Plasticity and associated epigenetic mechanisms play a role in thermal evolution during range expansion.

Due to global change, many species are shifting their distribution and are thereby confronted with novel thermal conditions at the moving range edges. Especially during the initial phases of exposure to a new environment, it has been hypothesized that plasticity and associated epigenetic mechanisms enable species to cope with environmental change. We tested this idea by capitalizing on the well-documented southward range expansion of the damselfly Ischnura elegans from France into Spain where the species invaded warmer regions in the 1950s in eastern Spain (old edge region) and in the 2010s in central Spain (new edge region). Using a common garden experiment at rearing temperatures matching the ancestral and invaded thermal regimes, we tested for evolutionary changes in (thermal plasticity in) larval life history and heat tolerance in these expansion zones. Through the use of de- and hypermethylating agents, we tested whether epigenetic mechanisms play a role in enabling heat tolerance during expansion. We used the phenotype of the native sister species in Spain, I. graellsii, as proxy for the locally adapted phenotype. New edge populations converged toward the phenotype of the native species through plastic thermal responses in life history and heat tolerance while old edge populations (partly) constitutively evolved a faster life history and higher heat tolerance than the core populations, thereby matching the native species. Only the heat tolerance of new edge populations increased significantly when exposed to the hypermethylating agent. This suggests that the DNA methylation machinery is more amenable to perturbation at the new edge and shows it is able to play a role in achieving a higher heat tolerance. Our results show that both (evolved) plasticity as well as associated epigenetic mechanisms are initially important when facing new thermal regimes but that their importance diminishes with time.

Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study.

BACKGROUND: Controlled donation after circulatory determination of death (cDCD) seems an effective way to mitigate the critical shortage of available organs for transplant worldwide. As a recently developed procedure for organ retrieval, some questions remain unsolved such as the uncertainty regarding the effect of functional warm ischemia time (FWIT) on organs´ viability. METHODS: We developed a multicenter prospective cohort study collecting all data from evaluated organs during cDCD from 2017 to 2020. All the procedures related to cDCD were performed with normothermic regional perfusion. The analysis included organ retrieval as endpoint and FWIT as exposure of interest. The effect of FWIT on the likelihood for organ retrieval was evaluated with Relative distribution analysis. RESULTS: A total amount of 507 organs´ related information was analyzed from 95 organ donors. Median donor age was 62 years, and 63% of donors were male. Stroke was the most common diagnosis before withdrawal of life-sustaining therapy (61%), followed by anoxic encephalopathy (21%). This analysis showed that length of FWIT was inversely associated with organ retrieval rates for liver, kidneys, and pancreas. No statistically significant association was found for lungs. CONCLUSIONS: Results showed an inverse association between functional warm ischemia time (FWIT) and retrieval rate. We also have postulated optimal FWIT's thresholds for organ retrieval. FWIT for liver retrieval remained between 6 and less than 11 min and in case of kidneys and pancreas, the optimal FWIT for retrieval was 6 to 12 min. These results could be valuable to improve organ utilization and for future analysis.

The importance of eco-evolutionary dynamics for predicting and managing insect range shifts.

Evolutionary change impacts the rate at which insect pests, pollinators, or disease vectors expand or contract their geographic ranges. Although evolutionary changes, and their ecological feedbacks, strongly affect these risks and associated ecological and economic consequences, they are often underappreciated in management efforts. Greater rigor and scope in study design, coupled with innovative technologies and approaches, facilitates our understanding of the causes and consequences of eco-evolutionary dynamics in insect range shifts. Future efforts need to ensure that forecasts allow for demographic and evolutionary change and that management strategies will maximize (or minimize) the adaptive potential of range-shifting insects, with benefits for biodiversity and ecosystem services.

Convergence of life history and physiology during range expansion toward the phenotype of the native sister species.

