including endoscopic skills, histopathological experience, and pattern of colonic pathology in different countries. The local literature is limited to a single small 20-year-old study. Our objective was to provide updated data on the diagnostic yield of colonoscopy in Saudi children with LGIB in Saudi Arabia. : This was a retrospective analysis of pediatric patients (0-14 years of age) who underwent colonoscopy for LGIB at the King Fahad Medical City (KFMC), from 2008 to 2018. LGIB was defined as fresh or dark blood per rectum. : During the study period, 175 children underwent colonoscopy for LGIB (99 males, mean age 7.05 ± 3.81 years), which constituted 53.5% of indications for colonoscopy procedures (n = 327) in our center. The terminal ileum was intubated in 81% of the procedures. Overall, inflammatory bowel disease (IBD) was the most commonly identified cause of LGIB (32% ) followed by colonic lymphonodular hyperplasia (CLNH) in 17% and juvenile polyp and rectal mucosal prolapse syndrome (RMPS), 11% each. On sub-analysis, cow's milk protein allergy (CMPA) and CLNH were the most common causes in infants and toddlers, 35% each; IBD (26.5%) and polyps (22.4%) in young children (2-6 years), and IBD (36%), CLNH (14.9%) and RMPS (14%) in older children (6-14 years). In comparing the IBD to the non-IBD group, IBD patients were older (mean 8.37 vs. 6.46 years, P = 0.002) and more likely to have diarrhea, weight loss, high erythrocyte sedimentation rate, anemia, and hypoalbuminemia (odds ratio 24, 11, 10.7, 6.5, and 4, respectively). Colonoscopy had a sensitivity of 97%, specificity of 100%, positive predictive value of 100%, negative predictive value of 81.4%, and accuracy of 97% in diagnosing LGIB. : Colonoscopy is an effective diagnostic tool in children with LGIB with a high diagnostic yield. Besides IBD, CLNH and RMPS are two other important pathologic entities that need to be considered in a child with LGIB.

Atypical clinical presentation of rheumatoid arthritis

Introduction. Rheumatoid arthritis is a systemic autoimmune disease with inflammation of the joints as its hallmark. Extra-articular manifestations affect nearly half of the patients either at the onset of disease or later during the disease course. Case outline. A 43-year-old man complained of chest pain, dry cough, and fatigue. Diagnosis of pericarditis was made based on echocardiography findings. Due to worsening of respiratory symptoms, he was admitted to the hospital. Initial diagnostic workup revealed elevated concentrations of acute phase reactants, pericardial effusion, and bilateral pulmonary nodules. Pathohistological analysis of lung nodules ruled out malignancy and tuberculosis. He was treated with colchicine, which led to a regression of a pericardial effusion. Afterwards, due to arthritis of the right wrist, high erythrocyte sedimentation rate, and C-reactive protein, positive immunoserology and bone erosion at the distal ulna diagnosis of seropositive rheumatoid arthritis was established. He was treated with antimalarial, methotrexate, and glucocorticoids until he suffered from COVID-19 pneumonia, which triggered arthritis flare. Owing to the loss of efficiency of combination therapy with methotrexate and glucocorticoid, baricitinib was added to the treatment. Low disease activity was achieved after three months of administering baricitinib and methotrexate, and no adverse events occurred during 20-month-long therapy. Conclusion. Every patient with pericarditis of unknown etiology should be diagnostically evaluated in term of connective tissue disease including rheumatoid arthritis, because the initial clinical presentation in some group of patients could lack characteristic synovitis.

