Enriched soil amendments influenced soil fertility, herbage yield and bioactive principle of medicinal plant (Cassia angustifolia Vahl.) grown in two different soils.

High cost of chemical fertilizers and poor nutrient content in conventional organic sources (manure, compost, charcoal etc.) can be addressed through development of enriched organic amendments. However, there is a need to evaluate enriched organic amendments as a potential alternative of chemical fertilizers. Therefore, an effort was made to prepare enriched organic amendments through blending distillation waste of aromatic plant biomass (DWB) with naturally available low-grade rock phosphate (RP) and waste mica (WM). Enrich compost (ENC) was produced from DWB in a natural composting process, blended with mineral powder, whereas biochar fortified mineral (BFM) was prepared by blending biochar, derived from DWB through hydrothermal reaction, with mineral powder. The main aims of the present study were to investigate the impacts of ENC and BFM applications on soil properties, and herbage yield and quality of a medicinal herb Senna (Cassia angustifolia Vahl.). The performances of ENC and BFM at two different rates (2.5 and 5 t ha-1) were compared with the application of conventional farmyard manure (FYM, 5 t ha-1) and chemical fertilizers (CF, NPK 60-40-20 kg ha-1) in two different soils in a pot experiment. Both, ENC and EBC improved soil quality and fertility by increasing soil organic carbon, available nutrients, microbial biomass and enzyme activity. The ENC and BFM increased total herbage yields by 21 and 16.3 % compared to FYM. In both soils, the CF treatment produced the maximum dry herbage yields (32.7-37.4 g pot-1), which however were comparable to ENC (31.9-33.7 g pot-1) and BFM (30.7-35.1 g pot-1) treatments. Bioactive compound (sennoside) production in senna was significantly improved by ENC and BFM compared to CF. The present study indicates that ENC and BFM could not only help to overcome the limitation of conventional FYM, but also have the potentials to substitute costly chemical fertilizers, particularly in medicinal plant cultivation.

Regional sources of NH3, SO2 and CO in the Third Pole.

The Third Pole (TP) is a high mountain region in the world, and is well-known for its pristine environment, but recent development activities in the region have degraded its air quality. Here, we investigate the spatial and temporal changes of the air pollutants ammonia (NH3), sulphur dioxide (SO2) and carbon monoxide (CO) in TP, and reveal their sources using satellite measurements and emission inventory. We observe a clear seasonal cycle of NH3 in TP, with high values in summer and low values in winter. The intense agriculture activities in the southern TP are the cause of high NH3 (6-8 × 1016 molec./cm2) there. Similarly, CO shows a distinct seasonal cycle with high values in spring in the southeast TP due to biomass burning. In addition, the eastern boundary of TP in the Sichuan and Qinghai provinces also show high values of CO (about 1.5 × 1018 mol/cm2), primarily owing to the industrial activities. There is no seasonal cycle found for SO2 distribution in TP, but relatively high values (8-10 mg/m2) are observed in its eastern boundary. The high-altitude pristine regions of inner TP are also getting polluted because of increased human activities in and around TP, as we estimate positive trends in CO (0.5-1.5 × 1016 mol/cm2/yr) there. In addition, positive trends are also found in NH3 (0.025 × 1016 molec./cm2/yr) during 2008-2020 in most regions of TP and SO2 (about 0.25-0.75 mg/m2/yr) in the Sichuan and Qinghai region during 2000-2020. As revealed by the emission inventory, there are high anthropogenic emissions of NH3, SO2 and CO within TP. There are emissions of pollutants from energy sectors, oil and refinery, agriculture waste burning and manure management within TP. These anthropogenic activities accelerate the ongoing development in TP, but severely erode its environment.

Effect of in vitro Digestion on the Bioaccessibility of Polyphenols and Potential Prebiotic Properties of Potato Peel.

