Using the results from nine Earth system models submitted to the Coupled Model Intercomparison Project Phase 5 (CMIP5), we identify the Eastern Tropical Pacific (ETP) as the region with the greatest ...uncertainty of future changes in oxygen‐deficient (<30 μM) water volumes since different models variously project both positive and negative changes in the oxygen‐deficient volume and export flux there. We investigate the factors controlling future changes in oxygen‐deficient volume in the ETP with global warming using a single off‐line biogeochemical model. Oxygen budget analysis clarifies that the Equatorial Undercurrent (EUC) is the key mechanism controlling future variations in the oxygen‐deficient volume in the ETP in our model. From the outputs of all of the CMIP5 models and our model, we identify a significant negative relationship between changes in the EUC volume transport and the oxygen‐deficient water volume from the present to the end of the 21st century, which indicates that the response of the EUC to global warming leads to one possible uncertainty in future projections of oxygen‐deficient volume in the ETP.
Key Points
Regions of uncertainty in future projections of oxygen‐deficient water ocean volume are spatiotemporally identified
Oxygen budget analysis is conducted in the Eastern Tropical Pacific using a biogeochemical model
Future changes in the Equatorial Undercurrent volume transport lead to uncertainty in the projection of oxygen‐deficient volumes
Object
The SARC-F questionnaire is a sarcopenia screening tool. However, the validity of the SARC-F score ≥4 (SARC-F≥4) for the evaluation of sarcopenia in the hospital setting has not been ...investigated. This study investigated the validity of SARC-F≥4 as a screening tool for sarcopenia among hospitalized older adults.
Design
Cross-sectional retrospective study.
Setting
A university hospital.
Participants
This study included older adult patients (age ≥65 years) who were hospitalized at, and subsequently discharged from, the hospital between April and September 2019 and underwent a nutritional assessment by the nutrition support team during their hospitalization.
Measurements
SARC-F was recorded at the time of admission, and the criteria specified by the Asia Working Group for Sarcopenia in 2019 (AWGS 2019) were applied to diagnose sarcopenia and possible sarcopenia. Appendicular muscle mass was estimated through validated equations, and three different models were developed for sarcopenia diagnosis. The sensitivity, specificity, and positive/negative likelihood ratios were calculated to analyze the accuracy of the SARC-F≥4 for sarcopenia and possible sarcopenia. Receiver-operating characteristic analyses were conducted to calculate the area under the curve (AUC).
Results
In total, 1,689 patients (mean age: 77.2±13 years; male: 54.4%) were analyzed, and 636 patients (37.7%) had SARC-F≥4. Patients with SARC-F≥4 had a statistically significant higher prevalence of AWGS 2019-defined sarcopenia than patients with SARC-F <4 in the models (65.4–78.9% vs 40.9–15.2%, p<0.001). The sensitivity, specificity, and positive/negative likelihood ratios of SARC-F≥4 for sarcopenia and possible sarcopenia were 49.1–51.3%, 73.9–81.2%, and 1.88–2.72/0.60–0.69 and 48.0%, 84.5%, and 3.11/0.62, respectively. The AUC for sarcopenia and possible sarcopenia were 0.644–0.695 and 0.708, respectively. The AUC of SARC-F for possible sarcopenia was equivalent to or larger than that for sarcopenia (DeLong test p=0.438, 0.088, and <0.001 vs the three models).
Conclusions
SARC-F≥4 is suitable as a screening tool for sarcopenia in hospitalized older adults. SARC-F assessment could facilitate the detection and exclusion of sarcopenia at hospitalization and may lead to early adoption of a therapeutic and preventive approach.
