Point-of-care ultrasound is a useful adjunct tool to a clinician's assessment in the evaluation of severe hyponatraemia.

INTRODUCTION: Hyponatraemia is the most common electrolyte disorder in inpatients resulting mainly from an imbalance in water homeostasis. Intravascular fluid status assessment is pivotal but is often challenging given multimorbidity, polypharmacy and diuretics use. We evaluated the utility of point-of-care ultrasound (POCUS) as an adjunct tool to standard practice for fluid assessment in severe hyponatraemia patients. METHODS: Patients presenting with severe hyponatremia (Serum Sodium [Na] < 120 mmol/L; Normal range: 135-145 mol/L), managed by standard care were included. Hyponatraemia biochemistry work-up and POCUS examination were undertaken. Both clinician and POCUS independently assigned one of the three fluid status groups of hypovolaemia, hypervolaemia or euvolaemia. The final diagnosis of three fluid status groups at admission was made at the time of discharge by retrospective case review. Clinician's (standard of care) and POCUS fluid assessments were compared to that of the final diagnosis at the time of discharge. RESULTS: n = 19 patients were included. Median Na on admission was 113 mmol/L (109-116), improved to 129 ± 3 mmol/L on discharge. POCUS showed the higher degree of agreement with the final diagnosis (84%; n = 16/19), followed by the clinician (63%; n = 12/19). A trend towards higher accuracy of POCUS compared to clinician assessment of fluid status was noted (84% vs. 63%, p = 0.1611). Biochemistry was unreliable in 58% (n = 11/19) likely due to renal failure, polypharmacy or diuretic use. Inappropriate emergency fluid management was undertaken in 37% (n = 7/19) of cases based on initial clinician assessment. Thirst symptom correlated to hypovolaemia in 80% (4/5) cases. CONCLUSION: As subjective clinical and biochemistry assessments of fluid status are often unreliable due to co-morbidities and concurrent use of medications, POCUS can be a rapid objective diagnostic tool to assess fluid status in patients with severe hyponatraemia, to guide accurate emergency fluid management.

Navigating the nexus: climate dynamics and microplastics pollution in coastal ecosystems.

Microplastics (MPs) pollution is an emerging environmental health concern, impacting soil, plants, animals, and humans through their entry into the food chain via bioaccumulation. Human activities such as improper solid waste dumping are significant sources that ultimately transport MPs into the water bodies of the coastal areas. Moreover, there is a complex interplay between the coastal climate dynamics, environmental factors, the burgeoning issue of MPs pollution and the complex web of coastal pollution. We embark on a comprehensive journey, synthesizing the latest research across multiple disciplines to provide a holistic understanding of how these inter-connected factors shape and reshape the coastal ecosystems. The comprehensive review also explores the impact of the current climatic patterns on coastal regions, the intricate pathways through which MPs can infiltrate marine environments, and the cascading effects of coastal pollution on ecosystems and human societies in terms of health and socio-economic impacts in coastal regions. The novelty of this review concludes the changes in climate patterns have crucial effects on coastal regions, proceeding MPs as more prevalent, deteriorating coastal ecosystems, and hastening the transfer of MPs. The continuous rising sea levels, ocean acidification, and strong storms result in habitat loss, decline in biodiversity, and economic repercussion. Feedback mechanisms intensify pollution effects, underlying the urgent demand for environmental conservation contribution. In addition, the complex interaction between human, industry, and biodiversity demanding cutting edge strategies, innovative approaches such as remote sensing with artificial intelligence for monitoring, biobased remediation techniques, global cooperation in governance, policies to lessen the negative socioeconomic and environmental effects of coastal pollution.

Actas Pink-2B dye removal in biochar nanocomposites augmented vertical flow constructed wetland (VF-CWs).

