Identification of desalination and wind power plants sites using m-polar fuzzy Aczel-Alsina aggregation information.

Real-world decision-making problems often include multi-polar uncertainties dependent on multi-dimensional attributes. The m-polar fuzzy (mF) sets can efficiently handle such multi-faceted complications with T-norm based weighted aggregation techniques. The Aczel-Alsina T-norms offer comparatively flexible and accurate aggregation than the other well-known T-norm families. Consequently, this work introduced novel mF Aczel-Alsina aggregation operators (AOs), including weighted averaging (mFAAWA, mFAAOWA, mFAAHWA) and weighted geometric (mFAAWG, mFAAOWG, mFAAHWG) AOs. The fundamental properties, including boundedness, idempotency, monotonicity, and commutativity are investigated. Based on the proposed AOs, a decision-making algorithm is developed and implemented to solve two detailed multi-polar site selection problems (for desalination plant and for wind-power plant). Finally, a comparison with mF Dombi and mF Yager AOs reveals that different T-norm based AOs may yeild different solutions for the same problem.

Quantifying digital economy and green initiatives for carbon neutrality targets: a Kilian bias-adjusted bootstrap model evaluation of China economy.

Digitalization has emerged as a new hope for low-carbon sustainable economic growth after its successful trial during the COVID-19 measures. Therefore, both developed and developing economies focus on digitalization to cope with carbon neutrality targets. Thus, this study attempted to generate a meaningful relationship between the digital economy and green energy, innovation, and environmental tax policy to capture the role of factors in acquiring carbon neutrality. For the abovementioned objectives, modern econometric methods, such as the Kilian bias-adjusted bootstrap, were adopted to evaluate the Chinese dataset between 1990 and 2021. The results indicate that the study factors play a significant role in acquiring carbon neutrality in the long-term Chinese economy. Furthermore, quantile autoregressive distributed lag model (QARDL) indicates that all the factors influence carbon neutrality in various quantiles. Consequently, the digital economy, green energy and innovation, and environmental taxes significantly assist in attaining carbon neutrality in the long term, and the ecological Kuznets curve prevails in the economy. Therefore, radical and wide-ranging policy implications are required in many areas including environmental restrictions, digital economy promotion, green and sustainable technologies, and clean energy sources.

mecA and fdh: markers of pathogenicity and commensalism in Staphylococcus epidermidis of pediatric origin from Pakistan.

Staphylococcus epidermidis is an opportunistic bacterial pathogen. The study screened isolates of S. epidermidis of pediatric origin for genetic markers of discriminatory potential. 103 isolates (n = 75 clinical; n = 28 community) were screened for methicillin resistance (mecA), formate dehydrogenase (fdh) and an array of virulence factors through multiplex PCR and Congo red assay. The isolates were typed in four distinct categories, based on the presence of selected virulent factors. The type A clinical isolates carrying icaADBC operon (n = 22; 29.3%, P = 0.117) were not significantly differentiating the origin of isolates. The type B clinical isolates representing methicillin resistant S. epidermidis (MRSE) (n = 73; 97.3%, P < 0.00001) and the type C clinical isolates lacking formate dehydrogenase fdh (n = 62; 82.6%, P < 0.00001) were having significant discriminatory potential of clinical isolates, respectively. All type D community isolates were carrying fdh (n = 28; 100%, P < 0.00001). MecA and fdh are significant differential markers of pathogenicity and commensalism in S. epidermidis of pediatric origin.

Mitogenome evidence shows two radiation events and dispersals of matrilineal ancestry from northern coastal China to the Americas and Japan.

Although it is widely recognized that the ancestors of Native Americans (NAs) primarily came from Siberia, the link between mitochondrial DNA (mtDNA) lineage D4h3a (typical of NAs) and D4h3b (found so far only in East China and Thailand) raises the possibility that the ancestral sources for early NAs were more variegated than hypothesized. Here, we analyze 216 contemporary (including 106 newly sequenced) D4h mitogenomes and 39 previously reported ancient D4h data. The results reveal two radiation events of D4h in northern coastal China, one during the Last Glacial Maximum and the other within the last deglaciation, which facilitated the dispersals of D4h sub-branches to different areas including the Americas and the Japanese archipelago. The coastal distributions of the NA (D4h3a) and Japanese lineages (D4h1a and D4h2), in combination with the Paleolithic archaeological similarities among Northern China, the Americas, and Japan, lend support to the coastal dispersal scenario of early NAs.

