Rapid Reduction Research Articles

Ultrasonic controllable synthesis of sulfur-functionalized metal–organic frameworks (S-MOFs) and their application in piezo-photocatalytic rapid reduction of hexavalent chromium (Cr)

The United Nations’ Sustainable Development Goals (SDGs) are significant in guiding modern scientific research. In recent years, scholars have paid much attention to MOFs materials as green materials. However, piezo catalysis of MOFs materials has not been widely studied. Piezoelectric materials can convert mechanical energy into electrical energy, while MOFs are effective photocatalysts for removing pollutants. Therefore, it is crucial to design MOFs with piezoelectric properties and photosensitivity. In this study, sulfur-functionalized metal–organic frameworks (S-MOFs) were prepared using organic sulfur-functionalized ligand (H2TDC) ultrasonic synthesis to enhance their piezoelectric properties and visible light absorption. The study demonstrated that the S-MOFs significantly enhanced the reduction of a 10 mg/L solution of hexavalent chromium to 99.4 % within 10 min, using only 15 mg of catalyst. The orbital energy level differences of the elements were analyzed using piezo response force microscopy (PFM) and X-ray photoelectron spectroscopy (XPS). The results showed that MOFs functionalized with sulfur atom ligands have a built-in electric field that facilitates charge separation and migration. This study presents a new approach to enhance the piezoelectric properties of MOFs, which broadens their potential applications in piezo catalysis and piezo-photocatalysis. Additionally, it provides a sustainable method for reducing hexavalent chromium, contributing to the achievement of sustainable development goals, specifically SDG-6, SDG-7, SDG-9, and SDG-12.

Multi-source remote sensing big data mining reveals cross-regional correlation between aquaculture and Enteromorpha disaster outbreaks

ABSTRACT Marine aquaculture is one of the most important marine resource utilization types, widely distributed in seashore areas. Because mass marine aquaculture development will lead to the eutrophication disaster of macroalgae blooms (green tide), it is imperative to discover the latent relationship. Inspired by the big data analysis theory, the spatiotemporal correlation change in 2017 and 2019 of the marine aquaculture and macroalgae blooms in Jiangsu Shoal in the West of the Yellow Sea and its adjacent seas were monitored and extracted respectively based on multi-source remote sensing images. Through optical and Synthetic Aperture Radar (SAR) images, the imaging characteristics of marine aquaculture in different growth cycles and sea conditions are analyzed. The relationship between the green tide and marine aquaculture harvest was explored from the early green algae distribution and spatiotemporal distribution changes. The earliest harvest area of marine aquaculture is the exact location of the outbreak of green tide. Along with the rapid reduction of aquaculture area, the distribution range of green tide gradually increased. The two showed opposite trends through many multi-source remote sensing data statistical analyses. Therefore, they have a strong correlation, which can be utilized to offer a significant value for the balance of marine environmental protection and resource development.

An Overview Analysis of Current Research Status in Iron Oxides Reduction by Hydrogen

This paper focuses on the study of current knowledge regarding the use of hydrogen as a reducing agent in the metallurgical processes of iron and steel production. This focus is driven by the need to introduce environmentally suitable energy sources and reducing agents in this sector. This theoretical study primarily examines laboratory research on the reduction of Fe-based, metal-bearing materials. The article presents a critical analysis of the reduction in iron oxides using hydrogen, highlighting the advantages and disadvantages of this method. Most experimental facilities worldwide employ their unique original methodologies, with techniques based on Thermogravimetric analysis (TGA) devices, fluidized beds, and reduction retorts being the most common. The analysis indicates that the mineralogical composition of the Fe ores used plays a crucial role in hydrogen reduction. Temperatures during hydrogen reduction typically range from 500 to 900 °C. The reaction rate and degree of reduction increase with higher temperatures, with the transformation of wüstite to iron being the slowest step. Furthermore, the analysis demonstrates that reduction of iron ore with hydrogen occurs more intensively and quickly than with carbon monoxide (CO) or a hydrogen/carbon monoxide (H2/CO) mixture in the temperature range of 500 °C to 900 °C. The study establishes that hydrogen is a superior reducing agent for iron oxides, offering rapid reduction kinetics and a higher degree of reduction compared to traditional carbon-based methods across a broad temperature range. These findings underscore hydrogen’s potential to significantly reduce greenhouse gas emissions in the steel production industry, supporting a shift towards more sustainable manufacturing practices. However, the implementation of hydrogen as a primary reducing agent in industrial settings is constrained by current technological limitations and the need for substantial infrastructural developments to support large-scale hydrogen production and utilization.

