Pulmonary congestion and systemic congestion in hemodialysis: dynamics and correlations

Introduction

Systemic congestion and pulmonary congestion (PC) are common in hemodialysis (HD) patients. However, the relationship between these two entities is not quite clear. We study this relationship and attempt to uncover the factors that may affect it considering different inter-dialytic intervals.

Methods

A prospective pilot observational and interventional study including 18 HD patients was conducted. The following were obtained: i) B-line score (BLS) by lung ultrasound (LUS) (reflecting significant pulmonary congestion if BLS > 5), ii) echocardiography, iii) bioelectrical impedance analysis (BIA) (reflecting global volume status), and iv) inferior vena cava (IVC) dynamics (reflecting systemic congestion) before and after the first two consecutive HD sessions of the week, with different inter-dialytic intervals (68 hours and 44 hours). Serum N-terminal pro-brain natriuretic peptide type B (NT-proBNP) levels were obtained before each session. Then, patients were randomized into two groups: the active group, where dry weight was reduced according to BLS + standard of care, and the control group, where dry weight was modified according to standard of care. All the measures were repeated on day 30.

Results

We found no correlation between pulmonary congestion represented by BLS and IVC dimensions and dynamics reflecting systemic congestion, independent of different inter-dialytic intervals. Pulmonary congestion was quite prevalent, as mean pre- and post-dialysis BLSs were quite elevated (16 ± 5.53 and 15.3 ± 6.63, respectively) in the first session compared with the second session (16.3 ± 5.26 and 13.6 ± 5.83, respectively). Systolic (left ventricular ejection fraction) and diastolic cardiac function (e/è ratio) parameters from one side and pulmonary congestion (BLS) from the other were not always correlated. BLS was correlated to e/è ratio before HD (session 1) (R 2 = 0.476, p = 0.002) and after HD (session 2) (R 2 = 0.193, p = 0.034). Pulmonary congestion reflected by BLS was correlated to the global volume state reflected by BIA only in the second HD session (HD2) (R 2 = 0.374, p = 0.007). NT-proBNP levels and BLS were correlated before both sessions (R 2 = 0.421, p = 0.004, and R 2 = 0.505, p = 0.001, respectively). Systemic congestion was quite prevalent, as mean pre- and post-dialysis IVC dimensions and dynamics were quite elevated in both sessions, with a higher level of systemic congestion in the first HD session (diameter and collapsibility of 2.1 cm and 23%, and 2.01 cm and 19%, respectively) compared with the second session (1.98 cm and 17.5%, and 1.9 cm and 22%, respectively) without reaching statistical significance. IVC dimensions and global volume status measured by BIA were correlated in the second dialysis session (R 2 = 0.260, p = 0.031). No correlation was found between IVC dimensions and diastolic cardiac function (e/è ratio) parameters or with NT-proBNP levels. On day 30, BLS was significantly reduced in the active group, whereas no difference was found in the control group. However, no real impact was observed on IVC dimensions and dynamics or in total volume status by BIA.

Conclusion

Pulmonary congestion is common in HD patients even after reaching their dry weight at the end of two consecutive sessions, and it is not correlated to systemic congestion, suggesting a complex multifactorial pathophysiology origin. Global volume status reflected by BIA and cardiac function are not always related to either systemic congestion represented by IVC dimensions or pulmonary congestion represented by BLS. Fluid redistribution anomalies may allow pulmonary congestion accumulation independently from systemic congestion and global volume status (non-cardiogenic pulmonary congestion). We recommend a personalised approach when managing HD patients by integrating systemic and pulmonary congestion parameters. Dry weight modification guided by repeat LUS may safely reduce pulmonary congestion. However, no impact was observed on systemic congestion or global volume status.

Intravascular volumes and the influence on anemia assessed by a carbon monoxide rebreathing method in patients undergoing maintenance hemodialysis

INTRODUCTION

Fluid overload is a major challenge in hemodialysis patients and might cause hypervolemia. We speculated that hemodialysis patients reaching dry weight could have undetected hypervolemia and low hemoglobin (Hb) concentration (g/dL) due to hemodilution.

METHODS

The study included hemodialysis patients (n = 22) and matched healthy controls (n = 22). Blood volume, plasma volume, red blood cell volume, and total Hb mass were determined using a carbon monoxide (CO)-rebreathing method in hemodialysis patients reaching dry weight and controls. Blood volume measurements were also obtained by a dual-isotope labeling technique in a subgroup for validation purposes.

FINDINGS

In the hemodialysis group, the median specific blood volume was 89.3 mL/kg (interquartile range [IQR]: 76.7-95.4 mL/kg) and was higher than in the control group (79.9 mL/kg [IQR: 70.4-88.0 mL/kg]; p < 0.037). The median specific plasma volume was 54.7 mL/kg (IQR: 47.1-61.0 mL/kg) and 44.0 mL/kg (IQR: 38.7-49.5 mL/kg) in the hemodialysis and control groups, respectively (p < 0.001). Hb concentration was lower in hemodialysis patients (p < 0.001), whereas no difference in total Hb mass was observed between groups (p = 0.11). A correlation was found between blood volume measured by the CO-rebreathing test and the dual-isotope labeling technique in the control group (r = 0.83, p = 0.015), but not the hemodialysis group (r = 0.25, p = 0.60).

DISCUSSION

The hemodialysis group had increased specific blood volume at dry weight due to high plasma volume, suggesting a hypervolemic state. However, correlation was not established against the dual-isotope labeling technique underlining that the precision of the CO-rebreathing test should be further validated. The total Hb mass was similar between hemodialysis patients and controls, unlike Hb concentration, which emphasizes that Hb concentration is an inaccurate marker of anemia among hemodialysis patients.

The role of plasma volume and fluid overload in the tolerance to ultrafiltration and hypotension in hemodialysis patients

INTRODUCTION

Ultrafiltration (UF) in hemodialysis (HD) patients is accompanied by irregular falls in plasma volume (PV) and blood pressure (BP).

METHODS

We obtained in 321 patients (large cohort), body weight (BW), BP, samples of blood to determine hemoglobin (Hb) and hematocrit (Ht), Pre and Post HD. We estimated the % variation of the PV and its effect on the BP. In a small cohort of 38/321 patients, arterial blood was drawn Pre and Post HD and at 2, 48, and 72 h to determined Hb and Ht and % variation of the PV. Bio-impedance spectroscopy (BIS) was performed, in the same times, to estimate: dry weight (DW), total body water (TBW), extracellular water (ECW), Fluid overload (FO) and phase angle (PhA).

RESULTS

We divided our large cohort in two groups. The Hypotensive group with a fall equal or more than 20 mmHg (96/321,30%) and Normotensive group with a drop equal or less than 19 mmHg (225/321,70%). The UF was 2.73 ± 0.72 L in the Hypotensive group and 2.53 ± 0.85 L in the Normotensive group (p < 0.0001). The % PV was -11.7 ± 17.8 in the Hypotensive group and -8.53 ± 10.07 in the Normotensive group (p < 0.0001). The systolic blood pressure (SBP) correlated with the % change of the PV (r = -0.232; p < 0.0001). The FO was contrasted with the % of water removed by UF (r = -0.890; p < 0.0001).

CONCLUSION

The SBP drop was secondary to the fall in the PV after UF. The FO was irregular and modulates in part the fall in the SBP.

