Precipitous Drop Research Articles

How Well Did U.S. Rail and Intermodal Freight Respond to the COVID-19 Pandemic versus the Great Recession?

This paper analyzes and compares patterns of U.S. domestic rail freight volumes during and after the disruptions caused by the 2007-2009 Great Recession and the COVID-19 pandemic in 2020. Trends in rail and intermodal (IM) shipment data are examined in conjunction with economic indicators, focusing on the extent of drop and recovery of freight volumes of various commodities and IM shipments, and the lead/lag time with respect to economic drivers. Impacts of the Great Recession and the rebound from it were slow to develop, whereas COVID-19 produced both profound disruptions in the freight market and rapid rebound, with important variations across commodity types. Demand for energy-related commodities (coal, petroleum, and fracking sand) dropped during the pandemic whereas demand for other commodities (grain products and lumber, and IM freight) rebounded rapidly and in some cases grew. Overall, rail freight experienced a rapid rebound following the precipitous drop in traffic in March and April, 2020, achieving a near-full recovery in 5 months. As the recovery proceeded through 2020, IM flow, containers moving by rail for their longest overland trips, rebounded strongly, some exceeding 2019 levels. In contrast, rail flows during the Great Recession changed slowly with the onset and recovery extending over multiple years. Pandemic response reflected the impacts of quick shutdowns and a rapid shift in consumer purchasing patterns. Results for the pandemic illustrate the resilience of the U.S. rail freight industry and the multifaceted role it plays in the overall logistics system. Amid a challenging logistic environment, freight rail kept goods moving when other methods of transport were constrained.

Stability and disruptive speech

Stability and disruptive speech

Effect of Maternal Gradient Nutritional Restriction during Pregnancy on Mammary Gland Development in Offspring.

We aimed to investigate the effect of different levels of nutritional restriction on mammary gland development during the embryonic period by gradient nutritional restriction in pregnant female mice. We started the nutritional restriction of 60 female CD-1(ICR) mice from day 9 of gestation based on 100%, 90%, 80%, 70% and 60% of ad libitum intake. After delivery, the weight and body fat of the offspring and the mother were recorded (n = 12). Offspring mammary development and gene expression were explored by whole mount and qPCR. Mammary development patterns of in offspring were constructed using Sholl analysis, principal component analysis (PCA) and regression analysis. We found that: (1) Mild maternal nutritional restriction (90-70% of ad libitum intake) did not affect offspring weight, while body fat percentage was more sensitive to nutritional restriction (lower at 80% ad libitum feeding). (2) A precipitous drop in mammary development and altered developmental patterns occurred when nutritional restriction ranged from 80% to 70% of ad libitum intake. (3) Mild maternal nutritional restriction (90% of ad libitum intake) promoted mammary-development-related gene expression. In conclusion, our results suggest that mild maternal nutritional restriction during gestation contributes to increased embryonic mammary gland development. When maternal nutritional restriction reaches 70% of ad libitum intake, the mammary glands of the offspring show noticeable maldevelopment. Our results help provide a theoretical basis for the effect of maternal nutritional restriction during gestation on offspring mammary development and a reference for the amount of maternal nutritional restriction.

Selective de-implementation of routine in vivo dosimetry.

As cone-beam computed tomography (CBCT) has become the localization method for a majority of cases, the indications for diode-based confirmation of accurate patient set-up and treatment are now limited and must be balanced between proper resource allocation and optimizing efficiency without compromising safety. We undertook a de-implementation quality improvement project to discontinue routine diode use in non-intensity modulated radiotherapy (IMRT) cases in favor of tailored selection of scenarios where diodes may be useful. After analysis of safety reports from the last 5 years, literature review, and stakeholder discussions, our safety and quality (SAQ) committee introduced a recommendation to limit diode use to specific scenarios in which in vivo verification may add value to standard quality assurance (QA) processes. To assess changes in patterns of use, we reviewed diode use by clinical indication 4 months prior and after the implementation of the revised policy, which includes use of diodes for: 3D conformal photon fields set up without CBCT; total body irradiation (TBI); electron beams; cardiac devices within 10 cm of the treatment field; and unique scenarios on a case-by-case basis. We identified 4459 prescriptions and 1038 unique instances of diode use across five clinical sites from 5/2021 to 1/2022. After implementation of the revised policy, we observed an overall decrease in diode use from 32% to 13.2%, with a precipitous drop in 3D cases utilizing CBCT (from 23.2% to 4%), while maintaining diode utilization in the 5 selected scenarios including 100% of TBI and electron cases. By identifying specific indications for diode use and creating a user-friendly platform for case selection, we have successfully de-implemented routine diode use in favor of a selective process that identifies cases where the diode is important for patient safety. In doing so, we have streamlined patient care and decreased cost without compromising patient safety.

