Inorganic carbon is overlooked in global soil carbon research: A bibliometric analysis.

Soils are a major player in the global carbon (C) cycle and climate change by functioning as a sink or a source of atmospheric carbon dioxide (CO2). The largest terrestrial C reservoir in soils comprises two main pools: organic (SOC) and inorganic C (SIC), each having distinct fates and functions but with a large disparity in global research attention. This study quantified global soil C research trends and the proportional focus on SOC and SIC pools based on a bibliometric analysis and raise the importance of SIC pools fully underrepresented in research, applications, and modeling. Studies on soil C pools started in 1905 and has produced over 47,000 publications (>1.7 million citations). Although the global C stocks down to 2 m depth are nearly the same for SOC and SIC, the research has dominantly examined SOC (>96 % of publications and citations) with a minimal share on SIC (<4%). Approximately 40 % of the soil C research was related to climate change. Despite poor coverage and publications, the climate change-related research impact (citations per document) of SIC studies was higher than that of SOC. Mineral associated organic carbon, machine learning, soil health, and biochar were the recent top trend topics for SOC research (2020-2023), whereas digital soil mapping, soil properties, soil acidification, and calcite were recent top trend topics for SIC. SOC research was contributed by 151 countries compared to 88 for SIC. As assessed by publications, soil C research was mainly concentrated in a few countries, with only 9 countries accounting for 70 % of the research. China and the USA were the major producers (45 %), collaborators (37 %), and funders of soil C research. SIC is a long-lived soil C pool with a turnover rate (leaching and recrystallization) of more than 1000 years in natural ecosystems, but intensive agricultural practices have accelerated SIC losses, making SIC an important player in global C cycle and climate change. The lack of attention and investment towards SIC research could jeopardize the ongoing efforts to mitigate climate change impacts to meet the 1.5-2.0 °C targets under the Paris Climate Agreement of 2015. This bibliographic study calls to expand the research focus on SIC and including SIC fluxes in C budgets and models, without which the representation of the global C cycle is incomplete.

Safety-net hospitals versus non-safety centers and clinical outcomes after trans-catheter aortic valve replacement.

OBJECTIVE: To compare post-procedural outcomes of trans-catheter valve replacement (TAVR) among safety-net (SNH) and non-safety net hospitals (non-SNH). BACKGROUND: SNH treat a large population of un-insured and low income patients; prior studies report worse outcome at these centers. Results of TAVR at these centers is limited. METHODS: Adults undergoing TAVR at hospitals in the US participating in the National In-patient sample (NIS) database from January 2014 to December 2015 were included. A 1:1 propensity-matched cohort of patients operated at SNH and non-SNH institutions was analyzed, on the basis of 16 demographic and clinical co-variates. Main outcome was all-cause post-procedural mortality. Secondary outcomes included stroke, acute kidney injury and length of post-operative stay. RESULTS: Between 2014 and 2015, 41,410 patients (mean age 80 ± 0.11 years, 46% female) underwent TAVR at 731 centers; 6,996 (16.80%) procedures were performed at SNH comprising 135/731 (18.4%) of all centers performing TAVR. SNH patients were more likely to be female (49% vs. 46%, p < .001); admitted emergently (31% vs. 21%; p < .001; at the lowest quartile for household income (25% % vs. 20%; p < .001) and from minorities (Blacks 5.9% vs. 3.9%; Hispanic 7.2% vs. 3.2%).Adjusted logistic regression was performed on 6,995 propensity-matched patient pairs. Post-procedural mortality [OR 0.99(0.98-1.007); p = .43], stroke [OR 1.009(0.99-1.02); p = .08], acute kidney injury [OR 0.99(0.96-1.01); p = .5] and overall length of stay (6.9 ± 0.1 vs. 7.1 ± 0.2 days; p = .57) were comparable in both cohorts. CONCLUSION: Post-procedural outcomes after TAVR at SNH are comparable to national outcomes and wider adoption of TAVR at SNH may not adversely influence outcomes.