Identification of quantitative trait loci controlling nitrogen use efficiency-related traits in rice at the seedling stage under salt condition by genome-wide association study

Rice cultivation is facing both salt intrusion and overuse of nitrogen fertilizers. Hence, breeding new varieties aiming to improve nitrogen use efficiency (NUE), especially under salt conditions, is indispensable. We selected 2,391 rice accessions from the 3K Rice Genomes Project to evaluate the dry weight under two N concentrations [2.86 mM - standard N (SN), and 0.36 mM - low N (LN)] crossed with two NaCl concentrations [0 (0Na) and 60 mM (60Na)] at the seedling stage. Genome-wide association studies for shoot, root, and plant dry weight (DW) were carried out. A total of 55 QTLs - 32, 16, and 7 in the whole, indica, and japonica panel - associated with one of the tested traits were identified. Among these, 27 QTLs co-localized with previously identified QTLs for DW-related traits while the other 28 were newly detected; 24, 8, 11, and 4 QTLs were detected in SN-0Na, LN-0Na, SN-60Na, and LN-60Na, respectively, and the remaining 8 QTLs were for the relative plant DW between treatments. Three of the 11 QTLs in SN-60Na were close to the regions containing three QTLs detected in SN-0Na. Eleven candidate genes for eight important QTLs were identified. Only one of them was detected in both SN-0Na and SN-60Na, while 5, 0, 3, and 2 candidate genes were identified only once under SN-0Na, LN-0Na, SN-60Na, and LN-60Na, respectively. The identified QTLs and genes provide useful materials and genetic information for future functional characterization and genetic improvement of NUE in rice, especially under salt conditions.

Basil (Ocimum basilicum) Landraces Can Be Used in a Water-Limited Environment

Basil (Ocimum basilicum L.) is a member of the Labiatae family and is one of the most widely consumed aromatic and medicinal plants in many countries due to its numerous properties and uses. The objective of the study was to determine whether landraces are better adapted to water-limited environments compared to commercial cultivars. Irrigation levels and genotypes affected plant height and leaf area index, with 25% and 33% higher values observed under complete irrigation, respectively. Additionally, limited water availability resulted in a 20% reduction in dry matter yield and a 21% reduction in essential oil yield over the three years in all of the genotypes tested, specifically in the lower irrigation treatment (d₄₀), compared to the control treatment (d₁₀₀). The landraces that performed the best under limited water supply were Athos white spike (AWS) and Gigas white spike (GWS), indicating their suitability for environments with limited water resources. The results demonstrate that there are landraces that can be utilized in dryland climates with appropriate water management, enabling water conservation and utilization of fields in water-scarce areas for irrigation purposes.

Association between Intra- and Extra-Cellular Water Ratio Imbalance and Natriuretic Peptides in Patients Undergoing Hemodialysis

Natriuretic peptides are associated with malnutrition and volume overload. Over-hydration cannot simply be explained by excess extracellular water in patients undergoing hemodialysis. We assessed the relationship between the extracellular and intracellular water (ECW/ICW) ratio, N-terminal pro-B-type natriuretic peptide (NT-proBNP), human atrial natriuretic peptide (hANP), and echocardiographic findings. Body composition was examined by segmental multi-frequency bioelectrical impedance analysis in 368 patients undergoing maintenance dialysis (261 men and 107 women; mean age, 65 ± 12 years). Patients with higher ECW/ICW ratio quartiles tended to be older, were on dialysis longer, and had higher post-dialysis blood pressure and lower body mass index, ultrafiltration volume, serum albumin, blood urea nitrogen, and creatinine levels (p < 0.05). The ECW/ICW ratio significantly increased with decreasing ICW, but not with ECW. Patients with a higher ECW/ICW ratio and lower percent fat had significantly higher natriuretic peptide levels. After adjusting for covariates, the ECW/ICW ratio remained an independent associated factor for natriuretic peptides (β = 0.34, p < 0.001 for NT-proBNP and β = 0.40, p < 0.001 for hANP) and the left ventricular mass index (β = 0.20, p = 0.002). The ICW-ECW volume imbalance regulated by decreased cell mass may explain the reserve capacity for fluid accumulation in patients undergoing hemodialysis.

Ultra-Responses of Asphodelus tenuifolius L. (Wild Onion) and Convolvulus arvensis L. (Field Bindweed) against Shoot Extract of Trianthema portulacastrum L. (Horse Purslane)

Weed infestation is a prime challenge coupled with lowering crop production owing to their competition with crop plants for available resources such as nutrients, water, space, moisture, and sunlight. Among weed control methods, the implementation of synthetic herbicides offers an instant solution for getting rid of weeds; however, they are a direct source of potential hazards for humans and generate resistance against synthetic weedicides, making them less effective. Allelopathy is something that happens in nature that can be used as a weed control method that increases crop yield and decreases dependency on synthetic chemicals. The mode of action of some phytochemicals corresponds to synthetic herbicides. Due to this feature, allelochemicals are used as bio-herbicides in weed management and prove more environmentally friendly than synthetic weedicides. The present investigation aims to assess the ultra-responses of A. tenuifolius and C. arvensis, while growing them in a pot experiment. Various levels of shoot extract (L2, L3, and L4) of T. portulacastrum along with the L1 (distilled water) and L5 (synthetic herbicide) were applied to the weeds. Results indicated that aqueous extracts of shoot of T. portulacastrum significantly (p ≤ 0.05) affect all the measured traits of weeds and their effects were concentration specific. All morphological parameters were suppressed due to biotic stress with an increase in free amino acids and calcium ions along with a decline in metaxylem cell area and cortical thickness in the root, while the vascular bundle area increased. The shoot extract intrusive with metabolisms corresponded with the synthetic herbicide. It is concluded that Trianthema shoot extract has a powerful phytotoxic impact on weeds (A. tenuifolius and C. arvensis) and can be used in bio-herbicide production.

Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension

Intradialytic hypotension (IDH) is a frequent and well-known complication of hemodialysis, occurring in about one third of patients. An integrated approach with different methods is needed to minimize IDH episodes and their complications. In this prospective observational study, recruited patients underwent a multiparametric evaluation of fluid status through a lung ultrasound (LUS) with the quantification of B-lines, a physical examination, blood pressure, NT-proBNP and chest X-rays. The evaluation took place immediately before and at the end of the dialysis session, and the patients were divided into IDH and no-IDH groups. We recruited a total of 107 patients. A pre-dialysis B-line number ≥ 15 showed a high sensitivity in fluid overload diagnosis (94.5%), even higher than a chest X-ray (78%) or physical examination (72%) alone. The identification at the beginning of dialysis of <8 B-lines in the overall cohort or <20 B-lines in patients with NYHA 3−4 class are optimal thresholds for identifying those patients at higher risk of experiencing an IDH episode. In the multivariable analysis, the NYHA class, a low pre-dialysis systolic BP and a low pre-dialysis B-line number were independent risk factors for IDH. At the beginning of dialysis, the B-line quantification at LUS is a valuable and reliable method for evaluating fluid status and predicting IDH episodes. A post-dialysis B-line number <5 may allow for an understanding of whether the IDH episode was caused by dehydration, probably due to due to an overestimation of the dry weight.

