Insignificant Trend Research Articles

Trends in river runoff in Latvia for the period 1951-2020

A time series of monthly, seasonal and annual mean specific runoff of rivers in Latvia are analysed in order to detect trends for the period 1951–2020. Trend analysis is performed by applying the Mann-Kendall test and the trend slope is calculated using Sen’s method. There were significant seasonal changes in the time series of specific runoff measured at 32 stations during the study period. In all hydrological regions, the trend values obtained for the winter season are statistically significant, but they are relatively weaker in the Eastern region. At the same time, river runoff in April and May has notably decreased, indicating a shift of the runoff maximum to an earlier time. Long-term changes in specific runoff are statistically significant in April in all hydrological regions, and only in May for the Eastern region. Generally, statistically insignificant trends in specific runoff are observed for the summer and autumn months. Annual mean specific runoff has not revealed any strong trends in spite of the increased precipitation and temperature. Clear seasonal changes have been found in several earlier studies in the Baltic countries, and they are confirmed by the current one.

ЭМПАГЛИФЛОЗИН В ЛЕЧЕНИИ ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ЕГО ВЛИЯНИЕ НА ЖЕЛУДОЧКОВЫЕ НАРУШЕНИЯ РИТМА

The study aims to assess empagliflozin affecting ventricular dysrhythmia and late potential of ventricles in patients with chronic heart failure with low etiology ejection fraction. The study included 35 male patients (61.7 ± 11.2 years old) who received standard therapy, followed by 10 mg empagliflozin in 6 months. The examination included echocardioscopy, 12-leads electrocardiography, signal-averaged electrocardiography, and daily electrocardiography monitoring. 10 mg empagliflozin added to the standard therapy provided for a statistically significant decrease in the number of single premature heart beats by 67.7 % (p = 0.001), in the episodes of unstable ventricular tachycardia by 74.5 % (p = 0.001), in the frequency of late ventricular potential by 31 % (Chisquare = 5.51; р = 0.019), and for a statistically insignificant trend to ejection fraction increase (p > 0.05).

Circulating Tumor DNA correlates with Lactate Dehydrogenase, CYFRA 21-1, and CRP levels in patients with advanced NSCLC.

Purpose: To investigate potential association between selected tumor markers and laboratory parameters (lactate dehydrogenase [LDH], neutrophils, hemoglobin, neutrophils, lymphocytes, C-reactive protein, albumin, carcinoembryonic antigen, and cytokeratin 19 fragment 21-1 [CYFRA 21-1]) and circulating tumor DNA (ctDNA) with survival in patients with advanced non-small cell lung cancer (NSCLC). Patients and Methods: The study encompassed 82 patients from a single center. All patients had (localy-) advanced adenocarcinomas. ctDNA was determined before starting therapy and at 6 weeks follow-up. Laboratory parameters were measured before each cycle of therapy and oncomarkers before starting the therapy as standard clinical practice. Mann-Whitney U test, Cox proportional hazards model, Fisher's exact test, and Kaplan-Meier survival estimation with Gehan-Wilcoxon test were used for statistical analysis of the corresponding variables. Results: We have confirmed predictive or prognostic significance for some of the selected laboratory markers and oncomarkers. Above all, we demonstrate a significant relationship between the levels of LDH and the oncomarker CYFRA 21-1 and the presence or absence of ctDNA at the time of diagnosis. We also demonstrate significantly lower CRP levels in patients within whom the ctDNA disappeared during treatment. A similar but statistically insignificant trend was observed for LDH. Conclusions: CYFRA 21-1, LDH and probably CRP correlate with ctDNA levels in NSCLC. Repeated measurement of these markers could thus help in early detection of disease progression in the same way as does ctDNA monitoring.

Role of vitamin D on gestational hypertension, diabetes mellitus, timing and mode of delivery.

