Cardiac Autonomic and Endothelial Function in Acute Lymphoblastic Leukaemia Patients Immediately After Chemotherapy and at the Three-Month Follow-up.

INTRODUCTION: Acute lymphoblastic leukemia (ALL) is a malignant uncontrolled overproduction of immature lymphoid cells in blood and bone marrow. The primary treatment of ALL is chemotherapy. Chemotherapy can have myriad systemic side effects, notably cardiovascular derangement. Autonomic derangement occurrence in cancer patients signifies cardiovascular risk in them and is a determinant of cardiovascular morbidity and mortality. Elevated soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) levels implicated in the regulation of inflammation indicate endothelial dysfunction. High levels of high-sensitivity C-reactive protein (hsCRP) can be indicative of low-grade inflammation. Hence, in this study the cardiac autonomic function and endothelial and inflammatory biomarker levels in adult patients with ALL were assessed immediately and three months after chemotherapy. METHODS: In this longitudinal study, 30 ALL patients (23 males, seven females) aged between 18 to 50 years, who had completed chemotherapy regimens, and 30 age and gender-matched healthy participants (controls) were recruited. Cardiac autonomic function tests (short-term heart rate variability (HRV), 30:15 ratio, synaptic excitation and inhibition (E/I) ratio, diastolic blood pressure (DBP) response to isometric hand grip), endothelial markers (sVCAM-1 and sICAM-1), and inflammatory marker (hsCRP) were assessed immediately and at three months after chemotherapy. RESULTS: Magnitudes of time domain and frequency domain indices, conventional autonomic function test indices, and biomarkers were deranged in ALL patients immediately after chemotherapy. After three months, cardiac autonomic function parameters were found to improve in the form of increased root mean square of successive differences between normal heartbeats (RMSSD), standard deviation of the interbeat intervals of normal sinus beats (SDNN), total power, high-frequency (HF)nu, and decreased low-frequency(LF)nu & LF-HF ratio. Endothelial (sVCAM-1) and inflammatory markers (hsCRP) were lower in the patient group as compared to the controls immediately after chemotherapy. Three months after chemotherapy, the levels of endothelial and inflammatory markers did not show much change. CONCLUSION: In this study, we found ALL patients showed higher sympathetic drive, decreased parasympathetic modulation, and sympathovagal imbalance immediately after chemotherapy as compared to the controls, indicating cardiovascular risk. After three months, improvement in cardiovascular autonomic function was observed. ALL itself is a state of inflammation with elevated endothelial and inflammatory markers; thus, the decreased endothelial and inflammatory markers could be attributed to the immediate effect of chemotherapy.

Is fat-to-lean mass ratio a better predictor of heart variability than body mass index?

BACKGROUND: Body mass index (BMI) may not accurately predict cardiometabolic risk due to confounders like age, gender, relatively high lean mass, and the "thin-fat phenotype" prevalent in south Asian populations. Fat-to-lean mass ratio (FTLM), which assesses the balance between fat and lean body mass, may provide a more complete assessment of cardiometabolic health. MATERIALS AND METHODS: This cross-sectional analytical study investigated the relationship between FTLM ratio, BMI, and heart rate variability (HRV) in apparently healthy male adults. 88 participants recruited through convenience sampling underwent anthropometric assessments, bioimpedance body composition analysis, and HRV testing. Pearson's or Spearman's correlation and linear regression analyses were performed where appropriate to assess the relationship between FTLM ratio, BMI, and HRV. RESULTS: Both BMI and FTLM showed significant positive correlation with normalized LF power and LF-HF ratio and a negative correlation with normalized HF power, RMSSD, and pNN50. However, FTLM ratio showed a stronger association with HRV parameters than BMI and could explain a greater percentage of the variability in LF-HF ratio (32% compared to 18.4%, P < 0.001). CONCLUSION: Assessment of both fat and lean mass, expressed as a ratio, is a better index of quantifying adiposity and predicting the influence of altered body composition on cardiometabolic health.

