The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

INTRODUCTION

Recovery from anesthesia is complex and affected by multiple factors. In patient with obesity, the increased prevalence of anxiety and depressive disorders poses a challenge in achieving optimal patient satisfaction. Therefore, strategies to enhance the quality of recovery are crucial for this population. This study aimed to investigate whether administration of dexamethasone to patients undergoing laparoscopic sleeve gastrectomy (LSG) could improve recovery outcomes.

METHODS

This prospective observational study was conducted at a tertiary university hospital in Samsun, Turkey. Thirty patients who received dexamethasone prior to LSG (group D) and 30 patients who did not (group C) were included with convenience sampling method. The quality of recovery was assessed using the Quality of Recovery 40 questionnaire (QoR-40). The primary outcome measure was the QoR-40 score at 24 h postoperatively.

RESULTS

The dexamethasone group showed a significant improvement in QoR-40 scores (185.4 ± 6.0 vs. 172.0 ± 8.4, p < 0.001), exhibited reduced morphine consumption (11.8 ± 7.8 vs. 21.8 ± 10.9 mg, p < 0.001), opioid demand count (21.50 [9.50-49.00], p = 0.001), the number of patient used antiemetic drug (1 vs. 22, p < 0.001), and achieved earlier mobilization (3 [3-4] vs. 3 [3-4] h, p < 0.0001). However, no significant differences were observed between the two groups concerning intraoperative complications, postoperative wound infections, or time to discharge.

CONCLUSIONS

In patients undergoing laparoscopic sleeve gastrectomy, preoperative dexamethasone administration was associated with improved the recovery quality after discharge and reduced early postoperative need for antiemetic medications.

Microbial consortia-mediated arsenic bioremediation in agricultural soils: Current status, challenges, and solutions

Arsenic poisoning in agricultural soil is caused by both natural and man-made processes, and it poses a major risk to crop production and human health. Soil quality, agricultural production, runoff, ingestion, leaching, and absorption by plants are all influenced by these processes. Microbial consortia have become a feasible bioremediation technique in response to the urgent need for appropriate remediation solutions. These diverse microbial populations collaborate to combat arsenic poisoning in soil by facilitating mechanisms including oxidation-reduction, methylation-demethylation, volatilization, immobilization, and arsenic mobilization. The current state, problems, and remedies for employing microbial consortia in arsenic bioremediation in agricultural soils are examined in this review. Among the elements affecting their success include diversity, activity, community organization, and environmental conditions. Also, we emphasize the sensitivity and accuracy limits of existing assessment techniques. While earlier reviews have addressed a variety of arsenic remediation options, this study stands out by concentrating on microbial consortia as a viable strategy for arsenic removal and presents performance evaluation and technical problems. This work gives vital insights for tackling the major issue of arsenic pollution in agricultural soils by explaining the potential methods and components involved in microbial consortium-mediated arsenic bioremediation.

Awake sternal fixation; comparison of technical details and early results with sternal fixation methods performed via general anesthesia

OBJECTIVES

Isolated sternal fractures are rare pathologies that rarely require surgical fixation. Although different fixation techniques are used, it is routinely performed under general anaesthesia. In our study, we aimed to share the details of the awake sternal fixation technique performed in our clinic and to compare the early results with sternal fixation methods performed under general anaesthesia.

METHODS

Between January 2009 and January 2023, 129 patients who were diagnosed with sternal fracture and who underwent investigations and follow-up in our clinic were evaluated retrospectively. Thirteen patients who underwent surgical fixation for isolated sternal fracture were included in the study. Patients were categorized according to fixation and anaesthetic technique; Group 1: fixation with steel wire under general anaesthesia (n = 4), Group 2: fixation with titanium plate-screw under general anaesthesia (n = 4), Group 3: fixation with awake titanium plate-screw with parasternal intercostal plane block (n = 5). Demographics, surgical indication, radiological findings, surgical incision, surgical time and hospital stay were statistically compared.

RESULTS

The mean age of the patients included in the study was 55.15 ± 15.01 years and 84.6% (n = 11) were male. The most common reason for fixation was displaced fracture (53.8%). Fixation surgery was performed due to pain in 30.8% (n = 4) and non-union in 15.4% (n = 2) of the fractures. The mean duration of surgery were 98.75 ± 16.52, 77.5 ± 35 and 41 ± 14.74 min respectively. Duration of surgery was significantly lower in Group 3 compared to the other groups (p = 0.012). The hospital stay duration for group 1 was 6 days, group 2 was 4 days, and group 3 was 1 day. A notable difference was observed among all groups (p = 0.019).

CONCLUSIONS

Awake sternal fixation technique with titanium plate screw system under superficial parasternal intercostal plane block is an easy and effective method for surgical treatment of isolated sternal fractures. This technique showed a direct positive effect on the duration of surgery and hospital stay.

Enhancing drought, heat shock, and combined stress tolerance in Myrobalan 29C rootstocks with foliar application of potassium nitrate

BACKGROUND

Drought and heat stress are significant concerns to food security in arid and semi-arid regions, where global warming is predicted to increase both frequency and severity. To cope with these challenges, the use of drought-tolerant plants or technological interventions are essential. In this study, the effects of foliar potassium nitrate (KNO3) application on the stress tolerance and recovery of Myrobalan 29C rootstocks (Prunus cerasifera Ehrh.) were evaluated. These rootstocks are widely recognized for their adaptability and are extensively used in fruit production. To assess their response, the rootstocks were subjected to drought, heat shock, or a combination of both stressors. Additionally, they were treated with 1.0% KNO3 via foliar application. Throughout the stress and recovery periods, various morphological, physiological, and bio-chemical parameters were measured.

RESULTS

Based on our results, KNO3 treatment improved LRWC, Chl stability, SC, and key stress markers like proline, MDA, H2O2, along with antioxidant enzymes CAT, SOD, POD during both stress and recovery phases. Moreover, our results emphasized KNO3's critical role in hormone regulation under stress. KNO3 application significantly altered hormone levels, notably increasing ABA during drought and heat shock stress, essential for stress response and adaptation. In contrast, IAA, GA, and cytokinin's significantly increased during the recovery phase in KNO3-treated plants, indicating improved growth regulation and stress recovery. In addition, KNO3 application improved the recovery process of the rootstocks by restoring their physiological and biochemical functions.

CONCLUSION

This study suggests that the application of foliar KNO3 is an effective technique for enhancing the drought and heat tolerance as well as the recovery of Myrobalan 29C rootstocks. These results hold significant value for farmers, policymakers, and researchers, as they offer crucial insights into the development of drought-tolerant crops and the management of climate change's adverse effects on agriculture.

Mitigating salt toxicity and overcoming phosphate deficiency alone and in combination in pepper (Capsicum annuum L.) plants through supplementation of hydrogen sulfide

While it is widely recognized that hydrogen sulfide (H2S) promotes plant stress tolerance, the precise processes through which H2S modulates this process remains unclear. The processes by which H2S promotes phosphorus deficiency (PD) and salinity stress (SS) tolerance, simulated individually or together, were examined in this study. The adverse impacts on plant biomass, total chlorophyll and chlorophyll fluorescence were more pronounced with joint occurrence of PD and SS than with individual application. Malondialdehyde (MDA), hydrogen peroxide (H2O2), and electrolyte leakage (EL) levels in plant leaves were higher in plants exposed to joint stresses than in plants grown under an individual stress. When plants were exposed to a single stress as opposed to both stressors, sodium hydrosulfide (NaHS) treatment more efficiently decreased EL, MDA, and H2O2 concentrations. Superoxide dismutase, peroxidase, glutathione reductase and ascorbate peroxidase activities were increased by SS alone or in conjunction with PD, whereas catalase activity decreased significantly. The favorable impact of NaHS on all the evaluated attributes was reversed by supplementation with 0.2 mM hypotaurine (HT), a H2S scavenger. Overall, the unfavorable effects caused to NaHS-supplied plants by a single stress were less severe compared with those caused by the combined administration of both stressors.

Enhancement of soybean tolerance to water stress through regulation of nitrogen and antioxidant defence mechanisms mediated by the synergistic role of salicylic acid and thiourea

Water stress (WS) poses a significant threat to global food and energy security by adversely affecting soybean growth and nitrogen metabolism. This study explores the synergistic effects of exogenous salicylic acid (SA, 0.5 mM) and thiourea (TU, 400 mg L-1), potent plant growth regulators, on soybean responses under WS conditions. The treatments involved foliar spraying for 3 days before inducing WS by reducing soil moisture to 50% of field capacity, followed by 2 weeks of cultivation under normal or WS conditions. WS significantly reduced plant biomass, chlorophyll content, photosynthetic efficiency, water status, protein content, and total nitrogen content in roots and leaves. Concurrently, it elevated levels of leaf malondialdehyde, H2O2, proline, nitrate, and ammonium. WS also triggered an increase in antioxidant enzyme activity and osmolyte accumulation in soybean plants. Application of SA and TU enhanced the activities of key enzymes crucial for nitrogen assimilation and amino acid synthesis. Moreover, SA and TU improved plant growth, water status, chlorophyll content, photosynthetic efficiency, protein content, and total nitrogen content, while reducing oxidative stress and leaf proline levels. Indeed, the simultaneous application of SA and TU demonstrated a heightened impact compared to their separate use, suggesting a synergistic interaction. This study underscores the potential of SA and TU to enhance WS tolerance in soybean plants by modulating nitrogen metabolism and mitigating oxidative damage. These findings hold significant promise for improving crop productivity and quality in the face of escalating water limitations due to climate change.