Industries generate hazardous dye wastewater, posing significant threats to public health and the environment. Removing dyes before discharge is crucial. The ongoing study primarily focused on synthesizing, applying, and understanding the mechanism of green nano-biochar composites. These composites, including zinc oxide/biochar, copper oxide/biochar, magnesium oxide/biochar, and manganese oxide/biochar, are designed to effectively remove Actas Pink-2B (Direct Red-31) in conjunction with constructed wetlands. Constructed wetland maintained pH 6.0-7.9. At the 10th week, the copper oxide/biochar treatment demonstrated the highest removal efficiency of total suspended solids (72%), dissolved oxygen (7.2 mg/L), and total dissolved solids (79.90%), followed by other biochar composites. The maximum removal efficiency for chemical oxygen demand (COD) and color was observed at a retention time of 60 days. The electrical conductivity also followed the same order, with a decrease observed up to the 8th week before becoming constant. A comprehensive statistical analysis was conducted, encompassing various techniques including variance analysis, regression analysis, correlation analysis, and principal component analysis. The rate of color and COD removal followed a second-order and first-order kinetics, respectively. A significant negative relationship was observed between dissolved oxygen and COD. The study indicates that employing biochar composites in constructed wetlands improves textile dye removal efficiency.

The novelty of this study is the selection of Cymbopogon as a proper plant for phytoremediation of dye along with green metal oxide coated biochar. These were selected due to their good ability to remove organic pollutant. This study demonstrates the uptake and degradation processes of persistent dye in constructed wetland.

Occurrence of toxic elements in river areas along drains and groundwater resources: source of contamination and associated health risk.

The objective of the current research was to examine the water quality of the River Ravi and the River Sutlej, with a specific focus on potentially toxic elements (PTEs). Additionally, we sought to monitor the sources of pollution in these rivers by gathering samples from the primary drains that carry industrial and municipal waste into these water bodies. Furthermore, we aimed to evaluate the impact of PTEs in surface water on groundwater quality by collecting groundwater samples from nearby populated areas. A total of 30 samples were collected from these three sources: rivers (6 samples), drains (9 samples), and groundwater (15 samples). The analysis revealed that the levels of PTEs in the samples from these three resources having a mean value: arsenic (As) 23.5 µg/L, zinc (Zn) 2.35 mg/L, manganese (Mn) 0.51 mg/L, lead (Pb) 6.63 µg/L, and chromium (Cr) 10.9 µg/L, exceeded the recommended values set by the World Health Organization (WHO). Furthermore, PTEs including (As 84%), (Zn 65%), (Mn 69%), (Pb 53%), (Cr 53%), and (Ni 27%), samples were beyond the recommended values of WHO. The results of the Principal Component Analysis indicated that surface water and groundwater exhibited total variability of 83.87% and 85.97%, respectively. This indicates that the aquifers in the study area have been contaminated due to both natural geogenic factors and anthropogenic sources. These sources include the discharge of industrial effluents, wastewater from municipal sources, mining activities, agricultural practices, weathering of rocks, and interactions between rocks and water. Spatial distribution maps clearly illustrated the widespread mobilization of PTEs throughout the study area. Furthermore, a health risk assessment was conducted to evaluate the potential adverse health effects of PTEs through the ingestion of drinking groundwater by both children and adults. Health risk assessment result show the mean carcinogenic values for As, Cr, Pb and Ni in children are calculated to be (1.88E-04), (2.61E-04), (2.16E-02), and (5.74E-05), respectively. Similarly, the mean carcinogenic values for the above mentioned PTEs in adults were recorded to be (2.39E-05), (3.32E-05), (1.19E-03), and (7.29E-06) respectively. The total hazard index values for As, Zn, Cr, Pb, Mn, Cu, and Ni in children were observed to be (9.07E + 00), (9.95E-07), (4.59E-04), (5.75E-04), (4.72E-05), (2.78E-03), and (5.27E-05) respectively. The analysis revealed that As has an adverse effect on the population of the study area as compared to other PTEs investigated in this study.

Multi-drug resistance pattern of bacterial isolates from urinary tract infection.

In the community and among hospitalized patients, urinary tract infections (UTIs) rank as the most common bacterial infections. The researchers processed urine samples obtained from affiliated hospitals of Peshawar Medical College. The samples were examined under a microscope to assess the presence of bacteria, pus cells and red blood cells. Following this, the samples were inoculated on MacConkey and blood agar and subsequent antibiotic susceptibility testing was conducted. The findings revealed that 35.9% of hospitalized patients and 16.9% of outpatients were diagnosed with UTIs. Furthermore, 82.2% of the identified UTIs were found to be multidrug-resistant (MDR), with MDR Escherichia coli accounting for 77% of cases. Trimethoprim sulfamethazine (26.8%), penicillin (0%), cefepime (27.8%), cefotaxime (23.7%), aztreonam (2.1%), meropenem (86.6%), ciprofloxacin (51.5%), amoxicillin/clavulanic acid (37.1%), nitrofurantoin (70.1%), gentamycin (73%), ceftazidime (19.5%), levofloxacin (51.5%) and ceftriaxone (25.77%) were subjected to antibiotic susceptibility testing. It is concerning that among the 13 antibiotics examined, solely nitrofurantoin displayed oral efficacy as an effective treatment choice for UTIs.