Facts to acidification-induced carbonate losses from Chinese croplands.

This letter explains the processes and mechanisms involved in the nitrogen-induced soil acidification causing substantial carbonate losses and subsequent CO2 emissions from Chinese croplands.

Dramatic loss of inorganic carbon by nitrogen-induced soil acidification in Chinese croplands.

Intensive crop production systems worldwide, particularly in China, rely heavily on nitrogen (N) fertilization, but left more than 50% of fertilizer N in the environment. Nitrogen (over) fertilization and atmospheric N deposition induce soil acidification, which is neutralized by soil inorganic carbon (SIC; carbonates), and carbon dioxide (CO2 ) is released to the atmosphere. For the first time, the loss of SIC stocks in response to N-induced soil acidification was estimated for Chinese croplands from 1980 to 2020 and forecasts were made up to 2100. The SIC stocks in croplands in 1980 were 2.16 Pg C (16.3 Mg C/ha) in the upper 40 cm, 7% (0.15 Pg C; 1.1 Mg C/ha) of which were lost from 1980 to 2020. During these 40 years, 7 million ha of cropland has become carbonate free. Another 37% of the SIC stocks may be lost up to 2100 in China, leaving 30 million ha of cropland (37.8%) without carbonates if N fertilization follows the business-as-usual (BAU) scenario. Compared to the BAU scenario, the reduction in N input by 15%-30% after 2020 (scenarios S1 and S2) will decrease carbonate dissolution by 18%-41%. If N input remains constant as noted in 2020 (S3) or decreases by 1% annually (S4), a reduction of up to 52%-67% in carbonate dissolution is expected compared to the BAU scenario. The presence of CaCO3 in the soil is important for various processes including acidity buffering, aggregate formation and stabilization, organic matter stabilization, microbial and enzyme activities, nutrient cycling and availability, and water permeability and plant productivity. Therefore, optimizing N fertilization and improving N-use efficiency are important for decreasing SIC losses from acidification. N application should be strictly calculated based on crop demand, and any overfertilization should be avoided to prevent environmental problems and soil fertility decline associated with CaCO3 losses.

Do soil property variations affect dicyandiamide efficiency in inhibiting nitrification and minimizing carbon dioxide emissions?

Nitrification inhibitors (NIs) are used to retard the nitrification process and reduce nitrogen (N) losses. However, the effects of soil properties on NI efficacy are less clear. Moreover, the direct and indirect effects of soil property variations on NI efficiency in minimizing carbon dioxide (CO2) emissions have not been previously studied. An incubation experiment was conducted for 40 days with two treatments, N (200 mg N-urea kg-1) and N + dicyandiamide (DCD) (20 mg DCD kg-1), and a control group (without the N) to investigate the response of ammonia-oxidizing bacteria (AOB) and archaea (AOA) to DCD application and the consequences for CO2, nitrous oxide (N2O) and ammonia (NH3) emissions from six soils from the Loess Plateau with different properties. The nitrification process completed within 6-18 days for the N treatment and within 30->40 days for the N + DCD treatment. AOB increased significantly with N fertilizer application, while this effect was inhibited in soils when DCD was applied. AOA was not sensitive to N fertilizer and DCD application. The nitrification rate was positively correlated with the clay (p < 0.05) and SOM contents (p < 0.01); DCD was more effective in loam soil with low SOM and high soil pH. Soil pH significantly was decreased with N fertilizer application, while it increased when DCD was applied. Moreover, DCD application decreased CO2 emissions from soils by 22%-172%; CO2 emissions were negatively correlated with the clay and SOM contents. DCD application decreased N2O emissions in each soil by 1.0- to 94-fold compared with those after N fertilizer application. In contrast, DCD application increased NH3 release from soils by 59-278%. NH3 volatilization was negatively correlated with clay (p < 0.05) and SOM (p < 0.01) contents and positively correlated with soil pH (p < 0.01). Therefore, soil texture, SOM and soil pH have significant effects on the DCD performance, nitrification process and gaseous emissions.

