Streambed immobilization controls the transport of antibiotic resistance genes in flowing water.

Antibiotic resistance is a serious global health issue, resulting in at least 1.2 million deaths in 2019. The environment is a potentially important reservoir of antibiotic resistance; however, the fate of Antibiotic Resistance Genes (ARGs) in the environment remains poorly characterized. One important environmental source of ARGs is manure used as a soil amendment. ARGs from manure may then enter nearby flowing waterbodies, where the factors governing their downstream transport remain unknown. To address this, we conducted experiments by spiking cattle manure in an artificial stream to estimate removal rates (k; m-1) for three ARGs (mefA, tetQ, and tetW) and a ruminant fecal marker (bacR). We then used a Stochastic Mobile-Immobile Model (SMIM) to separate the overall removal into two components, rs, and rh, corresponding to immobilizations in the surface (i.e., water column) and subsurface (i.e., streambed), respectively. Finally, we applied the SMIM across four model streams to predict the downstream travel distance of ARGs and bacR. Our results showed measurable removal for all targets in all experimental replicates (n = 3) and no differences were found in the removal rates among replicates for any target (ANCOVA; p > 0.05). We found that the removal of bacR was significantly lower than tetW (p < 0.05) and slightly lower than mefA (p = 0.088), while tetQ removal was slightly different from tetW's (p = 0.072). We also found that rh values were orders of magnitude larger than rs for ARGs and bacR (t-test; p < 0.05). These findings suggest that ARGs and bacR are being removed from the water column through immobilization reactions occurring in the streambed. Additionally, we predicted that the 90 % removal (or D90) of targets occurs within the first 500 m in all model streams except in a slow-flow pastoral stream, which required 1400 m of downstream transport for 90 % removal. Our findings and model stand out as promising tools to predict the fate of ARGs in streams and will contribute to improving and managing agricultural practices that employ animal manure.

Cardiopulmonary deconditioning and plasma volume loss are not sufficient to provoke orthostatic hypertension.

Orthostatic hypertension, defined by an increase of systolic blood pressure (SBP) of ≥20 mmHg upon standing, harbors an increased cardiovascular risk. We pooled data from two rigorously conducted head-down tilt bedrest studies to test the hypothesis that cardiopulmonary deconditioning and hypovolemia predispose to orthostatic hypertension. With bedrest, peak VO2 decreased by 6 ± 4 mlO2/min/kg (p < 0.0001) and plasma volume by 367 ± 348 ml (p < 0.0001). Supine SBP increased from 127 ± 9 mmHg before to 133 ± 10 mmHg after bedrest (p < 0.0001). In participants with stable hemodynamics following head-up tilt, the incidence of orthostatic hypertension was 2 out of 67 participants before bedrest and 2 out of 57 after bedrest. We conclude that in most healthy persons, cardiovascular deconditioning and volume loss associated with long-term bedrest are not sufficient to cause orthostatic hypertension.

Impact of daily artificial gravity on autonomic cardiovascular control following 60-day head-down tilt bed rest.

Impaired cardiovascular autonomic control following space flight or immobilization may limit the ability to cope with additional hemodynamic stimuli. Head-down tilt bedrest is an established terrestrial analog for space flight and offers the opportunity to test potential countermeasures for autonomic cardiovascular deconditioning. Previous studies revealed a possible benefit of daily artificial gravity on cardiovascular autonomic control following head-down tilt bedrest, but there is a need for efficiency in a long-term study before an artificial gravity facility would be brought to space. We hypothesized that artificial gravity through short-arm centrifugation attenuates functional adaptions of autonomic function during head-down tilt bed rest. 24 healthy persons (8 women, 33.4 ± 9.3 years, 24.3 ± 2.1 kg/m2) participated in the 60-day head-down tilt bed rest (AGBRESA) study. They were assigned to three groups, 30 min/day continuous, or 6(5 min intermittent short-arm centrifugation, or a control group. We assessed autonomic cardiovascular control in the supine position and in 5 minutes 80° head-up tilt position before and immediately after bed rest. We computed heart rate variability (HRV) in the time (rmssd) and frequency domain, blood pressure variability, and baroreflex sensitivity (BRS). RR interval corrected rmssd was reduced supine (p = 0.0358) and during HUT (p = 0.0161). Heart rate variability in the high-frequency band (hf-RRI; p = 0.0004) and BRS (p < 0.0001) decreased, whereas blood pressure variability in the low-frequency band (lf-SBP, p = 0.0008) increased following bedrest in all groups. We did not detect significant interactions between bedrest and interventions. We conclude that up to daily 30 min of artificial gravity on a short-arm centrifuge with 1Gz at the center of mass do not suffice to prevent changes in autonomic cardiovascular control following 60-day of 6° head-down tilt bed rest. Clinical Trial Registration: https://drks.de/search/en/trial/DRKS00015677, identifier, DRKS00015677.