Impact of climate and anthropogenic changes on current and future variability in flows in the Nyong River Basin (equatorial Central Africa)

Abstract Due to climate and environmental changes, sub-Saharan Africa (SSA) has experienced several drought and flood events in recent decades with serious consequences on the economy of the sub-region. In this context, the region needs to enhance its capacity in water resources management, based on both good knowledge of contemporary variations in river flows and reliable forecasts. The objective of this article was to study the evolution of current and future flows in the Nyong River Basin (NRB) in Cameroon. To achieve this, the Pettitt and modified Mann–Kendall tests were used to analyze the hydrometeorological time series in the basin. The SWAT model was used to simulate the future flows in the NRB. During the 1970s, the Nyong basin experienced a joint decrease in rainfall and flow. Despite a general decrease in future precipitation, a significant increase in runoff is expected in this basin, regardless of the period (2022–2060 or 2061–2100), the model (RCA4 or CCCma) and the scenario (representative concentration pathway (RCP) 4.5 or RCP8.5). This increase in flow will be the result of the increase in impervious areas to the detriment of forest in the basin, which will compensate for the drop in precipitation with an increase in runoff.

Abstract Number ‐ 91: A Case of Complex Giant Neck Arteriovenous Malformation Treated with Endovascular Embolization

Introduction Arteriovenous malformations (AVM) of the head and neck are vascular malformations composed of a cluster of connecting arteries and veins that form a central nidus without an intervening capillary network1. They make up 1.5% of vascular malformations and more than 90% of AVMs are located intracranially1. Extracranial AVMs are predominantly located in the head and neck and can manifest with pain, ulcerations, fatal hemorrhage, airway compromise, and cosmetic aberrations1,2. Methods We present a case of a 21 year old female with a medical history of multiple suspected neck hemangiomas status post microsurgical and laser resections, with a surrounding port wine stain, who presented to the hospital with growth of one of her posterior neck hemangiomas during and after pregnancy. In the postpartum period she reported increasing neck pain and persistent bleeding from the site. Initially, she was hemodynamically stable and her neurologic exam did not show any focal deficits. She underwent computed tomography angiogram of her neck which showed an extensive dorsal neck AVM with multiple arterial supplies frombranches of the bilateral subclavian, vertebral, and external carotid arteries.Her lesion continued to bleed with a precipitous drop in hemoglobin requiring blood transfusions. Subsequently, she underwent urgentpercutaneousN‐butyl‐2‐cyanoacrylate (n‐BCA) embolizationand endovascular onyx embolization of a left thyrocervical trunk branch.The procedure was completed without complications. Months later, she developed skin exfoliation and underwent successful elective embolization involving vertebral artery branches. This, to reduce profuse venous shunting in the paravertebral venous plexus, avoiding long term spinal cord injury. Results The management of complex head and neck AVMs is both challenging and complex. They may pose significant bleeding risk and can become infiltrative within surrounding tissue3. AVMs may be classified as either focal or diffuse. Focal lesions may be curable with resection, whereas diffuse lesions pose a significant challenge, with relapse in 90% of cases3. Head and neck AVMs require expert management and a multidisciplinary approach. The team may consist of neurosurgery, neuro‐endovascular,plastic surgery, and dermatology services. Treatment options include medical management, surgical resection, endovascular and percutaneous embolization. Percutaenous n‐BCA embolization is employed to prevent hemorrhage during surgical resection, or stabilization in acute hemorrhage4,5. This holds especially true when an endovascular approach is difficult; typically due to tortuous vasculature5. Treatment may require a staged target approach, with endovascular or percutaneous embolization prior to surgical excision. Conclusions This case highlights the complexities of AVM management and the multidisciplinary approach necessary, to provide optimal care. In this case, we believe that pregnancy could have contributed to the overall change in aggressive nature of the AVM. The patient underwent emergent percutaneous and endovascular embolization to prevent life threatening hemorrhage followed by palliative embolization to avoid long term cervical spinal cord injury due to venous hypertension.

