Impact of Delirium on Outcomes After Intracerebral Hemorrhage

Background and Purpose: Delirium portends worse outcomes after intracerebral hemorrhage (ICH), but it is unclear if symptom resolution or postacute care intensity may mitigate its impact. We aimed to explore differences in outcome associated with delirium resolution before hospital discharge, as well as the potential mediating role of postacute discharge site. Methods: We performed a single-center cohort study on consecutive ICH patients over 2 years. Delirium was diagnosed according to DSM-5 criteria and further classified as persistent or resolved based on delirium status at hospital discharge. We determined the impact of delirium on unfavorable 3-month outcome (modified Rankin Scale score, 4–6) using logistic regression models adjusted for established ICH predictors, then used mediation analysis to examine the indirect effect of delirium via postacute discharge site. Results: Of 590 patients (mean age 70.5±15.5 years, 52% male, 83% White), 59% (n=348) developed delirium during hospitalization. Older age and higher ICH severity were delirium risk factors, but only younger age predicted delirium resolution, which occurred in 75% (161/215) of ICH survivors who had delirium. Delirium was strongly associated with unfavorable outcome, but patients with persistent delirium fared worse (adjusted odds ratio [OR], 7.3 [95% CI, 3.3–16.3]) than those whose delirium resolved (adjusted OR, 3.1 [95% CI, 1.8–5.5]). Patients with delirium were less likely to be discharged to inpatient rehabilitation than skilled nursing facilities (adjusted OR, 0.31 [95% CI, 0.17–0.59]), and postacute care site partially mediated the relationship between delirium and functional outcome in ICH survivors, leading to a 25% reduction in the effect of delirium (without mediator: adjusted OR, 3.0 [95% CI, 1.7–5.6]; with mediator: adjusted OR, 2.3 [95% CI, 1.2–4.3]). Conclusions: Acute delirium resolves in most patients with ICH by hospital discharge, which was associated with better outcomes than in patients with persistent delirium. The impact of delirium on outcomes may be further mitigated by postacute rehabilitation.

EVALUATING THE ANTHROPOGENIC IMPACT ON THE PRUT RIVER NEAR YAREMCHE-TOWN ON THE POLLUTION LEVEL INDICES OF BOTTOM SEDIMENTS

Introduction. One of the most objective and reliable indicators of the state of pollution of the aquatic environment and the overall level of technological load on it is the content of pollutants in bottom sediments (BS). There are no large industrial enterprises in and around Yaremche-town (Ivano-Frankivsk region), so there are no significant discharges of toxic substances into the sewage system, especially directly into the river. However, every year in this picturesque cornerof Prykarpattia the number of sanatoriums, recreation centres, cottage towns and just residential buildings grows. Accord-ingly, the Prut River, which is the pearl of this region, quite often gets untreated runoff, which pollutes not only water but also settles on bottom sediments.The purpose of this study was to assess the anthropogenic load on the Prut River based on a comprehensive environmental analysis of the state of pollution of the bottom sediments of this river upstream and downstream from Yaremche.Methods. Water extracts from bottom sediments were prepared by the recommendations of the relevant regula-tions in the ratio "bottom sediments - water" as 1: 5 in terms of the dry mass of bottom sediments. Laboratory study of hydrochemical parameters of selected samples was performed by gravimetric, titrimetric, photometric and other methods of analysis.Research results. The accumulation of ammonium salts, nitrites and nitrates, which are easily soluble, in the far above the discharge site of wastewater, is obviously due to the significant sorption properties of river sludge, which prevents these ions from being washed away by the flow. At the point of discharge of wastewater from the city, the content of these ions increases and reaches a maximum at point 3 - at a distance of approx. 100 m below the discharge site. Further downstream, their number systematically decreases. A similar distribution of concentrations is observed in the case of phosphates. Their source of getting into the river also, for the most part, belongs to the housing and communal services. A significant contribution to the increased phosphate content in the sample below the discharge is made by urban wastewater, in which even after treatment the concentration of phosphate ions remains quite high. The fact of the presence of oil products in the bottom sediments at the investigated area was revealed. The constant increase in the number of road transport on the banks of this resort river inevitably leads to the ingress of products of incomplete combustion of fuel, uncontrolled spills.Conclusions. Upstream from the place of discharge into the Prut River of treated wastewater in the city of Yaremche, the concentrations of salts-pollutants of the biogenic group are formed due to uncontrolled sources of domestic sew-age. In this area, the pollution of bottom sediments is insignificant, slightly higher at the discharge site, and they are of the greatest importance below the discharge. This fact indicates the growing anthropogenic impact of coastal cities on the state of the river and in general, and pollution of bottom sediments, in particular. For the first time oil products were found in bottom sediments in the studied area. The reason for this phenomenon is the constant increase in the number of vehicles on the banks of this river.