Effects of daily artificial gravity training on orthostatic tolerance following 60-day strict head-down tilt bedrest.

PURPOSE: Orthostatic intolerance commonly occurs following immobilization or space flight. We hypothesized that daily artificial gravity training through short-arm centrifugation could help to maintain orthostatic tolerance following head-down tilt bedrest, which is an established terrestrial model for weightlessness. METHODS: We studied 24 healthy persons (eight women; age 33.3 ± 9.0 years; BMI 24.3 ± 2.1 kg/m2) who participated in the 60-days head-down tilt bedrest (AGBRESA) study. They were assigned to 30 min/day continuous or 6 × 5 min intermittent short-arm centrifugation with 1Gz at the center of mass or a control group. We performed head-up tilt testing with incremental lower-body negative pressure until presyncope before and after bedrest. We recorded an electrocardiogram, beat-to-beat finger blood pressure, and brachial blood pressure and obtained blood samples from an antecubital venous catheter. Orthostatic tolerance was defined as time to presyncope. We related changes in orthostatic tolerance to changes in plasma volume determined by carbon dioxide rebreathing. RESULTS: Compared with baseline measurements, supine and upright heart rate increased in all three groups following head-down tilt bedrest. Compared with baseline measurements, time to presyncope decreased by 323 ± 235 s with continuous centrifugation, by 296 ± 508 s with intermittent centrifugation, and by 801 ± 354 s in the control group (p = 0.0249 between interventions). The change in orthostatic tolerance was not correlated with changes in plasma volume. CONCLUSIONS: Daily artificial gravity training on a short-arm centrifuge attenuated the reduction in orthostatic tolerance after 60 days of head-down tilt bedrest.

Predicting nitrous oxide emissions through riverine networks.

Nitrous oxide (N2O) is currently the leading ozone-depleting gas and is also a potent greenhouse gas. Predictions of N2O emissions from riverine systems are difficult and mostly accomplished via regression equations based on dissolved inorganic nitrogen (DIN) concentrations or fluxes, although recent studies have shown that hydromorphological characteristics can influence N2O emissions in riverine reaches. Here, we propose a predictive model for N2O riverine concentrations and emissions at the reach scale. The model is based on Damköhler numbers and captures the primary effects of reach-scale biogeochemical and hydromorphological characteristics in flowing waters. It explains the change in N2O emissions from small streams to large rivers under varying conditions including biome, land use, climate, and nutrient availability. The model and observed data show that dimensionless N2O concentrations and emission rates have higher variability and mean values for small streams (reach width <10 m) than for larger streams due to high spatial variability of stream hydraulics and morphology.

[Leiomyoma of the esophagus : A further indication for robotic surgery?] / Das Leiomyom des Ösophagus : Eine weitere Indikation für den Roboter?

BACKGROUND: Leiomyomas of the esophagus are rare tumors but the most common benign lesion of the esophagus originating from smooth muscle cells. The symptoms are mainly determined by the size of the tumor and are caused by dysphagia and/or retrosternal pain. The majority of patients are however asymptomatic. The diagnostics include esophagoscopy, endosonography and chest computed tomography. Surgery is considered the treatment of choice and ideally involves enucleation of the tumor but may lead to esophagectomy. In addition to the classical open procedures, minimally invasive procedures are also used. Regardless of the selected procedure, a lesion of the mucosa should be avoided. OBJECTIVE: A review of the literature on thoracoscopic and robotic resections in the treatment of leiomyomas was carried out and an illustration of a clinical case is presented. MATERIAL AND METHODS: A review of minimally invasive surgical treatment of esophageal leiomyomas is presented. The literature search was carried out in PubMed for publications of thoracoscopic and robotic-assisted thoracic enucleation of leiomyomas of the esophagus. In addition, the robotic-assisted thoracic enucleation of a horseshoe-shaped leiomyoma in the middle third of the esophagus is described. RESULTS: The enucleation of the esophageal leiomyoma was carried out through a right-sided robotic-assisted operation with one lung ventilation. The surgery time was 143 min. There were no intraoperative or postoperative complications. On the 3rd postoperative day a light diet was started and the thorax drainage was removed. Histopathology confirmed a leiomyoma. The patient was discharged on the 5th postoperative day and free of complaints. CONCLUSION: Robotic-assisted surgery for leiomyomas of the esophagus is a safe procedure. Taking the available data into account, robotic-assisted thoracic enucleation of leiomyomas was characterized by less mucosal lesions, general complications and a lower conversion rate as well as a shorter hospital stay compared to classical thoracoscopic enucleation. Thus, robotic-assisted surgery can be the method of choice for leiomyomas of the esophagus.

