Plasma exchange-A useful adjunct therapy to red cell exchange in patients with sickle cell disease and multiorgan dysfunction.

BACKGROUND: Urgent red cell exchange (RBCx) is indicated for many complications of sickle cell disease (SCD), including acute chest syndrome, stroke, and hepatic/splenic sequestration. Many who receive RBCx remain hospitalized and develop further complications, including multiple organ dysfunction syndrome (MODS), a leading cause of death in intensive care units. Therapeutic plasma exchange (TPE) has been advocated as an effective treatment of MODS, but its role in SCD compared with RBCx alone is not well studied. METHODS: We identified all ICU encounters from 2013 to 2019 involving RBCx procedures for MODS or SCD crisis that progressed to MODS, a total of 12 encounters. Data regarding hospital length of stay (LOS), survival, number of TPE procedures following RBCx, and procedure characteristics were collected. Surrogate laboratory markers of end-organ damage and disease severity scores were recorded at the time of admission, post-RBCx, post-TPE, and at discharge. RESULTS: Eight encounters involved RBCx followed by TPE (TPE group) while four involved RBCx alone (RBCx group). The TPE group had a higher SOFA score at ICU admission (9.5 vs. 7.0), greater predicted mortality, and a statistical trend toward higher disease severity scores following RBCx relative to the RBCx group (p = 0.10). The TPE group showed a significantly greater decrease in SOFA score between RBCx and discharge (p = 0.04). No significant difference in mortality or hospital LOS was observed between the groups. CONCLUSION: The findings suggest TPE may be considered as an adjunct treatment for patients with acute complications of SCD that progress to MODS, especially in cases where there is no significant improvement following RBCx.

Multiple Shape Coexistence in

From detailed spectroscopy of ^{110}Cd and ^{112}Cd following the ß^{+}/electron-capture decay of ^{110,112}In and the ß^{-} decay of ^{112}Ag, very weak decay branches from nonyrast states are observed. The transition rates determined from the measured branching ratios and level lifetimes obtained with the Doppler-shift attenuation method following inelastic neutron scattering reveal collective enhancements that are suggestive of a series of rotational bands. In ^{110}Cd, a γ band built on the shape-coexisting intruder configuration is suggested. For ^{112}Cd, the 2^{+} and 3^{+} intruder γ-band members are suggested, the 0_{3}^{+} band is extended to spin 4^{+}, and the 0_{4}^{+} band is identified. The results are interpreted using beyond-mean-field calculations employing the symmetry conserving configuration mixing method with the Gogny D1S energy density functional and with the suggestion that the Cd isotopes exhibit multiple shape coexistence.

Hepatitis C among vulnerable populations: A seroprevalence study of homeless, people who inject drugs and prisoners in London.

Injecting drugs substantially increases the risk of hepatitis C virus (HCV) infection and is common in the homeless and prisoners. Capturing accurate data on disease prevalence within these groups is challenging but is essential to inform strategies to reduce HCV transmission. The aim of this study was to estimate the prevalence of HCV in these populations. We conducted a cross-sectional study between May 2011 and June 2013 in London and, using convenience sampling, recruited participants from hostels for the homeless, drug treatment services and a prison. A questionnaire was administered and blood samples were tested for hepatitis C. We recruited 491 individuals who were homeless (40.7%), 205 drug users (17%) and 511 prisoners (42.3%). Eight per cent of patients (98/1207, 95% CI: 6.7%-9.8%) had active HCV infection and 3% (38/1207, 95% CI: 2.3%-4.3%) past HCV infection. Overall, one quarter (51/205) of people recruited in drug treatment services, 13% (65/491) of people from homeless residential sites and 4% (20/511) prisoners in this study were anti-HCV positive. Seventy-seven of the 136 (56.6%, 95% CI: 47.9%-65%) of HCV infected participants identified had a history of all three risk factors (homelessness, imprisonment and drug use), 27.3% (95% CI: 20.1%-35.6%) had 2 overlapping risk factors, and 15.4% (95% CI: 10.6%-23.7%) one risk factor. Drug treatment services, prisons and homelessness services provide good opportunities for identifying hepatitis C-infected individuals. Effective models need to be developed to ensure case identification in these settings that can lead to an effective treatment and an efficient HCV prevention.