Melatonin improves drought stress tolerance of pepper (Capsicum annuum) plants via upregulating nitrogen metabolism

While ameliorating effects of melatonin (MT) on abiotic stress tolerance in plants are widely reported, the mechanism that underlies this process remains elusive. This work investigated mechanisms by which MT improved drought tolerance in pepper (Capsicum annuum ) plants. A foliar spray of 0.1mM MT treatment was applied to plants grown at 80% and 40% of full field capacity for 3days. Drought stress caused a significant decrease in plant dry weight, relative water content, leaf water potential, PSII efficiency (F v /F m ratio), chlorophyll, soluble protein, leaf and root nitrogen content. Drought increased hydrogen peroxide, malondialdehyde (MDA), nitrate, ammonium, free amino acids, soluble sugars, proline and glycine betaine. Drought also increased peroxidase (POD), glutathione S-transferase (GST) and catalase (CAT) activities, electrolyte leakage (EL) and methylglyoxal (MG). MT pre-treatment reduced oxidative stress and improved nitrogen metabolism by activating various enzymes such as nitrate reductase (NR), nitrite reductase (NiR), glutamine synthetase (GS), glutamate synthetase (GOGAT) and glutamine dehydrogenase (GDH) activities. It also activated enzymes related to the glyoxalase system (Gly I and Gly II) and decreased NO3 - , NH4 + and free amino acid content. Our study suggests a cost-effective and sustainable solution to improve crop productivity in water-limited conditions, by enhancing plant growth, photosynthesis and nitrogen content.

Analgesic benefits of pre-operative versus postoperative transversus abdominis plane block for laparoscopic cholecystectomy: a frequentist network meta-analysis of randomized controlled trials

BACKGROUND

Transversus abdominis plane (TAP) block has been utilized to alleviate pain following laparoscopic cholecystectomy (LC). However, the optimal timing of administration remains uncertain. This study aimed to compare the efficacy of pre-operative and postoperative TAP blocks as analgesic options after LC.

METHODS

A frequentist network meta-analysis of randomized controlled trials (RCTs) was conducted. We systematically searched PubMed (via the National Library of Medicine), EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science up to March 2023. The study included RCTs that enrolled adult patients (≥ 18 years) who underwent LC and received either pre-operative or postoperative TAP blocks. The primary outcome assessed was 24-hour postoperative morphine consumption (mg). Additionally, pain rest scores within 3 hours, 12 hours, and 24 hours, as well as postoperative nausea and vomiting (PONV), were considered as pre-specified secondary outcomes.

RESULTS

A total of 34 trials with 2317 patients were included in the analysis. Postoperative TAP block demonstrated superiority over the pre-operative TAP block in reducing opioid consumption (MD 2.02, 95% CI 0.87 to 3.18, I2 98.6%, p < 0.001). However, with regards to postoperative pain, neither pre-operative nor postoperative TAP blocks exhibited superiority over each other at any of the assessed time points. The postoperative TAP block consistently ranked as the best intervention using SUCRA analysis. Moreover, the postoperative TAP block led to the most significant reduction in PONV.

CONCLUSIONS

The findings suggest that the postoperative TAP block may be slightly more effective in reducing 24-hour postoperative opioid consumption and PONV when compared to the pre-operative TAP block.

TRIAL REGISTRATION

PROSPERO, CRD42023396880 .

Synergistic mitigation of nickel toxicity in pepper (Capsicum annuum) by nitric oxide and thiourea via regulation of nitrogen metabolism and subcellular nickel distribution

Nickel (Ni) contamination hinders plant growth and yield. Nitric oxide (NO) and thiourea (Thi) aid plant recovery from heavy metal damage, but their combined effects on pepper (Capsicum annuum ) plant tolerance to Ni stress need more study. Sodium nitroprusside (0.1mM, SNP) and 400mgL-1 Thi, alone and combined, were studied for their impact on pepper growth under Ni toxicity. Ni stress reduces chlorophyll, PSII efficiency and leaf water and sugar content. However, SNP and Thi alleviate these effects by increasing leaf water, proline and sugar content. It also increased the activities of superoxide dismutase, catalase, ascorbate peroxidase and peroxidase. Nickel stress lowered nitrogen assimilation enzymes (nitrate reductase, nitrite reductase, glutamine synthetase, glutamate synthase and glutamate dehydrogenase) and protein content, but increased nitrate, ammonium and amino acid content. SNP and Thi enhanced nitrogen assimilation, increased protein content and improved pepper plant growth and physiological functions during Ni stress. The combined treatment reduced Ni accumulation, increased Ni in leaf cell walls and potentially in root vacuoles, and decreased Ni concentration in cell organelles. It effectively mitigated Ni toxicity to vital organelles, surpassing the effects of SNP or Thi use alone. This study provides valuable insights for addressing heavy metal contamination in agricultural soils and offers potential strategies for sustainable and eco-friendly farming practices.

Epigenetic and Hormonal Modulation in Plant-Plant Growth-Promoting Microorganism Symbiosis for Drought-Resilient Agriculture

Plant growth-promoting microorganisms (PGPMs) have emerged as valuable allies for enhancing plant growth, health, and productivity across diverse environmental conditions. However, the complex molecular mechanisms governing plant-PGPM symbiosis under the climatic hazard of drought, which is critically challenging global food security, remain largely unknown. This comprehensive review explores the involved molecular interactions that underpin plant-PGPM partnerships during drought stress, thereby offering insights into hormonal regulation and epigenetic modulation. This review explores the challenges and prospects associated with optimizing and deploying PGPMs to promote sustainable agriculture in the face of drought stress. In summary, it offers strategic recommendations to propel research efforts and facilitate the practical implementation of PGPMs, thereby enhancing their efficacy in mitigating drought-detrimental effects in agricultural soils.

Two-Dimensional Synergistic Interfacial Orientation on Tin Oxide-Reinforced Cobalt Carbonate Hydroxide Heterostructures for High-Performance Energy Storage

A hierarchical cobalt carbonate hydroxide (CCH) nanostructure with outstanding electrochemical kinetics and structural stability for energy storage is largely unknown. Herein, we report tin oxide-functionalized CCH surface-enabled unique two-dimensional (2D) interlayered heterostructures that promote high conductivity with more electroactive sites to maximize redox reactions. A simple electrodeposition technique was utilized to construct the hierarchical 2D CCH electrode, while a surface-reinforced method was employed to fabricate the 2D interlayered SnO on CCH. The fabricated SnO@CCH-8 electrode showed a maximum areal capacity of 720 mC cm-2 (specific capacitance of 515 F g-1) at a current density of 1 mA cm-2 in 3 M KOH electrolyte. The obtained results indicate that the synergetic effect of SnO in the CCH network delivers an efficient charge transfer pathway to achieve high-performance energy storage. Moreover, SnO@CCH-8//AC was devised as a hybrid supercapacitor (HSC), ensuring a maximum specific capacitance of 129 F g-1 and maximum specific energy and power of 40.25 W h kg-1 and 9000 W kg-1, respectively, with better capacitance retention (94%) even beyond 10,000 cycles. To highlight the excellent performance in real-time studies, the HSC was constructed using a coin cell and displayed to power 21 light-emitting diodes (LEDs).

Comparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study

BACKGROUND

Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3.

METHODS

This prospective, randomized, double-blind study included 60 patients aged 18-70 years who were planned to undergo LSN. The patients were randomly assigned to receive either unilateral ultrasound-guided S-QLB3 or TPVB. The primary outcome was postoperative cumulative 24-h morphine consumption. In addition, numeric rating scale (NRS) scores at rest/activity and the American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) scores were also evaluated.

RESULTS

While postoperative cumulative 24-h morphine consumption was lower in the TPVB group compared to the other group (mean±SD, 12±3.4 mg vs. 15.4±7.8 mg, P=0.03), NRS pain scores at rest/activity were similar in both groups at all measurement points. Considering the postoperative APS-POQ-R-TR data, only the score related to the pain-daily activity relationship was high in the S-QLB3 group (median [Q1-Q3], 0 [0-1] vs. 2 [0-5], P=0.004), whereas there was no difference between the other scores.

CONCLUSIONS

In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.

Citric acid and hydrogen sulfide cooperate to mitigate chromium stress in tomato plants by modulating the ascorbate-glutathione cycle, chromium sequestration, and subcellular allocation of chromium

The study aimed to investigate the role of hydrogen sulfide (H2S) in regulating chromium stress (Cr-S) tolerance of tomato plants treated with citric acid (CA). Prior to the Cr treatment, tomato plants were foliar-fed with CA (100 μM) daily for 3 days. Subsequently, the plants were grown for another ten days in a hydroponic system in a 50 μM Cr (VI) solution. Chromium treatment reduced photosynthetic pigments and plant biomass, but boosted the levels of hydrogen peroxide (H2O2) malondialdehyde (MDA), H2S, phytochelatins (PCs), and glutathione (GSH), electrolyte leakage (EL), and antioxidant enzyme activity in tomato plants. However, the foliar spray of CA mitigated the levels of H2O2, MDA, and EL, promoted plant growth and chlorophyll content, enhanced antioxidant enzymes' activities, and increased H2S production in Cr-S-tomato plants. CA also increased the levels of GSH and PCs, potentially reducing the toxicity of Cr through regulated sequestration. Additionally, the application of sodium hydrogen sulfide (NaHS), a donor of H2S, improved CA-induced Cr stress tolerance. The addition of CA promoted Cr accumulation in root cell wall and leaf vacuoles to suppress its toxicity. To assess the involvement of H2S in CA-mediated Cr-S tolerance, 0.1 mM hypotaurine (HT), an H2S scavenger, was provided to the control and Cr-S-plants along with CA and CA + NaHS. HT reduced the beneficial effects of CA by decreasing H2S production in tomato plants. However, the NaHS addition with CA + HT inverted the adverse impacts of HT, indicating that H2S is required for CA-induced Cr-S tolerance in tomato plants.

