Earthworms improve the rhizosphere micro-environment to mitigate the toxicity of microplastics to tomato (Solanum lycopersicum)

Microplastics (MPs) are widespread in agricultural soil, potentially threatening soil environmental quality and plant growth. However, toxicological research on MPs has mainly been limited to individual components (such as plants, microbes, and animals), without considering their interactions. Here, we examined earthworm-mediated effects on tomato growth and the rhizosphere micro-environment under MPs contamination. Earthworms (Eisenia fetida) mitigated the growth-inhibiting effect of MPs on tomato plant. Particularly, when exposed to environmentally relevant concentrations (ERC, 0.02% w/w) of MPs, the addition of earthworms significantly (p < 0.05) increased shoot and root dry weight by 12-13% and 13-14%, respectively. MPs significantly reduced (p < 0.05) soil ammonium (NH4+-N) (0.55-0.69 mg/kg), nitrate nitrogen (NO3--N) (7.02-8.65 mg/kg) contents, and N cycle related enzyme activities (33.47-42.39 μg/h/g) by 37.7-50.9%, 22.6-37.2%, and 34.2-48.0%, respectively, while earthworms significantly enhanced (p < 0.05) inorganic N mineralization and bioavailability. Furthermore, earthworms increased bacterial network complexity, thereby enhancing the robustness of the bacterial system to resist soil MPs stress. Meanwhile, partial least squares modelling showed that earthworms significantly influenced (p < 0.01) soil nutrients, which in turn significantly affected (p < 0.01) plant growth. Therefore, the comprehensive consideration of soil ecological composition is important for assessing MPs ecological risk.

The longitudinal behavioral effects of acute exposure to galactic cosmic radiation in female C57BL/6J mice: implications for deep space missions, female crews, and potential antioxidant countermeasures

Galactic cosmic radiation (GCR) is an unavoidable risk to astronauts that may affect mission success. Male rodents exposed to 33-beam-GCR (33-GCR) show short-term cognitive deficits but reports on female rodents and long-term assessment is lacking. Here we asked: What are the longitudinal behavioral effects of 33-GCR on female mice? Also, can an antioxidant/anti-inflammatory compound mitigate the impact of 33-GCR? Mature (6-month-old) C57BL/6J female mice received the antioxidant CDDO-EA (400 µg/g of food) or a control diet (vehicle, Veh) for 5 days and either Sham-irradiation (IRR) or whole-body 33-GCR (0.75Gy) on the 4th day. Three-months post-IRR, mice underwent two touchscreen-platform tests: 1) location discrimination reversal (which tests behavior pattern separation and cognitive flexibility, two abilities reliant on the dentate gyrus) and 2) stimulus-response learning/extinction. Mice then underwent arena-based behavior tests (e.g. open field, 3-chamber social interaction). At the experiment end (14.25-month post-IRR), neurogenesis was assessed (doublecortin-immunoreactive [DCX+] dentate gyrus neurons). Female mice exposed to Veh/Sham vs. Veh/33-GCR had similar pattern separation (% correct to 1st reversal). There were two effects of diet: CDDO-EA/Sham and CDDO-EA/33-GCR mice had better pattern separation vs. their respective control groups (Veh/Sham, Veh/33-GCR), and CDDO-EA/33-GCR mice had better cognitive flexibility (reversal number) vs. Veh/33-GCR mice. Notably, one radiation effect/CDDO-EA countereffect also emerged: Veh/33-GCR mice had worse stimulus-response learning (days to completion) vs. all other groups, including CDDO-EA/33-GCR mice. In general, all mice show normal anxiety-like behavior, exploration, and habituation to novel environments. There was also a change in neurogenesis: Veh/33-GCR mice had fewer DCX+ dentate gyrus immature neurons vs. Veh/Sham mice. Our study implies space radiation is a risk to a female crew's longitudinal mission-relevant cognitive processes and CDDO-EA is a potential dietary countermeasure for space-radiation CNS risks.

Effects of polystyrene, polyethylene, and polypropylene microplastics on the soil-rhizosphere-plant system: Phytotoxicity, enzyme activity, and microbial community

The widespread presence of soil microplastics (MPs) has become a global environmental problem. MPs of different properties (i.e., types, sizes, and concentrations) are present in the environment, while studies about the impact of MPs having different properties are limited. Thus, this study investigated the effects of three common polymers (polystyrene, polyethylene, and polypropylene) with two concentrations (0.01% and 0.1% w/w) on growth and stress response of lettuce (Lactuca sativa L.), soil enzymes, and rhizosphere microbial community. Lettuce growth was inhibited under MPs treatments. Moreover, the antioxidant system, metabolism composition, and phyllosphere microbiome of lettuce leaves was also perturbed. MPs reduced phytase activity and significantly increased dehydrogenase activity. The diversity and structure of rhizosphere microbial community were disturbed by MPs and more sensitive to polystyrene microplastics (PSMPs) and polypropylene microplastics (PPMPs). In general, the results by partial least squares pathway models (PLS-PMs) showed that the presence of MPs influenced the soil-rhizosphere-plant system, which may have essential implications for assessing the environmental risk of MPs.

Clinical characteristics, outcomes and risk factors for mortality in hospitalized diabetes and chronic kidney disease patients after COVID-19 infection following widespread vaccination

BACKGROUND

COVID-19 poses a significant threat to patients with comorbidities, such as diabetes and chronic kidney disease (CKD). China experienced a nationwide COVID-19 endemic from December 2022 to January 2023, which is the first occurrence of such an outbreak following China's widespread administration of COVID-19 vaccinations.

METHODS

A total of 338 patients with diabetes and CKD combined with COVID-19 infection between December 7, 2022 and January 31, 2023 were included in this study. The end follow-up date was February 10, 2023. Univariate analysis and multivariate Cox analysis were used to analyze risk factors for death.

RESULTS

During the 50-day median follow-up period, 90 patients in the study cohort died, for a mortality rate of 26.63%. The median age of the study cohort was 74 years, with a male predominance of 74%. During hospitalization, 21% of patients had incident AKI, 17% of patients experienced stroke, and 40% of patients experienced respiratory failure. Cox proportional hazard regression showed that older age, a diagnosis of severe or critically severe COVID-19 infection, incident AKI and respiratory failure, higher level of average values of fasting glucose during hospitalization, UA, and total bilirubin were independent risk factors for death in our multivariate model.

CONCLUSIONS

These findings highlight the critical importance of identifying and managing comorbid risk factors for COVID-19, especially among the elderly, in order to optimize clinical outcomes, even after COVID-19 vaccination.

Performance and micro-pacing in sprint cross-country skiing: A comparison of individual time-trial and head-to-head race formats

This study compared performance strategies and sub-technique selection in cross-country skate skiing sprint races, specifically individual time-trial (ITT) and head-to-head (H2H) formats. Fourteen male cross-country skiers from the Chinese national team participated in the FIS-sanctioned sprint race day. GNSS and heart rate sensors recorded positioning, skiing speeds, heart rate, sub-technique usage, and skiing kinematics. Statistical parametric mapping (SPM) was used to determine the course positions (clusters) where instantaneous skiing speed was significantly associated with section time. One-way analyses of variance were used to examine differences between the ITT and H2H. H2H race speeds were 2.4 ± 0.2% faster than the ITT race (p < 0.05).Variations in sub-technique and skiing kinematics were observed between race formats, indicating different strategies and tactics employed by athletes. SPM identified specific clusters (primarily uphill) where the fastest athlete gained significant time over the slowest. The greatest time gains were associated with higher G3 sub-technique usage and longer G3 cycle length on steep uphill terrain (9-13% gradients). Integrating SPM analyses and sub-technique assessments can help optimise performance and tactics in sprint races. This study enhances our understanding of cross-country skiing dynamics and performance variations among elite competitors.

Toxicity Mechanisms of Nanoplastics on Crop Growth, Interference of Phyllosphere Microbes, and Evidence for Foliar Penetration and Translocation

Despite the increasing prevalence of atmospheric nanoplastics (NPs), there remains limited research on their phytotoxicity, foliar absorption, and translocation in plants. In this study, we aimed to fill this knowledge gap by investigating the physiological effects of tomato leaves exposed to differently charged NPs and foliar absorption and translocation of NPs. We found that positively charged NPs caused more pronounced physiological effects, including growth inhibition, increased antioxidant enzyme activity, and altered gene expression and metabolite composition and even significantly changed the structure and composition of the phyllosphere microbial community. Also, differently charged NPs exhibited differential foliar absorption and translocation, with the positively charged NPs penetrating more into the leaves and dispersing uniformly within the mesophyll cells. Additionally, NPs absorbed by the leaves were able to translocate to the roots. These findings provide important insights into the interactions between atmospheric NPs and crop plants and demonstrate that NPs' accumulation in crops could negatively impact agricultural production and food safety.