In our globally changing planet many species show range expansions whereby they encounter new thermal regimes that deviate from those of their source region. Pressing questions are to what extent and through which mechanisms, plasticity and/or evolution, species respond to the new thermal regimes and whether these trait changes are adaptive. Using a common-garden experiment, we tested for plastic and evolutionary trait changes in life history and a set of understudied biochemical/physiological traits during the range expansion of the damselfly Ischnura elegans from France into a warmer region in Spain. To assess the adaptiveness of the trait changes we used the phenotype of its native sister species in Spain, I. graellsii, as proxy for the locally adapted phenotype. While our design cannot fully exclude maternal effects, our results suggest that edge populations adapted to the local conditions in the newly invaded region through the evolution of a faster pace-of-life (faster development and growth rates), a smaller body size, a higher energy budget and increased expression levels of the heat shock gene DnaJ. Notably, based on convergence toward the phenotype of the native sister species and its thermal responses, and the fit with predictions of life history theory these potential evolutionary changes were likely adaptive. Nevertheless, the convergence toward the native sister species is incomplete for thermal plasticity in traits associated with anaerobic metabolism and melanization. Our results highlight that evolution might at least partly contribute in an adaptive way to the persistence of populations during range expansion into new thermal environments and should be incorporated when predicting and understanding species' range expansions.

Inhaled Sedation in Patients with COVID-19-Related Acute Respiratory Distress Syndrome: An International Retrospective Study.

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic and the shortage of intravenous sedatives has led to renewed interest in inhaled sedation for patients with acute respiratory distress syndrome (ARDS). We hypothesized that inhaled sedation would be associated with improved clinical outcomes in COVID-19 ARDS patients. METHODS: Retrospective international study including mechanically ventilated patients with COVID-19 ARDS who required sedation and were admitted to 10 European and US intensive care units. The primary endpoint of ventilator-free days through day 28 was analyzed using zero-inflated negative binomial regression, before and after adjustment for site, clinically relevant covariates determined according to the univariate results, and propensity score matching. RESULTS: A total of 196 patients were enrolled, 78 of whom died within 28 days. The number of ventilator-free days through day 28 did not differ significantly between the patients who received inhaled sedation for at least 24 h (n = 111) and those who received intravenous sedation only (n = 85), with medians of 0 (interquartile range [IQR] 0-8) and 0 (IQR 0-17), respectively (odds ratio for having zero ventilator-free days through day 28, 1.63, 95% confidence interval [CI], 0.91-2.92, p = 0.10). The incidence rate ratio for the number of ventilator-free days through day 28 if not 0 was 1.13 (95% CI, 0.84-1.52, p = 0.40). Similar results were found after multivariable adjustment and propensity matching. CONCLUSION: The use of inhaled sedation in COVID-19 ARDS was not associated with the number of ventilator-free days through day 28.

A set of accessible enhancers enables the initial response of breast cancer cells to physiological progestin concentrations.

Here, we report that in T47D breast cancer cells 50 pM progestin is sufficient to activate cell cycle entry and the progesterone gene expression program. At this concentration, equivalent to the progesterone blood levels found around the menopause, progesterone receptor (PR) binds only to 2800 genomic sites, which are accessible to ATAC cleavage prior to hormone exposure. These highly accessible sites (HAs) are surrounded by well-organized nucleosomes and exhibit breast enhancer features, including estrogen receptor alpha (ERα), higher FOXA1 and BRD4 (bromodomain containing 4) occupancy. Although HAs are enriched in RAD21 and CTCF, PR binding is the driving force for the most robust interactions with hormone-regulated genes. HAs show higher frequency of 3D contacts among themselves than with other PR binding sites, indicating colocalization in similar compartments. Gene regulation via HAs is independent of classical coregulators and ATP-activated remodelers, relying mainly on MAP kinase activation that enables PR nuclear engagement. HAs are also preferentially occupied by PR and ERα in breast cancer xenografts derived from MCF-7 cells as well as from patients, indicating their potential usefulness as targets for therapeutic intervention.

Evolution of cold tolerance and thermal plasticity in life history, behaviour and physiology during a poleward range expansion.