Comparison of ultrasound-guided transversalis fascia plane block and anterior quadratus lumborum block in patients undergoing caesarean delivery: a randomized study

BACKGROUND

Cesarean section is becoming increasingly common. Well-managed postoperative analgesia improves patient comfort while encouraging early ambulation and breastfeeding. The analgesic efficacy of transversalis facial plane block (TFPB) vs. anterior quadratus lumborum block (QLB) was compared in this study.

METHODS

We analyzed the data of 49 pregnant women (gestation, ≥ 37weeks; age, 18-45years) scheduled for elective cesarean delivery (CD) under general anesthesia. They were randomly divided into TFPB and anterior QLB groups. All blocks were administered bilaterally with 25mL of 0.25% bupivacaine under ultrasound guidance prior to extubation. Postoperative morphine consumption and numerical rating scale (NRS) pain scores (static and dynamic [during coughing]) were recorded at 1, 3, 6, 9, 12, 18, and 24h.

RESULTS

There was no difference in postoperative morphine consumption between the groups at the third, sixth, and ninth hours, but the anterior QLB group consumed less morphine at the 12th, 18th, and 24th hours. Except for the first hour, resting and dynamic NRS scores were comparable between the groups. The first-hour resting and dynamic NRS scores were lower in the TFPB group (resting NRS, anterior QLB group, median [interquartile range], 2 [2-3] vs. TFPB group, 2 [0-2], p = 0.046; dynamic NRS, anterior QLB group, median [interquartile range], 3 [2-4] vs. TFPB group 2 [0-3], p = 0.001).

CONCLUSIONS

In patients undergoing CD, anterior QLB decreased morphine consumption in the late period (9-24h) compared to TFPB, while pain scores were similar between both groups. The reduction in morphine consumption was statistically significant, but not clinically significant.

Modified subcostal approach to anterior quadratus lumborum block for managing postoperative pain in patients undergoing open nephrectomy

BACKGROUND

Quadratus lumborum block is a relatively new truncal block and different approaches to this block have been described. With a recent modification to the subcostal approach to the anterior quadratus lumborum block (QLB3), the injection point was moved further cranially and medially, thereby aiming to enhance the spread of the local anesthetic into the thoracic paravertebral space. Although the level of blockade achieved with this modification seems sufficient for open nephrectomy, the modification is still for clinical evaluation. In this retrospective study, we aimed to evaluate the effects of the modified subcostal QLB3 approach on postoperative analgesia.

METHODS

All adult patients who received a modified subcostal QLB3 for postoperative analgesia following open nephrectomy between January 2021- 2022 were retrospectively evaluated. Accordingly, total opioid consumption and pain scores during rest/activity within the first 24 h after surgery were evaluated.

RESULTS

A total of 14 patients underwent open nephrectomy were analyzed. Pain scores within the first 6 h postoperatively, particularly the dynamic numeric rating scale (NRS) scores (4-6.5/10), were high. The median (interquartile range) resting and dynamic NRS scores for the first 24 h were 2.75 (1.79) and 3.91 (1.67), respectively. The mean ± standard deviation IV-morphine equivalent dose for the first 24 h was 30.9 ± 10.9 mg.

CONCLUSIONS

It was found that the modified subcostal QLB3 did not provide satisfactory analgesia in the early postoperative period. Further randomized studies that extensively investigate the postoperative analgesic efficacy are required to draw a stronger conclusion.

Alleviation of arsenic toxicity in pepper plants by aminolevulinic acid and heme through modulating its sequestration and distribution within cell organelles

Aminolevulinic acid (ALA) is essential for chlorophyll and heme synthesis. However, whether heme interacts with ALA to elicit antioxidants in arsenic (As)-exposed plants is still unknown. ALA was applied daily to pepper plants for 3 days prior to beginning As stress (As-S). Then, As-S was initiated for 14 days by employing sodium hydrogen arsenate heptahydrate (0.1 mM AsV). Arsenic treatment decreased photosynthetic pigments (chl a by 38% and chl b by 28%), biomass by 24%, and heme by 47% content, but it elevated contents of malondialdehyde (MDA) by 3.3-fold, hydrogen peroxide (H₂O₂) by 2.3-fold, glutathione (GSH), methylglyoxal (MG), and phytochelatins (PCs) and electrolyte leakage (EL) by 2.3-fold along with enhanced subcellular As concentration in the pepper plant's roots and leaves. The supplementation of ALA to the As-S-pepper seedlings enhanced the amount of chlorophyll, heme content, and antioxidant enzyme activity as well as plant growth, while it reduced the levels of H₂O₂, MDA, and EL. ALA boosted GSH and phytochelates (PCs) in the As-S-seedlings by controlling As sequestration and rendering it harmless. The addition of ALA enhanced the amount of As that accumulated in the root vacuoles and reduced the poisonousness of the soluble As in the vacuoles. The ALA treatment facilitated the deposition and fixation of As in the vacuoles and cell walls, thereby reducing the transport of As to other cell organelles. This mechanism may have contributed to the observed decrease in As accumulation in the leaves. The administration of 0.5 mM hemin (H) (a source of heme) significantly enhanced ALA-induced arsenic stress tolerance. Hemopexin (Hx, 0.4 μg L^-1), a heme scavenger, was treated with the As-S plants along with ALA and ALA + H to observe if heme was a factor in ALA's increased As-S tolerance. Heme synthesis/accumulation in the pepper plants was reduced by Hx, which counteracted the positive effects of ALA. Supplementation of H along with ALA + Hx reversed the negative effects of Hx, demonstrating that heme is required for ALA-induced seedling As-S tolerance.

Gibberellic acid mitigates nickel stress in soybean by cell wall fixation and regulating oxidative stress metabolism and glyoxalase system

It is broadly known that excessive concentration of nickel (Ni) causes venomous effects on plant health as well as food security. The underlying gibberellic acid (GA) mechanism to overcome Ni-induced stress is still unclear. Our outcomes represented the potential role of gibberellic acid (GA) to boost the soybean stress tolerance mechanism against Ni toxicity. GA elevated the seed germination, plant growth, biomass indices, and photosynthetic machinery as well as relative water contents under Ni-induced stress in soybean. We found that the GA lowered the Ni uptake, and distribution in the soybean plants, as well as GA, can decrease the Ni fixation in the root cell wall by lowering the hemicelluloses content. However, it reduces the MDA level, over-generation of ROS, electrolyte leakage, and methylglyoxal contents by up-surging the level of antioxidant enzyme, and glyoxalase I and glyoxalase II activities. Furthermore, GA regulates the antioxidant-related (CAT, SOD, APX, and GSH) and phytochelatins (PCs) genes expression to sequester the excessive Ni to the vacuoles and efflux the Ni outer the cell. Hence, less Ni was translocated toward shoots. Overall, GA augmented cell wall Ni elimination, and the antioxidant defense mechanism possibly upgraded the soybean tolerance against Ni stress.

Salicylic acid interacts with other plant growth regulators and signal molecules in response to stressful environments in plants

Salicylic acid (SA) is one of the potential plant growth regulators (PGRs) that regulate plant growth and development by triggering many physiological and metabolic processes. It is also known to be a crucial component of plant defense mechanisms against environmental stimuli. In stressed plants, it is documented that it can effectively modulate a myriad of metabolic processes including strengthening of oxidative defense system by directly or indirectly limiting the buildup of reactive nitrogen and oxygen radicals. Although it is well recognized that it performs a crucial role in plant tolerance to various stresses, it is not fully elucidated that whether low or high concentrations of this PGR is effective to achieve optimal growth of plants under stressful environments. It is also not fully understood that to what extent and in what manner it cross-talks with other potential growth regulators and signalling molecules within the plant body. Thus, this critical review discusses how far SA mediates crosstalk with other key PGRs and molecular components of signalling pathways mechanisms, particularly in plants exposed to environmental cues. Moreover, the function of SA exogenously applied in regulation of growth and development as well as reinforcement of oxidative defense system of plants under abiotic stresses is explicitly elucidated.

5-Aminolevulinic Acid Induces Chromium [Cr(VI)] Tolerance in Tomatoes by Alleviating Oxidative Damage and Protecting Photosystem II: A Mechanistic Approach

Chromium [Cr(VI)] pollution is a major environmental risk, reducing crop yields. 5-Aminolevunic acid (5-ALA) considerably improves plant abiotic stress tolerance by inducing hydrogen peroxide (H₂O₂) and nitric oxide (NO) signalling. Our investigation aimed to uncover the mechanism of tomato tolerance to Cr(VI) toxicity through the foliar application of 5-ALA for three days, fifteen days before Cr treatment. Chromium alone decreased plant biomass and photosynthetic pigments, but increased oxidative stress markers, i.e., H₂O₂ and lipid peroxidation (as MDA equivalent). Electrolyte leakage (EL), NO, nitrate reductase (NR), phytochelatins (PCs), glutathione (GSH), and enzymatic and non-enzymatic antioxidants were also increased. Foliar application of 5-ALA before Cr treatment improved plant growth and photosynthetic pigments, diminished H₂O₂, MDA content, and EL, and resulted in additional enhancements of enzymatic and non-enzymatic antioxidants, NR activity, and NO synthesis. In Cr-treated tomato seedlings, 5-ALA enhanced GSH and PCs, which modulated Cr sequestration to make it nontoxic. 5-ALA-induced Cr tolerance was further enhanced by sodium nitroprusside (SNP), a NO donor. When sodium tungstate (ST), a NR inhibitor, was supplied together with 5-ALA to Cr-treated plants, it eliminated the beneficial effects of 5-ALA by decreasing NR activity and NO synthesis, while the addition of SNP inverted the adverse effects of ST. We conclude that the mechanism by which 5-ALA induced Cr tolerance in tomato seedlings is mediated by NR-generated NO. Thus, NR and NO are twin players, reducing Cr toxicity in tomato plants via antioxidant signalling cascades.