Correction to 'On the possibility (or lack thereof) of agreement between experiment and computation of flows over wings at moderate Reynolds number'.

[This corrects the article DOI: 10.1098/rsfs.2016.0076.].

On the possibility (or lack thereof) of agreement between experiment and computation of flows over wings at moderate Reynolds number.

The flight of many birds and bats, and their robotic counterparts, occurs over a range of chord-based Reynolds numbers from 1 × 104 to 1.5 × 105. It is precisely over this range where the aerodynamics of simple, rigid, fixed wings becomes extraordinarily sensitive to small changes in geometry and the environment, with two sets of consequences. The first is that practical lifting devices at this scale will likely not be simple, rigid, fixed wings. The second is that it becomes non-trivial to make baseline comparisons for experiment and computation, when either one can be wrong. Here we examine one ostensibly simple case of the NACA 0012 aerofoil and make careful comparison between the technical literature, and new experiments and computations. The agreement (or lack thereof) will establish one or more baseline results and some sensitivities around them. The idea is that the diagnostic procedures will help to guide comparisons and predictions in subsequent more complex cases.

Efficient bridging of 20 mm rat sciatic nerve lesions with a longitudinally micro-structured collagen scaffold.

An increasing number of biomaterial nerve guides has been developed that await direct comparative testing with the 'gold-standard' autologous nerve graft in functional repair of peripheral nerve defects. In the present study, 20 mm rat sciatic nerve defects were bridged with either a collagen-based micro-structured nerve guide (Perimaix) or an autologous nerve graft. Axons regenerated well into the Perimaix scaffold and, the majority of these axons grew across the 20 mm defect into the distal nerve segment. In fact, both the total axon number and the number of retrogradely traced somatosensory and motor neurons extending their axons across the implant was similar between Perimaix and autologous nerve graft groups. Implantation of Schwann cell-seeded Perimaix scaffolds provided only a beneficial effect on myelination within the scaffold. Functional recovery supported by the implanted, non-seeded Perimaix scaffold was as good as that observed after the autologous nerve graft, despite the presence of thinner myelin sheaths in the Perimaix implanted nerves. These findings support the potential of the Perimaix collagen scaffold as a future off-the-shelf device for clinical applications in selected cases of traumatic peripheral nerve injury.

A review of ecological effects and environmental fate of illicit drugs in aquatic ecosystems.

Although illicit drugs are detected in surface waters throughout the world, their environmental fate and ecological effects are not well understood. Many illicit drugs and their breakdown products have been detected in surface waters and temporal and spatial variability in use translates into "hot spots and hot moments" of occurrence. Illicit drug occurrence in regions of production and use and areas with insufficient wastewater treatment are not well studied and should be targeted for further study. Evidence suggests that illicit drugs may not be persistent, as their half-lives are relatively short, but may exhibit "pseudo-persistence" wherein continual use results in persistent occurrence. We reviewed the literature on the ecological effects of these compounds on aquatic organisms and although research is limited, a wide array of aquatic organisms, including bacteria, algae, invertebrates, and fishes, have receptors that make them potentially sensitive to these compounds. In summary, illicit drugs occur in surface waters and aquatic organisms may be affected by these compounds; research is needed that focuses on concentrations of illicit drugs in areas of production and high use, environmental fate of these compounds, and effects of these compounds on aquatic ecosystems at the concentrations that typically occur in the environment.

Pacemaker current inhibition in experimental human cardiac sympathetic activation: a double-blind, randomized, crossover study.

Hyperpolarization-activated, cyclic nucleotide-gated 4 (HCN4) channels comprise the final pathway for autonomic heart rate (HR) regulation. We hypothesized that HCN4 inhibition could reverse autonomic imbalance in a human model of cardiac sympathetic activation. Nineteen healthy men ingested oral metoprolol+reboxetine, ivabradine+reboxetine, or placebo+reboxetine in a double-blind, randomized, crossover fashion. We assessed HR, blood pressure (BP), stroke volume, and cardiac output during rest and profound orthostatic stress. HR variability, BP variability, and baroreflex sensitivity were analyzed. Metoprolol, but not ivabradine, decreased resting HR and BP. Ivabradine attenuated the HR increase to orthostatic stress, albeit to a lesser extent than metoprolol. Stroke volume and cardiac output at a given HR were significantly lower with metoprolol. Unlike metoprolol, ivabradine did not affect HR variability, BP variability, or baroreflex sensitivity. Ivabradine attenuates sympathetic influences on HR at the sinus node level, leaving myocardial sympathetic activation unopposed. Reversal of parasympathetic dysfunction by ivabradine appears limited.