Comprehensive Virtual Treatment for Severe Anxiety in Youth: A Case Report

Anxiety disorders and obsessive-compulsive disorder (OCD) are among the most common mental health conditions in children and adolescents and are associated with various impairments and long-term consequences. Evidence-based treatments exist but are often lacking in elements needed to effectively treat youth with more severe presentations. This case report illustrates a patient’s treatment course in an innovative program for children, adolescents, and young adults with severe anxiety. The program offers a continuum of outpatient, evidence-based care tailored to the severity of the patient’s condition. The case study focuses on “Jane,” an adolescent female with anxiety as well as obsessive-compulsive spectrum disorders, who had previously received extensive treatment without sustained improvement. Through the program’s three treatment phases, Jane and her parents demonstrated consistent engagement and adherence to treatment. Jane showed significant progress, with rapid reduction in symptoms and functional impairment. This case report underscores key elements of this treatment that address gaps in traditional approaches to care, particularly for patients with severe presentations, including the coordinated, team-based approach; the continuum of evidence-based, phased treatment titrated to need; the utilization of virtual individual, group and parent-focused care and between-session coaching to enhance learning generalization; and the use of measurement-based care. Further research is warranted to evaluate the generalizability and long-term outcomes of this program and its potential to transform the treatment landscape for pediatric anxiety and OCD.

The use of anabolic agents in the treatment of osteoporosis: a clinical update.

Anabolic therapies have revolutionized the management of patients with osteoporosis, especially those at very high fracture risk. The current review offers valuable insights into the latest evidence and guidelines on the use of anabolic agents, focusing on their comparative efficacy, safety profiles, and optimal implementation in clinical practice. Romosozumab, abaloparatide, and teriparatide have shown superior efficacy when compared to antiresorptive therapies in increasing bone mineral density and reducing fracture risk. Notably, sequential treatment strategies, commencing with an anabolic agent followed by an antiresorptive, has emerged as an effective approach for both rapid and sustained reduction of fracture risk in patients at high risk. Additionally, anabolics have shown potential in improving outcomes for patients who have a suboptimal response to antiresorptives. Careful patient selection and vigilant monitoring are essential to optimize therapeutic benefits while mitigating the potential risks. As we gain more clinical experience with these agents, we will better understand how to use them effectively, as part of long term, sequential treatment strategies. Ongoing research into novel anabolic therapies and innovative treatment sequences holds promise for expanding our toolkit against fragility fractures. Integrating anabolic agents into personalized treatment plans has the potential to significantly improve outcomes and quality of life for patients with severe osteoporosis, highlighting the importance of this therapeutic class in the management of this chronic condition.