How much nitrogen does Africa need to feed itself by 2050?

Nitrogen (N) fertilizers are very important for global food self-sufficiency (FSS), particularly for Africa, where the N input in agriculture is very low. This is the first work which studies and calculates the amount of N fertilizer that each country in Africa needs to feed itself by 2050. In this study, we used five different scenarios of inorganic fertilizer N (IFN) use and human diets to calculate the amount of N fertilizer needed to achieve FSS in Africa by 2050 and analyze the changes in N budget; N losses and N use efficiency (NUE). These scenarios include 1) business as usual (BAU), 2) equitable diet (EqD; self-sufficiency), 3) an IFN input 20% less than the EqD (S1), 4) an IFN input 40% less than the EqD (S2), and 5) a 20% increase in IFN input relative to the EqD (S3). Under the BAU scenario, production trends continue as they have over the past five decades, including an unhealthy human diet. In the EqD scenario, the priority is to meet the local demand for both animal and plant proteins with a healthy human diet. Under the EqD scenario, increasing the total N input from 35 kg N ha-1 yr-1 to 181 kg N ha-1 yr-1 during 2016-2050 is needed to achieve FSS in Africa. This increase in N fertilizer use represents unprecedented N inputs to African terrestrial ecosystems - at least 52 Tg N yr-1 - which would lead to inevitable increases in N losses. We also found that the NUE would decrease from 63% during 2010-2016 to 50% by 2050, whereas the total N surplus would increase from 13 kg N ha-1 yr-1 to 90 kg N ha-1 yr-1 by 2050. The estimated gaseous emissions would increase from 8 kg N ha-1 yr-1 to 61 kg N ha-1 yr-1 by 2050. Our findings conclude that, it is very important to consider the high N losses in Africa if the EqD scenario is applied. The S1 and S2 scenarios result in much less environmental N loss, and better NUE compared with the EqD scenario. Therefore, based on these findings we can recommend the implementation of the S2 scenario with an IFN dose of 77 kg N ha-1 yr-1, in parallel with the use of modern agricultural techniques and the increased use of organic inputs.

Can secondary metabolites extracted from Moringa seeds suppress ammonia oxidizers to increase nitrogen use efficiency and reduce nitrate contamination in potato tubers?

Nitrification inhibition as an alleviation tool to decrease nitrogen (N) losses and increase N use efficiency (NUE) as well as reducing NO3- accumulation in plants is a promising technology. No study thus far has directly or indirectly to use the secondary metabolites extracted from Moringa (Moringa oleifera Lam) seeds as nitrification inhibitors. Moringa seed extract (MSE) was studied based on its content of phenolic compounds (PC) and for its antioxidant characteristic. A 2-year field experiment and 30-day incubation experiment were conducted with three treatments of control (CK), N fertilizer (300 kg N ha-1 and 200 mg N kg-1 soil for the field and incubation experiment, respectively), and N fertilizer with MSE (500 ppm as a TPC) to investigate the responses of ammonia-oxidizing bacteria (AOB) and archaea (AOA) to MSE and the consequences for NUE and NO3- accumulation in potato tubers. Total phenolics amount was 144 mg gallic acid equivalent g-1 MSE, while flavonoid contents were 76.6 quercetin equivalent g-1 MSE. MSE showed antioxidant activity that was comparable to the standard antioxidants TBHQ and gallic acid. MSE application with N fertilizer retarded the nitrification process, as indicated by a higher NH4+-N and lower NO3--N content, compared with N fertilizer application alone. NH4+-N content reduced to initial CK level on Day 20 under N fertilizer application alone. However, NH4+-N content decreased to initial control level on Day 30 when MSE was applied. The mechanisms resulted from curbing AOB growth by phenolic compounds (TPC, TF, TAC), leading to a delay in nitrification process. AOB increased significantly when N fertilizer was applied alone; on the contrary, AOA was not sensitive to N fertilizer (with and without MSE). Increase in NUE from 37.5% to 66.3% in potato plants under MSE application with N fertilizer was also observed compared with N fertilizer application alone. The highest NO3- accumulation (569 mg NO3- kg-1) in tubers was recorded under N fertilizer application without MSE. MSE application significantly decreased NO3- accumulation (92 mg NO3- kg-1) in tubers which is lower than the maximum value of accepting tubers (200 mg NO3- kg-1). The highest average of N uptake, fresh and dry weight, carotenoids, chlorophyll a, chlorophyll b and nitrate reductase activity was recorded when MSE was applied with N fertilizer. Accordingly, using of Moringa extracted secondary metabolites to suppress AOB growth in the soil is a significant strategy to reduce nitrification rate and N loss from soils, and therefore increase NUE as well as reducing NO3- accumulation in potato tubers.