Boron Carbide as an Electrode Material: Tailoring Particle Morphology to Control Capacitive Behaviour

In this study, boron carbide powders consisting mainly of nano/micro fibers or polyhedral-equiaxed particles were synthesized via the sol-gel technique, and the influence of particle morphology on electrochemical performance of boron carbide electrodes was investigated. Thermal decomposition duration of the precursors played a determinant role in the final morphology of the synthesized boron carbide powders. The morphology of boron carbide powders successfully tuned from polyhedral-equiaxed (with ~3 µm average particle size) to nano/micro fibers by adjusting the thermal decomposition duration of precursors. The length and thickness of fibers were in the range of 30 to 200 µm and sub-micron to 5 µm, respectively. The electrochemical performance analysis of boron carbide powders has shown that the particle morphology has a considerable impact on the boron carbide electrodes electrochemical performance. It was found that the synergetic effects of polyhedral-equiaxed and nano/micro fiber morphologies exhibited the best electrochemical performance in supercapacitor devices, resulting in the power and energy density of 34.9 W/kg and 0.016 Wh/kg, respectively.

Nitric oxide and hydrogen sulfide work together to improve tolerance to salinity stress in wheat plants by upraising the AsA-GSH cycle

The participation of nitric oxide (NO) in wheat plant tolerance to salinity stress (SS) brought about by hydrogen sulphide (H₂S) via modifying the ascorbate-glutathione (AsA-GSH) cycle was studied. The SS-plants received either 0.2 mM sodium hydrosulfide (NaHS; H₂S donor), or NaHS plus 0.1 mM sodium nitroprusside (SNP; a NO donor) through the nutrient solution. Salinity stress decreased plant growth, leaf water status, leaf K⁺, and glyoxalase II (gly II), while it elevated proline content, leaf Na⁺ content, oxidative stress, methylglyoxal (MG), glyoxalase I (gly I), the superoxide dismutase, catalase and peroxidase activities, contents of endogenous NO and H₂S. The NaHS supplementation elevated plant development, decreased leaf Na⁺ content and oxidative stress, and altered leaf water status, leaf K⁺ and involved enzymes in AsA-GSH, H₂S and NO levels. The SNP supplementation boosted the positive impact of NaHS on these traits in the SS-plants. Moreover, 0.1 mM cPTIO, scavenger of NO, countered the beneficial effect of NaHS by lowering NO levels. SNP and NaHS + cPTIO together restored the beneficial effects of NaHS by increasing NO content, implying that NO may have been a major factor in SS tolerance in wheat plants induced by H₂S via activating enzymes connected to the AsA-GSH cycle.

Appropriateness of aspirin use among diabetic patients in primary prevention of atherosclerotic cardiovascular diseases: an analysis of the ASSOS study

OBJECTIVE

Aspirin is an essential drug in the prevention of atherosclerotic cardiovascular disease (ASCVD). It is ultimately indicated in a patient with ASCVD. However, its role is debated in primary prevention. We aimed to investigate the appropriateness of aspirin use in diabetic patients according to recommendations of recent guidelines.

PATIENTS AND METHODS

ASSOS was a multicenter observational study investigating aspirin use in cardiology outpatient clinics. We evaluated aspirin use in diabetic patients in primary prevention from the ASSOS study. We also assessed the appropriate use of aspirin according to the European Society of Cardiology (ESC), American College of Cardiology/American Heart Association (ACC/AHA), American Diabetes Association (ADA), Consensus Statement of Endocrinology, Cardiology, and Nephrology (ENCARNE), and the United States Preventive Services Task Force (USPTF).

RESULTS

A total of 5,007 patients of whom 1,537 had type 2 diabetes mellitus (DM) were included in the study. 1,132 of the total participants used aspirin for primary prevention; 313 of them had type 2 DM. Only 248 (76.7%), 132 (40.8%), and 128 (39.6%) diabetic patients indicated aspirin use according to the ESC/INCARNE, ACC/AHA, and ADA/USPTF guidelines, respectively.

CONCLUSIONS

Inappropriate aspirin use was common among diabetic patients, according to clinical practice guideline recommendations. In addition, the differences between the indications for the use of aspirin in diabetic patients according to the guidelines were remarkable. Guidelines that minimize these differences are needed for clinicians, and compliance with these guidelines in clinical practice could reduce inappropriate aspirin use.

Evaluation of Knowledge and Attitudes of Anesthesiology Specialists and Residents Toward Patients Infected with the Monkeypox Disease: A National Survey Study

Background: Monkeypox is a zoonotic disease native to West and Central Africa that is now becoming a global public health concern. By August 19, 2022, approximately 40,220 cases of monkeypox in 94 countries were reported outside the endemic region. Anesthesiologists are at high risk of exposure to infection, given the potential for respiratory transmission of the virus. This study aims to raise awareness by evaluating the knowledge of anesthesiology specialists and residents regarding monkeypox and their attitudes toward the management of infected patients. Methods: This descriptive study collected data through an online questionnaire (SurveyMonkey, San Mateo, CA) between August 11, 2022, and September 4, 2022. Members of the Turkish Society of Anesthesiology and Reanimation were contacted via e-mail and other social media applications (WhatsApp, Twitter, and LinkedIn); those who agreed to participate in the study were asked to answer the survey questions. Results: A total of 282 anesthesiology specialists and residents participated in the study. The accuracy rates of answers to the knowledge-related questions suggested that a sufficient level of knowledge about this disease has not yet been reached. However, the rate of agreement with the literature recommendations regarding peri-operative safety measures that should be taken was high. Conclusions: The increasing number of cases worldwide necessitates all branches of medicine including anesthesiology to be vigilant and take adequate precautions. Regional and international systematic strategies should be developed to increase the knowledge of anesthetists to provide high-quality healthcare and reduce the risk of transmission.

Comparison of Ketamine, Dexmedetomidine and Lidocaine in Multimodal Analgesia Management Following Sleeve Gastrectomy Surgery: A Randomized Double-Blind Trial

PURPOSE

The aim of this study was to compare the effects of ketamine, dexmedetomidine, and lidocaine infusions added to the multimodal analgesia regimen on pain scores and analgesic requirement in laparoscopic sleeve gastrectomy.

DESIGN

A prospective randomized double-blind trial. Seventy-three patients aged 18 to 65 years (ASA II-III) undergoing laparoscopic sleeve gastrectomy were included. The patients were divided into 3 groups. Intravenous (IV) ketamine (0.5 mg/kg/h), dexmedetomidine (0.5 mcg/kg/h), and lidocaine (2 mg/kg/h) were administered to Groups K, D and L, respectively. Postoperative infusions were continued for 12 hours.

METHODS

Visual Analog Scale (VAS) scores (during rest and movement) in the admission to postanesthesia care unit, 1, 3, 6, 12, 24, 48 hours, and on day 15 were assessed postoperatively. Rescue analgesia requirement, the number of patients with nausea, retching, and vomiting, time to mobilization, and hospital length of stay (LOS) were recorded.

FINDINGS

VAS_rest values during all measurements in the first 24 hours, and VAS_movement values in the first 6 hours and at 24 hours were lower in Group L when compared to Group K and Group D (P < .001, P < .001, P = .008, respectively). VAS_rest at 48 hours and VAS_movement at 12 and 48 hours were lower in Group L when compared to Group K (P = .044, P = .001 and P = .011, respectively). There was no statistically significant difference between Group D compared to the other two groups at these times (P > .05). The requirement of rescue analgesia on postoperative day 1 was significantly higher in Group K (P < .001). Hospital LOS was shorter in Group L than in the other groups (P = .002).

CONCLUSIONS

IV lidocaine added to multimodal analgesia provided better pain control in the early postoperative period compared to dexmedetomidine and ketamine and decreased the hospital LOS.

The involvement of hydrogen sulphide in melatonin-induced tolerance to arsenic toxicity in pepper (Capsicum annuum L.) plants by regulating sequestration and subcellular distribution of arsenic, and antioxidant defense system

Melatonin (MT) and hydrogen sulphide (H₂S) are recognised as vital biomolecules actively taking part in plant defence systems as free radical scavengers and antioxidants against a myriad of biotic and abiotic stressors. However, it has been yet unknown in plants subjected to arsenic (As) toxicity whether or not H₂S interacts with MT to regulate endogenous antioxidant defence system. Prior to beginning As stress (As-S) treatments, MT (0.10 mM) was applied externally to plants daily for three days. AsS was then started for two weeks with As(V) (0.1 mM as Na₂HAsO₄·7H₂O). The treatment of As reduced plant biomass (24.4%) and chlorophyll a (51.7%), chlorophyll b (25.9%), while it increased subcellular As in roots and leaves, levels of glutathione (GSH), hydrogen peroxide (H₂O₂), malondialdehyde (MDA), methylglyoxal (MG), H₂S and phytochelatins (PCs) in pepper plants. In As-stressed pepper plants, the application of MT increased plant biomass (16.3%), chlorophyll a (52.7%), chlorophyll b (28.2%), antioxidant enzymes' activities, and H₂S accumulation, while it lowered the concentrations of MDA and H₂O₂. In As-treated plants, GSH and phytochelatins (PCs) were increased by MT by regulating As sequestration to make it harmless. The addition of MT increased As accumulation in the vacuoles of roots and caused the soluble fraction of As in vacuoles to become less toxic to vital organelles. MT-induced tolerance to As stress was further enhanced using NaHS, a source of H₂S. Hypotaurine (0.1 mM HT), a H₂S scavenger, was applied to the control and As-stressed plants together with MT and MT + NaHS to determine whether H₂S was implicated in MT-induced increased As-S tolerance. By reducing H₂S generation in pepper plants, HT counteracted the beneficial effects of MT, whereas the addition of NaHS to MT + HT restored the negative effects of HT, proving that H₂S is necessary for the pepper plants As-stress tolerance caused by MT.