To determine the efficacy of VD in preventing the development of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH). The secondary purpose is to investigate the effect of VD on the mode and time of delivery. A vitamin D value of <20 ng/mL during pregnancy is considered a deficiency according to the Endocrine Society, and 400-600 IU/day VD replacement is recommended. Forty patients whose serum VD levels were below 20 ng/mL during routine pregnancy follow-up and who were planned for VD replacement therapy were included in the study. They were divided into two equal groups with 20 patients in each group. Twenty pregnant women with serum VD levels greater than 20 ng/mL were considered as the control group. While 400 IU/day VD replacement was applied to the patients in Group 1, 600 IU/day VD was given to Group 2. Group 3 consisted of control patients who did not undergo VD replacement. VD replacement was continued from the 14th week of pregnancy until delivery. Each group of participants was screened with a 50-g GCT at 24-28 weeks of gestation. Following 50-g GCT if serum glucose level was found >140 mg/dL, patients underwent 100-g OGTT. GDM was diagnosed in the presence of at least two of the following results: fasting serum glucose ≥92 mg/dL and/or 1-hour glycemia ≥180 mg/dL, and/or 2-hour glycemia ≥153 mg/dL. PIH was defined as systolic blood pressure >140 mmHg and diastolic blood pressure >90 mmHg. Patients in each group delivered by cesarean section or normal vaginal route. In addition to the incidence of PIH and GDM, the time and mode of delivery were recorded. PIH was detected in two patients in each of the 400 IU/day and 600 IU/day vitamin D replacement groups (10%). In the control group, PIH developed in 3 patients (15%). Although PIH was detected in an extra case in the control group, no significant difference was found between the replacement group and the control group in terms of PIH (p<0.44). While GDM was not detected in the 400 IU/day vitamin D group, GDM was detected in one patient (5%) in the 600 IU/day vitamin D group. No case of GDM was found in the control group either. There was no significant difference between the VD replacement and the control groups in terms of GDM rates. No significant difference was found between the VD replacement and the control groups in terms of mode of delivery. While the C/S ratio was 65% in the 400 IU/day vitamin D group, this ratio was 75% in the 600 IU/day vitamin D group. There was an insignificant trend of increase in C/S ratios in the group given 600 IU/day of vitamin D. The C/S ratio of the control group, which could not be given VD replacement, was found to be 70%. VD replacement therapy during pregnancy does not prevent the development of PIH and GDM, and does not significantly contribute to the time and mode of delivery.

PROSTATE CANCER EPIDEMIOLOGY IN THE EAST KAZAKHSTAN REGION, 2010-2019

Relevance: From 2010 to 2019, prostate cancer morbidity increased, and prostate cancer mortality decreased in Kazakhstan. The peak incidence was observed in patients aged 70 years and older. The East Kazakhstan region had higher morbidity and mortality from prostate cancer than the national average.&#x0D; The study aimed to: assess the indicators of prostate cancer epidemiology in the East Kazakhstan region from 2010 to 2019.&#x0D; Methods: The study calculated prostate cancer incidence, mortality, one-year and five-year survival, and early detection from 2010 to 2019. The statistical significance was assessed by the one-factor linear regression method. Intensive epidemiological indicators were calculated per 100 000 male population.&#x0D; Results: The prostate cancer incidence in East Kazakhstan increased from 2010 to 2019, while the mortality rate increased slightly. There was a statistically significant upward trend for morbidity (p=0.009) and a statistically insignificant trend for mortality (p=0.900).&#x0D; The one-year survival with prostate cancer tended to decrease. However, the trend of one-year survival rates had no statistical significance (p=0.202).&#x0D; The five-year survival rate of patients with prostate cancer in the East Kazakhstan region during the study period tended to decrease. However, the trend in the five-year survival rates of patients with prostate cancer in the East Kazakhstan region had no statistical significance (p=0.826).&#x0D; Early detection of prostate cancer in the early stages remained sustainable in the range of 72.7-77.4. In 2019, this indicator decreased to 63.2%.&#x0D; The share of prostate cancer cases detected at stage III tended to increase. The proportion of prostate cancer cases detected at stage IV tended to decrease during the study period.&#x0D; Conclusion: The prostate cancer epidemiological rates in East Kazakhstan were unstable in the study period. The incidence tended to increase; the mortality rate fluctuated within small limits and remained sustainable. The one-year survival rate tended to decrease. The five-year survival rate was slightly increasing. There was an increase in the detection of prostate cancer at stage III, while the detection at stage IV tended to decrease. Early detection of prostate cancer has decreased with an increase in detection at stage III. The proportion of prostate cancer cases detected at stage IV in the study period tended to decrease.