PS-R05-3: SEVERE GLOMERULAR MICROANGIOPATHY IN A PATIENT WITH NEPHROTIC SYNDROME FOLLOWING TAKAYASU ARTERITIS

Introduction: Takayasu arteritis (TA) is a large vessel inflammation that predominantly involves aorta and its main arteries. TA-caused kidney injury is known to be mainly due to renal artery stenosis. However, glomerulonephritis including membranous proliferative glomerulonephritis, focal segmental sclerosis, or crescentic nephritis has been histologically identified in some TA cases. Case description: A 69-year-old female presented with leg edema and refractory hypertension with nephrotic range proteinuria (17.0 g/gCr). She exhibited &gt; 10 mmHg blood pressure discrepancy between left and right upper limbs and severe aortic regurgitation. Lab test showed high level of C-reactive protein and high erythrocyte sedimentation rate. Contrast-enhanced computed tomography identified wall thickening of the left subclavian artery, which led to the diagnosis of TA. Renal biopsy demonstrated that double basement membrane, enlarged subendothelial space, and mesangiolysis with no immunoglobulin deposition. Although azilsartan 40 mg QD and nifedipine 30 mg BID had been prescribed, systolic blood pressure (sBP) was still &gt; 160 mmHg. Thus, while oral prednisolone was started to suppress TA-induced inflammation, azilsartan was replaced with sacubitril valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), for treating refractory hypertension. After a few weeks, sBP was decreased to 130 mmHg with sacubitril valsartan 200 mg QD and proteinuria was dramatically improved to 0.5 g/gCr. Discussion: TA commonly involves the renal artery, leading to stenosis and subsequent ischemic nephropathy. However, no stenosis and occlusion were observed in renal artery of this case. In addition, small vessel inflammation in the kidney such as vessel wall necrosis and immune cells infiltration around arterioles was not found. Serum levels of pro-inflammatory cytokines including vascular endothelial growth factor and interleukin-6, a well-known contributors for progression of TA-related inflammation, were within the normal range. The results indicate that TA-caused hypertension, but not vessel inflammation induced by TA, seems to play a pathological role for development of glomerular microangiopathy in this case. A previous study showed that 70% of TA patients presenting with glomerular lesion has severe hypertension and intimal thickening in renal arterioles was observed more frequently in TA patients presenting with glomerular lesion when compared to those without glomerulonephritis, which supports our hypothesis. In the present case, ARNI significantly reduced sBP which might directly contribute to the improvement of proteinuria. ARNI can be potent to control hypertension more effectively than conventional hypertensive agents in TA patients.

Shallow gas in Holocene sediments of the Pearl River Estuary and the implication for anthropogenic effects on its release

High-resolution seismic and side-scan surveys were conducted to investigate shallow gas accumulation and seepage in the Holocene sediment of the Pearl River Estuary. Extensive shallow gas accumulation and active seepage were detected in the Holocene sediments of the estuary and adjacent shelf regions. Laterally continuous and extremely shallow gas fronts were observed in areas with relatively higher sedimentation rates, whereas shallow gas was absent or discontinuous in regions with the sediment with lower sedimentation rates. Gas accumulation was present at extremely shallow depths in the West Shoal, which is the recent depocentre location. The co-occurrence of shallow gas distributions and variations in the sedimentation rate was related to the role of sediment accumulation in organic carbon burial and preservation, both of which are required for gas generation and accumulation in sediment. In addition, the consistency between the distribution of high water column methane concentrations in the West Shoal, the super shallow gas accumulation pattern in the sediment profile, and active seepage indicate that shallow gas in the Holocene sediment is a methane source in the Pearl River Estuary. Further, considerable evidence of recent or relic seepage is present in areas that have experienced active anthropogenic disturbances, including sand mining, dredging, and bridge building. The disrupted and discontinuous gas fronts at these sites suggest that active shallow gas releases were influenced by anthropogenic activity.

A Miocene Nannofossil Biostratigraphic Case Study: Alaminos Canyon Block 627 and Mississippi Canyon Block 555, and Sedimentation Rates in the Gulf of Mexico

The Miocene sediments of 2 deep—water boreholes from the northern Gulf of Mexico, from Alaminos Canyon (AC) Block 627 and Mississippi Canyon (MC) Block 555, have been biostratigraphically analyzed using calcareous nannofossils, revealing changes in sedimentation rates and depositional environments between these 2 areas. High nannofossil abundance values and low sedimentation rates generally recorded in the Alaminos Canyon region suggest a condensed section during much of the Miocene, associated with a basinal environment. Mississippi Canyon exhibits lower nannofossil abundance and higher sedimentation rates compared to Alaminos Canyon during the majority of the Miocene. Increased sediment volumes are largely attributed to input from the Mississippi River. Sedimentation rate was calculated for both sites. In the AC Block 627 borehole, sedimentation rate ranged from 13 to 107 m/million years (my), and in the MC Block 555 borehole, it varied from 11 to 914 m/my. One major anomaly was a low observed sedimentation rate in the lowest portion of the section at MC Block 555, in the interval defined between the extinctions of Triquetrorhabdulus carinatus and Dictyococcites bisectus. This may reflect a hiatus or possible fault which has shortened the section.

