Venous Thromboembolism (VTE) in May-Thurner Syndrome: Decision-Making Related to Long-Term Anticoagulation.

May-Thurner syndrome (MTS) involves the compression of the left iliac vein between the right iliac artery anteriorly and the lumbar vertebrae posteriorly. Patients may remain asymptomatic throughout their lives or experience unilateral lower limb swelling and symptoms of deep vein thrombosis (DVT), such as redness and pain in the limb, or features of its complication (pulmonary embolism) such as chest pain or shortness of breath. We present the case of a 34-year-old female exhibiting acute pain and tightness in her left leg, due to DVT of the left common femoral vein, extending up to the pelvic veins, which, on further diagnostic imaging, was found to be due to MTS. The patient was initiated on lifelong anticoagulation to prevent further complications. The rising incidence of MTS, coupled with frequent delays in its diagnosis, highlights the need to raise awareness among healthcare providers, especially acute medics (who are often the first point of contact for the patient) to expand their diagnostic umbrella of differentials to include MTS as a potential cause of such presentations and to look and think beyond DVT of the lower limb. This is especially important in females presenting with non-specific DVT symptoms, as early suspicion and referral to the respective medical teams including vascular medicine, can improve diagnostic accuracy and provide more management options, thereby improving long-term outcomes.

A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder.

Background: While there are well-established treatments for post-traumatic stress disorder (PTSD), these interventions appear to be less effective for individuals with comorbid borderline personality disorder (BPD) symptoms. Dialectical Behavior Therapy (DBT) for PTSD and DBT Prolonged Exposure (PE) are both effective interventions for treating these patients, but a comprehensive analysis evaluating the efficacy of these two interventions is lacking.Objective: To determine the effect sizes of PTSD-specific DBT treatments.Methods: We conducted a systematic review and pre-registered meta-analysis of the DBT literature for treating PTSD (osf.io/62rfq). Eligible trials and treatment evaluations published before September 2023 were searched in SCOPUS, PubMed, and the Cochrane Library databases. Thirteen articles were identified, and data were extracted for primary (PTSD symptoms) and secondary outcomes (BPD, depression, dissociation, non-suicidal self-injury [NSSI]). Treatment effects were calculated for randomised controlled trials, controlled clinical trials, and pre-post evaluations.Results: Overall, the studies involved 663 participants. Compared with control groups, PTSD-specific DBT treatments showed moderate effects in reducing PTSD symptom severity g = -0.69 (95% CI -1.03 to -0.34, p < .001) and depression g = -0.62 (95% CI -1.13 to -0.12, p = .016). Moreover, the pre-post changes showed an overall effect size for dissociative symptoms of g = -0.72 (95% CI -1.05 to -0.40, p < .001), for BPD-associated symptoms of g = -0.82 (95% CI -1.06 to -0.59, p < .001), and for NSSI frequency (g = -0.70, 95% CI -1.12 to -0.28, p = .001).Conclusions: Based on the results of our meta-analysis, DBT-PTSD and DBT PE were effective in reducing PTSD symptom severity and comorbid depressive symptoms. Further research on stage-based treatments should focus on systematically assessing NSSI, BPD symptoms, and suicidality.

We conducted the first meta-analysis assessing the efficacy of Dialectical Behavior Therapy for PTSD (DBT-PTSD) and Dialectical Behavior Therapy Prolonged Exposure (DBT PE) for individuals with comorbid PTSD and BPD symptoms.Based on RCTs/CCTs, we found moderately beneficial effects on PTSD symptoms, and depression for both stage-based interventions and large effects on non-suicidal self-injury frequency for DBT PE.DBT-PTSD and DBT PE resulted in pre-post improvements in dissociative symptoms, BPD-associated symptoms, and non-suicidal self-injury frequency.

Age-related differences in the prevalence of premature ejaculation: taking a second and more detailed look.

