Use of historical isoscapes to develop an estuarine nutrient baseline

Coastal eutrophication is a prevalent threat to the healthy functioning of ecosystems globally. While degraded water quality can be detected by monitoring oxygen, nutrient concentrations, and algal abundance, establishing regulatory guidelines is complicated by a lack of baseline data (e.g., pre-Anthropocene). We use historical carbon and nitrogen isoscapes over ~300 years from sediment cores to reconstruct spatial and temporal changes in nutrient dynamics for a central California estuary, Elkhorn Slough, where development and agriculture dramatically enhanced nutrient inputs over the past century. We found strong contrasts between current sediment stable isotopes and those from the recent past, demonstrating shifts exceeding those in previously studied eutrophic estuaries and substantial increases in nutrient inputs. Comparisons of contemporary with historical isoscapes also revealed that nitrogen sources shifted from a historical marine-terrestrial gradient with higher δ15N near the inlet to amplified denitrification at the head and mouth of the modern estuary driven by increased N inputs. Geospatial analysis of historical data suggests that an increase in fertilizer application – rather than population growth or increases in the extent of cultivated land – is chiefly responsible for increasing nutrient loads during the 20th century. This study demonstrates the ability of isotopic and stoichiometric maps to provide important perspectives on long-term shifts and spatial patterns of nutrients that can be used to improve management of nutrient pollution

Genome-Wide Association Study Identifies Chromosome 10q24.32 Variants Associated with Arsenic Metabolism and Toxicity Phenotypes in Bangladesh

Arsenic contamination of drinking water is a major public health issue in many countries, increasing risk for a wide array of diseases, including cancer. There is inter-individual variation in arsenic metabolism efficiency and susceptibility to arsenic toxicity; however, the basis of this variation is not well understood. Here, we have performed the first genome-wide association study (GWAS) of arsenic-related metabolism and toxicity phenotypes to improve our understanding of the mechanisms by which arsenic affects health. Using data on urinary arsenic metabolite concentrations and approximately 300,000 genome-wide single nucleotide polymorphisms (SNPs) for 1,313 arsenic-exposed Bangladeshi individuals, we identified genome-wide significant association signals (P<5×10−8) for percentages of both monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) near the AS3MT gene (arsenite methyltransferase; 10q24.32), with five genetic variants showing independent associations. In a follow-up analysis of 1,085 individuals with arsenic-induced premalignant skin lesions (the classical sign of arsenic toxicity) and 1,794 controls, we show that one of these five variants (rs9527) is also associated with skin lesion risk (P = 0.0005). Using a subset of individuals with prospectively measured arsenic (n = 769), we show that rs9527 interacts with arsenic to influence incident skin lesion risk (P = 0.01). Expression quantitative trait locus (eQTL) analyses of genome-wide expression data from 950 individual's lymphocyte RNA suggest that several of our lead SNPs represent cis-eQTLs for AS3MT (P = 10−12) and neighboring gene C10orf32 (P = 10−44), which are involved in C10orf32-AS3MT read-through transcription. This is the largest and most comprehensive genomic investigation of arsenic metabolism and toxicity to date, the only GWAS of any arsenic-related trait, and the first study to implicate 10q24.32 variants in both arsenic metabolism and arsenical skin lesion risk. The observed patterns of associations suggest that MMA% and DMA% have distinct genetic determinants and support the hypothesis that DMA is the less toxic of these two methylated arsenic species. These results have potential translational implications for the prevention and treatment of arsenic-associated toxicities worldwide

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Skin Erosion and Exteriorisation of a Cardiac Implantable Electronic Device: Modified Surgical Approach

10.3329/jbcps.v38i3.47064Journal of Bangladesh College of Physicians and Surgeons383155-15

Advances on Low Power Designs for SRAM Cell

As the development of complex metal oxide semiconductor (CMOS) technology, fast low-power static random access memory (SRAM) has become an important component of many very large scale integration (VLSI) chips. Lot of applications preferred to use the 6T SRAM because of its robustness and very high speed. However, the leakage current has increasing with the increase SRAM size. It consumes more power while in standby condition. The power dissipation has become an importance consideration due to the increase integration, operating speeds and the explosive growth of battery operated appliances. The objective of this paper is to review and discuss several methods to overcome the power dissipation problem of SRAM. Low power SRAM can be produced with improvement in term of power dissipation during the standby condition, write operation and read operation. Discharging and charging of bit lines consumes more power during write ‘0’ and ‘1’compared to read operation. One of the methods to produce low power SRAM design is with make modification circuit at a standard 6T SRAM cell. This modification circuit will help to decrease power dissipation and leakage current. Several method was discussed in this paper for understand the method to produce low power design of SRAM cell. Recommendations for future research are also set out. This review gives some idea for future research to improve the design of low power SRAM cell

