Is mild dehydration a risk for progression of childhood chronic kidney disease?

Children with chronic kidney disease (CKD) can have an inherent vulnerability to dehydration. Younger children are unable to freely access water, and CKD aetiology and stage can associate with reduced kidney concentrating capacity, which can also impact risk. This article aims to review the risk factors and consequences of mild dehydration and underhydration in CKD, with a particular focus on evidence for risk of CKD progression. We discuss that assessment of dehydration in the CKD population is more challenging than in the healthy population, thus complicating the definition of adequate hydration and clinical research in this field. We review pathophysiologic studies that suggest mild dehydration and underhydration may cause hyperfiltration injury and impact renal function, with arginine vasopressin as a key mediator. Randomised controlled trials in adults have not shown an impact of improved hydration in CKD outcomes, but more vulnerable populations with baseline low fluid intake or poor kidney concentrating capacity need to be studied. There is little published data on the frequency of dehydration, and risk of complications, acute or chronic, in children with CKD. Despite conflicting evidence and the need for more research, we propose that paediatric CKD management should routinely include an assessment of individual dehydration risk along with a treatment plan, and we provide a framework that could be used in outpatient settings.

Force Production Measurements During a Supine Medicine Ball Throw: a Reliability and Correlation Study.

OBJECTIVES: This study aimed to examine the reliability of supine medicine ball throw peak force and rate of force development (RFD) measurements. A secondary aim was to investigate the correlations between these measurements and vertical jump height. METHODS: Twenty young women (21±3 years) reported for experimental testing on two different occasions. Supine medicine ball throw assessments were performed during each testing session to assess peak force, RFDmax, and RFD at specific percentages of peak force (RFD30% and RFD40-80%). Vertical jumps were performed on a jump mat. The jump mat measured vertical jump height based on flight time. RESULTS: Good intraclass correlation coefficients (≥0.82) and coefficients of variation (≤14.0%) were observed between sessions for peak force, RFDmax, and RFD40-80%, but not for RFD30% (0.55, 27.2%). There were significant correlations between jump height and peak force (r=0.483, P=0.031), RFDmax (r=0.484, P=0.031), and RFD40-80% (r=0.491, P=0.028). There was no significant correlation between jump height and RFD30% (r=0.359, P=0.120). CONCLUSIONS: Our results showed that supine medicine ball throw peak force, RFDmax, and RFD40-80% were reliable measures for assessing upper-body explosive strength in young adults. These measurements were significantly associated with vertical jump height and therefore, may be effective predictors of one's athletic ability.

Spinal Versus General Anesthesia for Outpatient Total Hip and Knee Arthroplasty in the Ambulatory Surgery Center: A Matched-Cohort Study.

BACKGROUND: Spinal anesthesia is the predominant regimen in outpatient total joint arthroplasty (TJA), but induction often is unsuccessful, unobtainable, or against patient preference. We compared outcomes of same-day discharge (SDD) TJA with spinal versus general anesthesia in a free-standing ambulatory surgery center (ASC). METHODS: We took 105 general anesthesia TJA and one-to-one nearest-neighbor matched them to 105 spinal anesthesia TJA over 7 years at 1 ASC. The rate of successful SDD, minutes to discharge, postoperative pain and nausea, and 90-day complications were compared. Postanesthesia care unit outcomes were additionally stratified by spinal anesthetic (mepivacaine versus bupivacaine). RESULTS: All spinal anesthetic patients underwent SDD compared with 103 (98%) general anesthetic patients (P = .498). Mepivacaine spinal anesthesia patients spent the fewest minutes in postanesthesia care unit prior to discharge from the facility (206), followed by general anesthesia (227), and bupivacaine spinal anesthesia (291; P < .001). General anesthesia patients had the highest levels of pain at 1 hour (5.2 versus 1.5 versus 1.5) and 2 hours (3.2 versus 2.0 versus 1.3) postoperatively, and rates of nausea (48 versus 22 versus 28%) compared with mepivacaine and bupivacaine spinal anesthesia, respectively. The 90-day complications (6 versus 7), admissions (1 versus 3), and reoperations (5 versus 2) were similar among spinal and general anesthesia, respectively (P ≥ .445). CONCLUSIONS: Both spinal and general anesthesia led to reliable SDD with similar 90-day complication rates. General anesthesia facilitated faster discharge from the ASC compared with bupivacaine spinal anesthesia but led to higher levels of pain and incidence of nausea postoperatively. LEVEL OF EVIDENCE: Level 3, Retrospective Cohort Comparison.