Eudora Welty House & Garden

Eudora Welty House & Garden Jessica Russell If the past year had one theme, it would have been the gift of friendship. How heartening to reunite with fellow admirers of Eudora Welty on the grounds of her family home as our flagship events made their post-pandemic returns. Even so, among staff, 2022 brought challenges that, while unexpected, served to deepen our commitment to our mission and each other. Moreover, for every achievement to follow in this report, there is a friendship to thank—whether with the Eudora Welty Foundation, our colleagues at the Mississippi Department of Archives & History (MDAH), individual volunteers, or community partners too numerous to list—each one a treasured marvel. For, in Eudora Welty's words, "as is true of all friendships, it might not have happened—and it did." Although we were saddened to say goodbye to our dear friend and former director Lauren Rhoades, to our delight she has returned time and again, as a volunteer, a guest, and even a guest speaker. Most impactful, Rhoades now supports sites like ours in an official capacity as the new director of grants at the Mississippi Arts Commission, where she connects arts-based organizations with potential funding opportunities. In this role, Rhoades informed the Eudora Welty Foundation about the Building Fund for the Arts Grant, to which they successfully applied. Because of this very grant, we can make perhaps our biggest announcement of 2022, which is that the Eudora Welty Foundation will break ground on the much-needed community arts building behind our Visitor Center. The report in this volume by the Foundation, which is supervising construction, contains more details on this exciting development. After Rhoades's departure, I had the great honor of transitioning to director. By December, we welcomed Lauren Claret to fill my former role as Garden Projects Specialist, ending a lengthy staff shortage. We even grew our team, adding Mary Atchley as a part-time Visitor Center Associate to handle our gift shop and ticket sales. All the while, my seasoned colleagues, Special Projects Coordinator Rachel Lott, and Education Specialist Jennifer [End Page 189] Rose, continued to shine in their respective roles: Lott coordinates volunteers and plans exhibits, events, and social media. Rose leads educational programs for students of all ages, in groups large and small, onsite and away. With such a small team, our museum depends heavily on volunteers to lead house tours and maintain the Welty garden, and recruiting new volunteers is our greatest need as we look ahead to 2023. We saw a precipitous drop in volunteers at the onset of the pandemic. Although visitation has started a noticeable rise, volunteer numbers have not yet picked up. (On that note, if you or someone you know is interested in becoming a Welty House volunteer, please email info@eudoraweltyhouse.com.) To each of our house docents and Cereus Weeders, we say a heartfelt "thank you." Fortunately, we had the support of two interns last fall. Victoria Richard (Millsaps College, via the Eudora Welty Foundation) led Welty House tours and updated our digital plant records database with an emphasis on the rose collection. Meanwhile, Nikki Maxwell (University of Southern Mississippi, via MDAH) worked primarily off-site with the MDAH Eudora Welty Collection, noting the numerous references to gardening in the recently unsealed Welty family papers. The annual teachers' CEU workshop took place virtually in February of 2022, comparing the works of Welty and Poe. Michael Pickard, Associate Professor of English and Creative Writing at Millsaps College, and Millsaps College Professor emerita Suzanne Marrs, led the course, and they will do so again on February 24, 2023—this time in person at the Eudora Welty House & Garden Visitor Center—comparing the work of Welty and Nathaniel Hawthorne. Thanks to support from MDAH and the Eudora Welty Foundation, teachers may attend the 2023 workshop at no charge. The in-person return of the Mississippi Book Festival in 2022 made for an exciting weekend in late August, when museum staff treated 110 festival panelists to private tours of the Welty House and Garden. We spent the next day seeing old friends, and making new ones, as 500 fellow book lovers visited our booth at the...

Climatic and Vegetation Response Patterns over South Africa during the 2010/2011 and 2015/2016 Strong ENSO Phases