The participation of nitric oxide in hydrogen sulphide-mediated chromium tolerance in pepper (Capsicum annuum L) plants by modulating subcellular distribution of chromium and the ascorbate-glutathione cycle

The promising response of chromium-stressed (Cr(VI)-S) plants to hydrogen sulphide (H₂S) has been observed, but the participation of nitric oxide (NO) synthesis in H₂S-induced Cr(VI)-S tolerance in plants remains to be elucidated. It was aimed to assess the participation of NO in H₂S-mediated Cr(VI)-S tolerance by modulating subcellular distribution of Cr and the ascorbate-glutathione (AsA-GSH) cycle in the pepper seedlings. Two weeks following germination, plants were exposed to control (no Cr) or Cr(VI)-S (50 μM K₂Cr₂O₇) for further two weeks. The Cr(VI)-S-plants grown in nutrient solution were supplied with 200 μM sodium hydrosulphide (NaHS, donor of H₂S), or NaHS plus 100 μM sodium nitroprusside (SNP, a donor of NO). Chromium stress suppressed plant growth and leaf water status, while elevated proline content, oxidative stress, and the activities of AsA-GSH related enzymes, as well as endogenous H₂S and NO contents. The supplementation of NaHS increased Cr accumulation at root cell walls and vacuoles of leaves as soluble fraction to reduce its toxicity. Furthermore it limited oxidative stress, improved plant growth, modulated leaf water status, and the AsA-GSH cycle-associated enzymes' activities, as well as it further improved H₂S and NO contents. The positive effect of NaHS was found to be augmented on those parameters in the CrS-plants by the SNP supplementation. However, 0.1 mM cPTIO, the scavenger of NO, inverted the prominent effect of NaHS by decreasing NO content. The supplementation of SNP along with NaHS + cPTIO reinstalled the positive effect of NaHS by restoring NO content, which suggested that NO might have a potential role in H₂S-induced tolerance to Cr(VI)-S in pepper plants by stepping up the AsA-GSH cycle.

Combined application of asparagine and thiourea improves tolerance to lead stress in wheat by modulating AsA-GSH cycle, lead detoxification and nitrogen metabolism

Lead (Pb), like other heavy metals, is not essentially required for optimal plant growth; however, plants uptake it from the soil, which poses an adverse effect on growth and yield. Asparagine (Asp) and thiourea (Thi) are known to assuage the negative impacts of heavy metal pollution on plant growth; however, combined application of Asp and Thi has rarely been tested to discern if it could improve wheat yield under Pb stress. Thus, this experimentation tested the role of individual and combined applications of Asp (40 mM) and Thi (400 mg/L) in improving wheat growth under lead (Pb as PbCl₂, 0.1 mM) stress. Lead stress significantly reduced plant growth, chlorophyll contents and photosystem system II (PSII) efficiency, whereas it increased Pb accumulation in the leaves and roots, leaf proline contents, phytochelatins, and oxidative stress related attributes. The sole or combined application of Asp and Thi increased the vital antioxidant biomolecules/enzymes, including reduced glutathione (GSH), ascorbic acid (AsA), ascorbate peroxsidase (APX), catalase (CAT), superoxide dismutase (SOD), glutathione S-transferase (GST), dehydroascorbate reductase (DHAR), and glutathione reductase (GR). Furthermore, the sole or the combined application of Asp and Thi modulated nitrogen metabolism by stimulating the activities of nitrate and nitrite reductase, glutamate synthase (GOGAT) and glutamine synthetase (GS). Asp and Thi together led to improve plant growth and vital physiological processes, but lowered down Pb accumulation compared to those by their sole application. The results suggest that Asp and Thi synergistically can improve wheat growth under Pb-toxicity.

Analgesic efficacy of the bilateral erector spinae plane block for colorectal surgery: a randomized controlled trial

BACKGROUND

Colorectal cancer is quite common, and surgery is the most effective treatment for most patients. However, postoperative pain management is generally inadequate in most patients. This study aimed to determine the effect of ultrasonography (USG)-guided preemptive erector spina plan block (ESPB), as part of multimodal analgesia, on postoperative analgesia in patients undergoing colorectal cancer surgery.  METHODS: This is a prospective, randomized, single-blind trial. This study included 60 patients (ASA I-II) who underwent colorectal surgery at the hospital of Ondokuz Mayis University. The patients were divided into the ESP group and control group. Intraoperatively, all patients were administered intravenous tenoxicam (20 mg) and paracetamol (1 g) as part of multimodal analgesia. Intravenous morphine via patient-controlled analgesia was administered in all groups postoperatively. The primary outcome was the total morphine consumption in the first 24 h after surgery. The secondary outcomes included visual analog scale pain scores at rest and coughing and deep inspiration in the first 24 h and at 3 months postoperatively; number of patients requesting rescue analgesia; incidence of nausea and vomiting and need for antiemetics; intraoperative remifentanil consumption; postoperative first oral intake; time to first urination, first defecation, and first mobilization; hospitalization time; and incidence of pruritus.

RESULTS

Morphine consumption in the first 6 h postoperatively, total amount of morphine consumed in the first 24 h postoperatively, pain scores, intraoperative remifentanil consumption, incidence of pruritus, and postoperative antiemetic requirement were lower in the ESP group than in the control group. First defecation time and hospitalization time were shorter in the block group.

CONCLUSIONS

As a part of multimodal analgesia, ESPB reduced postoperative opioid consumption and pain scores in the early postoperative period and in the 3rd month.

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study

Background

We aimed to compare the effectiveness of bilateral erector spinae plane (ESP) block and superficial parasternal intercostal plane (S-PIP) + ESP block in acute post-sternotomy pain following cardiac surgery.

Methods

Forty-seven patients aged between 18 and 80 years of age with American Society of Anesthesiologists class II–III due to undergo median sternotomy for cardiac surgery were included in this prospective, randomized, double-blinded study. Following randomization into two groups, one group received bilateral ultrasound-guided ESP and the other S-PIP plus ESP block. Morphine consumption within the first 24 h after surgery was the primary outcome of the study while NRS scores at rest, NRS scores when coughing, time taken until extubation, use of rescue analgesic, presence of nausea/vomiting, length of hospital and intensive care unit (ICU) stay, and patient satisfaction were secondary outcome measures.

Results

Morphine use up to 24 h following surgery was statistically significantly different between the ESP block and ESP + S-PIP block groups (18.63 ± 6.60 [15.84–21.41] mg/24 h vs 14.41 ± 5.38 [12.08–16.74] mg/24 h, p = 0.021). The ESP + S-PIP block group had considerably reduced pain scores compared to the ESP block group across all time points. Rescue analgesics were required in 21 (87.5%) patients in the ESP block group and seven (30.4%) in the ESP + S-PIP group (p < 0.001). PONV, length of stay in the ICU and hospital, and time to extubation were similar between groups.

Conclusions

In open cardiac surgery, the combination of ESP and S-PIP blocks lowers pain scores and postoperative morphine requirement of patients.

Trial registration

Clinicaltrials Registration No: NCT05191953, Registration Date: 14/01/2022.

Awake Sternal Fixation Using the Ultrasound-Guided Superficial Parasternal Intercostal Plane Block in a Patient With Cervical Spine Fracture

We present the use of a bi-level, bilateral ultrasound-guided (US-guided) superficial parasternal intercostal plane block (S-PIP) for main anesthetic method in a 71-year-old patient with a C2 vertebral fracture undergoing repair of a sternal fracture. Conscious sedation was provided using midazolam and a remifentanil infusion. The patient had an uneventful recovery and was discharged from the hospital on the first postoperative day without complications. An US-guided S-PIP should be considered when patients are deemed at high risk for general anesthesia, especially in trauma patients with a cervical spine fracture.

Genotype-by-Diet Interactions for Larval Performance and Body Composition Traits in the Black Soldier Fly, Hermetia illucens

Simple Summary

The bioconversion of organic waste into valuable insect protein as an alternative animal feed ingredient has the potential to improve agricultural sustainability and may become a key element of future circular economy. However, while insects farmed for feed production are considered livestock from a regulatory perspective, systematic linking of genetic resource characterisations and fundamental phenotyping, crucial for precision breeding and feeding schemes, remains scarce even for prime insect candidates, such as the black soldier fly (BSF). The present study initiated to fill this knowledge gap by experimentally assessing BSF genotype-by-diet interactions for a number of economically and ecologically relevant larval phenotypic traits. Besides pervasive diet effects, strong impact of BSF genetic background and ubiquitous environment-mediated interactions were found. This implies some of the so-far unexplained response variation across global BSF studies could be driven by previously neglected mechanisms of genetic specificity, and thus that the concept of broad conspecific plasticity in this insect is likely too simplistic. Instead, it is emphasised that matching BSF genetics to dietary contexts is vital for purposive production optimisation, particularly when extrapolated to large-scale operations. These insights highlight that establishing tailored BSF breeding as an independent branch offers veritable opportunities to efficiently support this growing agricultural sector.

