Aqueduct Trail Network Development in Metro Boston

The Massachusetts Water Resources Authority (MWRA) and the Metropolitan Area Planning Council (MAPC) are collaborating with associated cities and towns to open up 40 + miles of existing and former aqueduct right-of-ways are available to be permitted for public access for the first time in the western suburbs of Boston. Four aqueducts are being considered for public access. The first one-mile section along the Weston Aqueduct in Framingham opened to the public in October 2012. By eventually connecting these aqueducts with existing trail systems, we are ultimately creating a 50+ mile continuous greenway network, primarily using existing public land permitted at no cost to municipalities, requiring minimal investment, and creating a maintenance partnership between the MWRA and cities and towns. The MWRA is working with each of the communities to issue public access permits. Each town will be able to conduct limited improvements to the right-of-way to allow for improved hiking, cycling, and dog-walking activities. A number of schools are adjacent or close to the aqueduct corridors and will provide car-free access for children to walk between school and home. Sections of these aqueduct corridors have been used as informal trails for a number of years. Under the new policy, public access activities will now be authorized and maintenance responsibilities will be split between the MWRA and municipalities. MAPC is working with each of the communities to connect the disjointed aqueduct segments into a seamless, continuous, connected greenway network. Working through each town’s public process, MAPC is identifying the trail segments that will connect with existing regional rail trails, including the circumferential Bay Circuit Trail around Boston and numerous others. MAPC expects to complete an implementation plan in 2013 that identifies the proposed alignment of the completed aqueduct trail network system

The Trail, 1963-12-18

https://soundideas.pugetsound.edu/thetrail_all/4031/thumbnail.jp

Gaseous mercury flux from salt marshes is mediated by solar radiation and temperature

Salt marshes are ecologically sensitive ecosystems where mercury (Hg) methylation and biomagnification can occur. Understanding the mechanisms controlling gaseous Hg flux from salt marshes is important to predict the retention of Hg in coastal wetlands and project the impact of environmental change on the global Hg cycle. We monitored Hg flux from a remote salt marsh over 9 days which included three cloudless days and a 4 mm rainfall event. We observed a cyclical diel relationship between Hg flux and solar radiation. When measurements at the same irradiance intensity are considered, Hg flux was greater in the evening when the sediment was warm than in the morning when the sediment was cool. This is evidence to suggest that both solar radiation and sediment temperature directly influence the rate of Hg(II) photoreduction in salt marshes. Hg flux could be predicted from solar radiation and sediment temperature in sub-datasets collected during cloudless days (R2 = 0.99), and before (R2 = 0.97) and after (R2 = 0.95) the rainfall event, but the combined dataset could not account for the lower Hg flux observed after the rainfall event that is in contrast to greater Hg flux from soils after rainfall events

Rationale and protocol of the Dapagliflozin And Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) randomized controlled trial.

BACKGROUND: Recent cardiovascular outcome trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors slow the progression of chronic kidney disease (CKD) in patients with type 2 diabetes at high cardiovascular risk. Whether these benefits extend to CKD patients without type 2 diabetes or cardiovascular disease is unknown. The Dapagliflozin and Prevention of Adverse Outcomes in CKD (DAPA-CKD) trial (NCT03036150) will assess the effect of the SGLT2 inhibitor dapagliflozin on renal and cardiovascular events in a broad range of patients with CKD with and without diabetes. METHODS: DAPA-CKD is a randomized, double-blind, placebo-controlled, trial in which ∼4300 patients with CKD Stages 2-4 and elevated urinary albumin excretion will be enrolled. The vast majority will be receiving a maximum tolerated dose of a renin-angiotensin system inhibitor at enrolment. RESULTS: After a screening assessment, eligible patients with a urinary albumin:creatinine ratio ≥200 mg/g and estimated glomerular filtration rate (eGFR) between 25 and 75 mL/min/1.73 m2 are randomly assigned to placebo or dapagliflozin 10 mg/day. Enrolment is monitored to ensure that at least 30% of patients do not have diabetes and that no more than 10% have an eGFR >60 mL/min/1.73 m2. The primary endpoint is a composite of a sustained decline in eGFR of ≥50%, end-stage renal disease, renal death or cardiovascular death. The trial will conclude when 681 primary renal events have occurred, providing 90% power to detect a 22% relative risk reduction (α level of 0.05). CONCLUSION: DAPA-CKD will determine whether the SGLT2 inhibitor dapagliflozin, added to guideline-recommended therapies, safely reduces the rate of renal and cardiovascular events in patients across multiple CKD stages with and without diabetes

