Dickenscoates3378

idotes/detoxicants can be used to avoid/reduce the toxic effects. Before using Microcystis in feed ingredients/supplements, further screening for health protection and cost control is required.This work systematically investigated the microbial community structure in the river sediments from upstream of Guanting Reservoir, Beijing, China. A total of 6 wastewater treatment plants (WWTPs) locate along the main rivers connected to the reservoir. Water and sediment samples were collected at sites near the effluents of WWTPs (regarded as W groups) or at the upstream/downstream rivers (R groups) to reveal the roles of the reclaimed water recharge. Multivariate techniques including typical statistical analysis, redundancy analysis (RDA), nonmetric multidimensional scaling analysis, and molecular ecological network analysis were used to evaluate the results and their relationships. The representative C/N/P water parameters and concentrations of target organic contaminants kept stable for W and R sites, while the microbial community parameters varied greatly for two groups. The microbial population at W sites were higher but with a lower biological diversity (with a lower Shannon index) than that at R sites, indicating WWTPs greatly altered the microbial community structure at the local reach. RDA results revealed that total organic carbon (TOC) and organophosphorus pesticides (OPPs) were two dominant factors affecting the function and composition of microbial communities at the phylum level. The network analysis revealed that the microbes with the most interactions mainly from R sites and they had closer relationships with each other.One of the main sources of plastic pollution in agricultural fields is the plastic mulch used by farmers to improve crop production. The plastic mulch is often not removed completely from the fields after harvest. Over time, the plastic mulch that is left of the fields is broken down into smaller particles which are dispersed by the wind or runoff. In the Region of Murcia in Spain, plastic mulch is heavily used for intensive vegetable farming. After harvest, sheep are released into the fields to graze on the vegetable residues. The objective of the study was to assess the plastic contamination in agricultural soil in Spain and the ingestion of plastic by sheep. Therefore, three research questions were established i) What is the plastic content in agricultural soils where plastic mulch is commonly used? ii) Do livestock ingest the microplastics found in the soil? iii) How much plastic could be transported by the livestock? To answer these questions, we sampled top soils (0-10 cm) from 6 vegetable fields and collected sheep faeces from 5 different herds. The microplastic content was measured using density separation and visual identification. We found ~2 × 103 particles∙kg-1 in the soil and ~103 particles∙kg-1 in the faeces. The data show that plastic particles were present in the soil and that livestock ingested them. After ingesting plastic from one field, the sheep can become a source of microplastic contamination as they graze on other farms or grasslands. The potential transport of microplastics due to a herd of 1000 sheep was estimated to be ~106 particles∙ha-1∙y-1. Further studies should focus on assessing how much of the plastic found in faeces comes directly from plastic mulching, estimating the plastic degradation in the guts of sheep and understanding the potential effects of these plastic residues on the health of livestock.In this study, a one pot facile synthesis of ferromagnetic manganese ferrite nanoparticles (MnFe2O4) was carried out using chemical co-precipitation method for mineralization of azo dye (Congo red (CR)) in aqueous solution under visible light irradiation. The synthesized MnFe2O4 nanoparticles were highly crystalline and showed face-centred cubic (FCC) structure with average particle size of 58 ± 4 nm. The BET analysis of the MnFe2O4 nanoparticles revealed the mesoporous distribution of material with high surface area can provide large electro active sites and short diffusion paths for the transport of ions which plays a vital role in the photocatalytic degradation of CR. The point of zero charge (pHPZC) was observed to be 6.7 indicating favourable condition for material-anionic dye interaction. The XPS studies revealed that the large amounts of oxygen vacancies were produced due to the defects in the lattice oxygen. The MnFe2O4 nanoparticles mineralised 98.3 ± 0.2% of 50 mg/L CR within 30 min when tested in photocatalytic reactor under 565 nm. The particles were recoverable under the influence of an external magnet after the photocatalytic reaction and were reusable. The recovered nanoparticles showed 96% of CR degradation efficiency even after five cycles of reuse. The by-product analysis with GC-MS indicated mineralization of CR into simple alcohols and acids. The aqueous solution containing mineralised CR was nontoxic to Trigonella foenumgraecum and Vigna mungo seeds and favoured increased germination, plumule and radicle length when compared to untreated CR.Uranyl carbonate (UC) and silica colloids (cSiO2) are widely distributed in carbonate-rich subsurface environments associated with uranium pollution. Mobile colloids such as cSiO2 can affect uranium's transport efficiency in the groundwater environment. Therefore, elucidating the mechanism of UC and cSiO2 co-transport in a saturated porous medium with different ionic strength (IS), pH, and UC concentration is essential for the prevention and control of groundwater radioactive pollution. At low UC concentrations ( less then 2.1 × 10-5 M), cSiO2 is more prone to be deposited on the surfaces of quartz sand (QS) than UC, resulting in cSiO2 preventing UC transport. Compared to pH 7 and 9, at pH 5 the adsorption of uranium [in the form of 81.5% UO2CO3(aq), 8.6% UO22+, and 5.2% UO2OH+] on cSiO2 renders cSiO2 more prone to aggregate, causing smaller amounts of cSiO2 (86.6%) and UC (55.8%) to be recovered. Mechanisms responsible for the evolution of the pH and zeta potential in effluents have been proposed. Chemical reactions (ligand-exchange reactions and deprotonation) that occur in the QS column between UC and cSiO2/QS cause the pH of the suspension to varying, which in turn causes changes in the zeta potential and particle size of cSiO2. Eventually, the recovery rates of cSiO2 and UC are changed, depending upon the colloid particle size. Changes in ionic strength can seriously affect the stability of cSiO2 particles, and that effect is more significant when UC is present. Moreover, colloidal filtration theory, a non-equilibrium two-site model, and the Derjaguin-Landau-Verwey-Overbeek theory successfully describe the individual-transport and co-transport of cSiO2 and UC in