Abstract

Further advancing black soldier fly (BSF) farming for waste valorisation and more sustainable global protein supplies critically depends on targeted exploitation of genotype-phenotype associations in this insect, comparable to conventional livestock. This study used a fully crossed factorial design of rearing larvae of four genetically distinct BSF strains (F_ST: 0.11–0.35) on three nutritionally different diets (poultry feed, food waste, poultry manure) to investigate genotype-by-environment interactions. Phenotypic responses included larval growth dynamics over time, weight at harvest, mortality, biomass production with respective contents of ash, fat, and protein, including amino acid profiles, as well as bioconversion and nitrogen efficiency, reduction of dry matter and relevant fibre fractions, and dry matter loss (emissions). Virtually all larval performance and body composition traits were substantially influenced by diet but also characterised by ample BSF genetic variation and, most importantly, by pronounced interaction effects between the two. Across evaluated phenotypes, variable diet-dependent rankings and the lack of generally superior BSF strains indicate the involvement of trade-offs between traits, as their relationships may even change signs. Conflicting resource allocation in light of overall BSF fitness suggests anticipated breeding programs will require complex and differential selection strategies to account for pinpointed trait maximisation versus multi-purpose resilience.

The combined supplementation of melatonin and salicylic acid effectively detoxifies arsenic toxicity by modulating phytochelatins and nitrogen metabolism in pepper plants

The main objective of the study was to assess if joint application of melatonin (MT, 0.1 mM) and salicylic acid (SA 0.5 mM) could improve tolerance of pepper plants to arsenic (As) as sodium hydrogen arsenate heptahydrate (0.05 mM). The imposition of arsenic stress led to accumulation of As in roots and leaves, and increased contents of leaf proline, phytochelatins, malondialdehyde (MDA) and H₂O₂, but it reduced plant biomass, chlorophylls (Chl), PSII maximum efficiency (Fv/Fm) and leaf water potential. Melatonin and SA applied jointly or alone enhanced nitrogen metabolism by triggering the activities of glutamate synthase, glutamine synthetase, and nitrite reductases and nitrate. In comparison with a single treatment of MT or SA, the joint treatment of MT and SA had better impact on enhancing growth and key biological events and decreasing tissue As content. This clearly shows a cooperative function of both agents in enhancing tolerance to As-toxicity in pepper plants.

Cerebral Oximetry after Low Pressure <em>versus</em> Standard Pressure Pneumoperitoneum in Laparoscopic Nephrectomy

OBJECTIVE

To evaluate whether pneumoperitoneum pressure lower than the standard pressure would allow higher cerebral oxygen saturation (rSO2) during laparoscopic nephrectomy (LN).

STUDY DESIGN

Randomised controlled trial.

PLACE AND DURATION OF STUDY

Ondokuz Mayis University Hospital, Samsun, Turkey, from January to November 2020.

METHODOLOGY

Sixty-two patients (aged 18-65 years; ASA I-III) scheduled for LN were equally divided into a low-pressure (LP; 8 mmHg) and standard-pressure (SP; 14 mmHg) group. Mechanical ventilator settings were adjusted to maintain 32-37 mmHg ETCO2 and >96% SpO2 throughout the surgery. The rSO2 was evaluated by near-infrared spectroscopy before and one minute after induction and then every five minutes until patient transfer to the recovery unit. Oxygen and carbon dioxide partial pressures, pH, and haemoglobin, recorded at five minutes after induction, five and 30 minutes after insufflation, and 10 minutes after desufflation, were examined for correlations with rSO2.

RESULTS

Both groups had similar rSo2, arterial blood gas, and haemoglobin values at all measurement times. The LP group showed no differences between the preoperative values and the values obtained at the different time points. In contrast, the SP group showed significant differences between the preoperative and the measured values (except at 25, 30, and 35 minutes) (p = 0.001). Four patients (12.9%) in both groups showed cerebral desaturation. The rSO2 values were moderately correlated with the CO2 and haemoglobin values.

CONCLUSION

Low insufflation pressure offered no advantages over standard pressure in terms of haemodynamics, arterial blood gases, cerebral oxygen saturation during LN, and CO2 insufflation did not change rSO2 levels. Key Words: Pneumoperitoneum, Spectroscopy, Oximetry, Nephrectomy, Surgery, Laparoscopic nephrectomy.

Sodium hydrosulfite together with silicon detoxifies arsenic toxicity in tomato plants by modulating the AsA-GSH cycle

The main intent of the current research was to appraise if combined application of hydrogen sulfide (H₂S, 0.2 mM) and silicon (Si 2.0 mM) could improve tolerance of tomato plants to arsenic (As as sodium hydrogen arsenate heptahydrate, 0.2 mM) stress. Plant growth, chlorophylls (Chl), PSII maximum efficiency (Fv/Fm), H₂S concentration and L-cysteine desulfhydrase activity were found to be suppressed, but leaf and root As, leaf proline content, phytochelatins, malondialdehyde (MDA) and H₂O₂ as well as the activity of lipoxygenase (LOX) increased under As stress. H₂S and Si supplied together or alone enhanced the concentrations of key antioxidant biomolecules such as ascorbic acid, and reduced glutathione and the activities of key antioxidant system enzymes including catalase (CAT), superoxide dismutase (SOD), dehydroascorbate reductase (DHAR), glutathione reductase (GR), and glutathione S-transferase (GST). In comparison with individual application of H₂S or Si, the joint supplementation of both had better effect in improving growth and key biochemical processes, and reducing tissue As content, suggesting a putative collaborative role of both molecules in improving tolerance to As-toxicity in tomato plants.

IS REPEAT FNAB NECESSARY FOR THYROID NODULES WITH ND / UNS CYTOLOGY?

CONTEXT/OBJECTIVE

The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with non-diagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinical-radiological-pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB.

METHODS

Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared.

RESULTS

The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p <0.020, p <0.002). When looking at the distribution of rFNAB results, a significant correlation was observed with female gender, solid component, hypoechogenicity, border irregularity and halo loss around the nodule in patients with BC-4,5,6 cytology results (respectively, 0.005 / 0.031 / 0.001 / 0.012 / 0.004).

CONCLUSION

rFNAB did not show the expected effect in ND / UNS nodules. We recommend direct surgical excision without rFNAB for nodules with border irregularity, solid structure, halo loss and hypoechogenicity, which should be considered more important in female patients.

What are the factors affecting glanular dehiscence after hypospadias surgery?

BACKGROUND

Glanular dehiscence (GD) is one of the main complications after hypospadias surgery. There is a limited number of publications regarding GD in the literature.

OBJECTIVE

The aim of this work is to reveal the factors that affect GD after a literature review.

EVIDENCE ACQUISITION

A literature search for relevant articles was performed in database using the search term glans dehiscence without setting date range limit or any other limits. All articles related to GD after hypospadias surgery were included in this study. After collecting the information from full text articles, 71 articles were included in this systematic review. In these studies, localization of hypospadic meatus, type of surgery, and other clinical data which were thought to behave as risk factors for GD were obtained. Chi-Square test was used to evaluate the differences between the parameters, where p < 0.05 was taken as statistically significant.

RESULTS

After evaluating the 71 articles that met the inclusion criteria, 309 cases (3.48%) of GD after 8858 hypospadias repairs were obtained in this review. GD rates were found significantly high for proximal hypospadias (5%), two-stage hypospadia repairs (5%) and re-do hypospadias repair (8.75%) (p = 0.002, 0.022, and 0.004, respectively). Glans width <14 mm, urethral plate (UP) width <7 mm, hypospadias surgeries performed before 6 months of age and after puberty, and caudal block anesthesia increased the rate of GD.

CONCLUSIONS

The rate of GD increases after proximal, cripple and staged hypospadias surgeries, a glans width <15 mm and UP width <8 mm, postpubertal surgeries, and caudal anesthesia use during surgery.

Superior vena cava perforation complicating ultrasound-guided subclavian venous catheterization: A case report

We present a case of a severe mechanical complication (superior vena cava [SVC] perforation) that developed after subclavian vein catheterization using an ultrasound-guided static approach in a patient who underwent right lower lobectomy with video-assisted thoracic surgery. The use of ultrasound during catheterization is reported to reduce mechanical complications. Despite the use of ultrasound in our patient, surgical exploration showed that the catheter placed in the right subclavian vein penetrated the superior portion of the SVC. At the end of the surgery, the catheter was removed under direct visualization. The surgeon attempted to stop bleeding in the SVC by compressing with gauze. However, bleeding could only be stopped by administering a hemostatic matrix. It is concluded that to reduce the incidence or size of iatrogenic perforation of the SVC, catheters with the smallest possible diameter should be used, and the dilator should only be inserted deep enough to enter the vein. If the static approach is used, the modifiedSeldinger technique is useful and to provide training to improve the ultrasound experience, especially if the dynamic approach is used.

Comparison of the analgesic effects of two quadratus lumborum blocks (QLBs), QLB type II vs QLB type III, in caesarean delivery: A randomised study

BACKGROUND

Quadratus lumborum blocks (QLBs) are relatively novel regional anaesthesia techniques, and the efficacy of all three types of QLB for postoperative analgesia in caesarean delivery (CD) has been demonstrated in separate studies. The aim of the present study is to compare the analgesic efficacy of the QLB-II and QLB-III blocks performed at the end of surgery in patients undergoing spinal anaesthesia for CD.

METHODS

We conducted a comparative, blinded, prospective, randomised and efficiency study. A total of 80 patients scheduled for elective CD under spinal anaesthesia were randomly allocated to receive either bilateral ultrasound-guided QLB-II or QLB-III block in a 1:1 ratio. The primary outcome was opioid consumption administered by a patient-controlled analgesia in the first 24 hours postoperatively. The secondary outcome of the study was pain intensity. Also, the time of first opioid requirement and the presence of nausea and vomiting were recorded.