Three dimensional Ballistocardiogram and Seismocardiogram: what do they have in common?

3D-body accelerations, i.e. Ballistocardiograms (BCG) and Seismocardiograms (SCG), ECG and Impedance-cardiograms (ICG) were recorded on healthy volunteers participating to the European Space Agency (ESA) 59th parabolic flight campaign. In the present paper we document the similarities and differences that can be seen in the seismo- and ballisto-cardiogram signals in different positions (standing and supine) under normal gravity condition as well as during the weightlessness phases (0G) of a parabolic flight. Our results demonstrate that SCG and BCG both present a similar three dimensional (3D) nature, with components of the BCG having lower frequency content than the SCG. The recordings performed in the 0G environment are the one with the smoothest shape and largest maximum magnitude of the Force vector. The differences seen between SCG and BCG stress further the importance for the need of using different nomenclature for the identification of peaks in both signals.

Cardiovascular changes in parabolic flights assessed by ballistocardiography.

This paper presents a comparison of the cardiovascular changes observed in microgravity as compared to ground based measurements. The ballistocardiogram (BCG), the electrocardiogram (ECG) and the transthoracic impedance cardiogram (ICG) were recorded on five healthy subjects during the 57th-European Space Agency (ESA) parabolic flight campaign. BCG is analyzed though its most characteristic wave, the IJ wave complex that can be identified along the longitudinal component of BCG and which has been demonstrated to be linked to cardiac ejection. The timings between the contraction of the heart and the ejection of blood in the aorta are analyzed via the time delay between the R-wave of the ECG and the I and J-waves of BCG (RI and RJ intervals respectively). Our results show that the IJ complex presents a larger amplitude in weightlessness and suggest that stroke volume (SV) increases in microgravity. We assume that ballistocardiography is an efficient method to assess the ventricular performance.

3D-ballistocardiography in microgravity: comparison with ground based recordings.

3D-Ballistocardiograms ECG and Impedancecardiograms (ICG) were recorded on 5 healthy volunteers participating to the European Space Agency (ESA) 57(th) parabolic flights campaigns. Comparisons are made between the baseline recordings performed on the ground and the recordings made during the microgravity phases of a parabolic flight. The spatial curves of the displacement, velocity and acceleration vectors, instead of their individual components are used to compute the magnitude of the force vector, kinetic energy and work during the cardiac cycle. Our hypothesis is that the 3D-BCG provides parameters correlated with the timings of ejection (PEP, LVET). Although our subject population is limited (N=5), this is the first study of BCG to be performed with N>1. Our results suggest that microgravity decrease the complexity of the 3D displacement curve and that peaks in curvature are consistently present in microgravity and on the ground. However they do not seem to be perfectly related to the classical cardiac ejection timings from ICG.

Timing and source of the maximum of the transthoracic impedance cardiogram (dZ/dt) in relation to the H-I-J complex of the longitudinal ballistocardiogram under gravity and microgravity conditions.

The transthoracic impedance cardiogram (ICG) and the acceleration ballistocardiogram (BCG) measured close to the center of mass of the human body are generated by changes of blood distribution. The transthoracic ICG is an integrated signal covering the whole thorax and spatial resolution is poor. Comparison between both signals can be used to elucidate the source of the ICG signal. We recorded the ECG, ICG, and BCG simultaneously in healthy subjects under resting and microgravity conditions during parabolic flights. The time interval between the R-peak of the ECG and the maximum of the ICG (R-dZ/dtmax) and the time interval between the R-peak of the ECG and the I-peak in the BCG (R-I) differed significantly (p<0.0001). The I-peak in the BCG always occurred earlier during systole than dZ/dtmax. The delay of dZ/dtmax ranged between 23 and 28 ms at rest and was lowest under microgravity conditions (12 ± 4 ms, p<0.02). Our results suggest that both signals have different sources. Combination of modern imaging techniques with classical non invasive approaches to detect changes of blood distribution may provide new insights into the complex interaction between blood flow and mechanocardiographic signals like the BCG.