Evaluation of Normalization Approaches for Quantitative Analysis of Bile Acids in Human Feces

Quantitative analysis of bile acids in human feces can potentially help to better understand the influence of the gut microbiome and diet on human health. Feces is a highly heterogeneous sample matrix, mainly consisting of water and indigestible solid material (as plant fibers) that show high inter-individual variability. To compare bile acid concentrations among different individuals, a reliable normalization approach is needed. Here, we compared the impact of three normalization approaches, namely sample wet weight, dry weight, and protein concentration, on the absolute concentrations of fecal bile acids. Bile acid concentrations were determined in 70 feces samples from healthy humans. Our data show that bile acid concentrations normalized by the three different approaches are substantially different for each individual sample. Fecal bile acid concentrations normalized by wet weight show the narrowest distribution. Therefore, our analysis will provide the basis for the selection of a suitable normalization approach for the quantitative analysis of bile acids in feces.

Multiple Laplacian Regularized RBF Neural Network for Assessing Dry Weight of Patients With End-Stage Renal Disease

Dry weight (DW) is an important dialysis index for patients with end-stage renal disease. It can guide clinical hemodialysis. Brain natriuretic peptide, chest computed tomography image, ultrasound, and bioelectrical impedance analysis are key indicators (multisource information) for assessing DW. By these approaches, a trial-and-error method (traditional measurement method) is employed to assess DW. The assessment of clinician is time-consuming. In this study, we developed a method based on artificial intelligence technology to estimate patient DW. Based on the conventional radial basis function neural (RBFN) network, we propose a multiple Laplacian-regularized RBFN (MLapRBFN) model to predict DW of patient. Compared with other model and body composition monitor, our method achieves the lowest value (1.3226) of root mean square error. In Bland-Altman analysis of MLapRBFN, the number of out agreement interval is least (17 samples). MLapRBFN integrates multiple Laplace regularization terms, and employs an efficient iterative algorithm to solve the model. The ratio of out agreement interval is 3.57%, which is lower than 5%. Therefore, our method can be tentatively applied for clinical evaluation of DW in hemodialysis patients.

[Effects of different amounts of organic acid soil conditioners on soil nutrients and crop growth]

Northwest China is burdened by declining soil fertility and poor capacity of water and nutrient retention. A pot experiment was conducted to examine the effects of organic acid conditio-ners (OASC) with four application rates (0, 20, 40, and 60 g·kg^-1) on soil nutrients and crop growth. Maize and common vetch were the focus crops and loessial soil and irrigated desert soil were the soil types. The results showed that OASC application reduced water evaporation loss and significantly improved soil available nutrient content, with the most obvious effects on soil phosphorus. Available phosphorus content and proportion were increased by 256.5% and 227.4%, respectively, compared with no OASC treatment. The shoot dry weights of maize and common vetch on loessial soil were initially increased with the increasing OASC application rate and were highest at the application rate of 20 g·kg^-1. The values progressively decreased with increasing OASC addition rates. Total salt content was significantly increased and the rate of emergence of common vetch decreased at OASC rate exceeding 20 g·kg^-1. For irrigated desert soil, the OASC application rate did not affect total salt content when maize was planted. There was significant increase in soil total salt contents when common vetch was planted and at the OASC rate of 60 g·kg^-1. The shoot dry weight of common vetch and maize was highest with the OASC application rates at 40 g·kg^-1 and 60 g·kg^-1, respectively. The optimal OASC rate for planting common vetch and maize on loess soil was 20 g·kg^-1. The application rates of 40 g·kg^-1 and 60 g·kg^-1 were optimal for planting common vetch and maize on irrigated desert, respectively.

Stability and Reproducibility of Ephedra sinica Ephedrine Alkaloid Content and Terrestrial Stem Dry Weight

Dried terrestrial stems of Ephedra sinica are known as 'Ephedra herb.' The pharmacological effects are mainly related to two major ingredients, (-)-ephedrine and (+)-pseudoephedrine (total alkaloids which are defined in Japanese Pharmacopoeia, TA). In this study, in order to aid in cultivation and breeding, the stability of TA content and stem dry weight of 46 E. sinica genets was evaluated from the first year of transplantation to the sixth year. TA content and composition ratio of these genets were stable after the second year, and dry weight was stable after the fourth year. These traits showed high inter-genet variability but low annual variability for each genet. Additionally, rank correlation coefficients of each trait among the genets were high. There was no significant correlation between these traits. Furthermore, to assess the reproducibility of these traits in clones, we evaluated TA content and dry weight of three clonal lines with high TA contents. TA content and composition ratio of the clonal lines were also stable after the second year of transplantation, and dry weight of the clonal lines was also stable after the fourth year. Moreover, TA content and composition ratio in each clonal line were comparable with those of each original genet after the second year. These results suggested that ephedrine alkaloids content and dry weight of E. sinica plants are stable, and that these traits are highly reproducible in clones. Therefore, selection breeding of E. sinica using vegetative propagation can be effective for high and stable quality of Ephedra herb.

Body Fat Plays an Important Role in of Bioimpedance Spectroscopy-Based Dry Weight Measurement Error for Patients with Hemodialysis

Accurate dry weight (DW) estimation is important for hemodialysis patients. Although bioimpedance spectroscopy (BIS) is commonly used to measure DW, the BIS-based DW frequently differs from the clinical DW. We analyzed the characteristics of patients whose BIS-based DWs were over- and underestimated. In this retrospective cohort study, we evaluated 1555 patients undergoing maintenance hemodialysis in Chungnam National University Hospital. The gap (DWCP-BIS) was calculated by comparing the BIS and clinical DWs. We analyzed the clinical characteristics of patients with positive (n = 835) and negative (n = 720) gaps. Compared with other patients, the DWCP-BIS-positive group had higher extracellular water (ECW) level and extracellular/intracellular water index (E/I) and had lower weight, body mass index (BMI), lean tissue index (LTI), fat tissue index (FTI), fat mass (FAT), and adipose tissue mass (ATM). The DWCP-BIS-negative group exhibited elevated BMI, FTI, FAT, and ATM; however, it had lower height, ECW, and E/I. Linear regression analysis revealed that FAT significantly predicted DWCP accuracy. The clinical DW of patients with a low fat mass tended to be underestimated, while the clinical DW of patients with comparatively large fat reserves tended to be overestimated. These characteristics will aid in the reduction of BIS-based DW errors.

A Recommendation for a Pre-Standardized Marine Microalgal Dry Weight Determination Protocol for Laboratory Scale Culture Using Ammonium Formate as a Washing Agent

Simple Summary

Microalgae are increasingly recognized as a source of valuable biomass with numerous health benefits. Cleaning of marine microalgal biomass is very crucial for microalgal studies as the salt on the microalgae cells will lead to overestimation of biomass determination. Incomplete washing of salt from microalgae could also interfere with the nutritional analyses. The biomass, especially dry weight, has been utilized for nutritional or compositional evaluation. Although standard methods of marine microalgal dry weight determination are available, these methods did not provide comprehensive details, and the parameters vary among themselves. Without a standard method, a comparison of results among previous studies can be misleading and unreliable. Therefore, the current study aimed to investigate and determine the ideal setting of several parameters in the marine microalgal dry weight determination for laboratory-scale culture. The present findings could assist in developing a standardized protocol to ensure a high quality of biomass for microalgal studies.