BACKGROUND: Potato peel is a byproduct of the potato processing industry and a potential source of functional ingredients such as dietary fiber, polyphenols, and prebiotics. However, the bioaccessibility of polyphenols and antioxidants during in vitro digestion and prebiotic potential after in vitro digestion of potato peel flour has not been reported. OBJECTIVE: The study was designed to assess the bioaccessibility of polyphenols and the prebiotic potential of potato peel flour. METHODS: In this study, the changes in polyphenol content and antioxidant capacity during different phases of in vitro digestion, including salivary, gastric and intestinal phases were studied. Additionally, an investigation was conducted to evaluate the prebiotic properties of potato peel flour by in vitro fermentation with Lactobacillus acidophilus. RESULTS: The findings revealed a significant increase in the recovery index for total phenolic content during both gastric (106.90%) and intestinal (102.71%) digestive phases. Furthermore, polyphenols in potato peel flour exhibited high residual intestinal digestibility index values (>90%). The antioxidant capacity increased by >50% during various phases of in vitro digestion. Regarding prebiotic properties, potato peel flour significantly increased L. acidophilus counts and promoted the production of short-chain fatty acids, specifically propionate and butyrate. CONCLUSION: This study suggests that potato peel flour has the potential to serve as a functional ingredient or nutraceutical that can enhance health and may help in reducing environmental problems.

Reporting of coronary artery calcification on chest CT studies in patients with interstitial lung disease.

AIM: To evaluate the prevalence of coronary artery calcification (CAC) on non-contrast computed tomography (CT) of the thorax in patients with interstitial lung disease (ILD), assess consistency of CAC reporting and assess incidence of subsequent cardiac events. MATERIALS AND METHODS: Patients with known interstitial lung disease who underwent a CT thorax over a 2-year period were retrospectively reviewed. Presence of CAC was assessed using a visual scale for CAC reporting and graded as mild, moderate, or severe by two cardiothoracic radiologists. CT reports were reviewed to determine if presence of CAC had been described. Electronic medical records were reviewed for any subsequent cardiothoracic events from the date of the CT thorax to present. RESULTS: 254 patients were included in the analysis (54.7% men; mean age 59.9 yo). 43.7% had CAC on their CT thorax; however, in 87.3% of those, reports did not comment on its presence. 8 patients had cardiac events; 7 of them had CAC on CT although only in 1 case this was reported. Global CAC and LAD CAC Patients with cardiac events had a significantly higher global CAC (p=0.016) and LAD CAC (p=0.048) when compared to patients without. CONCLUSION: We demonstrated a high prevalence of CAC in ILD patients and its significant association with adverse cardiac events. Unfortunately, CAC on CT thorax is still largely unreported. As per recent BSCI/BSCCT and BSTI guidelines, reporting of CAC should become part of routine practice, as may prompt prevention and impact on patients outcome.

Global Energy Metabolism Deficit in Alzheimer Disease Brain.

BACKGROUND: The understanding of Alzheimer's disease (AD) has been dominated by the amyloid hypothesis. However, therapies targeting beta-amyloid have largely failed, generating interest in other potential pathogenic factors including energy metabolism. OBJECTIVES: To interrogate canonical energy metabolism pathways from human prefrontal cortical tissue samples obtained from necropsy comparing AD and control. DESIGN, SETTING, AND PARTICIPANTS: Postmortem pre-frontal cortical tissue from 10 subjects histologically diagnosed with AD and 10 control (CTRL) subjects was subjected to untargeted metabolomics to interrogate energy metabolism pathways. The samples were matched by age, sex, and post-mortem interval. Metabolite Measurements: Untargeted metabolomics analyses were via Metabolon®. RESULTS: Glucose-derived energy metabolites in the glycolytic and pentose phosphate pathway and the ketone body ß-hydroxybutyrate were uniformly decreased in AD brain vs. CTRL brain. CONCLUSION: This pilot study aimed to identify energy metabolism abnormalities using untargeted brain metabolomics in two independent subject cohorts. Our study revealed a pattern of global energy deficit in AD brain, supporting a growing body of evidence of deficient energy metabolism in AD.

Evaluation of oncology infusion pharmacy practices: A nationwide survey.