Collective structure in 94Zr and subshell effects in shape coexistence.

Based on results from a measurement of weak decay branches observed following the ß- decay of 94Y and on lifetime data from a study of 94Zr by inelastic neutron scattering, collective structure is deduced in the closed-subshell nucleus 94Zr. These results establish shape coexistence in 94Zr. The role of subshells for nuclear collectivity is suggested to be important.

Number fluctuations of sparse quasiparticles in a superconductor.

We have directly measured quasiparticle number fluctuations in a thin film superconducting Al resonator in thermal equilibrium. The spectrum of these fluctuations provides a measure of both the density and the lifetime of the quasiparticles. We observe that the quasiparticle density decreases exponentially with decreasing temperature, as theoretically predicted, but saturates below 160 mK to 25-55/µm(3). We show that this saturation is consistent with the measured saturation in the quasiparticle lifetime, which also explains similar observations in qubit decoherence times.

Irrigation, organic matter addition, and tarping as methods of reducing emissions of methyl iodide from agricultural soil.

Methyl iodide (MeI) is increasingly being used as a highly effective alternative to the soil fumigant methyl bromide. Due to its volatile and toxic nature, MeI draws wide attention on its potential atmospheric emission following field fumigation treatment. Using soil columns that make it possible to determine emissions and gas phase distribution of soil fumigants, we studied MeI behavior in two soils differing in organic matter content. Additionally, the effectiveness of surface irrigation and tarping with virtually impermeable film (VIF) was assessed. In the lower organic matter, bare soil (control), emissions of MeI were rapid and high (83% of total). Although the peak emission flux was reduced by irrigation, the total loss was very similar to the control (82%). Tarping with VIF dramatically reduced emissions (0.04% total emissions). In the higher organic matter soil, degradation rate of MeI was increased around 4-fold, leading to a significant reduction in emissions (63% total emissions). The work suggests that surface tarping with VIF would be highly effective as an emissions reduction strategy and would also result in the maintenance of high soil gas concentrations (important for pest control). Ripping of the tarp after two weeks led to an immediate spike release of MeI, but, even so, the flux rate at this time was almost 20 times lower than the peak flux rate in the control. Even with tarp ripping, the total emission loss from the VIF treatment remained low (6%).

Chloropicrin emissions after shank injection: two-dimensional analytical and numerical model simulations of different source methods and field measurements.

Understanding the control mechanisms of fumigant movement in soil is a fundamental step for developing management strategies to reduce atmospheric emissions. Most soil fumigants including chloropicrin (CP) are applied by shank injection, and the application process often leaves vertical soil fractures that would potentially cause preferential fumigant movement and increased emissions. This potential transport pathway was evaluated by comparing cumulative emissions and soil air concentrations of CP from direct field measurements with those predicted using analytical and numerical models after assuming either point or rectangle sources for the injected CP. Results clearly showed that shank-injected CP, when treated as vertical rectangle sources, produced cumulative emission losses similar to the field measurements. Treating the shanked CP as point sources caused approximately 50% underprediction than the field measurements. The study also demonstrated that fumigant cumulative emissions can be predicted, with reasonable accuracy, using either analytical or numerical simulations.

Effect of organic material on field-scale emissions of 1,3-dichloropropene.

Soil fumigation is important for growing many fruits and vegetable crops, but fumigant emissions may contaminate the atmosphere. A large-scale field experiment was initiated to test the hypothesis that adding composted municipal green waste to the soil surface in an agricultural field would reduce atmospheric emissions of the 1,3-dichloropropene (1,3-D) after shank injection at a 133 kg ha(-1) application rate. Three micrometeorological methods were used to obtain fumigant flux density and cumulative emission values. The volatilization rate was measured continuously for 16 d, and the daily peak volatilization rates for the three methods ranged from 12 to 24 µg m(-2) s(-1). The total 1,3-D mass that volatilized to the atmosphere was approximately 14 to 68 kg, or 3 to 8% of the applied active ingredient. This represents an approximately 75 to 90% reduction in the total emissions compared with other recent field, field-plot, and laboratory studies. Significant reductions in the volatilization of 1,3-D may be possible when composted municipal green waste is applied to an agricultural field. This methodology also provides a beneficial use and disposal mechanism for composted vegetative material.