Trophic Indicators of Ecological Resilience in a Tidal Lagoon Estuary Following Wastewater Diversion and Earthquake Disturbance

Estuary ecological resilience can be gauged by response of estuary trophic state to abatement of nutrient pollution. Changes in trophic indicators were studied in the Avon-Heathcote Estuary (AHE) in Christchurch, New Zealand, over 6 years, spanning diversion of city wastewater inputs to an offshore outfall in 2010, and to temporary enrichment caused by the 2011 Christchurch earthquake. It was hypothesised that the tidally well-flushed and sandy AHE would not harbour a ‘legacy’ of eutrophication and would rapidly gain improved ecological function following the diversion. AHE sediments were coarse (156 μm median grain size) with low organic matter (OM 1.2%, N 0.03%, C 0.3%), which changed little either with diversion or earthquake. Upon diversion, median water column and porewater ammonium (36, 185 μmol) decreased by 87% and 57%, respectively, benthic microalgae (269 mg chlorophyll-a m−2) fell by 58%, and enrichment-affiliated polychaetes (3700–8000 m−2) fell by 60–80% at sites with largest benthic microalgal reductions, all within < 1–2 years. Oxygen and ammonium fluxes were usually oligotrophic and changed little upon diversion, except near the historic wastewater discharge site. Denitrification became more important for N loss, increasing from 5 to 29% of estuary N load. Responses to earthquake-driven enrichment were transient. Despite decades of heavy N loading and eutrophic growths of benthic microalgae and macroalgae, the AHE did not store a eutrophic legacy in its sediments. It reacted rapidly to improved water quality allowed by the outfall, showing that this common estuary type (sandy, well-flushed tidal lagoon) was resilient to eutrophication upon stressor removal.

Magnetic-field CMOS microsensor for low-energy electric discharge detection

This paper addresses the development and characterization of a non-intrusive silicon-based microsensor, which can detect electric partial discharges in electrical insulation equipment. Early partial discharge detection prevents failures and can be used to optimize maintenance operations. Despite the potential that CMOS technology offers, miniaturized electric discharge detector has neither been investigated nor implemented, until now. The developed microsensor demonstrates its ability to record electric discharge emission thanks to the presence of a miniaturized planar inductor. The squared inductor of 50 turns with a side length of 1.5 mm used in our sensor has been fabricated on top of a silicon substrate in a CMOS technology. The total inductor wire length of loop antenna is 30 cm to achieve 100 MHz bandwidth. Using the microsensor at 1 cm from the discharge site, a damped sinusoidal induced voltage with an amplitude of 2 V has been measured at its output. We observed that the output signal spectrum is highly concentrated around a central resonance frequency, which remains constant. The main advantage of such design resides in its monolithic integration added to the high autonomy, which improves the microsensor efficiency.

Novel diatom species (Bacillariophyta) from the freshwater discharge site of Laguna Diablas (Island Isabela = Albemarle) from the Galapagos

The Diablas wetlands are found on the south coast of Isabela Island on the Galapagos archipelago, consisting of one main lagoon and a series of smaller pools and lagoons. Recent studies have revealed a freshwater-brackish diatom assemblage in the Diablas wetlands, containing a relatively large number of novel taxa. This study gives formal description of seven new diatom taxa found in one sample from the Diablas wetlands. The sampling site contains floating moss at the mouth of a freshwater-brackish stream connecting the lagoon to the sea, with a salinity of around ca. 7 psu. The diatom assemblage in this sample, represented by genera observed in increased water conductivity (salinity), e.g. Luticola, also includes those which occur mostly in lower pH “soft waters”, e.g. Eunotia and Frustulia, and some marine taxa found in lower relative abundances (as Achnanthes parvula, Opephora cf. pacifica and Actinoptychus sp.). The new species are: Luticola galapagoensis, Luticola darwinii, Frustulia galapagosaxonica, Eunotia pacificomonodon, Eunotia isabelensis, Eunotia feremiserabilis and Pinnularia valdecontroversa. Some of the new taxa are morphologically similar to well-known Holarctic taxa but differ in terms of size and other metric data. The work continues to indicate the Diablas wetlands contain a diverse network of diatom habitats and associated assemblages of novel diatom species.