Assessing stress responses in potherb mustard (Brassica juncea var. multiceps) exposed to a synergy of microplastics and cadmium: Insights from physiology, oxidative damage, and metabolomics

Both microplastics (MPs) and cadmium (Cd) are common contaminants in farmland systems, is crucial for assessing their risks for human health and environment, and little research has focused on stress responses mechanisms of crops exposed to the combined pollution. The present study investigated the impact of polyethylene (PE) and polypropylene (PP) microplastics (MPs), in combination with Cd, on the physiological and metabolomic changes as well as rhizosphere soil of potherb mustard. Elevated levels of PEMPs and PPMPs were found to impede nutrient uptake in plants while promoting premature flowering, and the concomitant effect is lower crop yields. The substantial improvement in Cd bioavailability facilitated by MPs in rhizosphere soil, especially in high concentrations of MPs, then elevated bioavailability of Cd contributed to promoted Cd accumulation in plants, with distinct effects depending on the type and concentration of MPs. The presence of MPs Combined exposure to high concentrations of MPs and Cd resulted in alterations in plant physiology and metabolomics, including decreased biomass and photosynthetic parameters, elevated levels of reactive oxygen species primarily H2O2, increased antioxidant enzyme activities, and modifications in metabolite profiles. Overall, our study assessed the potential impact on food security (the availability of cadmium to plant) and crops stress responses regarding the contamination of MPs and Cd, providing new insights for future risk assessment in agriculture.

Microplastic pollution in terrestrial ecosystems: Global implications and sustainable solutions

Microplastic (MPs) pollution has become a global environmental concern with significant impacts on ecosystems and human health. Although MPs have been widely detected in aquatic environments, their presence in terrestrial ecosystems remains largely unexplored. This review examines the multifaceted issues of MPs pollution in terrestrial ecosystem, covering various aspects from additives in plastics to global legislation and sustainable solutions. The study explores the widespread distribution of MPs worldwide and their potential antagonistic interactions with co-occurring contaminants, emphasizing the need for a holistic understanding of their environmental implications. The influence of MPs on soil and plants is discussed, shedding light on the potential consequences for terrestrial ecosystems and agricultural productivity. The aging mechanisms of MPs, including photo and thermal aging, are elucidated, along with the factors influencing their aging process. Furthermore, the review provides an overview of global legislation addressing plastic waste, including bans on specific plastic items and levies on single-use plastics. Sustainable solutions for MPs pollution are proposed, encompassing upstream approaches such as bioplastics, improved waste management practices, and wastewater treatment technologies, as well as downstream methods like physical and biological removal of MPs. The importance of international collaboration, comprehensive legislation, and global agreements is underscored as crucial in tackling this pervasive environmental challenge. This review may serve as a valuable resource for researchers, policymakers, and stakeholders, providing a comprehensive assessment of the environmental impact and potential risks associated with MPs.

Environmental fate, aging, toxicity and potential remediation strategies of microplastics in soil environment: Current progress and future perspectives

Microplastics (MPs) are small plastic debris (<5 mm) that result from the fragmentation of plastic due to physical and physiochemical processes. MPs are emerging pollutants that pose a significant threat to the environment and human health, primarily due to their pervasive presence and potential bioaccumulation within the food web. Despite their importance, there is a lack of comprehensive studies on the fate, toxicity, and aging behavior of MPs. Therefore, this review aims to address this gap by providing a cohesive understanding of several key aspects. Firstly, it summarizes the sources and fate of MPs, highlighting their ubiquitous presence and the potential pathways through which they enter ecosystems. Secondly, it evaluates the aging process of MPs and the factors influencing it, including the morphological and physiological changes observed in crops and the release of pollutants from aged MPs, which can have detrimental effects on the environment and human health. Furthermore, the impacts of aging MPs on various processes are discussed, such as the mobilization of other pollutants in the environment. The influence of aged MPs on the soil environment, particularly their effect on heavy metal adsorption, is examined. Finally, the review explores strategies for the prevention technologies and remediation of MPs, highlighting the importance of developing effective approaches to tackle this issue. Overall, this review aims to contribute to our understanding of MPs, their aging process, and their impacts on the environment and human health. It underscores the urgency of addressing the issue of MPs and promoting research and remediation efforts to mitigate their adverse effects.

Integrating metabolomics and high-throughput sequencing to investigate the effects of tire wear particles on mung bean plants and soil microbial communities

Tire wear particles (TWPs) generated by vehicle tires are ubiquitous in soil ecosystems, while their impact on soil biota remains poorly understood. In this study, we investigated the effects of TWPs (0.1%, 0.7%, and 1.5% of dry soil weight) on the growth and metabolism of mung bean (Vigna radiata) plants over 32 days in soil pots. We found that TWPs-treated soils had high levels of heavy metals and polycyclic aromatic hydrocarbons (PAHs). However, there was no significant impact of TWPs exposure on plant growth, suggesting that mung bean plants have a degree of tolerance to TWPs. Despite the lack of impact on plant growth, exposure to TWPs had significant effects on soil enzyme activities, with a decrease of over 50% in urease and dehydrogenase activity. Furthermore, TWPs exposure resulted in marked changes in the plant metabolite profile, including altered levels of sugars, carboxylic acids, and amino acids, indicating altered nitrogen and amino acid-related metabolic pathways. TWPs exposure also disrupted the rhizospheric and bulk soil microbiota, with a decrease in the abundance of bacterial (Blastococcus) and fungal (Chaetomium) genera involved in nitrogen cycles and suppressing plant diseases. In summary, our study provides new insights into the effects of TWPs on plants and soil, highlighting the potential ecological consequences of TWPs pollution in terrestrial ecosystems and underscoring the need for further research in this area.

The interfacial interaction between Dechlorane Plus (DP) and polystyrene nanoplastics (PSNPs): An overlooked influence factor for the algal toxicity of PSNPs

As pollution has attracted attention due to its wide distribution. An environmental concern that may be overlooked is that NPs additives are easily released into the environment due to their physical combination with NPs. However, the knowledge gaps still exist about the interfacial reactions of NPs and the additives (e.g. flame retardants) and the joint ecological effect. In the present study, fourier transform infrared (FTIR) spectrometer coupled with 2D correlation spectroscopy (2D-COS) analysis revealed the interfacial reactions between polystyrene nanoplastics (PSNPs) and Dechlorane Plus (DP). Results showed that carbon‑oxygen bonds and carbon‑chlorine bonds were the important binding sites during adhesion and DP could reduce the colloidal stability. Single and joint ecological effects of PSNPs and DP on the microalgae Chlorella vulgaris were further deliberated. Reduced photosynthetic efficiency (reduced Fv/Fm by 0.03 %), higher growth inhibition (16.15 %) and oxidative damage (increased ROS by 152 %) were observed in algae under co-exposure. Notably, DP could significantly increase the attachment of PSNPs to the surface of the algae. Metabolomics further revealed that co-exposure significantly down-regulated amino acid metabolism and tricarboxylic acid cycle (TCA) cycle, and up-regulated fatty acid metabolism. The present study provides new insights into the risk assessment of NPs in aquatic environment by investigating the interfacial reaction mechanism and combined ecotoxicity of NPs and additives.

Concurrent Chemoradiotherapy plus Programmed Death-1 (PD-1) Blockade for Locally Advanced Cervical Cancer: Preliminary Results of a Single-Arm, Open-Label, Phase II Trial

PURPOSE/OBJECTIVE(S)

This study aims to assess the anti-tumor activity and safety of concurrent chemoradiotherapy plus PD-1 blockade in patients with locally advanced cervical cancer.

MATERIALS/METHODS

This is a single-arm, open-label, prospective phase II study. The key inclusion criteria were treatment-naive patients aged 18-75 years with stage II A2-IVA (FIGO 2018) locally advanced cervical cancer. All patients were treated with concurrent chemoradiotherapy including 2 cycle cisplatin (75mg/m2, for three days, every 3 weeks[Q3W]), nedaplatin or carboplatin can be selected for patients who can't tolerate cisplatin. After CCRT, patients achieving complete response (CR), partial responses(PR), stable disease(SD) received adjuvant chemotherapy (docetaxel 75 mg/m2 day 1+ cisplatin DDP 25 mg/m2 day 1-3, Q3W) for 2 cycle. PD-1 blockade Sintilimab and Tislelizumab was administered intravenously at 200 mg every 3 weeks up to 1 year or until disease progression, unacceptable toxicity, or withdrawal of consent. The primary endpoint was objective response rate (ORR) assessed by investigators per Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1. Secondary endpoints were the 12, 24-month overall survival (OS) rates, the 12, 24-month disease free survival (DFS) rates and safety.