How quickly does wood fragment in rivers? Methodological challenges, preliminary findings, and perspectives

AbstractLarge wood plays a significant role in fluvial ecosystems, influencing river geomorphology and ecology. However, it poses both benefits to river systems and risks, making it essential to understand its dynamics for effective management. A better understanding the wood breakdown process is required to evaluate the flood risk of wood in rivers. This paper aims to evaluate early‐stage fragmentation of wood in rivers after being recruited through bank erosion, taking into account its mobility and residence time. Two methods for characterising and monitoring wood fragmentation are suggested and compared: 1) photo‐interpretation based on ground and drone photo and 2) terrestrial LiDAR. We used Quantitative Structure Modelling (QSM) of point clouds to accurately simulate the full branching structure of trees. Close relationships exist between photo‐interpreted and LiDAR‐derived complexity metrics, but a scaled parameter (i.e., diameter) is needed to correlate branching complexity with volume. The debranching process occurs quickly, with a median reduction in branching complexity of over 80% within the initial 2 years. Further research with a larger sample size is necessary to investigate the impact of context – including transportation, submersion, accumulation, and isolation of wood pieces – on the fragmentation process. Field observations indicate that immobile wood pieces can experience a rapid reduction in their branching complexity, similar to the ones that are transported. Partial fine branching structure can be maintained on transported pieces. Both photo‐interpretation and terrestrial LiDAR offer complimentary approaches to monitoring wood fragmentation. Photo‐interpretation is easily implementable and may be used as a proxy for mechanical fragmentation, while terrestrial LiDAR may be used to monitor 3D wood fragmentation, volume and length evolution, following QSM modelling.

Effects of Achieving Rapid, Intensive, and Sustained Blood Pressure Reduction in Intracerebral Hemorrhage Expansion and Functional Outcome.

The time taken to achieve blood pressure (BP) control could be pivotal in the benefits of reducing BP in acute intracerebral hemorrhage (ICH). We aimed to assess the relationship between the rapid achievement and sustained maintenance of an intensive systolic BP (SBP) target with radiologic, clinical, and functional outcomes. Rapid, Intensive, and Sustained BP lowering in Acute ICH (RAINS) was a multicenter, prospective, observational cohort study of adult patients with ICH <6 hours and SBP ≥150 mm Hg at 4 Comprehensive Stroke Centers during a 4.5-year period. Patients underwent baseline and 24-hour CT scans and 24-hour noninvasive BP monitoring. BP was managed under a rapid (target achievement ≤60 minutes), intensive (target SBP <140 mm Hg), and sustained (target stability for 24 hours) BP protocol. SBP target achievement ≤60 minutes and 24-hour SBP variability were recorded. Outcomes included hematoma expansion (>6 mL or >33%) at 24 hours (primary outcome), early neurologic deterioration (END, 24-hour increase in NIH Stroke Scale score ≥4), and 90-day ordinal modified Rankin scale (mRS) score. Analyses were adjusted by age, sex, anticoagulation, onset-to-imaging time, ICH volume, and intraventricular extension. We included 312 patients (mean age 70.2 ± 13.3 years, 202 [64.7%] male). Hematoma expansion occurred in 70/274 (25.6%) patients, END in 58/291 (19.9%), and the median 90-day mRS score was 4 (interquartile range, 2-5). SBP target achievement ≤60 minutes (178/312 [57.1%]) associated with a lower risk of hematoma expansion (adjusted odds ratio [aOR] 0.43, 95% confidence interval [CI] 0.23-0.77), lower END rate (aOR 0.43, 95% CI 0.23-0.80), and lower 90-day mRS scores (aOR 0.48, 95% CI 0.32-0.74). The mean 24-hour SBP variability was 21.0 ± 7.6 mm Hg. Higher 24-hour SBP variability was not related to expansion (aOR 0.99, 95% CI 0.95-1.04) but associated with higher END rate (aOR 1.15, 95% CI 1.09-1.21) and 90-day mRS scores (aOR 1.06, 95% CI 1.04-1.10). Among patients with acute ICH, achieving an intensive SBP target within 60 minutes was associated with lower hematoma expansion risk. Rapid SBP reduction and stable sustention within 24 hours were related to improved clinical and functional outcomes. These findings warrant the design of randomized clinical trials examining the impact of effectively achieving rapid, intensive, and sustained BP control on hematoma expansion. This study provides Class III evidence that in adults with spontaneous ICH and initial SBP ≥150 mm Hg, lowering SBP to <140 mm Hg within the first hour and maintaining this for 24 hours is associated with decreased hematoma expansion.

