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Nutrient availability and efficient use are critical for crop productivity. Current agricultural practices rely on excessive chemical fertilizers, contributing to greenhouse gas emissions and environmental pollution. Rhizosphere microbes facilitate plant nutrient acquisition and contribute to nutrient use efficiency. Thus, engineering plant-microbe communication within the rhizosphere emerges as a promising and sustainable strategy to enhance agricultural productivity. Recent advances in plant engineering have enabled the development of plants capable of selectively enriching beneficial microbes through root exudates. At the same time, synthetic biology techniques have produced microbes capable of improving nutrient availability and uptake by plants. By engineering plant-microbe communication, researchers aim to harness beneficial soil microbes, thereby offering a targeted and efficient approach to optimizing plant nutrient use efficiency.
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Rizosfera , Plantas/metabolismo , Plantas/microbiologia , Microbiologia do Solo , Nutrientes/metabolismo , Raízes de Plantas/metabolismo , Raízes de Plantas/microbiologiaRESUMO
OBJECTIVE: The objective of our study was to evaluate whether ovarian suppression by two different hormonal methods may spare the ovary the cytotoxic effects of isotretinoin in a rat model. MATERIALS AND METHODS: Four groups (n=8 Sprague-Dawley albino rats per group) were studied: control (Group I), 7.5 mg/kg/day isotretinoin (Group II), isotretinoin plus the combination of 0.030 mg ethinyl estradiol/0.15 mg levonorgestrel (combined oral contraceptive, COC), and isotretinoin plus 100 µg (microgram) leuprolide acetate (GnRHa) (Group III and IV, respectively). Four rats from each group were decapitated on the 30th day of treatment, and the remaining rats were decapitated on the 30th day of untreated follow-up. Serum anti-Mullerian hormone (AMH) concentrations, healthy and atretic follicle numbers, and apoptotic activity of follicles in oophorectomy specimens were compared between the groups. RESULTS: There were no significant differences in AMH levels among the study groups before, immediately after (first month), and one month after their last medication (second month) (p=0.08, 0.47, and 0.08, respectively). At the end of the first month, the control group had a higher median count of healthy primordial follicles compared to the study groups: 13.5 (8-22), 5.5 (3-11), 6 (2-13), and 1 (0-1) in control, isotretinoin, isotretinoin+COC, and isotretinoin+GnRHa groups, respectively (p=0.02). However, there was no statistically significant difference in the number of healthy primordial follicles between the groups one month after the last medication (p=0.33). The median atretic antral follicle counts in the first month were 2 (1-4), 3.5 (1-4), 0 (0-2), and 0 (0-0) in the control, isotretinoin, isotretinoin+COC, and isotretinoin+GnRHa groups, respectively (p=0.02). Otherwise, there were no significant differences in other types of follicles among the control and treated groups (p>0.05). There was also no statistical difference between the groups regarding immunostaining intensity for active caspase-3 evaluated in the first or second month of treatment (p=0.8 and 0.2, respectively). CONCLUSIONS: Our results show that GnRH agonists or COC have no protective effects on ovarian reserve when co-administered with isotretinoin in the rat model.