Many species that are moving polewards encounter novel thermal regimes to which they have to adapt. Therefore, rapid evolution of thermal tolerance and of thermal plasticity in fitness-related traits in edge populations can be crucial for the success and speed of range expansions. We tested for adaptation in cold tolerance and in life history, behavioural and physiological traits and their thermal plasticity during a poleward range expansion. We reconstructed the thermal performance curves of life history (survival, growth and development rates), behaviour (food intake) and cold tolerance (chill coma recovery time) in the aquatic larval stage of the damselfly Ischnura elegans that is currently showing a poleward range expansion in northern Europe. We studied larvae from three edge and three core populations using a common-garden experiment. Consistent with the colder annual temperatures, larvae at the expansion front evolved an improved cold tolerance. The edge populations showed no overall (across temperatures) evolution of a faster life history that would improve their range-shifting ability. Moreover, consistent with damselfly edge populations from colder latitudes, edge populations evolved at the highest rearing temperature (28°C) a faster development rate, likely to better exploit the rare periods with higher temperatures. This was associated with a higher food intake and a lower metabolic rate. In conclusion, our results suggest that the edge populations rapidly evolved adaptive changes in trait means and thermal plasticity to the novel thermal conditions at the edge front. Our results highlight the importance of considering besides trait plasticity and the evolution of trait means, also the evolution of trait plasticity to improve forecasts of responses to climate change.

Durante su expansión hacia los polos, las especies encuentran nuevos regímenes de temperatura a los que tienen que adaptarse. Por esto, una rápida evolución de la tolerancia térmica y de la plasticidad térmica de rasgos fisiológicos clave en las poblaciones del borde del área de distribución es crucial para el éxito y la velocidad de las expansiones de rango. En este estudio testamos la adaptación de la tolerancia la frío y la plasticidad térmica de rasgos de historia de vida, comportamiento y fisiológicos durante una expansión de rango hacia el norte. Reconstruimos las curvas de rendimiento térmico de rasgos de historia de vida (supervivencia, tasa de crecimiento y tasa de desarrollo) y comportamiento (ingestión de alimento), así como la tolerancia al frío (tiempo de recuperación del coma por frío) en la larva acuática de la especie de caballito del diablo Ischnura elegans, especie que muestra un rango de expansión actual en el norte de Europa. Estudiamos larvas de tres poblaciones de la región de expansión norte y tres poblaciones de la región central usando experimentos en laboratorio. En concordancia con las temperaturas más bajas, las larvas del área de expansión mostraron mayor tolerancia al frío. Sin embargo, estas larvas no mostraron en general (a lo largo de las temperaturas estudiadas) evolución hacia una historia de vida más rápida, que aumentaría su habilidad para expandirse. Además, en consistencia con la menor temperatura de la región de expansión, las larvas presentaron mayor tasa de desarrollo a la temperatura experimental más alta (28°C), probablemente para explotar mejor los infrecuentes períodos con altas temperaturas en dicha región. Esto estuvo asociado con una mayor ingestión de alimento y una menor tasa metabólica. En conclusión, nuestros resultados sugieren que los valores medios y la plasticidad de los rasgos estudiados de las poblaciones del frente de expansión evolucionaron rápidamente para adaptarse a las nuevas condiciones térmicas en dicha región. Asimismo, nuestros resultados destacan la importancia de considerar, además de la media y plasticidad de los rasgos, la evolución de esta plasticidad, con el fin de mejorar las predicciones de las respuestas de las especies al cambio climático.

Thermal evolution of life history and heat tolerance during range expansions toward warmer and cooler regions.

Species' range edges are expanding to both warmer and cooler regions. Yet, no studies directly compared the changes in range-limiting traits within the same species during both types of range expansions. To increase our mechanistic understanding of range expansions, it is crucial to disentangle the contributions of plastic and genetic changes in these traits. The aim of this study was to test for plastic and evolutionary changes in heat tolerance, life history, and behavior, and compare these during range expansions toward warmer and cooler regions. Using laboratory experiments we reconstructed the thermal performance curves (TPCurves) of larval life history (survival, growth, and development rates) and larval heat tolerance (CTmax) across two recent range expansions from the core populations in southern France toward a warmer (southeastern Spain) and a cooler (northwestern Spain) region in Europe by the damselfly Ischnura elegans. First-generation larvae from field-collected mothers were reared across a range of temperatures (16°-28°C) in incubators. The range expansion to the warmer region was associated with the evolution of a greater ability to cope with high temperatures (increased mean and thermal plasticity of CTmax), faster development, and, in part, a faster growth, indicating a higher time constraints caused by a shorter time frame available for larval development associated with a transition to a greater voltinism. Our results thereby support the emerging pattern that plasticity in heat tolerance alone is inadequate to adapt to new thermal regimes. The range expansion to the cooler region was associated with faster growth indicating countergradient variation without a change in CTmax. The evolution of a faster growth rate during both range expansions could be explained by a greater digestive efficiency rather than an increased food intake. Our results highlight that range expansions to warmer and cooler regions can result in similar evolutionary changes in the TPCurves for life history, and no opposite changes in heat tolerance.