Background: Research indicates an inconsistent relationship between age and the prevalence of premature ejaculation (PE), with studies reporting an increase, decrease, or no change with age. Aim: To reexamine the possible relationship between age and PE prevalence, implementing methodological improvements that enhance the likelihood of detecting real effects. Methods: From a sample of 2772 men, we analyzed a subset of 418 classified as having probable or definite PE based on the Premature Ejaculation Diagnostic Tool. We not only analyzed men with lifelong PE (LPE; n = 316) and acquired PE (APE; n = 102) separately but assessed prevalence differences across age groups using an omnibus measure to establish PE status and specific PE diagnostic criteria, individually and in multifactorial combination. Outcome: Prevalence of PE in younger vs older men. Results: LPE, but not APE, showed age-related differences in prevalence, with LPE being lower in the higher age group. This pattern was most discernible when a multifactorial approach was used to establish PE status. Clinical Translation: Older men may be less distressed about their dysfunction or may benefit from diminishing ejaculatory function with age. Strengths and Limitations: This cross-sectional study used an improved methodology to detect age-related differences in PE prevalence. Future studies would benefit from a larger sample size that enables a breakdown of prevalence using a greater number of age categories. Conclusion: According to an improved methodology, men with LPE showed a decline in prevalence with aging. A methodology aimed at exploring this relationship should-at the very least-not only distinguish between LPE and APE subtypes but also consider using a multifactorial method of determining PE status that includes a measure of bother/distress.

The efficacy of aspirin versus low-molecular-weight heparin for venous thromboembolism prophylaxis after knee and hip arthroplasty: A systematic review and meta-analysis of randomized controlled trials.

PURPOSE: The purpose of this study was to assess the efficacy of aspirin versus low-molecular-weight heparin (LMWH) in preventing venous thromboembolism (VTE) following hip and knee arthroplasty. METHODS: PubMed/Medline, Embase, Cochrane Library and Google Scholar databases were searched from inception till June 2024 for original trials investigating the outcomes of aspirin versus LMWH in hip and knee arthroplasty. The primary outcome was VTE. Secondary outcomes included minor and major bleeding events, and postoperative mortality within 90 days. This review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 7 randomized controlled trials with 12,134 participants were included. The mean ages for the aspirin and LMWH cohorts were 66.6 (57.6-69.0) years and 66.8 (57.9-68.9) years, respectively. There was no statistically significant difference in the overall risk of VTE between the aspirin and the LMWH cohorts (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.48-1.89; p: 0.877). A subanalysis based on the specific VTE entity (pulmonary embolism [PE] or deep venous thrombosis) showed a significantly higher PE risk for patients receiving aspirin than the LMWH cohort (OR: 1.79; 95% CI: 1.11-2.89; p: 0.017). There was no difference in minor (OR: 0.64; 95% CI: 0.40-1.04; p: 0.072) and major bleeding (OR: 0.77; 95% CI: 0.40-1.47; p: 0.424) episodes across both groups. Furthermore, subanalysis among the total knee arthroplasty group showed that the aspirin cohort was significantly more likely to suffer VTEs than their LMWH counterparts (OR: 1.55; 95% CI: 1.21-1.98; p < 0.001). CONCLUSION: This study demonstrated a significantly higher risk of PE among patients receiving aspirin compared to LMWH following hip or knee arthroplasty for osteoarthritis. Aspirin was associated with a significantly higher overall VTE risk among patients undergoing knee arthroplasty, in particular. This might suggest the inferiority of aspirin compared to LMWH in preventing VTE following such procedures. LEVEL OF EVIDENCE: Level I.

Risk factors and mortality associated with venous thromboembolism in the elderly US population with chronic lymphocytic leukemia.

BACKGROUND: Venous thromboembolism (VTE) causes morbidity and mortality in cancer patients. The association of VTE with known risk factors in chronic lymphocytic leukemia (CLL) is not known. OBJECTIVE: To examine risk factors and mortality associated with VTE in White, Black, and Asian CLL patients. METHODS: The United States SEER-Medicare database (2000-2015) was used for CLL patients ≥ 65 years. Logistic regression was used to examine VTE risk factors and Cox proportional regression was used to evaluate the effect of VTE on mortality in White, Black, and Asian CLL patients. RESULTS: Among 34,075 CLL patients, VTE was diagnosed in 11.6 % of 31,395 White, 14.6 % of 2062 Black and 6.3 % of 618 Asian patients. Risk of having VTE was, ORa = 1.2 (95 % CI, 1.0-1.4) for Black patients and ORa = 0.5 (95 % CI, 0.4-0.7) for Asian patients compared to White patients. Anemia and heart failure were associated with VTE in all three racial cohorts and were the only risk factors in Asian patients. Other risk factors in White patients were the same as in the overall population, including hypertension, obesity, COPD, kidney disease, diabetes, hyperlipidemia, myocardial infarction, and chemotherapy. In Black patients, other risk factors were hypertension, and chemotherapy. Mortality was slightly higher with VTE in the overall population and in White patients. CONCLUSION: There was difference in VTE risk factors in White, Black, and Asian patients. VTE was marginally associated with mortality in CLL patients. Our findings may help to identify patients at higher risk of VTE in racially diverse CLL populations.

