In situ monitoring of internal water storage reveals nitrogen first flush phenomena, intermittent denitrification, and seasonal ammonium flushing.

Internal water storage (IWS) can be included in bioretention practices to increase storage capacity or promote denitrification-the microbial reduction of nitrate to nitrogen gas. IWS and nitrate dynamics are well studied in laboratory systems. However, the investigation of field environments, consideration of multiple nitrogen species, and determination between mixing versus denitrification is lacking. This study employs in situ monitoring (∼24 h duration) of water level, dissolved oxygen (DO), conductivity, nitrogen species, and dual isotopes of a field bioretention IWS system for nine storms events over a year period. Rapid peaks in IWS conductivity, DO, and total nitrogen (TN) concentrations occurred along the rising limb of the IWS water level and indicated a first flush effect. TN concentrations generally peaked during the first ∼0.33 h of sampling and the average peak IWS TN concentration (Cmax = 4.82 ± 2.46 mg-N/L) was 38% and 64% greater than the average TN along the IWS rising and falling limb, respectively. Dissolved organic nitrogen (DON) and nitrate plus nitrite (NOx) were the dominant nitrogen species of IWS samples. However, average IWS peak ammonium (NH4+) concentrations August through November (0.28 ± 0.47 mg-N/L) demonstrated statistically significant shifts compared to February through May (2.72 ± 0.95 mg-N/L). Average lysimeter conductivity measurements were more than ten times higher February through May. The sustained presence of sodium observed in lysimeters, from road salt application, contributed to NH4+ flushing from the unsaturated media layer. Dual isotope analysis showed denitrification occurred for discrete time intervals along the tail of the NOx concentration profile and the hydrologic falling limb. Longer antecedent dry periods (17 days) did not correlate to enhanced denitrification but did correspond to more leaching of soil organic nitrogen. Results from field monitoring highlight the complexities of nitrogen management in bioretention systems. First flush behavior into the IWS suggests management to prevent TN export is most critical during the onset of a storm.

Trends in diagnosis of cardiac transthyretin amyloidosis: 3-year analysis of scintigraphic studies: Prevalence of myocardial uptake and its predictor factors.

To determine the prevalence of myocardial uptake (MU) and to identify predictors of MU in patients undergoing scintigraphy. Retrospective single-center series of technetium-99 m-labelled 3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) scans performed from March 2017 to March 2020. All patients undergoing scintigraphy were included, except those with preexisting amyloidosis. The features of MU, patients' characteristics and comorbidities were documented. Multivariate analysis was used to find items predicting MU. A total of 3,629 99mTc-DPD scans (total 11,444) were performed in patients aged > 70. The overall prevalence of MU was 2.7% (82/3,629); 1.2% in 2017-2018, to 2% in 2018-2019, and to 3.7% in 2019-2020. The prevalence of MU in patients without suspected cardiomyopathy was 1.2%; 1.1% in 2017-2018, 1.5% in 2018-2019 and 1% in 2019-2020. There is an increase in the number of requests due to suspected cardiomyopathy from 0.2% in 2017-2018 to 1.4% in 2018-2019 and to 4.8% in 2019-2020. Age, male sex, hypertension, heart failure, atrial fibrillation, atrioventricular block, aortic stenosis, and carpal tunnel syndrome were found to be predictors of MU. In patients without heart failure, only age, atrial fibrillation, and carpal tunnel syndrome were predicted MU. The prevalence of MU in scintigraphic studies surged over time due to the incremental referrals under the indication of cardiomyopathy workup. Atrial fibrillation and carpal tunnel syndrome were predictors for MU in patients without heart failure. Identifying patients with MU and no heart failure for extended screening for ATTR can lead to an earlier diagnosis and application of novel treatments.

The impact of bioretention column internal water storage underdrain height on denitrification under continuous and transient flow.

Internal water storage (IWS), a below-grade saturated layer, is a bioretention design component created by adjusting the underdrain outlet elevation. Anaerobic conditions and the presence of a carbon source in IWS facilitates denitrification. Yet it remains unclear how underdrain height within the IWS impacts nitrate (NO3-) removal. This study applied synthetic stormwater with NO3- to three laboratory columns with underdrains located at the bottom, middle, or top of a 32 cm thick gravel-woodchip IWS. Under steady state conditions, underdrain nitrogen removal demonstrated a positive linear relationship with increasing hydraulic residence time (HRT). For a 1 cm/h hydraulic loading rate (HLR), nitrogen removal efficiency increased from 52 to 99% as underdrain height moved from the top to the bottom. Despite identical IWS thickness across columns, immobilize zones below the middle and top underdrains limited the steady state nitrogen removal. Dual isotopes in NO3- also indicated denitrification occurred in mobile zones and showed little or no denitrification in immobile zones due to limited mass transport. Transient flow conditions were applied, to mimic storms, followed by dry conditions. Lower effluent nitrogen concentrations and mass fluxes were observed from the bottom underdrain across the range of HLRs tested (1 to 5 cm/h) but performance of all three underdrains converged after the application of one pore volume. The top underdrain enhanced mixing between new incoming low-DOC stormwater and old IWS water with high-DOC which minimized effluent DOC concentrations. NO3- isotope enrichment factors indicated denitrification during transient flow for all three underdrain heights and enrichment increased for the 5 cm/h HLR. For sites with narrow IWS geometries (width to depth ratio < 1), optimal underdrain height is likely located between the bottom and top of the IWS to promote mixing with old IWS water high in DOC and sustain denitrification during storms.