the column. This study provides a strong basis for investigating UC pollution control in porous media.Toxins produced by cyanobacteria (cyanotoxins) are among the most dangerous natural compounds. In recent years, there have been many published papers related to the toxic alkaloids cylindrospermopsin (CYN) and anatoxin-a (ANTX-a), which are synthesized by several freshwater species of cyanobacteria (i.e. Raphidiopsis raciborskii and Anabaena flos-aquae) and are some of the most common cyanotoxins in aquatic reservoirs. The harmful properties of CYN are wide and primarily include cytotoxicity. To date, several analogs and decomposition products of CYN have been described, which can potentially increase its toxic effects in living organisms. The mode of action of ANTX-a is different than that observed after CYN exposure and involves structures in the nervous system. One of the most frequent situations in which cyanotoxins are introduced into the human body is by skin contact with contaminated water, i.e., during water sports, fishing or agriculture. Unfortunately, to date, knowledge on the influence of CYN, itsbition within 16 h. Different results were obtained for ANTX-a. The toxic effects of this compound on human keratinocytes estimated by the applied tests was observed only at the highest tested concentration (10 μg·mL-1) and after a long period of exposure. The results presented in this paper are, to the best of our knowledge, the first description of the influence of CYN, CYN decomposition products, and ANTX-a on human epidermal cells. Clearly, CYN and its decomposition products are serious threats not only when acting on internal organs but also during the skin contact stage. Further studies on cyanotoxins should focus on the determination of their decomposition products and ecotoxicology in natural aquatic environments.Herein an investigation on the performance and structural properties with aspects of stability, composition, functional group, and three-dimensional distribution were approached to evaluate the influence of nanobubble aeration to the two most common microbial aggregates, activated sludge and biofilm. This study found that applying nanobubble effectively provided extra oxygen for microbial aggregates and achieved a 10.58% improvement in total nitrogen removal. The structure of microbial aggregates was enhanced, where extracellular protein and polysaccharides respectively increased as maximum as 3.40 and 1.70 times in biofilm and activated sludge, accompanied by the development of activated sludge floc size and the thickness of biofilm. Further investigation on extracellular polymeric substance and surface of microbial aggregates showed the composition of functional substances of microbial aggregates were shifted by the application of nanobubble, especially the oxygen-sensitive ones. Confocal laser scanning microscopy imaging visualized that the nanobubble changed the morphology of biofilm to a more evenly one. However, an adaptive process was more needed for activated sludge rather than biofilm, it suggested application of NB optimized the distribution of functional microorganisms in-depth and the metabolism pathway of them by accelerating the structure development of microbial aggregates, especially for biofilm.Eutrophication is a significant threat to surface water biodiversity worldwide, with excessive phosphorus concentrations being among the most common causes. Wetland ditches under these conditions shift from primarily submerged aquatic vegetation to algae or duckweed dominance, leading to excessive shading and anoxic conditions. Phosphorus, from both point (e.g. wastewater treatment works) and diffuse (largely agricultural runoff) sources, is currently the central reason for failure in the majority of surface water bodies in England to meet required water quality guidelines. This study assesses phosphorus storage in the ditch systems at West Sedgemoor, a designated site of special scientific interest. Elevated phosphorus concentrations in sediment was observed across the Moor up to 4220 mg Kg-1, almost 10 times that which may be expected from background levels. The highest concentrations were generally observed at the more intensively farmed sites in the north of the moor, near key inlets and the outlet. Based upon their chemical and physical properties, clear distinction was observed between sites outside and within the Royal Society of the Protection of Birds nature reserve, using principal component analysis.Cadmium (Cd) is harmful to rice and human, thus screening and understanding the mechanism of Cd-safe rice lines, which accumulate little Cd in brown rice, is necessary. D62B was screened as a Cd-safe rice line with low Cd translocation from roots to shoots, and there must be a switch restricting Cd transport from roots to shoots. Here we found that shoot base played the role as switch. Cd concentration in the shoot base of D62B was 1.57 times higher compared with a high Cd-accumulating rice line (Wujin4B) and lower Cd translocation under Cd stress. Glutathione (GSH) and phytochelatins (PCs) were important in this process. GSH and PCs concentrations in the shoot bases of D62B were 1.01- 1.83 times higher than Wujin4B as well as the glutathione S-transferase (GST) and phytochelatin synthase (PCS) concentrations, keeping in consistent with up-regulation of the genes OsGST and OsPCS1. PCs synthesis was further promoted by exogenous GSH. Our results prove the role of shoot bases as switch for restricting Cd transport in D62B due to its great potential for GSH and PCs biosynthesis, and thereby Cd chelation. This could be considered a key mechanism for low Cd accumulation in brown rice of the Cd-safe rice line.The world is experiencing the worst global health crisis in recent decades since December/2019 due to a new pandemic coronavirus. The COVID-19 disease, caused by SARS-CoV-2, has resulted in more than 30 million cases and 950 thousand deaths worldwide as of September 21, 2020. Determining the extent of the virus on public surfaces is critical for understanding the potential risk of infection in these areas. In this study, we investigated the presence of SARS-CoV-2 RNA on public surfaces in a densely populated urban area in Brazil. Forty-nine of 933 samples tested positive (5.25%) for SARS-CoV-2 RNA, including samples collected from distinct material surfaces, including metal and concrete, and distinct places, mainly around hospital care units and public squares. Our data indicated the contamination of public surfaces by SARS-CoV-2, suggesting the circulation of infected patients and the risk of infection for the population. Constant monitoring of the virus in urban areas is required as a strategy to fight the pandemic and prevent further infections.The increasing