Anthropogenic emission controls organic aerosols at Gosan background site in the outflow from northeast Asia

Anthropogenic activities release substantial amounts of organic components into the atmosphere. In this study, eight groups of organic compounds such as polycyclic aromatic hydrocarbons (PAHs), hopanes, steranes, n-alkanes, fatty acids, fatty alcohols, phthalate esters, and lignin and resin acids were identified in the ambient aerosol samples collected from a regional background site in the Korean Climate Observatory at Gosan (KCOG), South Korea. The total identified organics were most abundant in winter (220 ± 60.3 ng m-3), followed by spring, autumn, and summer, with the predominance of n-fatty acids. All classes of aliphatic lipid components showed a significant positive correlation with fossil fuel-derived organic carbon (OC-FF) and biomass burning-derived organic carbon (OC-BB), indicating that they were abundantly emitted from anthropogenic sources such as fossil fuel combustion and biomass burning. The composition profiles and diagnostic ratios of PAHs indicate that they were largely derived from coal and/or biomass combustion in the continent. In contrast, hopanes are predominantly emitted from gasoline or diesel engines, particularly in the summer, from commercial ships. The high concentration of phthalates in the summer suggested that plastic emissions from the open ocean substantially contributed to the Gosan aerosols. The low ratios of unsaturated/saturated fatty acids indicate that Gosan organic aerosols were photochemically aged during atmospheric transport. The temporal and seasonal variations of organic species over KCOG provide crucial information on the emission strengths of different contributing sources in the East Asian outflow. Positive Matrix Factorization (PMF) results and 14C-based source apportionment studies demonstrated that anthropogenically derived organic aerosols largely contributed to the aerosol mass over KCOG. Thus, the East Asian continent might be the major source region for organic aerosols over the western North Pacific, except in the summer.

Hydroxy fatty acids in the surface Earth system

Lipids are ubiquitous and highly abundant in a wide range of organisms and have been found in various types of environmental media. These molecules play a crucial role as organic tracers by providing a chemical perspective on viewing the material world, as well as offering a wealth of information on metabolic activities. Among the diverse lipid compounds, hydroxy fatty acids (HFAs) with one to multiple hydroxyl groups attached to the carbon chain stand out as important biomarkers for different sources of organic matter. HFAs are widespread in nature and are involved in biotransformation and oxidation processes in living organisms. The unique chemical and physical properties attributed to the hydroxyl group make HFAs ideal biomarkers in biomedicine and environmental toxicology, as well as organic geochemistry. The molecular distribution patterns of HFAs can be unique and diagnostic for a given class of organisms, including animals, plants, and microorganisms. Thus, HFAs can act as a valuable proxy for understanding the ecological relationships between different organisms and their environment. Furthermore, HFAs have numerous industrial applications due to their higher reactivity, viscosity, and solvent miscibility. This review paper integrates the latest research on the sources and chemical analyses of HFAs, as well as their applications in industrial/medicinal production and as biomarkers in environmental studies. This review article also provides insights into the biogeochemical cycles of HFAs in the surface Earth system, highlighting the importance of these compounds in understanding the complex interactions between living organisms and the environment.

Subzero saline chilling with or without prechilling in icy water improved chilling efficiency and meat tenderness of broiler carcasses

Freshly slaughtered carcasses need to be chilled to improve product quality, meat safety, and processing efficiency. This research investigated the effect of subzero saline chilling (SSC) on broiler carcasses with or without prechilling in icy water. Water immersion chilling at 0.5°C (WIC) or SSC at 4% NaCl/-2.41°C (SSC) was a major chilling step. For the combination of pre- and postchilling, the warm water immersion chilling (WWIC) at 10°C was used as prechilling and the WIC as postchilling (WWIC-WIC), and WIC was used as prechilling and the SSC as postchilling (WIC-SSC). The internal temperature of breast fillets was monitored during chilling. Carcasses in a prechiller were transported to a postchiller when their internal temperature reached 15°C. Chilling was completed when the carcass temperature reached 4.4°C or below, and breast fillets were harvested at 3-h postmortem to measure the pH and sarcomere length. Color (L*, a*, and b*) values were evaluated on both breast skin and skinless breast surfaces. Meat tenderness was evaluated using the breast fillets after overnight storage and cooking to an internal temperature of 76°C. The carcasses in the SSC and WIC-SSC showed shorter chilling times (85-91 min) than those (100-144 min) of WIC and WWIC-WIC. A higher chilling yield was observed for the carcasses in WIC-SSC, and a lower cooking yield was seen for the carcasses in WWIC-WIC than other chilling methods (P < 0.05). The breast fillets of broilers in the SSC and WIC-SSC showed lower shear forces and longer sarcomere length than the WIC and WWIC-WIC. No difference was found for L* and a* values, while lower b* value was observed in the SSC than the other chilling methods (P < 0.05). Based on these results, chilling of broiler carcasses in the SSC (4% NaCl/-2.41°C) with or without prechilling in WIC at 0.5°C significantly improved chilling efficiency and meat tenderness, with minor color changes on carcasses.

Percutaneous shunt vessel embolisation with Amplatzer vascular plugs II and IV in the treatment of dogs with splenophrenic shunts: four cases (2019-2022)

OBJECTIVES

To describe the treatment of four dogs with splenophrenic shunts using percutaneous shunting vessel embolisation with Amplatzer vascular plugs II and IV and provide information on their clinical outcomes.

MATERIALS AND METHODS

Dogs with splenophrenic shunts treated at a veterinary hospital from January 2019 to December 2022 were identified through a medical record search.

RESULTS

Six dogs with splenophrenic shunts were identified. Two dogs were excluded because they were treated with laparoscopic surgery. Four underwent percutaneous shunting vessel embolization with Amplatzer vascular plugs and were included in the case series. A sheath was placed in the left external jugular vein and a balloon catheter was advanced to the shunting vessel under fluoroscopy. Portal vein pressure was confirmed to be within an acceptable range during temporary balloon occlusion. Based on preoperative CT angiography and intraoperative contrast examination, Amplatzer vascular plugs II were selected for two dogs and IV were selected for two dogs. Under fluoroscopy, the plug was deployed into the shunting vessel, and angiography confirmed occlusion. In all cases, the increase in portal pressure after temporary occlusion was within the acceptable range, and complete occlusion of blood flow was possible with a single plug. There were no major procedure-related complications. No dogs developed post-ligation seizures or signs of portal hypertension. In addition, improvements in ammonia values were observed in all cases.

CLINICAL SIGNIFICANCE

Percutaneous splenophrenic shunt embolisation using Amplatzer vascular plugs II and IV is technically feasible in dogs, and assessed by intra-procedure angiography, a single plug completely obstructed blood flow in all dogs. Based on the literature search, this is the first report describing Amplatzer vascular plugs for the treatment of splenophrenic shunts.

A year-round observation of δ13C of dicarboxylic acids and related compounds in fine aerosols: Implications from Central European background site

Isotopic analysis of specific compounds in aerosols can be a useful tool when studying atmospheric processes. Here, we present the results of stable carbon isotope ratio (δ13C) measurements performed on a one-year set (n = 96, Sep. 2013-Aug. 2014) of dicarboxylic acids and related compounds in PM1 at a rural Central European background site, Košetice (Czech Republic). The most 13C enriched acid was oxalic (C2, annual average = -16.6 ± 5.0‰) followed by malonic (C3, avg. = -19.9 ± 6.6‰) and succinic (C4, avg. = -21.3 ± 4.6‰) acids. Thus, δ13C values decreased with an increase in carbon numbers. Azelaic acid (C9, avg. = -27.2 ± 3.6‰) was found to be the least 13C enriched. A comparison of δ13C of dicarboxylic acids from other background sites, especially in Asia, shows similar values to those from the European site. This comparison also showed that C2 is more 13C enriched at background sites than at urban ones. In general, we did not observe significant seasonal differences in δ13C values of dicarboxylic acids at the Central European station. We observed statistically significant differences (p value < 0.05) between winter and summer δ13C values solely for C4, glyoxylic acid (ωC2), glutaric acid (C5) and suberic acid (C8). The only significant correlations between δ13C of C2 and δ13C of C3 were found in spring and summer, suggesting that the oxidation of C3 to C2 is significant in these months with a strong contribution from biogenic aerosols. The strongest season-independent annual correlation was observed in δ13C values between C2 and C4, the two dominant dicarboxylic acids. Therefore, C4 appears to be the main intermediate precursor of C2 throughout the whole year.

An example of governance for AI in health services from Aotearoa New Zealand

Artificial Intelligence (AI) is undergoing rapid development, meaning that potential risks in application are not able to be fully understood. Multiple international principles and guidance documents have been published to guide the implementation of AI tools in various industries, including healthcare practice. In Aotearoa New Zealand (NZ) we recognised that the challenge went beyond simply adapting existing risk frameworks and governance guidance to our specific health service context and population. We also deemed prioritising the voice of Māori (the indigenous people of Aotearoa NZ) a necessary aspect of honouring Te Tiriti (the Treaty of Waitangi), as well as prioritising the needs of healthcare service users and their families. Here we report on the development and establishment of comprehensive and effective governance over the development and implementation of AI tools within a health service in Aotearoa NZ. The implementation of the framework in practice includes testing with real-world proposals and ongoing iteration and refinement of our processes.

Combined Exercise and Education Program: Effect of Smaller Group Size and Longer Duration on Physical Function and Social Engagement among Community-Dwelling Older Adults

Background

Exercise, education, and social engagement are critical interventions for older adults for a healthy life expectancy and to improve their physical function.

Objective

To conduct a combined exercise and education (CEE) program for improved social engagement and physical function of older adults.

Design

Based on a short-term program we conducted in our previous study, in this study, the program was conducted for half the number of participants of the earlier study but for a longer duration.

Setting

A community of older adults in Ami, Japan, was the setting of the study.

Participants

23 healthy older adults >65 years living in the community were the participants in the study.

Interventions

Five 80-minute sessions conducted once in two weeks comprised 60-min exercise instruction and 20-min educational lectures per session on health. We examined the improvement in physical and social engagement before and after participation. Physical function and health-related questionnaire data were collected before and after the program.

Results

Data analysis from 15 participants showed improved physical performance but no effect on social engagement.

Conclusions

A higher program frequency, rather than program duration, may be vital to improving exercise performance and social engagement and maximizing the effects of high group cohesion in small groups. Further studies are needed to develop more effective interventions to extend healthy life expectancy.