El Niño-Southern Oscillation (ENSO) is a significant climate phenomenon on Earth due to its ability to change the global atmospheric circulation which influences temperature and precipitation across the globe. In this study, we investigate the responses of climatic and vegetation parameters due to two strong ENSO phases, i.e., La Niña (2010/2011) and El Niño (2015/2016) in South Africa. The study aims to understand the influence of strong seasonal ENSO events on climatic and vegetation parameters over South Africa. Remote sensing data from the Global Precipitation Measurement (GPM), Moderate Resolution Imaging Spectroradiometer (MODIS), Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2) and Atmospheric Infrared Sounder (AIRS) was used. The relationship between precipitation, temperature, and Normalized Difference Vegetation Index (NDVI) were studied using Pearson’s correlation. Comparison between the La Niña, neutral year, and El Niño periods showed two interesting results: (1) higher precipitation from the south coast to the east coast of South Africa, with some low precipitation in the interior during the La Niña and El Niño periods, and (2) a drop in precipitation by ~46.6% was observed in the southwestern parts of South Africa during the La Niña and El Niño events. The study further showed that wind speed and wind direction were not impacted by strong ENSO events during the MAM, JJA and SON seasons, but the DJF season showed varying wind speeds, especially on the west coast, during both ENSO events. Overall, the Pearson’s correlation results clearly showed that the relationship between climatic parameters such as precipitation, temperature, and vegetation parameters such a NDVI is highly correlated while other parameters, such as wind speed and direction, are not. This study has provided new insights into the relationship between temperature, precipitation, and NDVI in South Africa; however, future work will include other climatic and vegetation parameters such as relative humidity and net longwave radiation.

The Retrieval of Drop Size Distribution Parameters Using a Dual-Polarimetric Radar

The raindrop size distribution (DSD) is vital for applications such as quantitative precipitation estimation, understanding microphysical processes, and validation/improvement of two-moment bulk microphysical schemes. We trace the history of the DSD representation and its linkage to polarimetric radar observables from functional forms (exponential, gamma, and generalized gamma models) and its normalization (un-normalized, single/double-moment scaling normalized). The four-parameter generalized gamma model is a good candidate for the optimal representation of the DSD variability. A radar-based disdrometer was found to describe the five archetypical shapes (from Montreal, Canada) consisting of drizzle, the larger precipitation drops and the ‘S’-shaped curvature that occurs frequently in between the drizzle and the larger-sized precipitation. Similar ‘S’-shaped DSDs were reproduced by combining the disdrometric measurements of small-sized drops from an optical array probe and large-sized drops from 2DVD. A unified theory based on the double-moment scaling normalization is described. The theory assumes the multiple power law among moments and DSDs are scaling normalized by the two characteristic parameters which are expressed as a combination of any two moments. The normalized DSDs are remarkably stable. Thus, the mean underlying shape is fitted to the generalized gamma model from which the ‘optimized’ two shape parameters are obtained. The other moments of the distribution are obtained as the product of power laws of the reference moments M3 and M6 along with the two shape parameters. These reference moments can be from dual-polarimetric measurements: M6 from the attenuation-corrected reflectivity and M3 from attenuation-corrected differential reflectivity and the specific differential propagation phase. Thus, all the moments of the distribution can be calculated, and the microphysical evolution of the DSD can be inferred. This is one of the major findings of this article.

Increasing livelihood vulnerabilities to coastal erosion and wastewater intrusion: The political ecology of Thai aquaculture in peri‐urban Bangkok

AbstractMost livelihood research focuses on micro‐level decisions affecting occupations but fails to examine wider scale processes that shape markets, institutions, and thus livelihood choices. A political ecology framework can help address this gap by providing ways to analyse how multi‐scalar and extra‐local practices, policies, and discourses affect local‐level socio‐environmental outcomes. In the qualitative research reported here, that framework is applied to Tha Kam, a peri‐urban coastal sub‐district of Bangkok, where most residents are small‐scale aquaculture farmers. These farmers have experienced precipitous drops in incomes because of two major environmental changes: coastal erosion and wastewater intrusion. The causes are multiple and complex, and many originate not from practices within Tha Kham but from challenges present at a larger scale or that start upstream. The political and economic drivers of these problems stem from Thailand’s fragmented vertical and horizontal governance structure, unequal class relations in which smallholder farmers and peri‐urban residents are marginalised, and lack of accountability and representation. This combination of multi‐scalar factors and power imbalances has contributed to evolving injustices of peri‐urbanisation, all of which are profoundly geographical in their significance.