A bioresource catalyst system of alginate-starch-activated carbon microsphere templated Cu nanoparticles: Potentials in nitroarenes hydrogenation and dyes discoloration.

The evolution and development of solid-matrix are considered a backbone for supporting and stabilizing of metal nanoparticles (NPs) and are the soul of the catalytic system. In the current study, the alginate-starch microsphere (Alg-St) was cross-linked using CaCl2 as a cross-linker. In addition, the Alg-St microsphere was blended with different percentages of activated carbon (AC). The microspheres adsorbed Cu+2 was reduced to zero-valent copper NPs through NaBH4 and used as a dip-catalyst. The supported Cu NPs cum NaBH4 system was used as dip-catalyst for the hydrogenation of 4-nitrophenol (4NP), 2-nitroanilline (2NA), and degradation of methylene blue (MB) and Congo red (CR) dyes. Among the different kinetics models, the experimental data were well-fitted in the zero-order kinetic model. Moreover pH, and recyclability were studied for 4NP, where the best activity was achieved at pH 7.0 for 4NP. No leaching was observed after 3rd cycle in the catalyst.

Distribution characteristics of soil AM fungi community in soft sandstone area.

To explore the diversity and distribution characteristics of soil arbuscular mycorrhizae fungi (AMF) communities in the soft sandstone area, thirteen arsenic sandstone rock samples were collected from three planting plots (SI, SII and SIII) and one bare control plot (CK), separately. The sampling locations are as follows: the top of the slope (denoted by the number 1), sunny slope (2), shady slope (3) and gully bottom (4). These samples were then tested with an Illumina HiSeq PE250 high-throughput sequencing platform. Experimental results show that the SIII4 sample (from the gully bottom of the SIII plot) has the highest moisture content of 9.1%, while the CK sample in the control plot has lowest moisture content. SI2 has the highest pH of 9.58 and CK has the lowest pH of 8.73. SII1 has the highest available phosphorus (AP) content of 9.61 mg/kg, while SII3 has the lowest AP content of 2.29 mg/kg. Furthermore, SI2 has the highest NH4-N content of 11.24 mg/kg, while SII1 has the lowest NH4-N of 4.09 mg/kg. SII1 has the highest available potassium (AK) content of 48.92 mg/kg and CK has the lowest AK content of 1.82 mg/kg. In the observed-species index reflecting AMF genetic diversity, SI1 differences significantly from SII4 and SIII3 (P < 0.05). In the Shannon index, SI1 is significantly different from SI2, SI3, SI4; SII2 is significantly different from SII3; SI2, SI4, SII1 and SII3 are quite different from CK (P < 0.05). The dominant genera of AMF in these plots include Glomus (17.24%-65.53%), Scutellospora (0.04%-67.38%), Septoglomus (2.83%-43.03%) and Kamienskia (0.64%-46.38%). The dominant genera of AMF vary significantly between sunny slope and shady slope. Positive correlation exists between soil NH4-N and the AM fungal community structure. There are prominent positive correlations exist among genetic diversity index chao1, observed-species, pH and AP (P < 0.05), and obviously negative correlation between observed species and AK (P < 0.05). The research findings on the distribution characteristics of AM fungus community in the arsenic sandstone plot and their relationship with environmental factors can help with arsenic sandstone management in other similar areas.

Enrichment of residual carbon from coal gasification fine slag by spiral separator.