Size distributions of molecular markers for biogenic secondary organic aerosol in urban Beijing

To understand the source, formation, and seasonality of biogenic secondary organic aerosol (BSOA), a nine-stage cascade impactor was utilized to collect size-segregated particulate samples from April 2017 to January 2018 in Beijing, China. BSOA tracers derived from isoprene, monoterpene, and sesquiterpene were measured with gas chromatography-mass spectrometry. Isoprene and monoterpene SOA tracers exhibited significant seasonal variations, with a summer maximum and a winter minimum. Dominance of 2-methyltetrols (isoprene SOA tracers) with a good correlation with levoglucosan (a biomass burning tracer), which was combined with the detection of methyltartaric acids (possible indicators for aged isoprene) in summer, implies possible biomass burning and long-range transport. In contrast, sesquiterpene SOA tracer (β-caryophyllinic acid) was dominant in winter and was probably associated with the local burning of biomass. Bimodal size distributions were observed for most isoprene SOA tracers, consistent with previous laboratory experiments and field studies showing that they can be formed not only in the aerosol phase but also in the gas phase. Monoterpene SOA tracers cis-pinonic acid and pinic acid showed a coarse-mode peak (5.8-9.0 μm) in four seasons due to their volatile nature. Sesquiterpene SOA tracer β-caryophyllinic acid showed a unimodal pattern with a major fine-mode peak (1.1-2.1 μm), which is linked to local biomass burning. The tracer-yield method was used to quantify the contributions of isoprene, monoterpene, and sesquiterpene to secondary organic carbon (SOC) and SOA. The highest isoprene SOC and SOA concentrations occurred in summer (2.00 μgC m^-3 and 4.93 μg m^-3, respectively), contributing to 1.61% of OC and 5.22% of PM_2.5, respectively. These results suggest that BSOA tracers are promising tracers for understanding the source, formation, and seasonality of BSOA.

Physical and chemical properties of PM1 in Delhi: A comparison between clean and polluted days

Considering the significance of PM₁ aerosol in assessing health impacts of air pollution, an extensive analysis of PM₁ samples collected at an urban site in Delhi is presented in this study. Overall, PM₁ contributed to about 50 % of PM_2.5 mass which is alarming especially in Delhi where particle mass loadings are usually higher than prescribed limits. Major portion of PM₁ consisted of organic matter (OM) that formed nearly 47 % of PM₁ mass. Elemental Carbon (EC) contributed to about 13 % of PM₁ mass, whereas SO₄^2- (16 %), NH₄⁺ (10 %), NO₃^- (4 %) and Cl^- (3 %) were the major inorganic ions present. Sampling was performed in two distinctive campaign periods (in terms of meteorological conditions and heating (fire activities), during the year 2019, each spanning two-week time, i.e. (i) September 3rd -16th (clean days), and (ii) November 22nd -December 5th (polluted days). The 24-h averaged mean concentrations of PM_2.5 and BC during clean days (polluted days) were 70.6 ± 26.9 and 3.9 ± 1.0 μg m^-3 (196 ± 104 and 7.6 ± 4.1 μg m^-3) respectively, which were systematically lower (higher) than that of the annual mean (taken from studies conducted at same site in 2019) of 142 and 5.7 μg m^-3, respectively. Changes in characteristic ratios (i.e., organic carbon (OC)/elemental Carbon (EC) and K⁺/EC) show an increase in biomass emissions during polluted days. Increase in biomass emission can be attributed to increase in heating practices (burning of biofuels such as wood logs, straw, and cow-dung cake) in- and around- Delhi because of fall in temperature in winter during second campaign. Furthermore, a significant increase in NO₃^- fraction in PM₁ is observed during second campaign which shows fog processing of NO_X due to conducive meteorological conditions in winters. Also, comparatively stronger correlation of NO₃^- with K⁺ during second campaign (r = 0.98 as compared to r = 0.5 during first campaign) suggests the increased heating practices to be a contributing factor for increased fraction of NO₃^- in PM₁. We observed that during polluted days, meteorological parameters such as dispersion rate also played a major role in intensifying the impact of increased local emissions due to heating activities. Apart from this, change in the direction of regional emission transport to study site and the topology of Delhi are the possible reasons for the elevated pollution level, especially PM₁ in onset of winter in Delhi. This study also suggests that black carbon measurement techniques used in current study (optical absorbance with heated inlet and evolved carbon techniques) can be used as reference techniques to determine the site-specific calibration constant of optical photometers for urban aerosol.

Sulfate-associated liquid water amplifies the formation of oxalic acid at a semi-arid tropical location over peninsular India during winter

Aerosol liquid water (ALW) can serve as an aqueous-phase medium for numerous chemical reactions and consequently enhance the formation of secondary aerosols in a highly humid atmosphere. However, the aqueous-phase formation of secondary organic aerosols (SOAs) is not well understood in the Indian regions, particularly in tropical peninsular India. In this study, we collected total suspended particulate samples (n = 30) at a semiarid station (Ballari; 15.15°N, 76.93°E; 495 m asl) in tropical peninsular India during the winter of 2016. Homologous series of dicarboxylic acids (C₂-C₁₂), oxoacids (ωC₂-ωC₉), pyruvic acid (Pyr), and glyoxal (Gly) were determined by employing a water-extraction of aerosol and analyzed using capillary gas chromatography (GC). Results show that oxalic acid (C₂) was the most abundant organic acid, followed by succinic (C₄), malonic (C₃), azelaic (C₉), and glyoxylic (ωC₂) or phthalic (Ph) acids. Total diacids-C accounted for 1.7-5.8 % of water-soluble organic carbon (WSOC) and 0.6-3.6 % of total carbon (TC). ALW, estimated from the ISORROPIA 2.1 model, showed a strong linear relationship with sulfate (SO₄^2-), C₂, C₃, C₄, ωC₂, Pyr, and Gly. Based on molecular distribution, specific mass ratios (C₂/C₃, C₂/C₄, C₂/Gly, and Ph/C₉), linear relationships among the measured organic acids, ALW, organic (levoglucosan and oleic acid), and inorganic (SO₄^2-) marker compounds, we emphasize that diacids and related organic compounds, especially C₂, majorly form via aqueous-phase oxidation of precursor compounds including aromatic hydrocarbons (HCs) and unsaturated fatty acids (FAs) originated from biomass burning and combustion-related sources. The present study demonstrates that sulfate driven ALW largely enhances the formation of SOAs via the aqueous-phase reactions over tropical peninsular India during winter.

Organic aerosols in the inland Tibetan Plateau: New insights from molecular tracers

Aerosols affect the radiative forcing of the global climate and cloud properties. Organic aerosols are among the most important, yet least understood, components of the sensitive Tibetan Plateau atmosphere. Here, the concentration of and the seasonal and diurnal variations in biomass burning and biogenic aerosols, and their contribution to organic aerosols in the inland Tibetan Plateau were investigated using molecular tracers. Biomass burning tracers including levoglucosan and its isomers, and aromatic acids showed higher concentrations during winter than in summer. Molecular tracers of primary and secondary biogenic organic aerosols were more abundant during summer than those in winter. Meteorological conditions were the main factors influencing diurnal variations in most organic molecular tracers during both seasons. According to the tracer-based method, we found that biogenic secondary organic aerosols (38.5 %) and fungal spores (14.4 %) were the two dominant contributors to organic aerosols during summer, whereas biomass burning (15.4 %) was an important aerosol source during winter at remote continental background site. Results from the positive matrix factor source apportionment also demonstrate the importance of biomass burning and biogenic aerosols in the inland Tibetan Plateau. During winter, the long-range transport of biomass burning from South Asia contributes to organic aerosols. In contrast, the precursors, biogenic secondary organic aerosols, and fungal spores from local emissions/long-range transport are the major sources of organic aerosols during summer. Further investigation is required to distinguish between local emissions and the long-range transport of organic aerosols. In-depth insights into the organic aerosols in the Tibetan Plateau are expected to reduce the uncertainties when evaluating aerosol effects on the climate system in the Tibetan Plateau.

Formation of Amino Acids and Carboxylic Acids in Weakly Reducing Planetary Atmospheres by Solar Energetic Particles from the Young Sun

Life most likely started during the Hadean Eon; however, the environmental conditions which contributed to the complexity of its chemistry are poorly known. A better understanding of various environmental conditions, including global (heliospheric) and local (atmospheric, surface, and oceanic), along with the internal dynamic conditions of the early Earth, are required to understand the onset of abiogenesis. Herein, we examine the contributions of galactic cosmic rays (GCRs) and solar energetic particles (SEPs) associated with superflares from the young Sun to the formation of amino acids and carboxylic acids in weakly reduced gas mixtures representing the early Earth's atmosphere. We also compare the products with those introduced by lightning events and solar ultraviolet light (UV). In a series of laboratory experiments, we detected and characterized the formation of amino acids and carboxylic acids via proton irradiation of a mixture of carbon dioxide, methane, nitrogen, and water in various mixing ratios. These experiments show the detection of amino acids after acid hydrolysis when 0.5% (v/v) of initial methane was introduced to the gas mixture. In the set of experiments with spark discharges (simulation of lightning flashes) performed for the same gas mixture, we found that at least 15% methane was required to detect the formation of amino acids, and no amino acids were detected in experiments via UV irradiation, even when 50% methane was used. Carboxylic acids were formed in non-reducing gas mixtures (0% methane) by proton irradiation and spark discharges. Hence, we suggest that GCRs and SEP events from the young Sun represent the most effective energy sources for the prebiotic formation of biologically important organic compounds from weakly reducing atmospheres. Since the energy flux of space weather, which generated frequent SEPs from the young Sun in the first 600 million years after the birth of the solar system, was expected to be much greater than that of GCRs, we conclude that SEP-driven energetic protons are the most promising energy sources for the prebiotic production of bioorganic compounds in the atmosphere of the Hadean Earth.

Diurnal variations in primary and secondary organic aerosols in an eastern China coastal city: The impact of land-sea breezes

The land-sea breeze circulation significantly impacts the atmospheric transport of organic aerosols in coastal regions. However, the links between organic aerosols and land-sea breezes remain poorly understood. In this study, organic marker compounds for biomass burning, primary biological aerosols, biogenic and anthropogenic secondary organic aerosols (SOA) in fine particles from a coastal city in East China were analysed using gas chromatography-mass spectrometry. Land-sea breeze circulations were identified to explore their potential influence on organic molecular compositions. Organic marker compounds showed obvious diurnal/seasonal patterns. Surprisingly, due to the combined influence of weakened East Asian monsoons and land-sea breezes, all detected organic markers decreased except α/β-pinene SOA markers during land-sea breeze periods in early autumn; whereas, all the organic markers increased except α/β-pinene SOA markers, pollen and plant debris markers during land-sea breeze periods in early spring. Furthermore, the reaction pathway and aging of biogenic SOA were also related to land-sea breezes. During the land-sea breeze periods, the ratios of 2-methylglyceric acid (2-MGA) to 2-methyltetrols increased in early autumn, indicating that more isoprene-derived SOA generated from the high-NO_x (nitrogen oxides) pathway when the land-sea breezes occurred; while the ratios decreased in early spring, this may be related to the chemical transformation of 2-MGA to 2-MGA sulfates. Changes in the ratio of monoterpene SOA markers demonstrate that monoterpene SOA was relatively aged during sea breeze periods, while it was fresher when the land breeze occurred. Although boundary layer height, emissions, gas/particle partitioning, etc. are important reasons for the diurnal variations of organic aerosols, night/day ratios of molecular markers increased obviously when land-sea breezes occurred in both early autumn and early spring. Our results provide new insights into the shift in the chemical composition of organic aerosols over coastal areas that are influenced by land-sea breezes.