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Anticoncepcionais Orais , Reserva Ovariana , Feminino , Ratos , Animais , Humanos , Isotretinoína/farmacologia , Ratos Sprague-Dawley , Hormônio Antimülleriano , Fatores Imunológicos , Hormônio Liberador de GonadotropinaRESUMO
BACKGROUND: We sought to quantify the risk trend of resternotomy coronary artery bypass grafting (CABG) over the past 2 decades. METHODS: We compared the outcomes of 194 804 consecutive resternotomy CABG patients and 1 445 894 randomly selected first-time CABG patients (50% of total) reported to The Society of Thoracic Surgeons Adult Cardiac Surgery Database between 1999 and 2018. Primary outcomes were in-hospital mortality and overall morbidity. Using multiple logistic regression for each outcome for each year, we computed the annual trends of risk-adjusted odds ratios for the primary outcomes in the entire cohort and in 194 776 propensity-matched pairs. RESULTS: The annual resternotomy CABG case volume from participating centers declined by 68%, from a median of 25 (range, 14-44) to a median of 8 (range, 4-15). Compared with first-time CABG, resternotomy CABG patients were consistently older, with higher proportions of comorbidities. After propensity matching, primary outcomes of resternotomy and first-time CABG were similar (mortality: 3.5% vs 2.3%, standardized difference [SDiff], 7.5%; morbidity: 40.7% vs 40.3%, SDiff, 0.9%). Mortality of resternotomy CABG performed after prior CABG was higher than that after prior non-CABG (4.3% vs 2.4%; SDiff, 10.8). Morbidity was similar between these subgroups (41.0% vs 39.1%; SDiff, 2.9). The adjusted odds ratio for mortality after resternotomy CABG declined from 1.93 (95% CI, 1.73-2.16) to 1.22 (95% CI, 0.92-1.62), and that of morbidity declined from 1.13 (95% CI, 1.08-1.18) to 0.91 (95% CI, 0.87-0.95), P < .001 for both. CONCLUSIONS: The risk of resternotomy CABG has decreased substantially over time. Resternotomy CABG performed after a prior CABG is higher risk compared with that performed after a non-CABG operation.
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Doença da Artéria Coronariana , Complicações Pós-Operatórias , Humanos , Adulto , Complicações Pós-Operatórias/etiologia , Ponte de Artéria Coronária/efeitos adversos , Comorbidade , Modelos Logísticos , Resultado do Tratamento , Estudos RetrospectivosRESUMO
OBJECTIVE: Our multidisciplinary cardiac tumor team now has an experience of operating on 122 cases of primary cardiac sarcoma over a 23-year period. The purpose of this study is to present our short- and long-term outcomes for cardiac sarcoma. METHODS: We performed a retrospective review of a prospectively collected Institutional Review Board-approved cardiac tumor database for cardiac sarcoma. Patient characteristics, surgical factors, and patient outcomes were analyzed. Perioperative data were collected from direct patient communication and all available medical records. The primary end point was all-cause mortality at 1, 3, and 5 years from the time of our surgery and 1, 3, and 5 years from the initial diagnosis. The secondary end point was all-cause mortality between the first and second halves of the study. RESULTS: From October 1998 to April 2021, we operated on 122 patients with a primary cardiac sarcoma. The mean age was 45.3 years old, and 52.5% were male. Tumors were most frequently found in the left atrium (40.2%) and right atrium (32.0%). The most common type of tumor histologically was an angiosarcoma (38.5%), followed by high-grade sarcoma (14.8%). Survival from initial diagnosis at 1, 3, and 5 years was 88.4%, 43.15%, and 27.8%, respectively. Survival from surgery at our institution at 1 and 3 years was 57.1% and 24.5%, respectively. When comparing outcomes from different time periods, we found no significant difference in survival between the previous era (1998-2011) and the current era (2011-2021). CONCLUSIONS: Management of these complex patients can show reasonable outcomes in centers with a multidisciplinary cardiac tumor team. Mortality has not improved with time and is likely related to the systemic nature of this disease.
