The First Rock Glacier Inventory for the Greater Caucasus

Rock glaciers are an integral part of the periglacial environment. At the regional scale in the Greater Caucasus, there have been no comprehensive systematic efforts to assess the distribution of rock glaciers, although some individual parts of ranges have been mapped before. In this study we produce the first inventory of rock glaciers from the entire Greater Caucasus region—Russia, Georgia, and Azerbaijan. A remote sensing survey was conducted using Geo-Information System (GIS) and Google Earth Pro software based on high-resolution satellite imagery—SPOT, Worldview, QuickBird, and IKONOS, based on data obtained during the period 2004–2021. Sentinel-2 imagery from the year 2020 was also used as a supplementary source. The ASTER GDEM (2011) was used to determine location, elevation, and slope for all rock glaciers. Using a manual approach to digitize rock glaciers, we discovered that the mountain range contains 1461 rock glaciers with a total area of 297.8 ± 23.0 km2. Visual inspection of the morphology suggests that 1018 rock glaciers with a total area of 199.6 ± 15.9 km2 (67% of the total rock glacier area) are active, while the remaining rock glaciers appear to be relict. The average maximum altitude of all rock glaciers is found at 3152 ± 96 m above sea level (a.s.l.) while the mean and minimum altitude are 3009 ± 91 m and 2882 ± 87 m a.s.l., respectively. We find that the average minimum altitude of active rock glaciers is higher (2955 ± 98 m a.s.l.) than in relict rock glaciers (2716 ± 83 m a.s.l.). No clear difference is discernible between the surface slope of active (41.4 ± 3°) and relict (38.8 ± 4°) rock glaciers in the entire mountain region. This inventory provides a database for understanding the extent of permafrost in the Greater Caucasus and is an important basis for further research of geomorphology and palaeoglaciology in this region. The inventory will be submitted to the Global Land Ice Measurements from Space (GLIMS) database and can be used for future studies

Resolving the influence of temperature forcing through heat conduction on rock glacier dynamics: a numerical modelling approach

In recent years, observations have highlighted seasonal and interannual variability in rock glacier flow. Temperature forcing, through heat conduction, has been proposed as one of the key processes to explain these variations in kinematics. However, this mechanism has not yet been quantitatively assessed against real-world data. We present a 1-D numerical modelling approach that couples heat conduction to an empirically derived creep model for ice-rich frozen soils. We use this model to investigate the effect of thermal heat conduction on seasonal and interannual variability in rock glacier flow velocity. We compare the model results with borehole temperature data and surface velocity measurements from the PERMOS and PermaSense monitoring network available for the Swiss Alps. We further conduct a model sensitivity analysis in order to resolve the importance of the different model parameters. Using the prescribed empirically derived rheology and observed near-surface temperatures, we are able to model the correct order of magnitude of creep. However, both interannual and seasonal variability are underestimated by an order of magnitude, implying that heat conduction alone cannot explain the observed variations. Therefore, we conclude that non-conductive processes, likely linked to water availability, must dominate the short-term velocity signal.</p

Printable, adhesive, and self-healing dry epidermal electrodes based on PEDOT:PSS and polyurethane diol

ABSTRACT: Printable, self-healing, stretchable, and conductive materials have tremendous potential for the fabrication of advanced electronic devices. Poly(3,4-ethylenedioxithiopene) doped with polystyrene sulfonate (PEDOT:PSS) has been the focus of extensive research due to its tunable electrical and mechanical properties. Owing to its solution-processability and self-healing ability, PEDOT:PSS is an excellent candidate for developing printable inks. In this study, we developed printable, stretchable, dry, lightly adhesive, and self-healing materials for biomedical applications. Polyurethane diol (PUD), polyethylene glycol, and sorbitol were investigated as additives for PEDOT:PSS. In this study, we identified an optimal printable mixture obtained by adding PUD to PEDOT:PSS, which improved both the mechanical and electrical properties. PUD/PEDOT:PSS free-standing films with optimized composition showed a conductivity of approximately 30 S cm−1, stretchability of 30%, and Young's modulus of 15 MPa. A low resistance change (<20%) was achieved when the strain was increased to 30%. Excellent electrical stability under cyclic mechanical strain, biocompatibility, and 100% electrical self-healing were also observed. The potential biomedical applications of this mixture were demonstrated by fabricating a printed epidermal electrode on a stretchable silicone substrate. The PUD/PEDOT:PSS electrodes displayed a skin-electrode impedance similar to commercially available ones, and successfully captured physiological signals. This study contributes to the development of improved customization and enhanced mechanical durability of soft electronic materials

Predicting heart failure outcome from cardiac and comorbid conditions: The 3C-HF score

Background: Prognostic stratification in heart failure (HF) is crucial to guide clinical management and treatment decision-making. Currently available models to predict HF outcome have multiple limitations. We developed a simple risk stratification model, based on routinely available clinical information including comorbidities, the Cardiac and Comorbid Conditions HF (3C-HF) Score, to predict all-cause 1-year mortality in HF patients. Methods: We recruited in a cohort study 6274 consecutive HF patients at 24 Cardiology and Internal Medicine Units in Europe. 2016 subjects formed the derivation cohort and 4258 the validation cohort.Weentered information on cardiac and comorbid candidate prognostic predictors in amultivariablemodel to predict 1-year outcome

Is the Soleus a Sentinel Muscle for Impaired Aerobic Capacity in Heart Failure?