Abstract

Microalgal biomass is one of the crucial criteria in microalgal studies. Many reported methods, even the well-established protocol on microalgal dry weight (DW) determination, vary greatly, and reliable comparative assessment amongst published results could be problematic. This study aimed to determine the best condition of critical parameters in marine microalgal DW determination for laboratory-scale culture using four different marine microalgal species. These parameters included the washing process, grades of glass microfiber filter (GMF), GMF pretreatment conditions, washing agent (ammonium formate) concentrations, culture: washing agent ratios (v:v) and washing cycles. GMF grade GF/A with precombustion at 450 °C provided the most satisfactory DW and the highest ash-free dry weight (AFDW)/DW ratio. Furthermore, 0.05 M ammonium formate with 1:2 culture: washing agent ratio and a minimum of two washing cycles appeared to be the best settings of microalgal DW determination. The present treatment increased the AFDW/DW ratio of the four respective microalgae by a minimum of 19%. The findings of this study could serve as a pivotal reference in developing a standardized protocol of marine microalgal DW determination to obtain veracious and reliable marine microalgal DW.

Growth and Antioxidant Responses in Iron-Biofortified Lentil under Cadmium Stress

Cadmium (Cd) is a hazardous heavy metal, toxic to our ecosystem even at low concentrations. Cd stress negatively affects plant growth and development by triggering oxidative stress. Limited information is available on the role of iron (Fe) in ameliorating Cd stress tolerance in legumes. This study assessed the effect of Cd stress in two lentil (Lens culinaris Medik.) varieties differing in seed Fe concentration (L4717 (Fe-biofortified) and JL3) under controlled conditions. Six biochemical traits, five growth parameters, and Cd uptake were recorded at the seedling stage (21 days after sowing) in the studied genotypes grown under controlled conditions at two levels (100 μM and 200 μM) of cadmium chloride (CdCl₂). The studied traits revealed significant genotype, treatment, and genotype × treatment interactions. Cd-induced oxidative damage led to the accumulation of hydrogen peroxide (H₂O₂) and malondialdehyde in both genotypes. JL3 accumulated 77.1% more H₂O₂ and 75% more lipid peroxidation products than L4717 at the high Cd level. Antioxidant enzyme activities increased in response to Cd stress, with significant genotype, treatment, and genotype × treatment interactions (p < 0.01). L4717 had remarkably higher catalase (40.5%), peroxidase (43.9%), superoxide dismutase (31.7%), and glutathione reductase (47.3%) activities than JL3 under high Cd conditions. In addition, L4717 sustained better growth in terms of fresh weight and dry weight than JL3 under stress. JL3 exhibited high Cd uptake (14.87 mg g⁻¹ fresh weight) compared to L4717 (7.32 mg g⁻¹ fresh weight). The study concluded that the Fe-biofortified lentil genotype L4717 exhibited Cd tolerance by inciting an efficient antioxidative response to Cd toxicity. Further studies are required to elucidate the possibility of seed Fe content as a surrogacy trait for Cd tolerance.

Lung Ultrasound to Diagnose Pulmonary Congestion Among Patients on Hemodialysis: Comparison of Full Versus Abbreviated Scanning Protocols

RATIONALE & OBJECTIVE

Pulmonary congestion contributes to morbidity and mortality in patients with kidney failure on hemodialysis, but physical assessment is an insensitive approach to its detection. Lung ultrasound is useful for assessing the presence and severity of pulmonary congestion, but the most widely validated 28-zone study is cumbersome. We sought to compare abbreviated 4-, 6-, and 8-zone studies to 28-zone studies.

STUDY DESIGN

Diagnostic test study.

SETTING & PARTICIPANTS

Convenience sample of 98 patients with kidney failure on hemodialysis presenting to an emergency department in the United States.

TESTS COMPARED

4-, 6-, and 8-zone lung ultrasound studies versus a 28-zone lung ultrasound.

OUTCOME

Prediction of pulmonary congestion and 30-day mortality.

RESULTS

All patients completed a 28-zone lung ultrasound. Correlation coefficients (nonparametric Spearman) between each of the studies were high (all values > 0.84). Bland-Altman analysis showed good agreement. Each of the short-form studies discriminated well with area under the receiver-operator characteristic curve > 0.83 for no-to-mild versus moderate-to-severe pulmonary congestion. During a median follow-up period of 778 days, 46 (47%) died. Patients with moderate-to-severe pulmonary congestion on lung ultrasound had a 30-day mortality rate similar to that observed among patients with no-to-mild pulmonary congestion (OR, 0.95 [95% CI, 0.70-1.29]).

LIMITATIONS

Single-center study conducted in an emergency care setting, convenience sample of patients, and lack of long-term follow-up data.

CONCLUSIONS

Among hemodialysis patients presenting to an emergency department, 4-, 6-, or 8-zone lung ultrasounds were comparable to 28-zone studies for the assessment of pulmonary congestion. The mortality rates did not differ between those with no-to-mild and moderate-to-severe pulmonary congestion.

Supplementary Light Differently Influences Physico-Chemical Parameters and Antioxidant Compounds of Tomato Fruits Hybrids

One of the challenges for agriculture in the coming years will be producing more food avoiding reducing the nutritional values of fruits and vegetables, sources of nutraceutical compounds. It has been demonstrated that light-emitting diodes (LEDs) used as a supplementary light (SL) technology improve tomato yield in Mediterranean greenhouses, but few data have been reported about SL effects on fruit physio-chemical parameters. In this study, three tomato hybrid (F1) cultivars were grown for year-round production in a commercial semi-closed glasshouse in Southern Italy: red cherry type ("Sorentyno"), red plum type ("Solarino"), and yellow plum type ("Maggino"). From 120 to 243 days after transplant (DAT), Red/White/Blue LEDs were used as SL. The fruits harvested 180 DAT were analyzed and those obtained under LEDs had 3% more dry weight, 15% more total soluble solids, and 16% higher titratable acidity than fruits grown only under natural light. Generally, the antioxidant activity and the mineral profile of the fruits were not negatively influenced by SL. Lycopene content was unchanged and vitamin C content of "Sorentyno" even increased by 15% under LEDs. Overall, LEDs used as SL technology could be one of the tools used by agriculture in Mediterranean basin to produce more food maintaining high quality production.

Bioimpedance analysis is not superior to clinical assessment in determining hydration status: A prospective randomized-controlled trial in a Western dialysis population

INTRODUCTION

Fluid management is an important goal of dialysis treatment. The accurate assessment of fluid status is still a challenge for clinical nephrologists. Bioimpedance analysis (BIA) has been proposed as an objective tool to assess hydration.

METHODS

This was a prospective randomized controlled study to compare hydration status measured by clinical assessment compared to BIA using a body composition monitor (BCM). The primary outcome was defined as the decline of cardiac biomarker N-terminal pro brain natriuretic peptide (NT-proBNP) from baseline to the end of the study.