Risk Calculator to Predict 30-Day Readmission After Coronary Artery Bypass: A Strategic Decision Support Tool.

BACKGROUND: Re-admission is an important source of patient dissatisfaction and increased hospital costs. A simple calculator to determine the probability of re-admission may help guide patient dismissal planning. METHODS: Using the national readmissions database (NRD), we identified admissions for isolated primary coronary artery bypass (CABG) and stratified them according to 30-day readmission. Including pre, intra and postoperative variables, we prepared a logistic regression model to determine the probability for re-admission. The model was tested for reliability with boot-strapping and 10-fold cross-validation. RESULTS: From 135,699 procedures, 19,355 were readmitted at least once within 30days of dismissal. Patients who were readmitted were older (67±10 vs 65 ± 10 years, p<0.01), females (32% vs 24%; p<0.01) and had a higher Elixhauser comorbidity score (1.5±1.4 vs 1.1±1.2; p<0.01). Our final model (c- statistic=0.65) consisted of 16 pre and three postoperative factors. End-stage renal disease (OR 1.79 [1.57-2.04]) and length of stay>9days (OR 1.60 [1.52-1.68]) were most prominent indicators for readmission. Compared to Medicaid beneficiaries, those with private insurance (OR 0.62 [0.57-0.68]) and Medicare (OR 0.85 [0.79-0.92]) coverage were less likely to be readmitted. CONCLUSIONS: Our simple 30-days CABG readmission calculator can be used as a strategic tool to help reduce readmissions after coronary artery bypass surgery.

Safety and benefits of new techniques and technologies in less invasive mitral valve repair.

OBJECTIVE: To assess the safety and benefits of new techniques and technologies such as single-dose (del Nido) cardioplegia and suture fasteners (COR-KNOT) in patients undergoing mini-thoracotomy for degenerative mitral valve repair (MVR). METHODS: From 2009 to 2016, 252 patients underwent primary isolated degenerative MVR by mini-thoracotomy by a single surgeon. Del Nido cardioplegia was used in 153 patients (61%) and COR-KNOT in 168 (67%). Patient outcomes were compared using propensity-matching separately for del Nido versus Buckberg cardioplegia and COR-KNOT versus knot-pusher. RESULTS: There were no operative deaths and 99.2% of the patients had none/trivial mitral regurgitation at discharge. In patients receiving del Nido or Buckberg cardioplegia, occurrence of adverse events was similar. However, aortic cross clamp (AoCC; 54.2 ± 15.7 vs 64 ± 15.8 min; P < 0.0001) and operative room (OR; 308 ± 42.1 vs 336 ± 63 min; P < 0.001) times were shorter with del Nido cardioplegia. In patients receiving COR-KNOT versus knot-pusher, occurrence of adverse events was similar. However, AoCC (54.1 ± 15.2 vs 66.1 ± 15.9 min; P < 0.0001) and OR (311 ± 43.6 vs 336 ± 65.4 min; P < 0.0001) times were shorter with COR-KNOT. Results were similar after matching for both, del Nido versus Buckberg cardioplegia and COR-KNOT versus knot-pusher. CONCLUSION: New techniques and technologies, such as del Nido cardioplegia and COR-KNOT, decrease AoCC and OR times without compromising patient safety.

