Evaluation of the effects of dust pollution on specific plant species near and around the marble mining site in Rajasthan, India.

Airborne particles (dust pollution) pose a significant threat to both human and plant populations. Plant leaves act as crucial biofilters, capturing significant amounts of air pollution; this characteristic offers a valuable tool to measure local pollution levels and assess individual plant species' ability to intercept and mitigate harmful dust particles. The present study was carried out to asses the effect of responses of various plant species to dust pollution near and around the marble mining site comprising residential site, highway area, and Central University of Rajasthan as control. The anticipated pollution index, air pollution tolerance index (APTI), dust absorption capacity, metal accumulation index (MAI), and biochemical factors were used to evaluate plant responses. Azadirachta indica A. Juss. demonstrated the highest (29.0) and Vachellia nilotica L. showed lowest (5.6) APTI, respectively. A. indica showed maximum MAI values in comparison to other plant species situated at residential site. Additionally, monitoring of particulate matter (PM10) observed to highest at highway, followed by mining, residential, and control sites. Overall A. indica representing highest APTI and effective dust capturing capacity at all sites could serve as potential pollution sinks. V. nilotica, with its very low APTI, can be marked as biomonitoring tool for detecting dust pollution.

Palliative care needs among outpatient adults with cystic fibrosis: Baseline data from the Improving Life with CF trial.

BACKGROUND: Little is known about the burden of illness experienced by people with cystic fibrosis (pwCF) since the advent of CF transmembrane conductance regulator (CFTR) modulator therapies. Studies that characterize the nature of illness burden are needed to inform the development and implementation of palliative care programs that can serve this population and address quality of life concerns. METHODS: Adults with CF treated at five U.S. CF centers were surveyed to obtain baseline data for the Improving Life with CF primary palliative care implementation trial. Consenting patients completed the Integrated Palliative Care Outcome Scale (IPOS), a multidimensional measure of unmet needs for palliative care. Sociodemographic and clinical information was also obtained. The associations among these variables were examined through bivariate and multivariable analyses. RESULTS: Among 256 adults, the most distressing symptoms included not feeling "at peace", communication difficulties with family/friends, anxiety over illness or its treatment, and a lack of energy. In the multivariable analyses, CFTR modulator use was associated with lower IPOS total and physical symptoms scores; female sex and increased hospitalizations were associated with higher scores. Increased age and history of distal intestinal obstructive syndrome were associated with higher IPOS physical symptoms scores. CONCLUSIONS: These findings illuminate the nature of illness burden for pwCF in the era of CFTR modulator therapies. Although illness burden is positively affected by modulator therapy, there is a continuing need for palliative care to address physical, emotional, and spiritual distress, and the communication and practical needs experienced by adults with CF.

Management of neuropsychiatric symptoms in adults treated with elexacaftor/tezacaftor/ivacaftor.

INTRODUCTION: Reports of neuropsychiatric symptoms proximal to cystic fibrosis transmembrane conductance regulator (CFTR) modulator initiation are emerging, but their prevalence and management remain poorly characterized. METHODS: Retrospective chart review was used to categorize symptom trajectories of all adults at a single CF Center who initiated elexacaftor/tezacaftor/ivacaftor (ETI) before March 2022 and subsequently had ≥1 outpatient visit with the consulting CF psychiatrist. For those who developed neuropsychiatric symptoms probably related to ETI and modified treatment in response, the strategy resulting in greatest improvement with acceptable physical course and tolerability was identified. Ratings were made by a psychiatrist not involved in clinical care. RESULTS: Of 148 adults initiating ETI, 31 were psychiatrically evaluated, 16 of whom developed new/worsening and unexpected neuropsychiatric symptoms probably related to ETI, including neurocognitive (word finding, brain fog, memory, attention/concentration), insomnia, depression, anxiety, fatigue/low energy, mania/hypomania, other distress. This group had higher maximum lifetime Generalized Anxiety Disorder-7 scores (14.42 ± 0.96; p = 0.05) than those with improved, unchanged, or worsening/possibly related symptoms (N = 15; 9.9 ± 1.82). Treatment strategies resulting in much/very much improvement included pharmacologic interventions, psychotherapy, and dose reduction/discontinuing ETI. CONCLUSIONS: Although many people initiating ETI experience improved physical and mental health and quality of life, a subset report worsening neurocognition, mood, and anxiety. As novel therapies are developed, ascertaining and evaluating neuropsychiatric symptoms in clinical and research settings is advisable. Larger studies are needed to characterize prevalence, course, and risk factors (e.g., age, gender, clinical status, pharmacokinetics/pharmacogenomics, drug-drug interactions) for neuropsychiatric adverse events related to CFTR modulators and guide effective management.