Large spatiotemporal variability in metabolic regimes for an urban stream draining four wastewater treatment plants with implications for dissolved oxygen monitoring.

Urbanization and subsequent expansion of wastewater treatment plant (WWTP) capacity has the potential to alter stream metabolic regimes, but the magnitude of this change remains unknown. Indeed, our understanding of downstream WWTP effects on stream metabolism is spatially and temporally limited, and monitoring designs with upstream-downstream comparison sites are rare. Despite this, and despite observed spatiotemporal variability in stream metabolic regimes, regulators typically use snapshot monitoring to assess ecosystem function in receiving streams, potentially leading to biased conclusions about stream health. To address these important practical issues, we assessed the spatiotemporal variability in stream metabolism at nine sites upstream and downstream of four WWTPs in a suburban stream. We used one year (2017-2018) of high-frequency dissolved oxygen (DO) data to model daily gross primary productivity (GPP) and ecosystem respiration (ER). We found that GPP was 1.7-4.0 times higher and ER was 1.2-7.2 times higher downstream of the WWTPs, especially in spring when light was not limited by canopy shading. Critically, we observed that these effects were spatially limited to the kilometer or so just downstream of the plant. These effects were also temporally limited, and metabolic rates upstream of WWTPs were not different from sites downstream of the plant after leaf-out at some sites. Across sites, regardless of their relation to WWTPs, GPP was positively correlated with potential incident light suggesting that light is the dominant control on GPP in this system. Temporal windowing of DO to proposed regulatory monitoring lengths revealed that the violation frequency of water quality criteria depended on both the monitoring interval and start date. We conclude that spatiotemporal variability in metabolism and DO are crucial considerations when developing monitoring programs to assess ecosystem function, and that evidence of WWTP effects may only arise during high light conditions and at limited scales.

Can Karst Conduit Models Be Calibrated? A Dual Approach Using Dye Tracing and Temperature.

Modeling flow and transport using both temperature and dye tracing provides constraints that can improve understanding of karst networks. A laminar flow and transport model using the finite element subsurface flow model simulated the conduit connection between a sinking stream and spring in central Pennsylvania to evaluate how conduit morphology might affect dye transport. Single and overly tortuous conduit models resulted in high concentrations as dye flowed back into the conduit from the matrix after dye injections ceased. A forked conduit model diverted flow from the main conduit, reducing falling limb dye concentration. Latin hypercube sampling was performed to evaluate the sensitivity of 52 parameter combinations (conduit hydraulic conductivity, conduit cross-sectional area, matrix transmissivity, matrix porosity, and dispersivity) for four conduit geometry scenarios. Sensitivity of arrival time for 50% of the dye indicated no parameter combinations which simulate falling limb dye concentrations for tortuous geometries, confirming the importance of the forked geometry regardless of other parameters. Temperature data from high-resolution loggers were then incorporated into the forked conduit model to reproduce seasonal spring temperature using variable sink inflow. Unlike the dye trace models, the thermal models were sensitive to other model parameters, such as conduit cross-sectional area and matrix transmissivity. These results showed this dual approach (dye and temperature) to karst network modeling is useful for (1) exploring the role of conduit and matrix interaction for contaminant storage, (2) constraining karst conduit geometries, which are often poorly understood, and (3) quantifying the effect of seasonal trends on karst aquifers.

Wastewater treatment plant effluent introduces recoverable shifts in microbial community composition in receiving streams.