High nutrient loads amplify carbon cycling across California and New York coastal wetlands but with ambiguous effects on marsh integrity and sustainability

Eutrophic conditions in estuaries are a globally important stressor to coastal ecosystems and have been suggested as a driver of coastal salt marsh loss. Potential mechanisms in marshes include disturbance caused by macroalgae accumulations, enhanced soil sulfide levels linked to high labile carbon inputs, accelerated decomposition, and declines in belowground biomass that contribute to edge instability, erosion, and slumping. However, results of fertilization studies have been mixed, and it is unclear the extent to which local environmental conditions, such as soil composition and nutrient profiles, help shape the response of salt marshes to nutrient exposure. In this study, we characterized belowground productivity and decomposition, organic matter mineralization rates, soil respiration, microbial biomass, soil humification, carbon and nitrogen inventories, nitrogen isotope ratios, and porewater profiles at high and low marsh elevations across eight marshes in four estuaries in California and New York that have strong contrasts in nutrient inputs. The higher nutrient load marshes were characterized by faster carbon turnover, with higher belowground production and decomposition and greater carbon dioxide efflux than lower nutrient load marshes. These patterns were robust across marshes of the Atlantic and Pacific coasts that varied in plant species composition, soil flooding patterns, and soil texture. Although impacts of eutrophic conditions on carbon cycling appeared clear, it was ambiguous whether high nutrient loads are causing negative effects on long-term marsh sustainability in terms of studied metrics. While high nutrient exposure marshes had high rates of decomposition and soil respiration rates, high nutrient exposure was also associated with increased belowground production, and reduced levels of sulfides, which should lead to greater marsh sustainability. While this study does not resolve the extent to which nutrient loads are negatively affecting these salt marshes, we do highlight functional differences between Atlantic and Pacific wetlands which may be useful for understanding coastal marsh health and integrity

Changing characteristics of rotavirus diarrhea in children younger than five years in urban Bangladesh

Background: Childhood rotavirus diarrhea is still one of the major public health challenges. The present study aimed to determine changing characteristics of rotavirus diarrhea in under-5 children at two periods of time. Methods: We enrolled 5,357 under-5 children with rotavirus positive in two different time periods; i) 1993-1997 (n = 2,493), and ii) 2008-2012 (n = 2,864) considering beginning and ending of two decades. These children were enrolled in the urban Dhaka Hospital of icddr,b. Results: Overall, proportion of rotavirus was about 25% in 1993-97, which was 42% in 2008-12 (68% rise; p5 [38% vs. 35%; aOR-1.32 (95% CI-1.10-1.58)] required more intravenous fluid [9% vs. 3%; aOR-4.93 (95% CI-3.19-7.63)], had higher co-infection with Shigella [3% vs. 1%; aOR-3.36 (95% CI-1.61-7.03)], Vibrio cholerae [4% vs. 1%; aOR-3.70 (95% CI-2.12-6.46)]; and ETEC [13% vs. 7%; aOR-2.21 (95% CI-1.65-2.97)]; however, significantly lower proportion of them used sanitary toilets [54% vs. 78%; aOR-0.66 (95% CI-0.54-0.80)], boiled drinking water [16% vs. 38%; aOR-0.60 (95% CI-0.48-0.74)], used antimicrobial at home [63% vs. 82%; aOR-0.56 (95% CI-0.46-0.69)] and had some or severe dehydration [18% vs. 34%; aOR-0.15 (95% CI-0.12-0.20)] in 1st observation period compared to that of 2 nd. Conclusion: Proportion of episodes of under-5 rotavirus diarrhea increased over the period. Concomitant changes in host, socio-demographic and clinical characteristics, and co-infections were also observed. Thus, vaccination campaign which is prevailing in private sector should also be introduced in public sector