RESULTS

From February 2020 to June 2022, a total of 15 patients was enrolled. Median age was 57 years (range, 36-74 years). Stage IIA1 was documented in 2 patients, stage IIA2 in two patients, stage IIIA in one patient, stage IIIC1 in eight patients, and stage IVA in two patients. And 66.7% (10/15) of patients had Metastatic lymph node. Four patients received adjuvant chemotherapy. The ORR was 100%, with 4 patients achieving CR and 11 PR. The 12 and 24-month OS rates are 93.3% and 84%, the 12 and 24-month DFS rates are 86% and 75.4%, respectively. Treatment-related adverse events (TRAEs) occurred in 86.7% (13/15) of patients. Grade 3 TRAEs are leukocyte (n = 1), thrombocytopenia (n = 1), hepatitis (n = 1), skin reaction (n = 1). No treatment-related deaths occurred. And IFN-γ was significantly elevated after radiotherapy (p = 0.0073).

CONCLUSION

Concurrent chemoradiotherapy plus PD-1 blockade showed promising antitumor activity and manageable toxicities in patients with locally advanced cervical cancer. Long-term outcomes are still pending to further evaluate their therapeutic effects. (ChiCTR2000032856).

Toxicity effects of polystyrene nanoplastics and arsenite on Microcystis aeruginosa

Despite the increasing research on the fate of nanoplastics (NPs, <100 nm) in freshwater systems, little is known about the joint toxic effects of metal(loid)s and NPs modified with different functional groups on microalgae. Here, we explored the joint toxic effects of two types of polystyrene NPs [one modified with a sulfonic acid group (PSNPs-SO₃H), and one without this functional group (PSNPs)] and arsenic (As) on the microalgae Microcystis aeruginosa. The results highlighted that PSNPs-SO₃H showed a smaller hydrodynamic diameter and greater potential to adsorb positively charged ions than PSNPs, contributing to the more severe growth inhibition, while both of them produced oxidative stress. Metabolomics further revealed that the fatty acid metabolism of the microalgae was significantly up-regulated under both NPs exposure, while PSNPs-SO₃H down-regulated the tricarboxylic acid cycle (TCA cycle) of the microalgae. As uptake by algae was significantly reduced by 82.58 % and 59.65 % in the presence of 100 mg/L PSNPs and PSNPs-SO₃H, respectively. The independent action model showed that the joint toxicity of both NPs with As was assessed as antagonistic. In addition, PSNPs and PSNPs-SO₃H had dissimilar effects on the composition of the microalgae extracellular polymeric substances (EPS), resulting in different uptake and adsorption of As, thereby affecting the physiology and biochemistry of algae. Overall, our findings propose that the specific properties of NPs should be considered in future environmental risk assessments.

Single and combined effects of polystyrene nanoplastics and Cd on submerged plants Ceratophyllum demersum L

Nanoplastics (NPs) and heavy metals are widely distributed in aquatic ecosystem, posing a potential threat to ecosystem function. Submerged macrophytes play an important role in water purification and maintaining ecological functions. However, the coupled effects of NPs and cadmium (Cd) on submerged macrophytes physiology and the mechanisms involved are still unclear. Here, the potential effects of single and co-Cd/PSNPs exposure on Ceratophyllum demersum L. (C. demersum) were explored. Our results showed that NPs aggravated the inhibition of Cd on plant growth ate (a decrease of 35.54 %), reduced chlorophyll synthesis (a decrease of 15.84 %), and disrupted the antioxidant enzyme system (a decrease of 25.07 % on SOD activity) of C. demersum. Massive PSNPs adhered to the surface of C. demersum when exposed to co-Cd/PSNPs while they did not adhere when exposed to single-NPs. The metabolic analysis further demonstrated that co-exposure down-regulated plant cuticle synthesis and that Cd exacerbated the physical damage and shadowing effects of NPs. In addition, co-exposure upregulated pentose phosphate metabolism, leading to the accumulation of starch grains. Furthermore, PSNPs reduced Cd enrichment capacity of C. demersum. Our results unraveled distinct regulatory networks for submerged macrophytes exposed to single and composite of Cd and PSNPs, providing a new theoretical basis for assessing the risks of heavy metals and NPs in the freshwater environment.

Type-dependent effects of microplastics on tomato (Lycopersicon esculentum L.): Focus on root exudates and metabolic reprogramming

Much attention has been paid to the prevalence of microplastics (MPs) in terrestrial systems. MPs have been shown to affect the physio-biochemical properties of plants. Different MPs may have distinctive behaviors and diverse effects on plant growth. In the present study, the effects of polystyrene (PS), polyethylene (PE), and polypropylene (PP) MPs on physio-biochemical properties, root exudates, and metabolomics of tomato (Lycopersicon esculentum L.) under hydroponic conditions were investigated. Our results show that MPs exposure has adverse effects on tomato growth. MPs exposure had a significant type-dependent effect (p < 0.001) on photosynthetic gas parameters, chlorophyll content, and antioxidant enzyme activities. After exposure to MPs, the content of low molecular weight organic acids in tomato root exudates was significantly increased, which was considered as a strategy to alleviate the toxicity of MPs. In addition, MPs treatment significantly changed the metabolites of tomato root and leaf. Metabolic pathway analysis showed that MPs treatment had a great effect on amino acid metabolism. We also found that plants exposed to PS and PP MPs produced more significant metabolic reprogramming than those exposed to PE MPs. This study provides important implications for the mechanism studies on the toxic effect of various MPs on crops and their future risk assessment.

Effects of co-modified biochar immobilized laccase on remediation and bacterial community of PAHs-contaminated soil

Considering the stability and economy of immobilized enzymes, this study prepared co-modified biochar immobilized laccase product named Fe₃O₄@NaBC@GA@LC via orthogonal experimental design and explored its possibility of remediating polycyclic aromatic hydrocarbons (PAHs) contaminated soil in steel plants. Compared with the free laccase treatment, the relative activity of Fe₃O₄@NaBC@GA@LC remained 60 % after 50 days of incubation at room temperature. The relative activity of Fe₃O₄@NaBC@GA@LC could still retain nearly 80 % after five reuses. In the process of simulating the PAHs-contaminated site treatment experiment in Hangzhou Iron and steel plant, immobilized laccase exhibited efficient adsorption and degradation performances and even the removal rate of 5-ring PAHs reached more than 90 % in 40 days, resulting in improving urease activity and dehydrogenase in the soil and promoted the growth of a PAH degrading bacteria (Massilia). Our results further explained the efficient degradation effects of Fe₃O₄@NaBC@GA@LC on PAHs, which make it a promising candidate for PAHs-contaminated soil remediation.

[Influence of reactive oxygen species responsive self-assembled nanomicelle loaded with pyroptosis inhibitor on full-thickness skin defects in diabetic rats]