Seasonal characteristics of biogenic secondary organic aerosol tracers in a deciduous broadleaf forest in northern Japan

We collected total suspended particulate (TSP) samples from January 2010 to December 2010 at Sapporo deciduous forest to understand the oxidation processes of biogenic volatile organic compounds (BVOCs). The gas chromatography-mass spectrometric technique was applied to determine biogenic secondary organic aerosols (BSOAs) in the TSP samples. We found the predominance of the isoprene SOA (iSOA) tracers (20.6 ng m^-3) followed by α/β-pinene SOA (pSOA) tracers (8.25 ng m^-3) and β-caryophyllene SOA (cSOA) tracer (1.53 ng m^-3) in the forest aerosols. The results showed large isoprene fluxes and relatively high levels of oxidants in the forest atmosphere. The iSOA and pSOA tracers showed a clear seasonal trend with summer and autumn maxima and winter and spring minima. Their seasonal trends were mainly controlled by BVOCs emission from the local broadleaf deciduous forest. Additionally, the regional level of isoprene emissions from the oceanic sources may also be contributed during summertime aerosols. cSOA tracer showed high concentrations in the winter and spring, possibly due to an additional contribution of biomass burning (BB) aerosols from the local or regional BB activities. The biogenic secondary organic carbon (BSOC) was contributed mainly by the oxidation products of isoprene (136 ngC m^-3) followed by β-caryophyllene (63.0 ngC m^-3) and α/β-pinene (35.9 ngC m^-3). The mass concentration ratio (0.92) of pinonic acid + pinic acid and 3-methyl-1,2,3-butanetricarboxylic acid ((PNA + PA)/3-MBTCA) indicates the photochemical transformation of first-generation oxidation products to the higher generation oxidation products. The average ratios of isoprene to α/β-pinene (1.64) and β-caryophyllene (18.6) oxidation products suggested a large difference in the emissions of isoprene and α/β-pinene compared to β-caryophyllene. The cSOA tracers in the forest aerosols are also contributed by BB during the winter and spring. Positive matrix factorization analyses of the BSOA tracers confirmed that organic aerosols of deciduous forests are mostly related to isoprene emissions. This study suggests that isoprene is a more significant precursor for the BSOA than α/β-pinene and β-caryophyllene in a broadleaf deciduous forest.

Tracing the biomass burning emissions over the Arabian Sea in winter season: Implications from the molecular distributions and relative abundances of sugar compounds

The widespread haze pollution over South Asia typically occurs in winter, affecting the abundance of organic aerosols (OA) over the Arabian Sea due to prevailing meteorology. We determined the concentrations of biomass burning (BB) derived anhydrosugars (levoglucosan: Lev, galactosan: Gal, and mannosan: Man), sugars (glucose, fructose, sucrose, and trehalose) and sugar alcohols (arabitol, mannitol, erythritol, and inositol) over the Arabian Sea during a winter cruise (6-24 December 2018). Molecular distributions revealed predominance of levoglucosan or sucrose. Besides, levoglucosan strongly correlated with mannosan, galactosan, sugar alcohols and elemental carbon, emphasizing their BB-origin. Backward air mass trajectories intercepted by the satellite-based fire counts over the Indo-Gangetic Plain together with relationship between stable carbon isotopic composition of TC (δ¹³C_TC) and levoglucosan-C to organic carbon (%), confirmed the impact of BB-derived OA. A comparison of Lev/Man (av. 16.2) and Lev/K⁺ (av. 0.27) ratios over the Arabian Sea with the source-emissions revealed their origin from crop-residue burning. Rather high concentrations of Lev over the Arabian Sea compared to those documented over the Bay of Bengal, East China Sea, Sea of Japan and the western North Pacific further suggests a stronger impact of BB in the continental outflow over this marine basin. Besides, Lev/K⁺ ratios in marine aerosols exponentially decreased with an apparent increase in ambient relative humidity and temperature over the Arabian Sea during the South Asian outflow, implying a photochemical oxidation of BBOA. Such field-based relationship of Lev with the meteorological parameters can be useful for modelling the impact of BBOA on the surface Ocean. Besides, the aeolian input of sugar-C and water-soluble organic carbon (WSOC) accounted for 83 % and 92 % of that riverine supply to the Arabian Sea, respectively. This means atmospheric dry-deposition of sugars is an important external source of dissolved organic compounds to the surface water.

Tracer-based characterization of fine carbonaceous aerosol in Beijing during a strict emission control period

Strict emission controls were implemented in Beijing and the surrounding regions in the North China Plain to guarantee good air quality during the 2014 Asia-Pacific Economic Cooperation (APEC) summit. Thus, the APEC period provides a good opportunity to study the sources and formation processes of atmospheric organic aerosol. Here, fine particles (PM_2.5, particulate matter with a diameter of 2.5 μm or less) collected in urban Beijing before and during the APEC period were analyzed for molecular tracers of primary and secondary organic aerosol (SOA). The primary organic carbon (POC) and secondary organic carbon (SOC) were also reconstructed using a tracer-based method. The concentrations of biogenic SOA tracers ranged from 1.09 to 34.5 ng m^-3 (mean 10.3 ± 8.51 ng m^-3). Monoterpene oxidation products were the largest contributor to biogenic SOA, followed by isoprene- and sesquiterpene-derived SOA. The concentrations of biogenic SOA tracers decreased by 50 % during the APEC, which was largely attributed to the implementation of emission controls by the Chinese government. The increasing mass fractions of biogenic SOA tracers from isoprene and sesquiterpene during the pollution episodes implied that their photooxidation processes contributed to the poor air quality in urban Beijing. The reconstructed biogenic and anthropogenic SOC and POC concentrations were 89.6 ± 96.8 ng m^-3, 570 ± 611 ng m^-3, and 2.49 ± 2.08 μg m^-3, respectively, accounting for 21.9 ± 11.4 % of OC in total. Biomass-burning derived OC was the largest contributor to carbonaceous aerosol over the North China Plain. By comparing the results before and during the APEC, the emission controls effectively mitigated about 34 % of the estimated OC and were more effective at reducing SOC than POC. This suggests that the reduction of the primary organic aerosol loading is harder than SOA over the North China Plain.

Large contribution of fossil-derived components to aqueous secondary organic aerosols in China

Incomplete understanding of the sources of secondary organic aerosol (SOA) leads to large uncertainty in both air quality management and in climate change assessment. Chemical reactions occurring in the atmospheric aqueous phase represent an important source of SOA mass, yet, the effects of anthropogenic emissions on the aqueous SOA (aqSOA) are not well constrained. Here we use compound-specific dual-carbon isotopic fingerprints (δ¹³C and Δ¹⁴C) of dominant aqSOA molecules, such as oxalic acid, to track the precursor sources and formation mechanisms of aqSOA. Substantial stable carbon isotope fractionation of aqSOA molecules provides robust evidence for extensive aqueous-phase processing. Contrary to the paradigm that these aqSOA compounds are largely biogenic, radiocarbon-based source apportionments show that fossil precursors produced over one-half of the aqSOA molecules. Large fractions of fossil-derived aqSOA contribute substantially to the total water-soluble organic aerosol load and hence impact projections of both air quality and anthropogenic radiative forcing. Our findings reveal the importance of fossil emissions for aqSOA with effects on climate and air quality.

Abundance, chemical structure, and light absorption properties of humic-like substances (HULIS) and other organic fractions of forest aerosols in Hokkaido

Atmospheric organic aerosol (OA) are considered as a significant contributor to the light absorption of OA, but its relationship with abundance, composition and sources are not understood well. In this study, the abundance, chemical structural characteristics, and light absorption property of HULIS and other low-to-high polar organics in PM0.95 collected in Tomakomai Experimental Forest (TOEF) were investigated with consideration of their possible sources. HULIS were the most abundant (51%), and correlation analysis revealed that biogenic secondary organic aerosols significantly contribute to HULIS. The mass spectra obtained using a high-resolution aerosol mass spectrometer (HR-AMS) showed that HULIS and highly polar water-soluble organic matter (HP-WSOM) were substantially oxygenated organic aerosol fractions, whereas water-insoluble organic matter (WISOM) had a low O/C ratio and more hydrocarbon-like structures. The WISOM fraction was the predominant light-absorbing organics. HULIS and WISOM showed a noticeable seasonal change in mass absorption efficiency (MAE365), which was highest in winter. Further, HULIS were shown to be less absorbing than those reported for urban sites. The findings in this study provide insights into the contribution of biogenic secondary OA on aerosol property and radiative forcing under varying contributions from other types of OA.

A synopsis of global frontiers in fertility preservation

Since 2007, the Oncofertility Consortium Annual Conference has brought together a diverse network of individuals from a wide range of backgrounds and professional levels to disseminate emerging basic and clinical research findings in fertility preservation. This network also developed enduring educational materials to accelerate the pace and quality of field-wide scientific communication. Between 2007 and 2019, the Oncofertility Consortium Annual Conference was held as an in-person event in Chicago, IL. The conference attracted approximately 250 attendees each year representing 20 countries around the world. In 2020, however, the COVID-19 pandemic disrupted this paradigm and precluded an in-person meeting. Nevertheless, there remained an undeniable demand for the oncofertility community to convene. To maintain the momentum of the field, the Oncofertility Consortium hosted a day-long virtual meeting on March 5, 2021, with the theme of "Oncofertility Around the Globe" to highlight the diversity of clinical care and translational research that is ongoing around the world in this discipline. This virtual meeting was hosted using the vFairs ® conference platform and allowed over 700 people to participate, many of whom were first-time conference attendees. The agenda featured concurrent sessions from presenters in six continents which provided attendees a complete overview of the field and furthered our mission to create a global community of oncofertility practice. This paper provides a synopsis of talks delivered at this event and highlights the new advances and frontiers in the fields of oncofertility and fertility preservation around the globe from clinical practice and patient-centered efforts to translational research.

P-603 Presence of an asymmetrical response to ovarian stimulation in patients with low ovarian reserve

Study question

Does ovarian reserve decline with a symmetrical manner between right and left ovaries in poor responders (POR) with diminished ovarian reserve (DOR)?

Summary answer

Asymmetrical ovarian response to ovarian stimulation with the left-side dominance was found in POR with DOR.

What is known already

Ovarian follicles are produced during fetal stage and not regenerated after birth. Thus, the number of ovarian follicles declines with age, resulting in infertile POR with DOR. In the morphometric study of human neonatal ovaries, no significant difference was found in the number of follicles between the right and left ovaries in the same individual. A previous study demonstrated that there is a difference in the number of follicles between right and left ovaries in patients with normal ovarian reserve with the right-side dominance, suggesting the asymmetrical activation and growth of follicles.