Acidification of European croplands by nitrogen fertilization: Consequences for carbonate losses, and soil health.

Soil acidification is an ongoing problem in intensively cultivated croplands due to inefficient and excessive nitrogen (N) fertilization. We collected high-resolution data comprising 19,969 topsoil (0-20 cm) samples from the Land Use and Coverage Area frame Survey (LUCAS) of the European commission in 2009 to assess the impact of N fertilization on buffering substances such as carbonates and base cations. We have only considered the impacts of mineral fertilizers from the total added N, and a N use efficiency of 60 %. Nitrogen fertilization adds annually 6.1 × 107 kmol H+ to European croplands, leading to annual loss of 6.1 × 109 kg CaCO3. Assuming similar acidification during the next 50 years, soil carbonates will be completely removed from 3.4 × 106 ha of European croplands. In carbonate-free soils, annual loss of 2.1 × 107 kmol of basic cations will lead to strong acidification of at least 2.6 million ha of European croplands within the next 50 years. Inorganic carbon and basic cation losses at such rapid scale tremendously drop the nutrient status and production potential of croplands. Soil liming to ameliorate acidity increases pH only temporarily and with additional financial and environmental costs. Only the direct loss of soil carbonate stocks and compensation of carbonate-related CO2 correspond to about 1.5 % of the proposed budget of the European commission for 2023. Thus, controlling and decreasing soil acidification is crucial to avoid degradation of agricultural soils, which can be done by adopting best management practices and increasing nutrient use efficiency. Regular screening or monitoring of carbonate and base cations contents, especially for soils, where the carbonate stocks are at critical levels, are urgently necessary.

The ethical dilemma of embryonic stem cell research.

To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. Data were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum.

A Comparison of Microwave Ablation and Cryoablation for the Treatment of Renal Cell Carcinoma: A Systematic Literature Review and Meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis comparing microwave ablation (MWA) and cryoablation for renal cell carcinoma (RCC). METHODS: The systematic search was performed in MEDLINE, Embase, and Cochrane databases. Studies published in English from January 2006 to February 2022 that assessed adults with primary RCC who received MWA or cryoablation were included. Study arms from RCTs, comparative observational, and single-arm studies were eligible. The outcomes included local tumor recurrence (LTR), overall survival, disease-free survival, overall/major complications, procedure/ablation time, 1- to 3-month primary technique efficacy, and technical success. Single-arm meta-analyses were performed using the random effects model. Sensitivity analyses excluding low-quality studies assessed using the MINORs scale were performed. Univariable and multivariable examined the effects of prognostic factors. RESULTS: Baseline characteristics were similar between groups and mean tumor size for MWA and cryoablation were 2.74 and 2.69 cm. Single-arm meta-analyses were similar for LTR and secondary outcomes between cryoablation and MWA. Ablation time was significantly shorter with MWA than with cryoablation (meta-regression weighted mean difference 24.55 minutes, 95% confidence interval -31.71, -17.38, P < .0001). One-year LTR was significantly lower with MWA than cryoablation (odds ratio 0.33, 95% confidence interval 0.10-0.93, P = .04). There were no significant differences for other outcomes. CONCLUSION: MWA provides significantly improved 1-year LTR and ablation time compared with cryoablation for patients with RCC. Other outcomes appeared similar or favorable for MWA; however, results were not statistically significant. MWA of primary RCC is as safe and effective as cryoablation, which should be confirmed with future comparative studies.

Randomized controlled trial of interferon gamma versus amantadine in combination with interferon alpha and ribavirin for hepatitis C genotype 3 non-responders and relapsers.