Bald eagle mortality and nest failure due to clade 2.3.4.4 highly pathogenic H5N1 influenza a virus

The bald eagle (Haliaeetus leucocephalus) is a culturally and ecologically vital species in North America that embodies conservation success but continues to face threats that include emerging pathogens. The introduction of A/goose/Guangdong/1/1996 lineage highly pathogenic (HP) clade 2.3.4.4b H5N1 influenza A virus (IAV) in North America in late 2021 resulted in high rates of mortality among bald eagles. Here we show an alarming rate of bald eagle nest failure and mortality attributed to HP IAV. We documented fatal, systemic HP IAV infection in breeding adult and nestling bald eagles along the southeastern U.S. coast. Concurrently, annual bald eagle nest surveys in Georgia and Florida revealed a precipitous drop in success in coastal counties compared with previous years, portending negative impacts on population recruitment. As an apex predator and efficient scavenger, it is likely that bald eagles become infected through consumption of infected waterfowl. These results and similar reports of raptor mortality in Europe, Asia, and Africa, indicate a clear threat to raptor health. The possible long-term persistence of HP H5N1 IAV in North America poses an impending threat to bald eagle populations not only related to direct mortality but also decreased recruitment and warrants continued efforts to understand these potential impacts.

A metal-organic framework surrounded with conjugate acid-base pairs for the efficient capture of Cr(VI) via hydrogen bonding over a wide pH range.

Given the large amount of toxic Cr(VI) wastewater from various industries, it is urgent to take effective treatment measures. Adsorption has been regarded as highly desirable for Cr(VI) removal, but the effectiveness of most adsorbents is significantly dependent on pH value, in which precipitous performance drop and even structural collapse generally occur in strong acidic/alkaline aqueous. Thus, maintaining high adsorption performance and structural integrity over a wide pH range is challenging. To efficiently remove Cr(VI), we designed and prepared of an acid-base resistant metal-organic framework (MOF) Zr-BDPO, by introducing weak acid-base groups (-NH-, -N= and -OH) onto the ligand. Zr-BDPO achieved a maximum adsorption capacity of 555.6mg·g-1 and retained skeletal structure at pH=1-11. Interestingly, all these groups can generate conjugate acid-base pairs by means of H+ and OH- in the external solution and then form buffer layer. The removal of Cr(VI) at a broad range of pH values primarily via hydrogen bonds between -NH- and -OH, and the oxoanion species of Cr(VI) is unusual. This strategy that insulating high concentrations of acids and bases and relying on hydrogen bonds to capture Cr(VI) oxoanions provides a new perspective for actual Cr(VI) wastewater treatment.

Changes in Sleep Regularity and Perceived Life Stress across the COVID-19 Pandemic: A Longitudinal Analysis of a Predominately Female United States Convenience Sample

The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on sleep and psychological well-being for individuals worldwide. This pre-registered investigation extends our prior study by tracking self-reported social jetlag (SJL), social sleep restriction (SSR), and perceived life stress from May 2020 through October 2021. Using web-based surveys, we collected self-reported sleep information with the Ultrashort Munich Chronotype Questionnaire at three additional timepoints (September 2020, February 2021 and October 2021). Further, we measured perceived life stress with the Perceived Stress Scale at two additional timepoints (February 2021 and October 2021). In a subsample of 181, predominantly female (87%), United States adults aged 19-89 years, we expanded our prior findings by showing that the precipitous drop in SJL during the pandemic first wave (May 2020), compared to pre-pandemic (February, 2020), rapidly rose with loosening social restrictions (September 2020), though never returned to pre-pandemic levels. This effect was greatest in young adults, but not associated with self-reported chronotype. Further, perceived life stress decreased across the pandemic, but was unrelated to SJL or SSR. These findings suggest that sleep schedules were sensitive to pandemic-related changes in social restrictions, especially in younger participants. We posit several possible mechanisms supporting these findings.

Soluble components from mesenchymal stromal cell processing exert anti-inflammatory effects and facilitate ischemic muscle regeneration

