A woman in her thirties with dyspnoea two weeks after abdominoplasty. / En kvinne i 30-årene med dyspné to uker etter bukplastikkoperasjon.

Background: While most cases of venous thromboembolism follow a benign course, occasionally the condition may manifest a complex clinical presentation and need a comprehensive diagnostic workup to identify the underlying cause and provide the patient with appropriate treatment. Case presentation: A woman in her late thirties presented to the emergency department with a five-day history of dyspnoea. She had recently undergone liposuction surgery after pregnancy. Upon admission, initial investigations revealed a pulmonary embolism with right heart strain, and she was treated with anticoagulants. The following day, she complained of acute-onset right flank pain without fever or other accompanying symptoms. A CT scan of the abdomen confirmed a right-side renal infarction. Further investigations revealed patent foramen ovale between the right and left atria of the heart, believed to be the source of a right-to-left shunt of arterial emboli. Although the patient had not suffered a clinical stroke, it was decided to close this defect using percutaneous technique. Interpretation: Patent foramen ovale is a common condition in adults, but in most cases it remains asymptomatic. However, patients with patent foramen ovale have an elevated risk of arterial emboli affecting multiple organs. The diagnosis depends on thorough assessment to prevent potentially fatal outcomes.

Deciphering the differential expression patterns of yield-related negative regulators in hexaploid wheat cultivars and hybrids at different growth stages.

BACKGROUND: Hexaploid bread wheat underwent a series of polyploidization events through interspecific hybridizations that conferred adaptive plasticity and resulted in duplication and neofunctionalization of major agronomic genes. The genetic architecture of polyploid wheat not only confers adaptive plasticity but also offers huge genetic diversity. However, the contribution of different gene copies (homeologs) encoded from different subgenomes (A, B, D) at different growth stages remained unexplored. METHODS: In this study, hybrid of elite cultivars of wheat were developed via reciprocal crosses (cytoplasm swapping) and phenotypically evaluated. We assessed differential expression profiles of yield-related negative regulators in these cultivars and their F1 hybrids and identified various cis-regulatory signatures by employing bioinformatics tools. Furthermore, the preferential expression patterns of the syntenic triads encoded from A, B, and D subgenomes were assessed to decipher their functional redundancy at six different growth stages. RESULTS: Hybrid progenies showed better heterosis such as up to 17% increase in the average number of grains and up to 50% increase in average thousand grains weight as compared to mid-parents. Based on the expression profiling, our results indicated significant dynamic transcriptional expression patterns, portraying the different homeolog-dominance at the same stage in the different cultivars and their hybrids. Albeit belonging to same syntenic triads, a dynamic trend was observed in the regulatory signatures of these genes that might be influencing their expression profiles. CONCLUSION: These findings can substantially contribute and provide insights for the selective introduction of better cultivars into traditional and hybrid breeding programs which can be harnessed for the improvement of future wheat.

"Ion-Flux": The natural course of ECG changes in severe hypokalemia.

Whereas the electrocardiogram (ECG) changes in hypokalemia are well known, they often receive less attention than the more striking features of hyperkalemia. Furthermore, there is a need for further discussion as to the subtleties of ECG changes that can aid in the differential diagnoses. This case study presents the ECG changes of a patient with severe hypokalemia due to diarrhea. It highlights how bifid T-waves in hypokalemia can be distinguished from other conditions such as coronary artery disease or pericarditis. Furthermore, it also shows the gradual reversal of ECG changes in the same patient when potassium is normalized.

Neural Networks for the Detection of COVID-19 and Other Diseases: Prospects and Challenges.