PURPOSE: Oncology care continues to evolve at a rapid pace including provision of infusion-based care. There is currently a lack of robust metrics around oncology infusion centers and pharmacy practice. The workgroup completed a nationwide survey to learn about oncology-based infusion pharmacy services offered. The objective was to highlight consistent, measureable oncology-based infusion pharmacy metrics that will provide a foundation to describe overall productivity including emphasis on high patient-safety standards. METHODS: A nationwide survey was developed via a workgroup within the Vizient Pharmacy Cancer Care Group beginning in April 2019 and conducted electronically via the Vizient Pharmacy Network from September to November 2020. The survey was designed to capture a number of key metrics related to oncology-based infusion pharmacy services. RESULTS: Forty-one sites responded to the survey. Responses highlighted hours of operation (median = 11.5), number of infusion chairs (median = 45). Staffing metrics included 7.1 pharmacist full-time equivalent (FTE) and 7.6 technician FTE per week. 80.5% of sites had cleanrooms and 95.1% reported both hazardous and nonhazardous compounding hoods. 68.3% of sites reported using intravenous (IV) technology, 50.0% measured turnaround time, and 31.4% prepared treatment medications in advance. CONCLUSION: There was variability among oncology infusion pharmacy practices in regard to survey responses among sites. The survey results highlight the need for standardization of established productivity metrics across oncology infusion pharmacies in order to improve efficiency and contain costs in the changing oncology landscape. The survey provides insight into oncology infusion pharmacy practices nationwide and provides information for pharmacy leaders to help guide their practices.

The Role of Computed Tomography and Radiographs in the Management of Intertrochanteric Fractures.

Introduction: The Intertrochanteric fracture is a common hip trauma encountered in elderly patients. There is a lack of general agreement regarding its surgical management and choice of implant. Purpose of this study to conclude the final decision matrix regarding surgical management of intertrochanteric fractures based on parameters assessed on plain radiographs and CT scan. Materials and methods: We have retrospectively evaluated 55 patients with intertrochanteric fractures presented to our institute after informed consent with radiographs and CT scans between July 2017 to July 2018. Assessment of various parameters regarding fracture geometry and classification as well as measurement was done. Results: Mean lateral wall thickness in present study was 20.76mm. Incidence of coronal fragments was 90.9% and absence of coronal fragment in 5 patients. We noted the cases with anterior comminution had also a posterior comminution rendered the fracture unstable in almost 20 % cases. Conclusion: Better understanding of fracture geometry by combined used of radiograph and CT scan enhanced preoperative planning, choice of suitable implant, helps in reduction manoeuvre and improving quality of osteosynthesis.

Nodal-paranodal antibodies in HIV-immune mediated radiculo-neuropathies: Clinical phenotypes and relevance.

BACKGROUND: The frequency of nodal-paranodal antibodies in HIV-infected patients with chronic immune-mediated radiculo-neuropathies (IMRN) has not been previously described. METHODS: HIV-infected patients who met the inclusion criteria for chronic IMRN were screened for immunoglobulin G (IgG) antibodies directed against nodal (neurofascin (NF)186) and paranodal (NF155, contactin-1 (CNTN1) and contactin-associated protein(Caspr1)) cell adhesion molecules, using a live, cell-based assay. To explore potential pathogenicity, binding of human IgG to myelinated co-cultures was assessed by incubation with patients' sera positive for nodal or paranodal antibodies. Normal human serum was added as a source of complement to assess for complement activation as a mechanism for myelin injury. RESULTS: Twenty-four HIV-infected patients with IMRN were included in the study, 15 with chronic inflammatory demyelinating polyneuropathy (CIDP), 4 with ventral root radiculopathies (VRR), and 5 with dorsal root ganglionopathies (DRG). Five patients with CIDP had combined central and peripheral demyelination (CCPD). Three patients (12.7%) tested positive for neurofascin IgG1 antibodies in the following categories: 1 patient with VRR was NF186 positive, and 2 patients were NF155 positive with DRG and mixed sensory-motor demyelinating neuropathy with optic neuritis, respectively. CONCLUSION: The frequency of nodal-paranodal antibodies is similar among IMRN regardless of HIV status. Interpretation of the results in the context of HIV is challenging as there is uncertainty regarding pathogenicity of the antibodies, especially at low titres. Larger prospective immune studies are required to delineate pathogenicity in the context of HIV, and to establish a panel of antibodies to predict for a particular clinical phenotype.

A gradual increase of aerosol pollution in the Third Pole during the past four decades: Implication for regional climate change.