Objective: To investigate the influence of reactive oxygen species (ROS) responsive self-assembled nanomicelle loaded with pyroptosis inhibitor on full-thickness skin defects in diabetic rats. Methods: Experimental research methods were employed. A nucleotide-binding oligomerization domain (NOD) 1/2 inhibitor (NOD-IN-1) was encapsulated with nanomicelle polyethylene glycol-block-polypropylene sulfide (PEG-b-PPS), and the resulting product was called PEPS@NOD-IN-1. The morphology and hydration particle size of PEG-b-PPS and PEPS@NOD-IN-1 were observed by transmission electron microscope and particle size analyzer, respectively, and the encapsulation rate and drug loading rate of PEPS@NOD-IN-1 to NOD-IN-1 and the cumulative release rate of NOD-IN-1 by PEPS@NOD-IN-1 in phosphate buffer solution (PBS) alone and hydrogen peroxide-containing PBS within 40 h were measured and calculated by microplate reader, and the sample number was 3. Twenty-four male Sprague-Dawley rats aged 6-7 weeks were injected with streptozotocin to induce type 1 diabetes mellitus. Six full-thickness skin defect wounds were made on the back of each rat. The injured rats were divided into PBS group, NOD-IN-1 group, PEG-b-PPS group, and PEPS@NOD-IN-1 group with corresponding treatment according to the random number table, with 6 rats in each group. The wound healing was observed on post injury day (PID) 3, 7, and 12, and the wound healing rate was calculated. The ROS levels in wound tissue were detected by immunofluorescence method on PID 3. On PID 7, the granulation tissue thickness in wound was assessed by hematoxylin-eosin staining, the mRNA expressions of NOD1 and NOD2 were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction, and the protein expressions of NOD1, NOD2, and GSDMD-N terminals were detected by Western blotting. Six wounds from different rats in each group were taken for detection of the above indicators. Wound tissue (3 samples per group) was taken from rats in PBS group and PEPS@NOD-IN-1 group on PID 7, and transcriptome sequencing was performed using high-throughput sequencing technology platform. Differentially expressed genes (DEGs) significantly down-regulated in PEPS@NOD-IN-1 group as compared with PBS group were screened, and the enrichment analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) was performed. The DEG heatmap of the NOD-like receptor pathway, a pyroptosis-related pathway, was made. Protein-protein interaction (PPI) analysis of DEGs in heatmap was performed through the STRING database to screen key genes of PEPS@NOD-IN-1 regulating the NOD-like receptor pathway. Data were statistically analyzed with analysis of variance for repeated measurement, one-way analysis of variance, and Tukey test. Results: PEG-b-PPS and PEPS@NOD-IN-1 were in spherical structures of uniform size, with hydration particle sizes of (134.2±3.3) and (143.1±2.3) nm, respectively. The encapsulation rate of PEPS@NOD-IN-1 to NOD-IN-1 was (60±5)%, and the drug loading rate was (15±3)%. The release of NOD-IN-1 from PEPS@NOD-IN-1 in PBS alone was slow, and the cumulative release rate at 40 h was only (12.4±2.3)%. The release of NOD-IN-1 from PEPS@NOD-IN-1 in hydrogen peroxide-containing PBS within 10 h was very rapid, and the cumulative release rate at 10 h reached (90.1±3.6)%. On PID 3 and 7, the wounds of rats in the four groups were gradually healed, and the healing in PEPS@NOD-IN-1 group was better than that in the other three groups. On PID 12, the wound scab area in PBS group was large, the wound epithelialization in NOD-IN-1 group and PEG-b-PPS group was obvious, and the wound in PEPS@NOD-IN-1 group was close to complete epithelialization. Compared with those in PBS group, NOD-IN-1 group, and PEG-b-PPS group, the wound healing rates on PID 7 and 12 in PEPS@NOD-IN-1 group were significantly increased (P<0.05), the level of ROS in wound tissue on PID 3 was significantly decreased (P<0.05), the thickness of granulation tissue in wound on PID 7 was significantly thickened (P<0.05), and the mRNA expressions of NOD1 and NOD2 and the protein expressions of NOD1, NOD2, and GSDMD-N terminals in wound tissue on PID 7 were significantly decreased (P<0.05). KEGG pathway analysis showed that DEGs significantly down-regulated in PEPS@NOD-IN-1 group as compared with PBS group were significantly enriched in NOD-like receptors, hypoxia-inducible factors, mitogen-activated protein kinases, and tumor necrosis factor (TNF) pathways. In the DEG heatmap of NOD-like receptor pathway, the genes regulating pyroptosis mainly involved NOD1, NOD2, NOD-like receptor thermoprotein domain-related protein 3, Jun, signal transduction and transcriptional activator 1 (STAT1), TNF-α-induced protein 3. The PPI results showed that NOD1, NOD2, and STAT1 were the key genes of PEPS@NOD-IN-1 regulating the NOD-like receptor pathway. Conclusions: PEPS@NOD-IN-1 can down-regulate the level of local ROS in wounds and the expression of NOD1, NOD2, and GSDMD-N terminals, the key regulators of pyroptosis, thereby promoting the repair of full-thickness skin defect wounds in diabetic rats. PEPS@NOD-IN-1 can also significantly down-regulate the pyroptosis, inflammation, and hypoxia-related pathways of wounds, and regulate NOD-like receptor pathways by down-regulating key genes NOD1, NOD2, and STAT1.

Three typical microplastics affect the germination and growth of amaranth (Amaranthus mangostanus L.) seedlings

Microplastics (MPs) have been a global emerging contaminant and have aroused wide public concern. Currently, it is still unknown the phytotoxicity effect of MPs on amaranth (Amaranthus mangostanus L.). This study investigated the early responses of amaranth by exposing its seeds to suspensions of polystyrene (PS), polyethylene (PE), and polypropylene (PP) MPs. We observed the effects of MPs on seed germination and growth of amaranth, especially on the oxidative damage in amaranth roots. Impacts of MPs on the germination and growth of amaranth varied with the type, concentration, and particle size of MPs. PE MPs and PP MPs inhibited the shoot extension of amaranth, while the root length under PP MPs treatment was generally shorter than that under PS MPs and PE MPs. The accumulation of H₂O₂ in amaranth roots increased with the rising of MPs concentration. Compared with the control, a little number of dead cells were found in the roots of amaranth under high MPs treatment. It is noteworthy that only under 100 mg/L PP treatment, the amaranthus seedlings root cells were disorganized, due to the reactive oxygen species (ROS) damage in the roots. These findings provide essential information to assess the phytotoxicity of MPs in agricultural products, and provide insights into the underlying mechanisms of the observed phytotoxicity.

Single and combined toxicity of polystyrene nanoplastics and arsenic on submerged plant Myriophyllum verticillatum L

The contamination of nanoplastics (NPs) and heavy metals (HM) in water bodies has caused widespread concern, while their effects on submerged plants are poorly reported. Polystyrene nanoplastics (PSNPs) and arsenic (As) were used to assess their toxicity on Myriophyllum verticillatum L. via the orthogonal experiments. PSNPs significantly reduced the accumulation of As (17.24%-66.67%) in plant. Single As and high As-PSNPs treatments significantly inhibited plant growth, with a maximum reduction of 70.09% in the growth rate. The mineral nutrient content was significantly affected by PSNPs and As treatments. The antioxidant system was significantly inhibited, which was more pronounced in the roots. Similar findings were observed for soluble protein and soluble sugar. Some organic acids and amino acids showed down-regulation at high concentrations of As, leading to a decrease in the content of the mineral element and down-regulation of antioxidant enzyme synthesis. Furthermore, PSNPs could alleviate As toxicity under 0.1 mg/L As treatment but exacerbate As toxicity at 1 mg/L As dose. This study has important implications for the study of submerged plants exposed to co-contamination of microplastics and heavy metals, as well as the possible ecological risk assessment in freshwater.

Aging-induced down-regulation of Pka/Bkca pathway in rat cerebral arteries

The incidence of cerebrovascular diseases increases significantly with aging. This study aimed to test the hypothesis that aging may influence the protein kinase A (PKA)-dependent vasodilation via RyR/BKCa pathway in the middle cerebral arteries (MCA). Male Sprague-Dawley rats were randomly divided into control (4-6 month-old) and aged (24-month-old) groups. The functions of MCA and ion channel activities in smooth muscle cells were examined using myograph system and patch-clamp. Aging decreased the isoproterenol/forskolin-induced relaxation in the MCA. Large-conductance Ca2+-activated-K+ (BKCa) channel inhibitor, iberiotoxin, significantly attenuated the forskolin-induced vasodilatation and hyperpolarization in the young group, but not in the aged group. The amplitude and frequency of spontaneous transient outward currents (STOCs) were significantly decreased in the aged group. Single channel recording revealed that the mean open time of BKCa channels were decreased, while an increased mean closed time of BKCa channels were found in the aged group. The Ca2+/voltage sensitivity of the channels was decreased accompanied by reduced BKCa α and β1-subunit, the expression of RyR2, PKA-Cα and PKA-Cβ subunits were also declined in the aged group. Aging induced down-regulation of PKA/BKCa pathway in cerebral artery in rats. The results provides new information on further understanding in cerebrovascular diseases resulted from age-related cerebral vascular dysfunction.

Accuracy of progress assessment with clear aligners

OBJECTIVES

This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the clear aligner process.

METHODS

Nineteen cases were included in this retrospective case control study. Pretreatment dental cast (T0) and post treatment dental cast after staged treatment (T1) were available for three-dimensional (3D) model superimposition. The movements of maxillary teeth in the horizontal plane (cross section) after staged treatment and the widths of upper and lower dentitions were measured by 3D model superimposition in real world and iTero Progress Assessment. The data collected from the two methods were compared.

RESULTS

The movements [Median (upper and lower quartiles)] of maxillary teeth in the horizontal plane after staged treatment were 2.31 (1.59, 3.22) and 1.79 (1.21, 3.03) mm in iTero Progress Assessment and 3D model analysis, respectively. Significant difference was observed between the two groups (P<0.05). In the measurement of upper and lower dentition width, four indicators were measured, including intercanine width upper, intermolar width upper, intercanine width lower, and intermolar width lower. Before treatment, the measurement of iTero Progress Assessment were (35.78±2.49), (56.21±2.51), (27.43±1.38), (52.26±2.91) mm, respectively, and actual measurement were (35.77±2.53), (56.17±2.47), (27.40±1.41), (52.30±2.86) mm, respectively, without significant difference (P>0.05). After stage treatment, the measurement of iTero Progress Assessment were (37.37±2.86), (57.76±2.56), (28.89±2.00), (54.16±2.19) mm, respectively, and actual measurement were (37.29±2.94), (57.71±2.63), (28.88±2.05), (54.01±2.15) mm, respectively, and there was no significant difference (P>0.05).