Study design, size, duration

A retrospective analysis was conducted in patients with POR with DOR based on the Bologna Criteria. Inclusion criteria was patients who received more than five times of ovarian stimulations followed by oocyte retrievals. Data were obtained from a total of 265 participants who received IVF-ET treatments from April 2015 to March 2021 after receiving written informed consents under an approval from the institutional ethical committee. Patients with the history of previous ovarian surgery were excluded.

Participants/materials, setting, methods

The enrolled patients were received ovarian simulation under short or GnRH antagonist protocols for oocyte retrieval. We collected the data of retrieved oocyte number as well as the outcome of IVF from medical chart. We defined the right-left asymmetry of ovarian reserve (%) based on the number of retrieved oocytes from dominant side ovary per total number of retrieved oocytes. Statistical significance was determined using Dunnett or chi-square tests, with P &lt; 0.05 being statistically significant.

Main results and the role of chance

The average age of participants was 37.2±5.99 years of age exhibiting low serum AMH levels (average 0.09±0.20 ng/ml). We analyzed 2,181 cycles of ovarian stimulation (average 8.3±3.9 cycles/patient). The number of retrieved oocytes were 3, 882 in total cycles (average 12.8±7.1/patient). Among participants, 22 cases (8.4%) showed left and right equal in the number of retrieved oocytes, whereas &gt;70% asymmetry was observed in 107 cases (40.7%) and &gt;80% asymmetry was detected in 60 cases (22.8%). In 18 cases (6.9%), oocytes were collected from one side ovary only showing 100% asymmetry. In the cases with &gt;70 and 100% asymmetry, the left-side dominance was 1.3-fold and 5.0-fold higher than right-side dominance, respectively. In cases with 100% asymmetry, there was no difference in the number of cryopreserved high-quality embryos between left and right sides of ovary.

Limitations, reasons for caution

Although we enrolled POR with DOR patients who received ovarian stimulations more than five times, the duration of ovarian stimulation was different among patients. It affects the numbers of ovarian stimulation cycles and retrieved oocytes in each patient.

Wider implications of the findings

Considering the finding of right-side dominance in the number of follicles with normal ovarian reserve, the activation and development of follicles might be accelerated in the right side due to asymmetric blood supply to the ovaries, and thus follicles are likely remained in the left-side ovary with low ovarian reserve.

Trial registration number

not applicable

Unraveling the sources of atmospheric organic aerosols over the Arabian Sea: Insights from the stable carbon and nitrogen isotopic composition

The isotopic composition of stable carbon (δ¹³C) and nitrogen (δ¹⁵N) in marine aerosols influenced by the continental outflows are useful proxies for understanding the aging and secondary formation processes. Every winter, the haze pollutants transported from South Asia significantly affect the chemical composition of marine atmospheric boundary layer of the Arabian Sea. Here, we assessed the δ¹³C of total carbon (TC) and δ¹⁵N of total nitrogen (TN) in marine aerosols collected over the Arabian Sea during a winter cruise (6-24 December 2018). TC (2.1-13.4 μg m^-3) is strongly correlated with TN (0.9-5.0 μg m^-3), likely because of their common source-emissions, biomass burning and fossil-fuel combustion in the Indo-Gangetic Plain and South Asia (corroborated by backward-air mass trajectories and satellite fire counts). Besides, the linear relationship between the mass ratios of water-soluble organic carbon (WSOC) to TC (0.04-0.65) and δ¹³C_TC (-25.1‰ to -22.9‰) underscores the importance of aging process. This means oxidation of organic aerosols during transport not only influences the WSOC levels but also affects their δ¹³C_TC. Likewise, the prevalent inverse linear relationship between the equivalent mass ratio of (NH₄⁺/non-sea-salt- or nss-SO₄^2-) and δ¹⁵N_TN (+15.3‰ to +25.1‰) emphasizes the overall significance of neutralization reactions between major acidic ([nss-SO₄^2-] ≫ [NO₃^-]) and alkaline species (NH₄⁺) in aerosols. Higher δ¹⁵N_TN values in winter than the spring inter-monsoon clearly emphasizes the significance of the anthropogenic combustion sources (i.e., biomass burning) in the South Asian outflow. A comparison of δ¹³C_TC and δ¹⁵N_TN with the source emissions revealed that crop-residue burning emissions followed by the coal fired power plants mostly dictate the atmospheric abundance of organic aerosols in the wider South Asian outflow.

Aerosol Proteinaceous Matter in Coastal Okinawa, Japan: Influence of Long-Range Transport and Photochemical Degradation

The characteristics, sources, and atmospheric oxidation processes of marine aerosol proteinaceous matter (APM), including total proteins and free amino acids (FAAs), were investigated using a set of 1 year total suspended particulate (TSP) samples collected in the coastal area of Okinawa Island in the western North Pacific rim. The concentrations of APM at this site (total proteins: 0.16 ± 0.10 μg m^-3 and total FAAs: 9.7 ± 5.6 ng m^-3, annual average) are comparable to those of marine APM. The major FAA species of APM are also similar to previously reported marine APM with glycine as the dominant species (31%). Based on the different seasonal trends and weak correlations of total proteins and FAAs, we found that they were contributed by different sources, especially with the influence of long-range transport from the Asian continent of northern China and Mongolia and the oceanic area of the Bohai Sea, Yellow Sea, and East China Sea. The photochemical oxidation processes of high-molecular-weight proteins releasing FAAs (especially glycine) were also considered as an important factor influencing the characteristics of APM at this site. In addition, we propose a degradation process based on the correlation with ozone and ultraviolet radiation, emphasizing their roles in the degradation of proteins. Our findings help to deepen the understanding of atmospheric photochemical reaction processes of organic aerosols.

Latitudinal difference in the molecular distributions of lipid compounds in the forest atmosphere in China

Lipids are important biogenic markers to indicate the sources and chemical process of aerosol particles in the atmosphere. To better understand the influences of biogenic and anthropogenic sources on forest aerosols, total suspended particles (TSP) were collected at Mt. Changbai, Shennongjia, and Xishuangbanna that are located at different climatic zones in northeastern, central and southwestern China. n-Alkanes, fatty acids and n-alcohols were detected in the forest aerosols based on gas chromatography-mass spectrometry. The total concentrations of aliphatic compounds ranged from 15.3 ng m^-3 to 566 ng m^-3, and fatty acids were the most abundant (44-95%) followed by n-alkanes and n-alcohols. Low molecular weight- (LFAs) and unsaturated fatty acids (UnFAs) showed diurnal variation with higher concentrations during the nighttime in summer, indicating the potential impact from microbial activities on forest aerosols. The differences of oleic acid (C_18:1) and linoleic acid (C_18:2) concentrations between daytime and nighttime increased at lower latitude, indicating more intense photochemical degradation occurred at lower latitude regions. High levels of n-alkanes during daytime in summer with higher values of carbon preference indexes, combining the strong odd carbon number predominance with a maximum at C₂₇ or C₂₉, implied the high contributions of biogenic sources, e.g., higher plant waxes. In contrast, higher concentrations of low molecular weight n-alkanes were detected in winter forest aerosols. Levoglucosan showed a positive correlation (R² > 0.57) with high- and low molecular weight aliphatic compounds in Mt. Changbai, but such a correlation was not observed in Shennongjia and Xishuangbanna. These results suggest the significant influence of biomass burning in Mt. Changbai, and fossil fuel combustion might be another important anthropogenic source of forest aerosols. This study adds useful information to the current understanding of forest organic aerosols at different geographical locations in China.

Seasonal changes in stable carbon isotopic composition in the bulk aerosol and gas phases at a suburban site in Prague

Isotope fractionation between the gas and aerosol phases is an important phenomenon for studying atmospheric processes. Here, for the first time, seasonally resolved stable carbon isotope ratio (δ¹³C) values are systematically used to study phase interactions in bulk aerosol and gaseous carbonaceous samples. Seasonal variations in the δ¹³C of total carbon (TC; δ¹³C_TC) and water-soluble organic carbon (WSOC; δ¹³C_WSOC) in fine aerosol particles (PM_2.5) as well as in the total carbon of part of the gas phase (TCgas; δ¹³C_TCgas) were studied at a suburban site in Prague, Czech Republic, Central Europe. Year-round samples were collected for the main and backup filters from 14 April 2016 to 1 May 2017 every 6 days with a 48 h sampling period (n = 66). During all seasons, the highest ¹³C enrichment was found in WSOC, followed by particulate TC, whereas the highest ¹³C depletion was found in gaseous TC. We observed a clear seasonal pattern for all δ¹³C, with the highest values in winter (avg. δ¹³C_TC = -25.5 ± 0.8‰, δ¹³C_WSOC = -25.0 ± 0.7‰, δ¹³C_TCgas = -27.7 ± 0.5‰) and the lowest values in summer (avg. δ¹³C_TC = -27.2 ± 0.5‰, δ¹³C_WSOC = -26.4 ± 0.3‰, δ¹³C_TCgas = -28.9 ± 0.3‰). This study supports the existence of different aerosol sources at the site during the year. Despite the different seasonal compositions of carbonaceous aerosols, the isotope difference (Δδ¹³C) between δ¹³C_TC (aerosol) and δ¹³C_TCgas (gas phase) was similar during the seasons (year avg. 1.97 ± 0.50‰). Moreover, Δδ¹³C between WSOC and TC in PM_2.5 showed a difference between spring and winter, but in general, these values were also similar year-round (year avg. 0.71 ± 0.37‰). During the entire period, TCgas and WSOC were the most ¹³C-depleted and most ¹³C-enriched fractions, respectively, and although the resulting difference Δ(δ¹³C_WSOC - δ¹³C_TCgas) was significant, it was almost invariant throughout the year (2.67 ± 0.44‰). The present study suggests that the stable carbon isotopic fractionation between the bulk aerosol and gas phases is probably not entirely dependent on the chemical composition of individual carbonaceous compounds from different sources.

Molecular characterization and spatial distribution of dicarboxylic acids and related compounds in fresh snow in China

Low molecular weight organic compounds are ubiquitous in the atmosphere. However, knowledge on their concentrations and molecular distribution in fresh snow remains limited. Here, twelve fresh snow samples collected at eight sites in China were investigated for dicarboxylic acids and related compounds (DCRCs) including oxocarboxylic acids and α-dicarbonyls. Dissolved organic carbon (DOC) concentrations in the snow samples ranged from 0.99 to 14.6 mg C L^-1. Concentrations of total dicarboxylic acids were from 225 to 1970 μg L^-1 (av. 650 μg L^-1), while oxoacids (28.3-173, av. 68.1 μg L^-1) and dicarbonyls (12.6-69.2, av. 31.3 μg L^-1) were less abundant, accounting for 4.6-8.5% (6.2%), 0.45-1.4% (0.73%), and 0.12-0.88% (0.46%) of DOC, respectively. Molecular patterns of dicarboxylic acids are characterized by a predominance of oxalic acid (C₂) (95.0-1030, av. 310 μg L^-1), followed by phthalic (Ph) (9.69-244, av. 69.9 μg L^-1) or succinic (C₄) (23.8-163, av. 63.7 μg L^-1) acid. Higher concentrations of Ph in snow from Beijing and Tianjin than other urban and rural regions suggest significant emissions from vehicular exhausts and other fossil fuel combustion sources in megacities. C₂ constituted 40-54% of total diacids, corresponding to 1.5-2.6% of snow DOC. The total measured DCRCs represent 5.5-10% of snow DOC, which suggests that there are large amounts of unknown organics requiring further investigations. The spatial distributions of diacids exhibited higher loadings in megacities than rural and island sites. Molecular distributions of diacids indicated that the photochemical modification was restrained under the weak solar radiation during the snow events, while anthropogenic primary sources had a more significant influence in megacities than rural areas and islands.

