Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia

Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.

Occurrence, source estimation, and risk assessment of Polycyclic Aromatic Hydrocarbons in coastal seawaters from the Quintero Industrial Complex (Valparaíso, Chile)

In the 1960s, the Quintero industrial complex was inaugurated in Chile. This began a history of dramatic anthropogenic impacts on the Chilean coast. Among the known, we could mention high atmospheric emissions of chemicals due to combustion processes and frequent oil spills. For this reason, we surveyed the concentrations of fifteen EPA_PAHs in the surface coastal waters of the Quintero Bay area in 2015. The levels found are in the range of the highest levels when reviewing the literature (0.97 μg L^-1 up to 9.84 μg L^-1). The highest levels were found in the vicinity of the industrial complex and decreased in the other two zones. The concentration of individual compounds significantly exceeds the levels recommended by the EPA (Environmental Protection Agency) and the EU water framework directive (WFD). The risk estimations revealed that PAH concentrations represent high-risk for wildlife. Molecular ratios of PAHs were used to identify the possible sources, being these were mainly of pyrogenic origin, agreeing with an origin in the combustion of wood, coal, grass, and fossil fuels. This study contributes to the first data for surface water in a country's highly impacted industrial coastal area.

ODP109 PARATHYROID HORMONE AND 25 OH VITAMINA D IN PREGNANCY: DATA FROM AN ARGENTINEAN COHORT SUPPORTING SUPPLEMENTATION

 

Vitamin D (Vit D) deficiency has become a global health care issue, as it affects a great number of women during pregnancy and lactation. Vit D levels are critical during pregnancy, being the mother the only source of them for the developing fetus; an enzymatic system for conversion of 25OH VitD into 1-25(OH) 2 VitD is present in the placenta, thus reinforcing the importance of VitD during gestation. VitD deficiency has been associated with obstetric complications and adverse outcomes in offspring, affecting skeletal, immunological and respiratory systems. It is known that prenatal supplements available do not contain enough VitD to fulfil requirements. It is generally accepted that elevated PTH is an indicator of VitD deficiency, and Hysaj O et al (2021) showed that 25OH VitD is a statistically significant determinant of PTH levels in early and late pregnancy.

Aim

To evaluateVitD status and its relationship to parathyroid hormone (PTH) in a cohort of pregnant women representative of multiple Argentinian regions.

Subjects and Methods

Data from samples of 423 pregnant women in 1st and 2nd trimester were collected between 2016 and 2021. VitD was measured in different platforms: DiaSorin Liaison CLIA (n=184), Roche COBAS ECLIA (n=166), Abbott ARCHITECT CMIA (n=33), Biomérieux VIDAS ELFA (n=18) and Siemens CENTAUR CLIA (n=16). PTH (ng/L) was measured in 162 samples by SIEMENS IMMULITE CLIA and Roche COBAS ECLIA. As VitD is light-exposure dependent, we considered warm and high light-exposure season period from December to March and cold and low light season from April to September. VITD (ng/L) levels were classified as Deficient (<20), Insufficient (between 21 and 29) and Sufficient (>30) (Endocrine Society, 2014).

Results

From 423 data collected, 102 were excluded because of lacking information on VitD supplementation. From the remaining non supplemented 321 samples, 48% resulted insufficient, 30% deficient and 22% sufficient for VitD (groups comparison: p< 0. 05, Kruskal Wallis-Dunn test). The seasonal period and pregnancy trimester distributions didn't show significant differences. Similar results of VitD insufficiency were found in the major used platforms, regardless the seasonal period considered. PTH results expressed as median and interquartile range were (ng/L): 32. 0 (13.7-169. 0) in Deficient pregnancies (N=92), 23.7(13.3-88. 0) in Insufficient (n=50) and 18.7 (9.8-55.7) in Sufficient (n=20).