CONCLUSIONS

The data from iTero Progress Assessment did not coincide with the model superimposition results with palate as reference. The accuracy of model superimposition in iTero Progress Assessment needs further investigation, whereas the arch width analysis is accurate. Therefore, iTero Progress Assessment results should be interpreted with caution by orthodontists in clinical applications.

Impact of cardiac resynchronisation therapy in patients with cardiac sarcoidosis

Background

Implantation of a device is usually required in cardiac sarcoidosis (CS) patients presenting with advanced conduction abnormalities or ventricular arrhythmias. A cardiac resynchronisation therapy (CRT) device is often chosen in patients with concomitant left ventricular systolic impairment. The role of CRT in CS is not well established.

Purpose

To describe the cohort of CS patients with CRT device in situ in our hospital focusing on the short-term effect in serial echocardiography and long-term outcomes on morbidity and mortality.

Methods

All consecutive CS patients with a CRT device in situ were identified in our CS database (2005–2022). A confident CS diagnosis was provided after review of all relevant clinical and imaging baseline data in our CS multi-disciplinary meeting and a consensus decision for CRT-D implantation was made based on international guidelines. All patients were followed up for at least 6 months with serial echocardiography. Serial data regarding symptoms, rhythm disturbance and echocardiographic parameters were obtained and comparisons were performed using Wilcoxon signed rank test.

Results

A total of 51 CS patients with CRT-D were identified (mean age: 57±10 years old). Patients were male predominant (64.7%) and Caucasian in origin (86.2%). Extra-cardiac sarcoidosis was confirmed histologically in 33 (64.7%) patients. The prevalence of smoking, diabetes, hypertension and ischaemic heart disease was 27.5%, 21.6%, 49.0% and 7.8% respectively. At the time of device implantation or during follow-up, 43 (84.3%) patients were found to have active cardiac sarcoidosis on cardiac PET.

Post CRT implantation there was a significant difference in LV ejection fraction (35.9±15.0% vs 42.2±14.1%, p&lt;0.001), LV end-systolic diameter (4.90±1.46 cm vs 4.62±1.32 cm, p=0.012) and LV end-diastolic diameter (5.99±1.18 cm vs 5.66±1.06 cm, p&lt;0.001). No significant changes were observed in the right ventricular function (p=0.09) and severity of mitral regurgitation (p=0.40). There was one patient who experienced acute heart failure decompensation admission within six months of CRT-D implantation. The New York Heart Association (NYHA) class improved in 26 patients (51.0%), worsened in 4 (7.8%) patients and remained the same in 21 (41.2%) patients at 6 months post CRT-implantation. During the mean follow up of 47.6 months, the composite end-point of death and cardiac transplantation was reached in 9 (17.6%) patients (8 deaths and 1 cardiac transplantation). 5 patients had major complications including a large haematoma, a small atrio-septal defect, haemothorax, device associated endocarditis and lead fracture. Minor wound infections were seen in 3 patients and 4 patients received inappropriate shock or anti-tachycardia pacing.

Conclusions

CRT in cardiac sarcoidosis patients is associated with short-term improvement in LV remodelling and functional status but over a four year follow up, morbidity and mortality are common.

Funding Acknowledgement

Type of funding sources: None.

Analysis of a Skating Time-Trial Competition and Associated Performance-Determinants in Cross-Country Skiers

Purpose: To examine the contributions of time in different terrains and sub-technique distribution to overall time-trial performance, as well as the relationships of laboratory and field-based performance determinants in cross-country skiers. Methods: Fourteen male XC skiers were monitored during a 10 km (3 × 3.3 km) skating time-trial competition. On separate days, the skiers performed body composition assessments, laboratory tests while roller-ski skating and a 3 km uphill skating field test. Results: Time in uphill terrain was most strongly correlated with overall performance (r = 0.99, p < 0.01). G2 and G3 were the predominant sub-techniques (61% of overall time) with more use of G2 on lap three compared to lap one (p < 0.05). Body mass and lean mass were inversely correlated with overall and uphill performance (r = -0.60-0.75, all p < 0.05). VO₂ at 4 mmol·L^-1, VO_2peak and TTE while roller-ski skating in the laboratory and the 3 km uphill skating field test correlated with overall performance (r = -0.66-0.85, all p < 0.05). Conclusions: Time in uphill terrain was the main contributor to overall performance, and G3 and G2 the most used sub-techniques with increased utilization of G2 throughout the competition. VO_2peak and TTE while roller-ski skating in the laboratory and performance in an uphill skating field test had the strongest associations with time-trial performance.

Phytotoxicity of polystyrene, polyethylene and polypropylene microplastics on tomato (Lycopersicon esculentum L.)

Despite the fact that microplastic pollution in terrestrial ecosystems has received increasing attention, there are few studies on the potential effects of different microplastics on terrestrial plants. In this study, the toxicity of polystyrene (PS), polyethylene (PE) and polypropylene (PP) microplastics with different concentrations (0, 10, 100, 500 and 1000 mg/L) to tomato (Lycopersicon esculentum L.) were studied by a hydroponic experiment. The results showed that the three microplastics had inhibitory effects on seed germination when the concentration was less than or equal to 500 mg/L, and the inhibition rate ranged from 10.1% to 23.6%. Interestingly, the inhibition effect was alleviated under 1000 mg/L microplastic treatment. Generally, PE was more toxic to seedling growth than PS and PP. Additionally, it was confirmed that microplastics could cause oxidative stress in plants, and PP was relatively less toxic to antioxidant enzymes than PS and PE. These results can provide a theoretical basis and data support for further investigation on the toxicity of microplastics to tomatoes, and contribute to understanding the type specificity of microplastics' toxic effects on plants.

Effects of polyethylene and polylactic acid microplastics on plant growth and bacterial community in the soil

Microplastics (MPs), especially biodegradable MPs (BMPs) have attracted increasing attention in recent years. However, the effects of MPs with different biodegradability on the soil-plant systems are not well explored. In this study, the effects of polyethylene MPs (PEMPs) and polylactic acid MPs (PLAMPs) on physio-biochemical performance and metabolomic profile of soybean (Glycine max), as well as the bacterial communities in soil were investigated. Our results showed that PEMPs had no noticeable toxicity on the plant growth, while 0.1% PLAMPs significantly decreased the root length by 27.53% when compared with the control. The peroxidase (POD) activity was reduced and catalase (CAT) activity was increased by MPs in plant leaves. The metabolomics study suggested that the significantly affected metabolic pathway is amino acid metabolism. Additionally, Shannon and Simpson indices of rhizosphere soil were changed only under 0.1% PLAMPs. The key bacteria involved in the dinitrogen fixation were also altered. This study provides a novel insight into the potential effects of MPs with different biodegradability on soil-plant systems and highlights that BMPs might have stronger negative effects for terrestrial ecosystem, which needs to be further explored in future research.

Kochia scoparia L., a newfound candidate halophyte, for phytoremediation of cadmium-contaminated saline soils

In recent years, heavy metal pollution in saline soil is increasingly severe due to the rapid development of industry and agriculture. Halophytes can survive at higher concentrations of salt and heavy metal, which make them suitable candidates for the phytoremediation of heavy metals in saline soils. In the present study, the halophyte plant Kochia scoparia (L.) Schrad. seedlings were exposed to different doses of Cd (0, 5, 10, 30 mg/kg) and NaCl (0, 200, 400, 800 mM) to explore its tolerance and phytoremediation ability for Cd. There was no significant toxic effect of Cd on the K. scoparia seedlings. NaCl reduced the biomass of K. scoparia compared with the control, but did not show any visible toxic symptom. Furthermore, Cd accumulation in K. scoparia is mainly distributed in the shoot; especially when exposed to low-Cd (5 mg/kg) treatment, the accumulation of Cd in the shoots was up to 5.42-22.25 mg/kg, which was 3.18-53.4 times of that in the roots. Moreover, the contents of glutathione and oxalate in plants increased gradually with the increase of NaCl concentration. Under the treatment of 800 mM NaCl without Cd, the content of glutathione reached the highest 51.21 μg/g, and the proportion of oxalate reached the highest 28.76% under the treatment of 30 mg/kg Cd with 400 Mm NaCl. Finally, we also found the significant alterations of cadmium chemical forms in rhizosphere soil with the addition of NaCl. Overall, K. scoparia could be an efficient and valuable candidate for the phytoextraction of low-Cd (5 mg/kg)-contaminated saline soil.

Novel biomarkers predict ablation outcomes in long stranding persistent atrial fibrillation

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR

Background

Ablation of long-standing persistent atrial fibrillation (LSPAF) is not always successful. The arrhythmia burden was reduced by 75% by 12 months in majority (72%) of patients with LSPAF who underwent surgical or percutaneous ablation in the CASA-AF trial. We hypothesised that biomarker(s) improve prediction of clinical success and offer insights into mechanisms.