Error-quantified, synoptic-scale relationships between chlorophyll-a (Chl-a) and phytoplankton pigment groups at the sea surface are presented. A total of ten pigment groups were considered to ...represent three Phytoplankton Size Classes (PSCs, micro-, nano- and picoplankton) and seven Phytoplankton Functional Types (PFTs, i.e. diatoms, dinoflagellates, green algae, prymnesiophytes (haptophytes), pico-eukaryotes, prokaryotes and Prochlorococcus sp.). The observed relationships between Chl-a and PSCs/PFTs were well-defined at the global scale to show that a community shift of phytoplankton at the basin and global scales is reflected by a change in Chl-a of the total community. Thus, Chl-a of the total community can be used as an index of not only phytoplankton biomass but also of their community structure. Within these relationships, we also found non-monotonic variations with Chl-a for certain pico-sized phytoplankton (pico-eukaryotes, Prokaryotes and Prochlorococcus sp.) and nano-sized phytoplankton (Green algae, prymnesiophytes). The relationships were quantified with a least-square fitting approach in order to enable an estimation of the PFTs from Chl-a where PFTs are expressed as a percentage of the total Chl-a. The estimated uncertainty of the relationships depends on both PFT and Chl-a concentration. Maximum uncertainty of 31.8% was found for diatoms at Chl-a = 0.49 mg m−3. However, the mean uncertainty of the relationships over all PFTs was 5.9% over the entire Chl-a range observed in situ (0.02 < Chl-a < 4.26 mg m−3). The relationships were applied to SeaWiFS satellite Chl-a data from 1998 to 2009 to show the global climatological fields of the surface distribution of PFTs. Results show that microplankton are present in the mid and high latitudes, constituting only ~10.9% of the entire phytoplankton community in the mean field for 1998–2009, in which diatoms explain ~7.5%. Nanoplankton are ubiquitous throughout the global surface oceans, except the subtropical gyres, constituting ~45.5%, of which prymnesiophytes (haptophytes) are the major group explaining ~31.7% while green algae contribute ~13.9%. Picoplankton are dominant in the subtropical gyres, but constitute ~43.6% globally, of which prokaryotes are the major group explaining ~26.5% (Prochlorococcus sp. explaining 22.8%), while pico-eukaryotes explain ~17.2% and are relatively abundant in the South Pacific. These results may be of use to evaluate global marine ecosystem models.
Global warming is expected to decrease ocean oxygen concentrations by less solubility of surface ocean and change in ocean circulation. The associated expansion of the oxygen minimum zone would have ...adverse impacts on marine organisms and ocean biogeochemical cycles. Oxygen reduction is expected to persist for a thousand years or more, even after atmospheric carbon dioxide stops rising. However, long‐term changes in ocean oxygen and circulation are still unclear. Here we simulate multimillennium changes in ocean circulation and oxygen under doubling and quadrupling of atmospheric carbon dioxide, using a fully coupled atmosphere‐ocean general circulation model and an offline biogeochemical model. In the first 500 years, global oxygen concentration decreases, consistent with previous studies. Thereafter, however, the oxygen concentration in the deep ocean globally recovers and overshoots at the end of the simulations, despite surface oxygen decrease and weaker Atlantic meridional overturning circulation. This is because, after the initial cessation, the recovery and overshooting of deep ocean convection in the Weddell Sea enhance ventilation and supply oxygen‐rich surface waters to deep ocean. Another contributor to deep ocean oxygenation is seawater warming, which reduces the export production and shifts the organic matter remineralization to the upper water column. Our results indicate that the change in ocean circulation in the Southern Ocean potentially drives millennial‐scale oxygenation in deep ocean, which is opposite to the centennial‐scale global oxygen reduction and general expectation.
Key Points
Deep ocean oxygen overshoots pre‐industrial condition under 2 and 4 × CO2 level
Enhanced deep convection in the Weddell Sea cause global deep ocean oxygenation
Warming and slow freshening of deep water cause enhanced deep convection
Objectives
To determine the association between SARC-F scores and the in-hospital mortality risk among older patients admitted to acute care hospitals.
Design
Single-center retrospective study.
...Setting
A university hospital.
Participants
All consecutive patients aged older than 65 were admitted and discharged from the study hospital between July 2019 and September 2019.
Measurements
Relevant patient data included age, sex, body mass index, nutritional status, fat-free mass, disease, activities of daily living (ADL), duration of hospital stay, SARC-F, and occurrence of death within 30 days of hospitalization. The diseases that caused hospitalization and comorbidities (Charlson Comorbidity Index; CCI) were obtained from medical records. The Eastern Cooperative Oncology Group-performance status (PS) was used to determine ADL, and the in-hospital mortality rate within 30 days of hospitalization as the outcome.
