Historical and traditional flood-irrigated (FI) schemes are progressively being upgraded by means of drip irrigation (DI) to tackle current water and demographic challenges. This modernization ...process is likely to foster several changes of environmental relevance at the system level. In this paper we assess the effects derived from DI uptake on soil health and structure in ancient FI systems through the case study of Ricote, SE Spain, first established in the 10-13th centuries CE. We approach the topic by means of physico-chemical analyses (pH, electrical conductivity, available P, carbon analyses, bulk density, soil water content and particle size distribution), Electrical Resistivity Measurements (ERT) and robust statistics. We reach a power of 1-ß = 77 aiming at detecting a large effect size (f ≥ 0.4). Results indicate that, compared to FI, DI soils present significantly higher water content, a higher proportion of coarse particles relative to fines due to clay translocation, and less dispersion in salt contents. The soils away from the emitters, which were formerly FI and comparatively account for larger extensions, appear significantly depleted in organic matter, available P and N. These results are not affected by departures from statistical model assumptions and suggest that DI uptake in formerly FI systems might have relevant implications in terms of soil degradation and emission of greenhouse gases. A proper assessment of the edaphological trade-offs derived from this modernization process is mandatory in order to tackle undesired environmental consequences.
•Drip irrigation uptake requires abandoning flood-irrigation.•Former flood-irrigated soils undergo carbon and nutrient depletion.•Drip-irrigated soils show higher clay translocation and more stable EC values.•Edaphological trade-offs from drip irrigation uptake must be properly assessed.
The Air Force Medical Service (AFMS) currently runs three in-theater hospitals for severely injured or wounded personnel. Part of the practioners' preparation was treating DoD beneficiaries for a ...broad range of injuries and illnesses. Opportunities for this preparation are not as numerous "in house" as they once were, and AFMS does not always get proper credit for those gained elsewhere. Proper credit for that work is important for funding.
Severe acute kidney injury (AKI) is associated with a significant risk of mortality and persistent renal replacement therapy (RRT) dependence. The objective of this study was to develop prediction ...models for mortality at 90-day and 1-year following RRT initiation in critically ill patients with AKI.
All patients who commenced RRT in the intensive care unit for AKI at a tertiary care hospital between 2007 and 2014 constituted the development cohort. We evaluated the external validity of our mortality models using data from the multicentre OPTIMAL-AKI study.
The development cohort consisted of 594 patients, of whom 320(54%) died and 40 (15% of surviving patients) remained RRT-dependent at 90-day Eleven variables were included in the model to predict 90-day mortality (AUC:0.79, 95%CI:0.76–0.82). The performance of the 90-day mortality model declined upon validation in the OPTIMAL-AKI cohort (AUC:0.61, 95%CI:0.54–0.69) and showed modest calibration. Similar results were obtained for mortality model at 1-year.
Routinely collected variables at the time of RRT initiation have limited ability to predict mortality in critically ill patients with AKI who commence RRT.
•Mortality is frequent after severe acute kidney injury.•Accurate prediction may help with shared decision-making.•Clinical parameters at dialysis initiation would be ideal for this purpose.•The models in this study only resulted in a moderate predictive ability.•Additional information might be necessary for adequate risk prediction.
In the presence of radiation, particle strikes can cause temporary signal errors in ICs. Particle strikes that directly affect memory are known as single event upsets (SEUs), while strikes that ...affect combinational logic and spread to memory are called single event transients (SETs). This paper focuses on SEU and SET-tolerant approaches to constructing pipeline latches and flip-flops. Level-sensitive latches, edge-triggered master-slave flip-flops, and pulse-triggered flip-flops comprise the pipeline memory classes considered in this paper. TPDICE basic cells are utilized to achieve fault-tolerance and transient bypass capability. A number of single-ended and differential structures are presented and evaluated with respect to performance, energy consumption, and complexity. In addition, the SEU and SET tolerance of these structures is demonstrated. All evaluations are based off simulations performed in 90 nm CMOS. Accompanying the above evaluations, this paper also addresses concerns of multiple bit upset (MBU) affecting these designs at the 90 nm technology node. Novel hardened-by-design techniques are introduced to address these concerns, and their effectiveness is quantified.