PROSTATE CANCER EPIDEMIOLOGY IN THE EAST KAZAKHSTAN REGION, 2010-2019

Relevance: From 2010 to 2019, prostate cancer morbidity increased, and prostate cancer mortality decreased in Kazakhstan. The peak incidence was observed in patients aged 70 years and older. The East Kazakhstan region had higher morbidity and mortality from prostate cancer&#x0D; than the national average.&#x0D; The study aimed to assess the indicators of prostate cancer epidemiology in the East Kazakhstan region from 2010 to 2019.&#x0D; Methods: The study calculated prostate cancer incidence, mortality, one-year and five-year survival, and early detection from 2010 to 2019.&#x0D; The statistical significance was assessed by the one-factor linear regression method. Intensive epidemiological indicators were calculated per 100&#x0D; 000 male population.&#x0D; Results: The prostate cancer incidence in East Kazakhstan increased from 2010 to 2019, while the mortality rate increased slightly. There was&#x0D; a statistically significant upward trend for morbidity (p=0.009) and a statistically insignificant trend for mortality (p=0.900).&#x0D; The one-year survival with prostate cancer tended to decrease. However, the trend of one-year survival rates had no statistical significance (p=0.202).&#x0D; The five-year survival rate of patients with prostate cancer in the East Kazakhstan region during the study period tended to decrease. However,&#x0D; the trend in the five-year survival rates of patients with prostate cancer in the East Kazakhstan region had no statistical significance (p=0.826).&#x0D; Early detection of prostate cancer in the early stages remained sustainable in the range of 72.7-77.4. In 2019, this indicator decreased to 63.2%.&#x0D; The share of prostate cancer cases detected at stage III tended to increase. The proportion of prostate cancer cases detected at stage IV tended&#x0D; to decrease during the study period.&#x0D; Conclusion: The prostate cancer epidemiological rates in East Kazakhstan were unstable in the study period. The incidence tended to increase; the mortality rate fluctuated within small limits and remained sustainable. The one-year survival rate tended to decrease. The five-year&#x0D; survival rate was slightly increasing. There was an increase in the detection of prostate cancer at stage III, while the detection at stage IV tended&#x0D; to decrease. Early detection of prostate cancer has decreased with an increase in detection at stage III. The proportion of prostate cancer cases&#x0D; detected at stage IV in the study period tended to decrease.

Spatio-temporal analysis of the ameliorative state of lands in the foothill, steppe and forest-steppe zones of the Altai Territory

The problem of land degradation is global throughout the world. Many studies have noted that land reclamation can adversely affect their quality. In Russia and a number of countries of the post-Soviet space, the quality of land is assessed by such an indicator as the ameliorative state. The purpose of the research was the spatio-temporal analysis of the ameliorative state of the lands of the Altai Territory in the forest-steppe, steppe and foothill zone. The object of study was chosen due to the diversity of its landscape and climate variability due to the influence of mountain systems. Such general scientific research methods as analysis and synthesis, as well as applied methods were used: multivariate data analysis (cluster and regression analysis), GIS technologies. The calculations were made in the STATISTICA package, the significance level in all calculations was taken equal to 0.05. Research results. The structure of agricultural lands on rain-fed and reclaimed lands in each agrochemical zone has been determined. In the structure of lands, the share of arable land on reclaimed lands is higher than on rainfed lands. This is due to a significant increase in productivity during land reclamation. The share of reclaimed lands with perennial plantations in the foothill zone is 12 times higher than that of rainfed lands. The deposit in the foothill zone is only on rainfed lands. Clustering of 25 districts was completed according to the state of reclaimed land at the beginning of 2015 and 2022. The regions of the region that have reduced or increased the ameliorative state of the lands have been identified. The rate of change in the land area corresponding to each ameliorative state is estimated. The oldest reclamation systems are located in the steppe zone of the Altai Territory, which affects the dynamics of changes in the quality of reclamated lands. The reclamation state of the lands in the foothill zone remained unchanged; statistically insignificant trends were revealed in the forest-steppe zone. In conclusion, the results of the calculations are summarized. For the period 2015-2022 the area of reclaimed land has not changed. The region is characterized by the predominance of lands of good and satisfactory ameliorative condition, regardless of the agrochemical zones. The changes revealed by the typification of areas according to the reclamation state of lands at the beginning and end of the period are mainly due to a decrease in the reclamation state of lands in the steppe zone with the transition from good to satisfactory.