Results
We analyzed 2,424 patients. The mean age was 75.9±6.9 and 55.5% were male. Fifty-three in-hospital mortalities occurred among the participants within the first 30 days of hospitalization. Patients who died in-hospital were older, had poorer nutritional status and severer PS scores, and more comorbidities than those who did not. A SARC-F score of ≥4 predicted a higher mortality risk within those 30 days with the following precision: sensitivity 0.792 and specificity 0.805. There were significantly more deaths in Kaplan-Meier curves regarding a score of SARC-F≥4 than a score of SARC-F<4 (p<0.001). Cox proportional hazard analysis was used to identify the clinical indicators most associated with in-hospital mortality. SARC-F≥4 (Hazard Ratio: HR 5.65, p<0.001), CCI scores (HR1.11, p=0.004), and infectious and parasitic diseases (HR3.13, p=0.031) were associated with in-hospital mortality. The SARC-F items with significant in-hospital mortality effects were assistance with walking (HR 2.55, p<0.001) and climbing stairs (HR 2.46, p=0.002).
Conclusion
The SARC-F questionnaire is a useful prognostic indicator for older adults because a SARC-F ≥4 score during admission to an acute care hospital predicts in-hospital mortality within 30 days of hospitalization.
Abstract Introduction Fibroblast growth factor (FGF) signaling is essential for early trophoblast expansion and maintenance in the mouse, but is not required for trophectoderm specification during ...blastocyst formation. This signaling pathway is stably activated to expand the trophoblast stem cell compartment in vivo , while in vitro , FGFs are used for the derivation of trophoblast stem (TS) cells from blastocysts and early post-implantation mouse embryos. However, the function of FGFs during human trophoblast development is not known. Methods We sought to derive TS cells from human blastocysts in a number of culture conditions, including in the presence of FGFs and stem cell factor (SCF). We also investigated the expression of FGF receptors (FGFRs) in blastocysts, and the expression of FGFR2 and activated ERK1/2 in first trimester human placentae. Results We found that SCF, but not FGF2/4, improved the quality of blastocyst outgrowths, but we were unable to establish stable human TS cell lines. We observed CDX2 expression in the trophectoderm of fully blastocysts, but rarely observed transcription of FGFRs. FGFR2 protein was not detected in human blastocysts, but was strongly expressed in mouse blastocysts. However, we found robust FGFR2 expression and activated ERK1/2 in the cytotrophoblast layer of early human placenta. Discussion Our data suggests that initiation of FGF-dependent trophoblast expansion may occur later in human development, and is unlikely to drive maintenance of a TS cell compartment during the peri-implantation period. These findings suggest that cytotrophoblast preparations from early placentae may be a potential source of FGF-dependent human TS cells.
Objectives
Community-dwelling older adults with sarcopenia are likely to fall. However, few studies have investigated whether sarcopenia is associated with falls during hospitalization in older ...adults. The purpose of this study was to determine whether the SARC-F when used as a simple screening tool for sarcopenia at the time of admission, predicts in-hospital falls.
Design
A retrospective, observational study.
Setting
A 900-bed university hospital.
Participants
A total of 9,927 patients aged 65 years and older were hospitalized at the hospital between April 2019 and March 2020.
Measurements
The SARC-F contains five items: strength, assistance in walking, rise from a chair, climb stairs, and falls were evaluated at hospital admission. To investigate the relationship between the SARC-F score and falls, a ROC curve analysis was performed. Multivariate analysis adjusted for fall-related confounding factors such as age, gender, ADL, and disease were performed.