OBJECTIVES: To evaluate the efficacy and safety of triple combination regimens comprising of interferon alpha-2b (IFN-alpha) and ribavirin plus either IFN-gamma or amantadine in genotype 3 patients, responders or relapsers to interferon plus ribavirin combination. METHODS: Patients were randomized to receive IFN-alpha 3MU thrice a week, ribavirin 800-1200 mg per day with either IFN-gamma 2 MU thrice a week or amantadine 100 mg twice daily. Treatment was continued for 48 weeks in patients showing complete or partial (2 log reduction) early virological response (EVR) at 12 weeks and negative PCR at 24 weeks. RESULTS: Total enrollments were 44; 25 were previously non-responders out of them 12 were in the IFN-gamma arm. Nineteen were relapsers, out of them 10 received IFN-Gamma. Overall EVR with triple regimens was 61.4% (27/44). The EVR for IFN-gamma arm was 72.7% (16/22) and for amantadine arm 50% (11/22) (p=0.089). Sustained virological response (SVR) was 50% (11/22) in the gamma arm and 27.3% (6/22) in the amantadine arm (p=0.122). This figure was 60% (6/10) and 44% (5/9) for relapsers (p=0.845), and 41.6% (5/12) and 7.7% (1/13) for non-responders (p = 0.046).Treatment was well tolerated by most of the patients in both arms. CONCLUSIONS: About one third of patients responded to the triple regimens. However IFN-gamma was a better option. Its combination with pegylated interferon and ribavirin needs further evaluation. ( TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00538811).

Lung Function Monitoring After Lung Transplantation and Allogeneic Hematopoietic Stem Cell Transplantation.

PURPOSE: Bronchiolitis obliterans syndrome (BOS) is a major cause of morbidity and mortality in lung transplantation and allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Clinical guidelines recommend lung function monitoring to aid early identification of BOS, but real-world rates of pulmonary function testing (PFT) have not been studied. The purpose of this study was to quantify PFT rates in lung transplantation and allo-HSCT recipients. METHODS: This longitudinal retrospective study used US data from the IQVIA PharMetrics Plus commercial claims database (January 1, 2006-September 30, 2018) and the Medicare Limited Data Set (January 1, 2010-December 31, 2018). Study recipients had no evidence of transplantation 12 months before transplantation, which was identified by using diagnosis and procedure codes. PFTs were identified by using procedure codes. Outcomes were percentage of recipients who received ≥1 PFT in each follow-up year, including spirometry, lung diffusion capacity, lung function volume test, and plethysmography, including the average number of total and specific tests per recipient. FINDINGS: The study identified 367 commercially insured and 1776 Medicare recipients who underwent lung transplantation; 92% and 86% received ≥1 lung function test in the first year after transplantation, respectively. Among recipients observable 3 years after transplant, 85% and 83% received ≥1 PFT. Among 2187 commercially insured and 1864 Medicare recipients who underwent allo-HSCT, 44% and 36% received ≥1 lung function test in the first posttransplant year. In the third year after transplant, only 31% and 26% of observable allo-HSCT recipients underwent any PFT. IMPLICATIONS: Morbidity and mortality from BOS remain high in lung transplant and allo-HSCT recipients, but lung function testing in the first posttransplant year is not universal, with substantially lower rates among allo-HSCT recipients. Furthermore, testing rates in all cohorts declined over time. Increased and sustained monitoring could lead to earlier detection of BOS and earlier intervention and treatment.

The economic burden of NIPC and BOS following allogeneic HSCT in patients with commercial insurance in the United States.