Parental History of Hypertension: A Risk for Autonomic Dysfunction and Metabolic and Vascular Derangement in Normotensive Male Offspring.

BACKGROUND: Children of hypertensive parents have an increased propensity of developing hypertension, at an age very much prior to their parents. Understanding the pathophysiology of hypertension in such young individuals, especially baroreflex sensitivity (BRS), is necessary. Reduced heart rate variability (HRV), insulin resistance (IR), dyslipidemia, and decreased vasodilatory adipokines, namely, apelin and relaxin, in normotensives may predispose to the onset of hypertension. Thus, this study compared autonomic functions, vascular markers, and metabolic profiles between normotensive male offspring with and without parental hypertension. METHODS: This analytical cross-sectional study comprised 40 male normotensive offspring of hypertensive parents, aged 18-35 years, recruited as the study group and 40 age- and body mass index (BMI)-matched normotensive male offspring with non-hypertensive parents enrolled as controls. Cardiovascular autonomic functions, including BRS, HRV, diastolic blood pressure response to isometric handgrip test (ΔDBPIHG), Valsalva ratio, and metabolic and vascular markers, were assessed. RESULTS: The study group exhibited reduced BRS, HRV, and Valsalva ratio and higher ΔDBPIHG compared to controls, indicating impaired autonomic functions. The study group had higher IR and triglyceride levels and reduced apelin and relaxin levels. BRS showed significant correlations with HRV, Valsalva ratio, ΔDBPIHG, and metabolic and vascular markers. CONCLUSIONS: Normotensive male offspring of hypertensive parents exhibit impaired autonomic functions, as evidenced by reduced BRS, HRV, and Valsalva ratio. Additionally, they have higher IR, dyslipidemia, and decreased levels of vasodilatory adipokines, indicating an increased risk for future hypertension development. These findings signify that early identification of hypertensive potential in this high-risk population is warranted, which would enable taking necessary preventive measures.

Altered baroreflex sensitivity at rest and during Valsalva maneuver in healthy male offspring of hypertensive patients.

INTRODUCTION: A family history of hypertension puts young adults at a higher risk of developing hypertension, that too, at an earlier age than their parents. Recent studies suggest that the baroreflex mechanism, which takes care of the short-term regulation of blood pressure (BP), also plays a role in the long-term regulation of BP. Studies have reported decreased baroreflex sensitivity (BRS) in hypertensives. Reduced BRS is shown to herald the future occurrence of cardiovascular diseases (CVD) and helps in risk stratification AIM: To assess BRS at rest and during the Valsalva maneuver among apparently healthy male offspring (age 18-35 years) of hypertensive patients. METHODS: We recruited 37 participants whose parents (either/both) were hypertensive in the study group and whose parents (both) were not hypertensive in the control group. We measured basic anthropometric parameters (height, weight, waist circumference), cardiovascular parameters (heart rate and BP), short-term heart rate variability, and BRS (at rest and during Valsalva). RESULTS: We found that BRS at rest and BRS during the Valsalva maneuver were reduced among healthy male offspring of hypertensive parents than in healthy male offspring of non-hypertensive parents. Further, HRV indices and Valsalva ratio showed a sympathovagal imbalance in the form of decreased vagal and increased sympathetic activity. CONCLUSION: The reduced BRS and sympathovagal imbalance in male offspring of hypertensive parents reveal the early risk of developing hypertension in the future.

The Burden of Peripheral Neuropathy in Nondiabetic Chronic Kidney Disease and the Role of Ghrelin Isoforms in its Development.