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Neoplasias Cardíacas , Hemangiossarcoma , Sarcoma , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Sarcoma/cirurgia , Neoplasias Cardíacas/cirurgia , Estudos Retrospectivos , Fatores de TempoRESUMO
BACKGROUND: We assessed volume-outcome relationships of resternotomy coronary artery bypass grafting (CABG). METHODS: We studied 1,362,218 first-time CABG and 93,985 resternotomy CABG patients reported to The Society of Thoracic Surgeons Adult Cardiac Surgery Database between 2010 and 2019. Primary outcomes were in-hospital mortality and mortality and morbidity (M&M) rates calculated per hospital and per surgeon. Outcomes were compared across 6 total cardiac surgery volume categories. Multivariable generalized linear mixed-effects models were used considering continuous case volume as the main exposure, adjusting for patient characteristics and within-surgeon and hospital variation. RESULTS: We observed a decline in resternotomy CABG unadjusted mortality and M&M from the lowest to the highest case-volume categories (hospital-level mortality, 3.9% ± 0.6% to 3.3% ± 0.1%; M&M, 18.5% ± 1.1% to 15.7% ± 0.4%, P < .001; surgeon-level mortality, 4.1% ± 0.3% to 4.1% ± 1.3%; M&M, 18.5% ± 0.6% to 14.5% ± 2.2%, P < .001). Looking at outcomes vs continuous volume showed that beyond a minimum annual volume (hospital 200-300 cases; surgeon 100-150 cases, approximately), mortality and M&M rates did not further improve. Using individual-level data and adjusting for patient characteristics and clustering within surgeon and hospital, we found higher procedural volume was associated with improved surgeon-level outcomes (mortality adjusted odds ratio, 0.39/100 procedures; 95% CI, 0.24-0.61; M&M adjusted odds ratio, 0.37/100 procedures; 95% CI, 0.28-0.48; P < .001 for both). Hospital-level adjusted volume-outcomes associations were not statistically significant. CONCLUSIONS: We observed an inverse relationship between total cardiac case volume and resternotomy CABG outcomes at the surgeon level only, indicating that individual surgeon's experience, rather than institutional volume, is the key determinant.
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Ponte de Artéria Coronária , Hospitais , Adulto , Humanos , Ponte de Artéria Coronária/métodos , Morbidade , Mortalidade Hospitalar , Modelos LinearesRESUMO
The conversion of CO2 and epoxides to cyclic carbonates over a silica-supported di-iron(III) complex having a reduced Robson macrocycle ligand system is shown to proceed at 1 atm and 80 °C, exclusively producing the cis-cyclohexene carbonate from cyclohexene oxide. We examine the effect of immobilization configuration to show that the complex grafted in a semirigid configuration catalytically outperforms the rigid, flexible configurations and even the homogeneous counterparts. Using the semirigid catalyst, we are able to obtain a TON of up to 800 and a TOF of up to 37 h-1 under 1 atm CO2. The catalyst is shown to be recyclable with only minor leaching and no change to product selectivity. We further examine a range of epoxides with varying electron-withdrawing/donating properties. This work highlights the benefit arising from the constraining effect of a solid surface, akin to the role of hydrogen bonds in enzyme catalysts, and the importance of correctly balancing it.
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Herein, we exploit the natural tendency of two-dimensional (2D) clay nanoparticles to self-assemble and restrict water permeability in soils to fabricate a first of its kind synthetic, pH-activated, reversible, and tunable colloidal flow gate. To realize this, we studied the effect of the pH level of a suspension of claylike layered double hydroxide (LDH) nanoparticles on the LDH coagulation process. We then packed the LDH into a fixed-bed column and examined the effect of pH on mass transport through the column. We found that the 2D platelike LDH particles coagulate in an edge-to-edge configuration, which renders highly nonisotropic aggregates, pivotal for obstructing the transport of liquid and molecules therein. We showed that the coagulation and flow through the column may be regulated by imposing various pH levels as an external stimulus to affect LDH zeta potential. Hence, this work shows that the flow through a column comprising a 2D particle bed can be regulated in a reversible manner by simply alternating the pH of the wash solution, equilibration time, or gate dimensions. Furthermore, we show that, subject to pH treatment, we may open and close the colloidal gate for the transport of large molecules and provide selective transport thereof.