Managing agricultural emissions to the atmosphere: state of the science, fate and mitigation, and identifying research gaps.

The impact of agriculture on regional air quality creates significant challenges to sustainability of food supplies and to the quality of national resources. Agricultural emissions to the atmosphere can lead to many nuisances, such as smog, haze, or offensive odors. They can also create more serious effects on human or environmental health, such as those posed by pesticides and other toxic industrial pollutants. It is recognized that deterioration of the atmosphere is undesirable, but the short- and long-term impacts of specific agricultural activities on air quality are not well known or understood. These concerns led to the organization of the 2009 American Chemical Society Symposium titled . An outcome of this symposium is this special collection of 14 research papers focusing on various issues associated with production agriculture and its effect on air quality. Topics included emissions from animal feeding operations, odors, volatile organic compounds, pesticides, mitigation, modeling, and risk assessment. These papers provide new research insights, identify gaps in current knowledge, and recommend important future research directions. As the scientific community gains a better understanding of the relationships between anthropogenic activities and their effects on environmental systems, technological advances should enable a reduction in adverse consequences on the environment.

Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case-control study and recommendations.

We conducted a case­control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear-positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7­3.4) and of white (OR: 2.9; 95% CI: 1.8­4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7­20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7­60.6), unemployed (OR: 4.1; 95% CI: 3.0­5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4­1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.

1,3-dichloropropene and chloropicrin emissions following simulated drip irrigation to raised beds under plastic films.

Using laboratory soil chambers a nonscaled representation of an agricultural raised bed was constructed. For a sandy loam soil, 1,3-dichloropropene (1,3-D) and chloropicrin (CP) were applied at 5 cm depth with an excess of water (simulated drip irrigation). Application was made under both high density polyethylene (HDPE) and virtually impermeable film (VIF) covering the soil bed (the furrow was left uncovered). Soil gas distribution of the fumigants, together with emissions into the headspace above the bed, sidewall and furrow were determined over time. Total emissions from the HDPE treatment were cis 1,3-D 28%, trans 1,3-D 24%, and CP 8%. Due to its lower permeability, the values for VIF were 13%, 7%, and 1.5%, respectively. With HDPE, the majority (86-93%) of the emissions occurred from the bed, while for VIF the majority (92-99%) of the emissions was from the furrow. Compared to a range of literature values for shank injection, the use of drip application appears to offer a benefit in reducing 1,3-D and CP emissions. However, the most meaningful comparison is with our previous data for simulated shank injection where the same soil was covered (completely) with the same plastic films (1). In this comparison, only 1,3-D emissions under HDPE were lower with drip application; 1,3-D emissions under VIF and CP emissions under both films were greater with the drip application.

High rate of transmission among contacts in large London outbreak of isoniazid mono-resistant tuberculosis.

BACKGROUND: For a continuing London outbreak of isoniazid mono-resistant tuberculosis (TB), we aimed to determine transmission rates and risk factors for contacts of early cases, in order to inform future guidance on contact tracing. METHODS: Paper-based proformas were completed by TB nurses, and then analysed using EpiInfo/SAS statistical software. RESULTS: Forty community contacts (11%) became cases, 45 (13%) were recommended chemoprophylaxis and 270 (76%) were discharged clear of infection. The highest transmission rate was among contacts exposed to two or more cases (29% became cases) and close contacts of sputum smear-positive cases (22%). Other risk factors were being male and exposure to drug-using cases or cases with prison links. The number needed to be screened (NNS) to detect one case was lowest [5 (95% CI: 4-8)] for contacts of sputum smear-positive pulmonary cases, although the NNS was still only 20 (95% CI:8-72) for casual contacts of smear-positive cases. CONCLUSIONS: Transmission of disease to contacts was high (11%) compared with other documented outbreaks (0.7-2%). The results support recommended guidelines for contact tracing but also provide grounds to recommend, for outbreak cases, screening of casual contacts of smear-positive cases and contacts exposed to more than one case, drug users or prisoners.

Analytical solution describing pesticide volatilization from soil affected by a change in surface condition.