Introduction: Peripheral neuropathy is one of the most common complications in chronic kidney disease (CKD). The neuroprotective role of ghrelin is being explored recently. Here we aim to determine the burden of neuropathy in nondiabetic CKD and to find the association of peripheral nerve function with plasma ghrelin levels in these patients. Methods: This was a cross-sectional study conducted in nondiabetic CKD patients on conservative management to determine the magnitude of neuropathy. The association of ghrelin isoforms with nerve functions was assessed between three groups, namely CKD with neuropathy, CKD without neuropathy, and healthy volunteers, with 20 participants in each group. Results: The proportion of neuropathy in nondiabetic CKD was 78% (n = 78), of which 51% (n = 40) were asymptomatic. Des acyl ghrelin (DAG) and total ghrelin (TG) levels were 1545.5 ± 487.4 and 1567.4 ± 485.3 pg/mL, respectively, in CKD patients with neuropathy and were found to be elevated compared to those without neuropathy, who had 1000.4 ± 264.2 and 1019.7 ± 264.3 pg/mL of DAG and TG, respectively (P < 0.001). Assessment of correlation between nerve conduction parameters and DAG levels showed positive correlation between DAG levels and common peroneal latency (r = 0.69; P < 0.01), median sensory latency (r = 0.45; P < 0.05), and sural latency (r = 0.51; P < 0.05). We found negative correlation between median velocity (r =-0.56; P < 0.05), common peroneal velocity (r = -0.64; P < 0.01), median sensory velocity (r =-0.49; P < 0.05), and sural velocity (r = -0.54; P < 0.05). There was no statistically significant difference in acyl ghrelin levels among the groups. Conclusion: The prevalence of peripheral neuropathy in CKD is significantly higher with almost half of them being asymptomatic. Impaired renal clearance in CKD leads to the accumulation of DAG, which subsequently inhibits the neuroprotective functions of AG leading to neuropathy in CKD.

Pulmonary function severity in relation to interleukin-23 levels in patients with psoriasis vulgaris.

Background Interleukin-23 (IL-23), a key inflammatory regulator in the pathogenesis of psoriasis, is suspected to play a role in the onset of pulmonary dysfunction (chronic obstructive pulmonary disease) in psoriasis. Despite that, pulmonary function tests are rarely studied in these subjects. This study aims to seek a possible relation between pulmonary function in psoriasis patients serum IL-23. Methods For this analytical cross-sectional study, male psoriasis patients in the age group of 25-45 years were recruited from dermatology out patient department (n = 40). Age and BMI matched apparently healthy individuals were recruited as control group (n = 40). After obtaining demographic and personal details, anthropometric parameters and blood pressure were recorded. The severity of psoriasis was assessed using Psoriasis Area and Severity Index score. Pulmonary function was assessed using computerized spirometry, and serum IL-23 was measured using ELISA. Results Forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow rate, and forced expiratory flow at 25%-75% of the pulmonary volume (FEF25%-75%) were significantly reduced in psoriasis. Based on the percentage of predicted values FEF25%-75% was significantly reduced in psoriasis. Serum IL-23 (pg/mL) was significantly higher in psoriasis. The increase in IL-23 in psoriasis subjects does not correlate with their pulmonary function. Conclusions Psoriasis may be associated with a reduced lung function even when the disease is in the mild stage. Increased IL-23 found in these subjects is suggestive of systemic inflammation, which indirectly lowers lung function.

Are There as Many Essential and Non-essential Minerals in Hydroponic Strawberry (Fragaria ananassa L.) Compared to Those Grown in Soil?

The present study aims to compare the contents of minerals (essential major-K, Ca, Mg, Na, P, S; essential trace-Fe, Mn, Zn, Cu, B, Mo, As, Se, Ni, V, Cr, Co; non-essential-Sn, Ga, Li, Be, Rb, Sr, Al, Pd, Cd, Hg, Pb, Ge) in strawberry (stem, leaf, and fruit) cultivated in two different cultivation systems, soil and hydroponic. The concentrations of 30 minerals in the acid-digested strawberry samples were determined by ICP-MS and ICP-OES. Hydroponic strawberry (leaf > fruit > stem) indicated higher values for most minerals which were below the plant toxicity levels. In leaves collected from the hydroponic system, it was observed there were larger amounts of Fe, Zn, B, As, Se, Ni, V, Cr, Al, Cd, and Pd. Hydroponic fruits were the significant sources of K, P, Mn, Zn, Cr, and Co. Hydroponic strawberry leaves could contribute twice as many higher and safe daily intake of minerals to humans than other fruits. This analysis shows that, firstly, higher quality and safely edible produce can be provided by the hydroponic system; and secondly, strawberry leaf is a potential mineral source.