Study on the microstructure evolution and effect on mechanical properties of P92 steel during long term service

P92 heat-resistant steel is widely utilized in ultra-supercritical units due to its exceptional properties. This study examines the microstructure evolution and mechanical properties change of P92 during service spanning 0 to 93,000 h, while also exploring the correlation between microstructure changes and property variations. The results indicate that the matrix of P92 steel retains its characteristic tempered martensite structure, and the large-angle and small-angle grain boundaries in the steel remain nearly unchanged throughout extended service periods. However, the deterioration of P92 steel properties can mainly be attributed to alterations in precipitate size and martensitic lath width. The size of M23C6 and Laves particles increased from their initial dimensions of 150 nm and 0 nm to 260 nm and 370 nm, respectively. Moreover, the width of the martensitic lath increased from 350 nm to 700 nm. The martensitic lath contributes over 60 % of the theoretical tensile strength, playing a pivotal role in the exceptional strength of P92 steel during service. The presence of coarse Laves particles at the interface leads to a rapid reduction in impact energy, decreasing from approximately 130 J to 50 J, negatively affecting the impact energy of P92 steel.

The role of Au and Pd in photocatalytic activation of molecular oxygen: A mechanistic study

Activation of molecular oxygen plays an important role in photocatalytic selective oxidation reactions and complete degradation of organic pollutants. Noble metal cocatalysts are often employed to modulate the activation of oxygen to reach an optimum photocatalytic performance. However, the role of the metal nanoparticles (NPs) still remains unclear and deserves investigation for the design of efficient photocatalysts. Here, Au and Pd NPs are deposited on the TiO2 photocatalyst to study the promotional mechanism of O2 dissociation with the presence of glycerol under irradiation by near-ambient-pressure photoelectron spectroscopy and in-situ spectrometry approaches. While both Au and Pd NPs can dissociate O2 into activated oxygen species, a relatively strong bonds of dissociated oxygen atom is observed on Au NPs than on the Pd NPs. This results in a moderate reduction rate of O2 and eventually favors a mild oxidation reaction process for Au, and a rapid reduction rate of O2 and eventually a deep oxidation reaction process for Pd, respectively.

Human CD4+ iNKT cell adoptive immunotherapy induces anti-tumour responses against CD1d-negative EBV-driven B lymphoma.

Invariant natural killer T (iNKT) cells are a conserved population of innate T lymphocytes that are uniquely suitable as off-the-shelf cellular immunotherapies due to their lack of alloreactivity. Two major subpopulations of human iNKT cells have been delineated, a CD4- subset that has a TH1/cytolytic profile, and a CD4+ subset that appears polyfunctional and can produce both regulatory and immunostimulatory cytokines. Whether these two subsets differ in anti-tumour effects is not known. Using live cell imaging, we found that CD4- iNKT cells limited growth of CD1d+ Epstein-Barr virus (EBV)-infected B-lymphoblastoid spheroids in vitro, whereas CD4+ iNKT cells showed little or no direct anti-tumour activity. However, the effects of the two subsets were reversed when we tested them as adoptive immunotherapies in vivo using a xenograft model of EBV-driven human B cell lymphoma. We found that EBV-infected B cells down-regulated CD1d in vivo, and administering CD4- iNKT cells had no discernable impact on tumour mass. In contrast, xenotransplanted mice bearing lymphomas showed rapid reduction in tumour mass after administering CD4+ iNKT cells. Immunotherapeutic CD4+ iNKT cells trafficked to both spleen and tumour and were associated with subsequently enhanced responses of xenotransplanted human T cells against EBV. CD4+ iNKT cells also had adjuvant-like effects on monocyte-derived DCs and promoted antigen-dependent responses of human T cells in vitro. These results show that allogeneic CD4+ iNKT cellular immunotherapy leads to marked anti-tumour activity through indirect pathways that do not require tumour cell CD1d expression and that are associated with enhanced activity of antigen-specific T cells.