Efficient Rescue of Retinal Degeneration in Pde6a Mice by Engineered Base Editing and Prime Editing.

Retinitis pigmentosa (RP) is a complex spectrum of inherited retinal diseases marked by the gradual loss of photoreceptor cells, ultimately leading to blindness. Among these, mutations in PDE6A, responsible for encoding a cGMP-specific phosphodiesterase, stand out as pivotal in autosomal recessive RP (RP43). Unfortunately, no effective therapy currently exists for this specific form of RP. However, recent advancements in genome editing, such as base editing (BE) and prime editing (PE), offer a promising avenue for precise and efficient gene therapy. Here, it is illustrated that the engineered BE and PE systems, particularly PE, exhibit high efficiency in rescuing a target point mutation with minimal bystander effects in an RP mouse model carrying the Pde6a (c.2009A > G, p.D670G) mutation. The optimized BE and PE systems are first screened in N2a cells and subsequently assessed in electroporated mouse retinas. Notably, the optimal PE system, delivered via dual adeno-associated virus (AAV), precisely corrects the pathogenic mutation with average 9.4% efficiency, with no detectable bystander editing. This correction restores PDE6A protein expression, preserved photoreceptors, and rescued retinal function in Pde6a mice. Therefore, this study offers a proof-of-concept demonstration for the treatment of Pde6a-related retinal degeneration using BE and PE systems.

Aging of drinking water transmission pipes during long-term operation as a potential source of nano- and microplastics.

Microplastics (MPs) and nanoplastics (NPs) released into drinking water from transmission pipes can pose a potential health risk to consumers. This paper presents the results of a comprehensive study of PE and PVC pipes after long-term operation in drinking water distribution networks, which confirmed that degradable polymers can be a significant source of MPs. Both plastics age relatively quickly, and the degree of damage to the pipe surface depends on the time and operating conditions. During aging, polymer chains deteriorate, leading to a weakening of the structure and increased amorphousness of the plastics. As a result, the surfaces of PE and PVC crack and peel, resulting in the formation of particles with sizes corresponding to NP and MP with high potential for release into water. The magnitude of the phenomenon increases as the diameter of the pipes decreases, indicating that the most vulnerable customers are those at the ends of the network to which drinking water is supplied through small-diameter pipes. Aging PE and PVC pipes should be considered a real and very important source of MPs and NPs in drinking water, and water quality in this aspect should be monitored by manufacturers.

Causal association of sex hormone-binding globulin on gestational hypertension and pre-eclampsia: a two-sample Mendelian randomization study.

OBJECTIVES: Pre-eclampsia (PE) and gestational hypertension (GH) are two different categories of hypertensive disorders of pregnancy. Given earlier observational research, the relationship between sex hormone-binding globulin (SHBG) and a higher risk of GH/PE is still up for dispute. Hence, the present investigation aimed to examine the possible link between SHBG and the likelihood of GH/PE. METHODS: As a first stage, single nucleotide polymorphisms from summary-level genome-wide association studies were tightly screened using quality-control techniques. Afterward, we utilized a two-sample Mendelian randomization (MR) study to examine the causal impact of SHBG on the likelihood of GH/PE. There was no indication of a relationship between blood SHBG level (n = 214,989) and GH/PE (1864 cases and 461,069 controls) in the initial study. Consensus results were obtained from the replicated analysis, which utilized MR estimates based on serum SHBG level(n = 214,989) for GH (4255 cases and 114,735 controls). RESULTS: The findings did not indicate any proof of a cause-and-effect connection between SHBG and the likelihood of GH/PE (odds ratio [OR] = 0.99, 95% confidence interval [CI] = 0.999 - 1.00, p = .34). Replicate analysis also revealed similar patterns (OR = 0.92, 95%CI = 0.82-1.05, p = .21). The above findings were demonstrated to have a strong level of robustness. CONCLUSIONS: The findings of this research did not offer definitive proof to endorse the idea that SHBG has a direct causal impact on the likelihood of GH/PE, which goes against numerous widely accepted observational studies. To ascertain the potential processes behind the relationships seen in observational studies, more investigation is needed.