accumulation of toxic heavy metals in the environment has generated the need of efficient removal systems, being the adsorption method the most popular one applied in aqueous solutions. Of particular concern is the case of Pb2+, Cd2+ and Hg2+ due to their high potential hazard. In this paper, we describe the feasibility of a new family of nanomaterials, swelling high charge micas, in the removal of these cations from aqueous solutions. Batch adsorption experiments were carried out in the as-made micas, NaMn, and after functionalization with ethylammonium, EA-Mn, and mercaptoethylammonium, MEA-Mn. The results have demonstrated that all of them are efficient heavy metal adsorbents, being Na-M2 the best adsorbent for Pb2+ and Cd2+, and, MEA-M2 for Hg2+.Mercury (Hg) contamination in mangrove ecosystems has received increasing attention in recent years. Although many studies have investigated methylmercury (MeHg) contamination and its relationship to a number of environmental factors in mangrove sediments, the production of MeHg in this carbon-rich ecosystem has not been fully evaluated. In this study, we measured the total mercury (THg) and MeHg concentrations in the sediments collected from seven mangrove forests in China. In addition, we examined the origin and quality of sedimentary organic matter (OM), trying to evaluate their influence on the MeHg accumulation in mangrove sediments. We found that litterfall played an important role in regulating THg and MeHg contents in mangrove sediments. THg and MeHg concentrations in the mangrove sediments were positively correlated to OM content and the labile fraction of the OM. Multiple evidence (stable carbon isotopes, monosaccharide compositions, and biogenic silica) suggested that OM in mangrove sediments was dominated by input from litterfall. THg and MeHg concentrations were elevated at the sediments with higher input of mangrove OM. We observed that addition of mangrove litter stimulated the production of MeHg under anaerobic conditions. Overall, our results suggested that litterfall acted as a source of inorganic Hg, labile carbon, and low-molecular-weight OM which greatly favor the Hg methylation. Our study provides new insights into the MeHg production in mangrove sediments.Partial nitritation-anammox (PNA) is a promising and energy-efficient process for the sustainable nitrogen removal. However, its wide applications are still limited by the long start-up period and instability of long-term operation. Quorum sensing (QS), as a way of cell-to-cell communication generally regulating various microbial behaviors, has been increasingly investigated in PNA process, because QS may substantially manipulate the metabolism of microorganisms and overcome the limitations of PNA process. This critical review provides a comprehensive analysis of QS in PNA systems, and identifies the challenges and opportunities for the optimization of PNA process based on QS. The analysis is grouped based on the configurations of PNA process, including partial nitritation, anammox and single-stage PNA systems. QS is confirmed to regulate various properties of PNA systems, including microbial activity, microbial growth rate, microbial aggregation, microbial interactions and the robustness under adverse conditions. Major challenges in the mechanisms of QS, such as QS circuits, target genes and the response to environmental inputs, are identified. Potential applications of QS, such as short-term addition of certain acyl-homoserine lactones (AHLs) or substances containing AHLs, transient unfavorable conditions to stimulate the secretion of AHLs, are also proposed. This review focuses on the theoretical and practical cognation for QS in PNA systems, and serves as a stepping stone for further QS-based strategies to enhance nitrogen removal through PNA process.Acetochlor (ACT) as a widely used chiral chloroacetamide herbicide is appropriate to evaluate the potential toxicity in soil ecosystems at enantiomeric level. The acute and subchronic toxicities of R-acetochlor (R-ACT) and S-acetochlor (S-ACT) on earthworms (Eisenia fetida) were investigated in the present study. Residual analyses showed that S-ACT degraded faster than R-ACT in artificial soil with half-lives of 16.5 and 21.7 d, respectively. Additionally, significant enantioselective acute toxicity in earthworms from between S-ACT and R-ACT (p less then 0.05) was observed, and the acute toxicity of R-ACT were 1.9 and 1.5 times higher than those of S-ACT in the filter paper test and artificial soil test. The hydroxyl radical (OH-) content, superoxide dismutase (SOD) and antioxidant enzyme catalase (CAT) activities, and cytochrome P450 content in earthworms significantly increased under the influence of ACT enantiomers; however, the acetylcholinesterase (AchE) activity was significantly inhibited after exposure to the two enantiomers. Moreover, lipid peroxidation and DNA damage were induced by ACT enantiomers. The results of transcriptome sequencing indicated that R-ACT induced a stronger oxidative stress effect than S-ACT in earthworms by mediating signaling pathways, which may be the primary reason for the enantioselective toxicity between S-ACT and R-ACT. Overall, the results demonstrated that R-ACT has a higher risk than S-ACT in the soil environment, which is important for understanding the enantioselective behavior of chloroacetamide pesticides.The affinity of biochar (BC) adsorbing phosphate was weak, while generation of magnesium oxide (MgO)-BC nanocomposites that transformed the crystal structures of BC would change the adsorption processes in improving the phosphate adsorption. Hereon, four different crystal structure of absorbents were selected to illustrate why the crystal structures and surface properties of absorbents were of great importance for the phosphate adsorption. The results showed that MgO/KBC with higher combination degree between MgO and KBC could change the normal crystal structure (MgO/KBC1, MgO phase (dominant)) to C-Mg-O phase (dominant). Therefore, MgO/KBC could achieve highest adsorption rate (k2, 8.059 g mg-1 min-1) and qm (maximal adsorption capacity, 121.950 mg g-1) for phosphate adsorption among absorbents, and even it had high anti-interference capacity for anions and natural organic matter (NOM). The mechanisms of MgO/KBC for phosphate adsorption were hydrogen-bond interaction, inner-sphere complexation and surface chemical adsorption; adsorption of phosphate on MgO/KBC1 was mainly controlled by inner-sphere complexation (Mg-O-PO3H2-, Mg-O-PO3H2- species). In addition, the adsorbability of MgO/KBC for phosphate could be restored after recalcination, which further proved that an efficient nanocomposite, calcinated from waste biomass (fallen leaves), was proposed to control eutrophication.