Biliary cancer: gateway to comprehensive molecular profiling.

Cholangiocarcinoma is a rare malignancy with a poor prognosis. The majority of tumors present at an advanced stage, and relapse often occurs after surgery conducted with curative intent. In both of these cases, standard treatment is a combination of cisplatin and gemcitabine. The use of folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) in second-line treatment improves survival, but outcomes remain dismal. Studies have shown that cholangiocarcinoma possesses a wide spectrum of genetic aberrations. Clinical trials evaluating targeted therapies in patients with FGFR2 fusions, IDH1 mutations, and BRAF mutations have yielded very promising results, and the agents were generally well tolerated. Several FGFR2 fusion-targeted agents have achieved response rates between 20.7% and 35.5%, with disease stability rates ranging between 76% and 82%. Agents targeting FGFR2 fusions also have produced median progression-free survival (PFS) ranging from 5.7 to 6.9 months and median overall survival (OS) ranging from 12.5 to 21.1 months. Ivosidenib in patients with an IDH1/2 mutation has produced a response rate of 2% and a disease stability rate of 51%, with median PFS of 2.7 months and median OS of 10.8 months. In patients with a BRAF mutation, a combination of dabrafenib and trametinib led to an overall response rate of 51% and disease stability in another 40% of patients. Median PFS and OS were 9 and 14 months, respectively. Patients should be encouraged to participate in clinical trials.

Statistical analysis of forecasting COVID-19 for upcoming month in Pakistan.

In this paper, we have conducted analysis based on data obtained from National Institute of Health (NIH) - Islamabad and produced a forecast of COVID-19 confirmed cases as well as the number of deaths and recoveries in Pakistan using the Auto-Regressive Integrated Moving Average Model (ARIMA). The fitted forecasting models revealed high exponential growth in the number of confirmed cases, deaths and recoveries in Pakistan. Based on our model prediction the number of confirmed cases will be increased by 2.7 times, 95% prediction interval for the number of cases at the end of May 2020 = (5681 to 33079). There could be up to 500 deaths, 95% prediction interval = (168 to 885) and there could be eightfold increase in the number of recoveries, 95% prediction interval = (2391 to 16126). The forecasting results of COVID-19 are alarming for May in Pakistan. The health officials and government should adopt new strategies to control the pandemic from further spread until a proper treatment or vaccine is developed.

Patients' perspectives on dialysis decision-making and end-of-life care
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BACKGROUND: Few studies have explored dialysis patients' perspectives on dialysis decision-making and end-of-life-care (EoLC) preferences. We surveyed a racially diverse cohort of maintenance dialysis patients in the Cleveland, OH, USA, metropolitan area. MATERIALS AND METHODS: In this cross-sectional study, we administered a 41-item questionnaire to 450 adult chronic dialysis patients. Items assessed patients' knowledge of their kidney disease as well as their attitudes toward chronic kidney disease (CKD) treatment issues and EoLC issues. RESULTS: The cohort included 67% Blacks, 27% Caucasians, 2.8% Hispanics, and 2.4% others. The response rate was 94% (423/450). Most patients considered it essential to obtain detailed information about their medical condition (80.6%) and prognosis (78.3%). Nearly 19% of respondents regretted their decision to start dialysis. 41% of patients would prefer treatment(s) aimed at relieving pain rather than prolonging life (30.5%), but a majority would want to be resuscitated (55.3%). Only 8.4% reported having a designated healthcare proxy, and 35.7% reported completing a living will. A significant percentage of patients wished to discuss their quality of life (71%), psychosocial and spiritual concerns (50.4%), and end-of-life issues (38%) with their nephrologist. CONCLUSION: Most dialysis patients wish to have more frequent discussions about their disease, prognosis, and EoLC planning. Findings from this study can inform the design of future interventions.
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Preliminary Work Towards Finding Proteins as Potential Vaccine Candidates for Vibrio cholerae Pakistani Isolates through Reverse Vaccinology.

