Nitrate Contamination and Nitrogen Isotope Compositions in the Bazile Groundwater Management Area - A Water Quality Study. Creighton, NE

Surface water nitrogen contamination is a pervasive issue in Nebraska, and agricultural practices are the main source of nitrogen input to streams (Spalding and Exner, 1993). Nitrate can come from inorganic fertilizers such as anhydrous ammonia, or animal waste. Studies have been conducted on nitrates dating back to 1947 (Addleman, 1985). The Bazile Groundwater Management Area (BGMA) located in northeast Nebraska has historically had high nitrate contamination. This qualitative study assesses the seasonal sources of nitrogen to stream water. It is predicted that the source of input is from commercial synthetic fertilizers. By using nitrogen- oxygen isotope methods, the source of nitrogen input to streams can be determined by isotopic ratios. 14 nitrogen-oxygen isotope samples were taken at 7 different locations in the BGMA during fall and winter to assess the seasonal variability of nitrogen pollution. Results showed that in the fall, nitrate was being derived from a mixture of anhydrous ammonia and manure, whereas in the winter the source of nitrate was primarily anhydrous ammonia. Nitrate contamination levels were also recorded at each site location and most were found to be above 10 mg/L. When 88% of rural Nebraskans utilize groundwater for drinking water (Nebraska Groundwater Quality Report, 2017), it is important to know how much nitrate is entering streams, and where the nitrate is coming from

Streambed Flux Measurement Informed by Distributed Temperature Sensing Leads to a Significantly Different Characterization of Groundwater Discharge

Groundwater discharge though streambeds is often focused toward discrete zones, indicating that preliminary reconnaissance may be useful for capturing the full spectrum of groundwater discharge rates using point-scale quantitative methods. However, many direct-contact reconnaissance techniques can be time-consuming, and remote sensing (e.g., thermal infrared) typically does not penetrate the water column to locate submerged seepages. In this study, we tested whether dozens of groundwater discharge measurements made at “uninformed” (i.e., selected without knowledge on high-resolution temperature variations at the streambed) point locations along a reach would yield significantly dierent Darcy-based groundwater discharge rates when compared with “informed” measurements, focused at streambed thermal anomalies that were identified a priori using fiber-optic distributed temperature sensing (FO-DTS). A non-parametric U-test showed a significant difference between median discharge rates for uninformed (0.05 m day 1; n = 30) and informed (0.17 m day 1; n = 20) measurement locations. Mean values followed a similar pattern (0.12 versus 0.27 m day 1), and frequency distributions for uninformed and informed measurements were also significantly different based on a Kolmogorov–Smirnov test. Results suggest that even using a quick “snapshot-in-time” field analysis of FO-DTS data can be useful in streambeds with groundwater discharge rate

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Nitrate Contamination and Nitrogen Isotope Compositions in the Bazile Groundwater Management Area - A Water Quality Study. Creighton, NE

Surface water nitrogen contamination is a pervasive issue in Nebraska, and agricultural practices are the main source of nitrogen input to streams (Spalding and Exner, 1993). Nitrate can come from inorganic fertilizers such as anhydrous ammonia, or animal waste. Studies have been conducted on nitrates dating back to 1947 (Addleman, 1985). The Bazile Groundwater Management Area (BGMA) located in northeast Nebraska has historically had high nitrate contamination. This qualitative study assesses the seasonal sources of nitrogen to stream water. It is predicted that the source of input is from commercial synthetic fertilizers. By using nitrogen- oxygen isotope methods, the source of nitrogen input to streams can be determined by isotopic ratios. 14 nitrogen-oxygen isotope samples were taken at 7 different locations in the BGMA during fall and winter to assess the seasonal variability of nitrogen pollution. Results showed that in the fall, nitrate was being derived from a mixture of anhydrous ammonia and manure, whereas in the winter the source of nitrate was primarily anhydrous ammonia. Nitrate contamination levels were also recorded at each site location and most were found to be above 10 mg/L. When 88% of rural Nebraskans utilize groundwater for drinking water (Nebraska Groundwater Quality Report, 2017), it is important to know how much nitrate is entering streams, and where the nitrate is coming from

Streambed Flux Measurement Informed by Distributed Temperature Sensing Leads to a Significantly Different Characterization of Groundwater Discharge

Groundwater discharge though streambeds is often focused toward discrete zones, indicating that preliminary reconnaissance may be useful for capturing the full spectrum of groundwater discharge rates using point-scale quantitative methods. However, many direct-contact reconnaissance techniques can be time-consuming, and remote sensing (e.g., thermal infrared) typically does not penetrate the water column to locate submerged seepages. In this study, we tested whether dozens of groundwater discharge measurements made at “uninformed” (i.e., selected without knowledge on high-resolution temperature variations at the streambed) point locations along a reach would yield significantly dierent Darcy-based groundwater discharge rates when compared with “informed” measurements, focused at streambed thermal anomalies that were identified a priori using fiber-optic distributed temperature sensing (FO-DTS). A non-parametric U-test showed a significant difference between median discharge rates for uninformed (0.05 m day 1; n = 30) and informed (0.17 m day 1; n = 20) measurement locations. Mean values followed a similar pattern (0.12 versus 0.27 m day 1), and frequency distributions for uninformed and informed measurements were also significantly different based on a Kolmogorov–Smirnov test. Results suggest that even using a quick “snapshot-in-time” field analysis of FO-DTS data can be useful in streambeds with groundwater discharge rate

Streambed Flux Measurement Informed by Distributed Temperature Sensing Leads to a Significantly Different Characterization of Groundwater Discharge

Groundwater discharge though streambeds is often focused toward discrete zones, indicating that preliminary reconnaissance may be useful for capturing the full spectrum of groundwater discharge rates using point-scale quantitative methods. However, many direct-contact reconnaissance techniques can be time-consuming, and remote sensing (e.g., thermal infrared) typically does not penetrate the water column to locate submerged seepages. In this study, we tested whether dozens of groundwater discharge measurements made at “uninformed” (i.e., selected without knowledge on high-resolution temperature variations at the streambed) point locations along a reach would yield significantly different Darcy-based groundwater discharge rates when compared with “informed” measurements, focused at streambed thermal anomalies that were identified a priori using fiber-optic distributed temperature sensing (FO-DTS). A non-parametric U-test showed a significant difference between median discharge rates for uninformed (0.05 m·day−1; n = 30) and informed (0.17 m·day−1; n = 20) measurement locations. Mean values followed a similar pattern (0.12 versus 0.27 m·day−1), and frequency distributions for uninformed and informed measurements were also significantly different based on a Kolmogorov–Smirnov test. Results suggest that even using a quick “snapshot-in-time” field analysis of FO-DTS data can be useful in streambeds with groundwater discharge rates <0.2 m·day−1, a lower threshold than proposed in a previous study. Collectively, study results highlight that FO-DTS is a powerful technique for identifying higher-discharge zones in streambeds, but the pros and cons of informed and uninformed sampling depend in part on groundwater/surface water exchange study goals. For example, studies focused on measuring representative groundwater and solute fluxes may be biased if high-discharge locations are preferentially sampled. However, identification of high-discharge locations may complement more randomized sampling plans and lead to improvements in interpolating streambed fluxes and upscaling point measurements to the stream reach scale