Through a combined approach using analytical chemistry, real-time quantitative polymerase chain reaction (qPCR), and targeted amplicon sequencing, we studied the impact of wastewater treatment plant effluent sources at six sites on two sampling dates on the chemical and microbial population regimes within the Wissahickon Creek, and its tributary, Sandy Run, in Montgomery County, Pennsylvania, USA. These water bodies contribute flow to the Schuylkill River, one of the major drinking water sources for Philadelphia, Pennsylvania. Effluent was observed to be a significant source of nutrients, human and non-specific fecal associated taxa. There was an observed increase in the alpha diversity at locations immediately below effluent outflows, which contributed many taxa involved in wastewater treatment processes and nutrient cycling to the stream's microbial community. Unexpectedly, modeling of microbial community shifts along the stream was not controlled by concentrations of measured nutrients. Furthermore, partial recovery, in the form of decreasing abundances of bacteria and nutrients associated with wastewater treatment plant processes, nutrient cycling bacteria, and taxa associated with fecal and sewage sources, was observed between effluent sources, which we hypothesize is controlled by distance from effluent source. Antecedent moisture conditions were observed to impact overall microbial community diversity, with higher diversity occurring after rainfall. Finally, the efficacy of using a subset of the microbial community including the orders of Bifidobacteriales, Bacteroidales, and Clostridiales to estimate the degree of influence due to sewage and fecal sources was explored and verified.

Comparison of flowpaths to a well and spring in a karst aquifer.

The permeability of some karst aquifers consists of networks of poorly integrated conduits and dissolution-widened fractures. The flow includes conduit flow, especially during storm recharge, but lacks the focused recharge into single master conduits that occurs in more highly developed karst systems. The proportions of conduit and dispersed flow are difficult to quantify in such systems. This study examines the flowpaths in a small karst watershed, based on comparing the physical and chemical response to storm flow at both a spring and a well. By conducting continuous monitoring at both locations, a better understanding of the flowpaths in a poorly integrated network was obtained. A more permeable flowpath to the spring leads to faster storm response and lower ion concentrations. The flowpath to and from the well is more complicated. The higher ion content and slower storm response suggest slower, more dispersed flowpaths. However, the well has greater variation in ion chemistry. Periodic recharge may dilute well concentrations due to faster (conduit or fracture) flowpaths. Although karst systems such as this are difficult to characterize, applying a variety of geochemical and physical monitoring techniques at multiple locations illustrates that the flowpaths can vary in both space and time.

Geophysical and Hydrologic Studies of Lake Seepage Variability.

Variations in lake seepage were studied along a 130 m shoreline of Mirror Lake NH. Seepage was downward from the lake to groundwater; rates measured from 28 seepage meters varied from 0 to -282 cm/d. Causes of this variation were investigated using electrical resistivity surveys and lakebed sediment characterization. Two-dimensional (2D) resistivity surveys showed a transition in lakebed sediments from outwash to till that correlated with high- and low-seepage zones, respectively. However, the 2D survey was not able to predict smaller scale variations within these facies. In the outwash, fast seepage was associated with permeability variations in a thin (2 cm) layer of sediments at the top of the lakebed. In the till, where seepage was slower than that in the outwash, a three-dimensional resistivity survey mapped a point of high seepage associated with heterogeneity (lower resistivity and likely higher permeability). Points of focused flow across the sediment-water interface are difficult to detect and can transmit a large percentage of total exchange. Using a series of electrical resistivity geophysical methods in combination with hydrologic data to locate heterogeneities that affect seepage rates can help guide seepage meter placement. Improving our understanding of the causes and types of heterogeneity in lake seepage will provide better data for lake budgets and prediction of mass transfer of solutes or contaminants between lakes and groundwater.

Ranolazine in the treatment of atrial fibrillation: Results of the dose-ranging RAFFAELLO (Ranolazine in Atrial Fibrillation Following An ELectricaL CardiOversion) study.

BACKGROUND: Currently available antiarrhythmic agents for the treatment of atrial fibrillation (AF) have important limitations, leaving an unmet need for safe and effective therapy. Ranolazine is an approved antianginal agent with a favorable safety profile and electrophysiologic properties suggesting a potential role in the treatment of AF. OBJECTIVE: The purpose of this study was to assess the safety and efficacy of ranolazine in the prevention of AF recurrence after successful electrical cardioversion and to ascertain the most appropriate dose of this agent. METHODS: This prospective, multicenter, randomized, double-blind, placebo-control parallel group phase II dose-ranging trial randomized patients with persistent AF (7 days to 6 months) 2 hours after successful electrical cardioversion to placebo, or ranolazine 375 mg, 500 mg, or 750 mg bid. Patients were monitored daily by transtelephonic ECG. The primary end-point was the time to first AF recurrence. RESULTS: Of 241 patients randomized, 238 took at least 1 drug dose. Ranolazine proved to be safe and tolerable. No dose of the drug significantly prolonged time to AF recurrence. AF recurred in 56.4%, 56.9%, 41.7%, and 39.7% of patients in the placebo, ranolazine 375 mg, ranolazine 500 mg, and ranolazine 750 mg groups, respectively. The reduction in overall AF recurrence in the combined 500-mg and 750-mg groups was of borderline significance compared to the placebo group (P = .053) and significant compared to 375-mg group (P = .035). CONCLUSION: No dose of ranolazine significantly prolonged time to AF recurrence. However, the 500-mg and 750 mg-groups combined reduced AF recurrences, suggesting a possible role for this agent in the treatment of AF.