Background and Objective: Vibrio cholerae continues to emerge as a dangerous pathogen because of increasing resistance to a number of antibiotics. This paper provides a solution to emerging antibiotic resistance by introducing novel proteins as vaccine candidates against cholera. Materials and Methods: Vibrio cholerae genome versatility is a hurdle for developing a vaccine to combat diarrhoeal infection, so its core gene information was used to determine a potential vaccine candidate. Whole genome sequence data of more than 100 Vibrio cholerae strains were used simultaneously to get core genome information. The VacSol pipeline based on reverse vaccinology was selected to address the problem of safe, cheap, temperature-stable, and effective vaccine candidates which can be used for vaccine development against Vibrio cholerae. VacSol screens vaccine candidates using integrated, well-known, and robust algorithms/tools for proteome analysis. The proteomes of the pathogens were initially screened to predict homology using BLASTp. Proteomes that are non-homologous to humans are then subjected to a predictor for localization. Helicer predicts transmembrane helices for the protein. Proteins failing to comply with the set parameters were filtered at each step, and finally, 11 proteins were filtered as vaccine candidates. Results: This selected group of vaccine candidates consists of proteins from almost all structural parts of Vibrio cholerae. Their blast results show that this filtered group includes flagellin A protein, a protein from the Zn transporter system, a lipocarrier outer membrane protein, a peptidoglycan-associated protein, a DNA-binding protein, a chemotaxis protein, a tRNA Pseuriudine synthase A, and two selected proteins, which were beta lactamases. The last two uncharacterized proteins possess 100% similarity to V. albensis and Enterobacter, respectively. Tertiary structure and active site determination show a large number of pockets on each protein. Conclusions: The most interesting finding of this study is that 10 proteins out of 11 filtered proteins are introduced as novel potential vaccine candidates. These novel vaccine candidates can result in the development of cost-effective and broad-spectrum vaccines which can be used in countries where cholera is a major contributor to diarrheal disease.

Galectin-3 Levels Are Elevated and Predictive of Mortality in Pulmonary Hypertension.

BACKGROUND: Galectin-3, a novel binding-lectin involved in inflammation and fibrosis, is elevated in heart failure and is independently predictive of mortality in this condition. We sought to evaluate galectin-3 levels and its prognostic value in patients with pulmonary hypertension (PH), a known inflammatory state, in the setting of pulmonary arterial hypertension (PAH) and in heart failure with preserved ejection fraction-associated PH (HFpEF-PH). METHODS: We measured galectin-3 levels in 76 patients with PH; 37 patients with PAH and 39 patients with HFpEF-PH. Baseline characteristics, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels were assessed. Univariate and multivariate analyses were used to assess the prognostic value of galectin-3. RESULTS: Median (IQR) galectin-3 (ng/mL) for the entire cohort was 24.65 (IQR=10.39, 32.90); 22.33 (IQR=18.94, 27.30) and 28.94 (IQR=21.67, 39.85) in the PAH and HFpEF-PH, respectively (p=0.07). After evaluation of the galectin-3 levels by tertile, mortality rates were 16% (4/25), 34.6% (9/26), and 48% (12/25) in tertiles 1-3, respectively, and Kaplan-Meier analysis revealed a significant increase in mortality across increasing galectin-3 tertiles (log-rank p=0.014). On Cox regression analysis, galectin-3 was a strong predictor of mortality on both univariate HR=2.09 per tertile (95% CI=1.21, 3.62 per tertile; p-trend=0.008) and multivariate analysis HR=2.19 per tertile (95% CI=1.06, 4.54; p-trend=0.035) after adjusting for age, sex, race, glomerular filtration rate (eGFR), NT-proBNP, medications, and aetiology of PH (PAH vs. HFpEF-PH). CONCLUSION: Galectin-3 is a strong, independent prognostic marker in PH, regardless of aetiology. Larger studies should further evaluate the role of galectin-3 as a prognostic biomarker and possible therapeutic target in PH.

Antiarrhythmic Drug Therapy for Atrial Fibrillation.

Atrial fibrillation (AF) is the most frequently encountered arrhythmia. Prevalence increases with advancing age and so as its associated comorbidities, like heart failure. Choice of pharmacologic therapy depends on whether the goal of treatment is maintaining sinus rhythm or tolerating AF with adequate control of ventricular rates. Antiarrhythmic therapy and conversion of AF into sinus rhythm comes with the side effect profile, and we should select best antiarrhythmic therapy, individualized to the patient. New antiarrhythmic drugs are being tested in clinical trials. Drugs that target remodeling and inflammation are being tested for their use as prevention of AF or as upstream therapy.