Conclusions

This study shows VitD inadequate levels in 78% in non-supplemented pregnancies, regardless season or measurement platform. Relative elevated levels of PTH were associated to pregnancies with VitD deficiency, evidenciating a regulatory role according to published data. To improve VitD status during pregnancy it would be advisable to pose new strategies for prenatal supplements developed by a multidisciplinary professional team.

Presentation: No date and time listed

Composite design bioinspired by the mesocarp of Brazil nut (Bertholletia excelsa)

The mesocarp ofBertholletia excelsais a rich source of inspiration for strong, stiff and damage-tolerant composites. The bioinspired composites developed here are composed of an epoxy matrix with a 3D printed polylactic acid reinforced with 30% of carbon fiber (PLA-30CF) inspired in fibers, and syntactic foam inspired by sclereids. Monotonic and cyclic four-point bending tests and compact tension fracture toughness tests were carried out assisted by digital image correlation (DIC) to evaluate flexural properties, damage tolerance, and theR-curve of the composite. Its microstructure and fracture surface were analyzed by scanning electron microscopy. The mechanical performance of the bioinspired composite is promising: density of 1.0 g cm^-3, flexural apparent elastic modulus of 1.6 GPa, and flexural strength six times higher than the neat epoxy, i.e. 17 MPa. Although the PLA-30CF printed structure led to a risingR-curve, the syntactic foam needs optimization to have a synergistic effect.

Biogeosciences Perspectives on Integrated, Coordinated, Open, Networked (ICON) Science

This article is composed of three independent commentaries about the state of Integrated, Coordinated, Open, Networked (ICON) principles in the American Geophysical Union Biogeosciences section, and discussion on the opportunities and challenges of adopting them. Each commentary focuses on a different topic: (a) Global collaboration, technology transfer, and application (Section 2), (b) Community engagement, community science, education, and stakeholder involvement (Section 3), and (c) Field, experimental, remote sensing, and real-time data research and application (Section 4). We discuss needs and strategies for implementing ICON and outline short- and long-term goals. The inclusion of global data and international community engagement are key to tackling grand challenges in biogeosciences. Although recent technological advances and growing open-access information across the world have enabled global collaborations to some extent, several barriers, ranging from technical to organizational to cultural, have remained in advancing interoperability and tangible scientific progress in biogeosciences. Overcoming these hurdles is necessary to address pressing large-scale research questions and applications in the biogeosciences, where ICON principles are essential. Here, we list several opportunities for ICON, including coordinated experimentation and field observations across global sites, that are ripe for implementation in biogeosciences as a means to scientific advancements and social progress.

Perinatal exposure to low doses of glyphosate-based herbicide combined with a high-fat diet in adulthood causes changes in the jejunums of mice

AIM

Exposure to pesticides and consumption of high-fat diets are widespread in society. Reports have shown that exposure to glyphosate and a high-fat diet can cause gastrointestinal disorders and increase susceptibility to obesity. Thus, this study evaluated the impacts of perinatal exposure to glyphosate followed by consumption of a high-fat diet in adulthood on the histology and morphometry of jejunums and enteric nervous system of C57BL/6 mice.

MATERIAL AND METHODS

After mating, 20 C57BL/6 female mice were separated into a control group (CG) and a glyphosate group (GLY) that received water with 0.5% glyphosate. After the lactation period, some male offspring were randomly separated into CG-SD and GLY-SD (standard diet) groups or CG-HD and GLY-HD (high-fat diet) groups. After 12 weeks, jejunum samples were collected and submitted to histological analysis.

KEY FINDINGS

Indirect exposure to glyphosate changed the morphometry of the intestinal wall, increased the proportion of intraepithelial lymphocytes (IELs) and goblet cells, and altered the area occupied by collagen fibers. The hyperlipidemic diet hypertrophied the jejunal total wall, total muscular and submucosal layers, decreased IELs, and increased the proportion of goblet cells. GLY-HD mice had shallower crypts, shorter villi, and less goblet cells and IELs than mice from GLY-SD group. GLY-HD also showed an increased number of neurons in myenteric and submucosal plexuses. Groups exposed to glyphosate and/or fed a high-fat diet had atrophied submucosal neurons.