Total water intake guidelines are sufficient for optimal hydration in United States adults.

PURPOSE: Recent studies suggest that 24-h urine osmolality (UOsm) for optimal water intake should be maintained < 500 mmol·kg-1. The purpose of this study was to determine the total water intake (TWI) requirement for healthy adults to maintain optimal hydration as indicated by 24-h urine osmolality < 500 mmol·kg-1. METHODS: Twenty-four-hour UOsm was assessed in 49 men and 50 women residing in the United States (age: 41 ± 14 y, body mass index: 26.3 ± 5.2 kg·m-2). TWI was assessed from 7-day water turnover, using a dilution of deuterium oxide, corrected for metabolic water production. The diagnostic accuracy of TWI to identify UOsm < 500 mmol·kg-1 was evaluated using receiver operating characteristic (ROC) analysis in men and women separately. RESULTS: Twenty-four-hour UOsm was 482 ± 229 and 346 ± 182 mmol·kg-1 and TWI was 3.57 ± 1.10 L·d-1 and 3.20 ± 1.27 L·d-1 in men and women, respectively. ROC analysis for TWI detecting 24-h UOsm < 500 mmol·kg-1 in men yielded an area under the curve (AUC) of 77.4% with sensitivity, specificity, and threshold values of 83.3%, 64.5%, and 3.39 L·d-1, respectively. The AUC was 82.4% in women with sensitivity, specificity, and threshold values of 85.7%, 72.1%, and 2.61 L·d-1. CONCLUSION: Considering threshold values in men and women of 3.4 L·d-1 and 2.6 L·d-1, respectively, maintaining TWI in line with National Academy of Medicine guidelines of 3.7 L·d-1 in men and 2.7 L·d-1 in women should be sufficient for most individuals in the United States to maintain 24-h UOsm < 500 mmol·kg-1.

Effect of treatment adherence on the association between sex and unfavourable treatment outcomes among tuberculosis patients in Puducherry, India: a mediation analysis.

BACKGROUND: A better understanding of the complex interplay between risk factors of tuberculosis (TB) is essential. This study was part of the Regional Prospective Observational Research for Tuberculosis (RePORT) India consortium and includes newly diagnosed TB patients in Puducherry between 2014 and 2018. We employed mediation analysis to identify the effect of treatment adherence on association between sex and unfavourable TB treatment outcomes. METHODS: Required demographic and treatment-related variables were extracted from the RePORT India consortium database and causal mediation analysis using parametric regression models was done. RESULTS: Of the 712 TB patients, ~87 (12.2%) had unfavourable TB treatment outcomes. Total effect of male sex was significantly associated with the unfavourable TB treatment outcomes [adjusted odds ratio (aOR) = 2.48; 95% confidence interval (CI): 1.11-5.55]. However, the overall association between male sex and TB treatment outcomes was dominated by the indirect pathway, as the direct pathway does not show significant association (aOR = 1.67; 95% CI: 0.75-3.75), while the indirect pathway shows significantly higher odds of TB treatment outcomes (aOR = 1.48; 95% CI:1.27-1.73), indicating complete mediation by the treatment adherence. CONCLUSIONS: The study has shown a complete mediation of sexes through TB treatment adherence for unfavourable treatment outcomes. Developing of treatment strategies require better understanding between the biological and social factors related to TB.

Towards a heuristic understanding of the storage effect.

The storage effect is a general explanation for coexistence in a variable environment. Unfortunately, the storage effect is poorly understood, in part because the generality of the storage effect precludes an interpretation that is simultaneously simple, intuitive and correct. Here, we explicate the storage effect by dividing one of its key conditions-covariance between environment and competition-into two pieces, namely that there must be a strong causal relationship between environment and competition, and that the effects of the environment do not change too quickly. This finer-grained definition can explain a number of previous results, including (1) that the storage effect promotes annual plant coexistence when the germination rate fluctuates, but not when the seed yield fluctuates, (2) that the storage effect is more likely to be induced by resource competition than the apparent competition, and (3) why the storage effect arises readily in models with either stage structure or environmental autocorrelation. Additionally, our expanded definition suggests two novel mechanisms by which the temporal storage effect can arise-transgenerational plasticity and causal chains of environmental variables-thus suggesting that the storage effect is a more common phenomenon than previously thought.