Three dimensional ballisto- and seismo-cardiography: HIJ wave amplitudes are poorly correlated to maximal systolic force vector.

Ballistocardiography was recorded in 3-D on a free floating astronaut in space as well as on healthy volunteers participating to the ESA 55(th) and DLR 19(th) parabolic flights campaigns. In this paper we demonstrate further the usefulness of recording and analyzing ballistocardiograms (BCG) in three dimensions. The spatial curves of the displacement, velocity and acceleration vectors are analyzed instead of their individual 2-D components. The maximum magnitude of the force vector is shown to be poorly correlated to the HI and IJ wave amplitude traditionally computed on the longitudinal (feet-to-head) component of acceleration (uni-dimensional BCG). We also suggest that kinetic energy and work are useful parameters to consider for a physiological interpretation of the 3D-BCG. The technique presented is invariant from the axis of representation and provides important novel physiological information. We stress further the need of 3D recordings and analysis techniques for Ballisto- and Seismo-cardiography.

Three dimensional ballistocardiography: methodology and results from microgravity and dry immersion.

Balistocardiography was recorded in 3-D on a free floating astronaut in space as well as on healthy volunteers participating to a dry immersion study in a terrestrial laboratory. We demonstrate a new technique suitable for the analysis of 3-D BCG. The spatial curve of the displacement vector is analyzed instead of the three components of acceleration. The technique presented is invariant from the axis of representation and provides important novel physiological information.

A novel pharmacological approach to determining parasympathetic heart rate reserve in human subjects.

Severe cardiac parasympathetic dysfunction can be diagnosed using bedside tests, such as a Valsalva maneuver. However, the tests that are in use are of limited value in detecting and quantifying an early impairment in cardiac parasympathetic function. We showed that α-2-adrenoreceptor stimulation with clonidine combined with pharmacological baroreceptor loading unmasks impaired parasympathetic heart rate reserve before overt changes in heart rate regulation occur. The methodology could be utilized to monitor the progression of autonomic nervous system disease in studies carried out to test neuroprotective strategies.

The effects of season and agriculture on nitrous oxide production in headwater streams.

Streams and rivers are a globally significant source of nitrous oxide (N(2)O), a potent greenhouse gas. However, there remains much uncertainty in the magnitude of N(2)O emissions from these sources, partly due to an incomplete understanding of the factors that control microbial N(2)O production in lotic sediments. During 2004-2005 we measured sediment N(2)O production in 12 headwater streams across an agricultural land use gradient. Stream water nitrate (NO(3)(-)) concentrations were positively related to the proportion of agricultural land use in the basin and frequently exceeded 20 mg N L(-1) in the stream draining the most agricultural basin. Stream sediments were nearly always a net source of N(2)O, and production rates were positively related to stream water NO(3)(-) concentrations and sediment carbon content. There were no seasonal patterns in N(2)O production rates during 2004, but stream water NO(3)(-) and N(2)O production both peaked during the winter of 2005. The spike in NO(3)(-) concentrations likely resulted from winter rain and snowmelt that flushed NO(3)(-) from the soils following a dry summer and fall. In turn, the elevated stream water NO(3)(-) concentrations stimulated in-stream N(2)O production rates. Overall, we were only able to explain 29% of the variation in N(2)O production rates on a log scale. The unexplained variation may be due to differences in the fraction of denitrified NO(3)(-) that is converted to N(2)O among the study sites, or that our measures of substrate availability in the water column were not reflective of substrate availability in the porewater used by denitrifiers.

Cystic bone tuberculosis in children--a case series.

Cystic tuberculosis of the bone is a rare form of tuberculosis (TB) osteomyelitis associated with disseminated lesions. In children, the lesions involve the peripheral skeleton, are symmetric and less sclerotic while in adults, the lesions are axial and predominantly sclerotic. TB dactylitis and spina ventosa are the other common variants of TB osteomyelitis seen in children below five years. Here we report seven cases of cystic TB bone disease. There were three males and four females with age of diagnosis between 2-11 years. Most patients presented with localized swelling and pain. X-rays revealed classical cystic lesions and spina ventosa. Four children had multiple cystic lesions and three had isolated lesions. Diagnosis was confirmed by FNAC of the bone or histopathological/radiological evidence of TB. The patients responded well to anti-tubercular therapy. The entity of cystic TB bone disease should be borne in mind as, lack of awareness may delay diagnosis and treatment. Biopsy is mandatory to confirm diagnosis and antitubercular drugs are the mainstay of therapy. Curettage of affected bone in selected cases may promote early healing. Response to therapy is excellent and the overall prognosis is good.