Trends in climatic and hydrological parameters in the Ajora-Woybo watershed, Omo-Gibe River basin, Ethiopia

The identification of hydro-meteorological trends is essential for analyzing climate change and river discharge at the watershed level. The Ajora-Woybo watershed in Ethiopia was studied for long-term trends in rainfall, temperature, and discharge at the annual, monthly, and seasonal time scales. The rainfall and temperature data extend 1990 to 2020, whereas the discharge data span from1990 to 2015. The Pettitt and Standard Normal Homogeneity Test (SNHT) tests were used to determine homogeneity. The Mann–Kendall and Sen's slope tests, as well as numerous variability measures, were then employed for trend analysis. The degree of relationship between climate variables and river discharge was determined using Pearson correlation coefficients (r). Inhomogeneity was discovered in annual rainfall data from the Angacha and Areka stations. Rainfall and discharge showed insignificant trends over time, with increasing and decreasing variability across stations. Monthly rainfall decreasing trends were observed to be significantly falling in February and March. Rainfall and runoff increase just insignificantly during the Kiremt season. On the other hand, minimum, maximum, and mean annual temperatures showed significant trends with annual increases of 0.01 °C, 0.04 °C, and 0.025 °C, respectively. In this study, the relationships between discharge and temperature and rainfall were found to be moderate and minimal, respectively. Generally, the results of the long-term examination of the hydrological and climate parameters in the watershed show that water resources vary throughout and over time. As a result, designing strategies require due attention.Article highlightsHydrological and meteorological parameters are essential for analyzing trends in water resource and climate change at the watershed level.Mann-Kendall and Sen's slope tests, along with a number of variability measures, were utilized in conjunction with the time series analysis approach for trend analysis.The analysis of the rainfall, temperature, and discharge in the watershed's data generally demonstrates how the availability of water resource varies over time. Designing suitable plans for water resource management and sustainable development in the watershed is therefore essential.

Incidence and trends of ixodid tick-borne borreliosis and Siberian tick typhus in the Eastern Transbaikalia

Aim. To study the trends and to assess longterm incidence of ixodid tick-borne borreliosis (ITB) and Siberian tick typhus (STT) in Eastern Transbaikalia for the improvement of preventive measures.Materials and Methods. We carried out a retrospective analysis of ITB and STT incidence in different districts of the Eastern Transbaikalia during 2003–2021. Epidemic trends were characterised using linear regression equations.Results. Average annual incidence of ITB in 2003–2021 was 4 cases per 100,000 population. Analysis of two periods (2003–2012 and 2013– 2021) showed an increase in ITB incidence in 2013–2021 (5.1 ± 0.79 per 100,000 population) as compared to 2003–2012 (2.6 ± 0.73 per 100,000 population, p &lt; 0.05). Within 2013–2021 period, there has been a statistically insignificant trend towards decreasing ITB incidence. The incidence of STT was lower than that of ITB and there was no statistically significant trend towards change of this scenario (average annual incidence in 2003– 2021 was 2.1 ± 0.37 per 100,000 population). Between 2012 and 2021, in particular before 2017, the incidence of STT reduced (average annual incidence in 2012–2021 was 1.5 ± 0.43 per 100,000 population). The epidemiological risk of ITB and STT varied across the distinct territories of Eastern Transbaikalia.Conclusion. In order to prevent the incidence of tick-borne diseases, acaricide treatments should be regularly carried out. Amounts of such interventions should be determined depending on the risk of human infection.

Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery

This study compared the effects of a four-phase and a three-phase early mobilization protocol on respiratory parameters and complications in patients following coronary artery bypass graft surgery. This is a three-arm, parallel-group, randomized controlled clinical trial with 120 candidates for coronary artery bypass graft surgery. Participants were randomly allocated to three groups: four-phase early mobilization protocol, three-phase early mobilization protocol, and control. Arterial blood gases, oxygen saturation, and incidence of pulmonary complications were compared among the groups. Mean arterial blood gases and oxygen saturation improved significantly over time in both four-phase early mobilization protocol and three-phase early mobilization protocol groups compared to control (p < 0.05). There were observed trends for greater improvements in the study outcomes with three-phase early mobilization protocol than four-phase early mobilization protocol; however, did not reach statistically significant levels. The incidence of pulmonary complications was significantly in both intervention groups compared to control (odds ratio: 0.48, 95 % CI 0.007–0.537; p < 0.001). Both four-phase early mobilization and the three-phase early mobilization protocols improved respiratory parameters and reduced pulmonary complications. Statistically insignificant trends were found trends in the three-phase early mobilization protocol, focusing on chest physiotherapy and breathing exercises.