Development of a Cystic Fibrosis Primary Palliative Care Intervention: Qualitative Analysis of Patient and Family Caregiver Preferences.

To prevent or mitigate chronic illness burden, people with cystic fibrosis (pwCF) and their family caregivers need primary (generalist-level) palliative care from the time of diagnosis forward. We used qualitative methods to explore their preferences about a screening-and-triage model ("Improving Life with CF") developed to standardize this care. We purposively sampled and interviewed 14 pwCF and caregivers from 5 Improving Life with CF study sites. Thematic analysis was guided by a priori codes using the National Consensus Project's Guidelines for Quality Palliative Care. Participants included 7 adults and 2 adolescents with CF (3 with advanced disease), 4 parents, 1 partner (7 women; 5 people of color). Few were familiar with palliative care. Illness burden was described in multiple domains, including physical (e.g., dyspnea, pain), psychological (e.g., anxiety), and social (e.g., family well-being; impact on work/school). Most preferred survey-based screening with care coordination by the CF team. Preferences for screening approaches varied. PwCF and caregivers experience illness burden and are receptive to a CF-team delivered primary palliative care screening-and-triage model with flexible processes.

Salt stress resilience in plants mediated through osmolyte accumulation and its crosstalk mechanism with phytohormones.

Salinity stress is one of the significant abiotic stresses that influence critical metabolic processes in the plant. Salinity stress limits plant growth and development by adversely affecting various physiological and biochemical processes. Enhanced generation of reactive oxygen species (ROS) induced via salinity stress subsequently alters macromolecules such as lipids, proteins, and nucleic acids, and thus constrains crop productivity. Due to which, a decreasing trend in cultivable land and a rising world population raises a question of global food security. In response to salt stress signals, plants adapt defensive mechanisms by orchestrating the synthesis, signaling, and regulation of various osmolytes and phytohormones. Under salinity stress, osmolytes have been investigated to stabilize the osmotic differences between the surrounding of cells and cytosol. They also help in the regulation of protein folding to facilitate protein functioning and stress signaling. Phytohormones play critical roles in eliciting a salinity stress adaptation response in plants. These responses enable the plants to acclimatize to adverse soil conditions. Phytohormones and osmolytes are helpful in minimizing salinity stress-related detrimental effects on plants. These phytohormones modulate the level of osmolytes through alteration in the gene expression pattern of key biosynthetic enzymes and antioxidative enzymes along with their role as signaling molecules. Thus, it becomes vital to understand the roles of these phytohormones on osmolyte accumulation and regulation to conclude the adaptive roles played by plants to avoid salinity stress.

Preoperative penicillin allergy testing in patients undergoing cardiac surgery.

BACKGROUND: Cefazolin is a first-line prophylactic antibiotic used to prevent surgical site infections (SSIs) in cardiac surgery. Patients with a history of penicillin allergy often receive less effective second-line antibiotics, which is associated with an increased SSI risk. OBJECTIVE: To describe the impact of preoperative penicillin allergy evaluation on perioperative cefazolin use in patients undergoing cardiac surgery. METHODS: We performed a retrospective cohort study of patients with a documented penicillin allergy who underwent cardiac surgery at the Massachusetts General Hospital from September 2015 to December 2018. We describe penicillin allergy evaluation assessment and outcomes. We evaluated the association between preoperative penicillin allergy evaluation and first-line perioperative antibiotic use using a multivariable logistic regression model. RESULTS: Of 3802 cardiac surgical patients, 510 (13%) had a documented penicillin allergy; 165 (33%) were referred to allergy and immunology practitioners. Of 160 patients (31%) who underwent penicillin allergy evaluation (ie, penicillin skin testing and, if results were negative, an amoxicillin challenge), 154 (97%) were found not to have a penicillin allergy. Patients who underwent preoperative penicillin allergy evaluation were more likely to receive the first-line perioperative antibiotic (92% vs 38%, P < .001). After adjusting for potential confounders, patients who underwent preoperative penicillin allergy evaluation had higher odds of first-line perioperative antibiotic use (adjusted odds ratio, 26.6; 95% CI, 12.8-55.2). CONCLUSION: Integrating penicillin allergy evaluation into routine preoperative care ensured that almost all evaluated patients undergoing cardiac surgery received first-line antibiotic prophylaxis, a critical component of SSI risk reduction. Further efforts are needed to increase access to preoperative allergy evaluation.