Advances in Thromboprophylaxis for High-Risk Pregnancies: A Comprehensive Review of Current Strategies and Emerging Approaches.

Thrombosis during pregnancy poses a significant clinical challenge due to its potential for severe maternal and fetal complications. The incidence of thromboembolic events in pregnant women is heightened by pregnancy-associated hypercoagulability, venous stasis, and endothelial changes, all of which contribute to an elevated risk. Effective thromboprophylaxis is essential to mitigate these risks and improve outcomes for both mother and child. This review provides a comprehensive evaluation of current thromboprophylaxis strategies, including pharmacologic interventions such as low-molecular-weight heparins (LMWHs) and unfractionated heparin (UFH) and nonpharmacologic measures like compression stockings and lifestyle modifications. Additionally, the review explores emerging approaches, including personalized medicine strategies, novel anticoagulants, and technology-enabled monitoring solutions. By integrating current evidence with emerging trends, this review aims to offer insights into optimizing thromboprophylaxis in high-risk pregnancies, ultimately contributing to improved clinical outcomes and guiding future research directions in this critical area of maternal healthcare.

Error monitoring under working memory load: An electrocortical investigation.

Error monitoring is essential for detecting errors and may facilitate behavioral adjustments that can reduce or prevent future errors. At times, error monitoring must occur while individuals are engaged in other, cognitively demanding tasks that might consume processing resources necessary for error monitoring. Here, we set out to determine whether concurrent working memory (WM) load interferes with error monitoring, as measured using event-related potentials, the error-related negativity (Ne/ERN), and error positivity (Pe). Fifty-four participants (n = 33 female) completed an arrowhead flanker task, with trials presented under low (2 letter) or high (6 letter) WM load. Participants were required to hold letter strings in memory and to recall these letters at the end of a set of flanker trials. Results showed that WM load reduced the Pe but did not affect the Ne/ERN. Therefore, WM load appeared to attenuate later, more elaborated stages of error processing, though initial error detection was unaffected. Additionally, high WM load slowed reaction times overall, but did not lead to a significant increase in errors. As such, slower responses may have helped participants maintain comparable accuracy for low-load versus high-load trials. Overall, results indicate that WM load interferes with the evaluation of error significance, which could interfere with behavioral adaptations over time.

Isolation of marine polyethylene (PE)-degrading bacteria and its potential degradation mechanisms.

Microbial degradation of polyethylene (PE) offers a promising solution to plastic pollution in the marine environment, but research in this field is limited. In this study, we isolated a novel marine strain of Pseudalkalibacillus sp. MQ-1 that can degrade PE. Scanning electron microscopy and water contact angle results showed that MQ-1 could adhere to PE films and render them hydrophilic. Analyses using X-ray diffraction, fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy showed a decrease in relative crystallinity, the appearance of new functional groups and an increase in the oxygen-to­carbon ratio of the PE films, making them more susceptible to degradation. The results of gel permeation chromatography and liquid chromatography-mass spectrometry indicated the depolymerization of the long PE chains, with the detection of an intermediate, decanediol. Furthermore, genome sequencing was employed to investigate the underlying mechanisms of PE degradation. The results of genome sequencing analysis identified the genes associated with PE degradation, including cytochrome P450, alcohol dehydrogenase, and aldehyde dehydrogenase involved in the oxidative reaction, monooxygenase related to ester bond formation, and esterase associated with ester bond cleavage. In addition, enzymes involved in fatty acid metabolism and intracellular transport have been identified, collectively providing insights into the metabolic pathway of PE degradation.

PE/PPE Proteome and ESX-5 Substrate Spectrum in Mycobacterium marinum.