Terrestrial lipid biomarkers in marine aerosols over the western North Pacific during 1990-1993 and 2006-2009

Terrestrial lipid biomarkers are one of the key tracers in the studies of atmospheric aerosols. Here, we investigated such organic compounds in marine aerosols collected at Chichijima Island, the western North Pacific for two 4-year periods: 1990-1993 and 2006-2009. A homologous series of lipid biomarkers including C₁₈-C₃₇n-alkanes, C₉-C₃₄ fatty acids, and C₁₄-C₃₅ fatty alcohols were determined by gas chromatography/mass spectrometry (GC/MS). The atmospheric levels of these tracers increased from 1990-1993 to 2006-2009. Their seasonal trends were clearly characterized by winter-spring maxima and summer-fall minima. The relative abundance of the high-molecular-weight (HMW) n-alkanes (C₂₅-C₃₇) and n-alcohols (C₂₀-C₃₅) in total HMW lipids peaked in winter and winter/fall, respectively, whereas those of HMW fatty acids (C₂₀-C₃₄) peaked in summer. Air-mass backward trajectory analyses suggest that the Asian continent, Southeast Asia including tropical regions, and the Central Pacific are the main source regions. The seasonal shift and distribution of the carbon preference index and average chain length for the HMW lipids were controlled by the changes in climatic factors and source regions. The higher abundance of terrestrial lipids during 2006-2009 than 1990-1993 indicates a higher emission from terrestrial plantation in the 2000s than in the early 1990s in upwind regions of East Asia. Furthermore, HMW lipid compounds exhibited much stronger positive correlations with levoglucosan, a biomass-burning tracer, during 2006-2009 than 1990-1993, suggesting that biomass-burning emissions contributed more significantly in this century.

Hyperacute postprocedural high platelet reactivity: a novel predictor for in-hospital adverse events in acute coronary syndrome with prasugrel loading

Introduction

Postprocedural High platelet reactivity (HPR) seems to associate long term adverse cardiovascular events, mainly intrastent thrombosis. However, the relationship between hyper-acute postprocedural HPR with prasugrel loading and clinical outcomes in acute coronary syndrome (ACS) is still unclear. Moreover, factors contributing HPR in ACS with prasugrel loading are also unknown.

Purpose

This study aimed to assess the impact of hyper-acute postprocedural HPR with prasugrel loading on clinical outcomes in ACS during hospitalization, as well as to define appropriate cut-off values and identify contributing factors of HPR.

Methods

We performed a single-centre, retrospective observational study that enrolled 207 patients who underwent emergent PCI for ACS with prasugrel loading. The P2Y12reaction unit (PRU) value was measured immediately after PCI with the VerifyNow System. The primary endpoint was major adverse cardiac events (MACE, defined as the composite of death, myocardial infarction, stroke, heart failure, ventricular arrhythmia needing defibrillation).

Results

Mean patient age (standard deviation) was 70.5 (±13.0) years, 78.7% were male, and average time from prasugrel intake to PRU calculation was 98.3 (±49.1) min. During a mean hospital stay of 15.9 (±9.3) days, there were 34 in-hospital MACE (16.4%) and 10 deaths (4.8%). Thrombosis events, didn't stand out and mechanical complications, such as cardiac rupture and cardiac tamponade occupies most of cardiovascular death which occurred before 10 days on admission. PRU was significantly higher in MACE group than Non-MACE group (279±65 vs 227±72, p&lt;0.001 respectively). The ROC curve analysis of PRU for discriminating significant in-hospital MACE showed the cut off value of 293 (sensitivity:52.9%, specificity:83.2% [AUC=0.709, p&lt;0.0001]). 47patients (29.4%) were thus categorized as HPR (PRU&gt;293) immediately after emergent PCI. Kaplan-Meyer curve showed MACE events occurred in HPR group than non-HPR group (38.2% vs 10.0%, p&lt;0.001). Multiple cox analysis demonstrated that HPR was independent predictors of MACE in patients with ACS underwent PCI (OR 5.416, 95% CI 2.157–13.598, p&lt;0.0001). Multiple logistic regression model showed female sex, low haemoglobin value, and large mean platelet volume were independent predictors of HPR.

Conclusion

PRU was significantly higher in MACE group, and appropriate cut-off value of HPR in this study was 293. HPR was independent predictor of MACE during hospitalization, however thrombosis event was not significant. Evidence of clinical impact with postprocedural HPR within 120 minutes after prasugrel loading is scarce. This study shows post-procedural HPR, even without sufficient time after prasugrel intake, can be a useful predictive marker of adverse events during hospitalization.

Funding Acknowledgement

Type of funding sources: None. PRU between Non-MACE and MACE groupKaplan-Meyer curve

Association between adherence to home-based walking exercise with a pedometer and one-year adverse outcomes among lower extremity peripheral artery disease patients with endovascular treatment

Background

Home-based exercise after endovascular treatment (EVT) for lower extremity peripheral artery disease (LE-PAD) patients with intermittent claudication is suggested as an alternative therapy for supervised exercise; however, an association of adherence to home-based exercise with clinical adverse events has not been fully investigated.

Purpose

We aimed to investigate the association of adherence to home-based exercise with 1-year major adverse events (MAE), patency, and leg symptoms after EVT in a contemporary Japanese registry.

Methods

A total of 500 patients with LE-PAD within the Long Term Outcome of Endovascular Therapy for PAD with Intermittent Claudication Observational Prospective Multicenter (ASHIMORI-IC) registry (UMINCTR, UMINehab724.203718753) who underwent EVT between January 2016 and March 2019 were included in the analysis. After EVT, all patients were instructed to do home-based walking exercise with a pedometer. The study population was divided and compared between 2 groups according to adherence to home-based exercise: well-adherence and poor-adherence. The adherence of home-based exercise was as defined by step count derived from a pedometer on sites. The primary outcome was MAE defined as composite of all-cause death, myocardial infarction, stroke, target vessel revascularization, and major amputation of target lower limb for one year. The main secondary outcome was 1-year primary patency of the treated lesion, and the improvement of leg symptom (6-minute walk distance [6MWD] and claudication distance). The study followed the Consensus definitions from peripheral academic research consortium criteria.

Results

Overall, the mean age was 72.8 years, and 78% were men. At 1 year, MAE occurred in 45 patients (9.0%), and the primary patency rate was 85.3% (94.2% of EVT for aortoiliac and 71.9% of EVT for femoropopliteal). A significant difference in the incidence of MAE was observed between the well-adherence group and the poor-adherence group (10 of 233 patients [4.3%] vs. 35 of 267 patients [13.1%]; P&lt;0.001). After multivariate Cox regression analysis, patients in the well-adherence group showed the lower hazard ratio for 1-year MAE (0.30; 95% confidence interval, 0.15–0.58; P&lt;0.001) compared to those in the poor-adherence group. In the well-adherence group, compared with the poor-adherence group, higher primary patency rate (88.9% vs 81.5%; p=0.015), longer claudication onset distance (370 m [IQR 240–453 m] vs 240m [IQR 126–324 m]; P&lt;0.001), and longer 6MWD (422 m [IQR 359–483 m] vs 325 m [IQR 213–400 m]; P&lt;0.001) were observed even after adjusting for each baseline value.

Conclusion

Our study demonstrates the importance of adherence to home-based walking exercise after EVT in LE-PAD patients.

Funding Acknowledgement

Type of funding sources: None.

Cardio-ankle vascular index is useful screening method to detect obstructive coronary artery disease in asymptomatic diabetes patients with subclinical atherosclerosis

Background

Patients with diabetes mellitus are at very high risk for obstructive coronary artery disease; however, invasive coronary angiography is not allowed to apply in all patients. Cardio-ankle vascular index (CAVI), a marker of arterial stiffness has been reported to reflect atherosclerotic burden.

Purpose

To assess the diagnostic performance of CAVI vs. coronary calcium score for detecting obstructive coronary artery disease determined by Coronary CT angiography (CCTA) in asymptomatic diabetes patients.

Methods

During May 2015 to December 2019, 816 patients with diabetes mellitus were evaluated. First, intima-media thickness of carotid artery was measured in all subjects. Then, patients with intima-media thickness over 11mm underwent CAVI. Finally, 209 patients who have one or more cardiovascular risk factors other than diabetes mellitus were enrolled (68±11 years, 68% men). Patients were excluded if they had a disorder of the kidney, a prior history of coronary artery revascularization, atrial fibrillation, LV ejection fraction &lt;50%, ABI &lt;0.9 or allergy to contrast. Diagnostic performance of CAVI was evaluated with coronary stenosis &gt;50% by CCTA.

Results

CAVI, Agatston score, and intima-media thickness of carotid artery were 9.2±1.3, 396±621 and 2.0±0.7mm, respectively. CAVI was significantly correlated with age (r=0.530, p&lt;0.001), coronary artery calcification (r=0.182, p=0.008), and intima-media thickness of carotid artery (r=0.195, p=0.005). Among them, 108 patients (48%) had coronary stenosis. CAVI, Agatston score and intima-media thickness of carotid artery in patients with coronary stenosis were higher than that without coronary stenosis, respectively (9.8±1.1 vs 8.5±1.0, p&lt;0.001, 526±676 vs. 255±525, p=0.001, 2.2±0.7 vs. 1.8±0.6, p&lt;0.001). The ROC curve analysis of CAVI for discriminating coronary stenosis showed that the sensitivity 75.0% and specificity 77.2% at the cut off value of 9.23 (AUC=0.812, p&lt;0.001). Contrastingly, diagnostic performance of coronary calcium score and intima-media thickness of carotid artery were less than CAVI (sensitivity: 91.7%, specificity: 56.4%, AUC=0.753, p&lt;0.05 vs. CAVI, sensitivity: 68.5%, specificity: 59.4%, AUC=0.663, p&lt;0.05 vs. CAVI). Multivariate logistic analysis demonstrated that CAVI was significantly associated with coronary stenosis (OR=4.133, p&lt;0.001) after adjustment of conventional risk factors, although coronary calcium score was not correlated with coronary stenosis.

Conclusion

CAVI could be informative to select patients having obstructive coronary artery disease in asymptomatic diabetes patients with thick intima-media thickness.

Funding Acknowledgement

Type of funding sources: None.

Impact of high platelet reactivity on left ventricular remodeling in patients with acute coronary syndrome

Background/Introduction

Previous studies demonstrated that high platelet reactivity (HPR) predicts future cardiovascular death and coronary events in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). However, few studies have focused on the impact of HPR on left ventricular remodeling (LVR) and each echocardiographic parameter.