Insect communities in saline waters consist of realized but not fundamental niche specialists.

Considering how organisms adapt to stress is essential if we are to anticipate biological responses to global change in ecosystems. Communities in stressful environments can potentially be assembled by specialists (i.e. species that only occur in a limited range of environmental conditions) and/or generalist species with wider environmental tolerances. We review the existing literature on the salinity tolerance of aquatic insects previously identified as saline specialists because they were exclusively found in saline habitats, and explore if these saline realized niche specialists are also specialists in their fundamental niches or on the contrary are fundamental niche generalist species confined to the highest salinities they can tolerate. The results suggest that species inhabiting saline waters are generalists in their fundamental niches, with a predominant pattern of high survival in freshwater-low salinity conditions, where their fitness tends to be similar or even higher than in saline waters. Additionally, their performance in freshwater tends to be similar to related strictly freshwater species, so no apparent trade-off of generalization is shown. These results are discussed in the framework of the ecological and evolutionary processes driving community assembly across the osmotic stress gradient, and their potential implications for predicting impacts from saline dilution and freshwater salinization.This article is part of the theme issue 'Salt in freshwaters: causes, ecological consequences and future prospects'.

Effects of salinity changes on aquatic organisms in a multiple stressor context.

Under global change, the ion concentration of aquatic ecosystems is changing worldwide. Many freshwater ecosystems are being salinized by anthropogenic salt inputs, whereas many naturally saline ones are being diluted by agricultural drainages. This occurs concomitantly with changes in other stressors, which can result in additive, antagonistic or synergistic effects on organisms. We reviewed experimental studies that manipulated salinity and other abiotic stressors, on inland and transitional aquatic habitats, to (i) synthesize their main effects on organisms' performance, (ii) quantify the frequency of joint effect types across studies and (iii) determine the overall individual and joint effects and their variation among salinity-stressor pairs and organism groups using meta-analyses. Additive effects were slightly more frequent (54%) than non-additive ones (46%) across all the studies (n = 105 responses). However, antagonistic effects were dominant for the stressor pair salinity and toxicants (44%, n = 43), transitional habitats (48%, n = 31) and vertebrates (71%, n = 21). Meta-analyses showed detrimental additive joint effects of salinity and other stressors on organism performance and a greater individual impact of salinity than the other stressors. These results were consistent across stressor pairs and organism types. These findings suggest that strategies to mitigate multiple stressor impacts on aquatic ecosystems should prioritize restoring natural salinity concentrations.This article is part of the theme issue 'Salt in freshwaters: causes, ecological consequences and future prospects'.

Validated HPLC-UV detection method for the simultaneous determination of ceftolozane and tazobactam in human plasma.

AIM: A simple, rapid, economical and sensitive HPLC-UV method was developed for the simultaneous quantification of ceftolozane and tazobactam in plasma samples. METHODOLOGY: After deproteinization followed by a liquid-liquid back-extraction, the compounds were separated on a C18 column (150 mm × 4.6 mm, 5 µm) with UV-visible detection at 220 nm. The mobile phase consisted of acetonitrile and potassium dihydrogenphosphate buffer at pH 3.0 (8:92, v/v), delivered isocratically at a flow rate of 1.0 ml/min and at a column oven temperature of 30°C. Cefepime was used as an internal standard. RESULTS: Linearity was achieved in the concentration range of 0.50-100.00 µg/ml for ceftolozane and 0.25-50.00 µg/ml for tazobactam. The intra- and interday precision showed good reproducibility with coefficients of variation of less than 9.26% for ceftolozane and 9.62% for tazobactam. CONCLUSION: The sample preparation procedure avoids expensive or time-consuming steps used by other previously published methods. The methodology was validated according to standard guidelines and was used for quantification of ceftolozane and tazobactam in plasma samples from critically ill patients.