RESULTS

Morphine consumption was statistically significantly lower in the QLB-III group when compared with the QLB-II group at the 3rd, 6th, 12th and 24th hours (P < .001, P < .001, P = .004, and P = .015, respectively). The QLB-III group showed significantly lower pain scores at rest at the 1st, 3rd, 6th, 9th and 24th hours after surgery (P < .001, P < .001, P < .001, P = .007 and P < .001, respectively). The QLB-III group also showed significantly lower pain score on movement at all measurement times (P < .001).

CONCLUSIONS

The analgesic efficacy of QLB-III was superior to QLB-II in patients who had undergone CD under spinal anaesthesia without use of intrathecal opioids and nonsteroidal anti-inflammatory drugs.

Comparison of Ultrasound-Guided Pectointercostal Fascial Block and Transversus Thoracic Muscle Plane Block for Acute Poststernotomy Pain Management After Cardiac Surgery: A Prospective, Randomized, Double-Blind Pilot Study

OBJECTIVE

The objective of the present study was to evaluate morphine consumption and pain scores 24 hours postoperatively to compare the effects of a bilateral pectointercostal fascial block (PIFB) with those of a transversus thoracic muscle plane block (TTMPB) on acute poststernotomy pain in cardiac surgery patients who have undergone median sternotomy.

DESIGN

Prospective, randomized, double-blinded.

SETTING

The operating room, intensive care unit, and patient ward at a university hospital.

PARTICIPANTS

Thirty-nine American Society of Anesthesiologists II-to-III patients aged 18- to-80 years, scheduled for elective cardiac surgery via median sternotomy.

INTERVENTIONS

Patients randomly were allocated to groups scheduled to receive bilateral ultrasound-guided PIFB or TTMPB.

MEASUREMENTS AND MAIN RESULTS

The primary outcome was postoperative morphine use within the first 24 hours. Secondary outcomes were the numerical pain rating scale (NRS) scores at rest and during coughing, time of first analgesic demand from the patient-controlled analgesia (PCA) device, and rescue analgesia use. The nausea/vomiting scores, time to extubation, length of stays in intensive care and the hospital, patient satisfaction scores, and complications were also recorded. The first 24-hour morphine use did not significantly differ between the PIFB and TTMPB groups (mean ± standard deviation [95% CI], 13.89 ± 6.80 [10.83-16.95] mg/24 h and 15.08 ± 7.42 [11.83-18.33] mg/24 h, respectively, p = 0.608). No significant difference between the two groups in the NRS scores at rest and during coughing was observed; the groups had similar requirements for rescue analgesia in the first 24 hours (n [%], three [15.8] and seven [35], p = 0.273, respectively). The time from PCA to the first analgesia request was longer in the PIFB than in the TTMPB group (median [interquartile range], 660 [540-900] minutes, and 240 [161-525] minutes, respectively, p = 0.002).

CONCLUSIONS

PIFB and TTMPB showed similar effectiveness for morphine consumption within 24 hours postoperatively and in pain scores in cardiac surgery patients.

Endogenous nitric oxide and its potential sources regulate glutathione-induced cadmium stress tolerance in maize plants

It was aimed to assess that up to what extent endogenous nitric oxide (NO) and its sources are involved in glutathione (GSH)-mediated tolerance of maize plants to cadmium (Cd) stress. The Cd-stressed maize plants were sprayed with or without GSH (1.0 mM) once every week for two weeks. Before initiating the stress treatment, the Cd-stressed plants sprayed with GSH were supplied with or without 0.1 mM, 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (cPTIO; a NO scavenger) for two weeks or with 0.1 mM sodium tungstate (ST; a nitrate reductase inhibitor), or 0.1 mM NG-nitro-L-arginine methyl ester hydrochloride (L-NAME). Cadmium stress suppressed the activities of dehydroascorbate reductase, monodehydroascorbate reductase, and glyoxalase II, while increased leaf NO, Cadmium content, proline, oxidative stress, the activities of glutathione reductase, ascorbate peroxidase, the key enzymes of oxidative defense system, glyoxalase I, NR and NOS. GSH reduced oxidative stress and tissue Cd²⁺ content, but it improved growth, altered water relations, and additionally increased proline levels, activities of the AsA-GSH cycle, key enzymatic antioxidants, glyoxalase I and II, NR and NOS as well as NO content. The cPTIO and ST supplementation abolished the beneficial effects of GSH by reducing the activities of NO and NR. However, L-NAME did not retreat the favorable effects of GSH, although it reduced the NOS activity without eliminating NO content, suggesting that NR might be a prospective source of NO generated by GSH in Cd-stressed plants, which in turn accelerated the activities of antioxidant enzymes.

Salicylic acid-induced hydrogen sulphide improves lead stress tolerance in pepper plants by upraising the ascorbate-glutathione cycle

The contribution of hydrogen sulphide (H₂ S) to salicylic acid (SA) induced lead (Pb) stress tolerance modulated by the ascorbate-glutathione (AsA-GSH) cycle was examined in pepper (Capsicum annuum L.) plants. One week after germination, pepper seedlings were sprayed with 0.5 mM SA once a day for a week. Thereafter, seedlings were grown under control (no Pb) or Pb stress (Pb-S treatment consisting of 0.1 mM PbCl₂ ) for a further 2 weeks. Lead stress reduced plant growth and leaf water status as well as the activities of dehydroascorbate reductase and monodehydroascorbate reductase. However, lead stress elevated leaf Pb, the proline contents, oxidative stress, activities of glutathione reductase and ascorbate peroxidase, as well as the endogenous H₂ S content. Supplements of SA resulted in improvements in growth parameters, biomass, leaf water status and AsA-GSH cycle-related enzyme activities, as well as increasing the H₂ S content. The positive effect of SA was further enhanced when sodium hydrosulphide was added. However, 0.1 mM hypotaurine (HT) treatment reversed the beneficial effect of SA by reducing the plant H₂ S content. Application of NaHS in combination with SA + HT suppressed the adverse effect of HT mainly by restoring the plant H₂ S content, suggesting that higher H₂ S content, induced by exogenous SA supply, resulted in elevated regulation of the AsA-GSH cycle.

The effects of dexketoprofen on renal ischemia-reperfusion injury: an experimental study

Objective

Ischemia/reperfusion (I/R) may cause irreversible damage to tissues and organs. We evaluated the effects of dexketoprofen on a renal I/R model in rats.

Methods

The study included 30 male rats. Control group received 1 mL of saline. Dexketoprofen group received 1 mL (25 mg) of dexketoprofen intraperitoneally. After 60 minutes renal ischemia, 23 hours reperfusion was applied. In Sham group, laparotomy was performed with a medial line incision without any additional procedure. Changes in the plasma malondialdehyde (MDA), renal tissue MDA, plasma glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), BUN, creatinine and albumin levels, and histopathological changes were evaluated.

Results

CAT values were significantly lower in Control as compared with the Sham group. Plasma levels of MDA in the Control group were significantly higher than in the Dexketoprofen group. BUN and creatinine values were significantly higher in the Dexketoprofen group. The severity of tissue injury in the Dexketoprofen group was significantly higher than in Control and Sham groups

Conclusion

Although dexketoprofen reduces the I/R-induced systemic inflammation, it increases renal tissue damage.

P–336 The role of endoplasmic reticulum stress in endometriosis; preliminary results

Study question

Can X-box binding protein 1 (XBP–1) be used in evaluation of endoplasmic reticulum (ER) stress in endometriosis patients?

Summary answer

High levels of XBP–1 among endometriosis patients indicate an association between ER stress and endometriosis.

What is known already

ER is responsible for protein folding, lipid synthesis, and calcium homeostasis. ER stress occurs due to the accumulation of unfolded or misfolded proteins in the ER. ER stress causes the activation of several signal transduction cascades, defined as the unfolded protein response (UPR). In the studies conducted with ectopic endometrial tissue and cells, it was reported that UPR plays a role in the pathogenesis of endometriosis. The XBP–1 is a transcription factor involved in UPR, where it regulates ER stress-mediated apoptosis. XBP–1 is also responsible for endometrial cell migration, which is also a part of the pathogenesis of endometriosis.

Study design, size, duration

This prospective case-controlled study was conducted at University of Health Sciences Turkey, Istanbul Kanuni Sultan Suleyman Training and Research Hospital Department of Obstetrics and Gynecology between March 2020 – August 2020. A total of 60 subjects were included in the study. All patients gave their written informed consent before their enrollment in the study.

Participants/materials, setting, methods

30 endometriosis patients aged 18–45 years were included in the study group. Patients with a history of ovarian surgery, endocrine, autoimmune and metabolic disorders, and hormonal treatment during the previous three months were excluded. 30 healthy subjects without endometriosis were included in the control group. Endometriomas were measured with transvaginal ultrasonography and pain was evaluated with visual analogue scale (VAS). XBP–1 levels were determined from serum samples using Human XBP–1 ELISA Kit (Elabscience Co., USA).

Main results and the role of chance

The mean age of the control group was 28.33±2.49, and the study group was 27.76±2.45 (p = 0.374). The mean endometrioma volume in the study group was calculated to be 9.9± 9.05. The mean XBP–1 level in the control group was 1008.31± 329.05, whereas this level in the study group was significantly higher (2710.65±1484.13, p &lt; 0.001). When the study group was divided according to VAS scores into two groups, the mean XBP–1 level, and endometrioma volumes were significantly higher in the group with VAS scores &gt; 6 (p &lt; 0.001 and p = 0.03 respectively). A receiver operating curve (ROC) analysis was conducted in the study group. The area under the curve AUC for XBP–1 levels was 91% (95%CI: 0.86–0.96, p &lt; 0.001) for the cut-off value of 1279.52 with a sensitivity 87.2%, specificity 86.7%, PPV: 90.4%, NPV: 82.5%, +LR: 6.5, -LR: 0.1. The AUC for VAS scores &gt;6 was 96.2% (95%CI: 0.93–0.98, p &lt; 0.001) for the cut-off value 2227.71, with a sensitivity 90% and a specificity 91.1%, PPV: 87.1%, NPV: 96.1%, +LR: 10, -LR: 0.1.