Splines for Fast-Contracting Polyhedral Control Nets

Rapid reduction in the number of quad-strips, to accommodate narrower surface passages or reduced shape fluctuation, leads to configurations that challenge existing spline surface constructions. A new spline surface construction for fast contracting polyhedral control-nets delivers good shape. A nestedly refinable construction of piecewise degree (2,4) is compared with a uniform degree (3,3) spline construction.

CORPORATE CRIMINAL LIABILITY FOR CRIMINAL NEGLIGENCE OF FOREST AND LAND FIRE CAUSES

During the globalization era, forest exploitation has become more frequent, one of them is burning land as a cause of rapid reduction in forest area. Forest and land fires caused by human activities can be categorized as legal acts, i.e. those occurrences or events that can trigger legal consequences. Therefore, forest and land burning is not included in ordinary criminal offenses. This research aims to analyze the arrangements for criminal liability for criminal negligence that causes forest and land fires (Ius Constitutum) and to analyze the considerations of the judges for negligence for causing forest and land fires in Decision Number 71/Pid B/LH/2021/PN Snt. The method used is a normative method with a statutory approach, legal concepts and theories. The result of this research is that criminal liability for the causes of forest and land fires can be identified from several legislations that have been established and are applicable at this time, both those committed intentionally and due to negligence, and both those committed by individuals and those committed by corporations. The Judges’ consideration in Decision Number: 71/Pid B/LH/2021/PN Snt, imposed a fine and additional punishment on the defendant that is PT Mega Anugrah Sawit. The judge only recognized the defendant’s guilt due to negligence, while from the facts of the trial there was an element of intent.

Performance evolution of alkali-activated phosphorus slag paste filling material: Effect of hemihydrate phosphogypsum content

The stockpiling issues of phosphorus slag (PS) and hemihydrate phosphogypsum (HPG) have become vital technical obstacles limiting the economic development of enterprises. The synergistic substitution of PS and HPG for ordinary Portland cement in preparing alkali-activated phosphorus slag paste filling material (AAPS-PM) is essential to realize the high-value utilization of PS and HPG and reduce carbon emissions. HPG was selected as a sulfate activator for this research due to its metastable qualities and chemical composition benefits. The effect of HPG on the properties of AAPS-PM was systematically investigated by setting time, fluidity, strength development, water resistance, and pore solution pH experiments. The evolution of hydration products and pore size characteristics was elaborated employing X-ray diffractometer (XRD), scanning electron microscopy (SEM) and low-field nuclear magnetic resonance (NMR). The results demonstrated that the addition of HPG displayed remarkable procoagulant thickening characteristics on AAPS-PM. Additionally, HPG was conducive to developing early uniaxial compressive strength (UCS), whereas 90% content of HPG had a negative impact on the enhancement of later UCS. The softening coefficient and water absorption exhibited duality with 80% HPG content as the critical point, obtaining a maximum value of 0.73 and a minimum value of 6.63%, respectively. It is noteworthy that the decrease in pore solution pH was primarily correlated with the acidity carried by HPG. Herein, the alkali activator accelerated the depolymerization of PS vitreous and generated H3SiO4- and H3AlO42- and Al(OH)63-. Furthermore, the active ions combined with Ca2+ and SO42- supplied by HPG, which contributed to the formation of dihydrate gypsum, ettringite and C-(A)-S-H gels. Encouragingly, microscopic analysis confirmed the macroscopic performance changes of AAPS-PM. The gel network created by the interweaving of hydration products refined the pore structure and improved the microstructure morphology, which is the primary source of mechanical strength. Nevertheless, the high content of HPG provided a driving force for the development of capillary pores, resulting in a rapid reduction in later strength. Overall, this research can contribute new ideas to the large-scale integrated disposal of solid waste.