Background aimsSkeletal muscle regeneration after severe damage is reliant on local stem cell proliferation and differentiation, processes that are tightly regulated by macrophages. Peripheral artery disease is a globally prevalent cardiovascular disease affecting millions of people. Progression of the disease leads to intermittent claudication, subsequent critical limb ischemia and muscle injury. Tissue-derived and ex vivo–expanded mesenchymal stromal cells (MSCs) for skeletal muscle regeneration have been studied, but pre-clinical and clinical results have not been consistent. As a result, the potential therapeutic efficacy and associated repair mechanisms of MSCs remain unclear. Numerous studies have demonstrated the vulnerability of delivered MSCs, with a precipitous drop in cell viability upon transplantation. This has prompted investigation into the therapeutic benefit of apoptotic cells, microvesicles, exosomes and soluble signals that are released upon cell death. MethodsIn this study, we characterized various components produced by MSCs after cell death induction under different conditions. We discovered anti-inflammatory and pro-regenerative effects produced by cell components following a freeze and thaw (F&T) process on macrophage polarization in vitro. We further investigated the underlying mechanisms of macrophage polarization by those components resulting from severe cell death induction. ResultsWe found potent therapeutic effects from F&T-induced cell debris are dependent on the externalization of phosphatidylserine on the plasma membrane. In contrast, effects from the supernatant of F&T-induced cell death primarily depends on the released protein content. We then applied the F&T-induced cell supernatant to an animal model of peripheral artery disease to treat muscle injury caused by severe ischemia. Treatment with the F&T supernatant but not the vulnerable MSCs resulted in significantly improved recovery of muscle function, blood flow and morphology and inflammation resolution in the affected muscles 2 weeks after injury. ConclusionsThis study validates the therapeutic potential of F&T-induced supernatant obviating the need for a viable population from vulnerable MSCs to treat injury, thus providing a roadmap for cell-free therapeutic approaches for tissue regeneration.

166. Bring your boots: wading through GI PCR panel diagnostic stewardship applications

Abstract Background Infectious diarrhea is a common cause of emergency department (ED) visits and hospital admissions. Polymerase chain reaction (PCR) testing allows for quick and expansive pathogen identification and facilitates earlier targeted treatment. We implemented a multiplex gastrointestinal (GI) PCR panel in 2014. In collaboration with the Antimicrobial and Diagnostic Advisement Program (ADAP), post-launch optimization strategies have changed test use. We evaluate the impact of diagnostic stewardship initiatives. Methods GI PCR testing was initially unrestricted for ED or inpatients within 72 hours of admission. After fielding many questions regarding interpretation, the ADAP developed a guidance document in June 2019 regarding treatment considerations for all potential organisms detected. In January 2020, organism-specific treatment considerations were embedded in the test results real-time treatment guidance (figure 1). A pre-post quality improvement assessment of the changes was performed. In August 2021, individual GI PCR panel orders were replaced with an order set containing a decision tree to provide passive guidance evaluating acute vs chronic diarrhea, assessing recent antibiotic use (to consider C. difficile testing), no testing scenarios, and avoiding repeat testing (figure 2). Figure 1Example of templated comments for Norovirus embedded within GI PCR panel results. Figure 2 GI PCR panel order set Results GI PCR panel use peaked in 2019 with 3,142 tests processed. The guidance document was less helpful, requiring an external site link. Embedding organism-specific GI PCR guidance significantly improved appropriate antibiotic prescribing (77.9 vs 89.1%, p=0.001). A precipitous drop off in GI PCR test orders occurred after the COVID-19 pandemic began (1,774 in 2020), partly attributed to supply chain issues. When comparing intra-pandemic years (2020 vs 2021), implementation of a smart order set was associated with a 51.3% reduction in orders (1,774 vs 864) and $131,000 in savings despite significant patient volume increases in 2021. Low use rates have persisted into the first quarter of 2022 (n=229). Conclusion Diagnostic stewardship changes should be proactive and contextually relevant at the time of result interpretation. Antimicrobial stewardship programs are uniquely positioned to lead optimization initiatives and drive clinical and cost-effective solutions. Disclosures All Authors: No reported disclosures.

Seasonal behaviour and influence of altitude on fog‐water collection in the Eastern Iberian Peninsula (2003–2012)

AbstractA study on fog‐water collection potential at the Mediterranean Iberian Peninsula was carried out for the period 2003–2012. The area is denoted by a high population density, with fairly common water restrictions in certain periods during the year. Moreover, climate change projections point out a sharp drop in precipitation for this sector of the western Mediterranean Basin that would aggravate water problems. This work aims to look closely at knowledge of fog‐water collection and it presents results about: its behaviour during different seasons of the year; the fog‐water collection potential on dry days (precipitation <1 mm); the influence of site elevation on both collected volumes and the number of days with fog‐water collection. To do so, daily fog‐water collection data were analysed from 2003 to 2012 with a dense network of 23 fog‐water collectors, which run along the Mediterranean coast of the Iberian Peninsula. The most relevant results were: (a) the seasonal periods with the largest recorded fog‐water volumes were autumn and spring; the highest percentages of days with fog‐water collection were obtained in summer and autumn; (b) on days when precipitation was null or negligible (<1 mm), maximum daily fog‐water captures were considerable and exceeded 25 L m−2 at more than half the studied sites; (c) the greater the positive difference in elevation between nearby stations, the larger the positive difference in both fog collected volumes and fog days at equal exposition to prevailing winds, differences that increase in the summer period. Mount Muela (Murcia Region), combining a pair of stations only distanced by 600 m but at a 92‐m elevation difference, reported a contrast of two times the collected volume at the upper station compared to the lower and an increment of 61% more days with fog occurrence. Mount Montseny (Catalonia), with a pair of stations distanced by 1,600 m horizontally and 398 m in elevation difference, obtained a sixfold variation between stations for fog‐water collection and a 73% increment in foggy days.