An analytical solution describing the fate and transport of pesticides applied to soils has been developed. Two pesticide application methods can be simulated: point-source applications, such as idealized shank or a hot-gas injection method, and a more realistic shank-source application method that includes a vertical pesticide distribution in the soil domain due to a soil fracture caused by a shank. The solutions allow determination of the volatilization rate and other information that could be important for understanding fumigant movement and in the development of regulatory permitting conditions. The solutions can be used to characterize differences in emissions relative to changes in the soil degradation rate, surface barrier conditions, application depth, and soil packing. In some cases, simple algebraic expressions are provided that can be used to obtain the total emissions and total soil degradation. The solutions provide a consistent methodology for determining the total emissions and can be used with other information, such as field and laboratory experimental data, to support the development of fumigant regulations. The uses of the models are illustrated by several examples.

Kinetic distribution of 14C-metsulfuron-methyl residues in paddy soils under different moisture conditions.

Rice paddy soils undergo several cycles of drying and wetting during a growing season. A laboratory study was conducted to determine the effect of soil moisture conditions on the distribution and kinetics of extractable and bound residues of 14C-metsulfuron-methyl in six Chinese paddy soils during 84 d of incubation at 15 degrees C with moisture contents varying from 20 to 50% of the field water-holding capacity. The amount of extractable residues consistently increased and bound residues decreased with increasing soil moisture content. At the end of the incubation experiments, extractable residues and bound residues accounted for 34.5 to 84.4% and 11.6 to 53.3% of applied radioactivity in soils, respectively. Soil pH and soil microbial biomass carbon were the most predominant factors affecting the formation and relative distribution of herbicide residues between extractable and bound residue forms. In high-pH soils, bound residues decreased and extractable residues increased, suggesting an increased leaching risk for metsulfuron-methyl in alkaline soils. High precipitation rates, along with the common practice of liming in southeastern China, may lead to enhanced herbicide leaching as well as phytotoxicity to rotation plants and should be considered in overall pest management practices.

The effect of malondialdehyde is modified by simian virus 40 transformation in human lung fibroblast cells.

The effects of malondialdehyde (MDA), a product of oxidative stress, on normal lung fibroblast cells (MRC5) and transformed cells (MRC5 SV2) showed differing responses between the two cell lines. MRC5 cells showed lower viability at low MDA concentrations (<250 µM) but had better viability at higher concentrations than the transformed cells. Both cell lines showed an increase in the number of micronuclei, nuclear size and a relocation of p53 to the nucleus with increasing MDA. The expression of p53 was higher in the MRC5 cells at 24 h; 2-8 fold induction vs 1-2.5 fold in the MRC5 SV2 cells, but reduced to almost zero at 48 h in the MRC5 cells. Mutation sequencing of the PCR products of a 689 bp region (residues 4640-5328) of the TP53 gene revealed MRC5 had more mutations than MRC5 SV2 cells (n = 21 and 11 respectively) and that they were predominantly insertions (MRC5 81%, MRC5 SV2 100%). A common mutation was observed in both cell lines; a G insertion at residue 4724 (n = 7) which could prove to be a mutational hotspot. These results indicate that the transformed cells are slower to respond to oxidative stress and/or mutagenic compounds. The mutation spectrum of predominantly frameshift mutations (insertions) suggests that oxidative stress plays a minimal role in smoking related lung cancer, but could be of greater importance to other lung diseases and cancer caused by exposures such as passive smokers, passive vapers and atmospheric pollutants.

Diel leaf growth of rapeseed at critically low temperature under winter field conditions.

Growth and development of winter crops is strongly limited by low temperature during winter. Monitoring the temporal dynamics and thermal limits of leaf growth in that period can give important insights into the growth physiology at low temperature, crop management and future breeding traits for winter crops. In this study, we focussed on winter rapeseed as a model, dicotyledonous winter crop to study leaf growth under natural winter field conditions. Leaf growth was measured using a high-resolution marker based image sequence analysis method and the results were evaluated in the context of environmental conditions. Leaves stopped growing at a base temperature of 0°C. Above ~4°C, leaves grew with a diel (24h) growth rhythm, which is typically known for dicots at thermally non-limiting growth conditions. Relative leaf growth rates at temperatures above this 4°C threshold were higher at night and showed a pronounced depression during the day, which we could describe by a model based on the environmental factors vapour pressure deficit (VPD), temperature and light with VPD exerting the strongest negative effect on leaf growth. We conclude that leaf growth of the selected model species at low temperatures shows a transition between pronounced environmental regulation and a superposition of environmental and internal, possibly circadian-clock-dependent regulation.