Purpose

The purpose of this study was to investigate the impact of HPR in ACS patients on LVR and changes in echocardiographic volume indexes and LV ejection fraction.

Methods

This is a retrospective cohort study of prospectively collected data in a single center that enrolled patients who underwent emergency PCI for ACS including STEMI and NSTEMI with prasugrel loading. The primary outcome of the study was LVR associated with HPR. Secondary endpoints were changes in indexed LVESV, LVEDV, LVEF, E/e' and LAVI between baseline and follow-up. The P2Y12 reaction unit (PRU) value in response to prasugrel was assessed by the VerifyNow P2Y12 assay. Blood samples were collected once per procedure immediately after PCI. LVR index was calculated as the relative change in LVEDV observed at follow-up compared with baseline. LVR was defined as a relative increase in LVEDV ≥20%, measured at follow-up visit compared with the baseline value before discharge.

Results

A total of 196 ACS patients who underwent emergency PCI between January 2016 and July 2020 were enrolled in the study. The mean age of the study population was 69.9 years, and 76.0% were male. On echocardiography at follow up visit of mean duration of 7.0±4.0 months, LVR was found in 38 patients (19.4%). The optimal cutoff for PRU associated with increased LVR assessed by receiver-operating characteristic curve analysis was 245.5 (AUC: 0.656; 95% CI: 0.564 to 0.749; p=0.003). On the basis of this cutoff, HPR was found in 82 patients (42.1%) and the prevalence of LVR was significantly higher in the HPR group compared to the non-HPR group (30.5% vs. 11.4%; p=0.001). Multiple Cox regression analysis showed that HPR was an independent predictor of LVR (OR 4.22, 95% CI 1.83–9.71, p=0.001). In addition, Δ% EDV and Δ% ESV increased in the HPR group, and decreased in the non-HPR group with significant differences (5.8±32.6% vs. −8.0±26.2% in Δ% EDV; p=0.002, 2.0±37.5% vs. −13.3±33.0% in Δ% ESV; p=0.004, respectively). Δ%EF, Δ%E/e', Δ%LAVI were numerically improved in the non-HPR group compared with the HPR group, but this difference did not reach statistical significance.

Conclusion

In patients with ACS, HPR defined as PRU ≥246 immediately after emergency PCI was an independent predictor of LVR in the chronic phase.

Funding Acknowledgement

Type of funding sources: None. Predictors of the presence of LVRChanges (Δ%) of LVEDV and LVESV

Ageing and chronic disease-related changes in the morphometric characteristics of ovarian follicles in cynomolgus monkeys (Macaca fascicularis)

STUDY QUESTION

How is the localisation of ovarian follicles affected by ageing and chronic diseases?

SUMMARY ANSWER

Ovarian follicles shift deeper towards the medulla, due to thickening of the tunica albuginea (TA), with ageing and some major common chronic diseases.

WHAT IS KNOWN ALREADY

The ovary undergoes morphological and functional changes with ageing. The follicular pool follows these changes with alterations in the amount and distribution of residual follicles. Diseases causing a chronic inflammatory process are associated with morphological changes and impaired ovarian function.

STUDY DESIGN, SIZE, DURATION

We conducted a cross-sectional study, examining 90 ovaries from 90 female monkeys. The samples were collected from April 2018 to March 2019 at Tsukuba Primate Research Center in National Institutes of Biomedical Innovation, Health and Nutrition, Japan.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Ovarian samples were obtained from cynomolgus monkeys that died from natural causes or were euthanised. Ovarian sections were stained with haematoxylin and eosin (H&E) for histological analyses. In ovarian sections from 64 female macaques aged 0-25 years, a total of 13 743 follicles at different developmental stages (primordial, intermediary, primary, early secondary and late secondary) were assessed to determine the depth of each follicle from the outer surface of the ovarian cortex to the far end of the follicle, by using a digital imaging software. TA thickness was measured as sum of basal membrane and tunica collagen layer for each ovary under H&E staining. To explore the possibility of age-related trends in ovarian morphometric characteristics, samples were divided into four different age groups (0-3 years (pre-menarche), 4-9 years, 10-14 years and 15-20 years). To evaluate the effect of common chronic diseases on ovarian morphometric characteristics, macaques with diabetes mellitus (DM) (n = 10), endometriosis (n = 8) or inflammatory bowel disease (IBD) (n = 8) were compared to age-matched controls without chronic diseases.

MAIN RESULTS AND THE ROLE OF CHANCE

Ovarian morphometric analysis revealed that the relative location of follicles became deeper in all age groups according to development of follicles (P < 0.05). Total follicle distance from the ovarian surface was increased with ageing (P < 0.05). In a sub-analysis according to developmental stage, only primordial and intermediary follicles were localised deeper with increasing age (P < 0.05). TA thickness was also increased with ageing (P < 0.05). The localisation of the total number of follicles became deeper in ovaries from monkeys with DM, endometriosis or IBD as compared to the control group (P < 0.05). With DM, analysis of follicles distance at almost each developmental stage was significantly deeper compared to controls (P < 0.05) with the exception of early secondary follicles. With endometriosis, follicles at primary and early and late secondary stages were significantly deeper compared to controls (P < 0.05). Also with IBD, follicles at primary and early and late secondary follicles were significantly deeper compared to controls (P < 0.001). The TA was thicker with DM and endometriosis compared to controls (P < 0.05), but not with IBD (P = 0.16).

LARGE SCALE DATA

NA.

LIMITATIONS, REASONS FOR CAUTION

Two-dimensional histology was used to assess follicle localisation. The possibility of minimal variations between the measured distance to the actual distance in a spherical structure cannot be excluded. Additionally, the severity of disease was not assessed.

WIDER IMPLICATIONS OF THE FINDINGS

This study is the first step towards enhancing our understanding of how ageing and chronic diseases affect the relative localisation of dormant and developing follicles. These observations, combined with possible future human studies, may have managerial implications in the field of fertility preservation and other conditions involving ovarian tissue cryopreservation.

STUDY FUNDING/COMPETING INTEREST(S)

The present work was supported by the Grant-in-Aid for Scientific Research B (19H03801) (to K.K.), Challenging Exploratory Research (18K19624), Japan Agency for Medical Research and Development, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Takeda Science Foundation and Naito Foundation (to K.K.). All authors have no conflicts of interest directly relevant to the content of this article.

Characterization of dicarboxylic acids, oxoacids, and α-dicarbonyls in PM2.5 within the urban boundary layer in southern China: Sources and formation pathways

Low-molecular-weight dicarboxylic acids, which are important components of secondary organic aerosols, have been extensively studied in recent years. Many studies have focused on ground-level observations and literature reports on the vertical distribution of the organic aerosols within the urban boundary layer are limited. In this study, the vertical profiles of dicarboxylic acids and related organic compounds (DCRCs) in PM_2.5 were investigated at altitudinal levels (ground level and 488 m above the ground level) at the Canton Tower in Guangzhou, southern China, to elucidate their primary sources and secondary formation processes. The concentrations of DCRCs at ground level were generally higher than those at 488 m. Oxalic acid (C₂) was the most abundant species, followed by succinic acid (C₄) and malonic acid (C₃) at both heights. The higher ratio of DCRCs-bound carbon to organic carbon (i.e., DCRCs-C/OC) at 488 m (4.8 ± 1.2%) relative to that at ground level (2.7 ± 0.5%) indicated a higher degree of aerosol aging at 488 m. The abundance of C₂ was increased and the conversion of C₄ to C₃ was enhanced due to the photochemical oxidation of its homologues during long-range transport periods. The increase in C₂ was associated with in-cloud processes during pollution periods. Principal component analysis showed that DCRCs were mainly derived from atmospheric secondary processing and biomass burning was also an important source of long-chain carboxylic acids during autumn in Guangzhou. Our results illustrate that secondary processing and biomass burning play prominent roles in controlling the abundance of DCRCs. Furthermore, DCRCs are affected by air masses from regional areas, oxidation of their precursors via vertical transport and in-cloud processes.

Seasonal and temporal variations of ambient aerosols in a deciduous broadleaf forest from northern Japan: Contributions of biomass burning and biological particles

Total suspended particulate (TSP) samples were collected in a deciduous broadleaf forest in Sapporo, Hokkaido, Japan, from January to December 2010 to understand the molecular composition and abundance of sugar compounds (SCs) in atmospheric aerosols. We analyzed the samples for anhydrosugars, primary sugars, and sugar alcohols using a gas chromatograph-mass spectrometer. The annual mean concentrations of total SCs ranged from 16.1 to 1748 ng m^-3 (avg. 311 ng m^-3) with maxima in spring (avg. 484 ng m^-3) and minima in winter (avg. 28.2 ng m^-3). Primary sugars and sugar alcohols followed the seasonal pattern of total SCs. High levels of anhydrosugars in winter (avg. 22.9 ng m^-3) suggest a contribution of biomass burning from domestic heating due to lower ambient temperature. The high levels of arabitol and mannitol in spring followed by summer and autumn denote the contribution from multiple sources, i.e., growing vegetation and fungal spores in Sapporo forest. We observed an enhanced contribution of bioaerosols emitted from plant blossoms in spring and leaf decomposition in autumn. The identical seasonal trends of glucose and trehalose implied their similar sources in forest aerosols. Conversely, the highest concentration of sucrose in spring was due to the pollen emissions by blooming plants. Positive matrix factorization (PMF) analyses of the SCs suggested that organic aerosols in the deciduous forest are associated with the emissions from multiple sources, including vegetation, microbes, pollens, and wintertime biomass burning. The PMF analysis also suggested that vegetation is the primary carbon source in the forest atmosphere. The diagnostic mass ratios of levoglucosan to mannosan demonstrated the dominance of softwood burning. We noted that the meteorological parameters substantially affect the emission sources and seasonal concentrations of SCs in the deciduous forest.

P–678 Increased luteinizing hormone in ovarian dysfunction attenuates follicle development and oocyte quality in human

Study question

Can increased luteinizing hormone impair follicular development and oocyte quality in patients with ovarian dysfunction?

Summary answer

Increased luteinizing hormone attenuates follicular development and oocyte quality, resulting in arrest of follicle growth and empty follicles and low-quality embryos.

What is known already

Patients with ovarian dysfunction exhibit elevated gonadotropins and low estrogen levels reflecting their low ovarian reserve. For ovarian stimulation in these patients, natural or mild stimulation protocols are likely used, but we often experienced the arrest of follicle growth and empty follicles at oocyte retrieval. Animal studies demonstrated that chronic high LH exposure impaired the growth of antral follicles by suppressing the expression of FSHR in granulosa cells via a modulation of intraovarian regulators, including the LH-induced thecal factors. Study design, size, duration: Retrospective analysis was conducted in 72 patients with ovarian dysfunction who received ovarian stimulations followed by IVF-ET from April 2018 to March 2020 after obtaining written informed consents under an approval from the ethical committee of our hospital.