Objective

To identify biomarkers that predict success (75% arrhythmia burden reduction) after ablation for LSPAF at 12-months.

Methods

Amongst patients participating in the CASA-AF RCT (ISRCTN18250790), pre-ablation serum samples were selected for 20 patients who met criteria for ablation-success at 12 months, and 20 who did not. Olink ProteomicsTM (Sweden) provided analyses using three biomarker panels [inflammation (INFL), cardiovascular III (CVD III), and cell cytology (CELL)] each containing 92 biomarkers. Univariate and multivariable analyses were adjusted for age, sex, BMI, LA diameter and CRP. ROC analysis was undertaken to assess the diagnostic accuracy of the biomarkers. To counter the false discovery rate, Benjamini-Hochberg correction was utilised.

Results

When patients with ablation-success and -failure were compared, no differences in demographics or cardiac function were found. On univariate analysis, several biomarkers in each panel were associated with ablation-success. Multivariable analysis narrowed the range of biomarkers and identified those that were jointly predictive of outcome: INFL (MCP1 + CD8A + CD40, Figure 1), CVD III (FAS + CPB1) and CELL (GCG + ENTPD6 + IL17RB). These joint biomarkers were analysed using ROC (Figure 2), which showed that increases of biomarkers on the INFL panel (MCP1 + CD8A + CD40) were associated with a greater risk of failure and achieved the highest AUC for prediction of outcome [0.82 (0.75-0.87)].

Conclusion

The increase in the serum concentration of markers of inflammation (MCP1 + CD8A + CD40) might be used to identify patients less likely to have sustained benefit from LSPAF ablation. Further studies are required to confirm their prognostic value as pre-procedural biomarkers.

Conduction system pacing in the adult congenital population; feasibility and outcomes

Funding Acknowledgements

Type of funding sources: None.

Background

Left bundle pacing (LBP) is an evolving pacing method designed to capture the intrinsic conduction and minimise ventricular dys- synchrony. Anatomical complexity, scars of previous corrective surgeries and haemodynamic properties of adult congenital heart disease (ACHD) population could increase challenges of LBP. We describe our experience in LBP in ACHD patients and different patient groups.

Purpose

To compare the feasibility of LBP in ACHD patient population and non-ACHD patients.

Methods

We included all patients who had LBP at our institution in 2020 and 2021. Demographic data, imaging data, procedural parameters and follow up data were collected and analysed.

Results

A total of 36 patients were included and divided into two groups: ACHD (n=8, mean age, 54 years, 38% females) and non-ACHD (n=28, mean age, 74 years, 43% females). ACHD anatomy included simple lesions (4) as atrial and ventricular septal defects, partial anomalous pulmonary venous drainage, bicuspid aortic valve and Shone’s syndrome, moderate (3), as Tetralogy of Fallot with surgical repair, and complex (1), as transposition of great arteries with Mustard repair. Non-ACHD included patients with structurally normal heart, dilated cardiomyopathy, and those who underwent mitral and aortic valve interventions. Mean left ventricular ejection fraction in ACHD group was 59.5%, and 57.5% in non-ACHD. Late gadolinium enhancement in basal septal area was present in 5 patients in ACHD group. Acute success rate, defined as capture of left bundle branch, was 100% in ACHD group, and 88% in non-ACHD. No acute complications were recorded in both groups. Mean pre-procedural QRS duration was longer in ACHD group (170 ms, vs, 120, p=&lt;0.001). Mean reduction in QRS duration in ACHD group was 27 ms, vs, 15, p= 0.856. Mean procedural and fluoroscopy times were similar in both groups (ACHD, 75.5 minutes, vs, 70, p= 0.26, and ACHD, 9 minutes, vs 7.13, respectively, p= 0.46). Pacing parameters at implantation and after 2 months were satisfactory in both groups (Fig 1).

Conclusion

Left bundle pacing is feasible in ACHD population as compared to non-ACHD patients, with low incidence of complications. Procedural and fluoroscopic times were similar in both groups. Pacing parameters were satisfactory and stable over 2 month-follow up.

The acute haemodynamic response with endocardial biventricular pacing: comparing RV paced and LBBB patients

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific

Background

A third of patients that receive cardiac resynchronisation (CRT) are non-responders. Predictors of positive response include broader QRS duration, non-ischaemic aetiology and sinus rhythm, but it is still unclear whether lead placement site determines a positive responder.

Purpose

We assessed the acute haemodynamic response of endocardial biventricular pacing in patients with intrinsic left bundle brunch block (LBBB) versus LBBB due to pre-existing right ventricular pacing (RVP).

Methods

Patients who fulfilled standard criteria for CRT implantation but had failed conventional (coronary sinus) left ventricular (LV) lead placement (primary or revision) or were deemed clinical ‘non-responders after &gt; 6 months of conventional CRT were enrolled. The acute haemodynamic response during endocardial biventricular pacing was assessed with a roving LV lead at 9 different locations (basal and mid: septal, anterior, posterior and lateral walls and apex). Acute changes in beat-to-beat systolic blood pressure (SBP) in the left ventricle were recorded and analysed.

Results

We recruited 23 patients across 10 UK centres: 14 intrinsic LBBB and 9 dependent on RVP. Patient characteristics were comparable: age (mean 67 + 10.6 years vs. 62 + 15.4 years), ischaemic (63% vs 50%), QRS (160 + 18ms vs. 190 + 36ms, p =0.07). Of the RVP group 5/9 had septal RV leads (the remainder apically positioned).

There was no difference in the SBP improvement between the groups: change in SBP ranged from -5.25 – 19.91mmHg (median 3mmHg) in RVP patients vs -5.92 – 23.03mmHg (median 3mmHg) for intrinsic LBBB. However, the improvement in SBP was more consistent across the different segments in the patients with RVP (group A), as compared to intrinsic LBBB (group B), where the lateral wall and then non-septal walls provided the greatest haemodynamic improvement.

Figure 1: depicts SBP improvement (in mmHg) during endocardial biventricular pacing in different positions within the LV for patients with RVP (A) vs underlying intrinsic LBBB (B): 9 segment model of the LV: Ant (anterior wall), Lat (lateral wall), Post (posterior wall), Sept (septum). Outer ring represents the four basal LV locations, middle ring the mid LV locations and centre ring the apex. Scale depicts mmHg improvement in SBP.

Conclusion

When implanting an LV lead for patients who are RV pacing dependent any position within the LV provides an acute haemodynamic improvement, compared with those with intrinsic LBBB, where a targeted lateral wall approach is more important. This finding corroborates the key differences in LV activation patterns for induced versus intrinsic LBBB.

The Angular Distribution of Lower Band Chorus Waves Near Plasmaspheric Plumes

Plumes have been identified as an access region for chorus waves to enter the plasmasphere. Here, for the first time, chorus wave properties are parameterized by distance from the plume boundary. Case studies and statistical analysis indicate that the polar wave vector angle, θ _k , of chorus becomes more oblique near the plume edge. Occurrence rates of θ _k > 35° on the plume boundary are approximately double that observed further away from the plume. Whilst the increase in θ _k is apparent on both plume edges, the distribution of θ _k exhibits different behavior between the Eastward and Westward boundaries. In general, the distribution of azimuthal wave vector angles, ϕ _k , is symmetric about the anti-Earthwards direction. However, near the Eastward plume boundary, an Eastwards skew of ϕ _k is reported. This result provides new insight on chorus propagation in the context of the chorus-to-hiss mechanism, and has implications for quantifying wave-particle interactions in the near-plume region.