Responses of an old and a modern Indian wheat cultivar to future O3 level: Physiological, yield and grain quality parameters.

A field study was conducted to understand the physiological responses, yield and grain quality of an old (HUW234) and a modern (HD3118) wheat cultivar exposed to elevated ozone (O3). The cultivars were grown under ambient O3 (NF) and ambient +20 ppb O3 (NF+) conditions using open-top chambers (OTCs). The comparative study of an old and a modern cultivar showed variable physiological responses under elevated O3 exposure. Elevated O3 in old cultivar caused high reductions in Rubisco activity (Vcmax) and electron transport rate (J) compared to modern cultivar with simultaneous reductions in the rate of photosynthesis and chlorophyll fluorescence. In modern cultivar, high stomatal density and conductance caused higher O3 uptake thereby triggering more damage to the adjacent stomatal cells and photosynthetic pigments coupled with reductions in photosynthetic rate and photosynthetic nitrogen use efficiency (PNUE). Modern cultivar also showed relatively high reduction in grain yield compared to old one under NF + treatment. Furthermore, grain quality traits (such as starch, protein and amino acids) of modern cultivar were better than old cultivar under ambient O3, but showed more deterioration under NF + treatment. Results thus indicated that modern cultivar is relatively more susceptible to O3 and showed more negative impacts on plant performance, yield and quality of grains compared to old cultivar.

ROS production and its detoxification in early and late sown cultivars of wheat under future O3 concentration.

The present field study was planned with an objective to unravel the mechanisms behind the differential responses of early and late sown wheat cultivars with respect to their defense capacity to scavenge ROS induced under elevated O3 (EO3). Experiments were performed under ambient and elevated levels of O3 (ambient + 20 ppb) to plants inside open-top chambers (OTCs). Ozone concentrations, stomatal flux of O3 and meteorological parameters were measured throughout the experiment. Contents of superoxide radicals (O2-) and hydrogen peroxide (H2O2) and their localization, lipid peroxidation, antioxidative enzyme activities, ascorbic acid and total phenolic contents were measured at vegetative and reproductive developmental stages. EO3 exposure induced higher stomatal flux of O3 in early sown cultivars. Higher contents of O2-, H2O2 and lipid peroxidation were noticed under EO3 in all the cultivars but the magnitude of increases was higher in late sown cultivars at the reproductive stage. Activities of glutathione reductase (GR) and ascorbate peroxidase (APX) were higher in late sown cultivars under EO3. Ascorbic acid and total phenolic contents were significantly higher in early sown than late sown cultivars under EO3 treatment. The present study concludes that early sown cultivars are more efficient in their defense response due to higher induction of enzymatic and non-enzymatic antioxidants, while the induction of enzymatic antioxidants was more distinct in late sown cultivars. Non-enzymatic linked defense mechanism requires additional metabolic cost than enzymatic defense, making early sown cultivars more susceptible to EO3. Differential response of early and late sown cultivars with respect to antioxidative defense against O3 stress suggests that yield responses are governed by the time of sowing and intrinsic defense responses of the cultivars. In future with rising trend of O3, early sown cultivars are expected to be more vulnerable to oxidative stress compared to late sown cultivars.

Squamous Metaplasia in Pleomorphic Adenoma: A Diagnostic and Prognostic Enigma.

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Histologically, squamous metaplasia has been reported in PA, but has rarely been documented as being extensive enough to cause significant misdiagnosis. Here, we present an unusual case of PA in a 50-year-old female patient presenting with swelling on the postero-lateral aspect of the palate for a week. Histopathologically, the tumor exhibited the features of conventional PA with extensive squamous metaplasia and giant keratotic lamellae in cyst-like areas. Such exuberant squamous metaplasia and keratin can be a diagnostic and prognostic pitfall and lead to overtreatment of the patient.

Assessment of ozone toxicity among 14 Indian wheat cultivars under field conditions: growth and productivity.