PE/PPE proteins secreted by the ESX-5 type VII secretion system constitute a major protein repertoire in pathogenic mycobacteria and are essential for bacterial survival, pathogenicity, and host-pathogen interaction; however, little is known about their expression and secretion. The scarcity of arginine and lysine residues in PE/PPE protein sequences and the high homology of their N-terminal domains limit protein identification using classical trypsin-based proteomic methods. This study used endoproteinase AspN and trypsin to characterize the proteome of Mycobacterium marinum. Twenty-seven PE/PPE proteins were uniquely identified in AspN digests, especially PE_PGRS proteins. These treatments allowed the identification of approximately 50% of the PE/PPE pool encoded in the genome. Moreover, EspG5 pulldown assays retrieved 44 ESX-5-associated PPE proteins, covering 85% of the PPE pool in the identified proteome. The identification of PE/PE_PGRS proteins in the EspG5 interactome suggested the presence of PE-PPE pairs. The correlation analysis between protein abundance and phylogenetic relationships found potential PE/PPE pairs, indicating the presence of multiple PE/PE_PGRS partners in one PPE. We validated that EspG5 interacted with PPE31 and PPE32 and mapped critical residues for complex formation. The modified proteomic platform increases the coverage of PE/PPE proteins and elucidates the expression and localization of these proteins.

The influence of patient sex on pulmonary embolism evaluation, treatment modality, and outcomes.

BACKGROUND: Pulmonary embolism (PE) is the third-leading cause of cardiovascular mortality, accounting for 100,000 deaths per year in the United States. Although sex-based disparities have previously been described in this population, it is unclear if these differences have persisted with the expansion of PE evaluation and treatment approaches. The purpose of this study is to investigate sex-based differences in the evaluation, management, and outcomes of patients with acute PE. METHODS: We performed a retrospective analysis of patients enrolled in the national Pulmonary Embolism Response Team (PERT) Consortium database between October 2015 and October 2022. We evaluated patient demographics, clinical characteristics, diagnostic imaging performed, treatment at several phases of care (pre-PERT, PERT recommendations, and post-PERT), and clinical outcomes. RESULTS: A total of 5722 patients with acute PE (2838 [49.6%] women) from 35 centers were included. There were no differences in PE risk category between male and female patients. Women were less likely to undergo echocardiography (76.9% vs 73.8%) and more likely to receive no anticoagulation prior to PERT evaluation (35.5% vs 32.9%). PERT teams were more likely to recommend catheter-based interventions for men (26.6% vs 23.1%), and men were more likely to undergo these procedures (21.9% vs 19.3%). In a multivariable analysis, female sex was a predictor of in-hospital mortality (OR 1.53, 95% CI 1.06 to 2.21). CONCLUSIONS: In this analysis, we identified sex-based differences in the evaluation and management of patients presenting with acute PE. Subsequently, women presenting with acute PE were at higher risk of in-hospital mortality.

20 years clinical application of the vacuum bell for conservative treatment of pectus excavatum-past, present, future.

Background: For decades, open surgical repair was the only available method to treat pectus excavatum (PE). In 1998 Donald Nuss described first time a minimally invasive repair of pectus excavatum (MIRPE), and today MIRPE is performed with increasing frequency worldwide. However, despite its minimally invasive approach, with the widespread use of MIRPE the character and number of complications have increased. 20 years ago, non-surgical measures such as vacuum bell therapy (VBT) were introduced as a useful complement for specific treatment of PE patients. However, until today there are no existing validated guidelines concerning VBT. Methods: The study includes the results of an online survey submitted to the members of Chest Wall International Group (CWIG), a selective review of the English spoken current literature with focus on VBT and an analysis of our own previous studies concerning VBT. Results: Seventy-two percent of the CWIG members practicing in 47 different institutions confirmed to use VBT for PE patients. Furthermore, within the last 10 to 15 years an increasing number of studies were identified reporting on successful use of VBT for PE. However, a recently published study stated that the effect of VBT is predominantly because of thickening of the chest wall by increasing pre-sternal adipose tissue. There was one study comparing VBT to MIRPE but no randomized and/or prospective studies comparing conservative treatment vs. surgical repair or conservative treatment vs. no specific therapy. Variables predictive of an excellent outcome could be identified. Especially in younger PE patients, VBT is reported with increasing frequency in the survey as well as in the literature. However, validated guidelines concerning VBT are still not available. Conclusions: Non-operative treatment of PE with VBT proved to be safe and a potential alternative to surgical repair in carefully selected PE patients. Patient's age at diagnosis and severity of the PE represents relevant variables to decide which kind of therapy might be successful to correct PE. Especially in PE patients under the age of 10 years, VBT seems to represent the first step of specific therapy.