The Trail, 1964-11-05

https://soundideas.pugetsound.edu/thetrail_all/1896/thumbnail.jp

Exploring low grade inflammation by soluble urokinase plasminogen activator receptor levels in schizophrenia: a sex-dependent association with depressive symptoms

Background - There is evidence of increased low grade inflammation (LGI) in schizophrenia patients. However, the inter-individual variation is large and the association with demographic, somatic and psychiatric factors remains unclear. Our aim was to explore whether levels of the novel LGI marker soluble urokinase plasminogen activator receptor (suPAR) were associated with clinical factors in schizophrenia and if such associations were sex-dependent. Method - In this observational study a total of 187 participants with schizophrenia (108 males, 79 females) underwent physical examination and assessment with clinical interviews (Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Alcohol Use Disorder Identification Test (AUDIT), and Drug Use Disorder Identification Test (DUDIT)). Blood levels of suPAR, glucose, lipids, and high sensitivity C-reactive protein (hsCRP) were determined and body mass index (BMI) calculated. Multivariable linear regression analyses were used adjusting for confounders, and sex interaction tested in significant variables. Results - Adjusting for sex, age, current tobacco smoking and BMI, we found that levels of hsCRP and depressive symptoms (CDSS) were positively associated with levels of suPAR (p  Conclusion - Our findings indicate that increased suPAR levels are associated with depressive symptoms in females with schizophrenia, suggesting aberrant immune activation in this subgroup. Our results warrant further studies, including longitudinal follow-up of suPAR levels in schizophrenia and experimental studies of mechanisms

Dapagliflozin in patients with chronic kidney disease

Background: Patients with chronic kidney disease have a high risk of adverse kidney and cardiovascular outcomes. The effect of dapagliflozin in patients with chronic kidney disease, with or without type 2 diabetes, is not known. Methods: We randomly assigned 4304 participants with an estimated glomerular filtration rate (GFR) of 25 to 75 ml per minute per 1.73 m2 of body-surface area and a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of 200 to 5000 to receive dapagliflozin (10 mg once daily) or placebo. The primary outcome was a composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes. Results: The independent data monitoring committee recommended stopping the trial because of efficacy. Over a median of 2.4 years, a primary outcome event occurred in 197 of 2152 participants (9.2%) in the dapagliflozin group and 312 of 2152 participants (14.5%) in the placebo group (hazard ratio, 0.61; 95% confidence interval [CI], 0.51 to 0.72; P<0.001; number needed to treat to prevent one primary outcome event, 19 [95% CI, 15 to 27]). The hazard ratio for the composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal causes was 0.56 (95% CI, 0.45 to 0.68; P<0.001), and the hazard ratio for the composite of death from cardiovascular causes or hospitalization for heart failure was 0.71 (95% CI, 0.55 to 0.92; P = 0.009). Death occurred in 101 participants (4.7%) in the dapagliflozin group and 146 participants (6.8%) in the placebo group (hazard ratio, 0.69; 95% CI, 0.53 to 0.88; P = 0.004). The effects of dapagliflozin were similar in participants with type 2 diabetes and in those without type 2 diabetes. The known safety profile of dapagliflozin was confirmed. Conclusions: Among patients with chronic kidney disease, regardless of the presence or absence of diabetes, the risk of a composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes was significantly lower with dapagliflozin than with placebo