Genetic analyses of blood β-hydroxybutyrate predicted from milk infrared spectra and its association with longevity and female reproductive traits in Holstein cattle

Ketosis is one of the most prevalent and complex metabolic disorders in high-producing dairy cows and usually detected through analyses of β-hydroxybutyrate (BHB) concentration in blood. Our main objectives were to evaluate genetic parameters for blood BHB predicted based on Fourier-transform mid-infrared spectra from 5 to 305 d in milk, and estimate the genetic relationships of blood BHB with 7 reproduction traits and 6 longevity traits in Holstein cattle. Predicted blood BHB records of 11,609 Holstein cows (after quality control) were collected from 2016 to 2019 and used to derive 4 traits based on parity number, including predicted blood BHB in all parities (BHBp), parity 1 (BHB1), parity 2 (BHB2), and parity 3+ (BHB3). Single- and multitrait repeatability models were used for estimating genetic parameters for the 4 BHB traits. Random regression test-day models implemented via Bayesian inference were used to evaluate the daily genetic feature of BHB variability. In addition, genetic correlations were calculated for the 4 BHB traits with reproduction and longevity traits. The heritability estimates of BHBp, BHB1, BHB2, and BHB3 ranged from 0.100 ± 0.026 (± standard error) to 0.131 ± 0.023. The BHB in parities 1 to 3+ were highly genetically correlated and ranged from 0.788 (BHB1 and BHB2) to 0.911 (BHB1 and BHB3). The daily heritability of BHBp ranged from 0.069 to 0.195, higher for the early and lower for the later lactation periods. A similar trend was observed for BHB1, BHB2, and BHB3. There are low direct genetic correlations between BHBp and selected reproductive performance and longevity traits, which ranged from -0.168 ± 0.019 (BHBp and production life) to 0.157 ± 0.019 (BHBp and age at first calving) for the early lactation stage (5 to 65 d). These direct genetic correlations indicate that cows with higher BHBp (greater likelihood of having ketosis) in blood usually have shorter production life (-0.168 ± 0.019). Cows with higher fertility and postpartum recovery, such as younger age at first calving (0.157 ± 0.019) and shorter interval from calving to first insemination in heifer (0.111 ± 0.006), usually have lower BHB concentration in the blood. Furthermore, the direct genetic correlations change across parity and lactation stage. In general, our results suggest that selection for lower predicted BHB in early lactation could be an efficient strategy for reducing the incidence of ketosis as well as indirectly improving reproductive and longevity performance in Holstein cattle.

Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis

BACKGROUND

Treating to absolute treatment targets rather than relative measures such as Psoriasis Area and Severity Index (PASI)-75 is emerging as an important clinical concept included in psoriasis guidelines and clinical practice. Achieving treatment targets is associated with achievement of long-term outcomes.

OBJECTIVE

To evaluate the relationship between psoriasis severity, disease characteristics and achievement of PASI ≤2 with apremilast in a pooled analysis of the phase 3 ESTEEM 1 and 2 (NCT01194219 and NCT01232283), phase 3b LIBERATE (NCT01690299) and phase 4 UNVEIL (NCT02425826) clinical trials.

METHODS

Pooled data from patients with moderate-to-severe plaque psoriasis randomized to apremilast 30 mg BID were analysed by baseline PASI quartiles (Q1: 2.4-13.1; Q2: 13.2-15.9; Q3: 16.0-20.0; Q4: 20.1-57.8). Assessments included PASI, Dermatology Life Quality Index (DLQI), Scalp Physician's Global Assessment (ScPGA; ScPGA ≥1) and target (worst) Nail Psoriasis Severity Index (NAPSI; NAPSI ≥1).

RESULTS

Of 1062 patients, 963 had ScPGA ≥1 and 643 had NAPSI ≥1; 771 patients with baseline and Week 32 PASI assessments were included in analyses of Week 32 PASI target achievement. Rates of PASI ≤2 at Week 32 were greater in lower PASI quartiles (Q1: 43.5%; Q2: 31.2%; Q3: 26.8%; Q4: 18.4%). Most patients achieving PASI ≤2 target (83.6%) achieved DLQI ≤5 at Week 32; 59.3% of patients who did not achieve PASI ≤2 target achieved DLQI ≤5. At Week 32, mean improvements in ScPGA and NAPSI were similar with more moderate vs. more severe disease (ScPGA, range: 1.1-1.4; NAPSI, range: 1.6-2.5). In a subgroup analysis, achievement of PASI ≤2 target was higher in the lowest PASI quartile and with disease duration <5 years.

CONCLUSIONS

Greater achievement of PASI ≤2 was observed in patients with more moderate vs. more severe skin disease. Apremilast may be particularly beneficial in more moderate disease early in the treatment paradigm.

[Effect of body mass index on the assisted reproductive outcome of frozen-thawed embryo transfer in patients with polycystic ovary syndrome]

Objective: To investigate the effect of body mass index (BMI) on clinical pregnancy and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) during frozen-thawed embryo transfer. Methods: A total of 650 patients with PCOS who received routine in vitro fertilization or intracytoplasmic sperm injection treatment for frozen-thawed embryo transfer from June 2014 to June 2019 in Tianjin Central Hospital of Gynecology Obstetrics were retrospectively analyzed. According to BMI, PCOS patients were divided into group A (18.5≤BMI<23 kg/m², n=253), group B (23≤BMI<25 kg/m², n=167), and group C (BMI≥25 kg/m², n=230). The general information, clinical pregnancy outcomes, pregnancy complications, the incidence of macrosomia and low-birth-weight infants were compared in the three groups, and the influencing factors of neonatal birth weight were analyzed. Results: The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate all showed downward trend with the increase of BMI, but the differences were not statistically significant (all P>0.05). The live birth rate in group C [47.0% (108/230)] was significantly lower than those in groups A and B, with statistical significance (χ²=7.43, P=0.024). The late miscarriage rate was higher in group C [9.4% (13/139)] than in groups A and B (χ²=7.66, P=0.022). The birth rates of macrosomia in groups B [22.2% (16/72)] and group C [21.1% (16/76)] were significantly higher than that in group A, and the difference was statistically significant (χ²=14.15, P=0.001). There was no statistically significant difference in the incidence of gestational diabetes between the three groups (χ²=3.81, P=0.149). The incidence of hypertension disorders complicating pregnancy increased with the increase of BMI, and the difference was not statistically significant (P>0.05). Regression analysis showed that macrosomia was significantly associated with maternal pre-pregnancy BMI and gestational weeks, and the risk of macrosomia increased by 15% (95%CI: 3%-28%) for every increase in maternal BMI. Conclusions: The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of PCOS patients in frozen-thawed embryo transfer cycles show downward trend with the increase of BMI. Obese patients with PCOS have a significant increase in late miscarriage rate and a significant decrease in live birth rate. The incidence of hypertension disorders complicating pregnancy in PCOS patients in the obese group has an increasing trend, and the birth rate of macrosomia has increased significantly. Therefore, it is recommended that obese women with PCOS lose weight scientifically before pregnancy to improve pregnancy and neonatal outcomes.

Genetic parameters of hair cortisol as an indicator of chronic stress under different environments in Holstein cows

Chronic stress is a risk factor for a variety of physiological disorders because of its increased activation of the hypothalamic-pituitary-adrenal (HPA) axis; however, it is difficult to reveal environmental and genetic effects contributing to long-term HPA activity because of the complexity of chronic stress. The hair cortisol concentration (HCC) can be used to reflect the accumulation of HPA axis activity over time. Some studies suggest that the HCC might be associated with the protein concentration (PC) in the hair shaft; however, no studies have revealed a dynamic relationship between them. In the present study, 1,086 hair samples from 418 Holstein cows were collected, and the effects of environmental factors on HCC, PC, and ratio of HCC to PC (HCCP) were studied. Subsequently, regression analysis and curve fitting were used to identify for better-performing indicators of chronic stress. Additionally, univariate and bivariate genetic evaluation were used to estimate the genetic components of cortisol traits and genotype by environment interactions (G × E) under different environmental and physiological states. The results showed that HCC and PC are significantly affected by hair color, sampling year, and season, whereas HCCP is not influenced by hair color. Adjusted PC and HCCP, where confounding effects are excluded, were moderately related with chronic stress indicators. Moderate to high heritabilities were obtained for HCC (0.347 and 0.390 for winter and summer, respectively), PC (0.402 and 0.495 for winter and summer, respectively) and HCCP (0.289 and 0.460 for winter and summer, respectively) when animals in the same season were evaluated. A moderate G × E interaction was detected in this study, as indicated by the low or negative genetic correlation for the same cortisol trait in different environments (e.g. heat stress condition and thermoneutral condition). In conclusion, HCCP is not affected by hair color compared with the other 2 traits; thus, it has potential as an indicator of chronic stress. Hair cortisol traits could monitor stress response process in cattle, as well as provide a better understanding of genetic mechanism for long-term HPA activity.

Differences in hypertension and prehypertension among people living with and without HIV in China: role of HIV infection and antiretroviral therapy

OBJECTIVES

Hypertension is a growing health concern in people living with HIV (PLWH). However, association between HIV infection and hypertension is equivocal.

METHODS

In all, 1472 PLWH and 2944 HIV-negative individuals frequency-matched by age and sex were derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China. Prehypertension was defined as systolic blood pressure (BP) of 120-139 mmHg and/or diastolic blood pressure of 80-89 mmHg.