Rationale & Objective: Coronavirus disease 2019 (COVID-19) may be associated with high rates of acute kidney injury (AKI) and kidney replacement therapy (KRT), potentially overwhelming health care ...resources. Our objective was to determine the pooled prevalence of AKI and KRT among hospitalized patients with COVID-19. Study Design: Systematic review and meta-analysis. Data Sources: MEDLINE, Embase, the Cochrane Library, and a registry of preprinted studies, published up to October 14, 2020. Study Selection: Eligible studies reported the prevalence of AKI in hospitalized patients with COVID-19 according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition. Data Extraction & Synthesis: We extracted data on patient characteristics, the proportion of patients developing AKI and commencing KRT, important clinical outcomes (discharge from hospital, ongoing hospitalization, and death), and risk of bias. Outcomes & Measures: We calculated the pooled prevalence of AKI and receipt of KRT along with 95% CIs using a random-effects model. We performed subgroup analysis based on admission to an intensive care unit (ICU). Results: Of 2,711 records reviewed, we included 53 published and 1 preprint study in the analysis, which comprised 30,657 hospitalized patients with COVID-19. Data for AKI were available for 30,639 patients (n = 54 studies), and receipt of KRT, for 27,525 patients (n = 48 studies). The pooled prevalence of AKI was 28% (95% CI, 22%-34%; I2 = 99%), and the pooled prevalence of KRT was 9% (95% CI, 7%-11%; I2 = 97%). The pooled prevalence of AKI among patients admitted to the ICU was 46% (95% CI, 35%-57%; I2 = 99%), and 19% of all ICU patients with COVID-19 (95% CI, 15%-22%; I2 = 88%) commenced KRT. Limitations: There was significant heterogeneity among the included studies, which remained unaccounted for in subgroup analysis. Conclusions: AKI complicated the course of nearly 1 in 3 patients hospitalized with COVID-19. The risk for AKI was higher in critically ill patients, with a substantial number receiving KRT at rates higher than the general ICU population. Because COVID-19 will be a public health threat for the foreseeable future, these estimates should help guide KRT resource planning.
Shifting substrate oxidation in heart muscle from fatty acids to glucose (substrate-switch) may improve contractile function in heart failure. We tested whether application of two agents (etomoxir ...and NVP-LAB121) capable of inducing a substrate-switch reverts the onset of heart failure in rats with chronic pressure-overload. Hypertrophy was induced by aortic banding in rats for 1 or 15 weeks. Rats were treated for 10 days with the CPT-1-inhibitor etomoxir 29.5 μmol/(kg day) or with NVP-LAB121 60 μmol/(kg day), a pyruvate-dehydrogenase-kinase-inhibitor, before assessment by echocardiography and perfusion as isolated working hearts. We also analyzed PDH- and CPT1-activity and expression of α- and β-MHC by RT-PCR. Aortic banding increased heart-to-body-weight-ratio (g/kg) from 3.44 ± 0.26 to 4.14 ± 0.48 after 1 week and from 2.80 ± 0.21 to 6.54 ± 0.26 after 15 weeks. Ejection fraction was impaired after 15 weeks (57 ± 11 vs. 73 ± 8%,
P
< 0.05) and rats exhibited signs of heart failure. Total PDH activity was the same in all groups. CPT-1 activity was unchanged after 1 week but decreased after 15 weeks (
P
< 0.01). Neither etomoxir nor NVP-LAB121 affected cardiac function in vivo, but etomoxir improved function of the isolated heart. The drugs did not affect total PDH and CPT-1 activity, but increased PDH-activity status, prevented a decrease in PDK4 expression in heart failure, increased α and β-MHC expression and shifted substrate oxidation toward glucose in the isolated working rat heart. In conclusion, pharmacologic induction of substrate-switching is associated with changes in myofibrillar isoform expression but does not reverse heart failure in vivo. The improvement of function in vitro deserves further investigation.
In the presence of radiation, particle strikes can cause temporary signal errors in ICs. Particle strikes that directly affect memory are known as single event upsets (SEUs), while strikes that ...affect combinational logic and spread to memory are called single event transients (SETs). In this paper, we propose two novel approaches to hardening integrated circuits against SEUs and SETs. The proposed approaches are fully-differential dual-interlocked storage cell (DICE) and triple path DICE (TPDICE). The fully-differential DICE and TPDICE approaches are compared against two existing approaches, which are triple modular redundancy (TMR) and basic SET-tolerant DICE. All approaches except for the basic SET-tolerant DICE scheme share a common theme, which is the ability to bypass SEUs and SETs. This is critical for performance, as it allows the system to proceed with subsequent operations while a cell is recovering from the effects of a particle strike. SET pulse widths can be substantial (up to 2 ns), and so high-performance systems cannot afford to pause operations while these pulses are present. The minimum clock periods obtained for the basic SET-tolerant approach were 515 ps with no SET, and 1310 ps with a 500 ps SET (in 0.18 /spl mu/m CMOS). In contrast, the clock periods for the bypass-capable approaches with no SET/500 ps SET were 628/749 ps for TMR, 348/480 ps for fully-differential DICE, and 434/552 ps for TPDICE. Among the approaches that bypass transient pulses, TPDICE is the most balanced. TMR suffers from overhead due to its need for external voting circuitry. In addition to this, fully-differential DICE cannot be used with combinational logic, while TPDICE can.
PDF