Artificial neural networks (ANNs) ability to learn, correct errors, and transform a large amount of raw data into beneficial medical decisions for treatment and care has increased in popularity for enhanced patient safety and quality of care. Therefore, this paper reviews the critical role of ANNs in providing valuable insights for patients' healthcare decisions and efficient disease diagnosis. We study different types of ANNs in the existing literature that advance ANNs' adaptation for complex applications. Specifically, we investigate ANNs' advances for predicting viral, cancer, skin, and COVID-19 diseases. Furthermore, we propose a deep convolutional neural network (CNN) model called ConXNet, based on chest radiography images, to improve the detection accuracy of COVID-19 disease. ConXNet is trained and tested using a chest radiography image dataset obtained from Kaggle, achieving more than 97% accuracy and 98% precision, which is better than other existing state-of-the-art models, such as DeTraC, U-Net, COVID MTNet, and COVID-Net, having 93.1%, 94.10%, 84.76%, and 90% accuracy and 94%, 95%, 85%, and 92% precision, respectively. The results show that the ConXNet model performed significantly well for a relatively large dataset compared with the aforementioned models. Moreover, the ConXNet model reduces the time complexity by using dropout layers and batch normalization techniques. Finally, we highlight future research directions and challenges, such as the complexity of the algorithms, insufficient available data, privacy and security, and integration of biosensing with ANNs. These research directions require considerable attention for improving the scope of ANNs for medical diagnostic and treatment applications.

AtCIPK16, a CBL-interacting protein kinase gene, confers salinity tolerance in transgenic wheat.

Globally, wheat is the major source of staple food, protein, and basic calories for most of the human population. Strategies must be adopted for sustainable wheat crop production to fill the ever-increasing food demand. Salinity is one of the major abiotic stresses involved in plant growth retardation and grain yield reduction. In plants, calcineurin-B-like proteins form a complicated network with the target kinase CBL-interacting protein kinases (CIPKs) in response to intracellular calcium signaling as a consequence of abiotic stresses. The AtCIPK16 gene has been identified in Arabidopsis thaliana and found to be significantly upregulated under salinity stress. In this study, the AtCIPK16 gene was cloned in two different plant expression vectors, i.e., pTOOL37 having a UBI1 promoter and pMDC32 having a 2XCaMV35S constitutive promoter transformed through the Agrobacterium-mediated transformation protocol, in the local wheat cultivar Faisalabad-2008. Based on their ability to tolerate different levels of salt stress (0, 50, 100, and 200 mM), the transgenic wheat lines OE1, OE2, and OE3 expressing AtCIPK16 under the UBI1 promoter and OE5, OE6, and OE7 expressing the same gene under the 2XCaMV35S promoter performed better at 100 mM of salinity stress as compared with the wild type. The AtCIPK16 overexpressing transgenic wheat lines were further investigated for their K+ retention ability in root tissues by utilizing the microelectrode ion flux estimation technique. It has been demonstrated that after 10 min of 100 mM NaCl application, more K+ ions were retained in the AtCIPK16 overexpressing transgenic wheat lines than in the wild type. Moreover, it could be concluded that AtCIPK16 functions as a positive elicitor in sequestering Na+ ions into the cell vacuole and retaining more cellular K+ under salt stress to maintain ionic homeostasis.

Natural Course of Electrocardiogram Changes and the Value of Multimodality Imaging in Acute Pericarditis.

BACKGROUND: ECG is the initial diagnostic tool that in combination with typical symptoms often raises the suspicion of pericarditis. Echocardiography remains the first-line imaging modality for assessment of pericardial diseases, particularly effusion/tamponade, constrictive physiology, and assessment of regional wall motion abnormalities as differential diagnoses. However, cardiac CT and cardiac magnetic resonance may be necessary in complicated cases and to identify pericardial inflammation in specific settings (atypical presentation, new onset constriction), as well as myocardial involvement and monitoring the disease activity. SUMMARY: In acute pericarditis, the most commonly used ECG criteria recommended by international guidelines are the widespread ST-segment elevation or PR depression. However, the classic ECG pattern of widespread ST-segment elevation or PR depression can be seen in less than 60% of patients. In addition, ECG changes are often temporally dynamic, evolve rapidly during the course of disease, and may be influenced by a number of factors such as disease severity, time (stage) of presentation, degree of myocardial involvement, and the treatment initiated. Overall, temporal dynamic changes on ECG during acute pericarditis or myopericarditis have received limited attention. Hence, the aim of this brief clinical review was to increase awareness about the various ECG changes observed during the course of acute pericarditis. KEY MESSAGES: ECG may be normal at presentation or for days after the index episode of chest pain, but serial ECGs can reveal specific patterns of temporally dynamic ST elevation in patients with pericarditis or myopericarditis, particularly during new episodes of chest pain.