We analyse the long-term (1980-2020) changes in aerosols over the Third Pole (TP) and assess the changes in radiative forcing (RF) using satellite, ground-based and reanalysis data. The annual mean aerosol optical depth (AOD) varies from 0.06 to 0.24, with the highest values of around 0.2 in the north and southwest TP, which are dominated by dust from Taklimakan and Thar deserts, respectively. However, Organic Carbon (OC), Black Carbon (BC) and sulphate aerosols have significant contributions to the total AOD in the south and east TP. High amounts of dust are observed in spring and summer, but BC in winter. Trajectory analysis reveals that the air mass originated from East and South Asia carries BC and OC, whereas the air from South Asia, Central Asia and Middle East brings dust to TP. Significant positive trends in AOD is found in TP, with high values of about 0.002/yr in the eastern and southern TP. There is a gradual increase in BC and OC concentrations during 1980-2020, but the change from 2000 is phenomenal. The RF at the top of the atmosphere varies from -10 to 2 W/m2 in TP, and high positive RF of about 2 W/m2 is estimated in Pamir, Karakoram and Nyainquentanglha mountains, where the massive glacier mass exists. The RF has increased in much of TP during recent decades (2001-2020) with respect to previous decades (1981-2000), which can be due to the rise in BC and dust during the latter period. Therefore, the positive trend in BC and its associated change in RF can amplify the regional warming, and thus, the melting of glaciers or ice in TP. This is a great concern as it is directly connected to the water security of many South Asian countries.

Improvement of rooting and growth in kiwifruit (Actinidia deliciosa) cuttings with organic biostimulants.

Seaweed extracts have shown profoundly positive effects on crop growth, quality and reproduction in diverse agricultural and horticultural crops. Seaweed extracts can be used to promote the rooting and growth of cuttings in perennial fruit species like kiwifruit (Actinidia deliciosa). In this study, the cuttings were treated with 1, 5, 10 and 50% solutions of G Sap (Gracilaria edulis), K Sap (Kappaphycus alvarezii), AN (Ascophyllum nodosum), EM (Ecklonia maxima), HA (Humic acid) and control (water) for 6 h as base dipping. Subsequently, the treatments of G Sap, K Sap, AN, EM, HA and control were repeated every 15 days for a period of six months as application of 50 ml solutions in the potted cuttings. All the treatments exhibited significant effects on the rooting percent in all the kiwifruit cultivars, namely 'Monty', 'Abott', 'Hayward', 'Allison' and 'Bruno' (P ≤ 0.01) as compared to the control. Shoot and root growth parameters including leaf number per cutting, number of roots per cutting, number of branches, plant height, shoot diameter, root length, root diameter and root weight were all positively increased with the application of seaweed extracts (P ≤ 0.05). Cuttings treated with seaweed extract exhibited significantly higher levels of pigments (chlorophyll a, chlorophyll b and total carotenoids), metabolites (total carbohydrates and soluble phenols) and less electrolyte leakage as compared to the control cuttings. Significant positive and negative correlations were observed between biochemical parameters combined with plant nutrient concentration. Principal component analysis (PCA) revealed that PC1 and PC2 (first two principal components) accounted for 75% of the entire variation. While, PC1 accounted for 63% of the total variation, PC2 accounted for 11% of the total variation. The leaves and the roots of kiwifruit cultivar 'Hayward' treated with G Sap at 10%, K Sap at 10%, AN at 10%, EM at 10%, HA at 10% exhibited higher expression of all four root promoting candidate genes (GH3-3, LBD16, LBD29 and LRP1) compared to the control. Therefore, it can be concluded that, seaweed extract and humic acid can be used as a suitable alternative to synthetic hormones for promoting the rooting and growth of kiwifruit cuttings.

Spatial heterogeneity in global atmospheric CO during the COVID-19 lockdown: Implications for global and regional air quality policies.