Association of Longitudinal Urinary Metabolic Biomarkers With ADPKD Severity and Response to Metformin in TAME-PKD Clinical Trial Participants

Dysregulated cellular metabolism contributes to autosomal dominant polycystic kidney disease (ADPKD) pathogenesis. The Trial of Administration of Metformin in Polycystic Kidney Disease (TAME-PKD) tested the effects of metformin treatment over 2 years in adult ADPKD patients with mild-moderate disease severity. Metformin was found to be safe and tolerable with an insignificant trend toward reduced estimated glomerular filtration rate (eGFR) decline compared to placebo. Here we tested whether targeted urinary metabolic biomarkers measured in TAME-PKD participants correlated with disease progression, severity, and metformin treatment in cross-sectional and longitudinal analyses. Concentrations of total protein, targeted metabolites (lactate, pyruvate, and succinate), and glycolytic enzymes (pyruvate kinase-M2, lactate dehydrogenase-A, and pyruvate dehydrogenase kinase-1) were measured and normalized by creatinine or osmolality in urine specimens and compared with height-adjusted total kidney volume (htTKV) and eGFR at the different study timepoints. In cross-sectional analyses utilizing placebo group data, urinary succinate normalized by creatinine negatively correlated with ln (htTKV), whereas protein excretion strongly positively correlated with ln (htTKV), and negatively correlated with eGFR. Significant time-varying negative associations occurred with eGFR and the lactate/pyruvate ratio and with urine protein normalized by osmolality, indicating correlations of these biomarkers with disease progression. In secondary analyses, urinary pyruvate normalized by osmolality was preserved in metformin-treated participants but declined in placebo over the 2-year study period with a significant between-arm difference, suggesting time-dependent urinary pyruvate changes may serve as a discriminator for metformin treatment effects in this study population. Proteinuria with enhanced glycolytic and reduced oxidative metabolic markers generally correlated with disease severity and risk of progression in the TAME-PKD study population.

Impacts of climate variability and land use on the blue and green water resources in a subtropical basin of China

Water scarcity has become a global severe challenge over the past few decades. Quantifying the impact of climate variability and land use on water resource availability is crucial for integrated water resource management. Many studies have focused on blue water but ignored green water which is important in the terrestrial ecosystem, especially on different temporal scales. In this study, we selected the Shanmei Reservoir, the most import drinking water resource for a rapidly development city of Southeast China, as a case for analysis of these impacts for the entire basin. We adopted the Soil and Water Assessment Tool (SWAT) to investigate the spatial and temporal distributions of blue water (BW), green water flow (GWF) and green water storage (GWS) in the Shanmei Reservoir Basin (SRB). The results of the blue and green water components (BW and GW) revealed that SRB is dominated by BW, accounting for 52.6% of the total water resources, while GW accounted for 47.4%. There was an insignificant upward trend of BW and a significant upward trend of GWF, with a tendency rate of 1.125 mm a−1. Precipitation was the key factor affecting BW on annual and monthly scales. The GWF was more sensitive to temperature at both the annual and monthly scales. The GWS was significantly correlated with precipitation at the monthly scale, while insignificant correlation occurred at the annual scale. The spatial distribution of BW was largely dominated by precipitation, and land-use types led to the differentiation of GW. It indicates that the BW of paddy fields is greater than that of forests, while the GWS of forests is greater than that of orchards and rainfed croplands.

Survival of Patients with Primary Mediastinal B-Cell Lymphoma Treated By Immunochemotherapy with or without Radiotherapy