Seasonal and daily variations in concentrations of methyl-tertiary-butyl ether (MTBE) at Cranberry Lake, New Jersey.

Methyl-tertiary-butyl ether (MTBE), an additive used to oxygenate gasoline, has been detected in lakes in northwestern New Jersey. This occurrence has been attributed to the use of gasoline-powered watercraft. This paper documents and explains both seasonal and daily variations in MTBE concentrations at Cranberry Lake. During a recent boating season (late April to September 1999), concentrations of MTBE typically exceeded 20 microg/L. MTBE concentrations varied daily from 12 to 24 microg/L over a 2-week period that included the Labor Day holiday. Concentrations were highest on weekends when there is more boat traffic, which had an immediate effect on MTBE mass throughout the lake. MTBE concentrations decreased to about 2 microg/L shortly after the end of the summer recreational season. The loss of MTBE can be accounted for by volatilization, with a half-life on the order of 10 days. The volatilization rate was modeled with the daily decrease in MTBE then the modeled rate was validated using the data from the seasonal decline.

Using stormwater hysteresis to characterize karst spring discharge.

Discharge from karst springs contains a mixture of conduit and matrix water, but the variations in groundwater mixing are poorly known. Storm events present an opportunity to try to map flow components because water entering during storms is more dilute and provides a tracer as it mixes with pre-event water along the flowpath from the recharge area to discharge at a spring. We used hysteresis plots of Mg/Ca ratios in a spring in the Cumberland Valley of Pennsylvania to map conduit (higher Ca) vs. diffuse (higher Mg) sources of recharge. We observed two types of temporal heterogeneity: within a storm event and from storm to storm. The timing of the variation in Mg/Ca suggested sources of mixing waters. An increase in the Mg/Ca ratio at the beginning of some storms while conductivity declined suggested diffuse recharge through the epikarst. The rapid changes in Mg/Ca ratios for low-intensity events probably occurred as the rainfall waxed and waned and illustrate that a variety of flowpaths are available at this spring because additional flushing of Mg occurred. In contrast, the conductivity hysteresis began with dilute water initially and rotation was similar from storm to storm. Hysteresis plots of the Mg/Ca ratio have the potential of revealing more of the complexity in discharge than conductivity alone. A better understanding of flow components in karst is needed to protect these aquifers as a groundwater resource.

Freeze core sampling to validate time-lapse resistivity monitoring of the hyporheic zone.

A freeze core sampler was used to characterize hyporheic zone storage during a stream tracer test. The pore water from the frozen core showed tracer lingered in the hyporheic zone after the tracer had returned to background concentration in collocated well samples. These results confirmed evidence of lingering subsurface tracer seen in time-lapse electrical resistivity tomographs. The pore water exhibited brine exclusion (ion concentrations in ice lower than source water) in a sediment matrix, despite the fast freezing time. Although freeze core sampling provided qualitative evidence of lingering tracer, it proved difficult to quantify tracer concentration because the amount of brine exclusion during freezing could not be accurately determined. Nonetheless, the additional evidence for lingering tracer supports using time-lapse resistivity to detect regions of low fluid mobility within the hyporheic zone that can act as chemically reactive zones of importance in stream health.

Stream bottom resistivity tomography to map ground water discharge.

This study investigates the effectiveness of direct current electrical resistivity as a tool for assessing ground water/surface water interactions within streams. This research has shown that patterns of ground water discharge can be mapped at the meter scale, which is important for understanding stream water quality and ecosystem function. Underwater electrical resistivity surveys along a 107-m stream section within the Burd Run Watershed in South Central Pennsylvania identified three resistivity layers: a resistive (100 to 400 Omega m) surface layer corresponding to the streambed sediments, a conductive (20 to 100 Omega m) middle layer corresponding to residual clay sediments, and a resistive (100 to 450 Omega m) bottom layer corresponding to the carbonate bedrock. Tile probing to determine the depth to the bedrock and resistivity test box analysis of augered sediment samples confirmed these interpretations of the resistivity data. Ground water seeps occurred where the resistivity data showed that the residual clays were thinnest and bedrock was closest to the streambed. Plotting the difference in resistivity between two surveys, one conducted during low-stage and the other during high-stage stream conditions, showed changes in the conductivity of the pore fluids saturating the sediments. Under high-stream stage conditions, the top layer showed increased resistivity values for sections with surface water infiltration but showed nearly constant resistivity in sections with ground water seeps. This was expressed as difference values less than 50 Omega m in the area of the seeps and greater than 50 Omega m change for the streambed sediments saturated by surface water. Thus, electrical resistivity aided in characterizing ground water discharge zones by detecting variations in subsurface resistivity under high- and low-stream stage conditions as well as mapping subsurface heterogeneities that promote these exchanges.