The COVID-19 lockdown (LD) provided a unique opportunity to examine the changes in regional and global air quality. Changes in the atmospheric carbon monoxide (CO) during LD warrant a thorough analysis as CO is a major air pollutant that affects human health, ecosystem and climate. Our analysis reveals a decrease of 5-10% in the CO column during LD (April-May 2020) compared to the pre-lockdown (PreLD, March 2020) periods in regions with high anthropogenic activity, such as East China (EC), Indo-Gangetic Plain (IGP), North America, parts of Europe and Russia. However, this reduction did not occur in the regions of frequent and intense wildfires and agricultural waste burning (AWB). We find high heterogeneity in the CO column distributions, from regional to city scales during the LD period. To determine the sources of CO emissions during LD, we examined the ratios of nitrogen dioxide (NO2), sulfur dioxide (SO2) to CO for major cities in the world. This facilitated the identification of contributions from different sources; including vehicles, industries and biomass burning during LD. The comparison between CO levels during the LD and PreLD periods indicates a notable reduction in the global tropospheric CO, but no significant change in the stratosphere. It is found that CO emissions decreased during LD in the hotspot regions, but rebounded after the LD restrictions were lifted. This study, therefore, highlights the importance of policy decisions and their implementations in the global and regional scales to improve the air quality, and thus to protect public health and environment.

Adoption of cleaner technologies and reduction in fire events in the hotspots lead to global decline in carbon monoxide.

Carbon Monoxide (CO) is not a greenhouse gas (GHG), but has the capacity to change atmospheric chemistry of other GHGs such as methane and ozone, and therefore indirectly affects Earth's radiative forcing of the GHGs and surface temperature. Here, we use the CO mixing ratio at 850 hPa from the Tropospheric Emission Spectrometer (TES) reanalysis and the Measurement of Pollution in the Troposphere (MOPITT) satellite measurements for the period 2005-2019 to examine the spatio-temporal changes in CO across the latitudes. We find a substantial decrease in global CO, about -0.21 ± 0.09 ppb/yr (-0.23 ± 0.12%/yr) with the TES data and about -0.36 ± 0.07 ppb/yr (-0.45 ± 0.08%/yr) with the MOPITT satellite measurements during the study period. The highest CO decreasing trend is observed in Eastern China (-2.7 ± 0.37 ppb/yr) followed by Myanmar (-2.142 ± 0.59 ppb/yr) and South America (-1.08 ± 0.82 ppb/yr). This negative trend in CO is primarily due to the decrease in biomass burning and stringent environmental regulations in the respective regions and countries. The sources including road transport, which account for about 33.6% of CO emissions, followed by industries (18.3%) and agricultural waste burning (8.8%), might also be responsible for the reduction in CO due to the adaptation of improved emission control technology and regulations in the past decades from 2005 to 2019. Therefore, the study provides new insights on the current trends of global CO distribution and reasons for recent reduction in global CO emissions, which would be useful for future decision-making process to control air pollution.

Edge-Enhancing Gradient-Echo MP2RAGE for Clinical Epilepsy Imaging at 7T.

The 3D edge-enhancing gradient-echo (EDGE) MR imaging sequence offers superior contrast-to-noise ratio in the detection of focal cortical dysplasia. EDGE could benefit from 7T MR imaging but also faces challenges such as image inhomogeneity and low acquisition efficiency. We propose an EDGE-MP2RAGE sequence that can provide both EDGE and T1-weighted contrast, simultaneously, improving data-acquisition efficiency. We demonstrate that with sequence optimization, EDGE images with sufficient uniformity and T1-weighted images with high gray-to-white matter contrast can be achieved.

Improved air quality leads to enhanced vegetation growth during the COVID-19 lockdown in India.

The direct effect of pandemic induced lockdown (LD) on environment is widely explored, but its secondary impacts remain largely unexplored. Therefore, we assess the response of surface greenness and photosynthetic activity to the LD-induced improvement of air quality in India. Our analysis reveals a significant improvement in air quality marked by reduced levels of aerosols (AOD, -19.27%) and Particulate Matter (PM 2.5, -23%) during LD (2020)from pre-LD (March-September months for the period 2017-2019). The vegetation exhibits a positive response, reflected by the increase in surface greenness [Enhanced Vegetation Index (EVI, +10.4%)] and photosynthetic activity [Solar Induced Fluorescence (SiF, +11%)], during LD from pre-LD that coincides with two major agricultural seasons of India; Zaid (March-May) and Kharif (June-September). In addition, the croplands show a higher response [two-fold in EVI (14.45%) and four-fold in SiF (17.7%)] than that of forests. The prolonged growing period (phenology) and high rate of photosynthesis (intensification) led to the enhanced greening during LD owing to the reduced atmospheric pollution. This study, therefore, provides new insights into the response of vegetation to the improved air quality, which would give ideas to counter the challenges of food security in the context of climate pollution, and combat global warming by more greening.