Coal gasification is one of the most promising clean coal technologies. However, gasification process also produces a huge amount of solid waste of high carbon content, named coal gasification fine slag. The coal gasification fine slag is mainly handled by landfilling, which is not only a hazardous pollution, but also wasting the energy from residual carbon. Developing a technology to utilize coal gasification fine slag and recover the residual carbon is becoming essential for an eco-friendly coal chemical industry. In this paper, the enrichment behavior of residual carbon in coal gasification fine slag by a spiral separator is studied. The raw coal gasification fine slag sample and separator products are characterized on particle size distribution, size-depending ash content, reactivity, micromorphology and porous structure. The experimental results show that the spiral separator is efficient to remove ash and enriched carbonaceous components in coal gasification fine slag by separating feed (100%) into concentrate (81.2%), middlings (8.8%), and tailings (10.08%), where the ash content in tailings is up to 90%, accounting for 18.5% of total ash in feeding. The beneficial product "concentrate" has a good distribution of size-depending ash content, that most combustibles are enriched in these particles of diameter >100 µm. After spiral separator, the concentrate products have a more pure and developed porous structure with the surface area increasing from 199.8 m2/g (feeding) to 231.8 m2/g, as well as a better combustion reactivity of lower ignition temperature compared with feedings. Accordingly, an economic and feasible combination process of spiral separator connecting sieve can produce an enriched-carbon product of ∼45% yield and ∼80% carbonaceous content. The Iodine adsorption ability of sieved products increases by 47.6% compared with feed, and reaches up to about half of industry activated carbon. The finally sieved concentrate products have a good market prospect as fuel and adsorbent.

Versatility of Hydrogels: From Synthetic Strategies, Classification, and Properties to Biomedical Applications.

Hydrogels are three-dimensional, cross-linked, and supramolecular networks that can absorb significant volumes of water. Hydrogels are one of the most promising biomaterials in the biological and biomedical fields, thanks to their hydrophilic properties, biocompatibility, and wide therapeutic potential. Owing to their nontoxic nature and safe use, they are widely accepted for various biomedical applications such as wound dressing, controlled drug delivery, bone regeneration, tissue engineering, biosensors, and artificial contact lenses. Herein, this review comprises different synthetic strategies for hydrogels and their chemical/physical characteristics, and various analytical, optical, and spectroscopic tools for their characterization are discussed. A range of synthetic approaches is also covered for the synthesis and design of hydrogels. It will also cover biomedical applications such as bone regeneration, tissue engineering, and drug delivery. This review addressed the fundamental, general, and applied features of hydrogels in order to facilitate undergraduates, graduates, biomedical students, and researchers in a variety of domains.

Automated Detection of Rehabilitation Exercise by Stroke Patients Using 3-Layer CNN-LSTM Model.

According to statistics, stroke is the second or third leading cause of death and adult disability. Stroke causes losing control of the motor function, paralysis of body parts, and severe back pain for which a physiotherapist employs many therapies to restore the mobility needs of everyday life. This research article presents an automated approach to detect different therapy exercises performed by stroke patients during rehabilitation. The detection of rehabilitation exercise is a complex area of human activity recognition (HAR). Due to numerous achievements and increasing popularity of deep learning (DL) techniques, in this research article a DL model that combines convolutional neural network (CNN) and long short-term memory (LSTM) is proposed and is named as 3-Layer CNN-LSTM model. The dataset is collected through RGB (red, green, and blue) camera under the supervision of a physiotherapist, which is resized in the preprocessing stage. The 3-layer CNN-LSTM model takes preprocessed data at the convolutional layer. The convolutional layer extracts useful features from input data. The extracted features are then processed by adjusting weights through fully connected (FC) layers. The FC layers are followed by the LSTM layer. The LSTM layer further processes this data to learn its spatial and temporal dynamics. For comparison, we trained CNN model over the prescribed dataset and achieved 89.9% accuracy. The conducted experimental examination shows that the 3-Layer CNN-LSTM outperforms CNN and KNN algorithm and achieved 91.3% accuracy.

Diastolic function grading by American Society of Echocardiography guidelines and prediction of heart failure readmission and all-cause mortality in a community-based cohort.