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BACKGROUND: Long-term survival is an important metric in assessing procedural value. We previously confirmed that the Society of Thoracic Surgeons predicted risk of mortality score (PROM) accurately predicts 30-day mortality in Israeli patients. The present study investigated the ability of the PROM to reliably predict long-term survival. METHODS: Data on 1279 patients undergoing cardiac surgery were prospectively entered into our database and used to calculate PROM. Long-term mortality was obtained from the Israeli Social Security Database. Patients were stratified into five cohorts according to PROM (A: 0-0.99%, B: 1.0-1.99%, C: 2.0-2.99%, D: 3.0-4.99% and E: ≥ 5.0%). Kaplan-Meier estimates of survival were calculated for each cohort and compared by Wilcoxon signed-rank test. We used C-statistics to assess model discrimination. Cox regression analysis was performed to identify predictors of long-term survival. RESULTS: Follow-up was achieved for 1256 (98%) patients over a mean period of 62 ± 28 months (median 64, range 0-107). Mean survival of the entire cohort was 95 ± 1 (95% CI 93-96) months. Higher PROM was associated with reduced survival: A-104 ± 1 (103-105) months, B-96 ± 2 (93-99) months, C-93 ± 3 (88-98) months, D-89 ± 3 (84-94) months, E-74 ± 3 (68-80) months (p < 0.0001). The Area Under the Curve was 0.76 ± 0.02 indicating excellent model discrimination. Independent predictors of long-term mortality included advanced age, lower ejection fraction, reoperation, diabetes mellitus, dialysis and PROM. CONCLUSIONS: The PROM was a reliable predictor of long-term survival in Israeli patients undergoing cardiac surgery. The PROM might be a useful metric for assessing procedural value and surgical decision-making.
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Procedimentos Cirúrgicos Cardíacos , Cirurgiões , Cirurgia Torácica , Humanos , Israel/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do TratamentoRESUMO
Fe-N-C electrocatalysts hold a great promise for Pt-free energy conversion, driving the electrocatalysis of oxygen reduction and evolution, oxidation of nitrogen fuels, and reduction of N2, CO2, and NOx. Nevertheless, the catalytic role of iron carbide, a component of nearly every pyrolytic Fe-N-C material, is at the focus of a heated controversy. We now resolve the debate by examining a broad range of Fe3C sites, spanning across many typical size distributions and carbon environments. Removing Fe3C selectively by a non-oxidizing acid reveals its inactivity towards two representative reactions in alkaline media, oxygen reduction and hydrazine oxidation. The activity is assigned to other pre-existing sites, most probably Fe-Nx. DFT calculations prove that the Fe3C surface binds O and N intermediates too strongly to be catalytic. By settling the argument on the catalytic role of Fe3C in alkaline electrocatalysis, we hope to spur innovation in this critical field.
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A unique 4-fold interpenetrated metal-organic framework, TIF-1, was synthesized by combining an anionic indium node with a cationic linker. This framework shows a rare type of 4-fold interpenetrated dia network, constructed from tessellation of biangular and tetragonal type metal-organic micropores. The porosity of TIF-1 is moderate due to four-fold interpenetration and charge-balancing anions. The cationic feature of this MOF may give good efficiency for selective small anion exchange or separation. In addition, the thermal stability and moderate CO2 adsorption property of the complex were studied.
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This report describes the case of a 43-year-old woman with a right-sided cardiac calcifying fibrous pseudotumor who presented with embolic stroke. This rare clinicopathologic entity should be included in the differential diagnosis of cardiac masses. Tissue diagnosis should be pursued. Management should be tailored to symptoms and feasibility of resection.
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Calcinose/diagnóstico , Ecocardiografia Transesofagiana/métodos , AVC Embólico/diagnóstico , Doenças do Mediastino/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Calcinose/complicações , Calcinose/cirurgia , Diagnóstico Diferencial , AVC Embólico/etiologia , Feminino , Humanos , Doenças do Mediastino/complicações , Doenças do Mediastino/cirurgia , Procedimentos Cirúrgicos Torácicos/métodosRESUMO
OBJECTIVE: Verbal fluency (VF) impairment is a strong predictor of social functioning in bipolar disorder (BPD). The enzyme catechol-O- methyltransferase (COMT) has a critical role in cognitive responses by modulating dopaminergic activity in the prefrontal cortex (PFC). Here, we investigated the role of COMT polymorphism (i) in VF performance as well as (ii) in modulation of PFC activity during a VF-task in euthymic BPD patients. METHODS: 30 subjects with remitted BPD-I and 23 healthy controls (HCs) were genotyped for COMT Val158Met (rs4680) polymorphism and were compared in a VF-task. PFC activity was measured by 24-Channel Functional Near Infrared Spectroscopy. RESULTS: Bipolar subjects displayed lower VF performance than HCs. During the VF-task, BPD-group displayed higher activity than HCs in the Brocca's area, Premotor-cortex and supplementary motor area (SMA). In the index group, Val/Met polymorphism was associated with higher activity in the left- frontopolar and dorsolateral PFC (DLPFC) during the VF-task. LIMITATIONS: Antipsychotic use may have interfered with the results. CONCLUSIONS: Increased activity in the Brocca's area may represent compensation of low VF performance, whereas hyperactivity in premotor-cortex and SMA may be associated with increased behavioral intention and/or restlessness in BPD. Higher activity in left-frontopolar and DLPC among Val/Met individuals compared to Met-homozygotes may represent less effective prefrontal dopaminergic signaling in Val/Met individuals with BPD.