Current variations and practice patterns in tympanic membrane perforation repair.

OBJECTIVE: Management of tympanic membrane perforations is varied. This study aimed to better understand current practice patterns in myringoplasty and type 1 tympanoplasty. METHODS: An electronic questionnaire was distributed to American Academy of Otolaryngology - Head and Neck Surgery members. Practice patterns were compared in terms of fellowship training, practice length, practice setting, paediatric case frequency and total cases per year. RESULTS: Of the 321 respondents, most were comprehensive otolaryngologists (60.4 per cent), in private practice (60.8 per cent), with a primarily adult practice (59.8 per cent). Fellowship training was the factor most associated with significant variations in management, including pre-operative antibiotic usage (p = 0.019), contraindications (p < 0.001), approach to traumatic perforations (p < 0.001), use of local anaesthesia (p < 0.001), graft material (p < 0.001), tympanoplasty technique (p = 0.003), endoscopic assistance (p < 0.001) and timing of post-operative audiology evaluation (p = 0.003). CONCLUSION: Subspecialty training appears to be the main variable associated with significant differences in peri-operative decision-making for surgical repair of tympanic membrane perforations.

Reduced circulating FABP2 in patients with moderate to severe COVID-19 may indicate enterocyte functional change rather than cell death.

The gut is of importance in the pathology of COVID-19 both as a route of infection, and gut dysfunction influencing the severity of disease. Systemic changes caused by SARS-CoV-2 gut infection include alterations in circulating levels of metabolites, nutrients and microbial products which alter immune and inflammatory responses. Circulating plasma markers for gut inflammation and damage such as zonulin, lipopolysaccharide and ß-glycan increase in plasma along with severity of disease. However, Intestinal Fatty Acid Binding Protein / Fatty Acid Binding Protein 2 (I-FABP/FABP2), a widely used biomarker for gut cell death, has paradoxically been shown to be reduced in moderate to severe COVID-19. We also found this pattern in a pilot cohort of mild (n = 18) and moderately severe (n = 19) COVID-19 patients in Milan from March to June 2020. These patients were part of the first phase of COVID-19 in Europe and were therefore all unvaccinated. After exclusion of outliers, patients with more severe vs milder disease showed reduced FABP2 levels (median [IQR]) (124 [368] vs. 274 [558] pg/mL, P < 0.01). A reduction in NMR measured plasma relative lipid-CH3 levels approached significance (median [IQR]) (0.081 [0.011] vs. 0.073 [0.024], P = 0.06). Changes in circulating lipid levels are another feature commonly observed in severe COVID-19 and a weak positive correlation was observed in the more severe group between reduced FABP2 and reduced relative lipid-CH3 and lipid-CH2 levels. FABP2 is a key regulator of enterocyte lipid import, a process which is inhibited by gut SARS-CoV-2 infection. We propose that the reduced circulating FABP2 in moderate to severe COVID-19 is a marker of infected enterocyte functional change rather than gut damage, which could also contribute to the development of hypolipidemia in patients with more severe disease.

National epidemiologic trends (2008-2018) in the United States for the incidence and expenditures associated with incisional hernia in relation to abdominal surgery.

PURPOSE: It is unknown whether the trend of rising incisional hernia (IH) repair (IHR) incidence and costs until 2011 currently persists. We aimed to evaluate how the IHR procedure incidence, cost and patient risk-profile have changed over the last decade relative to all abdominal surgeries (AS). METHODS: Repeated cross-sectional analysis of 38,512,737 patients undergoing inpatient 4AS including IHR within the 2008-2018 National Inpatient Sample. Yearly incidence (procedures/1,000,000 people [PMP]), hospital costs, surgical and patient characteristics were compared between IHR and AS using generalized linear and multinomial regression. RESULTS: Between 2008-2018, 3.1% of AS were IHR (1,200,568/38,512,737). There was a steeper decrease in the incidence of AS (356.5 PMP/year) compared to IHR procedures (12.0 PMP/year) which resulted in the IHR burden relative to AS (2008-2018: 12,576.3 to 9,113.4 PMP; trend difference P < 0.01). National costs averaged $47.9 and 1.7 billion/year for AS and IHR, respectively. From 2008-2018, procedure costs increased significantly for AS (68.2%) and IHR (74.6%; trends P < 0.01). Open IHR downtrended (42.2%), whereas laparoscopic (511.1%) and robotic (19,301%) uptrended significantly (trends P < 0.01). For both AS and IHR, the proportion of older (65-85y), Black and Hispanic, publicly-insured, and low-income patients, with higher comorbidity burden, undergoing elective procedures at small- and medium-sized hospitals uptrended significantly (all P < 0.01). CONCLUSION: IH persists as a healthcare burden as demonstrated by the increased proportion of IHR relative to all AS, disproportionate presence of high-risk patients that undergo these procedures, and increased costs. Targeted efforts for IH prevention have the potential of decreasing $17 M/year in costs for every 1% reduction.