Physiological responses induced by phospholipase C isoform 5 upon heat stress in Arabidopsis thaliana.

Plant's perception of heat stress involves several pathways and signaling molecules, such as phosphoinositide, which is derived from structural membrane lipids phosphatidylinositol. Phospholipase C (PLC) is a well-known signaling enzyme containing many isoforms in different organisms. In the present study, Phospholipase C Isoform 5 (PLC5) was investigated for its role in thermotolerance in Arabidopsis thaliana. Two over-expressing lines and one knock-down mutant of PLC5 were first treated at a moderate temperature (37 °C) and left for recovery. Then again exposed to a high temperature (45 °C) to check the seedling viability and chlorophyll contents. Root behavior and changes in 32Pi labeled phospholipids were investigated after their exposure to high temperatures. Over-expression of PLC5 (PLC5 OE) exhibited quick and better phenotypic recovery with bigger and greener leaves followed by chlorophyll contents as compared to wild-type (Col-0) and PLC5 knock-down mutant in which seedling recovery was compromised. PLC5 knock-down mutant illustrated well-developed root architecture under controlled conditions but stunted secondary roots under heat stress as compared to over-expressing PLC5 lines. Around 2.3-fold increase in phosphatidylinositol 4,5-bisphosphate level was observed in PLC5 OE lines upon heat stress compared to wild-type and PLC5 knock-down mutant lines. A significant increase in phosphatidylglycerol was also observed in PLC5 OE lines as compared to Col-0 and PLC5 knock-down mutant lines. The results of the present study demonstrated that PLC5 over-expression contributes to heat stress tolerance while maintaining its photosynthetic activity and is also observed to be associated with primary and secondary root growth in Arabidopsis thaliana.

Body-Centric Terahertz Networks: Prospects and Challenges.

Following recent advancements in Terahertz (THz) technology, THz communications are currently being celebrated as key enablers for various applications in future generations of communication networks. While typical communication use cases are over medium-range air interfaces, the inherently small beamwidths and transceiver footprints at THz frequencies support nano-communication paradigms. In particular, the use of the THz band for in-body and on-body communications has been gaining attention recently. By exploiting the accurate THz sensing and imaging capabilities, body-centric THz biomedical applications can transcend the limitations of molecular, acoustic, and radio-frequency solutions. In this paper, we study the use of the THz band for body-centric networks, by surveying works on THz device technologies, channel and noise modeling, modulation schemes, and networking topologies. We also promote THz sensing and imaging applications in the healthcare sector, especially for detecting zootonic viruses such as Coronavirus. We present several open research problems for body-centric THz networks.

32Pi Labeled Transgenic Wheat Shows the Accumulation of Phosphatidylinositol 4,5-bisphosphate and Phosphatidic Acid Under Heat and Osmotic Stress.

The ensuing heat stress drastically affects wheat plant growth and development, consequently compromising its grain yield. There are many thermoregulatory processes/mechanisms mediated by ion channels, lipids, and lipid-modifying enzymes that occur in the plasma membrane and the chloroplast. With the onset of abiotic or biotic stresses, phosphoinositide-specific phospholipase C (PI-PLC), as a signaling enzyme, hydrolyzes phosphatidylinositol 4,5-bisphosphate (PIP2) to generate inositol 1,4,5-trisphosphate (IP3) and diacylglycerol (DAG) which is further phosphorylated into phosphatidic acid (PA) as a secondary messenger and is involved in multiple processes. In the current study, a phospholipase C (PLC) signaling pathway was investigated in spring wheat (Triticum aestivum L.) and evaluated its four AtPLC5 overexpressed (OE)/transgenic lines under heat and osmotic stresses through 32Pi radioactive labeling. Naturally, the wheat harbors only a small amount of PIP2. However, with the sudden increase in temperature (40°C), PIP2 levels start to rise within 7.5 min in a time-dependent manner in wild-type (Wt) wheat. While the Phosphatidic acid (PA) level also elevated up to 1.6-fold upon exposing wild-type wheat to heat stress (40°C). However, at the anthesis stage, a significant increase of ∼4.5-folds in PIP2 level was observed within 30 min at 40°C in AtPLC5 over-expressed wheat lines. Significant differences in PIP2 level were observed in Wt and AtPLC5-OE lines when treated with 1200 mM sorbitol solution. It is assumed that the phenomenon might be a result of the activation of PLC/DGK pathways. Together, these results indicate that heat stress and osmotic stress activate several lipid responses in wild-type and transgenic wheat and can explain heat and osmotic stress tolerance in the wheat plant.