Participants/materials, setting, methods

The data of hormonal levels, transvaginal ultrasound during ovarian stimulation and clinical outcome of IVF were extracted from electric chart. For evaluation of embryo, high quality embryos referred to embryos having Veeck classification &gt;grade 3 and &gt;4 blastomeres. Statistical significance was determined using Dunnett or chi-square tests, with P &lt; 0.05 being statistically significant.

Main results and the role of chance

The median age of participants was 42 years of age (range 26–49) with low serum AMH levels (median 0.9 ng/ml, range 0–1.83). We analyzed 361 cycles of ovarian stimulation in total (median 4 cycles/patient, range 1–21). These stimulation cycles were classified into 3 groups; group A (n = 230): normal LH level, group B (n = 93): elevated LH level (&gt; 10 mIU/ml) after ovarian stimulation and group C (n = 33): elevated LH level from the initiation of ovarian stimulation. Among 361 cycles, the arrest of follicle growth was detected in 5 cycles (group A: 0%, group B: 60%, group C: 40%). The proportions of empty follicle in group A, B and C were 17.3±2.0%, 20.9±3.3%and 38.6±7.2%, respectively. The rate of empty follicle was significantly high in group C. Although there was no significant difference in the rates of oocyte degeneration and fertilization, the rate of high-quality embryos in group C was 0.8-fold lower than that of group A.

Limitations, reasons for caution

Due to limitation of participants, we could not determine the appropriate LH level for ovarian stimulation in patients with ovarian dysfunction based on receiver operatorating characteristic curve.

Wider implications of the findings: Normalization of LH levels for ovarian simulation in patients with ovarian dysfunction could improve follicle development and oocyte quality.

Trial registration number

Not applicable

Why airborne transmission hasn't been conclusive in case of COVID-19? An atmospheric science perspective

Airborne transmission is one of the routes for the spread of COVID-19 which is caused by inhalation of smaller droplets1 containing SARS-CoV-2 (i.e., either virus-laden particulate matter: PM and/or droplet nuclei) in an indoor environment. Notably, a significant fraction of the small droplets, along with respiratory droplets, is produced by both symptomatic and asymptomatic individuals during expiratory events such as breathing, sneezing, coughing and speaking. When these small droplets are exposed to the ambient environment, they may interact with PM and may remain suspended in the atmosphere even for several hours. Therefore, it is important to know the fate of these droplets and processes (e.g., physical and chemical) in the atmosphere to better understand airborne transmission. Therefore, we reviewed existing literature focussed on the transmission of SARS-CoV-2 in the spread of COVID-19 and present an environmental perspective on why airborne transmission hasn't been very conclusive so far. In addition, we discuss various environmental factors (e.g., temperature, humidity, etc.) and sampling difficulties, which affect the conclusions of the studies focussed on airborne transmission. One of the reasons for reduced emphasis on airborne transmission could be that the smaller droplets have less number of viruses as compared to larger droplets. Further, smaller droplets can evaporate faster, exposing SARS-CoV-2 within the small droplets to the environment, whose viability may further reduce. For example, these small droplets containing SARS-CoV-2 might also physically combine with or attach to pre-existing PM so that their behaviour and fate may be governed by PM composition. Thus, the measurement of their infectivity and viability is highly uncertain due to a lack of robust sampling system to separately collect virions in the atmosphere. We believe that the present review will help to minimize the gap in our understanding of the current pandemic and develop a robust epidemiological method for mortality assessment.

Low molecular weight dicarboxylic acids, oxocarboxylic acids and α-dicarbonyls as ozonolysis products of isoprene: Implication for the gaseous-phase formation of secondary organic aerosols

Oxidation of isoprene, a major biogenic volatile organic compound emitted from forest canopies, is a potential source of oxalic acid; the dominant species in organic aerosols. We evaluated here ozonolysis of isoprene in dry darkness as a source of oxalic (C₂), malonic (C₃) and succinic (C₄) acids. We found that oxalic acid and methylglyoxal are dominant products within 10 min of reaction followed by glyoxylic, malonic or succinic acids. Interestingly, molecular distributions of oxidation products from early reactions (9-29 min) were characterized by the predominance of methylglyoxal followed by C₂, which became dominant after 30 min. The isoprene-derived secondary organic aerosols (SOAs) showed chemical evolution with reaction time towards the molecular characteristics of dicarboxylic acids similar to those of ambient aerosols (C₂>C₃≥C₄). The carbon-based relative abundances of methylglyoxal decreased steadily (40%→30%), while those of C₂ increased with reaction time (15%→25%), but no such variations persisted for glyoxal (6-10%). This finding means that methylglyoxal is more important intermediate of oxalic acid than glyoxal. In contrast, smaller variability and lower concentrations of pyruvic and glyoxylic acids than other intermediates indicate that oxalic acid formation under dry conditions follows a different pathway than in aqueous-phase heterogeneous chemistry usually invoked for cloud/fog/atmospheric waters. Here, we propose new reaction schemes for high levels of methylglyoxal and oxalic acid via gas-phase chemical reactions with ozone and OH radicals to better interpret the ambient SOA composition. Furthermore, the relative abundances of C₂ exhibit small variability from 1 to 8 h, suggesting its stable character towards the oxidation by hydroxyl radicals.

Distinctive Sources Govern Organic Aerosol Fractions with Different Degrees of Oxygenation in the Urban Atmosphere

Understanding how the sources of an atmospheric organic aerosol (OA) govern its burden is crucial for assessing its impact on the environment and adopting proper control strategies. In this study, the sources of OA over Beijing were assessed year-around based on the combination of two separation approaches for OA, one from chemical fractionation into the high-polarity fraction of water-soluble organic matter (HP-WSOM), humic-like substances (HULIS), and water-insoluble organic matter (WISOM), and the other from statistical grouping using positive matrix factorization (PMF) of high-resolution aerosol mass spectra. Among the three OA fractions, HP-WSOM has the highest O/C ratio (1.36), followed by HULIS (0.56) and WISOM (0.17). The major sources of different OA fractions were distinct: HP-WSOM was dominated by more oxidized oxygenated OA (96%); HULIS by cooking-like OA (40%), less oxidized oxygenated OA (27%), and biomass burning OA (21%); and WISOM by fossil fuel OA (77%). In addition, our results provide evidence that mass spectral-based PMF factors are associated with specific substructures in molecules. These structures are further discussed in the context of the FT-IR results. This study presents an overall relationship of OA groups monitored by chemical and statistical approaches for the first time, providing insights for future source apportionment studies.

Impacts of Chemical Degradation on the Global Budget of Atmospheric Levoglucosan and Its Use As a Biomass Burning Tracer

Levoglucosan has been widely used to quantitatively assess biomass burning's contribution to ambient aerosols, but previous such assessments have not accounted for levoglucosan's degradation in the atmosphere. We develop the first global simulation of atmospheric levoglucosan, explicitly accounting for its chemical degradation, to evaluate the impacts on levoglucosan's use in quantitative aerosol source apportionment. Levoglucosan is emitted into the atmosphere from the burning of plant matter in open fires (1.7 Tg yr^-1) and as biofuels (2.1 Tg yr^-1). Sinks of atmospheric levoglucosan include aqueous-phase oxidation (2.9 Tg yr^-1), heterogeneous oxidation (0.16 Tg yr^-1), gas-phase oxidation (1.4 × 10^-4 Tg yr^-1), and dry and wet deposition (0.27 and 0.43 Tg yr ^-1). The global atmospheric burden of levoglucosan is 19 Gg with a lifetime of 1.8 days. Observations show a sharp decline in levoglucosan's concentrations and its relative abundance to organic carbon aerosol (OC) and particulate K⁺ from near-source to remote sites. We show that such features can only be reproduced when levoglucosan's chemical degradation is included in the model. Using model results, we develop statistical parametrizations to account for the atmospheric degradation in levoglucosan measurements, improving their use for quantitative aerosol source apportionment.

Molecular markers for fungal spores and biogenic SOA over the Antarctic Peninsula: Field measurements and modeling results

Biogenic organic aerosols are important components of atmospheric organic aerosols and play vital roles in atmospheric chemistry, global climate, and biogeochemical cycles of carbon. However, studies on biogenic organic aerosols in the vast regions of the Southern Ocean and over the coastal waters of the Antarctic, especially Antarctic Peninsula, are still extremely limited. To understand the concentrations, molecular composition and seasonality of biogenic organic aerosols in Antarctica, atmospheric aerosols were collected at the Palmer Station on the west Antarctic Peninsula experiencing dramatic climate warming. Molecular marker compounds of fungal spores and secondary organic aerosols formed from the photooxidation of isoprene and monoterpene were analyzed using gas chromatography/mass spectrometry. Concentrations of sugar alcohols and biogenic SOA tracers both presented seasonal patterns with higher average concentrations in summer (90.7 and 122 pg m^-3) than in winter (8.88 and 57.2 pg m^-3). Sugar alcohols and biogenic SOA tracers were predominated by mannitol and isoprene oxidation products. Relative contributions of fungal-spore organic carbon (OC), isoprene-derived secondary OC (SOC) and monoterpene-derived SOC estimated with tracer-based methods were 26.2%, 55.6% and 18.2%, respectively. The observed seasonality of total biogenic SOA and some molecular species at the Antarctic Peninsula was further supported by the results from the global model CESM/IMPACT. Model results also suggest higher biogenic SOA in East Antarctica than that in West Antarctica, which is attributed to the influence of vertical atmospheric circulation. Our results of air-mass trajectory indicate the potential influence of marine emissions on the biogenic organic aerosols over the Antarctic Peninsula.

Impact of the Coronavirus Disease 2019 Outbreak on Activity and Exercise Levels among Older Patients

OBJECTIVES

This study aimed to clarify the impact of the coronavirus disease 2019 outbreak on the levels of activity among older patients with frailty or underlying diseases. A total of 175 patients (79.0±7.0 years) undergoing outpatient or home-based rehabilitation, stratified into groups, based on frailty status. The percentage of patients who went out at least once a week decreased after the outbreak from 91% to 87%, from 65% to 46%, and from 47% to 36% in the non-frail, frail, and nursing care requirement groups, respectively. The proportion of older patients participating in exercise during the outbreak was 75%, 51%, and 41% in the non-frail, frail, and nursing care requirement groups, respectively. The proportion of older patients participating in voluntary exercise after instruction was lowest in the frail group (35%). Older patients with frailty are susceptible to the negative effects of refraining from physical activity and require careful management.