BACKGROUND: Diastolic function (DF) guidelines have been simplified but lack extensive outcome data. Using a rural university heart failure (HF) database, we assessed whether DF grading could predict HF, HF readmission, and all-cause mortality (ACM). METHODS: In this single-center retrospective study that included 613 patients in sinus rhythm hospitalized for HF (HF with preserved-254 patients, with mid-range-216 patients, and reduced ejection fraction-143 patients), we recorded demographics, Doppler-echo, Framingham HF score, laboratories, HF readmission, and ACM with follow-up to 2167 days. RESULTS: Diastolic dysfunction (Ddys) parameters (left atrial volume index [LAVI] > 34 ml/m2 , tricuspid regurgitation [TR] velocity > 2.8 m/sec, and E/e' > 14) had moderate sensitivity (46.2%-65.0%) for predicting HF among all phenotypes combined with DF grading having moderate predictability and additive to a clinical composite for HF prediction (AUC = .677, P < 0.0001; difference = .043, P < 0.001) for combined phenotypes. Ddys parameters and Ddys severity (2016 ASE criteria: grade II and III) were significantly associated with HF readmission for decompensated HF within 60-2167 days of follow-up (LAVI > 34 ml/m2 : HR 1.56 [1.26-2.19]; E/e' > 14: HR 1.44 [1.21-1.99]; TR > 2.8 m/sec: H1.43 [1.19-1.88]; LV Dys grade II: HR 2.12 [1.42-2.96]; LV Ddys grade III: HR 2.39 [1.57-4.82]). CONCLUSION: The findings of this study highlight the clinical and prognostic relevance of determining the severity of LV Ddys in patients with HF with regard to HF verification and HF readmission.

Occurrence, distribution, and pollution indices of potentially toxic elements within the bed sediments of the riverine system in Pakistan.

Potentially toxic elements (PTEs) are a major source of pollution due to their toxicity, persistence, and bio-accumulating nature in riverine bed sediments. The sediment, as the largest storage and source of PTEs, plays an important role in transformation of mercury (Hg), lead (Pb), nickel (Ni), chromium (Cr), copper (Cu), zinc (Zn), and other toxic PTEs. Several important industrial hubs that contain a large population along the banks of different rivers, such as Kabul, Sutlej, Ravi, Jhelum, and Chenab in Pakistan, are acting as major sources of PTEs. In this study, 150 bed sediment samples (n=30 from each river) were collected from different sites. Total (acid extracted) PTE (Hg, Cu, Cr, Ni, Zn, and Pb) concentrations in bed sediments were determined using inductively coupled plasma mass spectrometry (ICP-MS). Sediment pollution indices were calculated in the major rivers of Pakistan. The results demonstrated high levels of Hg and Ni concentrations which exceeded the guideline standards of river authorities in the world. The contamination factor (CF) and contamination degree (CD) indices for Hg, Ni, and Pb showed a moderate to high (CF≥6 and CD≥24) contamination level in all the selected rivers. The values of geo-accumulation index (Igeo) were also high (Igeo≥5) for Hg and Pb and heavily polluted for Ni, while Cr, Cu, and Zn showed low to unpolluted (Igeo) values. Similarly, the enrichment factor (EF) values were moderately severe (5≤EF≤10) for Hg, Pb, and Ni in Sutlej, Ravi, and Jhelum, and severe (10≤EF≤25) in Kabul and Jhelum. Moreover, Hg and Ni showed severe to very severe enrichment in all the sampling sites. The ecological risk index (ERI) values represented considerable, moderate, and low risks, respectively, for Hg (The ERI value should not be bold. Please unbold the  ERI in the whole paper. It should be same like RI, CD and EF. [Formula: see text]≥160), Pb and Ni (40≤[Formula: see text]≤80), and Cr, Cu, and Zn ([Formula: see text]≤40). Similarly, potential ecological risk index (PERI) values posed considerable (300≤RI≤600) risk in Ravi and moderate (150≤RI≤300) in Kabul and Jhelum, but low (RI≤150) risk in Ravi and Chenab. On the basis of the abovementioned results, it is concluded that bed sediment pollution can be dangerous for both ecological resources and human beings. Therefore, PTE contamination should be regularly monitored and a cost-effective and environmentally friendly wastewater treatment plant should be installed to ensure removal of PTEs before the discharge of effluents into the freshwater ecosystems.

A kinetic evaluation and optimization study on NOx reduction by reburning under pressurized oxy-combustion.

