Amazonian earthworm biodiversity is heavily impacted by ancient and recent human disturbance.

Despite the importance of earthworms for soil formation, more is needed to know about how Pre-Columbian modifications to soils and the landscape. Gaining a deeper understanding is essential for comprehending the historical drivers of earthworm communities and the development of effective conservation strategies in the Amazon rainforest. Human disturbance can significantly impact earthworm diversity, especially in rainforest soils, and in the particular case of the Amazonian rainforest, both recent and ancient anthropic practices may be important. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by sedentary habits and intensification patterns of pre-Colombian societies primarily developed in the second part of the Holocene period. We have sampled earthworm communities in three Brazilian Amazonian (ADEs) and adjacent reference soils (REF) under old and young forests and monocultures. To better assess taxonomic richness, we used morphology and the barcode region of the COI gene to identify juveniles and cocoons and delimit Molecular Operational Taxonomic Units (MOTUs). Here we suggest using Integrated Operational Taxonomical units (IOTUs) which combine both morphological and molecular data and provide a more comprehensive assessment of diversity, while MOTUs only rely on molecular data. A total of 970 individuals were collected, resulting in 51 taxonomic units (IOTUs, MOTUs, and morphospecies combined). From this total, 24 taxonomic units were unique to REF soils, 17 to ADEs, and ten were shared between both soils. The highest richness was found in old forest sites for ADEs (12 taxonomic units) and REFs (21 taxonomic units). The beta-diversity calculations reveal a high species turnover between ADEs and REF soils, providing evidence that ADEs and REFs possess distinct soil biota. Furthermore, results suggest that ADE sites, formed by Pre-Columbian human activities, conserve a high number of native species in the landscape and maintain a high abundance, despite their long-term nature.

Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic Stenosis in Rheumatic Heart Disease: A Systematic Review.

Transcatheter aortic valve replacement (TAVR) is well-established for severe symptomatic aortic stenosis (AS), but its use in rheumatic heart disease (RHD) has been limited. We systematically review the use of TAVR for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure characteristics, efficacy, and safety endpoints were collected and all definitions were based on the Valve Academic Research Consortium-2 (VARC-2) criteria. We included 3 case series and 12 case reports, with a total of 43 patients. Mean age was 76 years, 75% were female, and 85% had NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients were moderate to high risk, with Society of Thoracic Surgery score ranging from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases. Procedural success occurred in 37 (86%) patients. Of the 7 patients with periprocedural complications, 4 had valve dislodgement, 1 deployment failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only 1 patient had heart block requiring pacemaker. Among 13 studies (23 patients), 30-day mortality was 0%. One case series with 19 patients had a 30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%, respectively. TAVR appears feasible for selected patients with rheumatic severe AS, albeit our results indicate a 14% incidence of device failure. Future randomized clinical trials may clarify the role of TAVR in this group.

A "Dirty" Footprint: Macroinvertebrate diversity in Amazonian Anthropic Soils.

Amazonian rainforests, once thought to be pristine wilderness, are increasingly known to have been widely inhabited, modified, and managed prior to European arrival, by human populations with diverse cultural backgrounds. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by pre-Columbian societies with sedentary habits. Much is known about the chemistry of these soils, yet their zoology has been neglected. Hence, we characterized soil fertility, macroinvertebrate communities, and their activity at nine archeological sites in three Amazonian regions in ADEs and adjacent reference soils under native forest (young and old) and agricultural systems. We found 673 morphospecies and, despite similar richness in ADEs (385 spp.) and reference soils (399 spp.), we identified a tenacious pre-Columbian footprint, with 49% of morphospecies found exclusively in ADEs. Termite and total macroinvertebrate abundance were higher in reference soils, while soil fertility and macroinvertebrate activity were higher in the ADEs, and associated with larger earthworm quantities and biomass. We show that ADE habitats have a unique pool of species, but that modern land use of ADEs decreases their populations, diversity, and contributions to soil functioning. These findings support the idea that humans created and sustained high-fertility ecosystems that persist today, altering biodiversity patterns in Amazonia.

Multiband 5G NR system with photonic-assisted RF amplification.