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Transtorno Bipolar/genética , Catecol O-Metiltransferase/genética , Córtex Pré-Frontal/fisiopatologia , Fala/fisiologia , Adulto , Transtorno Bipolar/fisiopatologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Espectroscopia de Luz Próxima ao Infravermelho , Adulto JovemRESUMO
BACKGROUND: It is known that the patients with chronic low back pain (CLBP) has different spatiotemporal characteristics than healthy controls such as average speed, cadence, step and stride length parameters. CLBP is a heterogeneous phenomenon in terms of causing various level of disability. RESEARCH QUESTION: Does disability levels make a difference on spatiotemporal characteristics of patients with CLBP? METHODS: 66 patients with CLBP and 32 healthy controls between the ages of 25 and 65 years participated to study. The patients who had neurological, orthopedic, cardiovascular, metastatic history excluded from study. Resting, activity and night pain and functional disability were evaluated with Visual Analog Scale (VAS), Oswestry Disability Index (ODI) respectively. The patients were divided into two groups according to their disability level: moderate and severe. Gait analyses were performed with Optogait treadmill-based photocell system (Version 1.6.4.0, Microgate, Bolzano, Italy). After two trials were done, the spatiotemporal characteristics recorded for one minute while patients walked their preferred speed on the treadmill. One-way ANOVA was used to compare these parameters among the perceived disability level (moderate, severe) and healthy controls.The level of significance was accepted as 0.05. RESULTS: Step length, stride length, and preferred walking speed were the parameters that differentiate the gait between healthy controls and patients with CLBP (p < 0.05). According to post-hoc analyses, moderate CLBP was identified as the group most different from the healthy controls (p < 0.05). SIGNIFICANCE: Results of this study describe how compensating mechanism were seen in CLBP subgroups. As opposed to expectations, an increase in disability would not create higher difference in spatiotemporal characteristics between healthy controls and patients with severe disability. We propose that patients with severe and moderate disability had different ways to normalize their gait.
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Avaliação da Deficiência , Marcha/fisiologia , Dor Lombar/fisiopatologia , Adulto , Idoso , Teste de Esforço , Feminino , Análise da Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Velocidade de Caminhada , Adulto JovemRESUMO
OBJECTIVE: Various methods for cardiothoracic, cardiovascular, and cardiac surgical training exist across the globe, with the common goal of producing safe, independent surgeons. A comparative analysis of international training paradigms has not been undertaken, and our goal in doing so was to offer insights into how to best prepare future trainees and ensure the health of our specialty. METHODS: We performed a comparative analysis of available publications offering detailed descriptions of various cardiothoracic, cardiovascular, and cardiac surgical training paradigms. Corresponding authors from previous publications and other international collaborators were also reached directly for further data acquisition. RESULTS: We report various approaches to common challenges surrounding (1) selection of trainees and plans for the future surgical workforce; (2) trainee assessments and certification of competency before independent practice; and (3) challenges related to a changing practice landscape. CONCLUSIONS: Cardiothoracic surgery remains a dynamic and rewarding specialty. Current and future trainees face several challenges that transcend national borders. To foster collaboration and adoption of best practices, we highlight international strengths and weaknesses of various nations in terms of workforce selection, trainee operative experience and assessment, board certification, and preparation for future changes anticipated in cardiothoracic surgery.