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1.
bioRxiv ; 2024 May 10.
Article in English | MEDLINE | ID: mdl-38766136

ABSTRACT

Polygenic prediction of complex trait phenotypes has become important in human genetics, especially in the context of precision medicine. Recently, Morgante et al. introduced mr.mash, a flexible and computationally efficient method that models multiple phenotypes jointly and leverages sharing of effects across such phenotypes to improve prediction accuracy. However, a drawback of mr.mash is that it requires individual-level data, which are often not publicly available. In this work, we introduce mr.mash-rss, an extension of the mr.mash model that requires only summary statistics from Genome-Wide Association Studies (GWAS) and linkage disequilibrium (LD) estimates from a reference panel. By using summary data, we achieve the twin goal of increasing the applicability of the mr.mash model to data sets that are not publicly available and making it scalable to biobank-size data. Through simulations, we show that mr.mash-rss is competitive with, and often outperforms, current state-of-the-art methods for single- and multi-phenotype polygenic prediction in a variety of scenarios that differ in the pattern of effect sharing across phenotypes, the number of phenotypes, the number of causal variants, and the genomic heritability. We also present a real data analysis of 16 blood cell phenotypes in UK Biobank, showing that mr.mash-rss achieves higher prediction accuracy than competing methods for the majority of traits, especially when the data has smaller sample size.

2.
J Am Heart Assoc ; 13(7): e034024, 2024 Apr 02.
Article in English | MEDLINE | ID: mdl-38533974

ABSTRACT

BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory out-of-hospital cardiac arrest (OHCA). However, survivors managed with ECPR are at risk of poor functional status. The purpose of this study was to investigate return to work (RTW) after refractory OHCA. METHODS AND RESULTS: Of 44 360 patients with OHCA in the period of 2011 to 2020, this nationwide registry-based study included 805 patients with refractory OHCA in the working age (18-65 years) who were employed before OHCA (2% of the total OHCA cohort). Demographics, prehospital characteristics, status at hospital arrival, employment status, and survival were retrieved through the Danish national registries. Sustainable RTW was defined as RTW for ≥6 months without any long sick leave relapses. Median follow-up time was 4.1 years. ECPR and standard advanced cardiovascular life support were applied in 136 and 669 patients, respectively. RTW 1 year after OHCA was similar (39% versus 54%; P=0.2) and sustainable RTW was high in both survivors managed with ECPR and survivors managed with standard advanced cardiovascular life support (83% versus 85%; P>0.9). Younger age and shorter length of hospitalization were associated with RTW in multivariable Cox analysis, whereas ECPR was not. CONCLUSIONS: In refractory OHCA-patients employed prior to OHCA, approximately 1 out of 2 patients were employed after 1 year with no difference between patients treated with ECPR or standard advanced cardiovascular life support. Younger age and shorter length of hospitalization were associated with RTW while ECPR was not.


Subject(s)
Cardiopulmonary Resuscitation , Extracorporeal Membrane Oxygenation , Out-of-Hospital Cardiac Arrest , Humans , Adolescent , Young Adult , Adult , Middle Aged , Aged , Out-of-Hospital Cardiac Arrest/therapy , Return to Work , Hospitals , Cardiopulmonary Resuscitation/methods , Retrospective Studies
3.
Resuscitation ; 197: 110151, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38401709