Best Practices for Optimizing Patients Undergoing Surgical Procedures to Prevent Postoperative Venous Thromboembolism: A Quality Improvement Project.

Introduction Current studies suggest that both chemical and mechanical venous thromboembolism (VTE) prophylaxis is underused, which is concerning due to the potential lethality of VTEs. The Caprini risk score is a preoperative VTE risk assessment that determines a patient's risk of enduring a VTE. The objective of this study was to examine postoperative cases of VTE to determine if accurate VTE risk stratification was performed and whether appropriate VTE prophylaxis was administered. Methods A retrospective analysis was conducted on 23 reported cases of VTE that occurred at a Central Florida hospital from April 1, 2021, to March 31, 2022. Relevant demographic and medical information was gathered from each patient chart to calculate an individual Caprini risk score and determine the type of chemical VTE prophylaxis that was received. Results Out of 23 reported cases of VTE in surgical patients, 17 were ultimately determined to have suffered VTE associated with their hospitalization and surgery. Thirteen out of 17 (76%) received appropriate perioperative chemical deep vein thrombosis (DVT) prophylaxis based on the calculated Caprini risk score and corresponding recommendations. Four out of 17 (24%) were determined to have received insufficient perioperative chemical DVT prophylaxis. Conclusion Consistent utilization of a DVT/pulmonary embolism (PE) risk stratification tool, such as the Caprini risk score calculator, is essential in the prevention of postoperative VTE. Hospitals can improve the utilization of such a tool and thereby reduce the number of embolic events by making it more visible and accessible to the overseeing provider in the electronic medical record (EMR).

First record of a possible trypanotolerant cattle breed in Latin America: Parasitological, serological, and clinical aspects.

Trypanosoma vivax infections are endemic in Africa, where they provoke trypanosomosis against which some local taurine breeds are tolerant and are thus named trypanotolerant. In Latin America, T. vivax was imported in 1919, since when it has been responsible for periodic outbreaks of the disease. This study assessed whether a South American taurine breed resilient to several parasitic and infectious diseases (Curraleiro Pé-Duro-CPD) can meet trypanotolerant criteria (control parasite proliferation, prevent anemia, survive without treatment, and maintain productivity). Three groups were established, each consisting of six animals (Group 1: CPD-infected; Group 2: Holstein/Gyr-infected; Group 3: Holstein/Gyr-uninfected, negative control). Groups 1 and 2 were infected with T. vivax on Day 0 and evaluated until day 532. Throughout the experimental period, parasitological (Woo and Brener), molecular (cPCR), serological (enzyme-linked immunosorbent assay - ELISA, indirect fluorescent antibody test - IFAT, immunochromatographic assay - IA), and clinical (hemogram, fever, weight loss) aspects were evaluated. During the acute phase of the disease, T. vivax was initially detected in Holstein/Gyr. Notably, the CPD animals restored their packed cell volume (PCV) values to the normal range 74 days after inoculations. In the chronic phase, two of the six CPD animals were positive by cPCR until D + 522 following immunosuppression with dexamethasone. Regarding serological aspects, the two CPD animals had positive tests until D + 532. The absence of T. vivax in blood during the chronic phase did not correspond to "self-cure". Holstein/Gyr animals exhibited fever on more evaluation days than CPD animals. Both breeds experienced weight loss, with Holstein/Gyr animals losing significantly more weight. On D + 25, the Holstein/Gyr group required treatment. During the 532 days, none of the CPD animals required treatment, even after being sensitized with dexamethasone. Animals from Group 3 tested negative for T. vivax throughout the experiment. This study demonstrated that CPD cattle fulfill the mentioned trypanotolerant criteria.

Biodegradation of low-density polyethylene by mixed fungi composed of Alternaria sp. and Trametes sp. isolated from landfill sites.