Tirzepatide: A novel cardiovascular protective agent in type 2 diabetes mellitus and obesity.

Cardiovascular disease (CVD) remains a major global health concern, and obesity and diabetes mellitus have been found to be important risk factors. Tirzepatide a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP1) receptor agonist has been shown to have cardioprotective effects. Noteworthy benefits of Tirzepatide include decreased cardiovascular risk factors in people with Type 2 diabetes mellitus (T2DM). In the SURPASS-4 trial, tirzepatide significant decreased blood pressure, body weight, and HbA1c. Furthermore, the SURMOUNT-1 trial demonstrated the effectiveness of tirzepatide in reducing cardiometabolic risk factors in people with obesity without T2DM. Together, the dual receptor agonism improves lipid profiles, increases insulin secretion, reduces inflammation, and promotes endothelial integrity. Tirzepatide shows promise as a comprehensive therapeutic option for managing cardiovascular risk factors in patients with T2DM and obesity. While further studies are needed to assess the long-term cardiovascular benefits, current evidence supports tirzepatide's potential impact on cardiovascular health beyond its antidiabetic properties.

Temporal and regional trends in adults with diabetics kidney disease in the US from 1999 to 2020.

AIMS: We aim to analyze trends in mortality rates among adults with diabetic kidney disease (DKD) in the US from 1999 to 2020. METHODS: We queried the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database for mortality statistics from 1999 to 2020 associated with DKD in adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) were calculated and trends were analyzed using the Joinpoint Regression Program. RESULTS: From 1999 to 2020, a total of 528,430 deaths were reported among adults with DKD. The mortality rates increased over time with males consistently exhibiting higher AAMR than females. NH American Indian or Alaska Native individuals had the highest AAMR, followed by NH Blacks, Hispanics, NH Whites, and NH Asians. The West region had the highest AAMR, followed by the Midwest, South, and Northeast. Rural regions had higher AAMR than urban areas, and mortality rates increased with age. CONCLUSIONS: This study reveals notable disparities in DKD mortality rates across demographic groups and geographic regions. NH American Indians or Alaska Natives, males, elderly individuals, rural residents, and those in the West region were disproportionately affected. Understanding these trends is crucial for developing targeted interventions to reduce DKD-related mortality and address healthcare disparities.

Trends and social aspects in the management and conversion of agricultural residues into valuable resources: A comprehensive approach to counter environmental degradation, food security, and climate change.

The circular economy is essential as it encourages the reuse and recycling of resources while reducing waste, which ultimately helps to reduce environmental pollution and boosts economic efficiency. The current review highlights the management of agricultural and livestock residues and their conversion into valuable resources to combat environmental degradation and improve social well-being. The current trends in converting agricultural residues into useful resources emphasize the social benefits of waste management and conversion. It also emphasizes how waste conversion can reduce environmental degradation and enhance food security. Using agricultural residues can increase soil health and agricultural output while reducing pollution, greenhouse gas emissions, and resource depletion. Promoting sustainable waste-to-resource conversion processes requires a combination of strategies that address technical, economic, social, and environmental aspects. These multiple strategies are highlighted along with prospects and considerations.

Exploring zeolite-based composites in adsorption and photocatalysis for toxic wastewater treatment: Preparation, mechanisms, and future perspectives.