ABSTRACT

BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) for selected refractory out-of-hospital cardiac arrest (OHCA) is increasingly used. Detailed knowledge of health-related quality of life (HRQoL) and long-term cognitive function is limited. HRQoL and cognitive function were assessed in ECPR-survivors and OHCA-survivors with prehospital return of spontaneous circulation after standard advanced cardiac life support (sACLS). METHODS: Fifteen ECPR-survivors and 22 age-matched sACLS-survivors agreed to participate in this follow-up study. Participants were examined with echocardiography, 6-minute walk test, and neuropsychological testing, and answered HRQoL (EQ-5D-5L and Short Form 36 (SF-36)), and mental health questionnaires. RESULTS: Most patients were male (73 % and 82 %) and median age at follow-up was similar between groups (55 years and 60 years). Low flow time was significantly longer for ECPR-survivors (86 min vs. 15 min) and lactate levels were significantly higher (14.1 mmol/l vs. 3.9 mmol/l). No between-group difference was found in physical function nor in cognitive function with scores corresponding to the 23rd worst percentile of the general population. SACLS-survivors had HRQoL on level with the Danish general population while ECPR-survivors scored lower in both EQ-5D-5L (index score 0.73 vs. 0.86, p = 0.03, visual analog scale: 70 vs. 84, p = 0.04) and in multiple SF-36 health domains (role physical, bodily pain, general health, and mental health). CONCLUSIONS: Despite substantially longer low flow times with thrice as high lactate levels, ECPR-survivors were similar in cognitive and physical function compared to sACLS-survivors. Nonetheless, ECPR-survivors reported lower HRQoL overall and related to mental health, pain management, and the perception of limitations in physical role.


Subject(s)
Cardiopulmonary Resuscitation , Emergency Medical Services , Extracorporeal Membrane Oxygenation , Out-of-Hospital Cardiac Arrest , Humans , Male , Middle Aged , Female , Out-of-Hospital Cardiac Arrest/therapy , Follow-Up Studies , Quality of Life , Retrospective Studies , Cognition , Lactates
4.
J Evol Biol ; 37(3): 336-345, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-38320319

ABSTRACT

In nature, organisms are exposed to variable and occasionally stressful environmental conditions. Responses to diurnal and seasonal fluctuations, such as temperature and food accessibility, involve adaptive behavioural and physiological changes. While much work has been done on understanding the genetic architecture and evolutionary potential of stress tolerance traits under constant thermal conditions, there has been less focus on the quantitative genetic background in variable environments. In this study, we use the Drosophila Genetic Reference Panel (DGRP) to investigate the locomotor activity, a key behavioural trait, under variable natural thermal conditions during the summer in a temperate environment. Male flies from 100 DGRP lines were exposed to natural thermal and light conditions in Drosophila activity monitors across three experimental days. We found that activity was highly temperature and time dependent and varied between lines both within and between days. Furthermore, we observed variation in genetic and environmental variance components, with low to moderate estimates of the heritability for locomotor activity, consistently peaking in the afternoons. Moreover, we showed that the estimated genetic correlations of locomotor activity between two time points decreased, as the absolute differences in ambient temperature increased. In conclusion, we find that the genetic background for locomotor activity is environment specific, and we conclude that more variable and unpredictable future temperatures will likely have a strong impact on the evolutionary trajectories of behavioural traits in ectotherms.


Subject(s)
Drosophila melanogaster , Drosophila , Male , Animals , Drosophila melanogaster/genetics , Circadian Rhythm/genetics , Locomotion , Biological Evolution
5.
Gen Comp Endocrinol ; 350: 114471, 2024 05 01.
Article in English | MEDLINE | ID: mdl-38373463

ABSTRACT

Although well established that several fishes including goldfish in the suborder Cypinoidei within the family Cypriniformes use the maturation-inducing steroid 17,20ß-dihydroxy-pregn-4-ene-3-one (17,20ßP) and its metabolites as a priming pheromone which they detect with sensitivity and specificity, it is unclear whether and how other Cypriniformes might have evolved to do so. This study examined this question in the family Xenocyprididae. Using electro-olfactogram recording we tested the olfactory sensitivity of silver (Hypophthalmichthys molitrix) and bighead carp (H. nobilis) to a range of 213 steroids in 21 mixtures at 10-9M. While silver carp detected 6 of 21 mixtures, bighead carp detected 5 (p< 0.05). Silver carp were sensitive to 13 21-carbon steroids in these mixtures including 17,20ßP while bighead carp detected 9, including 8 detected by silver carp. This assortment of steroids overlapped that detected by goldfish (family Cyprinidae) but no non-Cyprinoid, suggesting common evolutionary origin and function with differences characteristic of species-specificity.