Energy Transfer in Aqueous Light Harvesting Antennae Based on Brush-like Inter-Conjugated Polyelectrolyte Complexes.

Conjugated polyelectrolytes (CPEs) have the potential to serve as building blocks of artificial light-harvesting systems. This is primarily due to their delocalized electronic states and potential for hierarchical self-assembly. We showed previously that inter-CPE complexes composed of oppositely charged exciton-donor and exciton-acceptor CPEs displayed efficient electronic energy transfer. However, near ionic charge equivalence, complexed CPE chains become net-neutral and thus experience a precipitous drop in aqueous solubility. To increase the stability and to rationally manipulate the phase behavior of inter-CPE complexes, we synthesized a series of highly water-soluble exciton-donor CPEs composed of alternating ionic and polar nonionic fluorene monomers. The nonionic monomer contained oligo(ethyleneglycol) sidechains of variable length. We then formed exciton donor-acceptor complexes and investigated their relative energy transfer efficiencies in the presence of a fixed exciton-acceptor CPE. We find that, even when the polar nonionic sidechains become quite long (nine ethyleneglycol units), the energy transfer efficiency is hardly affected so long as the inter-CPE network retains a net polyelectrolyte charge. However, near the onset of spontaneous phase separation, we observe a clear influence of the length of the oligo(ethyleneglycol) sidechains on the photophysics of the complex. Our results have implications for the use of polyelectrolyte phase separation to produce aqueous light-harvesting soft materials.

COVID-19 Outcomes at a Comprehensive Sickle Cell Center: A Two-Year Report

The Georgia Comprehensive Sickle Cell (SC) center at Grady health system is the largest adult comprehensive sickle cell center in the United States and has the first 24/7 acute care unit for management of sickle cell vaso-occlusive events (VOE). in 2019, the center provided around 3000 sickle cell clinic visits and 4000 acute care visits. When the COVID-19 pandemic reached the US, the SC center had seen a precipitous drop in the number of both clinic and acute care visits as local and state regulations for lockdown were passed. On the two-year anniversary for the COVID-19 pandemic, we are submitting this report of all the COVID-19 cases at a single adult center for sickle cell disease. Since the start of the pandemic, we have been tracking any COVID-19 cases reported in the patient population the SC center follows. Out of 1343 patients currently following in the center, 173 patients contracted COVID-19 between March 2020 and February 2022, and were tracked in the clinical database under IRB approval. The results show that of the 173 patients, 85 were female and 89 were male. By genotype, 62% of patients were SS, 29% were SC and 9% were Sβ+ thalassemia or Sβ0 thalassemia. 32% of patients were on hydroxyurea for disease modification with the majority of them being of the SS genotype and 45% had elevated fetal hemoglobin determined by a percentage fetal hemoglobin above 5% by hemoglobin electrophoresis. Chronic pain was defined in the patients experiencing daily pain episodes for more than 4 days a week for the last 3 months and calculation of daily morphine equivalents was reported based on the clinic follow-ups and the narcotic database utilization. 35% of the SC patients had chronic pain and the median morphine equivalents was 90 mg daily with a range between 45 and 225mg. On evaluating the rate of emergency department (ED) visits or hospitalizations for the sickle cell patients with COVID-19, 85% of patients had either an ED visit or hospitalization. 54% of the SC patients had the reason for the visit related to VOE and 29% had the reason related to COVID-19 primarily. 15% of SC patients were not seen in any emergency setting or required any hospitalization. 22% of the patients had lung findings on imaging. The treatment utilized for the patients was most commonly Remdesivir in 33, dexamethasone in 26, red cell products in 21 and monoclonal antibody in 13 patients. Of the 3 deaths reported, 2 happened early in the pandemic. One patient had presented in June 2020 with VOE and was found to have bilateral lung opacities but was asymptomatic and was discharged home to return few days later with clinical picture of multi-organ failure (MOF) for which a red cell erythrocytapheresis was attempted to no avail. The second patient had presented in July 2020 with COVID-19 pneumonia and was treated with Remdesivir and convalescent plasma to no avail after development of MOF and ARDS. The third death occurred in August 2021 during the delta variant wave and the patient was hospitalized for COVID-19 pneumonia and had initial improvement after initial treatment but after worsened lung findings, ARDS developed followed by MOF. Several reports from different centers have been published regarding the rate of COVID-19 related mortality and morbidity in sickle cell disease. The Grady comprehensive sickle cell center experience differs in the fact that 63 out of 173 (36%) patients who had contracted COVID-19 required treatment and 3 of those 63 had died. In fact, the deaths occurred early in the course of the pandemic in June and July 2020 respectively and since then, the rate of complicated COVID-19 hospitalizations has decreased with better treatment available. No deaths were registered during the omicron wave and 1 death was registered during the delta wave. In addition, the timeline for the COVID-19 cases reported fits the population timeline of peaks respectively happening in the summer of 2020, winter of 2021, summer of 2021 and winter of 2021. During the initial peak, we have noted a decrease in the number of clinic and acute care visits respectively. This was anticipated given the statewide lockdown that was implemented. To circumvent that, the SC center resorted to virtual visits utilization to deliver the needed healthcare visits to the patients. This measure has aided in protecting patients against COVID-19 during the multiple COVID-19 peaks occurring in the last 2 years and has accordingly reduced the mortality and morbidity of the patient population. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The impact of the COVID-19 pandemic on paediatric surgical volumes in Africa: A retrospective observational study