Analytical Validation of MINI-PET as Point-of-Care for Erythrocyte Sedimentation Rate Measure in Horses.

The erythrocyte sedimentation rate (ESR) is a widely used diagnostic assay in human medicine but nowadays poorly applied in veterinary medicine. This test measures the speed (millimeters per hour) at which red blood cells settle in a whole anticoagulated blood tube. In human medicine, high ESR values are associated with various disorders, including infections, rheumatoid arthritis, oncologic diseases, and other inflammatory conditions. The ESR can also be influenced by some factors such as age and gender. In veterinary medicine, the ESR with the Westergren manual method was almost forgotten over the years due to blood consumption and long turn-around time. The instrument MINI-PET, using a modified Westergren method, does not require blood consumption or release waste product and recently has been applied in canine medicine. The aims of the study in the horse were as follows: to establish the appropriate time to read the ESR with the Westergren reference method; to compare the MINI-PET ESR results with the reference technique; to assess the ESR reference intervals with MINI-PET; and to establish the ESR stability from collection at different time points by MINI-PET. Using 150 horses, we established 60 minutes as the appropriate time for ESR reading with the Westergren method. Moreover, ESR results obtained in 8 minutes with MINI-PET showed a good correlation with the Westergren ESR. Reference intervals (RIs) with MINI-PET were established in mm/h for the healthy horses (geldings 18.6-100.1; stallions, 13.8-55.7; and mares 1-73.7) according to the American Society of Veterinary Clinical Pathology guidelines. In addition, the ESR stability from the blood collection time was evaluated in the MINI-PET on 15 horses: at room temperature, ESR is stable up to 8 hours and at 4°C up to 24 hours. In conclusion, MINI-PET represents a rapid and reliable tool for measuring ESR in horses, offering a valid option to replace the traditional manual technique.

Elevated sedimentation of clastic matter in pelagic Panthalassa during the early Olenekian

AbstractThe end‐Permian mass extinction is thought to have greatly altered biogeochemical cycles. The absence of chert and dominance of claystone in low‐latitude pelagic deep‐sea sedimentary sequences of Early Triassic Panthalassa (the deep‐sea chert gap) has been believed to record radiolarian die‐off and consequent decline in biogenic silica production. However, recent studies showed that the upper portion of the deep‐sea chert gap has sedimentation rates higher than bedded chert, meaning that increased clastic inputs, rather than decreased biogenic silica inputs, resulted in the anomalous lithology. In this study, we focus on the Akkamori‐2 section, which preserves a rare sedimentary sequence spanning a large part of the lower portion of the claystone of the deep‐sea chert gap. We obtained conodont fossils that allow correlation with sections in South China that have numerous dated tuffs. By projecting the dates of the tuffs to our measured sections, we show that sedimentation rates of the lower portion of the deep‐sea chert gap is also higher than bedded chert. Hence, most of the deep‐sea chert gap was formed under increased clastic inputs, which likely records disturbance in the terrestrial landscape, probably aridification and/or increased seasonality in arid areas, that lead to elevated dust flux to the pelagic ocean. On the other hand, the idea that the deep‐sea chert gap records lingering effects of the mass extinction event on radiolarians cannot explain the high sedimentation rates of the deep‐sea chert gap. This previously favored scenario needs to be reconsidered, taking into account the burial efficiency of biogenic silica in the Early Triassic ocean, and also effects of increased clay deposition on preservation of radiolarians.

Extrapulmonary Tuberculosis: Clinical and Diagnostic Features and Risk Factors for Early Mortality