Subject(s)
Carps , Pheromones , Animals , Goldfish
6.
Bull Environ Contam Toxicol ; 112(2): 25, 2024 Jan 28.
Article in English | MEDLINE | ID: mdl-38280922

ABSTRACT

This study investigated the influence of soil water status on the toxicokinetics of phenanthrene in the springtail Folsomia candida allowing estimation of uptake and elimination rates at two contrasting soil water potentials. Fitting a three-phase model to the observations showed that uptake rate (ku) was almost two times higher in moist soil (-2 kPa) than in dry soil (-360 kPa). During the first days of the exposure, elimination rate (ke) was not significantly different in moist and dry soil, but after eight days ke had increased significantly more in moist soil than in dry soil. Our results confirm the general notion that the exposure route via soil pore water is important. Understanding the significance of soil moisture in exposure and effects of contaminants on soil invertebrates is crucial for assessing the ecological risks associated with soil pollution in a changing climate.


Subject(s)
Arthropods , Phenanthrenes , Soil Pollutants , Animals , Soil , Environmental Pollution , Phenanthrenes/toxicity , Water
7.
Bioinformatics ; 39(11)2023 11 01.
Article in English | MEDLINE | ID: mdl-37882742

ABSTRACT

SUMMARY: Here, we present an expanded utility of the R package qgg for genetic analyses of complex traits and diseases. One of the major updates of the package is, that it now includes Bayesian linear regression modeling procedures, which provide a unified framework for mapping of genetic variants, estimation of heritability and genomic prediction from either individual level data or from genome-wide association study summary data. With this release, the qgg package now provides a wealth of the commonly used methods in analysis of complex traits and diseases, without the need to switch between software and data formats. AVAILABILITY AND IMPLEMENTATION: The methodologies are implemented in the publicly available R software package, qgg, using fast and memory efficient algorithms in C++ and is available on CRAN or as a developer version at our GitHub page (https://github.com/psoerensen/qgg). Notes on the implemented statistical genetic models, tutorials and example scripts are available at our GitHub page https://psoerensen.github.io/qgg/.


Subject(s)
Genome-Wide Association Study , Genomic Medicine , Bayes Theorem , Genomics , Software
8.
Perfusion ; : 2676591231198798, 2023 Oct 03.
Article in English | MEDLINE | ID: mdl-37787741

ABSTRACT

INTRODUCTION: Prone position ventilation (PPV) of patients with adult respiratory distress syndrome (ARDS) supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO) may improve oxygenation and alveolar recruitment and is recommended when extensive dorsal consolidations are present, but only few data regarding adverse events (AE) related to PPV in this group of patients have been published. METHODS: Nationwide retrospective analysis of 68 COVID-19 patients admitted from March 2020 - December 2021 with severe ARDS and need of V-V ECMO support. The number of patients treated with PPV, number of PPV-events, timing, the time spent in prone position, number and causes of AE are reported. Causes to stop the PPV regimen and risk factors for AE were explored. RESULTS: 44 out of 68 patients were treated with PPV, and 220 PPV events are evaluated. AE were identified in 99 out of 220 (45%) PPV events and occurred among 31 patients (71%). 1 fatal PPV related AE was registered. Acute supination occurred in 19 events (9%). Causes to stop the PPV regimen were almost equally distributed between effect (weaned from ECMO), no effect, death (of other reasons) and AE. Frequent causes of AE were pressures sores and ulcers, hypoxia, airway related and ECMO circuit related. Most AE occurred during patients first or second PPV event. CONCLUSIONS: PPV treatment was found to carry a high incidence of PPV related AE in these patients. Causes and preventive measures to reduce occurrence of PPV related AE during V-V ECMO support need further exploration.

