Atmospheric Deposition of Coal-Related Pollutants in the Pacific Northwest of the United States from 1950 to 2016.

Coal-related elements are toxic and persistent pollutants that have spread globally since the industrial revolution, mainly from point-source emissions. A sediment core was collected from Deep Lake in northeastern Washington State (USA) by the Washington State Department of Ecology, with the aim of assessing recent changes in atmospheric deposition in the US Pacific Northwest. The core was divided into depth intervals and dated by lead-210. A sample from each cross section was digested and analyzed for toxic metals and metalloids using inductively coupled plasma-mass spectrometry. Data show recent increases in the concentrations of arsenic, barium, selenium, and mercury. Comparison with 1993 US Geological Survey ice core data from the Upper Fremont Glacier in Wyoming (USA), Asian coal consumption data, and weather patterns suggests that pollutant inputs to Deep Lake sediments are the result of coal-burning activities in the Asia-Pacific region. Most notably, mercury deposition in Deep Lake has increased from approximately 20 ppb in 1996 to 9470 ppb in 2014 (an ~400-fold increase), and since 1993 when the ice core was analyzed. Environ Toxicol Chem 2020;39:335-342. © 2019 SETAC.

High-density element concentrations in fish from subtidal to hadal zones of the Pacific Ocean.

Anthropogenic use of high density, toxic elements results in marine pollution which is bio-accumulating throughout marine food webs. While there have been several studies in various locations analyzing such elements in fish, few have investigated patterns in these elements and their isotopes in terms of ocean depth, and none have studied the greatest depth zones. We used a flame atomic absorption spectrophotometer-hydride system and an inductively coupled plasma-mass spectrometer to determine concentrations of the high-density elements arsenic (As), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), lead (Pb), mercury (Hg), nickel (Ni), selenium (Se), plus the light-metal barium (Ba), in fish ranging from bathyal (1000 m in Monterey Bay) to upper hadal zones (6500-7626 m in the Kermadec and Mariana Trenches) in the Pacific Ocean. Five species of fish-including the Mariana Trench snailfish, the world's deepest known fish newly discovered-were analyzed for patterns in total element concentration, depth of occurrence, Se:Hg ratio, plus mercury isotopes in the deepest species. Co and As levels decreased with depth. In the Mariana Trench, Pb, Hg, Cd, and Cu were higher than in all other samples, and higher in those plus Ba than in the Kermadec Trench. The latter samples had far higher Ni and Cr levels than all others. Mercury relative isotope analysis showed no depth trends in the deepest species. Se:Hg showed a large molar excess of Se in bathyal flatfish species. These patterns indicate that exposures to pollutants differ greatly between habitats including trenches of similar depths.

Coronary artery calcification predicts cardiovascular complications after sepsis.

PURPOSE: Sepsis is a highly prevalent and fatal condition, with reported cardiovascular event rates as high as 25-30% at 1year. Risk stratification in septic patients has been extremely limited. MATERIAL AND METHODS: 267 septic patients with detectable troponin levels, APACHE II scores, and CT scans of the chest or abdomen were assessed. Patients with a recent cardiac intervention were excluded. Coronary artery calcification (CAC) was identified as present or absent on body CT scans. Cardiovascular death, acute myocardial infarction (AMI), or PCI at 1year was assessed using multivariate logistic regression analysis. RESULTS: Patients with CAC were older, predominantly male with more risk factors for coronary disease, but similar peak troponin levels and APACHE II scores. In a multivariate analysis, CAC was predictive of the primary outcome (OR 6.827; 95% CI 1.336-54.686; p=0.037). Patients with no CAC, history of CHF or CKD were at low risk (<1%) for cardiovascular complications at 1year even at very high troponin levels (<8.0ng/dL). CONCLUSION: CAC risk stratifies septic patients for cardiovascular complications better than traditional risk factors and can be identified on body CT scans. This novel, risk stratifying framework built on CAC can help guide individualized management of septic patients.

Heart transplantation in cardiac amyloidosis.

"Cardiac amyloidosis" is the term commonly used to reflect the deposition of abnormal protein amyloid in the heart. This process can result from several different forms, most commonly from light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis, which in turn can represent wild-type (ATTRwt) or genetic form. Regardless of the origin, cardiac involvement is usually associated with poor prognosis, especially in AL amyloidosis. Although several treatment options, including chemotherapy, exist for different forms of the disease, cardiac transplantation is increasingly considered. However, high mortality on the transplantation list, typical for patients with amyloidosis, and suboptimal post-transplant outcomes are major issues. We are reviewing the literature and summarizing pros and cons of listing patients with amyloidosis for cardiac or combine organ transplant, appropriate work-up, and intermediate and long-term outcomes. Both AL and ATTR amyloidosis are included in this review.

Predictors, Morbidity, and Costs Associated with Pneumothorax during Electronic Cardiac Device Implantation.

BACKGROUND: Pneumothorax (PTX) is a major cause of morbidity associated with cardiac implantable electronic devices (CIEDs). We sought to evaluate predictors of PTX at our centers during CIED implantations, including the venous access technique utilized, as well as to determine morbidity and costs associated with PTX. METHODS: We reviewed records of all patients undergoing cardiac device implant or revision with new venous access at our institutions between 2008 and 2014. Common demographic and procedure characteristics were collected including age, sex, body mass index (BMI), comorbidities, and method of venous access (axillary vein vs classic proximal subclavian vein technique). RESULTS: We identified 1,264 patients who met criteria for our analysis, with a total of 21 PTX cases during CIED implantation. The strongest predictor for PTX was the venous access strategy: 0 of 385 (0%) patients with axillary vein approach versus 21 of 879 (2.4%) with traditional subclavian vein approach, P = 0.0006. Additional predictors of PTX included advanced age, female sex, low BMI, and a new device implant (vs device upgrade). The occurrence of PTX was associated with increased length of stay: 3.0 days (median; interquartile range [IQR] 3) versus 1.0 day (median; IQR: 1), P = 0.0001, with a cost increase of 361.4%. CONCLUSION: An axillary vein vascular access strategy was associated with greatly reduced risk of iatrogenic PTX versus the traditional subclavian approach for CIED placement. Similarly, device upgrade with patent vascular access carried less risk of PTX compared to new device implantation. PTX occurrence significantly prolonged hospitalization and increased costs.

Efficient LED light distribution cavities using low loss, angle-selective interference transflectors.

Recent advances in solid state light source efficiency and luminance present the technical challenge of distributing light from very small point sources to large areas, with area distribution ratios having orders of magnitude greater than previously addressed. Broad adoption of LEDs in lighting and liquid crystal displays is in part contingent on addressing this fundamental light distribution issue. Here we present new materials based on giant birefringent nanotechnology which address these deficiencies allowing us to guide light in air via a novel light distribution system. Resulting from controlled in-plane and out-of-plane x,y,z refractive indices of adjacent layers, these multilayer interference films possess both angle selective and polarization selective reflectance. The angle selectivity can be tuned in both azimuth and polar angle, relieving a key constraint of prior materials. Our work has been done on a physically large scale enabling demonstration of large light management systems of industrial and practical relevance.