Limitations, reasons for caution

A limitation of this study was the methodology of serum sample collection. Since there are no data available on the timing of sample collection with regard to the menstruation cycle of the subjects, samples were collected at the first consultation of the patients without considering the date of their cycle.

Wider implications of the findings: In this study, XBP–1 levels in the endometriosis group and also among patients with VAS scores of &gt; 6 were significantly higher. This association between XBP–1 and endometriosis and the positive correlation with pain indicates that XBP–1 can be a potential biomarker, especially in the presence of severe pain symptoms

Trial registration number

NCT04440397

Methyl Jasmonate and Sodium Nitroprusside Jointly Alleviate Cadmium Toxicity in Wheat (Triticum aestivum L.) Plants by Modifying Nitrogen Metabolism, Cadmium Detoxification, and AsA-GSH Cycle

The principal intent of the investigation was to examine the influence of joint application of methyl jasmonate (MeJA, 10 μM) and a nitric oxide-donor sodium nitroprusside (SNP, 100 μM) to wheat plants grown under cadmium (Cd as CdCl2, 100 μM) stress. Cd stress suppressed plant growth, chlorophylls (Chl), and PSII maximum efficiency (F v /F m ), but it elevated leaf and root Cd, and contents of leaf proline, phytochelatins, malondialdehyde, and hydrogen peroxide, as well as the activity of lipoxygenase. MeJA and SNP applied jointly or singly improved the concentrations of key antioxidant biomolecules, e.g., reduced glutathione and ascorbic acid and the activities of the key oxidative defense system enzymes such as catalase, superoxide dismutase, dehydroascorbate reductase, glutathione S-transferase, and glutathione reductase. Exogenously applied MeJA and SNP jointly or singly also improved nitrogen metabolism by activating the activities of glutamine synthetase, glutamate synthase, and nitrate and nitrite reductases. Compared with individual application of MeJA or SNP, the combined application of both showed better effect in terms of improving plant growth and key metabolic processes and reducing tissue Cd content, suggesting a putative interactive role of both compounds in alleviating Cd toxicity in wheat plants.

MAIN FINDINGS

The main findings are that exogenous application of methyl jasmonate and nitric oxide-donor sodium nitroprusside alleviated the cadmium (Cd)-induced adverse effects on growth of wheat plants grown under Cd by modulating key physiological processes and up-regulating enzymatic antioxidants and the ascorbic acid-glutathione cycle-related enzymes.

Comparison of decentration, tilt and lenticular astigmatism of ıntraocular lens between sutured and sutureless scleral fixation techniques

PURPOSE

To evaluate at six months the intraocular lens (IOL) decentration, tilt and lenticular astigmatism between foldable sutured and sutureless scleral fixation IOLs compared to conventional phacoemulsification surgery.

METHODS

We retrospectively reviewed records for 22 eyes with sutureless scleral fixation, 16 eyes with sutured scleral fixation and 23 eyes with conventional phacoemulsification. IOL decentration and angle of IOL tilt were compared on Scheimpflug images 6 months after surgery. Lenticular astigmatism is described as the difference between refractive and net corneal astigmatism.

RESULTS

The angle of tilt in both meridians was significantly lower in the sutureless group than in the sutured group (P=0.008 horizontally and P=0.002 vertically). IOL decentration did not show a significant difference between the three groups in either horizontal or vertical meridians (P˃0.05). Lenticular astigmatism was significantly lower in the sutureless and control groups than in the sutured group (P=0.003 and P<0.001).

CONCLUSION

In addition to being relatively quick and easy to perform, the sutureless scleral fixation technique showed superior results in terms of IOL tilt and lenticular astigmatism at the six-month follow-up compared to the sutured technique.

Nitrate reductase is required for salicylic acid-induced water stress tolerance of pepper by upraising the AsA-GSH pathway and glyoxalase system

A trial was conducted to evaluate whether nitrate reductase (NR) participates in salicylic acid (SA)-improved water stress (WS) tolerance in pepper (Capsicum annuum L.) plants. Before starting WS treatment, 0.5 mM SA was applied to half of the well-watered (WW) plants as well as to WS-plants as a foliar spray once a day for a week. The soil water holding capacity was maintained at 40 and 80% of the full water storing capacity for WS and and well-watered (WW) plants, respectively. Water stress caused substantial decreases in total plant dry weight, F_v /F_m , chlorophyll a and b, relative water content, leaf water potential (ΨI) by 53, 37, 49, 21, 36 and 33%, respectively relative to control, but significant increases in malondialdehyde (MDA), hydrogen peroxide (H₂ O₂ ), electrolyte leakage (EL), methylglyoxal (MG), proline, key antioxidant enzymes' activities, NO and NR activity. The SA reduced oxidative stress, but improved antioxidant defence system, ascorbate-glutathione (AsA-GSH) cycle enzymes, glyoxalase system-related enzymes, glyoxalase I (Gly I) and glyoxalase II (Gly II), plant growth, photosynthetic traits, NO, NR and proline. SA-induced WS tolerance was further improved by supplementation of sodium nitroprusside (SNP), a donor of NO. NR inhibitor, sodium tungstate (ST) was applied in conjunction with SA and SA + SNP to the WW and WS-plants to assess whether NR contributes to SA-improved WS tolerance. ST abolished the beneficial effects of SA by reducing NO and NR activity in WS-pepper, but the application of SNP along with SA + ST reversed negative effects of ST, showing that NO and NR are jointly needed for SA-induced WS tolerance of pepper plants.

Global population genetic structure and demographic trajectories of the black soldier fly, Hermetia illucens

Background

The black soldier fly (Hermetia illucens) is the most promising insect candidate for nutrient-recycling through bioconversion of organic waste into biomass, thereby improving sustainability of protein supplies for animal feed and facilitating transition to a circular economy. Contrary to conventional livestock, genetic resources of farmed insects remain poorly characterised. We present the first comprehensive population genetic characterisation of H. illucens. Based on 15 novel microsatellite markers, we genotyped and analysed 2862 individuals from 150 wild and captive populations originating from 57 countries on seven subcontinents.

Results

We identified 16 well-distinguished genetic clusters indicating substantial global population structure. The data revealed genetic hotspots in central South America and successive northwards range expansions within the indigenous ranges of the Americas. Colonisations and naturalisations of largely unique genetic profiles occurred on all non-native continents, either preceded by demographically independent founder events from various single sources or involving admixture scenarios. A decisive primarily admixed Polynesian bridgehead population serially colonised the entire Australasian region and its secondarily admixed descendants successively mediated invasions into Africa and Europe. Conversely, captive populations from several continents traced back to a single North American origin and exhibit considerably reduced genetic diversity, although some farmed strains carry distinct genetic signatures. We highlight genetic footprints characteristic of progressing domestication due to increasing socio-economic importance of H. illucens, and ongoing introgression between domesticated strains globally traded for large-scale farming and wild populations in some regions.

Conclusions

We document the dynamic population genetic history of a cosmopolitan dipteran of South American origin shaped by striking geographic patterns. These reflect both ancient dispersal routes, and stochastic and heterogeneous anthropogenic introductions during the last century leading to pronounced diversification of worldwide structure of H. illucens. Upon the recent advent of its agronomic commercialisation, however, current human-mediated translocations of the black soldier fly largely involve genetically highly uniform domesticated strains, which meanwhile threaten the genetic integrity of differentiated unique local resources through introgression. Our in-depth reconstruction of the contemporary and historical demographic trajectories of H. illucens emphasises benchmarking potential for applied future research on this emerging model of the prospering insect-livestock sector.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12915-021-01029-w.

Ultrasound-guided erector spinae plane block for postoperative analgesia in patients undergoing open radical prostatectomy: A randomized, placebo-controlled trial

STUDY OBJECTIVE

The aim of this study was to evaluate the effect of ultrasound-guided erector spinae plane (ESP) block on postoperative pain in radical prostatectomy, which leads to both visceral and somatic pain.

DESIGN

Prospective, randomized, placebo controlled, double-blinded.

SETTING

University hospital.

PATIENTS

A total of ASA I-III, 50 patients aged 18-65 who were scheduled for elective open radical prostatectomy surgery.

INTERVENTIONS

Patients were randomly allocated to receive an ultrasound-guided ESP block, with either local anesthetic (10 mL of 1% lidocaine +10 mL of 0.5% bupivacaine) or placebo bilaterally.

MEASUREMENTS

The primary outcome was morphine consumption in the first 24 h after surgery. The secondary outcomes were NRS pain scores at rest and coughing, intraoperative remifentanil consumption and need for rescue analgesic during the first 24 h after surgery.

MAIN RESULTS

Both NRS scores for post-anesthesia care unit and NRS_rest scores for 1st hours were lower in Group ESPB (p < 0.001 and p = 0.033, respectively). Cumulative morphine consumption at 24 h post-surgery was similar between the groups (p = 0.447). Rescue analgesic requirement was higher in the placebo injection group than in the ESPB group at the 1st postoperative hour (p = 0.002).

CONCLUSIONS

In open radical prostatectomies, except for the first hour, ESP block is ineffective for pain scores and on morphine consumption compared to the placebo injection group in the postoperative period.