9.
Scand Cardiovasc J ; 57(1): 2267804, 2023 12.
Article in English | MEDLINE | ID: mdl-37822186

ABSTRACT

The standard Conventional Cold Storage (CCS) during heart transplantation procurement is associated with time-dependent ischemic injury to the graft, which is a significant independent risk factor for post-transplant early morbidity and mortality - especially when cold ischemic time exceeds four hours. Since 2018, Rigshospitalet (Copenhagen, Denmark) has been utilising ex vivo perfusion (Organ Care System, OCS) in selected cases. The objective of this study was to compare the short-term clinical outcomes of patients transplanted with OCS compared to CCS. Methods: This retrospective single-centre study was based on consecutive patients undergoing a heart transplant between January 2018 and April 2021. Patients were selected for the OCS group when the cold ischemic time was expected to exceed four hours. The primary outcome measure was six-month event-free survival. Results: In total, 48 patients were included in the study; nine were transplanted with an OCS heart. The two groups had no significant differences in baseline characteristics. Six-month event-free survival was 77.8% [95% CI: 54.9-100%] in the OCS group and 79.5% [95% CI: 67.8-93.2%] in the CCS group (p = 0.91). While the OCS group had a median out-of-body time that was 183 min longer (p < 0.0001), the cold ischemic time was reduced by 51 min (p = 0.007). Conclusion: In a Scandinavian setting, our data confirms that utilising OCS in heart procurement allows for a longer out-of-body time and a reduced cold ischemic time without negatively affecting safety or early post-transplant outcomes.


Subject(s)
Heart Transplantation , Humans , Heart Transplantation/adverse effects , Tissue Donors , Retrospective Studies , Organ Preservation/adverse effects , Perfusion/adverse effects
10.
Int J Cardiol Heart Vasc ; 48: 101250, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37602285

ABSTRACT

Objective: To examine changes in concentration, time-to-peak and the ensuing half-life of cardiac biomarkers in patients with myocardial infarction. Methods: Blood sampling was performed every third hour within 24 h after percutaneous coronary intervention (PCI) on a cohort of patients with ST elevation myocardial infarction. Cardiac troponin (cTn) was measured by the Dimension Vista, Vitros, Atellica, and Alinity high-sensitivity (hs) cTnI assays, and the Elecsys hs-cTnT assay. Further, creatine kinase (CK), myoglobin, creatine kinase MB (CKMB) and other biomarkers were analyzed. Results: A total of 36 patients completed blood sampling (median age 60 years, IQR 56.4-66.5 years; seven women, 19.4%). Hs-cTnI measured by the Vitros assay was the first hs-cTn to peak at 9.1 h (95%-CI 6.2-10.1) after PCI and 11.7 h (95%-CI 10.4-14.8) after symptoms onset. There were no notable differences between hs-cTn assays in regard to time-to-peak. Also, Vitros hs-cTnI reached the highest median ratio of concentration to upper reference level of nearly 2,000. The median half-life from peak concentration ranged from 7.6 h for myoglobin (CI 6.8-8.6) to 17.8 h for CK (CI 6.8-8.6). For hs-cTn assays the median T½ ranged from 12.4 h for the Vista hs-cTnI assay (95%-CI 11.0-14.1 h) to 17.3 h for the Elecsys hs-cTnT (95%-CI 14.9-20.8 h). Conclusions: This study updates knowledge on the kinetics of cardiac biomarkers in current clinical use. There was no notable difference in trajectories, time-to-peak or half-life between hs-cTn assays.