RESULTS

Despite the fact that prevalence of hypertension was overall lower among PLWH than among HIV-negative people (21.1% vs. 29.1%, P < 0.001), it was similar at ages 18-29 (7.6% vs. 8.5%) and 30-44 years (17.1% vs. 18.5%) but significantly lower in PLWH at ages 45-59 (26.1% vs. 40.7%) and 60-75 years (37.1% vs. 57.3%). Prehypertension prevalence was consistently higher in PLWH across all age groups. In the model adjusting for traditional risk factors, HIV infection was associated with hypertension (adjusted odds ratio [aOR] = 1.27, 95% confidence interval: 1.04-1.55) and prehypertension (aOR = 1.77, 95% CI: 1.51-2.08), and attenuated after additional adjustment for abdominal obesity. Age-stratified analysis showed that these associations of HIV with hypertension were observed at ages 18-29 and 30-44 years and associations with prehypertension were observed at ages 18-29, 30-44 and 45-59 years only. Years since HIV diagnosis and stavudine use were the HIV-specific factors independently associated with hypertension or/and prehypertension.

CONCLUSIONS

HIV infection is independently associated with prehypertension and hypertension especially at younger ages, and this risk may increase as treatment becomes prolonged. Our findings reinforce the urgent necessity for active BP screening and control strategies be adopted for PLWH in China.

Knowledge, Anxiety, Depression, and Sleep Quality Among Medical Staff in Central South Areas of China During the Break of COVID-19: Does the Level of Hospitals Make a Difference?

Purpose: To evaluate the knowledge, anxiety, depression, and sleep quality toward COVID-19 among Chinese medical staff from tertiary and basic-level hospitals in central south areas of China. Method: A structured questionnaire was composed of Demographic and clinical characteristics of medical staff, Knowledge toward COVID-19 including epidemiology and clinical manifestations, The Self-rating anxiety scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), and The Pittsburgh Sleep Quality Index (PSQI). It was administered to medical staff from tertiary hospitals (Group A) (n = 407) and basic-level hospitals (Group B) (n = 388) during February 2020 and May 2020. Results: Medical staff in group A had a stronger knowledge toward COVID-19 than group B (23.69 ± 5.83 & 18.15 ± 6.35, p < 0.001). Mild anxiety symptoms were found in both groups. The SAS scores (Mean ± SD) of group B were 58.87 ± 10.17, which was significantly higher than that of group A (52.59 ± 12.09, p < 0.001). There were no significant differences in CES-D scores between the two groups (p = 0.981). The mean score of total PSQI in group B (8.41 ± 3.03) was statistically higher than that of group A (7.31 ± 3.74, p < 0.001). Additionally, the scores of sub-components of group B, including subjective sleep quality, sleep latency, sleep disorder, sleeping medication use and daytime dysfunction, were significantly higher compared to Group A (p < 0.05). Conclusions: Our study showed greater anxiety, more severe depression and poorer sleep quality among medical staff in central south areas of China during the COVID-19 outbreak. Additionally, compared to the tertiary hospital group, medical staff from basic-level hospitals had poorer knowledge toward COVID-19 and worse mental health conditions. In addition, residence, specialty, title and education level may also be factors of knowledge of COVID-19 and psychiatry problems. In light of this information, more attention should be paid to early identification and intervention of symptoms of anxiety and depression in susceptible medical staff from the basic-level hospitals.

[Study on maternal-fetal status of Pb, Cd, As, Hg, Mn and Se elements and transplacental transfer efficiency]

Objective: To understand the levels of Pb, Cd, As, Hg, Mn, and Se in maternal and umbilical cord blood, and to explore the transplacental transfer efficiency (TTE). Methods: From September 2010 to December 2013, a total of 773 pregnant women and their newborns (Laizhou Bay Birth Cohort) were recruited from a second grade hospital in the south bank of Laizhou Bay, Bohai, Shandong Province. According to different detection methods, the six measured elements are classified into three groups including the Hg measurement group (595 mother-newborn pairs), the Pb measurement group (534 mother-newborn pairs), and the Cd, As, Mn and Se measurement group (244 mother-newborn pairs). The demographic characteristics of pregnant women and their newborns were obtained by the questionnaire. The concentrations of elements in maternal and umbilical cord blood were detected and the TTE of each element (elemental concentration in cord blood/elemental concentration in maternal blood) was calculated. The correlation of elements between maternal and cord blood was analyzed using Spearman's rank correlation coefficient. Results: The mean±SD of maternal age, gestational week and newborn birth weight of 773 mother-infant pairs were (28.34±4.50) years, (39.47±1.39) weeks and (3 419.47±497.39) g respectively. The median concentrations of Pb, Cd, As, Hg, Mn and As in maternal and cord blood were 31.12 and 30.02, 1.19 and 0.47, 8.05 and 6.03, 0.69 and 1.26, 100.70 and 105.55, 127.25 and 115.00 μg/L, respectively. The TTE of Pb, Cd, As, Hg, Mn, and Se was 0.98, 0.41, 0.73, 1.73, 0.96 and 0.91, respectively. Pb, Cd, Hg, Mn, and Se showed a significant positive correlation between maternal blood and cord blood, with Spearman correlation coefficients of 0.397, 0.298, 0.698, 0.555, and 0.285 (all P values<0.001). Conclusion: Each element was commonly detected in maternal blood and cord blood. The TTE of Hg was the highest.

HIV infection and electrocardiogram abnormalities: baseline assessment from the CHART cohort

OBJECTIVES

To investigate the prevalence of various electrocardiogram (ECG) abnormalities among HIV-positive and HIV-negative individuals.

METHODS

This cross-sectional evaluation included 1412 HIV-positive and 2824 HIV-negative participants aged 18 to 75 years and frequency matched by age and sex, derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China, between February and December 2017.

RESULTS

HIV-positive individuals had higher prevalence of sinus tachycardia (5.6% (79/1412) vs. 1.3% (36/2824), p < 0.001) and ST/T wave abnormalities (14.9% (211/1412) vs. 9.4% (264/1412), p < 0.001) but lower prevalence of sinus bradycardia (4.8% (68/1412) vs. 7.5% (211/2824), p 0.001); such associations remained statistically significant after adjusting for traditional risk factors (respectively, adjusted odds ratio (aOR) 4.68, 95% confidence interval (CI) 3.06-7.17; aOR 1.89, 95% CI 1.54-2.34; aOR 0.60, 95% CI 0.44-0.80). In adjusted models, being in higher carotid intima-media thickness categories was significantly associated with ST/T abnormalities in HIV-positive individuals only (0.78-1.00 mm: aOR 1.46, 95% CI 1.01-2.12; >1.00 mm: aOR 2.18, 95% CI 1.39-3.42), whereas being in higher blood pressure categories was significantly associated with both sinus tachycardia (prehypertension: aOR 5.61, 95% CI 1.76-17.91; hypertension: aOR 12.62, 95% CI 3.60-44.27) and ST/T abnormalities (hypertension: aOR 2.04, 95% CI 1.41-2.95) in HIV-negative individuals only. Longer duration of known HIV infection was the only HIV-specific factor of ST/T abnormalities (aOR 1.61, 95% CI 1.17-2.22), with none for sinus tachycardia.

CONCLUSIONS

HIV infection is independently associated with sinus tachycardia and ST/T abnormalities. Further research is needed to investigate specific mechanisms by which HIV infection leads to ECG abnormalities and to evaluate whether inclusion of ECG parameters improves cardiovascular disease prediction. Integrating ECG screening into routine HIV care is recommended in China.

[Effect of the number of previous spontaneous abortions on the first in vitro fertilization cycle]

Objective: To investigate the effect of the number of previous spontaneous abortions on the first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods: A retrospective case-control study was conducted to analyze the clinical data of 1 279 patients who received IVF/ICSI treatment for the first time from July 2014 to July 2018 in Tianjin Central Hospital of Gynecology Obstetrics;they were divided into 0 time group (group A, n=924), 1 time group (group B, n=267) and 2 times group (group C, n=88) for comparison, according to the previous frequency of spontaneous abortions. Results: There were no statistically significant differences in age, basal testosterone, estradiol, progesterone, prolactin and embryo quality in group A, B and C (all P>0.05). The biochemical pregnancy rate of group C (9.1%) was higher than those of the other two groups (4.1% and 4.1%; all P>0.05). The clinical pregnancy rate of group A (42.5%) [>group B (40.4%) and >group C (35.2%)] was not statistically significant(P>0.05).Early abortion rate in group A (8.9%) was<group B (15.7%), also <group C (38.7%), there were significant differences (all P<0.05).The live birth rate of group C (21.6%) was significantly lower than that of group A (35.5%; P<0.05), but the difference between group C and group B (30.7%) was not statistically significant (P>0.05). Conclusions: Women with a history of one- or two-time spontaneous abortion have no obvious effect on embryo quality, and have a negative impact of clinical pregnancy rate, early abortion rate, live birth rate in the first IVF/ICSI cycle; especially for patients with a history of two times spontaneous abortion, early abortion rate has a significant increase, live birth rate decreases significantly, suggesting that patients with a history of two times of spontaneous abortion should find the causes of miscarriage according to the process of recurrent spontaneous miscarriage and receive treatment if necessary before subsequent pregnancy.