Water scarcity has become a critical global concern exacerbated by population growth, globalization, and industrial expansion, resulting in the production of wastewater containing a wide array of contaminants. Tackling this challenge necessitates the adoption of innovative materials and technologies for effective wastewater treatment. This review article provides a comprehensive exploration of the preparation, applications, mechanisms, and economic environmental analysis of zeolite-based composites in wastewater treatment. Zeolite, renowned for its versatility and porous nature, is of paramount importance due to its exceptional properties, including high surface area, ion exchange capability, and adsorption capacity. Various synthetic methods for zeolite-based composites are discussed. The utilization of zeolites in wastewater treatment, particularly in adsorption and photocatalysis, is thoroughly investigated. The significance of zeolite in adsorption and its role in the photocatalytic degradation of pollutants are examined, along with its applications in treating volatile organic compounds (VOCs), dye wastewater, oil-field wastewater, and radioactive waste. Mechanisms underlying zeolite-based adsorption and photocatalysis, including physical and chemical adsorption, ion exchange, and surface modification, are elucidated. Additionally, the role of micropores in the adsorption process is explored. Furthermore, the review delves into regeneration and desorption studies of zeolite-based composites, crucial for sustainable wastewater treatment practices. Economic and environmental analyses are conducted to assess the feasibility and sustainability of employing zeolite-based composites in wastewater treatment applications. Future recommendations are provided to guide further research and development in the field of zeolite-based composites, aiming to enhance wastewater treatment efficiency and environmental sustainability. By exploring the latest advancements and insights into zeolite-based nanocomposites, this paper aims to contribute to the development of more efficient and sustainable wastewater treatment strategies. The integration of zeolite-based materials in wastewater treatment processes shows promise for mitigating water pollution and addressing water scarcity challenges, ultimately contributing to environmental preservation and public health protection.

Total Soil CO2 Efflux from Drained Terric Histosols.

Histosols cover about 8-10% of Lithuania's territory and most of this area is covered with nutrient-rich organic soils (Terric Histosols). Greenhouse gas (GHG) emissions from drained Histosols contribute more than 25% of emissions from the Land Use, Land Use Change and Forestry (LULUCF) sector. In this study, as the first step of examining the carbon dioxide (CO2) fluxes in these soils, total soil CO2 efflux and several environmental parameters (temperature of air and topsoil, soil chemical composition, soil moisture, and water table level) were measured in drained Terric Histosols under three native forest stands and perennial grasslands in the growing seasons of 2020 and 2021. The drained nutrient-rich organic soils differed in terms of concentrations of soil organic carbon and total nitrogen, as well as soil organic carbon and total nitrogen ratio. The highest rate of total soil CO2 efflux was found in the summer months. Overall, the rate was statistically significant and strongly correlated only with soil and air temperature. A trend emerged that total soil CO2 efflux was 30% higher in perennial grassland than in forested land. Additional work is still needed to estimate the net CO2 balance of these soils.

Characterization of Root and Foliar-Applied Iron Oxide Nanoparticles (α-Fe2O3, γ-Fe2O3, Fe3O4, and Bulk Fe3O4) in Improving Maize (Zea mays L.) Performance.

Iron (Fe) oxide nanoparticles (NPs) improve crop growth. However, the comparative effect of root and foliar-applied different sources of Fe oxide NPs on plant performance at morphological and physiological levels still needs to be discovered. In this study, we characterized the growth and physiological responses of hydroponic-cultured maize seedlings to four sources of Fe (i.e., α-Fe2O3, γ-Fe2O3, Fe3O4 NPs, and bulk Fe3O4) and two application methods (root vs. foliar). Results showed that Fe concentration in root and shoot increased by elevating the level of NPs from 100 mg L-1 to 500 mg L-1. Overall, the responses of maize seedlings to different sources of Fe oxide NPs were as follows: Fe3O4 > γ-Fe2O3 > α-Fe2O3 > bulk Fe3O4. The application of Fe at concentrations ranging from 100 mg L-1 to 500 mg L-1 had no significant effects on various growth parameters of maize, including biomass, chlorophyll content, and root length. Iron oxide NPs increased the plant biomass by 23-37% by root application, whereas it was 5-9% by foliar application. Chlorophyll contents were increased by 29-34% and 18-22% by foliar and root applications, respectively. The non-significant response of reactive oxygen species (i.e., superoxide dismutase, catalase, and peroxidase) suggested optimum maize performance for supplementing Fe oxide NPs. A confocal laser scanning microscope suggested that Fe oxide NPs entered through the epidermis and from the cortex to the endodermis. Our results provide a scientific basis that the root application of Fe3O4 at the rate of 100 mg L-1 is a promising approach to obtain higher maize performance and reduce the quantity of fertilizer used in agriculture to minimize environmental effects while improving crop productivity and quality. These findings demonstrated the tremendous potential of Fe NPs as an environmentally friendly and sustainable crop approach.

Seasonal linkages between soil nitrogen mineralization and the microbial community in broadleaf forests with Moso bamboo (Phyllostachys edulis) invasion.