11.
J Orthop Sports Phys Ther ; 53(9): 529­539, 2023 09.
Article in English | MEDLINE | ID: mdl-37506306

ABSTRACT

OBJECTIVE: We aimed to examine whether targeting spinal manipulative therapy (SMT), by applying the intervention to a specific vertebral level, produces superior clinical outcomes than a nontargeted approach in patients with nonspecific low back pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, Embase, CENTRAL, CINAHL, Scopus, PEDro, and Index to Chiropractic Literature were searched up to May 31, 2023. STUDY SELECTION CRITERIA: Randomized controlled trials comparing targeted SMT (mobilization or manipulation) to a nontargeted approach in patients with nonspecific low back pain, and measuring the effects on pain intensity and patient-reported disability. DATA SYNTHESIS: Data extraction, risk of bias, and evaluation of the overall certainty of evidence using the GRADE approach were performed by 2 authors independently. Meta-analyses were performed using the restricted maximum likelihood method. RESULTS: Ten randomized controlled trials (n = 931 patients) were included. There was moderate-certainty evidence of no difference between targeted SMT and a nontargeted approach for pain intensity at postintervention (weighted mean difference = -0.20 [95% CI: -0.51, 0.10]) and at follow-up (weighted mean difference = 0.05 [95% CI: -0.26, 0.36]). For patient-reported disability, there was moderate-certainty evidence of no difference at postintervention (standardized mean difference = -0.04 [95% CI: -0.36, 0.29]) and at follow-up (standardized mean difference = -0.05 [95% CI: -0.24, 0.13]). Adverse events were reported in 4 trials, and were minor and evenly distributed between groups. CONCLUSION: Targeting a specific vertebral level when administering SMT for patients with nonspecific low back pain did not result in improved outcomes on pain intensity and patient-reported disability compared to a nontargeted approach. J Orthop Sports Phys Ther 2023;53(9):1-11. Epub: 28 July 2023. doi:10.2519/jospt.2023.11962.


Subject(s)
Low Back Pain , Manipulation, Spinal , Humans , Low Back Pain/therapy , Low Back Pain/etiology , Back Pain/etiology , Manipulation, Spinal/methods , Pain Measurement , Bias
12.
JACC Case Rep ; 14: 101841, 2023 May 17.
Article in English | MEDLINE | ID: mdl-37152699

ABSTRACT

Therapeutic options for patients with isolated severe to torrential tricuspid regurgitation have been limited. Because a surgical option is often not attractive, new catheter-based therapies are emerging. We report the first-in-human percutaneous transcatheter tricuspid valve replacement with the MonarQ system in a 75-year-old female patient with severely symptomatic torrential tricuspid regurgitation. (Level of Difficulty: Advanced.).

13.
Diagnostics (Basel) ; 13(3)2023 Jan 18.
Article in English | MEDLINE | ID: mdl-36766468

ABSTRACT

In the context of brain tumour response assessment, deep learning-based three-dimensional (3D) tumour segmentation has shown potential to enter the routine radiological workflow. The purpose of the present study was to perform an external evaluation of a state-of-the-art deep learning 3D brain tumour segmentation algorithm (HD-GLIO) on an independent cohort of consecutive, post-operative patients. For 66 consecutive magnetic resonance imaging examinations, we compared delineations of contrast-enhancing (CE) tumour lesions and non-enhancing T2/FLAIR hyperintense abnormality (NE) lesions by the HD-GLIO algorithm and radiologists using Dice similarity coefficients (Dice). Volume agreement was assessed using concordance correlation coefficients (CCCs) and Bland-Altman plots. The algorithm performed very well regarding the segmentation of NE volumes (median Dice = 0.79) and CE tumour volumes larger than 1.0 cm3 (median Dice = 0.86). If considering all cases with CE tumour lesions, the performance dropped significantly (median Dice = 0.40). Volume agreement was excellent with CCCs of 0.997 (CE tumour volumes) and 0.922 (NE volumes). The findings have implications for the application of the HD-GLIO algorithm in the routine radiological workflow where small contrast-enhancing tumours will constitute a considerable share of the follow-up cases. Our study underlines that independent validations on clinical datasets are key to asserting the robustness of deep learning algorithms.