FINDINGS

About 281 chronic hemodialysis patients were assessed for eligibility, and 132 patients provided written informed consent to participate (65 BIA group, 67 clinical group). Predialytic NT-proBNP, and decline of NT-proBNP were similar in both groups. The amount of overhydration (2.18 ± 2.11 L vs. 1.29 ± 1.97 L; p 0.016) and the number of patients with severe overhydration (46.0% vs. 30.6%, p = 0.04) were significantly higher in the BIA group at the end of the study. Fluid accumulation in the interdialytic period was significantly lower in the clinical group (p = 0.013). Adverse events occurred more often in the BIA group (p = 0.032). The cumulative number of hypovolemic events was significantly higher in the BIA group (p = 0.002).

DISCUSSION

Fluid management by BIA does not lead to a better cardiac outcome (appraised by surrogate markers) than fluid management by careful clinical assessment. Adapting the dry weight according to BIA results increases the risk of adverse events, especially hypovolemic episodes. Careful clinical fluid assessment is important for optimal care of chronic hemodialysis patients.

Volume overload in hemodialysis: diagnosis, cardiovascular consequences, and management

Volume overload in haemodialysis (HD) patients associates with hypertension and cardiac dysfunction and is a major risk factor for all-cause and cardiovascular mortality in this population. The diagnosis of volume excess and estimation of dry weight is based largely on clinical criteria and has a notoriously poor diagnostic accuracy. The search for accurate and objective methods to evaluate dry weight and to diagnose subclinical volume overload has been intensively pursued over the last 3 decades. Most methods have not been tested in appropriate clinical trials and their usefulness in clinical practice remains uncertain, except for bioimpedance spectroscopy and lung ultrasound (US). Bioimpedance spectroscopy is possibly the most widely used method to subjectively quantify fluid distributions over body compartments and produces reliable and reproducible results. Lung US provides reliable estimates of extravascular water in the lung, a critical parameter of the central circulation that in large part reflects the left ventricular end-diastolic pressure. To maximize cardiovascular tolerance, fluid removal in volume-expanded HD patients should be gradual and distributed over a sufficiently long time window. This review summarizes current knowledge about the diagnosis, prognosis and treatment of volume overload in HD patients.

Comparison of bioelectrical impedance analysis in healthy pregnant women and patient on hemodialysis

Pregnant woman undergoing dialysis face challenges such as miscarriage and stillbirth when carrying a baby to term. A complication of prenatal care is the difficulty in properly managing body fluids. We compare fluid volumes between healthy pregnant women and two pregnant women undergoing dialysis using bioelectrical impedance analysis (BIA). Data of 52 healthy pregnant women at various stages of their pregnancy were analyzed for the study. We included these many cases so as to collect sufficient data to compare them with our two cases of women undergoing dialysis who successfully completed their term deliveries. Fluid volumes were measured every week before and after dialysis using BIA. We also measured the levels of human atrial natriuretic peptide after dialysis. During dialysis, the dry weight (DW) of pregnant patients is altered based on the state of the amniotic fluid and fetus. However, evaluating body fluid and DW using radiography is difficult in pregnant women. BIA offers a mostly harmless alternative for such measurements. Using BIA, we were able to easily measure body fluid volume and change the setting of DW for dialysis. Thus, our successful example can serve as a reference for future cases of pregnant women undergoing dialysis. Nevertheless, given that the state of the fetus and amniotic fluid affect the results of dialysis, it is important that we use not only BIA but also a comprehensive evaluation to determine dialysis settings in pregnant women.

Water Deficit Affects the Growth and Leaf Metabolite Composition of Young Loquat Plants

Water scarcity in the Mediterranean area is very common and understanding responses to drought is important for loquat management and production. The objective of this study was to evaluate the effect of drought on the growth and metabolism of loquat. Ninety two-year-old plants of 'Marchetto' loquat grafted on quince were grown in the greenhouse in 12-liter pots and three irrigation regimes were imposed starting on 11 May and lasting until 27 July, 2013. One-third of the plants was irrigated with 100% of the water consumed (well watered, WW), a second group of plants was irrigated with 66% of the water supplied to the WW plants (mild drought, MD), and a third group was irrigated with 33% of the water supplied to the WW plants (severe drought, SD). Minimum water potential levels of -2.0 MPa were recorded in SD plants at the end of May. Photosynthetic rates were reduced according to water supply (WW>MD>SD), especially during the morning hours. By the end of the trial, severe drought reduced all growth parameters and particularly leaf growth. Drought induced early accumulation of sorbitol in leaves, whereas other carbohydrates were not affected. Of over 100 leaf metabolites investigated, 9 (squalene, pelargonic acid, glucose-1-phosphate, palatinol, capric acid, aconitic acid, xylitol, lauric acid, and alanine) were found to be useful to discriminate between the three irrigation groups, suggesting their involvement in loquat metabolism under drought conditions. Loquat behaved as a moderately drought-tolerant species (limited stem water potential and growth reductions) and the accumulation of sorbitol in favor of sucrose in mildly-stressed plants may be considered an early protective mechanism against leaf dehydration and a potential biochemical marker for precise irrigation management.

[Different methods to manage dry weight in hemodialysis patients]

Estimating the euvolemia and dry weight of hemodialysis patients still represents a challenge for the nephrologist, since both dehydration and hyperhydration are associated with intradialytic events and cardiovascular complications in the short and long term. Despite the need for a precise and objective definition of the dry weight for the individual patient on dialysis, this is usually determined on a clinical basis. To obtain greater sensitivity the dosage of natriuretic peptides, Bioelectrical Impedance Analysis (BIA) and, more recently, Lung Ultra-Sound (LUS) can all be used. The BIA allows to estimate the subject's body composition and, in particular, the distribution of body fluids. The presence of hyperhydration, as determined through the BIA, is predictive of an increased mortality in numerous observational studies. In recent years, pulmonary ultrasound has taken on an increasingly important role not only within the cardiology and intensive care units, but also in a nephrology setting, especially in dialysis. The purpose of this article is to analyze the advantages and limitations of the methods that can be used to assess the dry weight of patients undergoing hemodialysis treatment.

Percent ash-free dry weight as a robust method to estimate energy density across taxa

Determining how energy flows through ecosystems reveals underlying ecological patterns that drive processes such as growth and food web dynamics. Models that assess the transfer of energy from producers to consumers require information on the energy content or energy density (ED) of prey species. ED is most accurately measured through bomb calorimetry, but this method suffers from limitations of cost, time, and sample requirements that often make it unrealistic for many studies. Percent dry weight (DW) is typically used as a proxy for ED, but this measure includes an indigestible portion (e.g., bones, shell, salt) that can vary widely among organisms. Further, several distinct models exist for various taxonomic groups, yet none can accurately estimate invertebrate, vertebrate and plant ED with a single equation. Here, we present a novel method to estimate the ED of organisms using percent ash-free dry weight (AFDW). Using data obtained from 11 studies diverse in geographic, temporal and taxonomic scope, AFDW, DW as well as percent protein and percent lipid were compared as predictors of ED. Linear models were produced on a logarithmic scale, including dummy variables for broad taxonomic groups. AFDW was the superior predictor of ED compared to DW, percent protein content and percent lipid content. Model selection revealed that using correction factors (dummy variables) for aquatic animals (AA) and terrestrial invertebrates (TI) produced the best-supported model-log10(ED) = 1.07*log10(AFDW) - 0.80 (R 2 = 0.978, p < .00001)-with an intercept adjustment of 0.09 and 0.04 for AA and TI, respectively. All models including AFDW as a predictor had high predictive power (R 2 > 0.97), suggesting that AFDW can be used with high degrees of certainty to predict the ED of taxonomically diverse organisms. Our AFDW model will allow ED to be determined with minimal cost and time requirements and excludes ash-weight from estimates of digestible mass. Its ease of use will allow for ED to be more readily and accurately determined for diverse taxa across different ecosystems.