An explanation for unexpected population crashes in a constant environment.

Unexpected population crashes are an important feature of natural systems, yet many observed crashes have not been explained. Two difficulties in explaining population crashes are their relative rarity and the multi-causal nature of ecological systems. We approach this issue with experimental microcosms, with large numbers of replicates of red flour beetle populations (Tribolium castaneum). We determined that population crashes are caused by an interaction between stochasticity and successive episodes of density dependence: demographic stochasticity in oviposition rates occasionally produces a high density of eggs; so high that there are insufficient flour resources for subsequent larvae. This mechanism can explain unexpected population crashes in more general settings: stochasticity 'pushes' population into a regime where density dependence is severely overcompensatory. The interaction between nonlinearity and stochasticity also produces chaotic population dynamics and a double-humped one-generation population map, suggesting further possibilities for unexpected behaviour in a range of systems. We discuss the generality of our proposed mechanism, which could potentially account for previously inexplicable population crashes.

Long-Term Effectiveness of the TIME Intervention to Improve Diabetes Outcomes in Low-Income Settings: a 2-Year Follow-Up.

BACKGROUND: We previously found that a 6-month multidimensional diabetes program, TIME (Telehealth-Supported, Integrated Community Health Workers, Medication-Access) resulted in improved clinical outcomes. OBJECTIVE: To follow TIME participant clinical outcomes for 24 months PARTICIPANTS: Low-income Latino(a)s with type 2 diabetes DESIGN AND INTERVENTION: We collected post-intervention clinical data for five cohorts (n = 101, mean n = 20/cohort) who participated in TIME programs from 2018 to 2020 in Houston, Texas. MAIN MEASURES: We gathered HbA1c (primary outcome), weight, body mass index (BMI), and blood pressure data at baseline, 6 months (intervention end), and semiannually thereafter until 24 months after baseline to assess sustainability. We also evaluated participant loss to follow-up until 24 months. KEY RESULTS: Participants decreased HbA1c levels during the intervention (p < 0.0001) and maintained these improvements at each timepoint from baseline to 24 months (p range: < 0.0001 to 0.015). Participants reduced blood pressure levels during TIME and maintained these changes at each timepoint from baseline until 18 months (systolic p range < 0.0001 to 0.0005, diastolic p range: < 0.0001 to 0.008) but not at 24 months (systolic: p = 0.065; diastolic: p = 0.85). There were no significant weight changes during TIME or post-intervention: weight (p range = 0.07 to 0.77), BMI (p range = 0.11 to 0.71). Attrition rates (loss to follow-up during the post-intervention period) were 5.9% (6 months), 24.8% (12 months), 35.6% (18 months), and 41.8% (24 months). CONCLUSIONS: It is possible for vulnerable populations to maintain long-term glycemic and blood pressure improvements using a multiple dimensional intervention. Attrition rates rose over time but show promise given the majority of post-intervention timepoints occurred during the COVID-19 pandemic when low-income populations were most susceptible to suboptimal healthcare access. Future studies are needed to evaluate longitudinal outcomes of diabetes interventions conducted by local clinics rather than research teams.

Early Physiological Plant Response and Systemic Effects of Huanglongbing Infection in Split-Root Plants.

Huanglongbing (HLB), caused by 'Candidatus Liberibacter asiaticus' (CLas), is a devastating disease of citrus. After initial infection, CLas quickly colonizes the root system before canopy symptoms develop. There is limited understanding of CLas movement from roots to canopy and local and systemic effects on root dynamics. Using split-root rhizoboxes and late summer below-the-split bud inoculation, effects of local infection on systemic disease development were studied. Upward bacterial movement from roots is linked to seasonal flushes and CLas population in roots. CLas stayed isolated to one side of the roots for at least 8 months, until the spring flush. HLB caused differential root responses depending on tree age at infection. Systemic effects, independent of CLas movement, occur very early after infection. Stimulation of root growth occurred on noninfected roots prior to CLas detection in 1.5-year-old trees but decreased in 2.5-year-old trees. Independent of tree age, root growth was stimulated during spring root flushes after CLas population stabilized. Root dieback began simultaneously with detection of CLas in roots (6 weeks postinoculation). Infection and tree age altered root lifespan. In total, 1.5-year-old CLas-infected roots from summer and fall flushes had 3 and 6 weeks reduced lifespan. In contrast, 2.5-year-old CLas-infected plants lifespan was unaffected. Season affected root lifespan with late summer root flush lifespan was three times shorter than fall or spring root flushes. Split-root inoculation allowed study of local and systemic effects of CLas infection in roots, information crucial to prolonging the productivity of HLB-affected trees.