Unraveling the pathways influencing the berry color and firmness of grapevine cv. Flame Seedless treated with bioregulators using biochemical and RNA-Seq analysis under semi-arid subtropics.

Plant bioregulators (PBRs) regulate developmental and physiological processes in plants. In this study, biochemical and transcriptomic analyses were conducted to evaluate the influence of PBRs [abscisic acid (ABA), benzothiadiazole (BTH), ethephon, and prohexadione-calcium (Pro-Ca)] on the grapevine cv. Flame Seedless under semi-arid subtropics. This study aims to see the effect of exogenous application of PBRs on overall berry quality, including uniformity of berry color. Uniform colored berries, the maximum total soluble solids (TSS) and total antioxidant activity (TAoA), and the highest total phenolics (TPC) and flavonoids (TFC) contents were obtained with the treatments, namely, 400 mg L-1 ethephon and 400 mg L-1 ABA. Further, RNA-Seq analysis has also identified some key DEGs like UFGT (VIT_16s0039g02230), GST (VIT_04s0079g00690), and chalcone synthase (CHS) (VIT_05s0136g00260) which were part of the anthocyanin biosynthesis pathway controlling grape berries color. Thus, ethephon (400 mg L-1) and ABA (400 mg L-1) were found promising for attaining greater uniformity in berry color development because of increased total anthocyanins content. In addition, they were also found associated with enhanced TAoA, TPC, and TFC. Hence, ethephon and ABA can be recommended for improving the berry quality.

Significant increase in water vapour over India and Indian Ocean: Implications for tropospheric warming and regional climate forcing.

The increase in greenhouse gases (GHGs) due to anthropogenic activities enhances regional and global temperatures. The most abundant GHG, i.e., water vapour, has a vital positive feedback on the global warming and Earth's climate system. This study focuses on the spatial and temporal changes in water vapour in the troposphere over India and Indian Ocean as derived from the ground-based, satellite and reanalyses data, and assesses the impact on water vapour changes on the regional climate by analysing radiative effects. The analyses show that the annual mean column water vapour (CWV) is high over the northern Indian Ocean, Bay of Bengal and Peninsular India, ranging from 30 to 60 kg/m2. Most regions show significant positive trends in the annual mean CWV, about 0.1-0.2 kg/m2/yr. There is a significant positive trend in water vapour in the troposphere (except 200 hPa) over the India land regions, with the highest values at 1000 hPa (0.034 g/kg/yr). The corresponding water vapour radiative effect (WVRE) is about 20-80 W/m2, depending on seasons and regions. This study, therefore, indicates that the increase in tropospheric water vapour over India and Indian Ocean could affect the regional temperature and climate.

Current use of testosterone therapy in LGBTQ populations.

Testosterone therapy (TT) is a type of gender-affirming hormone therapy (GAHT) in lesbian, gay, bisexual, transgender, and genderqueer (LGBTQ) populations for gender dysphoria (GD), body uneasiness, and sexual dysfunction. The physical and physiological effects of TT vary widely depending on the dosing regimen and duration of treatment. An individualized approach prioritizing patient-specific desired effects in the context of pre-existing characteristics and health history is strongly recommended. Although TT is an effective treatment for many patients, there has been an increase in the illegitimate acquisition of TT in recent years. Non-judicious prescribing and lack of physician surveillance increases the risk of unintended side effects and potential serious health consequences.