Predictors of long-term symptom burden and quality of life in patients hospitalised with chest pain: a prospective observational study.

OBJECTIVE: To describe the magnitude and predictors of symptom burden (SB) and quality of life (QoL) 3 months after hospital admission for acute chest pain. DESIGN: Prospective observational study. SETTING: Single centre, outpatient follow-up. PARTICIPANTS: 1506 patients. OUTCOMES: Scores reported for general health (RAND-12), angina-related health (Seattle Angina Questionnaire 7 (SAQ-7)) and dyspnoea (Rose Dyspnea Scale) 3 months after hospital admission for chest pain. METHODS: A total of 1506 patients received questionnaires assessing general health (RAND-12), angina-related health (SAQ-7) and dyspnoea (Rose Dyspnea Scale) 3 months after discharge. Univariable and multivariable regression models identified predictors of SB and QoL scores. A mediator analysis identified factors mediating the effect of an unstable angina pectoris (UAP) diagnosis. RESULTS: 774 (52%) responded. Discharge diagnoses were non-ST elevation myocardial infarction (NSTEMI) (14.2%), UAP (17.1%), non-coronary cardiac disease (6.6%), non-cardiac disease (6.3%) and non-cardiac chest pain (NCCP) (55.6%). NSTEMI had the most favourable, and UAP patients the least favourable SAQ-7 scores (median SAQ7-summary; 88 vs 75, p<0.001). NCCP patients reported persisting chest pain in 50% and dyspnoea in 33% of cases. After adjusting for confounders, revascularisation predicted better QoL scores, while UAP, current smoking and hypertension predicted worse outcome. NSTEMI and UAP patients who were revascularised reported higher scores (p<0.05) in SAQ-7-QL, SAQ7-PL, SAQ7-summary (NSTEMI) and all SAQ-7 domains (UAP). Revascularisation altered the unstandardised beta value (>±10%) of an UAP diagnosis for all SAQ-7 and RAND-12 outcomes. CONCLUSIONS: Patients with NSTEMI reported the most favourable outcome 3 months after hospitalisation for chest pain. Patients with other diseases, in particular UAP patients, reported lower scores. Revascularised NSTEMI and UAP patients reported higher QoL scores compared with patients receiving conservative treatment. Revascularisation mediated all outcomes in UAP patients. TRIAL REGISTRATION NUMBER: NCT02620202.

Comparison of bacterial diversity, root exudates and soil enzymatic activities in the rhizosphere of AVP1-transgenic and nontransgenic wheat (Triticum aestivum L.).