14.
Environ Geochem Health ; 45(5): 1723-1737, 2023 May.
Article in English | MEDLINE | ID: mdl-35633438

ABSTRACT

This study investigated mercury pollution at two e-waste recycling sites in Ghana-Dagomba Line in Kumasi and Agbogbloshie in Accra. A total of 129 soil samples taken at 100 m and 50 m resolutions, respectively, for Dagomba Line and Agbogbloshie, were analysed for mercury using a Zeeman atomic absorption spectrometry. Mercury concentrations from the recycling sites (ranging from 0.11 to 7.57 mg/kg Dagomba Line, and 0.01-4.36 mg/kg at Agbogbloshie) were significantly higher than that of the surrounding areas (0.01-0.17 mg/kg in Kumasi and 0.01-2.18 mg/kg in Accra) and unpolluted control sites (0.05 mg/kg in Kumasi and 0.02 mg/kg in Accra). The dismantling sites at both locations had the highest mercury concentrations. Furthermore, the concentrations were significantly higher at the Dagomba Line site in Kumasi than at Agbogbloshie, even though the Dagomba Line site is relatively recent. The mercury concentrations at both sites exceeded the pollution prevention and abatement level of 0.1 mg/kg. However, the estimated human health risk showed no potential human health effects. Moreover, the mercury concentrations in water and sediment (0.12-7.69 ng/L and 0.02-0.28 ng/L for Dagomba Line and Agbogbloshie, respectively) were below the US EPA standards. Findings from this study show that e-waste recycling can contaminate the topsoil with mercury, irrespective of the scale of the activity.


Subject(s)
Electronic Waste , Mercury , Humans , Mercury/analysis , Ghana , Electronic Waste/analysis , Recycling , Water/analysis , Environmental Monitoring
15.
J Environ Manage ; 326(Pt A): 116699, 2023 Jan 15.
Article in English | MEDLINE | ID: mdl-36395644

ABSTRACT

Biogas production from anaerobic digestion (AD) of biowastes is restricted by the recalcitrant nature of many substrates, and this may also reduce the fertiliser value of the produced digestate. The degradability of substrates can potentially be enhanced by physico-chemical pre-treatments before AD, and/or the degradation can be increased by a longer digestion time. In this study, we evaluated the effects of electrokinetic (high voltage) and ultrasonication pre-treatments of biowastes in a two-step AD process on nitrogen fertiliser replacement value (NFRV) of digestates obtained from two biogas plants with contrasting hydraulic retention time (HRT) in the primary AD step. The fertiliser value was tested by direct injection to spring barley and surface-banding to winter wheat, and the ammonium N was 15N-labelled to evaluate ammonia losses. The electrokinetic pre-treatment step significantly (p < 0.05) increased the NH4+-N/total N in the digestates before the second AD step but had an insignificant effect on the fertiliser value in winter wheat and spring barley. Ultrasonication pre-treatment had also no significant effect on the fertiliser value. The two-step AD significantly (p < 0.001) increased 15N recoveries and mineral fertiliser equivalence of labelled ammonium-N in winter wheat and reduced ammonia losses, with a significant effect (p < 0.001) observed in digestates sourced from a shorter HRT biogas reactor. The fertiliser equivalence of labelled ammonium-N in the digestates was 80-88% after injection, indicating relatively low N immobilisation with all the digestates. NFRV in the crops was mainly explained by the NH4+-N/total N ratio, C/N ratio and dry matter content of the digestates. The findings suggest that electrokinetic and ultrasonication pre-treatments combined with a second AD step have no considerable impact on the fertiliser value of digestates, whereas a second AD step significantly reduced ammonia losses after application by surface-banding in winter wheat.