Influence of dry weight reduction on anemia in patients undergoing hemodialysis

Objective

Volume load in patients undergoing hemodialysis correlates with renal anemia, with reductions in volume load significantly improving hemoglobin levels. We performed a prospective controlled study to assess the effect of post-dialysis dry weight reduction, resulting from the gradual enhancement of ultrafiltration, on renal anemia in this patient population.

Methods

Sixty-four patients with renal anemia on maintenance hemodialysis were randomized to an ultrafiltration group, in which dry weight was gradually reduced by slightly increasing the ultrafiltration volume while maintaining routine hemodialysis, and a control group, in which patients underwent conventional dialysis while routine ultrafiltration was maintained. After 28 weeks, post-dialysis weight and levels of hematocrit, hemoglobin, C-reactive protein, serum albumin, serum ferritin, and transferrin saturation were compared.

Results

All parameters were similar at baseline between the two groups and remained unchanged at week 28 in the control group compared with baseline. In contrast, the ultrafiltration group showed a significant reduction in post-dialysis weight and C-reactive protein concentration and a significant increase in hematocrit, hemoglobin, albumin, serum ferritin, and transferrin saturation.

Conclusions

Dry weight reduction resulting from enhanced ultrafiltration may improve renal anemia in patients undergoing hemodialysis.

Pollinator size and its consequences: Robust estimates of body size in pollinating insects

Body size is an integral functional trait that underlies pollination-related ecological processes, yet it is often impractical to measure directly. Allometric scaling laws have been used to overcome this problem. However, most existing models rely upon small sample sizes, geographically restricted sampling and have limited applicability for non-bee taxa. Allometric models that consider biogeography, phylogenetic relatedness, and intraspecific variation are urgently required to ensure greater accuracy. We measured body size as dry weight and intertegular distance (ITD) of 391 bee species (4,035 specimens) and 103 hoverfly species (399 specimens) across four biogeographic regions: Australia, Europe, North America, and South America. We updated existing models within a Bayesian mixed-model framework to test the power of ITD to predict interspecific variation in pollinator dry weight in interaction with different co-variates: phylogeny or taxonomy, sexual dimorphism, and biogeographic region. In addition, we used ordinary least squares regression to assess intraspecific dry weight ~ ITD relationships for ten bees and five hoverfly species. Including co-variates led to more robust interspecific body size predictions for both bees and hoverflies relative to models with the ITD alone. In contrast, at the intraspecific level, our results demonstrate that the ITD is an inconsistent predictor of body size for bees and hoverflies. The use of allometric scaling laws to estimate body size is more suitable for interspecific comparative analyses than assessing intraspecific variation. Collectively, these models form the basis of the dynamic R package, "pollimetry," which provides a comprehensive resource for allometric pollination research worldwide.

Green synthesis and characterisation of silver nanoparticles and their effects on antimicrobial efficacy and biochemical profiling in Citrus reticulata

The synthesis of nanoparticles by utilising plant extract has revolutionised the field of nanotechnology. In the present study, AgNPs were synthesised by utilising the leaves of Moringa oleifera as reducing and stabilising agent. UV-visible spectroscopy showed characteristic surface plasmon band in the range of 413-420 nm. Scanning electron microscopy (SEM) elucidated rectangular segments fused together. X-ray diffraction (XRD) analysis confirmed the crystalline nature of AgNPs and presence of metallic silver ions was confirmed by energy dispersive X-ray (EDX). The different concentrations (10, 20, 30 and 40 ppm) of AgNPs were exogenously applied on Citrus reticulata to record the disease incidence at different day intervals. The disease intensity was progressively increased in all the applied treatments with the passage of time. The 30 ppm concentration of AgNPs was found to be most suitable concentration for creating the resistance against brown spot disease. Moreover, the effects of AgNPs were also assessed for biochemical profiling in C. reticulata. The enhanced production of endogenous enzymes and non-enzymatic components was observed in response to 30 ppm concentration of AgNPs. The present work highlighted that green synthesised AgNPs can be as used as biological control of citrus diseases and the enhanced production of secondary metabolites antioxidants.

Effects of Fe/SDS and Au nanoparticles on P. aeruginosa bacterial growth and biosurfactant production

The aim of this study was to evaluate the effects of iron (Fe)/SDS and gold (Au) nanoparticles on growth and biosurfactant production of Pseudomonas aeruginosa PBCC5. The concentrations of the nanoparticles used were 1, 500 and 1000 mg/l. In this research, the surface tension of biosurfactant, dry weight of biosurfactant and biomass, emulsification indexes (E24) were measured and transmission electron microscopy analysis was used to monitor the nanoparticles. The test results showed that the effect of nanoparticles on the bacterial growth and biosurfactant production varied corresponding to the type and concentration of nanoparticles. Fe/SDS nanoparticles showed no bacterial toxicity when the concentration of nanoparticles was 1 mg/ml and increased the growth and biosurfactant production, 23.21 and 20.73%, respectively. While at higher concentrations (500, 1000 mg/l), the nanoparticles suppressed bacterial growth as well as biosurfactant production. Similarly, Au nanoparticles had no bacterial toxicity and also increased bacterial growth and biosurfactant production. The surface tensions of all samples decreased from 72 of distiled water to 32-35 mN/m.

Arbuscular Mycorrhizal Symbiosis Modulates Antioxidant Response and Ion Distribution in Salt-Stressed Elaeagnus angustifolia Seedlings

Elaeagnus angustifolia L. is a drought-resistant species. Arbuscular mycorrhizal symbiosis is considered to be a bio-ameliorator of saline soils that can improve salinity tolerance in plants. The present study investigated the effects of inoculation with the arbuscular mycorrhizal fungus Rhizophagus irregularis on the biomass, antioxidant enzyme activities, and root, stem, and leaf ion accumulation of E. angustifolia seedlings grown during salt stress conditions. Salt-stressed mycorrhizal seedlings produced greater root, stem, and leaf biomass than the uninoculated stressed seedlings. In addition, the seedlings colonized by R. irregularis showed notably higher activities of superoxide dismutase (SOD), catalase (CAT), and ascorbate peroxidase (APX) in the leaves of the mycorrhizal seedlings in response to salinity compared to those of the non-mycorrhizal seedlings. Mycorrhizal seedlings not only significantly increased their ability to acquire K⁺, Ca²⁺, and Mg²⁺, but also maintained higher K⁺:Na⁺ ratios in the leaves and lower Ca²⁺:Mg²⁺ ratios than non-mycorrhizal seedlings during salt stress. These results suggest that the salt tolerance of E. angustifolia seedlings could be enhanced by R. irregularis. The arbuscular mycorrhizal symbiosis could be a promising method to restore and utilize salt-alkaline land in northern China.