A DOC coagulant, gypsum treatment can simultaneously reduce As, Cd and Pb uptake by medicinal plants grown in contaminated soil.

The efficiency of gypsum, as a dissolved organic carbon (DOC) coagulator, for the simultaneous immobilization of two heavy metals (Cd and Pb) and one metalloid (As) in agricultural soils near an abandoned mining site was examined. The agricultural soil was defined as long-term contaminated as As (1540mgkg-1), Cd (55mgkg-1) and Pb (1283mgkg-1) concentrations exceeded the Korean guideline values for As (25mgkg-1), Cd (4mgkg-1), and Pb (200mgkg-1). Gypsum was incorporated into the contaminated soil at 3% (w/w). In comparison two commonly using immobilizing agents (lime and compost), together with a mixture (lime+gypsum) were also included in the pot trial for the cultivation of two medical plants (A. gigas and A. macrocephala) and to evaluate the effectiveness of gypsum on As, Cd and Pb immobilization. The results showed that even though pH change-induced immobilizing agents such as lime were more effective than gypsum at immobilizing Cd and Pb, addition of gypsum also effectively reduced heavy metal phytoavailability as indicated by decreases in the concentration of Cd and Pb in medicinal plants. Furthermore, gypsum and gypsum+ lime were also most effective in reducing As concentrations in both plants studied. This was mainly attributed to significant decreases in soil DOC (48-64%) when gypsum and gypsum+lime were applied to the soil. Consequently, it was concluded that enhanced DOC coagulation with gypsum, could be considered as a promising technique for the immobilization of both metals (Cd and Pb) and metalloids (As) in agricultural soils.

Risk-based remediation of polluted sites: A critical perspective.

Sites contaminated with chemical pollutants represent a growing challenge, and remediation of such lands is of international concern. Risk-based land management (RBLM) is an emerging approach that integrates risk assessment practices with more traditional site-specific investigations and remediation activities. Developing countries are yet to adopt RBLM strategies for remediation. RBLM is considered to be practical, scientifically defensible and cost-efficient. However, it is inherently limited by: firstly, the accuracy of risk assessment models used; secondly, ramifications of the fact that they are more likely to leave contamination in place; and thirdly, uncertainties involved and having to consider the total concentrations of all contaminants in soils that overestimate the potential risks from exposure to the contaminants. Consideration of contaminant bioavailability as the underlying basis for risk assessment and setting remediation goals of those contaminated lands that pose a risk to environmental and human health may lead to the development of a more sophisticated risk-based approach. However, employing the bioavailability concept in RBLM has not been extensively studied and/or legalized. This review highlights the extent of global land contamination, and the concept of risk-based assessment and management of contaminated sites including its advantages and disadvantages. Furthermore, the concept of bioavailability-based RBLM strategy has been proposed, and the challenges of RBLM and the priority areas for future research are summarized. Thus, the present review may help achieve a better understanding and successful implementation of a sustainable bioavailability-based RBLM strategy.

Influence of cold stress on contents of soluble sugars, vitamin C and free amino acids including gamma-aminobutyric acid (GABA) in spinach (Spinacia oleracea).