Simulating emissions of 1,3-dichloropropene after soil fumigation under field conditions.

Soil fumigation is an important agricultural practice used to produce many vegetable and fruit crops. However, fumigating soil can lead to atmospheric emissions which can increase risks to human and environmental health. A complete understanding of the transport, fate, and emissions of fumigants as impacted by soil and environmental processes is needed to mitigate atmospheric emissions. Five large-scale field experiments were conducted to measure emission rates for 1,3-dichloropropene (1,3-D), a soil fumigant commonly used in California. Numerical simulations of these experiments were conducted in predictive mode (i.e., no calibration) to determine if simulation could be used as a substitute for field experimentation to obtain information needed by regulators. The results show that the magnitude of the volatilization rate and the total emissions could be adequately predicted for these experiments, with the exception of a scenario where the field was periodically irrigated after fumigation. In addition, the timing of the daily peak 1,3-D emissions was not accurately predicted for these experiments due to the peak emission rates occurring during the night or early-morning hours. This study revealed that more comprehensive mathematical models (or adjustments to existing models) are needed to fully describe emissions of soil fumigants from field soils under typical agronomic conditions.

Large Angle Optical Access in a Sub-Kelvin Cryostat.

The development of lens-antenna-coupled aluminum-based microwave kinetic inductance detectors (MKIDs) and on-chip spectrometers needs a dedicated cryogenic setup to measure the beam patterns of the lens-antenna system over a large angular throughput and broad frequency range. This requires a careful design since the MKID has to be cooled to temperatures below 300 mK to operate effectively. We developed such a cryostat with a large opening angle θ = ± 37 . 8 ∘ and an optical access with a low-pass edge at 950 GHz . The system is based upon a commercial pulse tube cooled 3 K system with a 4 He - 3 He sorption cooler to allow base temperatures below 300 mK . A careful study of the spectral and geometric throughput was performed to minimize thermal loading on the cold stage, allowing a base temperature of 265 mK . Radio-transparent multi-layer-insulation was employed as a recent development in filter technology to efficiently block near-infrared radiation.

Use of quantum-point-contact high-electron-mobility-transistors for time domain multiplexing of large arrays of high impedance low temperature bolometers.

The use of a multiplexing readout for an array of bolometers simplifies the electronics and wiring, so making the readout of large arrays of bolometers (>100) feasible. Here we describe a time domain multiplexing technique and its performance based on the use of quantum-point-contact high-electron-mobility-transistors as low temperature (to approximately 100 mK) switches for measuring high impedance (5...70 MOmega) resistances and sensors. The presented system is well matched to ground based millimetric astronomy demands.

Effect of surface application of ammonium thiosulfate on field-scale emissions of 1,3-dichloropropene.

Soil fumigation is important for food production but has the potential to discharge toxic chemicals into the environment, which may adversely affect human and ecosystem health. A field experiment was conducted to evaluate the effect of applying ammonium thiosulfate fertilizer to the soil surface prior to fumigating with 1,3-dichloropropene (1,3-D). The ammonium thiosulfate solution was applied as a spray with minimal water to minimize the effect on emissions from saturating (e.g. sealing) the soil pores with water. Two independent data sets were collected for determining the emission rate. One data set was used with three micrometeorological approaches: aerodynamic, integrated horizontal flux and theoretical profile shape; the other dataset with two indirect, back calculation methods that used the CALPUFF and ISCST3 dispersion models. Using the five methodologies, the 1,3-D emission rate was obtained for 16days. The maximum emission rates ranged from 7 to 20µgm-2s-1, the maximum 24-hour averaged emission rates ranged from 5 to 13µgm-2s-1, and the total 1,3-D emissions ranged from 12 to 26%. Comparing to fumigation without ammonium thiosulfate spray revealed that emissions were reduced from 3% (CALPUFF) to 29% (ADM). Using a simulation model, ammonium thiosulfate spray would be expected to reduce emissions by almost 21%. These data provide evidence that emissions of 1,3-D can be reduced by spraying ammonium thiosulfate fertilizer on the soil surface prior to soil fumigation, and provides another emission-reduction strategy to those recently reported (e.g., deep injection, water seals and organic amendments).