Assessment of the Effect of Thermotherapy on 'Candidatus Liberibacter asiaticus' Viability in Woody Tissue of Citrus via Graft-Based Assays and RNA Assays.

In 2019, citrus production in Florida declined by more than 70%, mostly because of Huanglongbing (HLB), which is caused by the bacterium 'Candidatus Liberibacter asiaticus' (CLas). Thermotherapy for HLB-affected trees was proposed as a short-term management solution to maintain field productivity. It was hypothesized that thermotherapy could eliminate HLB from affected branches; therefore, the study objectives were to show which time-temperature combinations eliminated CLas from woody tissues. Hardening, rounded Valencia twigs collected from HLB-affected field trees were treated in a steam chamber at different time-temperature combinations (50°C for 60 s; 55°C for 0, 30, 60, 90, and 120 s; 60°C for 30 s; and an untreated control). Three independent repetitions of 13 branches per treatment were grafted onto healthy rootstocks and tested to detect CLas after 6, 9, and 12 months. For the RNA-based CLas viability assay, three branches per treatment were treated and bark samples were peeled for RNA extraction and subsequent gene expression analyses. During the grafting study, at 12 months after grafting, a very low frequency of trees grafted with twigs treated at 55°C for 90 s and 55°C for 120 s had detectable CLas DNA. In the few individuals with CLas, titers were significantly lower (P ≤ 0.0001) and could have been remnants of degrading DNA. Additionally, there was a significant decrease (P ≤ 0.0001) in CLas 16S rRNA expression at 55°C for 90 s, 55°C for 120 s, and 60°C for 30 s (3.4-fold change, 3.4-fold change, and 2.3-fold change, respectively) in samples 5 days after treatment. Heat injury, not total CLas kill, could explain the limited changes in transcriptional activity; however, failed recovery and eventual death of CLas resulted in no CLas detection in most of the grafted trees treated with the highest temperatures or longest durations.

The Effect of Stirrup Length on Impact Attenuation and Its Association With Muscle Strength.

ABSTRACT: Keener, MM, Critchley, ML, Layer, JS, Johnson, EC, Barrett, SF, and Dai, B. The effect of stirrup length on impact attenuation and its association with muscle strength. J Strength Cond Res 35(11): 3056-3062, 2021-Horseback-riders have a high prevalence of low back injuries, which may be related to the repetitive low back impacts experienced in riding. The purposes of this study were to quantify the effect of 3 stirrup lengths and 2 riding styles on the peak acceleration experienced by the rider and the association between the peak acceleration and the rider's different elements of muscle strength. Thirteen female riders performed a sitting or rising trot at each of the 3 stirrup lengths (2-point length, mid-seat length, or dressage length), while the acceleration of the tibia, sacrum, seventh cervical vertebra (C7), and head were collected. Subjects completed a push-up, a vertical jump, and 4 core exercises to assess upper-body strength, lower-body strength, and core endurance, respectively. Peak acceleration of the sacrum, C7, and head were generally lower in the standing phase of the rising trot compared with the sitting phase of either the sitting or rising trot, particularly at the shortest stirrup length. Peak acceleration of the sacrum, C7, and head decreased as the stirrup length was shortened in the standing phase of the rising trot. Canonical correlations showed nonsignificant correlations between strength measurements and peak acceleration. Riding with more weight supported through the legs with a short stirrup length may decrease low back impacts and their associated injury risk. Technique training is likely needed to encourage riders to use lower-body and core strength for impact attenuation.

Zinkicide Is a ZnO-Based Nanoformulation with Bactericidal Activity against Liberibacter crescens in Batch Cultures and in Microfluidic Chambers Simulating Plant Vascular Systems.