Pressurized oxy-combustion is an emerging and more efficient technology for carbon capture, utilization, and storage than the first generation (atmospheric) oxy-combustion. NOx is a major conventional pollutant produced in pressurized oxy-combustion. In pressurized oxy-combustion, the utilization of latent heat from moisture and removal of acid gases (NOx and SOx) are mainly conducted in an integrated direct-contact wash column. Recent studies have shown that NOx particular inlet concentration should be maintained before direct contact wash column to remove NOx and SOx efficiently. As a result, minimizing NOx for environmental reasons, avoiding corrosion in carbon capture, utilization, and storage, and achieving effective NOx and SOx removal in direct contact wash columns are crucial. Reburning is a capable and affordable technology for NOx reduction; however, this process is still less studied at elevated pressure, particularly in pressurized oxy-combustion. In this paper, the kinetic evaluation and optimization study on NOx reduction by reburning under pressurized oxy-combustion was conducted. First, the most suitable mechanism was selected by comparing the results of different kinetic models with the experimental data in literature at atmospheric and elevated pressures. Based on the validated mechanism, a variety of parameters were studied at high pressure, i.e., comparing the effects of oxy and the air environment, different reburning fuels, residence time, H2O concentration, CH4/NO ratio, and equivalence ratio on the NO reduction. The results show that de-NOx efficiency in an oxy environment is significantly enhanced compared to the air environment. Improvement in the de-NOx efficiency is considerably higher with a pressure increase of up to 10 atm, but the effect is less prominent above 10 atm. The formation of HCN is significantly reduced while the N2 formation is enhanced as the pressure increases from 1 to 10 atm. The residence time required for the maximum NO reduction decreases as the pressure increases from 1 atm to 15 atm. At the higher pressure, the NO reduction rises prominently when the ratio of CH4/NO increases from 1 to 2; however, the effect fades after that. At higher pressure, the NO reduction by CH4 reburning decreases as the H2O concentration increases from 0 to 35%. The optimum equivalence ratio and high pressure for maximum NO reduction are 1.5 and 10 atm, respectively. This study could provide guidance for designing and optimizing a pressurized reburning process for NOx reduction in POC systems.

Complete mitogenomes document substantial genetic contribution from the Eurasian Steppe into northern Pakistani Indo-Iranian speakers.

To elucidate whether Bronze Age population dispersals from the Eurasian Steppe to South Asia contributed to the gene pool of Indo-Iranian-speaking groups, we analyzed 19,568 mitochondrial DNA (mtDNA) sequences from northern Pakistani and surrounding populations, including 213 newly generated mitochondrial genomes (mitogenomes) from Iranian and Dardic groups, both speakers from the ancient Indo-Iranian branch in northern Pakistan. Our results showed that 23% of mtDNA lineages with west Eurasian origin arose in situ in northern Pakistan since ~5000 years ago (kya), a time depth very close to the documented Indo-European dispersals into South Asia during the Bronze Age. Together with ancient mitogenomes from western Eurasia since the Neolithic, we identified five haplogroups (~8.4% of maternal gene pool) with roots in the Steppe region and subbranches arising (age ~5-2 kya old) in northern Pakistan as genetic legacies of Indo-Iranian speakers. Some of these haplogroups, such as W3a1b that have been found in the ancient samples from the late Bronze Age to the Iron Age period individuals of Swat Valley northern Pakistan, even have sub-lineages (age ~4 kya old) in the southern subcontinent, consistent with the southward spread of Indo-Iranian languages. By showing that substantial genetic components of Indo-Iranian speakers in northern Pakistan can be traced to Bronze Age in the Steppe region, our study suggests a demographic link with the spread of Indo-Iranian languages, and further highlights the corridor role of northern Pakistan in the southward dispersal of Indo-Iranian-speaking groups.

Faecal and nitrate contamination in the groundwater of Mardan district, Pakistan.

This study aimed to determine the status of groundwater contamination with faecal coliform and nitrate in the rural areas of Mardan district, Pakistan. Both analytes require regular monitoring according to the National Environmental Quality Standards (NEQS) of Pakistan. Groundwater samples (n = 100) were collected from 25 villages across four zones. Samples were analysed for physicochemical parameters including pH, electrical conductivity (EC), Escherichia coli (E. coli) contamination, nitrite, and nitrate ([Formula: see text] and [Formula: see text]). Whilst the average concentrations of [Formula: see text] in the water samples were within the permissible limits of 50 mg L-1 set by the World Health Organisation (WHO) and NEQS two villages exceeded the safety limits. Non-carcinogenic health risks of [Formula: see text] were estimated in terms of average daily dose (ADD) and hazard quotient (HQ). The HQ values for [Formula: see text] were > 1 for children signifying potential health risks; however, the adult population had HQ < 1 which indicates no risk. Groundwater samples tested positive for E. coli contamination in 13 villages, suggesting that residents may be living at risk of various microbial diseases due to drinking of contaminated water. The findings of this study provide valuable baseline data for groundwater researchers, policymakers, and the local public health department.