Serum autoantibodies support the diagnosis of interstitial lung disease (ILD) related to systemic autoimmune diseases (SAD-ILD). Nevertheless, their presence in the bronchoalveolar lavage (BAL) has not been explored.

To demonstrate the presence of autoantibodies in the BAL of ILD patients at onset of clinical evaluation, its relation with serum autoantibodies and to analyze clinical features of patients with autoantibodies in BAL.

Autoantibodies against extractable nuclear antigens (ENAs) were analyzed by immunoblot in the BAL of 155 patient with suspected diagnosis of ILD and 10 controls.

Seven ENAs were detected in the BAL of 19 patients (Anti-Ro52, Anti-Ro60, CENP-B, Anti-La, Jo-1, Sm/RNP and Anti-SL70). The most frequent ENA was anti-Ro52 (13 patients; 68,4% of positives ones). Seven patients presented more than one ENAs. Fourteen were diagnosed of SAD-ILD, 3 of interstitial pneumonia with autoimmune features, one of non-specific idiopathic pneumonia and other of silicosis. In 10 cases (52%) IgA autoantibodies were also detected. The autoantibodies observed in BAL were also detected in the serum of 17 patients (90%). There were no significant clinical differences with the patients with SAD-ILD or interstitial pneumonia with autoimmune features with patients with negative BAL.

The study of ENAs in BAL is feasible and can be a useful tool in the ILD initial algorithm, specifically sustaining the suspected diagnosis of SAD-ILD.

The study of ENAs in BAL is feasible and can be a useful tool in the ILD initial algorithm, specifically sustaining the suspected diagnosis of SAD-ILD.

NECPAL is a tool for identification of patients with advanced chronic disease in need of palliative care. The main objective of the study is to know the prevalence of patients with palliative needs in an acute respiratory ward in a Spanish tertiary hospital using NECPAL. A second objective of the study is to know the annual mortality rate of these patients.

Cross sectional study and prospective monitoring of a cohort identified as palliative patients with the NECPAL tool for 12 months. Patient identification was performed in patients admitted to the respiratory ward of our hospital for longer than 3 days. We have assessed the annual vital status (deceased or not deceased) of patients and have recorded demographics, clinical and functional data, as well as the use of healthcare resources.

We monitored a cohort of 363 patients. Of them, 87 patients (24.3%) (IC 95% 19-30) were identified as NECPAL positive. 60% of patients (n = 64) died within 12 months of their admission. There was no significant difference in the mortality ratio of oncologic versus non oncologic patients. In a multivariable analysis, mortality was associated with demand by patients or relatives for palliative care and with the presence of specific disease progression markers or indicators.

prevalence of patients with palliative needs in acute respiratory wards is high (one out of four patients). 60% of the patients identified as NECPAL positive in our cohort died in the first 12 months. Training of healthcare professionals as well as availability of appropriate resources are indispensable factors to improve care of this population.

prevalence of patients with palliative needs in acute respiratory wards is high (one out of four patients). 60% of the patients identified as NECPAL positive in our cohort died in the first 12 months. Training of healthcare professionals as well as availability of appropriate resources are indispensable factors to improve care of this population.So far, most cases of hypercholesterolaemia (60-80%) are attributed to pathogenic variants in the LDLR gene. Only 1-5% of cases are caused by variants in the APOB gene, and 0-3% by variants in the PCSK9 gene. There is a large variety in known pathogenic mutations of the LDLR gene, while for those affecting the APOB gene, the highest incidence is p.Arg3527Gln, described predominantly in Central European and North American populations. In the Iberian Peninsula the predominant gene affected is that of the LDL receptor, similar to the rest of the world, with the involvement of the APOB gene being described in individuals from the northwest, and anecdotal in the rest of the territory. A genetics analysis was performed on the population attending the first year of a lipid clinic in southwestern Spain with a 6-point score from the Dutch lipid clinics. The genetic, biochemical and clinical findings are described. The first findings show indications of a possible higher prevalence of patients with mutation in the APOB gene compared to other territories. Historical evidence is presented that could give a possible explanation to this, thus supporting the assumption.

Retinal vein occlusion (RVO) is mainly related with vascular risk factors (VRF).

To analyze the lipid profile and serum folate, vitamin B

and homocysteine levels, in patients with RVO and a population-based control group.

Case-control study. Patients with RVO were assessed during an 11-year period.

We included 368 patients and 325 controls of similar age and sex. HDL cholesterol and folate levels were lower (52 [43-63] mg/dL vs. 55 [46-66]; p=0.016 and 7 [5-10] ng/mL vs. 9 [7-13]; p<0.0001, respectively) and non-HDL cholesterol and homocysteine levels higher (148.9±37.3 mg/dL vs. 142.9±34.5; p=0.03 and 13.4 [11.2-18.2] μmol/L vs. 11.1 [9.0-14.4]; p<0.001) in patients with RVO than controls. Although total cholesterol, LDL-C, and triglyceride levels were higher and serum vitamin B

levels were lower in RVO patients, these differences did not reach statistical significance.