Phloem-limited bacterial "Candidatus Liberibacter" species are associated with incurable plant diseases worldwide. Antimicrobial treatments for these pathogens are challenging due to the difficulty of reaching the vascular tissue they occupy at bactericidal concentrations. Here, in vitro antimicrobial mechanisms of Zinkicide TMN110 (ZnK), a nonphytotoxic zinc oxide (ZnO)-based nanoformulation, were compared to those of bulk ZnO (b-ZnO) using as a model the only culturable species of the genus, Liberibacter crescens Minimum bactericidal concentration (MBC) determination and time-kill assays showed that ZnK has a bactericidal effect against L. crescens, whereas b-ZnO is bacteriostatic. When ZnK was used at the MBC (150 ppm), its antimicrobial mechanisms included an increase in Zn solubility, generation of intracellular reactive oxygen species, lipid peroxidation, and cell membrane disruption; all of these were of greater intensity than those of b-ZnO. Inhibition of biofilms, which are important during insect vector colonization, was stronger by ZnK than by b-ZnO at concentrations between 2.5 and 10 ppm in batch cultures; however, neither ZnK nor b-ZnO removed L. crescens preformed biofilms when applied between 100 and 400 ppm. In microfluidic chambers simulating source-to-sink phloem movement, ZnK significantly outperformed b-ZnO in Zn mobilization and bactericidal activity against L. crescens planktonic cells in sink reservoirs. In microfluidic chamber assays assessing antibiofilm activity, ZnK displayed a significantly enhanced bactericidal activity against L. crescens individual attached cells as well as preformed biofilms compared to that of b-ZnO. The superior mobility and antimicrobial activity of ZnK in microenvironments make this formulation a promising product to control plant diseases caused by "Candidatus Liberibacter" species and other plant vascular pathogens.IMPORTANCE "Candidatus Liberibacter" species are associated with incurable plant diseases that have caused billions of dollars of losses for United States and world agriculture. Chemical control of these pathogens is complicated, because their life cycle combines intracellular vascular stages in plant hosts with transmission by highly mobile insect vectors. To date, "Candidatus Liberibacter" species are mostly unculturable, except for Liberibacter crescens, a member of the genus that has been used as a model for in vitro assays. Here, we evaluated the potential of Zinkicide (ZnK) as an antimicrobial against "Candidatus Liberibacter" species in batch cultures and under flow conditions, using L. crescens as a biological model. ZnK displayed bactericidal activity against L. crescens in batch cultures and showed increased mobility and bactericidal activity in microfluidic devices resembling "Candidatus Liberibacter" species natural habitats. ZnK performance observed here against L. crescens makes this compound a promising candidate to control plant diseases caused by vascular pathogens.

Urinary markers of hydration during 3-day water restriction and graded rehydration.

PURPOSE: This investigation had three purposes: (a) to evaluate changes in hydration biomarkers in response to a graded rehydration intervention (GRHI) following 3 days of water restriction (WR), (b) assess within-day variation in urine concentrations, and (c) quantify the volume of fluid needed to return to euhydration as demonstrated by change in Ucol. METHODS: 115 adult males and females were observed during 1 week of habitual fluid intake, 3 days of fluid restriction (1000 mL day-1), and a fourth day in which the sample was randomized into five different GRHI groups: no additional water, CON; additional 500 mL, G+0.50; additional 1000 mL, G+1.00; additional 1500 mL, G+1.50; additional 2250 mL, G+2.25. All urine was collected on 1 day of the baseline week, during the final 2 days of the WR, and during the day of GRHI, and evaluated for urine osmolality, color, and specific gravity. RESULTS: Following the GRHI, only G+1.50 and G+2.25 resulted in all urinary values being significantly different from CON. The mean volume of water increase was significantly greater for those whose Ucol changed from > 4 to < 4 (+ 1435 ± 812 mL) than those whose Ucol remained ≥ 4 (+ 667 ± 722 mL, p < 0.001). CONCLUSIONS: An additional 500 mL of water is not sufficient, while approximately 1500 mL of additional water (for a total intake between 2990 and 3515 mL day-1) is required to return to a urine color associated with adequate water intake, following 3 days of WR.

Examining the links between hydration knowledge, attitudes and behavior.

