Variations in Physical Activity and Sedentary Behavior During and After Hospitalization in Acutely Admitted Older Medical Patients: A Longitudinal Study

Background: Inactivity and bedrest are frequent among older patients during hospitalization and are associated with functional decline. No longitudinal objective evidence exists on how patients' diurnal profile for physical activity changes during acute hospitalization and what happens when the patient is discharged to own home. By the use of accelerometers, this study aims to describe and compare the distribution of physical activity and sedentary behavior in acutely hospitalized older patients during hospitalization and after discharge. Methods: The study population consisted of 80 patients (+65 years) from the STAND-Cph trial, who were admitted with acute medical illness and were able to stand. Physical activity and sedentary behavior were measured as number of steps, uptime (walking/standing) and sedentary behavior (lying/sitting) per hour with an activity monitor worn on the thigh (activPAL3, PAL Technologies Ltd). The patients wore the monitor for three periods of one week: during hospitalization, after discharge, and four weeks after discharge. Results: The patients’ median age was 80 years [IQR: 75-88], 68% of the patients were female and The median DEMMI was 57 [IQR: 48-67]. The daily median uptime was 1.7 h [IQR: 1-2.8] during hospitalization, 4.0 h [IQR: 2.7-5.4] after discharge and 4.0 h [IQR: 2.8-5.8] four weeks after discharge. The median number of steps was 728 [IQR: 176-2089], 2207 [IQR: 1433-3148], and 2622 [IQR: 1714-3865], respectively. During hospitalization, a small peak was observed both for number of steps and uptime between 9-11 AM. However, the diurnal profile had no notable variation. At discharge and four weeks after discharge, the median of physical activity peaked 2-3 times and had mostly the same diurnal profile. Conclusion: Older hospitalized patients spend most of their time engaged in sedentary behavior, where their main activity peak is in the morning between 9-11 AM. The uptime doubles and the number of steps triples after discharge, where peaks of activity are seen throughout the day. This indicates that daily routines are disrupted during hospitalization and that older patients have the potential to be more physically active during hospitalization. This emphasizes the need for interventions that encourage physical activity throughout the day during hospitalization.

Gender Differences in Vascular Stiffness Indicators and Daily Blood Pressure Profile in Patients with Arterial Hypertension and Depressive Disorders

Aim To study gender-related characteristics of vascular wall stiffness (VWS), central blood pressure (CBP), and BP diurnal profile in patients with arterial hypertension (AH) and depression.Material and methods This prospective, noninterventional study enrolled 161 patients, including 98 patients with AH and depression (50 (51 %) men and 48 (49 %) women) and 63 patients with AH without depression (32 (50.8 %) men and 31 (49.2 %) women. The 24-h BP monitoring (24-h BPM) with a BPLab Vasotens hardware system was performed for all patients. The following indexes were evaluated: mean diurnal, mean daytime, and mean nighttime systolic and diastolic BP (SBP and DBP); daytime and nighttime SBP and DBP time index; SBP and DBP variability; and suite of metrics characterizing VWS and CBP. Depression was diagnosed with the Hospital Anxiety and Depression Scale (HADS) and the Zung Self-Rating Depression Scale. Statistical analyses were performed using the STATISTICA 12 software.Results In the patient group with AH and depression, practically all indexes of 24-h BPM were higher for men than for women (р<0.05). Most 24-h BPM parameters did not differ in groups of men and women without depression. Independent of gender, 24-h BPM parameters were significantly higher in patients with both AH and depression than in AH patients without depression. Adverse changes in major indexes of VWS and CBP, were more pronounced in men than in women with AH and depression (р<0.05). Adverse changes in most VWS and CBP indexes were more statistically significant for men with AH and depression than for men without depression.Conclusion The presence of depression in men and women with AH was associated with significant pathological changes in both BP diurnal profile and CBP and VWS parameters. Furthermore, adverse changes in indexes were more pronounced for men with depression than for women. The study results should be taken into account in administration of antihypertensive and psychocorrective drug therapy to personalize the treatment and provide not only optimization of diurnal BP profile but also vasoprotection.