Correction: Ali, A., et al. Modeling Novel Putative Drugs and Vaccine Candidates against Tick-Borne Pathogens: A Subtractive Proteomics Approach. Vet. Sci. 2020, 7, 129.

The authors wish to make the following corrections to this paper [...].

Modeling Novel Putative Drugs and Vaccine Candidates against Tick-Borne Pathogens: A Subtractive Proteomics Approach.

Ticks and tick-borne pathogens (TBPs) continuously causing substantial losses to the public and veterinary health sectors. The identification of putative drug targets and vaccine candidates is crucial to control TBPs. No information has been recorded on designing novel drug targets and vaccine candidates based on proteins. Subtractive proteomics is an in silico approach that utilizes extensive screening for the identification of novel drug targets or vaccine candidates based on the determination of potential target proteins available in a pathogen proteome that may be used effectively to control diseases caused by these infectious agents. The present study aimed to investigate novel drug targets and vaccine candidates by utilizing subtractive proteomics to scan the available proteomes of TBPs and predict essential and non-host homologous proteins required for the survival of these diseases causing agents. Subtractive proteome analysis revealed a list of fifteen essential, non-host homologous, and unique metabolic proteins in the complete proteome of selected pathogens. Among these therapeutic target proteins, three were excluded due to the presence in host gut metagenome, eleven were found to be highly potential drug targets, while only one was found as a potential vaccine candidate against TBPs. The present study may provide a foundation to design potential drug targets and vaccine candidates for the effective control of infections caused by TBPs.

Exploring European ancestry among the Kalash population: a mitogenomic perspective.

With a population of around 4 000 individuals, the Kalash people have been living in the Hindu-Kush mountain valleys of present-day northern Pakistan for centuries. Due to their mysterious origin and fairer European complexion, the genetic history of this ethnic group has been investigated previously using different markers. To date, however, the maternal genetic architecture has not been systematically dissected based on high-resolution complete mitochondrial genomes (mitogenomes), making their maternal genetic history, especially their genetic connection with Europeans from a matrilineal perspective, unclear. To unravel this issue, we analyzed mitogenome data of 34 Kalash samples together with 6 075 individuals from across Eurasia. Our results indicated exclusive western Eurasian origin of the Kalash people, represented by eight haplogroups. Among these haplogroups, J2b1a7a and R0a5a (accounting for ~50% of the Kalash gene pool) displayed in situ differentiations in the Kalash and could be traced to the Mediterranean region. Age estimations suggested these haplogroups arose in the Kalash population ~2.26 and 3.01 thousand years ago (kya), a time frame consistent with the invasion of Alexander III of Macedon to the region. One possible explanation for the maternal genetic contribution from Europeans to the Kalash people would be the involvement of women in foreign campaigns of ancient Greek warfare, followed by a founder effect. Our study thus sheds important light on the genetic origin of the Kalash community of Pakistan.

Switchable-hydrophilicity solvent liquid-liquid microextraction versus dispersive liquid-liquid microextraction prior to HPLC-UV for the determination and isolation of piperine from Piper nigrum L.

Switchable-hydrophilicity solvent liquid-liquid microextraction and dispersive liquid-liquid microextraction were compared for the extraction of piperine from Piper nigrum L. prior to its analysis by using high-performance liquid chromatography with UV detection. Under optimum conditions, limits of detection and quantitation were found as 0.2-0.6 and 0.7-2.0 µg/mg with the two methods, respectively. Calibration graphs showed good linearity with coefficients of determination (R2 ) higher than 0.9962 and percentage relative standard deviations lower than 6.8%. Both methods were efficiently used for the extraction of piperine from black and white pepper samples from different origins and percentage relative recoveries ranged between 90.0 and 106.0%. The results showed that switchable-hydrophilicity solvent liquid-liquid microextraction is a better alternative to dispersive liquid-liquid microextraction for the routine analysis of piperine in food samples. A novel scaled-up dispersive liquid-liquid microextraction method was also proposed for the isolation of piperine providing a yield of 102.9 ± 4.9% and purity higher than 98.0% as revealed by NMR spectroscopy.