Subject(s)
Ammonium Compounds , Hordeum , Fertilizers , Edible Grain , Nitrogen , Ammonia , Biofuels , Anaerobiosis , Crops, Agricultural , Triticum
16.
Diagnostics (Basel) ; 12(12)2022 Dec 09.
Article in English | MEDLINE | ID: mdl-36553118

ABSTRACT

Consistent annotation of data is a prerequisite for the successful training and testing of artificial intelligence-based decision support systems in radiology. This can be obtained by standardizing terminology when annotating diagnostic images. The purpose of this study was to evaluate the annotation consistency among radiologists when using a novel diagnostic labeling scheme for chest X-rays. Six radiologists with experience ranging from one to sixteen years, annotated a set of 100 fully anonymized chest X-rays. The blinded radiologists annotated on two separate occasions. Statistical analyses were done using Randolph's kappa and PABAK, and the proportions of specific agreements were calculated. Fair-to-excellent agreement was found for all labels among the annotators (Randolph's Kappa, 0.40-0.99). The PABAK ranged from 0.12 to 1 for the two-reader inter-rater agreement and 0.26 to 1 for the intra-rater agreement. Descriptive and broad labels achieved the highest proportion of positive agreement in both the inter- and intra-reader analyses. Annotating findings with specific, interpretive labels were found to be difficult for less experienced radiologists. Annotating images with descriptive labels may increase agreement between radiologists with different experience levels compared to annotation with interpretive labels.

17.
Eur Heart J Acute Cardiovasc Care ; 11(11): 808-817, 2022 Nov 30.
Article in English | MEDLINE | ID: mdl-36229928

ABSTRACT

AIMS: In refractory out-of-hospital cardiac arrest (OHCA) with prolonged whole-body ischaemia, global tissue injury proceeds even after establishment of circulation with extracorporeal cardiopulmonary resuscitation (ECPR). We aimed to investigate the role of biomarkers reflecting hypoperfusion, inflammation, and organ injury in prognostication of patients with refractory OHCA managed with ECPR. METHODS AND RESULTS: This nationwide retrospective study included 226 adults with refractory OHCA managed with ECPR in Denmark (2011-2020). Biomarkers the first days after ECPR-initiation were assessed. Odds ratio of favourable neurological status (Cerebral Performance Category 1-2) at hospital discharge was estimated by logistic regression analyses. Cut-off values were calculated using the Youden's index. Fifty-six patients (25%) survived to hospital discharge, 51 (91%) with a favourable neurological status. Factors independently associated with favourable neurological status were low flow time <81 min, admission leukocytes ≥12.8 × 109/L, admission lactate <13.2 mmol/L, alkaline phosphatase (ALP) < 56 (day1) or <55 U/L (day2), and day 1 creatine kinase MB (CK-MB) < 500 ng/mL. Selected biomarkers (leukocytes, C-reactive protein, and lactate) were significantly better predictors of favourable neurological status than classic OHCA-variables (sex, age, low-flow time, witnessed arrest, shockable rhythm) alone (P = 0.001) after hospital admission. CONCLUSION: Biomarkers of hypoperfusion (lactate), inflammation (leucocytes), and organ injury (ALP and CK-MB) were independently associated with neurological status at hospital discharge. Biomarkers of hypoperfusion and inflammation (at hospital admission) and organ injury (days 1 and 2 after ECPR) may aid in the clinical decision of when to prolong or terminate ECPR in cases of refractory OHCA.


Subject(s)
Cardiopulmonary Resuscitation , Out-of-Hospital Cardiac Arrest , Adult , Humans , Retrospective Studies , Out-of-Hospital Cardiac Arrest/therapy , Cardiopulmonary Resuscitation/methods , Biomarkers , Inflammation , Lactates
18.
Sci Total Environ ; 851(Pt 1): 158177, 2022 Dec 10.
Article in English | MEDLINE | ID: mdl-35988625