The contents of soluble sugars (sucrose, fructose, glucose, maltose and raffinose), vitamin C and free amino acids (34 compounds, essential and non-essential) were quantified in open-field and greenhouse-grown spinaches in response to cold stress using liquid chromatography. In general, greenhouse cultivation produced nutritionally high value spinach in a shorter growing period, where the soluble sugars, vitamin C and total amino acids concentrations, including essential were in larger amounts compared to those grown in open-field scenarios. Further, low temperature exposure of spinach during a shorter growth period resulted in the production of spinach with high sucrose, ascorbate, proline, gamma-aminobutyric acid, valine and leucine content, and these constitute the most important energy/nutrient sources. In conclusion, cultivation of spinach in greenhouse at a low temperature (4-7°C) and exposure for a shorter period (7-21days) before harvest is recommended. This strategy will produce a high quality product that people can eat.

Remediation approaches for polycyclic aromatic hydrocarbons (PAHs) contaminated soils: Technological constraints, emerging trends and future directions.

For more than a decade, the primary focus of environmental experts has been to adopt risk-based management approaches to cleanup PAH polluted sites that pose potentially destructive ecological consequences. This focus had led to the development of several physical, chemical, thermal and biological technologies that are widely implementable. Established remedial options available for treating PAH contaminated soils are incineration, thermal conduction, solvent extraction/soil washing, chemical oxidation, bioaugmentation, biostimulation, phytoremediation, composting/biopiles and bioreactors. Integrating physico-chemical and biological technologies is also widely practiced for better cleanup of PAH contaminated soils. Electrokinetic remediation, vermiremediation and biocatalyst assisted remediation are still at the development stage. Though several treatment methods to remediate PAH polluted soils currently exist, a comprehensive overview of all the available remediation technologies to date is necessary so that the right technology for field-level success is chosen. The objective of this review is to provide a critical overview in this respect, focusing only on the treatment options available for field soils and ignoring the spiked ones. The authors also propose the development of novel multifunctional green and sustainable systems like mixed cell culture system, biosurfactant flushing, transgenic approaches and nanoremediation in order to overcome the existing soil- contaminant- and microbial-associated technological limitations in tackling high molecular weight PAHs. The ultimate objective is to ensure the successful remediation of long-term PAH contaminated soils.

Occurrence and diversity of tetracycline resistance genes in the agricultural soils of South Korea.

Reports on the occurrence and diversity of antibiotic-resistant bacteria and genes, which are considered to be emerging pollutants worldwide, have, to date, not been published on South Korean agricultural soils. This is the first study to investigate the persistence of tetracycline (oxytetracycline, tetracycline, and chlortetracycline)-resistant bacterial community and genes in natural and long-term fertilized (NPK, pig, and cattle manure composts) agricultural soils in South Korea. The results showed that oxytetracycline and chlortetracycline could be the dominant residues in animal manures; regular fertilization of manures, particularly pig manures, may be the prime cause for the spread and abundance of tetracycline resistance in South Korean agricultural soils. Both the country's natural and agricultural soils are reservoirs of antibiotic-resistant species. Of the 113 tetracycline-resistant isolates identified (19 typical bacterial genera and 36 distinct species), approximately 40 to 99 % belonged to Gram-positive bacteria and Bacillus constituted the predominant genera. Of the 24 tet genes targeted, tetG, tetH, tetK, tetY, tetO, tetS, tetW, and tetQ were detected in all soil samples, highlighting their predominance and robust adaptability in soils. Meanwhile, it is suggested that tetC, tetE, tetZ, tetM, tetT, and tetP(B) are the common residues in pig manures, and furthermore, the treatment of soils with pig manures may wield a different impact on the tet gene resistome in agricultural soils. This study thus highlights the necessity for regulating the usage of tetracyclines in South Korean animal farming. This must be followed by proper monitoring of the subsequent usage of animal manures especially that derived from pig farms located in agricultural soils.

Polyaromatic hydrocarbon (PAH) degradation potential of a new acid tolerant, diazotrophic P-solubilizing and heavy metal resistant bacterium Cupriavidus sp. MTS-7 isolated from long-term mixed contaminated soil.