AIMS: Soil microbial communities are among the most diverse communities that might be affected due to transgenic crops. Therefore, risk assessment studies on transgenes are essentially required as any adverse effects may depend not only on the specific gene and crop involved but also on soil conditions. METHODS AND RESULTS: The present study deals with the comparison of bacterial populations, root exudates and activities of soil enzymes in nontransgenic and AVP1-transgenic wheat rhizosphere, overexpressing vacuolar H + pyrophosphatase for salinity and drought stress tolerance. Amounts of organic acids and sugars produced as root exudates and activities of dehydrogenase, phosphatase and protease enzymes in soil solution showed no significant differences in AVP1-transgenic and nontransgenic wheat rhizosphere, except for urease and phenol oxidase activities. The higher copy number of nifH gene showed the abundance of nitrogen-fixing bacteria in the rhizosphere of AVP1-transgenic wheat compared with nontransgenic wheat. nifH gene sequence analysis indicated the common diazotrophic genera Azospirillum, Bradyrhizobium, Rhizobium and Pseudomonas in AVP1-transgenic and nontransgenic wheat except for Zoogloea detected only in nontransgenic wheat. Using 454-pyrosequencing of 16S rRNA gene from soil DNA, a total of 156, 282 sequences of 18 phyla were obtained, which represented bacterial (128,006), Archeal (7928) and unclassified (21,568) sequences. Proteobacteria, Crenarchaeota and Firmicutes were the most abundant phyla in the transgenic and nontransgenic wheat rhizosphere. Further comparison of different taxonomic units at the genus level showed similar distribution in transgenic and nontransgenic wheat rhizospheres. CONCLUSION: We conclude that the AVP1 gene in transgenic wheat has no apparent adverse effects on the soil environment and different bacterial communities. However, the bacterial community depends on several other factors, not only genetic composition of the host plants. SIGNIFICANCE OF THE STUDY: The present research supports introduction and cultivation of transgenic plants in agricultural systems without any adverse effects on indigenous bacterial communities and soil ecosystems.

Genome edited wheat- current advances for the second green revolution.

Common wheat is a major source of nutrition around the globe, but unlike maize and rice hybrids, no breakthrough has been made to enhance wheat yield since Green Revolution. With the availability of reference genome sequence of wheat and advancement of allied genomics technologies, understanding of genes involved in grain yield components and disease resistance/susceptibility has opened new avenues for crop improvement. Wheat has a huge hexaploidy genome of approximately 17 GB with 85% repetition, and it is a daunting task to induce any mutation across three homeologues that can be helpful for the enhancement of agronomic traits. The CRISPR-Cas9 system provides a promising platform for genome editing in a site-specific manner. In wheat, CRISPR-Cas9 is being used in the improvement of yield, grain quality, biofortification, resistance against diseases, and tolerance against abiotic factors. The promising outcomes of the CRISPR-based multiplexing approach circumvent the constraint of targeting merely one gene at a time. Deployment of clustered regularly interspaced short palindromic repeats (CRISPR)-associated (Cas) 9 endonuclease (CRISPR-Cas9) and Cas9 variant systems such as cytidine base editing, adenosine base editing, and prime editing in wheat has been used to induce point mutations more precisely. Scientists have acquired major events such as induction of male sterility, fertility restoration, and alteration of seed dormancy through Cas9 in wheat that can facilitate breeding programs for elite variety development. Furthermore, a recent discovery in tissue culturing enables scientists to significantly enhance regeneration efficiency in wheat by transforming the GRF4-GIF1 cassette. Rapid generation advancement by speed breeding technology provides the opportunity for the generation advancement of the desired plants to segregate out unwanted transgenes and allows rapid integration of gene-edited wheat into the breeding pipeline. The combination of these novel technologies addresses some of the most important limiting factors for sustainable and climate-smart wheat that should lead to the second "Green Revolution" for global food security.

Dehydrin responsive HVA1 driven inducible gene expression enhanced salt and drought tolerance in wheat.

Heterologous expression of plant genes is becoming an important strategy for the improvement of specific traits in existing cultivars. This study presents the response of a salt-sensitive high-yielding wheat variety under stress-inducible expression of barley HVA1 gene belonging to the Late embryogenesis abundance (LEA) gene family. Six homozygous transgenic wheat plants were developed and advanced for testing under various water regimes and salt stress conditions. Putative transgenic plants showed better germination and root shoot development at the early developmental stages under drought stress conditions. Moreover, transgenic plants illustrated higher values of physiological features as compared to non-transgenic plants under both drought and salinity stresses that indicate improved physiological processes in transgenic plants. Higher membrane stability index (MSI) and lower electrolyte leakage (EL) after exposure to abiotic stresses reveal improved cellular membrane stability (CMS) and reduced injury to chloroplast membrane. Interestingly, under salinity stress, transgenic wheat plants showed preference towards higher K+ accumulation in the shoot, which is not a well-understood HVA1 mediated Na + avoidance mechanism under excessive subsurface salts. The predisposition of K+/Na + under salt stress conditions on heterologous expression of the HVA1 gene in wheat needs to be studied in detail in further studies.