Introduction: Primary mediastinal B-cell lymphoma (PMBL) is B-non-Hodgkin lymphoma subtype with unique clinical and biological characteristics mostly affecting younger patients. The current treatment standard is based on combination of rituximab and anthracycline based chemotherapy (R-CHT), either standard (R-CHOP) or intensified (DA-EPOCH-R). Radiotherapy (RT) consolidation has been standard of care for a long time, but its role is currently unclear, especially in the context of PET/CT guided therapy and long term toxicity prevention considering young patient population (Hayden at al.2020, Giulino-Roth 2018). In this analysis we evaluate the survival benefit of RT consolidation in patients with PMBL achieving PET negative (PET-neg) response after R-CHT. Methods: Patients with confirmed diagnosis of PMBL observed in NiHiL project (Gov Trial No: NCT03199066) were analysed. All patients were treated by R-CHT; PET/CT was performed at the end of the immunochemotherapy. The treatment response was evaluated according to Cheson 2007 criteria. Only patients achieving PET negativity were included in primary analysis. Results: The study included 230 patients out of whom 133 (57.8%) were women. Median age was 37 years (range 19-79); localised stage (I-II) was observed in 165 patients (71.7%) and low or low-intermed IPI in 189 patients (82.2%). The diagnosis was confirmed by central pathologist in all cases. Patients were treated by R-CHT, mostly R-CHOP (52.2%) and R-CHOEP-like (25.2%; i.e. R-CHOEP or DA-EPOCH-R); other intensive regimens, incl. platinum were used in 19.6% of patients; 48 patients (20.8%) received ASCT as part of first line induction. PET/CT was performed at the end of R-CHT (including ASCT); 174 patients (75.7%) achieved PET-neg remission at the end of the immunochemotherapy, 56 (24.3%) were PET positive (PET-pos). After reaching PET negativity, radiotherapy was performed in 68 patients (39.1%) with median dose of 36Gy (range 20-42Gy); 106 patients were not consolidated by RT and observed (OBS). There was higher incidence of bulky disease and B-symptoms in RT group (57% vs 47% and 57% vs 48% resp.) without reaching statistical significance. Median follow up was 5.9 years. OS and PFS probability at 6y were 90.5% and 83.6% resp. for the whole cohort. RT consolidation in PET-negative subgroup led to a significant improvement (p=0.039) in PFS at 6y with 95% (n=68) vs 85.3% in OBS group (n=106). This was, however, not transformed into the OS difference (94.5% vs 92.1% probability at 6y for RT vs OBS; HR 1.64, CI95% 0.52-5.8), figure 1. In subgroup of patients treated by R-CHOP, there was an insignificant trend for better PFS probability in RT group (HR 2.41, 95%CI 0.71-6.92, p=0.17). This was not reflected in any OS difference. The outcome of patients who reached PET negativity by R-CHOEP was the same regardless of the radiotherapy use. Conclusion: Our analysis of retrospectively recorded patients shows that skipping RT in PET-neg PMBL patients at the end of immunochemotherapy does not hamper overall survival. There was borderline improvement of PFS. The patient cohorts with different chemotherapy regimens were not big enough to analyse the RT significance. However, data observed in patient subpopulation treated by CHOEP-like regimen confirm already published observations (Dunleavy et al. 2013) concluding possible RT oblivion after intensified immunochemotherapy. Therefore, the choice between radiotherapy consolidation vs observation in PET negative patients should be discussed with the patient especially when less intensive regimen (R-CHOP) is used. Acknowledgement: This work was supported by Cooperatio Program - research area Oncology and Hematology and by research grant NU21-03-00411 Figure 1. Survival analysis of patients reaching PET negative remission after chemotherapy (n=174) shows improvement in progression free survival (PFS) for patients consolidated with radiotherapy (RT), however without reflection in overall survival (OS). Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Urinary and Kidney Podocalyxin and Podocin Levels in Diabetic Kidney Disease: A Kidney Biopsy Study

Diabetic kidney diseases (DKDs) are the most common cause of dialysis-dependent kidney disease around the world. Previous studies have suggested that urinary level of podocyte-associated molecules may predict the prognosis of DKD. Observational cohort. 118 consecutive patientswith biopsy-proven DKD; 13 nondiabetic patients with hypertensive nephrosclerosis as controls. Urinary podocalyxin and podocin levels were obtained by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA) and the corresponding intrarenal levels by western blotting. Dialysis-free survival; kidney event-free survival; rate of kidney function decline in 12 months. Correlation and time to event analysis. Urinary podocalyxin level was closely correlated with its messenger RNA (mRNA) level(r=0.562, P<0.001), but this did not predict the progression of DKD. Intrarenal podocalyxin level had only modest correlation with its urinary mRNA and ELISA levels, was an independent predictor of dialysis-free survival (adjusted HR, 1.85; 95% CI, 1.21-2.82; P=0.005), and showed an insignificant trend of predicting kidney event-free survival (adjusted HR, 1.36; 95% CI, 0.94-1.95; P=0.10). Urinary podocin level by ELISA had a modest correlation with the rate of kidney function decline (r=0.238, P=0.01) but did not predict dialysis-free survival. Small sample size; lack of serial measurement. Intrarenal podocalyxin level, but not its urinary level, was an independent predictor of dialysis-free survival, whereas urinary podocin level by ELISA correlated with the rate of kidney function decline. Although intrarenal podocalyxin level has prognostic value, it may not be suitable for routine clinical use.