Objective: The aim of this study is to evaluate patients with EPTB in terms of demographics, anatomic localization, diagnosis and risk factors on early mortality. Materials and methods: The data of 217 inpatients who were followed up with EPTB, between January 2010 and December 2020, were evaluated retrospectively. Patients were followed-up during hospital admission and early mortality was considered. Risk factors on mortality were identified in multivariate analysis using logistic regression model. Results: The median age was 54 (IQR: 37-67) and the rate of male patients was 43.3%. 76 (35%) patients had at least one comorbidity. The most common underlying conditions were diabetes mellitus and immunosuppressive treatment. The most common forms of EPTB were lymph node, bone and CNS. Microbiological findings (ARB and/or TB-culture and/or M. tuberculosis PCR) were positive in 75 patients and histopathological findings (necrotising granuloma with/without pathological caseification) were supportive for diagnosis in 68.2%. The overall mortality rate was 8.5%. In the multivariate analysis, factors independently associated with increased risk of death included advanced age, elevated sedimentation rate above 50mmHg, miliary TB and CNS TB. Conclusion: In conclusion, EPTB is an important health problem in developing countries with significant mortality in specific forms. The most common forms of EPTB are lymph node, bone and CNS TB. The most common underlying conditions are diabetes and immunosuppressive therapy although most patients do not have any underlying diseases. The diagnosis is forcing and a substantial proportion of patients have negative microbiological findings. The diagnosis are based on pathological, radiological and/or clinical findings in patients without definitive microbiological diagnosis. Advanced age, high sedimentation rate and severe forms such as CNS and miliary TB are associated with early mortality.

Phenotyping for percutaneous coronary intervention and long-term recurrent weighted outcomes

IntroductionPercutaneous coronary interventions (PCI) are often performed in multimorbid patients with heterogeneous characteristics and variable clinical outcomes. We aimed to identify distinct clinical phenotypes utilizing machine learning and explore their relationship with long-term recurrent and weighted outcomes. MethodsThis prospective observational cohort study enrolled all-comer PCI patients in 2020‐2021. Multiple imputation k-means clustering was utilized to detect specific phenotypes. The study endpoints were patient-oriented and device oriented composite endpoints (POCE, DOCE), its individual components, and major bleeding. We applied semiparametric regression models for recurrent and weighted endpoints. ResultsThe study included a total of 643 patients. We unveiled three phenotype clusters: 1) inflammatory (n = 44, with high white blood cell counts, high values of C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio), 2) high erythrocyte sedimentation rate (ESR) (n = 204), and 3) non-inflammatory (n = 395). For ACS-only population, we four distinct phenotypes (high-CRP, high-ESR, high aspartate-aminotransferase, and normal). For all-comer PCI patients, identified phenotypes had a higher risk of POCE (mean ratio (MR) 1.42 (95% confidence interval (CI) 1.11–1.81) and MR 2.01 (95% CI 1.58–2.56), respectively), DOCE (MR 1.61 (95% CI 1.20–2.16), MR 2.60 (95%CI 1.94–3.48), respectively), and stroke (hazard ratio (HR) 2.86 (95% CI 1.10–7.4), 6.83 (95% CI 2.01–23.2)). Similarly, high-ESR and high-CRP phenotypes of ACS patients were significantly associated with the development of clinical composite outcomes. ConclusionMachine learning unveiled three distinct phenotype clusters in patients after PCI that were linked with the risk of recurrent and weighted clinical endpoints.German Clinical Trial Registry number: DRKS00020892.

Assessment of diagnostic procedures and tools of COVID-19 among Iraqi patients: A systematic review

Background: The pandemic SARS – CoV2 is a novel virus disease that first appeared in China in December 2019. On February 24, 2020, the disease spread throughout Iraq, and many different studies were conducted on it. This study highlights the procedures for diagnosing COVID-19 and evaluating tools among Iraqi patients through a systematic review of research conducted in Iraq during the past two years (2020–2021). Methods: From March 2020 to December 31, 2021, articles on relevant themes were carefully searched in the main databases: Science Direct, PubMed, Embase, and Iraqi Academic Scientific Journals. Using keywords related to COVID-19 and Iraq yielded a total of 2743 articles. Articles were chosen for this systematic review based on inclusion and exclusion criteria, according to the PRISMA 2020 statement for reporting systematic review. Only Iraqi studies that reported data on diagnostic procedure outcomes were included, with a total of 21 articles chosen. Results: A total of 21 articles were found to be relevant, which reviewed the biochemical and hematological parameters as diagnostic procedures and tools in Iraqi patients. The biochemical parameters are as follows: triglycerides, cholesterol, APRs, liver functions tests, kidney functions tests, antibodies, cytokines, and minerals. The hematological parameters are as follows: ABO group, red blood cell (RBC) indices, white blood cell (WBC) indices, and platelet indices. Conclusion: Diagnostic procedures and tools for COVID-19 among Iraqi patients were in agreement with the majority of other global studies. High serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ferritin, d-dimer, lactate dehydrogenase (LDH), and cytokines were associated with severe COVID-19 pneumonia and also hypoalbuminemia, lymphocytopenia, and neutrophilia. Biochemical and hematological parameters might be significant indicators for COVID-19 evaluation.