Aegilops tauschii presents a genetic roadmap for hexaploid wheat improvement.

Modern wheat shows phenomenal evolutional success and adaptability to a range of environments owing to polyploidization; however, during its hybridization process a major genetic gain has been overlooked. Recently, Gaurav et al. emphasized harnessing genetic diversity from wheat wild progenitor Aegilops tauschii for the improvement of hexaploid wheat through introgression or transgenesis.

Distributed Destination Search Routing for 5G and beyond Networks.

Fifth-generation and beyond networks target multiple distributed network application such as Internet of Things (IoT), connected robotics, and massive Machine Type Communication (mMTC). In the absence of a central management unit, the device need to search and establish a route towards the destination before initializing data transmission. In this paper, we proposes a destination search and routing method for distributed 5G and beyond networks. In the proposed method, the source node makes multiple attempts to search for a route towards the destination by expanding disk-like patterns originating from the source node. The source node increases the search area in each attempt, accommodating more nodes in the search process. As a result, the probability of finding the destination increases, which reduces energy consumption and time delay of routing. We propose three variants of routing for high, medium, and low-density network scenarios and analyze their performance for various network configurations. The results demonstrate that the performance of the proposed solution is better than previously proposed techniques in terms of time latency and reduced energy consumption, making it applicable for 5G and beyond networks.

Detection and Spatial Correlation Analysis of Infectious Diseases Using Wireless Body Area Network Under Imperfect Wireless Channel.

The biosensors on a human body form a wireless body area network (WBAN) that can examine various physiological parameters, such as body temperature, electrooculography, electromyography, electroencephalography, and electrocardiography. Deep learning can use health information from the embedded sensors on the human body that can help monitoring diseases and medical disorders, including breathing issues and fever. In the context of communication, the links between the sensors are influenced by fading due to diffraction, reflection, shadowing by the body, clothes, body movement, and the surrounding environment. Hence, the channel between sensors and the central unit (CU), which collects data from sensors, is practically imperfect. Therefore, in this article, we propose a deep learning-based COVID-19 detection scheme using a WBAN setup in the presence of an imperfect channel between the sensors and the CU. Moreover, we also analyze the impact of correlation on WBAN by considering the imperfect channel. Our proposed algorithm shows promising results for real-time monitoring of COVID-19 patients.

An Absorption Mitigation Technique for Received Signal Strength-Based Target Localization in Underwater Wireless Sensor Networks.

Localization is an indispensable technology for underwater wireless sensor networks (UWSNs). In what concerns UWSNs, the accurate location information is not only the requirement of the marine field applications but also the basis of the other corresponding research, for instance, network routing and topology control. Recently, an astonishing surge of interest has been drawn in the received signal strength (RSS)-based scheme due to cost-effectiveness and synchronization-free compared with others. However, unlike the terrestrial wireless sensor networks (WSNs), the acoustic signal may suffer the absorption loss in the underwater environment besides the path loss, which degrades the localization accuracy and limits the capability of the RSS-based technology in UWSNs. In this context, a robust localization method with an absorption mitigation technique (AMT) is developed. First, an RSS-based analytically tractable measurement model is conducted, where the maximum likelihood estimator (MLE) is derived. Nevertheless, it is quite challenging to solve the problem using MLE under a non-convex expression. Therefore, by exploiting certain approximations, the considered localization problem is converted into an optimization expression with a maximum absorption loss involved. A min-max strategy is then presented, with which the problem is turned to minimize the worst situation of the absorption loss. After a simple manipulation, the problem is further investigated as a generalized trust region sub-problem (GTRS) framework. Although the GTRS is a non-convex scheme, the solution can be obtained through an iteration method by introducing a multiplier. In addition, the closed-form expression of the Cramer-Rao lower bound (CRLB) of the analytically tractable measurement model is derived. Numerical simulations demonstrate the effectiveness of the proposed method compared with the state-of-the-art approaches in different scenarios.