Plant invasions significantly alter the microbiome of the soil in terms of fungal and bacterial communities, which in turn regulates ecosystem processes and nutrient dynamics. However, it is unclear how soil microbial communities, nitrogen (N) mineralization, and their linkages respond to plant invasions over the growing season in forest ecosystems. The present study investigated the seasonal associations between the microbial composition/function and net N mineralization in evergreen broadleaf, mixed bamboo-broadleaf, and Moso bamboo (Phyllostachys edulis) forests, depicting uninvaded, moderately invaded, and heavily invaded forests, respectively. The ammonification and nitrification rates in the bamboo forest were significantly higher than those in the broadleaf and mixed bamboo-broadleaf forests during the spring season only. The forest type and seasonal variation significantly influenced the net rates of ammonification and nitrification and the abundances of bacterial apr and AOB amoA, fungal cbhI and lcc genes, as well as the microbial composition. Moreover, the partial least squares path model revealed that bamboo invasion enhanced net ammonification through increasing total N and fungal-to-bacterial ratio, and enhanced net nitrification through modifying the bacterial composition and increasing the fungal-to-bacterial ratio during spring. However, microbial parameters had no significant effect on net ammonification and nitrification during autumn. We conclude that shifts in the microbial abundance and composition following bamboo invasion facilitated soil N mineralization during spring, contributing to the rapid growth of Moso bamboo at the beginning of the growth season and its invasion into adjacent subtropical forests.

Aortic Root Abscess Presenting As Chest Pain and Ischemic EKG Changes: Importance of Timely Diagnosis.

The occurrence of perivalvular abscess, a purulent infection that affects the myocardium and endocardium of natural or artificial valve tissues, can result from either the spread of bacteria from a distant source via bacteremia, or from the expansion of an existing infectious cardiac focus, such as infective endocarditis (IE). The aortic abscess should be suspected in patients with infective endocarditis who fail to improve despite being on appropriate antibiotics. Sometimes aortic abscesses can present as PR interval lengthening or heart block due to the extension of infection. We present an atypical presentation of aortic root abscess with chest pain and ischemic EKG changes. A 45-year-old intravenous drug user presented with chest pain episodes with EKG showing ST depression in V2-V6 and ST elevation in avR. The coronary angiographic study showed no significant coronary artery disease, but the patient complained of chest pain. Transthoracic echo in the catheterization lab showed severe aortic regurgitation. The patient became hemodynamically unstable, worsened his respiratory status, and had to be intubated. He had a bedside transesophageal echo that revealed an aortic root abscess. The patient's condition continued deteriorating, and he passed away the same day. This case focuses on the timely diagnosis of aortic root abscess, and Transesophageal echocardiography (TEE) is the gold standard for diagnosing aortic root abscesses. This case also focuses on keeping perivalvular abscess among our differentials in a patient presenting with chest pain and abnormal EKG, especially in a high-risk population.

Investigating the Complications and Causes of Failure of the AngioVac System: A Post-Marketing Surveillance From the MAUDE Database.

Background Aspiration thrombectomy devices, such as the AngioVac, allow the removal of thrombus, especially in patients with contraindications to anticoagulation use. The AngioVac was approved by the U.S. Food and Drug Administration to remove fresh, soft thrombi or emboli during extracorporeal bypass for up to six hours. Real-world data on the most common modes of failure and complications associated with the AngioVac are unavailable. Methods The Manufacturer and User Facility Device Experience database was queried for reports of the AngioVac device failure and adverse events from April 2013 to March 2022. Categorical variables were described as numbers, and all statistical calculations were performed with IBM SPSS Statistics, version 27.0 (IBM Corp., Armonk, NY). Results A total of 115 events were reported during the study period. After the exclusion of duplicate reports, the final cohort included 93 reports. The most common mode of failure for the AngioVac was physical damage of the device, with 13 reports (14%). The most common vessels associated with events were the superior vena cava and inferior vena cava, occurring in 23 reports (24.7%). The most common adverse clinical events were pulmonary embolism (PE), occurring in 33 reports (35.5%), and perforation, occurring in 16 reports (17.2%). Other less frequent adverse outcomes were arrhythmias, stroke, and foreign body device embedment. There were 45 deaths reported with the use of the AngioVac. Conclusions Aspiration thrombectomy devices provide promising efficacy; however, physicians should be aware of known adverse outcomes, even if they are infrequent. Based on this analysis, PE and vessel perforation were the most common adverse outcomes. Furthermore, the most common mode of failure was secondary to physical damage of the device.