Assessment of heavy metal pollution in seawater, benthic flora and fauna and their ability to survive under stressors along the northern Red Sea, Egypt

The purpose of this study was to assess the north coasts of the Egyptian Red Sea, including Ras Gharieb, Hurghada, Safaga and Qusier, by evaluating the heavy metal pollution in seawater and benthic flora and fauna in the winter and summer of 2016. The concentrations of heavy metals (Fe, Mn, Zn, Cu, Ni, Cd and Pb) were analysed with an atomic absorption spectrophotometer. The results revealed that the Fe levels in the seawater ranged from 7.86 and 27.95 µg l-1, while the Zn concentrations fell between 1.83 and 5.63 µg l-1. In contrast, the recorded values of Mn, Cu, Ni, Pb and Cd in the seawater were minimal at the study sites. Regarding the biota samples, Porifera species were more adaptable than others to an accumulation of most metals in their tissues. Furthermore, seaweeds and seagrasses demonstrated remarkable adaptation in highly polluted regions, especially those with high turbidity, landfilling, sedimentation and high eutrophication rates – much more than the benthic fauna. Our research highlights the critical need for strict regulation of metal emissions in these coastal regions.

A simple approach for coffee-ring suppression yielding homogeneous drying patterns of ZnO and TiO2 nanoparticles

Evaporation-induced self-assembly in colloidal droplets is a method for organising nanoparticles on substrates, with various resulting patterns. The coffee-ring pattern is among the most common ones, but its non-uniformity limits its applicability, which led to efforts for developing coffee-ring suppression strategies. Considering the wide applicability of ZnO and TiO2 nanoparticles, there is a high demand for practical means to deposit them as uniform films. Here, we present a simple approach for obtaining highly uniform thin films of ZnO and TiO2 nanoparticles by drop-coating in ambient conditions, without using surfactants or other surface chemistry modifications. Disc-like films were obtained via a restricted evaporation achieved by covering the droplets with a lid during drying, seconded by the relatively high sedimentation rate of these nanoparticles. To better understand the assembly mechanism, the influence of suspension concentration, type and temperature of the substrate, droplet volume, colloid type, and evaporation rate were studied. The method allows preparing disc-like nanoparticle films with a good control over their diameter and thickness, onto different kinds of substrates (glass, Si, polyethylene terephthalate, polystyrene). By fabricating both two-dimensional lattices and custom disc patterns we highlight the versatility of this drop-coating method and its potential for, e.g., automatized serial production processes.

Medium-sized channel shaping in the lower Yellow River due to water–sediment regulation

Abstract The Yellow River (YR) is famous for its ‘hanging river’ due to the high sedimentation rate in the lower reaches. Reservoir sediment retention (RSR) and water–sediment regulation (WSR) of the Xiaolangdi Reservoir (XLDR) contribute to mitigating the siltation and adjusting the bankfull channel geometry in the lower Yellow River (LYR). However, few studies have been conducted to quantify the contribution of RSR and WSR to medium-sized channel shaping. In this paper, we analyzed the temporal and spatial variations of bankfull discharge (BFD) in the LYR, established empirical expressions between the BFD and the previous five-year average discharge above 2,000 m3/s and the incoming sediment coefficient during flood seasons, and then constructed three different water and sediment scenarios to quantify the contribution of the WSR of the XLDR to medium-sized channel shaping in the LYR. Calculated results indicated that WSR accounted alone for 68%–94% of the medium-sized channel shaping, with RSR contributing 6%–32%. The contribution of WSR to the recovery of medium-sized channels increased with time and became stabilized eventually. Along the LYR, such contribution also increased from 68% to 97% and eventually became stabilized in narrow reaches, reaching over 90%. The results will lay a solid technical foundation for the WSR of the XLDR, river regulation downstream of the reservoir, and sediment disposal of the YR.