RVO-patients have lower serum HDL-C and folate levels and higher non-HDL-C and serum homocysteine levels than population-based controls of similar age and sex. In patients with RVO, apart from the lipid profile, determination of serum homocysteine, folate and vitamin B

levels might be useful, as well as the treatment of their alterations.

RVO-patients have lower serum HDL-C and folate levels and higher non-HDL-C and serum homocysteine levels than population-based controls of similar age and sex. In patients with RVO, apart from the lipid profile, determination of serum homocysteine, folate and vitamin B12 levels might be useful, as well as the treatment of their alterations.

Early mobility is underutilized in critical care.

Describe multidisciplinary intensive care unit (ICU) providers beliefs about the conduct of early mobility during critical illness.

A 7-item elicitation survey was administered to a multidisciplinary sample of ICU team members. We conducted independent thematic analysis of n=95 surveys.

Analysis resulted in three themes immediate risk vs. long-term reward conflict, nurse is the initiator and coordinator of early mobilization, and situational factors. Staffing was the primary facilitator and barrier to early mobility. Enablers included protection from complications of hospitalization, reduced hospital length of stay, and improved patient morale. Barriers strongly revolved around team member risk aversion (e.g., falls, hemodynamic instability, line dislodgment). Nurses were equally identified as positive and negative referents for early mobility.

Strong positive and negative attitudinal beliefs were elicited. Early mobility is a protective behavior that requires sufficient numbers of trained staff and equipment.

Strong positive and negative attitudinal beliefs were elicited. Early mobility is a protective behavior that requires sufficient numbers of trained staff and equipment.

The Left Ventricular Assist Device (LVAD) is a rapidly spreading treatment given to patients with advanced heart failure due to organ donor shortage. Thus, there is a need to study the life experience of patients who underwent LVAD implantation as a bridge to transplantation.

To examine the life experiences of patients who underwent LVAD implantation as a bridge to transplantation.

This qualitative, phenomenological research was carried out with 13 patients who underwent LVAD implantation as a bridge to transplantation. Data were collected through semi-structured in-depth interviews. Interviews were recorded through an audio recorder, transcribed verbatim, and evaluated using the inductive content analysis method.

Two main themes (fear and coping), each with four sub-themes, were obtained after data were analyzed. Participants' fears and coping strategies for these were identified.

In this study, fears and coping strategies came to the forefront in the life experiences of patients who underwent LVAD implantation as a bridge to transplantation.

In this study, fears and coping strategies came to the forefront in the life experiences of patients who underwent LVAD implantation as a bridge to transplantation.

Fibromuscular Dysplasia (FMD) is a rare non-atherosclerotic non-inflammatory vascular disease associated with arterial aneurysms and dissections. The epidemiology of FMD is not well understood. We sought to characterize the epidemiology of FMD utilizing a large aggregated electronic medical record database.

We used a commercial database (Explorys, IBM Watson), which aggregates data from electronic health records from 26 major integrated healthcare systems in the United States. Fibromuscular dysplasia cases were identified using a unique systemized nomenclature of medical terminology (SNOMED CT) term. We calculated the overall and age-, race-, and sex-based prevalence of FMD, and evaluated sex and race-specific differences in manifestations.

A total of 40,566,670 individuals were active in the database from January 2015 to January 2020. Of these, 4860 had a diagnosis of FMD with an overall prevalence of 12.0 cases per 100,000 individuals. The majority of patients with FMD were female (n=4130, 85.0%), Caull prevalence of FMD in this large aggregated electronic medical record study is estimated at 12.0 per 100,000 persons. FMD is more common in women and Caucasians, with variable characteristics and manifestations.

High density lipoprotein-cholesterol (HDL-C) concentration decreases in septic patients and the low level of HDL-C is associated with poor prognosis. However, no study has yet analyzed its prognostic implication specifically in pneumonia-ARDS cohort.

To evaluate the prognostic value of HDL-C levels in ARDS patients secondary to bacterial and viral pneumonia.

This was a retrospective observational study on 108 pneumonia-ARDS patients in RICU from 2017 to 2019. These patients were stratified into bacterial ARDS group (56) and viral ARDS group (52). The primary outcome was the association between HDL-C levels and 28-day mortality.

HDL-C levels were statistically lower in bacterial ARDS patients than those in viral ARDS patients (p<0.001). There were statistic negative correlations between HDL-C and APACHE II/SOFA score in bacterial ARDS patients (r=-0.284, p=0.034 and r=-0.369, p=0.005), but not in viral ARDS patients (r=-0.103, p=0.469 and r=-0.225, p=0.108). ROC analysis demonstrated that HDL-C had superior prediction value for 28-day mortality and identified HDL-C < 0.42mmol/L was significantly associated with adverse outcomes in bacterial ARDS patients. The low HDL-C was an independent risk factor for death of bacterial ARDS patients (OR 0.027, 95% CI [0.001-0.905], P=0.044).

HDL-C might be a valuable marker to assess the 28-d mortality for bacterial ARDS patients rather than viral ARDS patients.

HDL-C might be a valuable marker to assess the 28-d mortality for bacterial ARDS patients rather than viral ARDS patients.

Time continues to be a fundamental variable in reperfusion treatments for acute ischaemic stroke. Despite the recommendations made in clinical guidelines, only around one-third of these patients receive fibrinolysis within 60minutes. In this study, we describe our experience with the implementation of a specific protocol for patients with acute ischaemic stroke and evaluate its impact on door-to-needle times in our hospital.

Measures were gradually implemented in late 2015 to shorten stroke management times and optimise the care provided to patients with acute ischaemic stroke; these measures included the creation of a specific on-call neurovascular care team. We compare stroke management times before (2013-2015) and after (2017-2019) the introduction of the protocol.