An isolate of Cupriavidus (strain MTS-7) was identified from a long-term PAHs and heavy metals mixed contaminated soil with the potential to biodegrade both LMW and HMW PAHs with added unique traits of acid and alkali tolerance, heavy metal tolerance, self-nutrient assimilation by N fixation and P solubilization. This strain completely degraded the model 3 (150 mg L(-1) Phe), 4 (150 mg L(-1) Pyr) and 5 (50 mg L(-1) BaP) ring PAHs in 4, 20 and 30 days, respectively. It could mineralize 90-100% of PAHs (200 mg L(-1) of Phe and Pyr) within 15 days across pH ranging from 5 to 8 and even in the presence of toxic metal contaminations. During biodegradation, the minimum inhibitory concentrations were 5 (Cu(2+)) and 3 (Cd(2+), Pb(2+), Zn(2+)) mg L(-1) of the potentially bioavailable metal ions and over 17 mg L(-1) metal levels was lethal for the microbe. Further, it could fix 217-274 µg mL(-1) of N and solubilize 79-135 µg mL(-1) of P while PAHs degradation. MTS-7 as a superior candidate could be thus used in the enhanced bioaugmentation and/or phytoremediation of long-term mixed contaminated sites.

Pyrosequencing analysis of bacterial diversity in soils contaminated long-term with PAHs and heavy metals: Implications to bioremediation.

Diversity, distribution and composition of bacterial community of soils contaminated long-term with both polycyclic aromatic hydrocarbons (PAHs) and heavy metals were explored for the first time following 454 pyrosequencing. Strikingly, the complete picture of the Gram positive (+ve) and Gram negative (-ve) bacterial profile obtained in our study illustrates novel postulates that include: (1) Metal-tolerant and PAH-degrading Gram -ves belonging to the class Alphaproteobacteria persist relatively more in the real contaminated sites compared to Gram +ves, (2) Gram +ves are not always resistant to heavy metal toxicity, (3) Stenotrophomonas followed by Burkholderia and Pseudomonas are the dominant genera of PAH degraders with high metabolic activity in long-term contaminated soils, (4) Actinobacteria is the predominant group among the Gram +ves in soils contaminated with high molecular weight PAHs that co-exist with toxic heavy metals like Pb, Cu and Zn, (5) Microbial communities are nutrient-driven in natural environments and (6) Catabolically potential Gram +/-ves with diverse applicability to remediate the real contaminated sites evolve eventually in the historically-polluted soils. Thus, the most promising indigenous Gram +/-ve strains from the long-term contaminated sites with increased catabolic potential, enzymatic activity and metal tolerance need to be harnessed for mixed contaminant cleanups.

Kinetics of PAH degradation by a new acid-metal-tolerant Trabulsiella isolated from the MGP site soil and identification of its potential to fix nitrogen and solubilize phosphorous.

Development of an efficient bioinoculum is considered as an appropriate remedial approach to treat the PAHs-metal mixed contaminated sites. Therefore, we aimed to isolate a degrader able to exert an outstanding PAH catabolic potential with added traits of pH-metal-resistance, N-fix or P-solubilization from a manufactured gas plant site soil. The identified strain (MTS-6) was a first low and high molecular weight (LMW and HMW) PAHs degrading Trabulsiella sp. tolerant to pH 5. MTS-6 completely degraded the model 3 [150mgL(-1) phenanthrene (Phe)], 4 [150mgL(-1) pyrene (Pyr)] and 5 [50mgL(-1) benzo[a]pyrene (BaP)] ring PAHs in 6, 25 and 90 days, respectively. Presence of co-substrate (100mgL(-1) Phe) increased the biodegradation rate constant (k) and decreased the half-life time (t1/2) of HMW PAHs (100mgL(-1) Pyr or 50mgL(-1) BaP). The strain fixed 47µgmL(-1)N and solubilized 58µgmL(-1)P during PAH metabolism and exhibited an EC50 value of 3-4mgL(-1) for Cu, Cd, Pb and Zn. Over 6mgL(-1) metal levels was lethal for the microbe. The identified bacterium (MTS-6) with exceptional multi-functional traits opens the way for its exploitation in the bioremediation of manufactured gas plant sites in a sustainable way by employing bioaugmentation strategy.