Sources and Sinks of Nitrated Phenols: Application of an Observation-based Model

&lt;p&gt;&lt;strong&gt;Sources and Sinks of Nitrated Phenols:&amp;#160;&lt;/strong&gt;&lt;strong&gt;Application of an Observation-based Model &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Yuwen Peng&lt;sup&gt;1&lt;/sup&gt;, Sihang Wang&lt;sup&gt;1&lt;/sup&gt;, Caihong Wu&lt;sup&gt;1&lt;/sup&gt;, Jipeng Qi&lt;sup&gt;1&lt;/sup&gt;, Chaomin Wang&lt;sup&gt;1&lt;/sup&gt;, &lt;br&gt;Wei Song&lt;sup&gt;2&lt;/sup&gt;, Xinmin Wang&lt;sup&gt;2&lt;/sup&gt;, Bin Yuan&lt;sup&gt;1,&lt;/sup&gt;&lt;sup&gt;*&lt;/sup&gt;, Min Shao&lt;sup&gt;1,&lt;/sup&gt;&lt;sup&gt;**&lt;/sup&gt;&lt;/p&gt;&lt;p&gt;&lt;sup&gt;1&lt;/sup&gt; Institute for Environmental and Climate Research, Jinan University, 511443 Guangzhou, China&lt;/p&gt;&lt;p&gt;&lt;sup&gt;2&lt;/sup&gt; Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, China&lt;/p&gt;&lt;p&gt;&lt;sup&gt;*&lt;/sup&gt; [email protected]&lt;/p&gt;&lt;p&gt;&lt;sup&gt;**&lt;/sup&gt; [email protected]&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&amp;#160;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;Nitrated phenols are one of the intermediate products of aromatics oxidation that has been proved to be phytotoxic, mutagenic and important components of brown carbon and SOA in the atmosphere. Although its sources and sinks have been reported, high-time-resolution measurements of nitrophenols and the evaluation of reported rate constants insufficient. In this paper, we measured the concentration of nitrated phenols at an urban site in Guangzhou, then we use an observation-based model to compare different photolysis frequencies of nitrophenol and analyze its budget. The primary emission of traffic seems to be the dominant factor when considering its diurnal profile. Photolysis has proved to be the dominant sink of nitrophenol in the atmosphere.&lt;/p&gt;

Parameterized reactivity of hydroxy radical, ozone, nitrate radical and atmospheric oxidation capacity during summer at a suburban site between Beijing and Tianjin

Hydroxyl (OH) radicals, nitrate (NO3) radicals, and ozone (O3) play central roles in the troposphere because they control the lifetimes of many trace gases that resulted from anthropogenic and biogenic origins. To estimate the self-cleaning capacity of the atmosphere, the reactivities of OH, NO3 and O3 was comprehensively analyzed for the first time based on a parameterization method at a suburban site in Xianghe in the North China Plain from 6 July 2018 to 6 August 2018. The total OH reactivity, ROHtotal, NO3 reactivity, RNO3total, and O3 reactivity, RO3total, at the site varied from 8.5 s−1 to 68.1 s−1, 0.7 s−1 to 27.5 s−1, and 3.3 × 10−4 s−1 to 1.8 × 10−2 s−1 with campaign-averaged values of 25.6 ± 9.7 s−1, 2.2 ± 2.6 s−1 and 1.2 ± 1.7 × 10-3 s−1 (± standard deviation), respectively. NOx (NO + NO2) were by far the main contributors to the ROHtotal, RNO3total and RO3total, with average values of 47, 99 and 99 %, respectively. Isoprene dominated the OH and NO3 reactivity towards TVOCs (ROHTVOCs and RNO3TVOCs), accounting for 40 % and 77 %, respectively. However, alkenes dominated the O3 reactivity towards TVOCs (RO3TVOCs), representing 66 % of RO3total. ROHtotal, RNO3total and RO3total displayed a similar diurnal variation with the lowest during the afternoon and the highest during rush hours, and the diurnal profile of NOx appears to be the major driver for the diurnal profiles of ROHtotal, RNO3total and RO3total. The calculated atmospheric oxidative capacity (AOC) was up to 4.4 × 108 molecules cm−3 s−1 with campaign-averaged values of 3.1 × 107 molecules cm−3 s−1 dominated by OH radicals (2.9 × 107 molecule cm−3 s−1, 95 %), O3 (1.2 × 106 molecule cm−3 s−1, 4 %) and NO3 radicals (1.7 × 105 molecule cm−3 s−1, 1 %). The reaction with OH radicals was the dominant volatile organic compounds (VOCs) loss except for trans-2-butene, cis-2-butene, trans-2-pentene, propylene, 1-butene, 1-pentene, 1-hexene, acetone and styrene, where the reaction with O3 was more important for their loss rates. Compared with anthropogenic hydrocarbons, the oxidation by the NO3 radical was more important for the nighttime integral of isoprene loss rates. Overall, the present study may provide some useful suggestions for VOC pollution control in the Xianghe and North China Plain. To better understanding the trace gas reactivity and AOC, further studies, especially direct observations of the OH and NO3 radical concentrations and their reactivities, are required.