The study includes 182 patients attended before implementation of the protocol and 249 attended after. Once all measures were in effect, the overall median door-to-needle time was 45minutes (vs 74 minutes before, a 39% reduction; P<.001), with 73.5% of patients treated within 60minutes (a 47% increase; P<.001). Median overall time to treatment (onset-to-needle time) was reduced by 20minutes (P<.001).

The measures included in our protocol achieved a significant, sustained reduction in door-to-needle times, although there remains room for improvement. The mechanisms established for monitoring outcomes and for continuous improvement will enable further advances in this regard.

The measures included in our protocol achieved a significant, sustained reduction in door-to-needle times, although there remains room for improvement. The mechanisms established for monitoring outcomes and for continuous improvement will enable further advances in this regard.The prevalence of multiple sclerosis (MS) in Asian countries is thought to be lower than in Western countries, with Asian populations presenting 80% less risk of MS than white populations. Incidence and prevalence rates in Asian countries are therefore not well defined and their association with rates in neighboring countries, as well as with ethnic, environmental, and socioeconomic factors, are not well understood. We performed a comprehensive literature review of epidemiological data from China and neighbouring countries to study the frequency of the disease, focusing on prevalence, and the progression over time and the influence of sex-related, environmental, dietary, and sociocultural factors. Prevalence rates in China range between 0.88 cases/100,000 population in 1986 and 5.2 cases/100,000 population in 2013, with a non-significant upwards trend (p = .08). The increase observed in Japan, where figures ranged between 8.1 and 18.6 cases/100,000 population was highly significant (p less then .001). Prevalence rates in countries with predominantly white populations are considerably higher and have increased over time, reaching 115 cases/100,000 population in 2015 (r2 = 0.79, p less then .0001). In conclusion, the prevalence of MS in China appears to have risen in recent years, although Asian populations (including Chinese and Japanese populations, among others) appear to present less risk than other populations. Within Asia, geographical latitude appears not to be a determining factor for developing MS.

Glycaemic variability (GV) refers to variations in blood glucose levels, and may affect stroke outcomes. This study aims to assess the effect of GV on acute ischaemic stroke progression.

We performed an exploratory analysis of the multicentre, prospective, observational GLIAS-II study. Capillary glucose levels were measured every 4hours during the first 48hours after stroke, and GV was defined as the standard deviation of the mean glucose values. The primary outcomes were mortality and death or dependency at 3 months. Secondary outcomes were in-hospital complications, stroke recurrence, and the impact of the route of insulin administration on GV.

A total of 213 patients were included. Higher GV values were observed in patients who died (n=16; 7.8%; 30.9mg/dL vs 23.3mg/dL; p=0.05). In a logistic regression analysis adjusted for age and comorbidity, both GV (OR=1.03; 95% CI, 1.003-1.06; p=0.03) and stroke severity (OR=1.12; 95% CI, 1.04-1.2; p=0.004) were independently associated with mortality at 3 months. No association was found between GV and the other outcomes. Patients receiving subcutaneous insulin showed higher GV than those treated with intravenous insulin (38.95mg/dL vs 21.34mg/dL; p<0.001).

High GV values during the first 48hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration.

High GV values during the first 48 hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration.

Increased intracranial pressure has been associated with poor neurological outcomes and increased mortality in patients with severe traumatic brain injury. Traditionally, intracranial pressure-lowering therapies are administered using an escalating approach, with more aggressive options reserved for patients showing no response to first-tier interventions, or with refractory intracranial hypertension.

The therapeutic value and the appropriate timing for the use of rescue treatments for intracranial hypertension have been a subject of constant debate in literature. In this review, we discuss the main management options for refractory intracranial hypertension after severe traumatic brain injury in adults. We intend to conduct an in-depth revision of the most representative randomised controlled trials on the different rescue treatments, including decompressive craniectomy, therapeutic hypothermia, and barbiturates. We also discuss future perspectives for these management options.