Fluorescence characteristics of water-soluble organic carbon in atmospheric aerosol☆

Fluorescence spectroscopy is a commonly used technique to analyze dissolved organic matter in aquatic environments. Given the high sensitivity and non-destructive analysis, fluorescence has recently been used to study water-soluble organic carbon (WSOC) in atmospheric aerosols, which have substantial abundance, various sources and play an important role in climate change. Yet, current research on WSOC characterization is rather sparse and limited to a few isolated sites, making it challenging to draw fundamental and mechanistic conclusions. Here we presented a review of the fluorescence properties of atmospheric WSOC reported in various field and laboratory studies, to discuss the current advances and limitations of fluorescence applications. We highlighted that photochemical reactions and relevant aging processes have profound impacts on fluorescence properties of atmospheric WSOC, which were previously unnoticed for organic matter in aquatic environments. Furthermore, we discussed the differences in sources and chemical compositions of fluorescent components between the atmosphere and hydrosphere. We concluded that the commonly used fluorescence characteristics derived from aquatic environments may not be applicable as references for atmospheric WSOC. We emphasized that there is a need for more systematic studies on the fluorescence properties of atmospheric WSOC and to establish a more robust reference and dataset for fluorescence studies in atmosphere based on extensive source-specific experiments.

Effects of preemptive analgesia with intravenous acetaminophen on postoperative pain relief in patients undergoing third molar surgery: a prospective, single-blind, randomized controlled trial

BACKGROUND

The efficacy of preemptive analgesia in managing postoperative pain remains controversial. The aim of this study was to compare the efficacy of intravenous (IV) acetaminophen administered before or immediately after the surgical extraction of an impacted mandibular third molar.

MATERIAL AND METHODS

This prospective randomized clinical trial included 120 patients. The patients were assigned to one of three groups: the preoperative-treatment group (pre-group), which received 1000 mg of IV acetaminophen 20 min before surgery; the postoperative-treatment group (post-group), which received 1000 mg of IV acetaminophen after surgery; the no-treatment group (control-group), which did not receive any analgesic. Rescue analgesic (60 mg loxoprofen) was issued to each patient, with instructions on self-administration if needed. For the rescue medication usage, the time of first loxoprofen usage and the total amount of loxoprofen consumption were obtained for a 17-hour period after surgery. We measured pain using the visual analogue scale at 1 hour and at 2, 3, 4, 5, and 15 hours after surgery.

RESULTS

There was no significant difference in pain level among the three groups at any time interval. However, the pre-group demonstrated significantly lower rescue analgesic consumption and longer time until initial administration.

CONCLUSIONS

Administration of IV acetaminophen before third molar surgery provides more effective pain control than postoperative administration and no treatment.

Post-procedural high platelet reactivity with prasugrel loading predicts in-hospital adverse events in ACS patients

Background/Introduction

High platelet reactivity (HPR) is associated with adverse cardiovascular events, primarily intrastent thrombosis, after a percutaneous coronary intervention (PCI). However, the relationship between hyperacute postprocedural HPR with prasugrel loading and clinical outcomes in acute coronary syndrome (ACS) remains unclear. Moreover, factors contributing to HPR in ACS with prasugrel loading are also unknown.

Purpose

To assess the effects of post-procedural HPR with prasugrel loading on clinical outcomes in ACS during hospitalization, and to define the appropriate cut-off values and identify factors contributing to HPR.

Methods

A single-center, retrospective observational study that enrolled 154 patients who underwent emergent PCI for ACS with prasugrel loading was performed. The P2Y12 reaction unit (PRU) value was measured immediately after PCI using the VerifyNowR system. The primary end-point was major adverse cardiac events (MACE, defined as the composite of death, myocardial infarction, stroke, heart failure, ventricular arrhythmia needing defibrillation).

Results

The mean patient age (standard deviation) was 70.7 (±12.5) years, 76.6% were men, and the average time from the prasugrel intake to PRU calculation was 103.2 (±48.5) min. During the mean hospital stay of 15.6 (±8.5) days, 24 in-hospital MACE (15.5%) and 8 deaths (5.2%) occurred. Thrombosis events, including myocardial infarction recurrence, did not occur (only one case of spontaneous coronary artery dissection was considered as myocardial infarction recurrence). PRU was significantly higher in the MACE group than that in Non-MACE group (287±55 and 232±64, respectively, p&lt;0.001). The ROC curve analysis of PRU for discriminating the significant in-hospital MACE showed the cut-off value of 293 (sensitivity: 62.5%, specificity: 83.1% [AUC=0.756, p&lt;0.0001]). A total of 37 patients (24%) were thus categorized as HPR (PRU&gt;293) immediately after the emergent PCI. Kaplan-Meier curve showing MACE events occurred in the HPR group than that in the non-HPR group (40.5% vs 7.6%, p&lt;0.001). Multiple cox analysis demonstrated that HPR was independent predictors of MACE in patients with ACS who underwent PCI (OR 11.01, 95% CI 2.39–20.2, p&lt;0.0001). Multiple logistic regression model showed old age, female sex, low systolic blood pressure, short prasugrel intake to measure time, and large acute gain were independent predictors of HPR.

Conclusion

PRU was significantly higher in the MACE group, with an appropriate cut-off value of HPR of 293 in this study. HPR was an independent predictor of MACE during hospitalization; however, thrombosis events were not significant. HPR predictors were old age, female sex, low systolic blood pressure, short prasugrel intake to measure time, and large acute gain. This study shows the post-procedural HPR with prasugrel loading in patients with ACS can be a useful predictive marker of adverse events during hospitalization.

Funding Acknowledgement

Type of funding source: None

Cardio-ankle vascular index as an arterial stiffness marker improves on cardiovascular events by adding to framingham risk score

Background

The cardio-ankle vascular index (CAVI) is a non-invasive measurement that evaluates arterial stiffness using the analysis of oscillometric waveform during cuff-Inflation. Several studies reported that CAVI is associated with cardiovascular risk factors, while the clinical prognostic value of CAVI as a surrogate marker of atherosclerosis has not been fully elucidated. Meanwhile, the Framingham risk score (FRS) is an established marker of cardiovascular outcomes.

Purpose

To investigate whether adding CAVI to Framingham risk score improves the prediction of cardiovascular events.

Methods

This prospective observational study included consecutive 422 patients with cardiovascular risk factors but without known coronary artery disease (69±8 years, 63% men). CAVI was measured by the oscillometric method with VaSera vascular screening system. Patients with atrial fibrillation, left ventricular ejection fraction &lt;50%, both ABI&lt;0.9, severe valvular diseases, or hemodialysis were excluded. Primacy outcomes were cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure and revascularization.

Results

During a median follow-up of 3.1 years, cardiovascular events occurred in 12.8% (3.3%, 15.7%, and 19.1% in the low, intermediate and high-risk group of stratification by FRS, respectively). The ROC curve analysis for discriminating cardiovascular events showed that the AUC of CAVI added to Framingham risk score was the highest compared to Framingham risk score and CAVI alone (CAVI added to Framingham risk score: AUC 66.9, 95% CI 59.6–74.2, Framingham risk score alone: AUC 61.5, 95% CI 53.8–69.1, CAVI alone: AUC 62.3, 95% CI 54.1–70.6). The logistic regression analysis demonstrated that CAVI and Framingham risk score were independent predictors of cardiovascular events (CAVI: OR 1.381, 95% CI 1.164–1.597, p=0.004, Framingham risk score: OR 1.135, 95% CI 1.044–1.225, p=0.007). Next, when logistic regression analysis was performed simultaneously on Framingham risk factor and CAVI, CAVI was an independent predictor of cardiovascular events (OR 1.347, 95% CI 1.124–1.569, p=0.009). Furthermore, in the likelihood ratio test, CAVI added to Framingham risk score significantly improved the cardiovascular event prediction ability than Framingham risk factor alone. Next, when patients with intermediate risk (n=217) were divided into two groups based on CAVI of 9.0, the Kaplan-Meier estimate showed that events occurred more frequently in higher CAVI group (9.3% and 29.1%, log-rank, P=0.009) and the C-statistic was 0.662. Multiple Cox analysis showed that, in the intermediate risk group, CAVI was an independent predictor of primary outcomes (HR 1.387 per 1 index, 95% CI 1.081–1.779, p=0.010).

Conclusion

The measurement of CAVI could be a useful predictor for cardiovascular events. In addition, the combination of CAVI and Framingham risk score could improve the predictability compared to the Framingham risk score alone.

Funding Acknowledgement

Type of funding source: None

Protein tyrosine phosphatase receptor type Q in cerebrospinal fluid reflects ependymal cell dysfunction and is a potential biomarker for adult chronic hydrocephalus

BACKGROUND AND PURPOSE

Protein tyrosine phosphatase receptor type Q (PTPRQ) was extracted from the cerebrospinal fluid (CSF) of patients with probable idiopathic normal-pressure hydrocephalus (iNPH) by proteome analysis. We aimed to assess the feasibility of using CSF PTPRQ concentrations for the additional diagnostic criterion of iNPH in Japanese and Finnish populations.

METHODS

We compared PTPRQ concentrations among patients with probable iNPH and neurologically healthy individuals (normal control [NC] group), patients with normal-pressure hydrocephalus (NPH) of acquired and congenital/developmental aetiologies, patients with Alzheimer's disease and patients with Parkinson's disease in a Japanese analysis cohort. A corresponding iNPH group and NC group in a Finnish cohort was used for validation. Patients in the Finnish cohort who underwent biopsy were classified into two groups based on amyloid and/or tau deposition. We measured PTPRQ expression levels in autopsied brain specimens of iNPH patients and the NC group.

RESULTS

Cerebrospinal fluid PTPRQ concentrations in the patients with NPH of idiopathic, acquired and congenital/developmental aetiologies were significantly higher than those in the NC group and those with Parkinson's disease, but iNPH showed no significant differences when compared with those in the Alzheimer's disease group. For the patients with iNPH, the area under the receiver-operating characteristic curve was 0.860 in the Japanese iNPH and 0.849 in the Finnish iNPH cohorts. Immunostaining and in situ hybridization revealed PTPRQ expression in the ependymal cells and choroid plexus. It is highly possible that the elevated PTPRQ levels in the CSF are related to ependymal dysfunction from ventricular expansion.

CONCLUSIONS

Cerebrospinal fluid PTPRQ levels indicated the validity of this assay for auxiliary diagnosis of adult chronic hydrocephalus.

Difference in Freezing Tolerance Between Young Potato Plants Derived From Tissue Culture Plantlets and Seed Tubers

BACKGROUND

Although potato as a crop is commercially grown from seed tubers, plants grown from tissue culture plantlets are often used in physiological studies including freezing tolerance determination.

OBJECTIVE

This study aimed to examine the effects of the source of plants on freezing tolerance of potato plants at young developmental stages.

MATERIALS AND METHODS

We compared freezing tolerance and contents of soluble proteins and sugars of Solanum tuberosum plants derived from tissue culture with those derived from tubers before and after cold acclimation.

RESULTS

Tuber-derived plants showed significantly higher freezing tolerance than tissue-culture-derived plants after cold acclimation, although non-acclimated plants did not show any marked differences. Soluble protein contents were higher in tuber-derived plants regardless of cold acclimation. Sucrose content increased to a higher level in tuber-derived plants after cold acclimation.

CONCLUSION

These results suggest that source of plant tissue can have a significant effect on the response of young potato plants to freezing stress and that the use of tissue culture plants in freezing tolerance studies may not accurately reflect the frost tolerance of commercially grown plants.