We propose and report the implementation of a multiband and photonically amplified fifth-generation (5G) new radio (NR) system based on radio over fiber technology and four-wave mixing (FWM) nonlinear effect. A piece of highly nonlinear fiber has been employed to stimulate FWM, which enables photonics-assisted RF amplification up to millimeter waves. Experimental results demonstrate a uniform and stable 15 dB ultra-wideband gain for 4G and three 5G signals in the frequency range from 780 MHz to 26 GHz, coexisting in the transport network. The obtained digital performance has efficiently met the Third-Generation Partnership Project requirements, demonstrating the applicability of the proposed approach for using fiber-optic links to distribute and jointly amplify 4G and 5G signals in the optical domain.

Twigs occupied by Pheidole Westwood, 1839: Is there a difference between species? / Galhos ocupados por Pheidole Westwood, 1839: há diferença entre espécies?

Abstract: Pheidole is a genus with wide geographical distribution and diversity, especially in the leaf litter of neotropical forests, where nests are found at the soil-litter interface, in the soil and vegetation, among leaves, seeds, and twigs. Despite the availability of twigs and Pheidole species diversity in the leaf litter, most of this resource is not occupied, which suggests the existence of filters. This study analyzes whether twigs occupied by Pheidole species differ for the outer structure and anatomy of the wood. Twigs were collected from preserved Atlantic Forest fragments in southeastern Brazil. Twigs with Pheidole colonies were measured and the wood anatomy analyzed. We collected 224 twigs with Pheidole colonies, but the analysis was done at 41% due to wood decomposition. Five species were recorded in these twigs, which differ for the outer structure and anatomy of the wood. These results suggest the existence of preference in the occupation of twigs determined by wood structure.

Resumo: Pheidole é um gênero com ampla distribuição geográfica e diversidade, especialmente na serapilheira das florestas da Região Neotropical, onde os ninhos são encontrados na interface solo-serapilheira, solo, vegetação, entre folhas, sementes e galhos. Apesar da disponibilidade de galhos e diversidade de espécies de Pheidole na serapilheira, a maior parte deste recurso não é ocupada, o que sugere a existência de filtros. Neste trabalho analisamos se galhos ocupados por espécies de Pheidole diferem em relação à estrutura externa e anatomia da madeira. A coleta de galhos foi realizada em fragmentos conservados de Mata Atlântica na região Sudeste do Brasil. Os galhos com colônias de Pheidole foram mensurados e a anatomia da madeira analisada. Foram coletados 224 galhos com colônias de Pheidole, mas a análise foi realizada em 41% devido à decomposição da madeira. Nestes galhos foram registradas cinco espécies, que diferem em relação à estrutura externa e anatomia da madeira. Estes resultados sugerem a existência de preferência na ocupação do galho determinada pela estrutura da madeira.

Time-course of vascular dysfunction of brachial artery after transradial access for coronary angiography.

BACKGROUND: Prior studies have demonstrated endothelial and smooth muscle brachial artery dysfunction after transradial cardiac catheterization for diagnostic coronary angiography. The duration of this vascular dysfunction is unknown. OBJECTIVE: To determine the time-course of endothelial and smooth muscle cell dysfunction in the upstream brachial artery after transradial cardiac catheterization. METHODS: We studied 22 consecutive patients with suspected coronary artery disease (age 64.4 ± 7.7 years) undergoing diagnostic transradial cardiac catheterization. Using high-resolution vascular ultrasound, we measured ipsilateral brachial artery diameter changes during reactive hyperemia (endothelium-dependent dilatation) and administration of sublingual nitroglycerin (endothelium-independent dilatation). The measurements were taken at baseline (before cardiac catheterization), 6 h, 24 h, 1 week, and 1 month postprocedure. The contralateral brachial artery served as a control. RESULTS: Ipsilateral brachial artery diameter during endothelium-dependent dilatation decreased significantly compared with the contralateral diameters at 6 h and 24 h after transradial cardiac catheterization (3.22 vs. 4.11 and 3.29 vs. 4.11, respectively, P < 0.001). The administration of nitroglycerin did not affect this difference. At 1 week and 1 month postprocedure there was no significant difference in diameter of the ipsilateral versus the contralateral brachial artery. As expected the contralateral brachial artery showed no significant changes in diameter. CONCLUSION: Our results showed that transradial cardiac catheterization causes transient vascular endothelial and smooth muscle dysfunction of the ipsilateral brachial artery, which resolves within 1 week postprocedure. These findings strongly suggest the absence of systemic vascular dysfunction after transradial catheterization both immediately postprocedure as well as 1 week postprocedure. © 2015 Wiley Periodicals, Inc.

A review of simple, non-invasive means of assessing peripheral arterial disease and implications for medical management.