The available evidence aenging decisions.This study aimed to establish optimal criteria for evaluation of moderate (50%-69%) and severe (70%-99%) middle cerebral artery (MCA) stenosis with transcranial color-coded sonography (TCCS). A total of 375 cases provided 409 TCCS/digital subtraction angiography vessel pairs. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and mean flow velocity (MFV) of the MCA were measured. The stenotic/distal MFV ratios (SDRs) were calculated. With digital subtraction angiography as a reference, for 50%-69% MCA stenosis, the optimal combined criteria were PSV ≥180 cm/s (sensitivity 95.7%, specificity 64.9% and overall accuracy 69.7%); EDV ≥75 cm/s (90.0%, 66.4% and 68.7%); MFV ≥110 cm/s (95.7%, 64.0% and 69.4%); and SDR ≥2.5 (88.6%, 71.3% and 76.3%). Criteria for 70%-99% MCA stenosis were PSV ≥240 cm/s (93.5%, 89.9% and 85.5%); EDV ≥100 cm/s (96.8%, 89.0% and 87.3%); MFV≥160 cm/s (91.9%, 92.8% and 92.2%); and SDR ≥4 (87.1%, 92.2% and 91.4%). Parameters of the MCA detected by TCCS, especially SDR, may increase accuracy in diagnosis of 50%-69% and 70%-99% MCA stenosis.Biochar has become a popular research topic in sustainable chemistry for use both in agriculture and pollution abatement. To enhance aqueous Cr(VI), Pb(II) and Cd(II) removal efficiency, high surface area (535 m2/g) byproduct Douglas fir biochar (DFBC) from commercial syn-gas production obtained by fast pyrolysis (900-1000 °C, 1-10 s), was subjected to a KOH activation. KOH-activated biochar (KOHBC) underwent a remarkable surface area increase to 1049 m2/g and a three-fold increase in pore volume (BET analysis). Batch sorption studies on KOHBC verses pH revealed that the highest chromium, lead and cadmium removal capacities occurred at pH 2.0, 5.0 and 6.0, respectively. KOHBC exhibited much higher adsorption capacities than unactivated DFBC. Heavy metal loadings onto KOHBC were characterized by scanning electron microscopy, transmission electron microscopy and X-ray photoelectron spectroscopy. Sorption of Cr(VI), Pb(II) and Cd(II) all followed pseudo-second order kinetics and the Langmuir adsorption model. The highest Langmuir adsorption capacities at the respective pH's of maximum adsorption were 140.0 mg g-1 Pb(II), 127.2 mg g-1 Cr(VI) and 29.0 mg g-1 Cd(II). Metal ions spiked into natural and laboratory waste water systems exhibited high sorption capacities. Desorption studies carried out using 0.1 M HCl revealed that Pb(II) adsorption onto the KOHBC surface is reversible. Portions of Cd(II) and Cr(VI) adsorbed strongly onto KOHBC were unable to be desorbed by 0.1 M HCl and 0.1 M NaOH.Both biodegradable and nondegradable plastics are widely used. However, their interactions with petroleum hydrocarbons (PHs) have not been sufficiently studied. In this study, a type of biodegradable [polylactic acid (PLA)] and five types of nondegradable microplastics [polyamide (PA), polyethylene (PE), polyethylene terephthalate (PET), polystyrene (PS), and polyvinyl chloride (PVC)] were selected to investigate the sorption and desorption mechanisms of PHs. The sorption kinetics of the six types of microplastics followed a pseudo-second-order kinetics model (R2 ranged from 0.956 to 0.999) and indicated that chemical sorption dominated the sorption process. The key rate-controlling steps of the sorption of PHs on microplastics were intraparticle diffusion and liquid film diffusion. The sorption capacity of PHs on microplastics followed the order of PA > PE > PS > PET > PLA > PVC. The difference in sorption capacity might be due to the crystallinity, and rubber or glass state of the microplastics. In addition, all types of microplastics exhibited reversible sorption without noticeable desorption hysteresis. No obvious differences were observed in the sorption and desorption of PHs between biodegradable and nondegradable microplastics. Both biodegradable and nondegradable microplastics could sorb/desorb PHs and serve as transportation vectors.The presence of pesticides as well as that of several antibiotics provided at a great scale to poultry, cattle, and swine in aquatic environments within agroecosystems is a matter of growing concern. The objective of the present study was to characterize the sublethal effects of four environmental toxic compounds at two experimental pollution scenarios on the morphology, development and thyroid (T4), acetylcholinesterase (AChE) and glutathione S-transferase (GST) levels in Rhinella arenarum tadpoles. The first experimental pollution scenario aimed to evaluate the individual and mixed toxicity (5050% v/v) of a glyphosate-based herbicide (GBH) and the antibiotic ciprofloxacin (CIP) on earlier developmental stages. The second experimental pollution scenario aimed to evaluate the effects of other toxic compounds (the insecticide chlorpyrifos (CP) and the antibiotic amoxicillin (AMX)) added to the ones from the first scenario on previously exposed premetamorphic tadpoles. In all the treatments of the first pollution scenario, the most conspicuous effect observed in early-stage tadpoles was a high prevalence of morphological abnormalities. Exposure to GBH and to its mixture with CIP also led to a significant decrease in T4 levels and lower development. Both pollutant combinations from the second experimental scenario significantly increased T4 levels, inhibited AChE activities, and led to lower development, whereas the quaternary mixture led to a significant decrease in GST levels. The alterations here revealed by our approaches in several morphological and biochemical endpoints allow characterizing the ecotoxicological risk for anurans exposed to complex mixtures of pollutants that frequently occur in aquatic systems.Harmful algal blooms (HABs) caused by microalgae are becoming increasingly common and pose serious threats to human health, aquaculture, and marine environments and, therefore, their removal is becoming essential. Colloidal gas aphrons (CGAs), a recent technology adapted in flotation, showed promise in removing several contaminants from aqueous solutions. This study aimed to investigate the potency of CGAs in removing several microalgae strains (Spirulina platensis, Nannochloropsis oculata, and Chlorella vulgaris) from aqueous solutions. Surfactants, including cationic hexadecyl trimethyl ammonium bromide (HTAB), anionic sodium dodecylbenzene sulfonate (SDBS), sodium dodecyl sulfate (SDS), and their mixes, were used to prepare stable CGAs. The effect of different environmental parameters like algae concentration, pH, and salinity, on removing Spirulina platensis was thoroughly investigated. Operating conditions, including surfactant type, flotation time, flowrate, and solution temperature, were optimized. At pH 5 and 50 °C, Spirulina platensis, Chlorella vulgaris, and mixed microalgae were fully removed using CGAs produced from cationic HTAB surfactant. About 95% removal of