Purpose: Skeletal muscle wasting is well documented in chronic heart failure (CHF). This article provides a more detailed understanding of the morphology behind this muscle wasting and the relation between muscle morphology, strength, and exercise capacity in CHF. We investigated the effect of CHF on lower limb lean mass, detailed muscle–tendon architecture of the individual triceps surae muscles (soleus (SOL), medial gastrocnemius, and lateral gastrocnemius) and how these parameters relate to exercise capacity and strength. Methods: Eleven patients with CHF and 15 age-matched controls were recruited. Lower limb lean mass was assessed by dual energy x-ray absorptiometry and the architecture of skeletal muscle and tendon properties by ultrasound. Plantarflexor strength was assessed by dynamometry. Results: Patients with CHF exhibited approximately 25% lower combined triceps surae volume and physiological cross-sectional area (PCSA) compared with those of control subjects (P < 0.05), driven in large part by reductions in the SOL. Only the SOL volume and the SOL and medial gastrocnemius physiological cross-sectional area were statistically different between groups after normalizing to lean body mass and body surface area, respectively. Total lower limb lean mass did not differ between CHF and control subjects, further highlighting the SOL specificity of muscle wasting in CHF. Moreover, the volume of the SOL and plantarflexor strength correlated strongly with peak oxygen uptake (V˙O2peak) in patients with CHF. Conclusions: These findings suggest that the SOL may be a sentinel skeletal muscle in CHF and provide a rationale for including plantarflexor muscle training in CHF care

Soleus Muscle as a Surrogate for Health Status in Human Heart Failure

We propose the hypothesis that soleus muscle function may provide a surrogate measure of functional capacity in patients with heart failure. We summarize literature pertaining to skeletal muscle as a locus of fatigue and present our recent findings, using in vivo imaging in combination with biomechanical experimentation and modeling, to reveal novel structure-function relationships in chronic heart failure skeletal muscle and gait

Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity

Reduced walking capacity, a hallmark of chronic heart failure (CHF), is strongly correlated with hospitalization and morbidity. The aim of this work was to perform a detailed biomechanical gait analysis to better identify mechanisms underlying reduced walking capacity in CHF. Inverse dynamic analyses were conducted in CHF patients and age- and exercise level-matched control subjects on an instrumented treadmill at self-selected treadmill walking speeds and at speeds representing +20% and -20% of the subjects' preferred speed. Surprisingly, no difference in preferred speed was observed between groups, possibly explained by an optimization of the mechanical cost of transport in both groups (the mechanical cost to travel a given distance; J/kg/m). The majority of limb kinematics and kinetics were also similar between groups, with the exception of greater ankle dorsiflexion angles during stance in CHF. Nevertheless, over two times greater ankle plantarflexion work during stance and per distance traveled is required for a given triceps surae muscle volume in CHF patients. This, together with a greater reliance on the ankle compared to the hip to power walking in CHF patients, especially at faster speeds, may contribute to the earlier onset of fatigue in CHF patients. This observation also helps explain the high correlation between triceps surae muscle volume and exercise capacity that has previously been reported in CHF. Considering the key role played by the plantarflexors in powering walking and their association with exercise capacity, our findings strongly suggest that exercise-based rehabilitation in CHF should not omit the ankle muscle group

Prognostic Value of Indeterminable Anaerobic Threshold in Heart Failure.

Background In patients with heart failure (HF), during maximal cardiopulmonary exercise test, anaerobic threshold (AT) is not always identified. We evaluated whether this finding has a prognostic meaning. Methods and Results We recruited and prospectively followed up, in 14 dedicated HF units, 3058 patients with systolic (left ventricular ejection fraction <40%) HF in stable clinical conditions, New York Heart Association class I to III, who underwent clinical, laboratory, echocardiographic, and cardiopulmonary exercise test investigations at study enrollment. We excluded 921 patients who did not perform a maximal exercise, based on lack of achievement of anaerobic metabolism (peak respiratory quotient 1.05). Primary study end point was a composite of cardiovascular death and urgent cardiac transplant, and secondary end point was all-cause death. Median follow-up was 3.01 (1.39-4.98) years. AT was identified in 1935 out of 2137 patients (90.54%). At multivariable logistic analysis, failure in detecting AT resulted significantly in reduced peak oxygen uptake and higher metabolic exercise and cardiac and kidney index score value, a powerful prognostic composite HF index (P<0.001). At multivariable analysis, the following variables were significantly associated with primary study end point: peak oxygen uptake (% pred; P<0.001; hazard ratio [HR]=0.977; confidence interval [CI]=0.97-0.98), ventilatory efficiency slope (P=0.01; HR=1.02; CI=1.01-1.03), hemoglobin (P<0.05; HR=0.931; CI=0.87-1.00), left ventricular ejection fraction (P<0.001; HR=0.948; CI=0.94-0.96), renal function (modification of diet in renal disease; P<0.001; HR=0.990; CI=0.98-0.99), sodium (P<0.05; HR=0.967; CI=0.94-0.99), and AT nonidentification (P<0.05; HR=1.41; CI=1.06-1.89). Nonidentification of AT remained associated to prognosis also when compared with metabolic exercise and cardiac and kidney index score (P<0.01; HR=1.459; CI=1.09-1.10). Similar results were obtained for the secondary study end point. Conclusions The inability to identify AT most often occurs in patients with severe HF, and it has an independent prognostic role in HF

The influence of confounders in the analysis of mid-regional pro-atrial natriuretic peptide in patients with chronic heart failure

Natriuretic peptides play an important role in the diagnosis and risk stratification of patients with acute and chronic heart failure. Multiple studies have shown that these peptides are liable to the influence of individual factors. For N-terminal-pro-B-type natriuretic peptide (NT-proBNP) some of these confounding factors have been evaluated over the years such as age, gender, New York Heart Association (NYHA) class and body mass index (BMI). The aim of this study was to establish confounding factors of mid-regional pro-atrial natriuretic peptide (MR-proANP) assessment