Factores relacionados con el insomnio en ancianos internados en un centro sociosanitario / Factors associated to insomnia among institutionalized elderly in a nursing home

Objetivos: Describir las características del sueño de los ancianos internados en un centro sociosanitario tanto en relación con la presencia de insomnio como mediante la calidad del sueño. Metodología: Estudio descriptivo y transversal sobre 100 sujetos de 65 años o más, internados en la residencia Núñez de Balboa (Albacete). Variables: características sociodemográficas, comorbilidad, consumo de psicofármacos, diagnóstico de insomnio según el Manual diagnóstico y estadístico de los trastornos mentales V (DSM-V), dolor, Escala de depresión de Yesavage, Minimental State Examination, Índice de Barthel, Índice de calidad del sueño Pittsburgh (ICSP), y Mini Nutritional Assessment. Resultados: La prevalencia de insomnio fue del 15% y de "malos dormidores", del 77%. Destaca una latencia en la conciliación del sueño superior a 30 minutos en el 35% de los casos, una eficiencia del sueño inferior al 65% en el 42%, y en contraposición, una calidad subjetiva del sueño de muy buena o bastante buena en un 77%. Las puntuaciones más altas del ICSP se asociaron con peor estado funcional (r = -0,22; p < 0,05), mayor riesgo de depresión (r = 0,33; p < 0,001), peor estado nutricional (r = -0,25; p < 0,05), polifarmacia (r = 0,22; p < 0,05) y dolor (p < 0,05). Conclusiones: Nuestra muestra presenta una baja prevalencia de trastorno de insomnio frente a una alta frecuencia de "malos dormidores", principalmente en sujetos con mayor nivel de dependencia, con mayor riesgo de depresión, con peor estado nutricional, con dolor y polifarmacia (AU)

Objectives: To describe sleep characteristics in institutionalized older adults: insomnia prevalence and sleep quality and disturbances. Methodology: Cross-sectional descriptive study of 100 subject aged 65 or older institutionalized in the nursing home Núñez de Balboa (Albacete). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) and diagnosis of insomnia was assessed according to Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-V) criteria. Covariables: sociodemographic characteristics, comorbidity, use of psychoactive drugs, pain, Geriatric Depression Scale, Mini-Mental State Examination, Barthel Index, and Mini Nutritional Assessment. Results: The prevalence of insomnia was 15% and for the "poor sleepers" was 77%. We can highlight that the sleep latency was over 30 minutes in 35% of the cases and 42% had sleep efficiency under 65%. Subjective sleep quality was "really good or very good" in 77%. Highest PSQI scores were associated with worse functional status (r=-0.22; p<0.05), higher risk of depression (r=0.33; p<0.001), poorer nutritional status (r=-0.25; p<0.05), polypharmacy (r=0.22; p<0.05) and pain (p<0.05). Conclusions: Our sample presents a low prevalence of insomnia but high frequency of "poor sleepers". Worse sleep quality relates with high level of dependence, high risk of depression, poor nutritional status, pain and polypharmacy (AU)

"Falls prevention among older people and care providers: protocol for an integrative review".

AIM: To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. BACKGROUND: Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes this role and care providers' views on fall's prevention initiatives. DESIGN: A convergent synthesis of qualitative, quantitative, and mixed methods studies. The eligibility criteria will be based on participants, interventions/exposure, comparisons, and outcomes for quantitative studies and on population, the phenomena of interest and the context, for qualitative studies. To extract data and assess study qualities members of the research team will work in pairs according to their expertise. The review will follow the guidelines for integrative reviews and the proposed methods will adhere to the PRISMA statement checklist complemented by the ENTREQ framework. As qualitative synthesis are emergent, all procedures and changes in procedure will be documented. DISCUSSION: The review has a constructivist drive as studies that combine methods ought to be paradigmatic driven. Review questions are broad to allow issues emerge and have purposefully left the design flexible to allow for adjustments as the review progresses. The review seeks to highlight the roles that care providers play in fall prevention and their views on fall's prevention initiatives.

A new species of Aphelocheirus (Hemiptera: Heteroptera: Aphelocheiridae) from Morocco.