The Long-Term Trends and Interannual Variability in Surface Ozone Levels in Beijing from 1995 to 2020

Tropospheric ozone is an important atmospheric pollutant as well as an efficient greenhouse gas. Beijing is one of the cities with the most serious ozone pollution. However, long-term date of observed ozone in Beijing are limited. In this paper, we combine the measurements of the In-service Aircraft for a Global Observing System (IAGOS), ozonesonde observations as well as the recently available ozone monitoring network observations to produce a unique data record of surface ozone (at 14:00 Beijing time) in Beijing from 1995 to 2020. Using this merged dataset, we investigate the variability in surface ozone in Beijing on multiple timescales. The long-term change is primarily characterized by a sudden drop in 2011–2012 with an insignificant linear trend during the full period. Based on CAM-chem model simulations, meteorological factors played important roles in the 2011–2012 ozone drop. Before and after this sudden drop, ozone levels in Beijing increased significantly by 0.42 ± 0.27 ppbv year−1 before 2011 and 0.43 ± 0.41 ppbv year−1 after 2013. We also found a substantial increase in the amplitude of the ozone annual cycle in Beijing, which has not been documented in previous studies. This is consistent with ozone increases in summer and ozone decreases in winter. In addition, the results by the Ensemble Empirical Mode Decomposition (EEMD) analysis indicate significant interannual variations in ozone levels in Beijing with different time oscillation periods, which may be associated with natural variabilities and subsequent changes in meteorological conditions.

Abstract 13455: Clinical Outcomes of Intravascular Ultrasound During Percutaneous Coronary Intervention- United States Nation-Wide Analysis 2014 Through 2019

Introduction: Intravascular Ultrasound (IVUS) is a catheter-based real-time imaging procedure that assists in both diagnosis and treatment during Percutaneous Coronary Intervention (PCI). Over the years, IVUS-guided PCI have become more popular. In this study, we aimed to analyze the trends of use of IVUS-guided PCI, adjusted in-hospital mortality, hospital length of stay (LOS) and inpatient cost over the years. Methods: Data were extracted from the National Inpatient Sample (NIS) 2014 through 2019 Database. The NIS was searched for PCI with and without IVUS in adult patients (age ≥ 18) using ICD 9 and 10 codes. Outcomes of interest were utilization rates of IVUS during PCI, trend of adjusted in-hospital mortality, adjusted mean LOS and adjusted mean cost. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: Of 2,871,865 PCIs in 2014 through 2019, 201,075 (7.0%) were coupled with IVUS. The use of IVUS during PCI steadily increased from 6.2% in 2014 to 9.3% in 2019 (trend p&lt;0.001). The adjusted in-hospital mortality and inpatient LOS for PCI with IVUS showed statistically insignificant trend of higher mortality (1.3% in 2014 vs. 1.6% in 2019, trend p=0.053) and shorter LOS (3.2 days in 2014 vs. 3.0 days in 2019, trend p=0.148). The mean adjusted cost steadily increased over the years for patients undergoing PCI with IVUS (24236$ in 2014 vs. 28700$ in 2019, trend p=0.012). Conclusions: There is a steady rise in use of IVUS during PCI. There is a steady hike in hospital costs for PCI with IVUS hospitalizations however in-hospital mortality and LOS remain the same.

Projecting Changes in Rainfall Extremes for the Huai River Basin in the Context of 1.5 °C and 2 °C Global Warming

It is indisputable that global warming has triggered more frequent extreme weather and in turn led to severe flood disasters. To understand the trend of extreme rainfall under 1.5 °C and 2 °C warming, we investigated the historical variation and future trends in extreme rainfall for the Huai River basin, which has frequently been hit by floods, using recorded meteorological data and a projection of five General Circulation Models in the Coupled Model Intercomparison Project 6. We used the years 1995–2014 as the baseline period to study the temporal and spatial changes in extreme rainfall under 1.5 °C and 2.0 °C warming scenarios. The results indicated that (1) temperatures in the Huai River basin have risen significantly from 1995 to 2014, but there are insignificant variation trends in annual precipitation (AP), intensive precipitation (R95P), maximum daily precipitation (Rx1d) and heavy rain days (Rr50) during the same time span. (2) From 2015 to 2100, both temperature and extreme rainfall indices show increase trends, with a higher rate of increase under a higher emission scenario. (3) Under the warming scenario of 1.5 °C, AP, R95P, Rx1d and Rr50 in the basin will likely increase by 4.6%, 5.7%, 6.2% and 13.4%, respectively, compared with that in the baseline period. Under the warming scenario of 2.0 °C, AP, R95P, Rx1d and Rr50 will probably increase by 7.3%, 7.4%, 10.9% and 19.0%, respectively. (4) Spatially, the changes in extreme rainfall indices under the warming scenarios of 1.5 °C and 2.0 °C generally tend to increase from north to south. Higher intensity extreme rainfall will likely extend to the whole of the Huai River basin. It is therefore essential to study adaptive measures to cope with flooding in the Huai River basin induced by the increase in future rainfall extremes.