The Effect of Seed-Borne Fungi and Epichloë Endophyte on Seed Germination and Biomass of Elymus sibiricus

The interactive effects of asexual Epichloë (formerly known as Neotyphodium) endophytes isolated from Hordeum brevisubulatum, Elymus tangutorum and Achnatherum inebrians, and seed-borne fungi on Elymus sibiricus seeds, were determined by an in vitro study using supernatants from liquid cultures of the endophyte strains. In an 8 week greenhouse study, the effects on the seedlings growth was measured. The in vitro study was carried out with the seed-borne fungi Alternaria alternata, Bipolaris sorokiniana, Fusarium avenaceum, and a Fusarium sp. isolated from E. sibiricus. Different concentrations and combinations of the liquid cultures of endophytic fungi enhanced the interim germination, germination rate, length of coleoptile and radicle, and seedling dry weight of E. sibiricus under stress from seed-borne fungi. In the greenhouse study, different concentrations of the supernatant of the endophytes from H. brevisubulatum and E. tangutorum but not A. inebrians, signficantly (P < 0.05) enhanced E. sibiricus seed germination. There was no significant (P > 0.05) increase of the tiller numbers after 2 weeks. However, later on, there were significant (P < 0.05) increases in tiller number (4-8 weeks), seedling height (2-8 weeks) and dry weight (2-8 weeks). The application of Epichloë endophyte culture supernatants was an effective strategy to improve seed germination and growth under greenhouse conditions.

The dual role of LESION SIMULATING DISEASE 1 as a condition-dependent scaffold protein and transcription regulator

Since its discovery over two decades ago as an important cell death regulator in Arabidopsis thaliana, the role of LESION SIMULATING DISEASE 1 (LSD1) has been studied intensively within both biotic and abiotic stress responses as well as with respect to plant fitness regulation. However, its molecular mode of action remains enigmatic. Here, we demonstrate that nucleo-cytoplasmic LSD1 interacts with a broad range of other proteins that are engaged in various molecular pathways such as ubiquitination, methylation, cell cycle control, gametogenesis, embryo development and cell wall formation. The interaction of LSD1 with these partners is dependent on redox status, as oxidative stress significantly changes the quantity and types of LSD1-formed complexes. Furthermore, we show that LSD1 regulates the number and size of leaf mesophyll cells and affects plant vegetative growth. Importantly, we also reveal that in addition to its function as a scaffold protein, LSD1 acts as a transcriptional regulator. Taken together, our results demonstrate that LSD1 plays a dual role within the cell by acting as a condition-dependent scaffold protein and as a transcription regulator.

Investigation of optimum N-terminal probrain natriuretic peptide level in patients on maintained hemodialysis

Background: Serum N-terminal probrain natriuretic peptide (NT-proBNP) level is known to be strongly associated with fluid overload, and serves as a guide for fluid management in patients on hemodialysis (HD). This study aimed at investigating the relationship between NT-proBNP level and blood pressure (BP), ultrafiltration/dry weight ratio as well as hemoglobin, and to explore the optimal cutoff point of NT-proBNP level in Chinese patients on HD.

Methods: A total of 306 patients on maintained HD for stage 5 chronic kidney disease (CKD) were included in this prospective study. Their average ultrafiltration/dry weight ratio and BP before dialysis were recorded. The serum NT-proBNP, hemoglobin, serum calcium, and phosphorus were detected. The cutoff value for NT-proBNP level was calculated using receiver operating characteristic (ROC) analysis.

Results: The high NT-proBNP level was associated with high BP and ultrafiltration/dry weight ratio, and low hemoglobin level. The optimal cutoff point of NT-proBNP level for patients on maintained HD was 5666 pg/mL, with a sensitivity of 78.5%, specificity of 43.9%, and area under the curve (AUC) of 0.703 (<0.001).

Conclusions: NT-proBNP level ≤5666 pg/mL was recommended to achieve the target BP, hemoglobin level, and ultrafiltration/dry weight ratio in patients on maintained HD with an ejection fraction (EF) >50%.

Adult and offspring size in the ocean: a database of size metrics and conversion factors

The purpose of this dataset was to compile adult and offspring size estimates for marine organisms. Adult and offspring size estimates of 408 species were compiled from the literature covering >17 orders of magnitude in body mass and including Cephalopoda (ink fish), Cnidaria ("jelly" fish), Crustaceans, Ctenophora (comb jellies), Elasmobranchii (cartilaginous fish), Mammalia (mammals), Sagittoidea (arrow worms) and Teleost (i.e., Actinopterygii, bony fish). Individual size estimates were converted to standardized size estimates (carbon weight, g) to allow for among-group comparisons. This required a number of size estimates to be converted and a compilation of conversion factors obtained from the literature are also presented.

Leaf Morphology, Photosynthetic Performance, Chlorophyll Fluorescence, Stomatal Development of Lettuce (Lactuca sativa L.) Exposed to Different Ratios of Red Light to Blue Light

Red and blue light are both vital factors for plant growth and development. We examined how different ratios of red light to blue light (R/B) provided by light-emitting diodes affected photosynthetic performance by investigating parameters related to photosynthesis, including leaf morphology, photosynthetic rate, chlorophyll fluorescence, stomatal development, light response curve, and nitrogen content. In this study, lettuce plants (Lactuca sativa L.) were exposed to 200 μmol⋅m(-2)⋅s(-1) irradiance for a 16 h⋅d(-1) photoperiod under the following six treatments: monochromatic red light (R), monochromatic blue light (B) and the mixture of R and B with different R/B ratios of 12, 8, 4, and 1. Leaf photosynthetic capacity (A max) and photosynthetic rate (P n) increased with decreasing R/B ratio until 1, associated with increased stomatal conductance, along with significant increase in stomatal density and slight decrease in stomatal size. P n and A max under B treatment had 7.6 and 11.8% reduction in comparison with those under R/B = 1 treatment, respectively. The effective quantum yield of PSII and the efficiency of excitation captured by open PSII center were also significantly lower under B treatment than those under the other treatments. However, shoot dry weight increased with increasing R/B ratio with the greatest value under R/B = 12 treatment. The increase of shoot dry weight was mainly caused by increasing leaf area and leaf number, but no significant difference was observed between R and R/B = 12 treatments. Based on the above results, we conclude that quantitative B could promote photosynthetic performance or growth by stimulating morphological and physiological responses, yet there was no positive correlation between P n and shoot dry weight accumulation.

Fertilization with urea, ammonium and nitrate produce different effects on growth, hydraulic traits and drought tolerance in Pinus taeda seedlings

Urea fertilization decreases Pinus taeda L. growth in clay soils of subtropical areas. The negative effect of urea is related to changes in some hydraulic traits, similar to those observed in plants growing under drought. The aims of this work were (i) to determine whether different sources of nitrogen applied as fertilizers produce similar changes in growth and hydraulic traits to those observed by urea fertilization and (ii) to analyze the impact of those changes in plant drought tolerance. Plants fertilized with urea, nitrate [Formula: see text] or ammonium [Formula: see text] were grown well watered or with reduced water supply. Urea and [Formula: see text] fertilization reduced plant growth and increased root hydraulic conductance scaled by root dry weight (DW). [Formula: see text] fertilization did not reduce plant growth and increased shoot hydraulic conductance and stem hydraulic conductivity. We conclude that [Formula: see text] is the ion involved in the changes linked to the negative effect of urea fertilization on P. taeda growth. [Formula: see text] fertilization does not change drought susceptibility and it produces changes in shoot hydraulic traits, therefore plants avoid the depressive effect of fertilization. Urea and [Formula: see text] fertilizers induce changes in DW and root hydraulic conductance and consequently plants are less affected by drought.