With the development of industry and modern manufacturing, nondegradable low-density polyethylene (LDPE) has been widely used, posing a rising environmental hazard to natural ecosystems and public health. In this study, we isolated a series of LDPE-degrading fungi from landfill sites and carried out LDPE degradation experiments by combining highly efficient degrading fungi in pairs. The results showed that the mixed microorganisms composed of Alternaria sp. CPEF-1 and Trametes sp. PE2F-4 (H-3 group) had a greater degradation effect on heat-treated LDPE (T-LDPE). After 30 days of inoculation with combination strain H-3, the weight loss rate of the T-LDPE film was approximately 154% higher than that of the untreated LDPE (U-LDPE) film, and the weight loss rate reached 0.66 ± 0.06%. Environmental scanning electron microscopy (ESEM) and Fourier transform infrared spectroscopy (FTIR) were used to further investigate the biodegradation impacts of T-LDPE, including the changes on the surface and depolymerization of the LDPE films during the fungal degradation process. Our findings revealed that the combined fungal treatment is more effective at degrading T-LDPE than the single strain treatment, and it is expected that properly altering the composition of the microbial community can help lessen the detrimental impact of plastics on the environment.

Chemo-Enzymatic Depolymerization of Functionalized Low-Molecular-Weight Polyethylene.

Polyethylene (PE) is the most commonly used plastic type in the world, contributing significantly to the plastic waste crisis. Microbial degradation of PE in natural environments is unlikely due to its inert saturated carbon-carbon backbones, which are difficult to break down by enzymes, challenging the development of a biocatalytic recycling method for PE waste. Here, we demonstrated the depolymerization of low-molecular-weight (LMW) PE using an enzyme cascade that included a catalase-peroxidase, an alcohol dehydrogenase, a Baeyer Villiger monooxygenase, and a lipase after the polymer was chemically pretreated with m-chloroperoxybenzoic acid (mCPBA) and ultrasonication. In a preparative experiment with gram-scale pretreated polymers, GC-MS and weight loss determinations confirmed ~27% polymer conversion including the formation of medium-size functionalized molecules such as ω-hydroxy acids and α,ω-carboxylic acids. Additional polymer property analyses using AFM showed that enzymatic depolymerization reduced the particle sizes of this mCPBA- and enzyme-treated LMWPE. This multi-enzyme catalytic concept with distinct chemical steps represents a unique starting point for future development of bio-based recycling methods for polyolefin waste.

Unveiling the enigma: A challenging case of protein C deficiency concealed by fever and epistaxis.

Protein C deficiency is a rare genetic disorder caused by mutations in the protein C, inactivator of coagulation factors Va and VIIA gene, affecting approximately 1 in 200-500 individuals. It leads to a hypercoagulable state, increasing the risk of blood clots. Symptoms vary with age, ranging from life-threatening purpura fulminans in neonates to venous thromboembolism, particularly deep vein thrombosis, in adults. A recent case involved a 21-year-old South Asian male presenting with persistent fever, weight loss, epistaxis, abdominal tenderness, and acute pain in the right thigh and leg, raising suspicion of deep vein thrombosis. Tests confirmed deep vein thrombosis in multiple leg veins and a pulmonary embolism. The patient was diagnosed with protein C deficiency and received anticoagulant therapy, thrombolysis, and an inferior vena cava filter. Complications of protein C deficiency include deep vein thrombosis, pulmonary embolism, stroke, and ischemic colitis. Diagnosis involves immunoassays and genetic analysis. Treatment includes heparin followed by anticoagulation therapy with warfarin. In severe cases, an inferior vena cava filter may be implanted. The described case required extensive treatment due to multiple deep vein thrombosis and a pulmonary embolism, with lifelong anticoagulant therapy. Early diagnosis and appropriate management are crucial in young patients with a history of venous thromboembolism to prevent and manage complications associated with protein C deficiency.

Fauna - Microplastics interactions: Empirical insights from benthos community exposure to marine plastic waste.

Microplastic deposition in soft marine sediments raises concerns on their role in sediment habitats and unknown effects on resident macrobenthic communities. To assess the reciprocal influence that MPs and macrobenthos might have on each other, we performed a mesocosm experiment with ambient concentrations of environmental Polyethylene (PE) and a non-manipulated, natural macrobenthic community from the Belgian part of the North Sea (BPNS). Our results show that PE fragments increase mortality of abundant bivalves (specifically Abra alba) after 30 days of exposure but not for the most abundant polychaete Owenia fusiformis, possibly due to its predominant suspension feeding behavior. Fast burial of surface MPs exposes deep-dwelling burrowers to the pollutant, however reducing the amount of MPs interacting with (sub) surface living fauna. We conclude that macrobenthos promotes the sequestration of deposited MPs, counteracting resuspension, and can have cascading effects on biodiversity due to their effect on abundant and functionally important species.