Noninfectious pulmonary complications (NIPC) after allogeneic hematopoietic stem cell transplantation (alloHSCT), including bronchiolitis obliterans syndrome (BOS), cause significant morbidity and mortality, but their impact on health care resource utilization (HRU) and costs is unknown. This longitudinal retrospective study quantified the economic burden of NIPC and BOS in alloHSCT patients using commercial claims data from the IQVIA PharMetrics Plus database. Study patients were aged 0 to 64 years and underwent alloHSCT between 1 January 2006 and 30 September 2018, and were observable 12 months before and up to 5 years after index alloHSCT. NIPC patients were identified using International Classification of Disease (ICD) diagnosis codes. Outcomes were mean per patient HRU (inpatient admissions, outpatient office, hospital visits, and prescription medications) and costs paid by insurers in each post-transplant year. Among 2162 alloHSCT patients, 254 developed NIPCs, and 155 were propensity score (PS)-matched to non-NIPC patients. The year following transplantation, NIPC patients had significantly higher inpatient admission rates (3.8 ± 3.2 vs non-NIPC: 2.6 ± 2.4; P < .001) and higher total costs ($567 870 vs $412 400; P = .07), reflecting higher costs for inpatient admissions ($452 475 vs $300 202; P = .06). Among those observable for more years, costs remained higher for NIPC patients, reflecting significantly higher inpatient admission rates in the first 3 years following transplant. Subanalysis of patients with diagnoses likely reflective of BOS were consistent with these findings. AlloHSCT patients who developed NIPC had higher health care resource utilization and incurred higher costs compared with alloHSCT patients who did not develop NIPC following transplant.

Vulnerability and driving factors of soil inorganic carbon stocks in Chinese croplands.

The long-term stability of soil inorganic carbon (SIC) and its minimum contribution towards global C cycle has been challenged, as recent studies have showed rapid decreases in SIC stocks in intensive agricultural systems. However, the extent of SIC losses and its driving factors remains unclear. Here, we compared changes in SIC density (SICD) in Chinese croplands between the 1980s and 2010s. The SIC contents in 1980s were obtained from second national soil survey (n = 949) and published studies (n = 47). The SIC contents in 2010s were based on resampling of soil profiles from the same locations during 2019 and 2020 (n = 30), as well as data from published studies and national soil survey (n = 903). We found that Chinese croplands have lost 27-38% of SICD from the 0-40 cm soil layer and that the soil pH has decreased by 0.53 units over the past 30 years. These SIC losses increased with the ratio of precipitation (P) to potential evapotranspiration (PET) and most notably with nitrogen (N) fertilization. The SICD decreased greatly in humid and semiarid regions, and these losses were enhanced by high N fertilization rates; however, the SICD increased in very arid regions. This analysis demonstrates that the water balance and N fertilization are major drivers leading to dramatic losses of SICD in croplands and, consequently, to decreases in soil fertility and functions.

Investigating an outbreak of acute viral hepatitis caused by hepatitis E virus variants in Karachi, South Pakistan.

Hepatitis E is a classic water-borne disease in developing countries. Detection of anti-HEV IgM and IgG antibodies, in addition to HEV RNA are useful epidemiological markers in diagnosis of hepatitis E. This study was conducted to investigate an outbreak of acute viral hepatitis in South-Pakistan. Anti-HEV IgM and IgG were assessed comparatively with serological kits manufactured by Abbott, Cosmic, TGH, and Wantai, selecting HEV RNA as reference assay. Molecular evolutionary analysis was performed by phylogeny and HEV spread time analysis by Bayesian Coalescent Theory approach. Of the 89 patients, 24 (26.9%) did not have acute hepatitis viral marker. Of the remaining 65 cases, 4 (6.1%) were positive for anti-HAV IgM, one (1.5%) for anti-HBc IgM, 2 (3%) for HCV, 53 (81.5%) for anti-HEV IgM, and 5 (7.7%) were hepatitis-negative. The Wantai test was 100% sensitive and specific followed by Cosmic (98.1% and 100%), TGH (98.1% and 97.2%) and Abbott (79.2% and 83.3%). Two HEV variant strains were detected by phylogeny responsible for this acute hepatitis outbreak. Estimates on demographic history of HEV showed that HEV in Pakistan has remained at a steady nonexpanding phase from around 1970 to the year 2005, in which it expanded explosively with the emergence of new HEV variants. In conclusion, the limited sensitivity of available assay (Abbott anti-HEV EIA) may be a concern in HEV diagnosis in Pakistan. This study cautions that the dissemination of the variant strains to other areas of Pakistan may lead to explosive HEV outbreaks.