PURPOSE: This study aimed to examine the psychological factors (knowledge, barriers and facilitators) that can contribute to hydration-related behaviors (i.e., fluid intake) in the general population and how these relate to physical health. METHODS: A structured survey was developed to examine the links between hydration knowledge (29 items), attitudes about hydration (80 items), and fluid intake behavior (8 items) among US adults. Survey data from Phase 1 (n =301, US adults) psychometrically evaluated the items via item analysis (knowledge and fluid behavior) and factor analysis (attitudes). Phase 2 survey data (n =389, US adults and college students) refined and validated the new 16-item hydration knowledge measure, 4-item fluid intake behavior index, and 18-item attitude measure (barriers and facilitators of hydration-related behaviors) alongside indices of physical health (BMI and exercise behaviors). RESULTS: Participants had a moderate level of hydration knowledge (Phase 1: 10.91 ± 3.10; Phase 2: 10.87 ± 2.47). A five-factor measure of attitudes which assessed both facilitators (social pressure and attention to monitoring) and barriers (lack of effort, physical barriers and lack of a fluid container) to hydration demonstrated strong internal consistency (αs from 0.75 to 0.90). Attitudes about hydration-most notably barriers to hydration-were associated with indicators of health and with fluid intake behaviors, whereas hydration knowledge was not. CONCLUSIONS: Increasing hydration knowledge may be necessary for people who hold inaccurate information about hydration, but attitudes about hydration are likely to have a larger impact on fluid intake behaviors and health-related outcomes.

Phytophthora nicotianae Infection of Citrus Leaves and Host Defense Activation Compared to Root Infection.

Currently, little is known about the host pathogen interaction between Phytophthora spp. and citrus roots versus leaves. Therefore, we compared the molecular events occurring in citrus roots and leaves after zoospore inoculation with Phytophthora nicotianae. We analyzed the physical characteristics and genetic responses to P. nicotianae infection of leaves and roots for susceptible and tolerant citrus rootstocks to examine the potential for leaves to model root responses to P. nicotianae infection. Leaves responded faster and stronger to P. nicotianae infection than roots, and leaves showed greater differential response than roots. In addition to differences in hormonal responses, sugar, phospholipase D (PLD), and phospholipase A (PLA) involvement in the interaction between citrus and P. nicotianae was identified. This work, for the first time, creates a solid P. nicotianae zoospore infection protocol, reports P. nicotianae infection on citrus leaves through stomata, and provides evidence that different host organs respond to the pathogen differentially in timing and magnitude. This work identifies the hormones, sugars, pathogenesis-related genes, PLDs, and PLAs that are involved in the molecular events occurring in citrus under infection of P. nicotianae zoospore, and advances our understanding of the mechanisms underlying the interaction.

Effects of a 14-Day Hydration Intervention on Individuals with Habitually Low Fluid Intake.

BACKGROUND: Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [1]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [2]. In a small (n = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [3]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. OBJECTIVES: Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. METHODS: In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D2O) was administered to measure TBW. Urine samples were collected immediately prior, and 3-8 h after the D2O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. RESULTS: Twenty-four-hour urine osmolality decreased (-438.7 ± 362.1 mOsm; p < 0.001) and urine volume increased (1,526 ± 869 mL; p < 0.001) in the experimental group from baseline, while there were no differences in osmolality (-74.7 ± 572 mOsm; p = 0.45), or urine volume (-32 ± 1,376 mL; p = 0.89) in the control group. However, there were no changes in BV (Fig. 1a) or changes in TBW (Fig. 1b) in either group. CONCLUSIONS: Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [2] to 4 weeks [3] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.

Association of Copeptin, a Surrogate Marker of Arginine Vasopressin, with Decreased Kidney Function in Sugarcane Workers in Guatemala.

BACKGROUND: Vasopressin is elevated in response to heat and dehydration and has been postulated to have a role in the chronic kidney disease of unknown origin being observed in Central America. The aims of this study were to examine whether the vasopressin pathway, as measured by copeptin, is associated with the presence of kidney dysfunction, and to examine whether higher fluid intake is associated with lower circulating copeptin and thereby preserves kidney health among sugarcane workers exposed to hot conditions. METHODS: Utilizing a longitudinal study of 105 workers in Guatemala, we examined relationships between hydration indices, plasma copeptin concentrations, and kidney function markers at 3 times during the 6-month harvest. We also examined whether baseline copeptin concentrations increased the odds of developing an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Copeptin concentrations were positively associated with serum creatinine (ß 1.41, 95% CI 0.88-2.03) and negatively associated with eGFR (ß -1.07, 95% CI -1.43 to -0.70). In addition, as workers improved their hydration (measured by increases in fluid balance), copeptin concentrations were reduced, and this reduction was associated with an improvement in kidney function. CONCLUSIONS: Results suggest that copeptin should be studied as a potential prognostic biomarker.