Agronomic and remedial benefits and risks of applying biochar to soil: Current knowledge and future research directions.

'Biochar' represents an emerging technology that is increasingly being recognized for its potential role in carbon sequestration, reducing greenhouse gas emissions, waste management, renewable energy, soil improvement, crop productivity enhancement and environmental remediation. Published reviews have so far focused mainly on the above listed agronomic and environmental benefits of applying biochar, yet paid little or no attention to its harmful effects on the ecological system. This review highlights a balanced overview of the advantages and disadvantages of the pyrolysis process of biochar production, end-product quality and the benefits versus drawbacks of biochar on: (a) soil geochemistry and albedo, (b) microflora and fauna, (c) agrochemicals, (d) greenhouse gas efflux, (e) nutrients, (f) crop yield, and (g) contaminants (organic and inorganic). Future research should focus more on the unintended long-term consequences of biochar on biological organisms and their processes in the soil.

In-Situ Remediation Approaches for the Management of Contaminated Sites: A Comprehensive Overview.

Though several in-situ treatment methods exist to remediate polluted sites, selecting an appropriate site-specific remediation technology is challenging and is critical for successful clean up of polluted sites. Hence, a comprehensive overview of all the available remediation technologies to date is necessary to choose the right technology for an anticipated pollutant. This review has critically evaluated the (i) technological profile of existing in-situ remediation approaches for priority and emerging pollutants, (ii) recent innovative technologies for on-site pollutant remediation, and (iii) current challenges as well as future prospects for developing innovative approaches to enhance the efficacy of remediation at contaminated sites.

Ex-Situ Remediation Technologies for Environmental Pollutants: A Critical Perspective.

Pollution and the global health impacts from toxic environmental pollutants are presently of great concern. At present, more than 100 million people are at risk from exposure to a plethora of toxic organic and inorganic pollutants. This review is an exploration of the ex-situ technologies for cleaning-up the contaminated soil, groundwater and air emissions, highlighting their principles, advantages, deficiencies and the knowledge gaps. Challenges and strategies for removing different types of contaminants, mainly heavy metals and priority organic pollutants, are also described.

Association of sympathovagal imbalance with cardiovascular risks in patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is associated with cardiovascular risks like obesity, insulin resistance, dyslipidemia that can lead to sympathovagal imbalance (SVI). The study was designed to assess the cardiovascular risk in PCOS and link of metabolic derangements to SVI. Thirty-five newly diagnosed PCOS patients and 32 age-matched controls were recruited. Waist-hip ratio, body mass index (BMI), basal cardiovascular parameters such as basal heart rate (BHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were recorded. Autonomic functions were assessed using short-term heart rate variability (HRV) analysis, heart rate and blood pressure response to standing (30:15 ratio), deep breathing (E:I ratio) and isometric handgrip (ΔDBPihg). Fasting plasma glucose, insulin, lipid profile and testosterone were assayed. Insulin resistance (HOMA-IR) and lipid risk factors were calculated. The cases had increased BHR, BMI, SBP, DBP, MAP and RPP. The ratio of low-frequency to high-frequency (LF-HF) of HRV, the marker of SVI was significantly increased in cases. 30:15 ratio and ΔDBPihg were increased and E:I ratio was decreased in the cases. HOMA-IR, lipid risk factors and testosterone were significantly elevated in cases. There was a significant correlation of LF-HF with BMI, BHR, RPP, insulin resistance and lipid risk factors. On regression analysis, insulin resistance and lipid risk factors had independent association with LF-HF. PCOS patients have SVI, decreased HRV and increased RPP and the potential cardiovascular risks. The insulin resistance and dyslipidemia contribute to SVI and cardiovascular risks in PCOS patients.