Results
Mean age: 75.9±6.7 years; male: 56.2% were analyzed, and 159 patients (1.6%) fell during hospitalization. SARC-F scores at admission were significantly higher in the fall group than in the control group (3 1–6 points vs. 0 ¬0–2 point, p<0.001). Statistical association was observed between the SARC-F and in-hospital fall (area under the curve = 0.721 0.678–0.764, p < 0.001). The cut-off value for the highest sensitivity and specificity of the SARC-F score for in-hospital falls was two (sensitivity = 0.679, specificity = 0.715). Among the subitem of the SARC-F, the hazard ratios for climbing stairs were significantly higher (HR = 1.52 1.10–2.09, p = 0.011) and for a history of fall was significantly higher (HR = 1.41 1.02–1.95, p = 0.036). A SARC-F score ≥ 2 had a significantly higher incidence of in-hospital falls compared to a SARC-F score <2 (3.7% vs. 0.7%, p < 0.001). Also, a SARC-F score ≥ 2 had a significantly higher hazard ratio for falls (2.11 1.37–3.26, p < 0.001).
Conclusion
SARC-F can help predict falls among hospitalized older adults.
Objectives
Due to the water-rich cooking process required to soften texture modified diets (TMDs), TMDs may have poorer nutrition. The aim of this study was to investigate the associations between ...daily premorbid TMD consumption and nutritional status at the time of hospitalization, and its burden on hospitalization outcomes.
Design
Retrospective observational study.
Setting
An academic hospital.
Participants
The cohort comprised 3,594 older adult patients aged ≥65 years admitted to the hospital.
Measurements
Patients were interviewed on admission using a premorbid daily consumption meal form to determine whether the patient ate a TMD. Nutritional status was examined using nutritional screening tools (Mini-Nutritional Assessment Short Form MNA-SF, Malnutrition Universal Screening Tool MUST, Geriatric Nutritional Risk Index GNRI) and the European Society of Clinical Nutrition and Metabolism (ESPEN)-defined criteria of malnutrition at admission. Length of hospital stay (LOS) and in-hospital mortality were considered outcomes of hospitalization. Multivariate analyses were performed to detect associations between premorbid TMD consumption and nutritional status and outcomes.
Results
The mean age of the subjects was 75.9±7.0 years, including 58% males. Overall, 110 (3.1%) patients consuming a premorbid TMD were identified. They were older (p<0.001), had poor nutritional status (lower MNA-SF score p<0.001 and GNRI value p<0.001, higher MUST score p<0.001, and more prevalent ESPEN-defined malnutrition 61.8% vs. 14.0%, p<0.001 than did patients without a TMD. The mortality rate and LOS of patients with TMD was higher (7.3% vs. 2.9%, p=0.017) and longer (19 days vs. 8 days, p<0.001) than those without TMD. Multivariate analyses showed that TMD consumption was independently associated with poor nutritional status and prolonged LOS after adjusting confounders.
Conclusion
Daily consumption of a TMD during the premorbid period affects nutritional status at the time of hospitalization and outcomes. Further studies are necessary to investigate whether nutritional intervention can improve outcomes for people on a TMD.
Abstract For more than half a century, the structure of $^{12}$C, such as the ground band, has been understood to be well described by the three $\alpha$ cluster model based on a geometrical ...crystalline picture. On the contrary, recently it has been claimed that the ground state of $^{12}$C is also well described by a nonlocalized cluster model without any of the geometrical configurations originally proposed to explain the dilute gas-like Hoyle state, which is now considered to be a Bose–Einstein condensate of $\alpha$ clusters. The challenging unsolved problem is how we can reconcile the two exclusive $\alpha$ cluster pictures of $^{12}$C, crystalline vs. nonlocalized structure. We show that the crystalline cluster picture and the nonlocalized cluster picture can be reconciled by noticing that they are a manifestation of supersolidity with properties of both crystallinity and superfluidity. This is achieved through a superfluid $\alpha$ cluster model based on effective field theory, which treats the Nambu–Goldstone zero mode rigorously. For several decades, scientists have been searching for a supersolid in nature. Nuclear $\alpha$ cluster structure is considered to be the first confirmed example of a stable supersolid.
A terahertz (THz)-wave interferometer was devised for measurement of the THz-wave phase shift. In this measurement system, the relative phase shift is deduced from the interference between the THz ...waves generated by two photomixers. Experimental results with this interferometer revealed that the semiconductor phase modulator could be used as a THz-wave phase shifter by utilising its chromatic dispersion.
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