SIGNIFICANCE

This study suggests that perinatal glyphosate exposure combined with a high-fat diet in adulthood increases the risk of jejunum inflammation and dysfunction.

Feasibility of a combined mobile-health electrocardiographic and rapid diagnostic test screening for Chagas-related cardiac alterations

Background

Chronic Chagas cardiomyopathy (CChC) is the most common cause of death related to Chagas disease (CD), and it develops in 20–30% of infected individuals. However, access to both CD testing and basic cardiac care is often limited in rural deprived areas, hyperendemic for CD.

Purpose

To assess the feasibility of a combined mobile-health (m-Health) electrocardiographic (ECG) and rapid diagnostic test (RDT) screening for Chagas-related cardiac alterations in a remote rural village of the Bolivian Chaco, where a high prevalence of CChC is expected.

Methods

A representative sample of 140 healthy volunteers were consecutively enrolled in a rural Bolivian Community in February 2019. Demographic and clinical data were recorded through a standardized questionnaire. All patients performed an ECG by D-Heart, a validated low-cost hospital grade 8 and 12 lead smartphone portable ECG, and a serologic testing by Chagas Stat-Pak® (CSP). RDTs were read locally while ECGs were sent to a Cardiology clinic which transmitted reports within 24 hours from recording.

Results

Among 140 people (54 men, median age of 38 [23–54] years), 98 (70%, 95% CI 62.4–77.6) were positive for T. cruzi infection with CSP, with a linear, age-dependent, increasing trend (p&lt;0.001). Overall, 25 individuals (18%) showed ECG abnormalities, compatible with CD. Prevalence of ECG abnormalities was significantly higher in T. cruzi infected individuals (22 vs 7%, p=0.032). None of the study participants had performed an ECG test prior to enrolment. ECG abnormalities included Bundle Branch Blocks (n=8), 1st Degree Atrioventricular blocks (n=3), rhythm disturbances (n=5), pathologic Q waves (n=2), fragmented QRS (n=5) and low QRS voltage (n=2). Twenty-two patients with a positive CSP testing and possible CD-related ECG abnormalities were recalled from Camiri Community and referred to Gutierrez Hospital for chest X-ray and treatment initiation. At multivariate analysis, positive CSP results (OR 4.75, 95% CI 1.08–20.96, p=0.039) and smoking habit (OR 4.20, 95% CI 1.18–14.92, p=0.027) were confirmed as independent predictors of ECG abnormalities. For 6-day screening for a community of 150 inhabitants, the overall start-up amount was projected to 4.82$/patient and to 8.23$/patient when operative costs (i.e. on-site nurse and healthcare assistant with remote physician on call) were included.

Conclusions

Combined D-Heart® ECG and RDTs screening proved a reliable and effective low-cost strategy to identify patients at high risk of disease and in need of further cardiologic assessment, in a rural, highly endemic environments of the Bolivian Chaco. Onsite and m-Health programmes should be encouraged to support early diagnosis of CD and CChC and provide access to targeted therapy to maximize treatment benefits prior to advanced cardiac involvement.

Funding Acknowledgement

Type of funding source: None

International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module

BACKGROUND

We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.

METHODS

During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied.

RESULTS

Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher.

CONCLUSIONS

Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.

Divergent personalities influence the myogenic regulatory genes myostatin, myogenin and ghr2 transcript responses to Vibrio anguillarum vaccination in fish fingerlings (Sparus aurata)