Analytical performance of cardiac troponin assays - Current status and future needs.

Concurrent with the introduction of cardiac troponin measurements into the diagnostic definition of myocardial infarction (MI), clinicians and laboratory professionals signaled a clear clinical need for improved analytical quality. This was an important precipitant for developing high-sensitivity cardiac troponin (hs-cTn) assays, currently used in rapid algorithms guiding investigations of patients presenting to the emergency department with possible MI. The hs-cTn assays were also important for the detection and monitoring of low-grade chronic myocardial injury, a condition that has been linked to increased long-term risk of cardiovascular morbidity and mortality. This review summarizes the general recommendations for defining analytical performance specifications while providing relevant clinical situations related to analytical performance. Importantly, outcome studies suggest analytical quality performance for hs-cTn is sufficient for early discharge of patients investigated for possible MI. However, bias due to change in calibrators or reagents may significantly affect the percentage of patients discharged. Biological variation data is suitable for defining performance specifications when hs-cTn measurements are used for diagnosing and monitoring chronic myocardial injury. Further improvement in analytical performance for hs-cTn testing may result in even faster decision making in the emergency setting; while also identifying those with chronic injury at risk for an adverse cardiac event.

Determinants and clinical significance of aortic stiffness in patients with moderate or severe aortic stenosis.

BACKGROUND: Patients with degenerative aortic stenosis (AS) are often older and have systemic hypertension and atherosclerosis, which all lead to increased aortic stiffness. We aimed to assess the determinants of carotid-femoral pulse wave velocity (cf-PWV), a direct measure of aortic stiffness, and its association with revealed symptoms and clinical outcome in patients with AS. METHODS: We included 103 asymptomatic patients aged 66.6 ± 13.2 years (range 27-85 years, 69% males) with moderate (n = 50) and severe (n = 53) AS. All underwent a comprehensive echocardiography, exercise treadmill test (ETT) and assessment of aortic stiffness derived from cf-PWV by applanation tonometry. RESULTS: The mean cf-PWV was 10.6 ± 3.1 m/s and resting brachial blood pressure (BP) 139 ± 20/79 ± 11 mmHg. Increased cf-PWV (≥10 m/s) was found in 44% (n = 45) patients. Patients with moderate and severe AS had a similar degree of aortic stiffness (cf-PWV 10.7 ± 3.3 vs. 10.5 ± 3.0 m/s, p = 0.698). In a univariate logistic regression analysis, higher cf-PWV was not associated with revealed symptoms (odds ratio [OR] for 1SD higher cf-PWV 1.12; 95% CI 0.62-2.04, p = 0.706). In a multivariable linear regression analysis, age, resting brachial systolic BP and diabetes were associated with higher cf-PWV independent of antihypertensive treatment and left ventricular ejection fraction. The event-free survival was significantly lower in patients with cf-PWV ≥10 m/s compared to those with cf-PWV <10 m/s (p = 0.015). CONCLUSION: Increased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. cf-PWV did not correlate with the severity of AS or the frequencies of revealed symptoms by ETT.

Hazards of nitrogen fertilizers and ways to reduce nitrate accumulation in crop plants.

In modern agriculture, farm produce accumulates a lot of nitrates that can reach toxic levels owing to the unfair use of nitrogen fertilizers, cultural methods, farming policies in multiple areas of the world, thereby increasing concerns about the availability of hygienic food supply and environmental hazards. Over the past few decades, global interest in achieving greater output through intensive fertilization has been a growing trend. The fertilizer based on urea or ammonium mainly yields ammonium, which is then transformed to nitrate through the oxidation process that is biologically mediated. Nitrate tends to accumulate differently in distinct crop plants and distinct components of agricultural commodities based on species, crop variety, genetic history, environmental circumstances, harvest phase, post-harvest storage conditions, agronomic variables, nature, and fertilizer application rate. The current article highlights various factors that could directly or indirectly contribute to the accumulation of nitrates in different parts of crop plants and discusses strategies to minimize the accumulation of nitrates in farm produce, thus ensuring healthy food supply and protecting the environment from the accumulation of nitrates.