Abstract Atherosclerotic peripheral arterial disease (PAD) is highly prevalent in the elderly and subjects with atherosclerotic risk factors such as smoking, diabetes mellitus, hypertension, and hyperlipidemia. Importantly, PAD is rarely an isolated condition, but rather a manifestation of systemic atherosclerosis. Hence, there is often coexisting disease in the coronary and cerebral arteries and, consequently, an increased risk of myocardial infarction and stroke. Intermittent claudication is the classic symptom of PAD, yet up to 50% of patients are asymptomatic. Despite the availability of reliable, non-invasive screening tests, PAD is largely underdiagnosed and undertreated, mostly due to the paucity of symptoms and underutilization of screening tools. The ankle-brachial index (ABI), a simple, rapid, and inexpensive diagnostic tool, holds much prognostic value for PAD diagnosis and is ideal for implementation in the primary care physician's office. The early detection of PAD with ABI screening and subsequent medical management represents a critical opportunity to prevent considerable vascular morbidity and mortality. The management of PAD must address claudication symptoms (with cilostazol or pentoxifylline, or in severe cases endovascular or surgical revascularization) and modifiable atherosclerotic risk factors (with an aggressive global risk-reduction regimen involving lifestyle modifications, exercise, smoking cessation, and antiplatelet, lipid-lowering, and antihypertensive therapy).

Effects and mechanisms of left ventricular false tendons on functional mitral regurgitation in patients with severe cardiomyopathy.

OBJECTIVE: False tendons in the left ventricle are commonly observed. Preliminary observations associate false tendons with less functional mitral regurgitation. METHODS: Echocardiograms demonstrating severe cardiomyopathy (ejection fraction < or =30%) were retrospectively examined for left ventricular false tendons. The ejection fraction, cause of left ventricular systolic dysfunction, left ventricular diastolic dimensions, severity of mitral regurgitation, mitral annular diameter, mitral valve coaptation depth, mitral valve coaptation area, and orientation of false tendon were evaluated. The patients with false tendons were compared with a control group with cardiomyopathy without false tendons. RESULTS: A cohort of patients (n = 82) with severe left ventricular systolic dysfunction (mean ejection fraction, 21%) and false tendons were compared with a control group with similar left ventricular dysfunction and no false tendons (n = 121; mean ejection fraction, 20%; P = .10). The patients with false tendons had similar left ventricular diastolic internal dimensions compared with the control group (5.99 and 6.18 cm, respectively; P = .086). Yet patients with false tendons had a very low incidence of severe functional mitral regurgitation compared with the control group (4.9% vs 27%, P < .001). Patients with false tendons had significantly smaller mitral annular diameters (3.57 vs 4.03 cm, P < .001), shorter mitral valve coaptation depths (0.89 vs 1.24 cm, P < .001), and reduced coaptation areas (1.61 vs 2.52 cm(2), P < .001) than the control group. The reduction of mitral regurgitation was more significant for patient with transverse midcavity false tendons. CONCLUSIONS: Patients with false tendons and cardiomyopathy have less severe mitral regurgitation. The mechanism for the reduction in functional mitral regurgitation might be less mitral valve deformation, specifically lower coaptation depth and coaptation area when a false tendon is present.

Takotsubo cardiomyopathy, or broken-heart syndrome.

Takotsubo cardiomyopathy mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. In Japanese, "takotsubo" means "fishing pot for trapping octopus," and the left ventricle of a patient diagnosed with this condition resembles that shape. Takotsubo cardiomyopathy, which is transient and typically precipitated by acute emotional stress, is also known as "stress cardiomyopathy" or "broken-heart syndrome."Herein, we describe the clinical angiographic characteristics of 4 patients who exhibited this syndrome, and we review the existing literature and propose reasons to conduct prospective studies.

Management of failed thrombolysis after acute myocardial infarction: an overview of current treatment options.

Thrombolytic therapy remains the most commonly administered revascularization strategy for patients with ST-elevation myocardial infarctions (STEMI). However, many patients fail to have patent arteries or ST-segment resolution after these therapies. Multiple strategies have been examined to treat these patients with "failed thrombolysis." We examined the existing medical literature regarding treatment of failed thrombolysis including strategies testing repeat thrombolytic therapy and rescue percutaneous coronary intervention. Additional, we reviewed the literature regarding the efficacy of transferring patient for rescue percutaneous intervention and coronary stenting. The impact of contemporary antiplatelet strategies, cardiogenic shock, and coronary bypass surgery was examined. Overall, the management of patients with acute STEMI in whom thrombolytic therapy failed remains a challenging problem. As a result, many different strategies are currently in use. Among these therapeutic interventions, rescue PCI with coronary stenting appears to be superior when it is done in a timely manner by an experienced center.