ABSTRACT

Anaerobic digestion (AD) is an important tool for reducing greenhouse gas emissions from agricultural production. A prolonged retention time by adding an extra anaerobic digestion step can be utilized to further degrade the digestates, contributing to increased nitrogen mineralisation and reducing decomposable organic matter. These modifications could influence the potential N fertiliser value of the digestate and soil carbon sequestration after field application. This study investigated the effects of prolonging retention time by implementing an additional anaerobic digestion step on carbon and nitrogen dynamics in the soil and soil carbon sequestration. Two digestates obtained from two biogas plants operating at contrasting hydraulic retention times, with and without an additional digestion step, were applied to a loamy sand soil. N mineralisation dynamics were measured during 80 days and C mineralisation during 212 days. After 80 days of incubation, the net inorganic N release from digestates obtained from a secondary AD step increased by 9-17 % (% of the N input) compared to corresponding digestates obtained from a primary AD step. A kinetic four-pool carbon model was used to fit C mineralisation data to estimate carbon sequestration in the soil. After 212 days of incubation, the net C mineralisation was highest in undigested solid biomass (68 %) and digestates obtained from the primary AD step (59-65 %). The model predicted that 26-54 % of C applied is sequestered in the soil in the long-term. The long-term soil C retention related to the C present before digestion was similar for one- and two-step AD at 12-16 %. We conclude that optimizing the anaerobic digestion configurations by including a secondary AD step could potentially replace more mineral N fertiliser due to an improved N fertiliser value of the resultant digestate without affecting carbon sequestration negatively.


Subject(s)
Greenhouse Gases , Soil , Anaerobiosis , Biofuels , Carbon , Carbon Sequestration , Fertilizers/analysis , Nitrogen/analysis , Sand
19.
Chemosphere ; 307(Pt 1): 135553, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35780981

ABSTRACT

Mercury usage in Artisanal Small Scale Gold Mining is a major anthropogenic source of mercury in the environment. In this study, mercury pools and fluxes have been established for Ghana, which has a large ASGM sector, based on estimated losses of mercury to the environment, deposition calculated with GLEMOS, a global long-range transport model for mercury in air, and mercury measured in soils and water in Ghana. A model for mercury in soils and water of Ghana with a resolution of 5 × 5 km2 and a monthly or yearly time step has been developed to assess the regional increase in soil and water concentrations that can be attributed to anthropogenic sources and to simulate scenarios into the future. The model has been calibrated to reproduce present-day mercury concentration in the soil (average 0.0193 mg kg-1) with current deposition calculated with the long-range transport model and past years' deposition based on a scenario for the historic development of the mining activity. This calculation gives an average increase in soil concentrations from anthropogenic sources of 22%. The model gives a fair description of the regional differences in soil concentrations but underestimates concentrations in regions with intense mining activity and overestimates concentrations in regions with less mining when using deposition from the long-range model as input.


Subject(s)
Mercury , Environmental Monitoring , Ghana , Gold , Mercury/analysis , Soil , Water
20.
Int J Mater Form ; 15(5): 61, 2022.
Article in English | MEDLINE | ID: mdl-35855077

ABSTRACT

This article details the ESAFORM Benchmark 2021. The deep drawing cup of a 1 mm thick, AA 6016-T4 sheet with a strong cube texture was simulated by 11 teams relying on phenomenological or crystal plasticity approaches, using commercial or self-developed Finite Element (FE) codes, with solid, continuum or classical shell elements and different contact models. The material characterization (tensile tests, biaxial tensile tests, monotonic and reverse shear tests, EBSD measurements) and the cup forming steps were performed with care (redundancy of measurements). The Benchmark organizers identified some constitutive laws but each team could perform its own identification. The methodology to reach material data is systematically described as well as the final data set. The ability of the constitutive law and of the FE model to predict Lankford and yield stress in different directions is verified. Then, the simulation results such as the earing (number and average height and amplitude), the punch force evolution and thickness in the cup wall are evaluated and analysed. The CPU time, the manpower for each step as well as the required tests versus the final prediction accuracy of more than 20 FE simulations are commented. The article aims to guide students and engineers in their choice of a constitutive law (yield locus, hardening law or plasticity approach) and data set used in the identification, without neglecting the other FE features, such as software, explicit or implicit strategy, element type and contact model.

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