A realism-based approach to an ontological representation of symbiotic interactions.

BACKGROUND: The symbiotic interactions that occur between humans and organisms in our environment have a tremendous impact on our health. Recently, there has been a surge in interest in understanding the complex relationships between the microbiome and human health and host immunity against microbial pathogens, among other things. To collect and manage data about these interactions and their complexity, scientists will need ontologies that represent symbiotic interactions as they occur in reality. METHODS: We began with two papers that reviewed the usage of 'symbiosis' and related terms in the biology and ecology literature and prominent textbooks. We then analyzed several prominent standard terminologies and ontologies that contain representations of symbiotic interactions, to determine if they appropriately defined 'symbiosis' and related terms according to current scientific usage as identified by the review papers. In the process, we identified several subtypes of symbiotic interactions, as well as the characteristics that differentiate them, which we used to propose textual and axiomatic definitions for each subtype of interaction. To both illustrate how to use the ontological representations and definitions we created and provide additional quality assurance on key definitions, we carried out a referent tracking analysis and representation of three scenarios involving symbiotic interactions among organisms. RESULTS: We found one definition of 'symbiosis' in an existing ontology that was consistent with the vast preponderance of scientific usage in biology and ecology. However, that ontology changed its definition during the course of our work, and discussions are ongoing. We present a new definition that we have proposed. We also define 34 subtypes of symbiosis. Our referent tracking analysis showed that it is necessary to define symbiotic interactions at the level of the individual, rather than at the species level, due to the complex nature in which organisms can go from participating in one type of symbiosis with one organism to participating in another type of symbiosis with a different organism. CONCLUSION: As a result of our efforts here, we have developed a robust representation of symbiotic interactions using a realism-based approach, which fills a gap in existing biomedical ontologies.

Educational Intervention Changes College Students' Attitudes toward Prescription Opioid Drug Use.

Background: More than 47,000 people in the United States died from opioid drug overdoses in 2017. Among college students, opioid drugs are the second most abused drug. Objective: This study aimed to examine if an educational intervention impacted college students' attitudes towards prescription opioid drugs (POD). Methods: Two hundred forty-two participants (72 males, 21 ± 3 years) from an American university participated. After collecting demographic data (questionnaire 1; Q1), investigators recited a narrative in which the protagonist was injured and prescribed POD. Next, participants rated their agreement on 10 Likert prompts and two visual analog scales (VAS) before (Q2) and after (Q3) an educational intervention, then noted (Q4) which topics were most or least influential in any changed responses. Results: 7/10 Likert prompts (all p < 0.002) and both VAS (both p < 0.001) changed between Q2 and Q3. Educational intervention topics related to risk were most influential and topics related to alternative therapies were least influential. Conclusion/Importance: Educational interventions may be beneficial for college students. Any interventions that are employed should focus on risks associated with POD use.

Translational genomics using Arabidopsis as a model enables the characterization of pennycress genes through forward and reverse genetics.

Thlaspi arvense (pennycress) has the potential for domestication as a new oilseed crop. Information from an extensive body of research on the related plant species Arabidopsis can be used to greatly speed this process. Genome-scale comparisons in this paper documented that pennycress and Arabidopsis share similar gene duplication. This finding led to the hypothesis that it should be possible to isolate Arabidopsis-like mutants in pennycress. This proved to be true, as forward genetic screens identified floral and vegetative pennycress mutants that were similar to mutants found in Arabidopsis. Extending this approach, it was shown that most of the pennycress genes responsible for the formation of oxidized tannins could be rapidly identified. The causative mutations in the pennycress mutants could be identified either by PCR amplification of candidate genes or through whole-genome sequencing (WGS) analysis. In all, WGS was used to characterize 95 ethyl methane sulfonate mutants, which revealed a mutation rate of 4.09 mutations per megabase. A sufficient number of non-synonymous mutations were identified to create a mutant gene index that could be used for reverse genetic approaches to identify pennycress mutants of interest. As proof of concept, a Ta-max3-like dwarf mutant and Ta-kcs5/cer60-like wax mutants deficient in the biosynthesis of long chain fatty acids were identified. Overall, these studies demonstrate that translational genomics can be used to promote the domestication of pennycress. Furthermore, the ease with which important findings could be made in pennycress makes this species a new potential model plant.