Left main coronary artery stenosis: factors predicting cardiac events in patients awaiting coronary surgery.

Although most patients with left main coronary artery stenosis undergo urgent coronary artery bypass grafting, limited information is available regarding the risk factors that might lead to cardiac events between angiographic diagnosis and surgery. We retrospectively reviewed 1,731 cases of coronary artery bypass grafting at our institution, 97 of which were performed in patients with significant (> or = 50%) left main coronary artery stenosis. These patients were placed in 1 of 2 groups: eventful waiting or uneventful waiting. We analyzed multiple preoperative variables, and the incidence of serious cardiac events (death, myocardial infarction, unstable angina, left ventricular failure, and life-threatening ventricular arrhythmias) during the waiting period between angiography and surgery Four patients (4.1%) experienced serious cardiac events while awaiting surgery (1 had non-ST-elevation myocardial infarction; 3 had life-threatening ventricular arrhythmias); none died. All the events occurred more than 24 hours after cardiac catheterization. Of the preoperative variables analyzed (acute coronary syndrome, age, history of diabetes, hypertension, hyperlipidemia, smoking, renal failure, severity of left main stenosis, right coronary artery involvement, ejection fraction, and use of intra-aortic balloon pump), only acute coronary syndrome predicted the incidence of preoperative cardiac events (P=0.001). The occurrence of severe cardiac events while patients await coronary artery bypass grafting is rare. Carefully selected patients with severe left main coronary artery stenosis can safely await surgery. Concomitant acute coronary syndrome and severe left main coronary artery stenosis indicate a high risk for cardiac events. Therefore, in patients with these conditions, emergency coronary artery bypass may be preferable.

Internal mammary artery to pulmonary vasculature fistula--case series.

Internal mammary artery to pulmonary vasculature fistula is a rare condition that can be congenital or associated with coronary bypass surgery, trauma, inflammation, or neoplasia. We report six cases of symptomatic internal mammary artery to pulmonary vasculature fistula diagnosed after coronary bypass surgery using left internal mammary artery graft.

Postprandial hypertriglyceridemia increases circulating levels of endothelial cell microparticles.

BACKGROUND: This study evaluated a possible relationship between levels of endothelial microparticles (EMPs), known to be a sensitive indicator of endothelial disturbance, and changes in postprandial lipid levels in healthy volunteers after a low- or high-fat meal. METHODS AND RESULTS: Eighteen healthy subjects without known cardiovascular risk factors were evaluated. Lipid and EMP levels were measured before and 1 and 3 hours after a single low- or high-fat isocaloric meal. The low-fat meal had no significant postprandial effect on EMPs or lipids compared with fasting levels. In contrast, a single high-fat meal significantly increased EMP levels after 1 and 3 hours, from 389+/-54 (thousands per milliliter) when fasting to 541+/-139 (P=0.0002) and 677+/-159 (P<0.0001), respectively, and correlated with a postprandial elevation in serum triglycerides. CONCLUSIONS: A single high-fat meal led to a significant elevation of plasma EMP levels in healthy, normolipidemic subjects and correlated with a postprandial elevation of serum triglycerides. EMPs may be an indirect marker of endothelial dysfunction or injury induced by postprandial triglyceride-rich lipoproteins.

Noncardiac surgery following percutaneous coronary intervention.

Patient with coronary artery disease (CAD) undergoing major noncardiac surgery (NCS) are at increased risk of serious perioperative cardiac complications. At the same time, safety of percutaneous coronary intervention (PCI) before noncardiac surgery has been questioned. This paper reviews the available literature regarding the safety of PCI before NCS. At the same time, cardiac evaluation before NCS, perioperative medical management of patients undergoing NCS, and percutaneous coronary intervention and timing of NCS is also discussed.

Severe volume depletion leading to mitral insufficiency.

We report a patient with profound hypovolemia who developed dynamic left ventricular outflow tract obstruction and severe mitral regurgitation. Both the outflow tract obstruction and mitral regurgitation resolved with volume replacement. Unlike previous reports of dynamic left ventricular outflow obstruction and mitral regurgitation, the degree of mitral regurgitation was severe. Possible mechanisms are discussed.