BackgroundThe aim of this study is to investigate the impact that COVID-19 had on the pattern and trend of surgical volumes, urgency and reason for surgery during the first 6 months of the pandemic in sub-Saharan Africa. MethodsThis retrospective facility-based study involved collection of paediatric operation data from operating theatre records across 5 hospitals from 3 countries: Zimbabwe, Zambia and Nigeria over the first half of 2019 and 2020 for comparison. Data concerning diagnosis, procedure, anaesthesia, grade, speciality, NCEPOD classification and indication was collected. The respective dates of enactment of cancellation policies in each country were used to compare changes in weekly median surgical case volume before cancellation using the Wilcoxon Sign-Rank Test. ResultsA total of 1821 procedures were recorded over the study period. Surgical volumes experienced a precipitous drop overall from a median of 100 cases/week to 50 cases/week coinciding with cancellation of surgical electives. Median accumulated weekly procedures before COVID-related cancellation were significantly different from those after cancellation (p = 0.027). Emergency surgery fell by 23.3% while electives fell by 78,9% (P = 0.042). The most common primary indication for surgery was injury which experienced a 30.5% drop in number of procedures, only exceeded by congenital surgery which dropped 34.7%. ConclusionsThe effects of surgical cancellations during the covid-19 pandemic are particularly devastating in African countries where the unmet need and surgical caseload are high. Continued cancellations that have since occurred will cause similar drops in surgical case volume that these health systems may not have the resilience to recover from. Level of EvidenceLevel II.

Witnessing mass extinction: What's invisible, what's visible, what's possible

We are living in the time of the Sixth Mass Extinction. While many details elude us, we know that a mass extinction is underway from comparisons between background and current extinction rates, precipitous drops in wildlife populations, the shrinking of wild places, and the critical endangerment of biodiverse ecologies such as grasslands, tropical forests, wetlands, rivers and lakes, coral reefs, and continental shelves. This paper dissects the underpinnings of the Sixth Mass Extinction, with the intention of joining many other activists and thinkers to disrupt its seeming inevitability. First, I discuss what has been invisible about anthropogenic mass extinction—the event itself—and the factors of silence, ignorance, and denial underlying its invisibility. Then I turn to the visible dimension of the Sixth Mass Extinction, namely, the action orientation of “entitled instrumentalism” that is driving it; I describe entitled instrumentalism as the wholesale assimilation of the natural world into a human-owned domain. I end with considering the possibility of humanity charting an altogether different course. We must recognize mass extinction as the inevitable upshot of nature colonization and awaken to the need to restore and preserve Earth's cosmic wealth.