Product distribution and conversion mechanism of fossil-based biodegradable plastics during rapid pyrolysis

Fast pyrolysis has emerged as a promising technology for converting fossil-based biodegradable plastics (FBBPs) into clean energy and high-value products with rapid volume reduction and efficient utilisation. The degradation mechanism during pyrolysis is crucial, and different chemical structures and reaction processes directly affect the treatment efficiency and economic benefits. In this study, three typical FBBPs, including poly(butylene adipate-co-terephthalate) (PBAT), polybutylene succinate (PBS) and poly(epsilon-caprolactone) (PCL), have been analyzed in rapid pyrolysis experiments and corresponding products. Being pyrolyzed at 550℃, three kinds of FBBPs exhibited distinctly different decomposition behaviors and characteristics. These differences can be attributed to the bond-breaking ways and pyrolysis mechanisms, which enhance the value of products. Specifically, PBS exhibited the highest abundance of bio-oils and particulate matter (total 90.58%) compared to PBAT and PCL, mainly converted to ketones and acids with a homogeneous component distribution, which was likely to help facilitate further utilisation. In addition, the oxygen of PBS remained in the bio-oil fraction while showing high levels of CO in the bio-gas. Moreover, PCL had the highest amount of bio-gas (21.76%) among the three FBBPs, indicating that it was more likely to break into small molecule products. Notably, the broken chains or macro-molecules of PCL were primarily converted into esters, with di(but-2-en-1-yl) adipate accounting for 57.5% of bio-oils. This work elucidated the transformation pathways and mechanism of FBBP pyrolysis, providing guidance for the treatment and resource utilisation of FBBPs.

Cu-BTC-derived Cu@C as nano-heater embedded in 3D g-C3N4 for photothermal-coupled photocatalytic CO2 reduction under full-spectrum solar irradiation

This study developed a novel Cu@C/NCN-T composite for efficient photothermal catalytic CO2 reduction. The composite, consisting of carbon-coated Cu (Cu@C) derived from Cu-BTC embedded in three-dimensional graphitic carbon nitride (NCN-T), was immobilized on the surface of carbonized wood (C-wood) floating on water, creating a triphase system (CO2, H2O, and catalyst). The optimized composite demonstrated remarkable CO2 photothermal reduction performance, achieving a rate of 31.3 μmol·g−1·h−1. This performance surpassed that of pure NCN-T and Cu@C by 1.6 and 3.8 times, respectively. The combination of Cu and carbon materials endowed Cu@C/NCN-T with excellent light-absorption properties, resulting in a photothermal effect that elevated the surface temperature and facilitated the catalytic reaction. Furthermore, the Schottky junction formed between Cu@C and NCN-T promoted the separation of electron-hole pairs, with Cu@C acting as charge channels. A charge transfer mechanism was proposed to explain these findings. This catalyst engineering approach holds promise for the development of efficient non-noble metal catalysts for rapid CO2 photothermal reduction.

Composting and fermentation: mitigating hop latent viroid infection risk in hop residues