Myogenic regulators of muscle development, metabolism and growth differ between fish species in a context-specific manner. Commonly, the analysis of environmental influences on the expression of muscle-related gene regulators in teleosts is based on differences in swimming performance, feeding behaviour and stress-resistance, but the evaluation of behavioural phenotyping of immune and stress-related responsiveness in skeletal muscle is still scarce. Here we challenge proactive and reactive fingerlings of gilthead sea bream (Sparus aurata), one of the most commonly cultured species in the Mediterranean area, with highly pathogenic O1, O2α and O2β serotypes of Vibrio anguillarum, a widespread opportunistic pathogen of marine animals, to analyse skeletal muscle responses to bath vaccination. Transcripts related to inflammation (interleukin 1β, il1β; tumour necrosis factor-α, tnfα; and immunoglobulin M, igm), and muscle metabolism and growth (lipoprotein, lpl; myostatin, mstn-1; myogenin; and growth hormone receptors type I and II, ghr1 and ghr2, respectively) were analysed. Biochemical indicators of muscle metabolism and function (creatine kinase, CK, aspartate aminotransferase, AST; esterase activity, EA; total antioxidant status, TAC and glucose) were also determined. Our results indicate that proactive, but not reactive, fish respond to Vibrio vaccination by increasing the expression levels of mstn-1, myogenin and ghr2 transcripts at short-/medium- term (1 to 3 days' post vaccination). No effect of vaccination was observed in immune indicators or biochemical parameters in either phenotypes, except for elevated levels of EA in reactive fish one-week post vaccination. This suggests that behavioural divergence should be taken into account to evaluate the crosstalk between immune, metabolic and growth processes in muscle of immune-challenged fish.

Variations in the immune and metabolic response of proactive and reactive Sparus aurata under stimulation with Vibrio anguillarum vaccine

Environmental insults, such as exposure to pathogens, modulate the behavioural coping style of animals to stressors, and repeated exposure to stressful environments may lead to species-specific infection phenotypes. To analyse the influence of stress behavioural phenotypes on immune and metabolic performance, gilthead sea bream (Sparus aurata L.) were first screened for proactive and reactive coping styles. Once characterized, both behavioural phenotypes fish groups were bath vaccinated with bacterin from Vibrio anguillarum, an opportunistic widespread pathogen of fish. Gills and liver were sampled at 0 (control group), 1, 3 and 7 days post-vaccination. Immune-, oxidative stress- and metabolic-related transcripts (il1β, tnfα, igm, gpx1, sod, cat, lpl, ghr1 and ghr2), metabolic endpoints (glucose, cholesterol and triglycerides), hepatic health indicators (aspartate aminotransferase, alanine transaminase and alkaline phosphatase), oxidative stress status (esterase activity, total antioxidant capacity and total oxidative status) and stress biomarkers (cortisol) were determined. Present results indicate that screening for coping styles in the gilthead sea bream segregated the two distinct phenotypes as expected: proactive and reactive. Results also indicate that under bath vaccination proactive fish show high immune response and lower metabolism, whereas reactive fish show low immune and higher metabolic responses.

A combined docosahexaenoic acid–thyroid hormone protocol upregulates rat liver β-Klotho expression and downstream components of FGF21 signaling as a potential novel approach to metabolic stress conditions

We study the mechanism of how liver preconditioning by a DHA and triiodothyronine combined protocol underlies peroxisome-proliferator activated receptor α (PPARα)-fibroblast growth factor 21 (FGF21) upregulation.

Properties of US Standard Endotoxin (EC-5) in human male volunteers

There has been a great interest in endotoxin testing using both Limulus amebocyte lysate (LAL) and the rabbit pyrogen test. It is often difficult to relate the results to the actual biological potency of endotoxin in man. There is a need to have the US Standard Endotoxin (Lot EC-5) tested in human volunteers so that rabbit and human data can be compared.

Human male volunteers were divided randomly into 5 groups of 12. Each group was given an intravenous injection of Lot EC-5 at a level of either 0, 2, 4, 8, or 16 endotoxin units (EU) per kg of body weight. The oral temperature was taken and recorded every 15 min for 8 h. The pyrogenic properties of the US Standard Endotoxin in humans over the test period were determined. The results indicated that there is a direct correlation between EU/kg administered and temperature rise. The threshold pyrogenic dose (≥ 1.0°F rise in 50% of volunteers) in this study is approximately 4.1 EU/kg.