Spatio-temporal drought assessment of the Subarnarekha River basin, India, using CHIRPS-derived hydrometeorological indices.

Precipitation studies have a crucial role in deciphering climate change and monitoring natural disasters such as droughts. Such studies lead to better assessment of rainfall amounts and spatial variabilities; and have a vital role in impact assessment, mitigation, and prediction of occurrence. Thus, this study has been undertaken in the Subarnarekha River basin using Climate Hazards group Infrared Precipitation with Stations (CHIRPS) dataset. Precipitation datasets helped in deriving hydrometeorological indices such as the Rainfall Anomaly Index (RAI) and Standardized Precipitation Index (SPI) for the identification of drought occurrences. The core objective was to infer spatio-temporal drought scenarios and their trend characterization covering four decades over the years 1981 to 2020. Quantitative drought assessment was done using run theory for identifying the Drought Duration (DD), Drought Severity (DS), Drought Intensity (DI), and Drought Frequency (DF). Mann-Kendall (MK) test was performed to understand the precipitation and drought trends at annual and seasonal scales. Eight severe drought events were identified in the Subarnarekha River basin for the past 40years and the average DI value of 0.8 was recorded. MK test results for the precipitation showed a significant positive trend (95% confidence level) for pre-monsoon periods. However, for SPI, a significant positive trend was observed over the intervals of 3 (SPI3), 6 (SPI6), and 12 (SPI12) months respectively at an annual timescale, suggesting wetter conditions within the study area. Moreover, there had been insignificant negative trends for SPI1 and SPI3 during winter. It indicates that during the short-term SPI scale, i.e., 1month (SPI1) and 3months (SPI3), the instances of negative SPI values inferred were high, which point to the increasing incidences of meteorological drought possibly due to deficient soil moisture. Thus, the results indicated that the CHIRPS precipitation product-derived hydrometeorological indices could act as a valuable tool for assessing the past spatio-temporal drought conditions of the Subarnarekha River basin. This may further be helpful in planning for sustainable water resource management of such river basins.

Investigation of the trend and cycles using the long-term records of annual precipitation in Shandong, China

Abstract The length of historical records is important for analyzing trends and multidecadal variabilities in precipitation. Conventional studies usually used historical precipitation data less than 60 years, which may cause inaccurate precipitation predictions. To better understand the effects of the study period on precipitation trends and cycles, the Mann–Kendall test and Sen's slope test were applied to analyze the trend and wavelet, while the multi-temporal analysis was used to study the cycles of long historical precipitation data at four rain gauge stations in Shandong Province, China. The analysis results using long-term records show an insignificant upward trend and a longer cycle in the annual precipitation, whereas a downward trend is found when using short-term records. Furthermore, it is found that selecting the length of the representative cycle derived from the precipitation data series as the time scale for the study proved to be more reasonable. A thorough consideration of the impact of cycles on trends should, therefore, be taken to facilitate a more accurate precipitation trend analysis.

Pan-Arctic melt pond fraction trend, variability, and contribution to sea ice changes

Because the Pan-Arctic melt pond significantly influences the mass balance of sea ice, analyzing changes in the Pan-Arctic melt pond can offer insights into the Arctic sea ice and environment. In this study, the MODIS level 2 surface reflectance product (MOD09A1) was used to calculate variability and trends in the Pan-Arctic melt pond fraction (MPF) from May 9 to August 29 during the period 2000–2019, along with its relationship with September sea ice extent (SIE). The results showed that as a result of advances in Arctic ice melt onset and the extension of the melting period, the MPF as a whole showed an insignificant upward trend but that the MPF in the multiyear ice area increased significantly. Melt pond distribution is closely related to atmospheric circulation over the Arctic. Significant positive and negative geopotential height anomalies at different locations in the Arctic will cause poleward winds from different directions, bringing warm, humid air and leading to an increase in MPF in different regions of the Arctic. There is a strong negative correlation between integrated MPF and September SIE, concentrated in the northern part of the Beaufort Sea. On June 18, the integrated MPF had the strongest correlation with September SIE, at −0.96. The use of linear regression and support vector machine combined with integrated MPF and 850-hpa average wind, Arctic Oscillation (AO) and North Atlantic Oscillation (NAO) indexes to forecast September SIE shows that the support vector machine is more suitable for forecasting September SIE. When the forecast factor is only the integrated MPF, the MPF is integrated from May 9 to June 10 has the forecast accuracy is the highest, with a considerable forecast skill. When the average May–June AO is combined with the integrated MPF, the forecast skill will be further improved.