Tropospheric ozone (O3) is a well-known threat to global agricultural production. Wheat (Triticum aestivum L.) is the second most important staple crop in India, although little is known about intra-specific variability of Indian wheat cultivars in terms of their sensitivity against O3. In this study, 14 wheat cultivars widely grown in India were exposed to 30 ppb elevated O3 above ambient level using open top chambers to evaluate their response against O3 stress. Different growth and physiological parameters, foliar injury and grain yield were evaluated to assess the sensitivity of cultivars and classified them on the basis of their cumulative stress response index (CSRI). Due to elevated O3, growth parameters, plant biomass, and photosynthetic rates were negatively affected, whereas variable reductions in yield were observed among the test cultivars. Based on CSRI values, HD 2987, DBW 50, DBW 77, and PBW 550 were classified as O3 sensitive; HD 2967, NIAW 34, HD 3059, PBW 502, HUW 213, and HUW 251 as intermediately sensitive, while HUW12, KUNDAN, HUW 55, and KHARCHIYA 65 were found to be O3-tolerant cultivars. Cultivars released after year 2000 were found to be more sensitive compared to earlier released cultivars. Path analysis approach showed that leaf area, plant biomass, stomatal conductance, net assimilation rate, and absolute growth rate were the most important variables influencing yield under O3 stress. Findings of the current study highlight the importance of assessing differential sensitivity and tolerance of wheat cultivars and response of different traits in developing resistance against elevated O3.

The role of elevated ozone on growth, yield and seed quality amongst six cultivars of mung bean.

Tropospheric ozone (O3) can be deleterious to plants by decreasing crop yield and quality. Present study was conducted on six cultivars of mung bean (HUM-1, HUM-2, HUM-6, HUM-23, HUM-24 and HUM-26) grown under ambient O3 (NFC) and elevated O3 levels (ambient+10 ppb; NFC+) in open top chambers (OTCs) for two consecutive years. Ozone monitoring data showed high mean ambient concentration of O3 at the experimental site, which was above the threshold value of 40 ppb. Ozone exposure induced symptoms of foliar injury and also depicted accumulation of reactive oxygen species (ROS) which led to increased membrane damage vis-a-vis solute leakage. Root/shoot allometric coefficient (k), yield and seed quality showed negative response to O3. Differential response of mung bean cultivars against elevated O3 was assessed by comparing the levels of antioxidants, metabolites, growth, total biomass and yield. Cultivar HUM-1 showed maximum sensitivity towards O3 as compared to other cultivars. Findings of present study emphasized the possibility of selection of suitable O3 resistant cultivars for the areas experiencing high concentrations of O3.

Assessment of six Indian cultivars of mung bean against ozone by using foliar injury index and changes in carbon assimilation, gas exchange, chlorophyll fluorescence and photosynthetic pigments.

Six Indian cultivars of Vigna radiata L. (HUM-1, HUM-2, HUM-6, HUM-23, HUM-24 and HUM-26) were exposed with ambient and elevated (ambient + 10 ppb ozone (O3) for 6 h day(-1)) level of O3 in open top chambers. Ozone sensitivity was assessed by recording the magnitude of foliar visible injury and changes in various physiological parameters. All the six cultivars showed visible foliar symptoms due to O3, ranging 7.4 to 55.7 % injured leaf area. O3 significantly depressed total chlorophyll, photosynthetic rate (Ps), quantum yield (F(v)/F(m)) and total biomass although the extent of variation was cultivar specific. Cultivar HUM-1 showed maximum reduction in Ps and stomatal conductance. The fluorescence parameters also indicated maximum damage to PSII reaction centres of HUM-1. Injury percentage, chlorophyll loss, Ps, F(v)/F(m) and total biomass reduced least in HUM-23 depicting highest O3 resistance (R%).

Intraspecific responses of six Indian clover cultivars under ambient and elevated levels of ozone.

Intraspecific variation in six cultivars of clover Trifolium alexandrinum L., (Bundel, Wardan, JHB-146, Saidi, Fahli, and Mescavi) has been studied with ambient and elevated O3 (ambient + 10 ppb O3) in open top chambers. Significant effect of elevated O3 was detected on different morphological, physiological, and biochemical parameters depicting differential response among the test cultivars. Results showed that the magnitude of O3 induced foliar injury symptoms varied in all the cultivars. Ozone significantly depressed photosynthetic rate, stomatal conductance, and photosynthetic efficiency, although variations were cultivar specific. Ozone treatment diminished total biomass of all the cultivars; reduction was highest in Wardan with least O3 resistance followed by Bundel, JHB-146, Saidi, Mescavi, and Fahli. According to the cumulative sensitive index, variations in the sensitivity showed that two cultivars (Wardan and Bundel) were sensitive to elevated O3, while other three cultivars (Fahli, Saidi, and Mescavi) were resistant, and JHB-146 showed intermediate sensitivity. Therefore, the present study supported the selection of sensitive cultivar of clover as a bioindicator for O3 under Indian conditions for the areas experiencing higher concentrations of O3.