Development and field testing of an online instrument for measuring the real-time oxidative potential of ambient particulate matter based on dithiothreitol assay

We developed an online instrument for measuring the oxidative potential (OP) of ambient particulate matter (PM) using the dithiothreitol (DTT) assay. The instrument uses a mist chamber (MC) to continuously collect the ambient PM2.5 in water, and then determines its DTT activity using an automated syringe pump system. The instrument was deployed at an urban site in the University of Illinois campus, and its field performance was evaluated by comparing the results with the offline DTT activity measurements of simultaneously collected PM-laden filters. The online DTT activity measurements correlated well with the offline measurements but were higher than both methanol (slope =1.08, R2=0.93) and Milli-Q water (slope =1.86, R2=0.86) extracts of the PM filters, indicating a better efficiency of the MC for collecting the water-insoluble fraction of PM. The hourly measurements of ambient PM2.5 OP were obtained by running the online instrument intermittently for 50 days with minimal manual assistance. The daytime DTT activity levels were generally higher than at night. However, a 4-fold increase in the hourly averaged activity was observed on the night of 4 July (Independence Day fireworks display). The diurnal profile of the hourly averaged OP during weekdays showed a bimodal trend, with a sharp peak in the morning (around 07:00 LT), followed by a broader afternoon peak which plateaus around 14:00 LT and starts subsiding at night (around 19:00 LT). To investigate the association of the diurnal profile of DTT activity with the emission sources at the site, we collected time-segregated composite PM filter samples in four different time periods of the day (morning, 07:00–10:00 LT; afternoon, 10:00–15:00 LT; evening, 15:00–19:00 LT; and night, 19:00–07:00 LT) and determined the diurnal variations in the redox active components (i.e., water-soluble Cu, Fe, Mn, organic carbon, elemental carbon, and water-soluble organic carbon). Based on this comparison, we attributed the daytime OP of ambient PM2.5 to the vehicular (both exhaust and non-exhaust) emissions and resuspended dust, whereas secondary photochemical transformation of primary emissions appear to enhance the OP of PM during the afternoon and evening period.

Development and field-testing of an online instrument for measuring the real-time oxidative potential of ambient particulate matter based on dithiothreitol assay

We developed an online instrument for measuring the oxidative potential (OP) of ambient particulate matter (PM) using dithiothreitol (DTT) assay. The instrument uses a mist chamber (MC) to continuously collect the ambient PM2.5 in water, followed by its DTT activity determination using an automated syringe pump system. The instrument was deployed at an urban site in the University of Illinois campus, and its field performance was evaluated by comparing the results with the offline DTT activity measurements of simultaneously collected PM-laden filters. The online DTT activity measurements correlated well with the offline measurements but were higher than both methanol (slope = 0.86, R2 = 0.93) and Milli-Q water (slope = 0.52, R2 = 0.86) extracts of the PM filters, indicating a better efficiency of MC for collecting the water-insoluble fraction of PM. The hourly measurements of ambient PM2.5 OP were obtained by running the online instrument intermittently for 50 days with minimal manual assistance. The daytime DTT activity levels were generally higher than at night. However, a four-fold increase in the hourly averaged activity was observed on the night of July 04 (Independence Day fireworks display). Diurnal profile of the hourly averaged OP during weekdays showed a bimodal trend, with a sharp peak in the morning (around 7:00 AM), followed by a broader afternoon peak, which plateaus around 2:00 PM, and starts subsiding at night (around 7:00 PM). To investigate the association of the diurnal profile of DTT activity with the emission sources at the site, we collected time-segregated composite PM filter samples in four different time periods of the day [morning (7:00 AM–10:00 AM), afternoon (10:00 AM–3:00 PM), evening (3:00 PM–7:00 PM) and night (7:00 PM–7:00 AM)] and determined the diurnal variations in the redox active components [i.e. water soluble Cu, Fe, Mn, organic carbon, elemental carbon and water soluble organic carbon]. Based on this comparison, we attributed the daytime OP of ambient PM2.5 to the water-soluble Cu from both exhaust and non-exhaust emissions, whereas secondary particles formed by the photochemical transformation of primary emissions appear to enhance the OP of PM during the afternoon and evening period.