This paper provides the description of a new species of Aphelocheirus (Hemiptera: Heteroptera: Aphelocheiridae), Aphelocheirus pemae sp. nov. from Morocco. The species was found in two sites located in different basins (Sebou and Moulouya rivers) that are separated by approximately 400 km. Photographs of the dorsal habitus of the female and illustrations of the male genitalic structures are provided. A graphical key to species of the genus in Western Europe and the Maghreb is also included. The new species can be easily distinguished by the unique shape of the left and right parameres and absence of apical spines on the aedeagus.

Pilot study of a preventive multicomponent nurse intervention to reduce the incidence and severity of delirium in hospitalized older adults: MID-Nurse-P.

BACKGROUND: Although multicomponent interventions are the gold standard for delirium management, few nurse-led interventions in Acute Geriatric Units (AGU) are described. OBJECTIVES: To analyze if a preventive multicomponent non-pharmacologic nurse-led intervention randomized clinical trial (MID-Nurse Study) is feasible (pilot study), and can reduce the incidence, duration, and severity of delirium in hospitalized older adults in an AGU. DESIGN: Parallel-group double-blind randomized clinical trial (pilot Study). SETTING: AGU Complejo Hospitalario Universitario, Albacete (Spain). PARTICIPANTS: 50 patients ≥65 years hospitalized in the AGU. Intervention group (IG) 21, control group (CG) 29. INTERVENTION: After risk factor analysis, all participants in the IG received a daily multicomponent non-pharmacologic intervention (orientation, sensorial deficit, sleep, mobilization, hydration, nutrition, drug chart review, elimination, oxygenation, pain) by the intervention nurses. The CG received usual care. MEASUREMENTS: Daily delirium presence with the Confusion Assessment Method (CAM), and severity with the Delirium Rating Scale-Revised-98 (DRS). Outcome measures were delirium incidence, prevalence, severity, and number of days with delirium, mortality, length of stay, use of physical restraint measures, and use of drugs for delirium control. RESULTS: Mean age 86.5 (48% women). 21 participants presented delirium during hospitalization (14CG and 7 IG). Process, resources, management, and scientific objectives were considered positive, making the study feasible. Delirium prevalence (33.3% vs 48.3%) and incidence (14.3% vs 41.4%; p=0.039) were reduced in the IG compared to CG. Total delirium severity was lower in the IG compared to the CG (35.0 vs 65.0; p=0.040). Mortality was not different between groups (CG 17.2% vs IG 19.0%). CONCLUSION: The MID-Nurse Study is feasible, and a multicomponent nurse-led intervention on patients with delirium in an AGU can reduce delirium prevalence, incidence, and severity. The clinical trial registration number ClinicalTrials.gov ID: NCT02558777.

Glutathione oxidation correlates with one-lung ventilation time and PO2/FiO2 ratio during pulmonary lobectomy.

OBJECTIVES: During lung lobectomy, the operated lung completely collapses with simultaneous hypoxic pulmonary vasoconstriction, followed by expansion and reperfusion. Here, we investigated glutathione oxidation and lipoperoxidation in patients undergoing lung lobectomy, during one-lung ventilation (OLV) and after resuming two-lung ventilation (TLV), and examined the relationship with OLV duration. METHODS: We performed a single-centre, observational, prospective study in 32 patients undergoing lung lobectomy. Blood samples were collected at five time-points: T0, pre-operatively; T1, during OLV, 5 minutes before resuming TLV; and T2, T3, and T4, respectively, 5, 60, and 180 minutes after resuming TLV. Samples were tested for reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione redox potential, and malondialdehyde (MDA). RESULTS: GSSG and MDA blood levels increased at T1, and increased further at T2. OLV duration directly correlated with marker levels at T1 and T2. Blood levels of GSH and glutathione redox potential decreased at T1-T3. GSSG, oxidized glutathione/total glutathione ratio, and MDA levels were inversely correlated with arterial blood PO2/FiO2 at T1 and T2. DISCUSSION: During lung lobectomy and OLV, glutathione oxidation, and lipoperoxidation marker blood levels increase, with further increases after resuming TLV. Oxidative stress degree was directly correlated with OLV duration, and inversely correlated with arterial blood PO2/FiO2.