Nannochloropsis oculata was achieved using mixed surfactant CGAs. The results obtained from this work demonstrated the promising potential of CGAs produced from both single and mixed surfactants in harvesting various microalgae from aqueous media.Magnolol and honokiol are the two major active ingredients with similar structure and anticancer activity from traditional Chinese medicine Magnolia officinalis, and honokiol is now in a phase I clinical trial (CTR20170822) for advanced non-small cell lung cancer (NSCLC). In search of potent lead compounds with better activity, our previous study has demonstrated that magnolol derivative C2, 3-(4-aminopiperidin-1-yl)methyl magnolol, has better activity than honokiol. Here, based on the core of 3-(4-aminopiperidin-1-yl)methyl magnolol, we synthesized fifty-one magnolol derivatives. Among them, compound 30 exhibited the most potent antiproliferative activities on H460, HCC827, H1975 cell lines with the IC50 values of 0.63-0.93 μM, which were approximately 10- and 100-fold more potent than those of C2 and magnolol, respectively. Besides, oral administration of 30 and C2 on an H460 xenograft model also demonstrated that 30 has better activity than C2. Mechanism study revealed that 30 induced G0/G1 phase cell cycle arrest, apoptosis and autophagy in cancer cells. Moreover, blocking autophagy by the autophagic inhibitor enhanced the anticancer activity of 30in vitro and in vivo, suggesting autophagy played a cytoprotective role on 30-induced cancer cell death. Taken together, our study implied that compound 30 combined with autophagic inhibitor could be another choice for NSCLC treatment in further investigation.There are several routes of administration to the brain, including intraparenchymal, intraventricular, and subarachnoid injections. The blood-brain barrier (BBB) impedes the permeation and access of most drugs to the central nervous system (CNS), and consequently, many neurological diseases remain undertreated. For past decades, to circumvent this effect, several nanocarriers have been developed to deliver drugs to the brain. Importantly, intranasal (IN) administration can allow direct delivery of drugs into the brain through the anatomical connection between the nasal cavity and brain without crossing the BBB. In this regard, dendrimers may possess great potential to deliver drugs to the brain by IN administration, bypassing the BBB and reducing systemic exposure and side effects, to treat diseases of the CNS. In this original concise review, we highlighted the few examples advocated regarding the use of dendrimers to deliver CNS drugs directly via IN. This review highlighed the few examples of the association of dendrimer encapsulating drugs (e.g., small compounds haloperidol and paeonol; macromolecular compounds dextran, insulin and calcitonin; and siRNA) using IN administration. Good efficiencies were observed. In addition, we will present the in vivo effects of PAMAM dendrimers after IN administration, globally, showing no general toxicity.This research article describes an approach to modify the thiazolidinedione scaffold to produce test drugs capable of binding to, and inhibit, the in vitro transcriptional activity of the oncogenic protein FOXM1. This approach allowed us to obtain FOXM1 inhibitors that bind directly to the FOXM1-DNA binding domain without targeting the expression levels of Sp1, an upstream transcription factor protein known to activate the expression of FOXM1. Briefly, we modified the chemical structure of the thiazolidinedione scaffold present in anti-diabetic medications such as pioglitazone, rosiglitazone and the former anti-diabetic drug troglitazone, because these drugs have been reported to exert inhibition of FOXM1 but hit other targets as well. After the chemical synthesis of 11 derivatives possessing a modified thiazolidinedione moiety, we screened all test compounds using in vitro protocols to measure their ability to (a) dissociate a FOXM1-DNA complex (EMSA assay); (b) decrease the expression of FOXM1 in triple negative-breast cancer cells (WB assay); (c) downregulate the expression of FOXM1 downstream targets (luciferase reporter assays and qPCR); and inhibit the formation of colonies of MDA-MB-231 cancer cells (colony formation assay). We also identified a potential binding mode associated with these compounds in which compound TFI-10, one of the most active molecules, exerts binding interactions with Arg289, Trp308, and His287. Unlike the parent drug, troglitazone, compound TFI-10 does not target the in vitro expression of Sp1, suggesting that it is possible to design FOXM1 inhibitors with a better selectivity profile.N-(5-Chlorobenzo[d]oxazol-2-yl)-4-methyl-1,2,3-thiadiazole-5-carboxamideox-amide has been identified as a potent inhibitor of Mtb H37Rv, with a minimum inhibitory concentration (MIC) of 0.42 μM. In this study, a series of substituted 2-acylamide-1,3-zole analogues were designed and synthesized, and their anti-Mtb activities were analyzed. In total, 17 compounds were found to be potent anti-Mtb agents, especially against the MDR- and XDR-MTB strains, with MIC values less then 10 μM. These analogues can inhibit both drug-sensitive and drug-resistant Mtb. Four representative compounds were selected for further profiling, and the results indicate that compound 18 is acceptably safe and has favorable pharmacokinetic (PK) properties. In addition, this compound displays potent activity against Gram-positive bacteria, with MIC values in the range of 1.48-11.86 μM. The data obtained herein suggest that promising anti-Mtb candidates may be developed via structural modification, and that further research is needed to explore other compounds.Kidney fibrosis is the common consequence of chronic kidney diseases that inexorably progresses to end-stage kidney disease with organ failure treatable only with replacement therapy. Since transforming growth factor-β1 is the main player in the pathogenesis of kidney fibrosis, we posed the hypothesis that recombinant thrombomodulin can ameliorate transforming growth factor-β1-mediated progressive kidney fibrosis and failure. To interrogate our hypothesis, we generated a novel glomerulus-specific human transforming growth factor-β1 transgenic mouse to evaluate the therapeutic effect of recombinant thrombomodulin. This transgenic mouse developed progressive glomerular sclerosis and tubulointerstitial fibrosis with kidney failure. Therapy with recombinant thrombomodulin for four weeks significantly inhibited kidney fibrosis and improved organ function compared to untreated transgenic mice. Treatment with recombinant thrombomodulin significantly inhibited apoptosis and mesenchymal differentiation of podocytes by interacting with the G-protein coupled receptor 15 to activate the Akt signaling pathway and to upregulate the expression of anti-apoptotic proteins including survivin.