Hop cultivation, integral to the brewing industry, faces challenges from viroids, especially the citrus bark cracking viroid (CBCVd) but also the hop latent viroid (HLVd) influences hop cone quality. We focused on the degradation kinetics of HLVd thereby covering compost, silage, and digestate made from hop residues. In this study, HLVd serves as a model for understanding CBCVd, which causes significant stunting and yield losses in European hop crops. Composting experiments revealed that although composting significantly lowers HLVd levels, complete degradation within 7 weeks is not guaranteed, with loose compost showing a more rapid reduction than compacted variants. Infectivity experiments conducted using inocula obtained from HLVd-infected hop plant residues exposed to composting, ensiling, and biogas digestate did not result in the transmission of HLVd to viroid-free plants. Also extracting and analyzing the soil-root mixture of plants inoculated with HLVd-infected hop residues did not show evidence for viroid persistence. Degradation experiments further differentiated between the physiochemical and biological influences on viroid and viroid-like random RNA stability, showing that higher temperatures of 50 °C enhance degradation over 40 °C, and pH levels of 5 or 7 are slowing degradation. In contrast deionized water or a pH of 4 or 9 enhances viroid degradation. Adding extracts from digestate accelerated the process indicating a role of biological activity. Interestingly, a viroid-like random RNA with similar physiochemical properties, showed to degrade faster compared to HLVd, suggesting high robustness of the actual viroid secondary structure. These findings offer valuable insights into managing HLVd in hops and potentially other crops, highlighting effective strategies to mitigate viroid spread, and contributing to broader understanding of RNA degradation in agriculture.

THE ISSUES OF SCOPE AND LEGAL STATUS IN WTO – IMF CONSULTATIONS

In designing the international economic governance system after the Second World War, trade and finance, due to the close connection between them, were addressed as parts of a whole. A predictable and stable international monetary system was recognized as prerequisite for healthy and sustainable trade. However, these two issues were regulated under different institutional structures, by envisaging close cooperation and coordination. The International Monetary Fund (IMF), designed to be responsible for international finance and monetary issues, was established in 1944. The International Trade Organization (ITO) was designed to address international trade, while the General Agreement on Tariffs and Trade (GATT), with a limited scope, was temporarily put into implementation in January 1, 1948 to provide rapid tariff reductions until the ratification of ITO Charter. The ITO became still-born as it was not approved by national parliaments, especially the USA, and international trade continued to be regulated by the GATT. The GATT, with its unique organizational structure that gradually developed, continued its existence until the establishment of the World Trade Organization (WTO) in 1995 and hosted international trade negotiations. WTO, with more advanced legal and institutional structure, took over the functions of the GATT. Formal consultation procedures have constituted an important part of the cooperation between the GATT/WTO and the IMF in the context of the management of international trade and monetary/financial system. These procedures differ from traditional cooperation activities between international organizations and have a special character. It is regulated in a binding language as an obligation for the relevant WTO bodies to apply for consultations with the IMF on certain issues and to comply with the inputs received from the IMF. There are some points open to interpretation regarding the scope of the consultations and the binding and functional status of IMF inputs in the WTO. This study discusses the issues of scope and legal status.