Clinical Characteristics, Comorbidities and Prognosis in Patients With Heart Failure With Mid-Range Ejection Fraction.

BACKGROUND: Patients with left ventricular ejection fractions between 40% and 49% either discovered de novo, having declined from ≥50%, or improved from <40% have been described as heart failure (HF) with mid-range ejection fraction (HFmrEF). Though clinical signs and symptoms are similar to other phenotypes, possible prognostic differences and therapeutic responses reinforce the need for further understanding of patients' characteristics especially in a rural community based population. The purpose of this study is to evaluate the clinical characteristics, comorbidities and prognosis of a rural patient population with HFmrEF. MATERIALS AND METHODS: We queried the electronic medical record from a community based university practice for all patients with a HF diagnosis. We included only those patients with >3 months follow-up and interpretable Doppler echocardiograms. We recorded demographic, Doppler-echo, and outcome variables (up to 2,083 days). RESULTS: There were 633 HF patients: 42.4% with preserved ejection fraction (HFpEF, EF ≥50%), 36.4% with HFmrEF, and 21.0% with reduced ejection fraction (HFrEF, EF <40%). HFmrEF patients were older, had greater coronary disease prevalence, lower systolic blood pressure, elevated brain natriuretic peptide, lower hemoglobin, and higher creatinine than HFpEF. All-cause mortality was intermediate between HFrEF and HFpEF but was not significantly different. Landmark analysis revealed a trend toward greater second readmission in HFmrEF as compared to HFpEF (hazard ratio: 1.43 [0.96-2.14],P = 0.0767). CONCLUSIONS: Rural patients with HFmrEF without an ambulatory HF clinic represent a higher percentage of HF patients than previously reported with greater coronary disease prevalence with comparable readmission rates and nonsignificantly different all-cause mortality.

Hot corrosion behaviors of TP347H and HR3C stainless steel with KCl deposit in oxy-biomass combustion.

Oxy-combustion is one of the most promising technologies for carbon capture and sequestration. When CO2-neutral biomass is burned under oxy-combustion conditions, named "oxy-biomass combustion" a negative CO2 emission can be achieved. However, the high content of potassium and chlorine in biomass results in sever ash deposition and corrosion in air fired furnaces, which are further aggravated in oxy-combustion mode due to the enrichment of corrosive species by flue gas recycle. In this paper, the hot corrosion behaviors and mechanism of two representative materials (TP347H, HR3C) used for superheaters in furnaces are studied. The effects of oxy-combustion atmosphere, KCl deposition, effect of SO2, effect of water vapor, and temperature on the corrosion kinetics at the starting stage are investigated. The corrosion severity of the materials was determined using the weight gain method, and the microstructures and chemical compositions of corrosion layers were characterized by the scanning electron microscopy with energy dispersive spectroscopy, and X-ray diffraction. The results show that the hot corrosion rate is significantly sped up by KCl deposition, more than five times the gas corrosion rate under the same gas composition and temperature. HR3C with higher Cr and Ni contents is more likely to form Cr enrichment on the interface between the corrosion layer and the substrate than TP347H, resulting in stronger resistance to the hot corrosion than TP347H. When the corrosion atmosphere is changed from air-combustion to oxy-combustion, the hot corrosion rate is reduced with a denser Cr oxide film and less metal sulfides. The increase of temperature in the presence of KCl deposition significantly affects the hot corrosion rate, e.g. the corrosion rate at 650 °C is 16 times higher than that at 450 °C. Water vapor and SO2 concentrations have opposite influences on the hot corrosion, respectively. Compared to the dry environment, a high-humidity environment decreases the hot corrosion rate; however, a higher SO2 concentration facilitates the sulfation of KCl deposits, leading to stronger damage to the chromium oxide film and thereby an increased hot corrosion rate.