CsEXL3 regulate mechanical harvest-related droopy leaves under the transcriptional activation of CsBES1.2 in tea plant.

Due to a labor shortage, the mechanical harvesting of tea plantations has become a focal point. However, mechanical harvest efficiency was hampered by droopy leaves, leading to a high rate of broken tea shoots and leaves. Here, we dissected the genetic structure of leaf droopiness in tea plants using genome-wide association studies (GWAS) on 146 accessions, combined with transcriptome from two accessions with contrasting droopy leaf phenotypes. A set of 16 quantitative trait loci (QTLs) containing 54 SNPs and 34 corresponding candidate genes associated with droopiness were then identified. Among these, CsEXL3 (EXORDIUM-LIKE 3) from Chromosome 1 emerged as a candidate gene. Further investigations revealed that silencing CsEXL3 in tea plants resulted in weaker vascular cell malformation and brassinosteroid-induced leaf droopiness. Additionally, brassinosteroid signal factor CsBES1.2 was proved to participate in CsEXL3-induced droopiness and vascular cell malformation via using the CsBES1.2-silencing tea plant. Notably, CsBES1.2 bound on the E-box of CsEXL3 promoter to transcriptionally activate CsEXL3 expression as CUT&TAG based ChIP-qPCR and ChIP-seq suggested in vivo as well as EMSA and Y1H indicated in vitro. Furthermore, CsEXL3 instead of CsBES1.2 decreased lignin content and the expressing levels of lignin biosynthesis genes. Overall, our findings suggest that CsEXL3 regulates droopy leaves, partially through the transcriptional activation of CsBES1.2, with the potential to improve mechanical harvest efficiency in tea plantations.

Bivalirudin versus Heparin on Net Adverse Clinical Events, Major Adverse Cardiac and Cerebral Events, and Bleeding in Elderly Chinese Patients Treated with Percutaneous Coronary Intervention.

Bivalirudin as an anticoagulant reduces bleeding after percutaneous coronary intervention (PCI), while its impact in elderly Chinese patients treated with PCI needs more evidence. This study aimed to compare the clinical outcomes between bivalirudin and heparin in elderly Chinese patients treated with PCI. This cohort study retrieved data of 1,286 elderly patients treated with PCI who used bivalirudin (bivalirudin group, N = 493) or heparin (heparin group, N = 793) as anticoagulants. Net adverse clinical events (NACEs) (primary endpoint), major adverse cardiac and cerebral events (MACCEs), bleeding, and major bleeding within 30 days after PCI treatment were recorded for analysis. Our study illustrated that NACEs (12.4% vs. 17.4%, P = 0.015), bleeding (6.7% vs. 12.1%, P = 0.002), and major bleeding (2.2% vs. 6.6%, P < 0.001) were fewer in bivalirudin group compared to heparin group. No difference was found in MACCEs (7.5% vs. 9.6%,P = 0.200), and incidences of all-cause mortality (P = 0.257), cardiac mortality (P = 0.504), recurrent myocardial infarction (P = 0.423), ischemia-driven revascularization (P = 0.509), and stroke (P = 0.467), between bivalirudin group and heparin group. According to univariate logistic regression analyses, bivalirudin (vs. heparin) correlated with fewer NACEs (P = 0.016), bleeding (P = 0.002), and major bleeding (P = 0.001) in elderly patients treated with PCI, but not MACCEs (P = 0.202). After adjustment, bivalirudin (vs. heparin) was an independent factor for fewer NACEs [odds ratio (OR): 0.619, P = 0.009], bleeding (OR: 0.499, P = 0.003), and major bleeding (OR: 0.342, P = 0.003) in these patients. In summary, bivalirudin achieves fewer NACEs, bleeding, and major bleeding, but not MACCEs, versus heparin in elderly patients treated with PCI, which is verified in the multivariate model.

Effect of Adopting Low Calories on Patients' Vital Signs in The Nutritional Support of Critically Ill Patients in the ICU: A Systematic Review and Network Meta-Analysis.

Background: Feeding critically ill persons in Intensive Care Units (ICUs) is challenging as the nutritional substances pose severe health outcomes or can improve their well-being and length of stay (LOS) in the hospital. Our main objective is to investigate the effects of adopting low caloric intake among patients with vital signs in the nutritional support of critically ill patients in ICUs, focusing on reducing mortality rates and length of stay (LOS) in hospitals. Method: The initial literature search was performed in PubMed, the Cochrane Library of Trials, and MEDLINE. The network meta-analysis was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent reviewers were assigned data selection and extraction roles. Our study mainly included randomised controlled trials (RCTs) whose titles and abstracts were screened, after which duplicates were excluded. The remaining eligible studies were subjected to full-text analysis to identify data related to the topic of the present study. Analyses were performed using the Cochrane Risk of Bias tool, R software and MS Excel. Results: Twenty-two studies (involving 9 539 participants) met the inclusion criteria and were subjected to the network meta-analysis. In mortality rates, the greatest rank observed corresponded to a reduction of 71%. The regression of the effects of low caloric intake explained a 5.29% variation in LOS. A weak positive correlation was found between LOS and low caloric intake among critically ill patients in ICUs. Thus, Low caloric intake decreased mortality rates and lowered LOS. Conclusions: Our study found that low caloric intake reduces mortality rate and hospital LOS among critically ill patients. Secondary outcomes include nosocomial infection, clinical outcomes, functions, digestive infections, improved quality of life, resulting survival rates, ventilator days, bacteremia, blood glucose levels, diarrhoea, and tube replacement. Our findings have clinical implications for clinicians in the ICU, who should consider developing individualised nutritional plans for critically ill patients. Moreover, regular monitoring of nutritional intake and response is crucial. Healthcare providers should closely monitor patients' nutritional status, vital signs, and clinical outcomes.