Rapid Changes in Cerebrovascular Compliance During Vasovagal Syncope

Background: The rapid reduction in arterial blood pressure (ABP) during vasovagal syncope (VVS) is associated with a characteristic decline in diastolic cerebral blood velocity (CBV) and maintained systolic CBV as measured by transcranial Doppler. This increased pulsatility was originally considered to be indicative of a “dysfunctional” increase in cerebrovascular resistance (CVR). Conversely, it may be due to increased cerebrovascular compliance (Ci) that partially attenuates the cerebral effects of rapid hypotension. We tested the hypothesis that Ci supports CBV during pre-syncope in VVS. Method: Finger ABP and right middle cerebral artery blood velocity (MCAv) were recorded from 15 otherwise healthy patients (n = 11 female, 40 ± 16 years, 24.9 ± 4.0 kg/m2) at rest and during head-up tilt (80°, 5 to 28 min). Individual ABP and CBV waveforms of every second heartbeat during VVS were input into a modified Windkessel model to calculate Ci and CVR. MCAv pulsatility was determined as pulse amplitude (systolic MCAv-diastolic MCAv) and Pulsatility Index (Pi; pulse amplitude/mean MCAv). Linear mixed models assessed the contribution of Ci to changes in CBV and Pi. Within-subject mediation analysis investigated the possibility of Ci mediating the relation between blood pressure (i.e., mean ABP and pulse pressure, PP) and cerebrovascular pulsatility. Results: Diastolic and systolic ABP decreased progressively during presyncope, resulting in a nadir reduction of mean ABP of Δ24 ± 9 mmHg at end-tilt (all p ≤ 0.04 vs mid-tilt). Mean MCAv decreased by 22 ± 12% prior to end-tilt (p &lt; 0.01 vs mid-tilt). CVR decreased progressively for 10s prior to end-tilt (p ≤ 0.04 vs mid-tilt). Pi increased significantly, with peak increases occurring at 4 s prior to end-tilt (77 ± 50%, p &lt; 0.01 vs mid-tilt). The increase in Ci (307 ± 223%, p &lt; 0.01 vs mid-tilt) significantly contributed to changes in MCAv (χ2 =10.6, p &lt; 0.01) and Pi (χ2 = 4.9, p = 0.03). Correlations of PP and ABP with Pi were not significant. However, PP was related to MCAv pulse amplitude (total effect: b = 1.57) and Ci ( b = -0.01, both p &lt; 0.01). Ci partially mediated (indirect effect: b = -0.78, p &lt; 0.01) the direct relation between PP and MCAv pulse amplitude ( b = 0.79, p = 0.01). Conclusion: These data provide evidence that Ci attenuates the fall in CBV under conditions of falling PP. Cerebrovascular regulation in VVS appears to be functioning as in healthy populations. However, this regulation is not suffcient to preserve flow in the presence of such extreme and rapid reductions in ABP. USRI — Western University, Natural Sciences and Engineering Research Council of Canada (NSERC, Grant No. RGPIN-2018-06255). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Approaching the SDG targets with sustained political commitment: drivers of the notable decline in maternal and neonatal mortality in Morocco

BackgroundBetween 2000 and 2017/2018, Morocco reduced its maternal mortality ratio by 68% and its neonatal mortality rate by 52%—a higher improvement than other North African countries. We conducted the Exemplars...

EVALUATION OF THE EFFICACY AND TOLERABILITY OF A FIXED DOSE COMBINATION OF AMLODIPINE AND INDAPAMIDE IN PATIENTS OLDER THAN 55 YEARS

Objective: There is very limited real-life data on hypertension management in Bangladeshi population. Considering this fact, this study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in Bangladeshi patients over the age of 55 years, in an OPD setting with uncontrolled systolic hypertension in real-life clinical practice. Methods: This was a 3-month, multicenter, observational, open-label study conducted in 3 divisional cities of Bangladesh among patients with grade I or II hypertension who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP (&lt; 140 mmHg) achievement at 2 weeks, 1 month and 3 months, in four age groups: 55-59 years, 60-69 years, 70-79 years, and 80 years or older. Design and method: The COMBINE study recruited 213 patients, of whom 185 took indapamide/amlodipine 1.5/5 mg SPC fora full three-month course of therapy. Mean age was 62.4±7.4 years, 76 men [41.1%] and 109 women [58.9%]. The absolute decrease of SBP during 3 months of taking indapamide/amlodipine single-pill combination (SPC) was 29.3 mm Hg, DBP - 12.9 mm Hg. After 3 months of treatment significant SBP decreases from baseline were observed in each age group: ? 31.8 mmHg (from 156.7 to 124.9), ? 26.4 mmHg (from 152.7 to 126.3), ? 29.5 mmHg (from 152.8 to 123.3), and ? 25.8 mmHg (from 151.7 to 125.9) in the 55-59, 60-69, 70-79, and 80 years and older age groups, respectively. Leg edema was observed in 3 patients (1.62%), electrolyte imbalance was observed in 4 patients (2.16%) and 1 patients observed sudden fall of blood pressure. Conclusion: This COMBINE study results showed that indapamide/amlodipine SPC was associated with significant and rapid reductions in BP even in a different age range of Bangladeshi patients in routine clinical practice. This study result is consistent with already achieved data of this SPC globally.