Clinical praxis for assessment of dry weight in Sweden and Denmark: A mixed-methods study

Overhydration is an independent predictor of mortality in hemodialysis (HD) patients. More than 30% of HD patients are overhydrated, motivating the development of new methods for assessing hydration status. This study surveyed clinical praxis and local guidelines for dry weight (DW) assessment in Swedish and Danish HD units, and examined if differences in routines and utilization of bioimpedance spectroscopy (BIS) and other assistive technology affected frequency of DW adjustments and blood pressure (BP) levels. Cross-sectional information on praxis, guidelines and routines, plus treatment-related data from 99 stratified patients were collected. Qualitative data were analyzed with content analysis and interpreted in convergence with statistical analysis of quantitative data in a mixed-methods design. Local guidelines concerning DW existed in 54% of the units. A BIS device was present in 52%, but only half of those units used it regularly, and no correlations to frequency of DW adjustments or BP were found. HD nurses were authorized to adjust DW in 60% of the units; in these units, the frequency of DW adjustments was 1.6 times higher and systolic BP pre-HD 8 mmHg lower. There is a wide variation in routines for DW determination, and there are indications that authorization of HD nurses to adjust DW may improve DW assessment. BIS is sparsely used; its implementation may have been delayed by uncertainty over how to manage the device and interpret measurements. Hence, better methods and guidelines for assessing DW and using BIS need to be developed.

Influence of biochar, mycorrhizal inoculation, and fertilizer rate on growth and flowering of Pelargonium (Pelargonium zonale L.) plants

Peat is the most common substrate used in nurseries despite being a very expensive and a non-renewable material. Peat replacement with biochar could be a sound environmental practice, as it is produced from waste biomass, but evaluation of biochar as a potting substrate is needed. Ratios of peat:biochar of 100:0, 70:30, 30:70 (BC0, BC30, and BC70, respectively), two fertilizer rates (FERT1, FERT2), and arbuscular mycorrhizal fungi (AMF) inoculation were tested on potted Pelargonium plants. Plant growth, flowering, bio-physiological and nutritional responses, and root mycorrhization were evaluated. The BC30 mixture did not affect plant growth compared with pure peat. However, BC30 in combination with FERT2 treatment was more effective in enhancing nitrogen (N) and chlorophyll (CHL) leaf concentrations, and leaf and flower numbers. The BC70 mixture depressed plant growth, flowering traits, and root mycorrhization. Leaf N concentration was below the sufficiency range reported for Pelargonium growth. Leaf concentration of phosphorous (P) was adequate in pure peat and in BC30 but it dropped close to sub-optimal values in BC70. The pH value of the mixtures lowered P availability, though in BC30 the mycorrhizal activity could have allowed adequate P plant uptake. In BC70 plants, the deficiency of both N and P might be a reason for the observed growth reduction. The inoculation of the substrate with selected AMF improved plant growth (higher dry biomass, greater floral clusters, larger and more abundant leaves) and quality resulting in unstressed (lower electrolyte leakage and higher relative water content values) and greener leaves (low L(∗) and C(∗), high CHL content) and in more intensely colored flowers. We conclude that biochar can be applied in nursery/potted plant production provided that the proportion in the peat mixture does not exceed 30%. Furthermore, AMF inoculation contributed to achieving the best plant performance in 30% biochar amended medium.

Acute effects of haemodialysis on central venous and arterial pressure characteristics

AIM

Haemodynamic stability of patients during haemodialysis (HD) sessions is of pivotal importance and accurate determination of dry weight remains a challenge. Little information is available about central venous and aortic pressure during dialysis. In this pilot study we used a non-invasive technique to describe the changes in central venous pressure (CVP) during dialysis.

METHODS

An ultrasound-assisted pressure-manometer was used at the cephalic vein during haemodialysis to quantify CVP. Central aortic pressure changes were assessed as aortic augmentation index and subendocardial viability ratio. Bioimpedance was applied to measure total body water, as well as extracellular and intracellular water before and after HD. Measurements were performed prior during and after 1 and 2 h on HD.

RESULTS

Ten patients were included with a median age of 72 years (23-82). Haemodialysis reduced the weight by 2.0 kg, corresponding to a measured decrease in total body water of 1.9 L. The mean CVP showed a significant decrease (9.0-0.8 cmH₂O; P = 0.0005) during dialysis. The significant drop in CVP was found during the first hour (9-2.8 cmH₂O). Starting and stopping dialysis was reflected by a reduction of 2.6 cmH₂O and a rise of 2.8 cmH₂O (n.s.). Aortic augmentation index decreased from 26.1% to 21.0% (n.s.). Subendocardial viability ratio increased from 126% to 156% (P < 0.05) during HD, and decreased to 139% direct after HD (n.s.).

CONCLUSION

This is the first study that illustrates a prominent reduction of CVP during the first hour of haemodialysis. Non-invasive CVP measurement is feasible during haemodialysis and adds another piece in the puzzle of factors involved in haemodynamic stability.

Simulated digestion of dried leaves of Artemisia annua consumed as a treatment (pACT) for malaria

ETHNOPHARMACOLOGICAL RELEVANCE

Artemisinin (AN) is produced by Artemisia annua, a medicinal herb long used as a tea infusion in traditional Chinese medicine to treat fever; it is also the key ingredient in current artemisinin-based combination therapies (ACTs) effective in treating malaria. Recently we showed that dried leaves from the whole plant Artemisia annua that produces artemisinin and contains artemisinin-synergistic flavonoids seem to be more effective and less costly than ACT oral malaria therapy; however little is known about how digestion affects release of artemisinin and flavonoids from dried leaves.

MATERIAL AND METHODS

In the current study we used a simulated digestion system to determine how artemisinin and flavonoids are released prior to absorption into the bloodstream. Various delivery methods and staple foods were combined with dried leaves for digestion in order to investigate their impact on the bioavailability of artemisinin and flavonoids. Digestate was recovered at the end of the oral, gastric, and intestinal stages, separated into solid and liquid fractions, and extracted for measurement of artemisinin and total flavonoids.

RESULTS

Compared to unencapsulated digested dried leaves, addition of sucrose, various cooking oils, and rice did not reduce the amount of artemisinin released in the intestinal liquid fraction, but the amount of released flavonoids nearly doubled. When dried leaves were encapsulated into either hydroxymethylcellulose or gelatin capsules, there was >50% decrease in released artemisinin but no change in released flavonoids. In the presence of millet or corn meal, the amount of released artemisinin declined, but there was no change in released flavonoids. Use of a mutant Artemisia annua lacking artemisinin showed that the plant matrix is critical in determining how artemisinin is affected during the digestion process.

CONCLUSIONS

This study provides evidence showing how both artemisinin and flavonoids are affected by digestion and dietary components for an orally consumed plant delivered therapeutic and that artemisinin delivered via dried leaves would likely be more bioavailable if provided as a tablet instead of a capsule.

Melia azedarach plants show tolerance properties to water shortage treatment: an ecophysiological study

Candidate species for reforestation of areas prone to drought must combine water stress (WS) tolerance and economic or medicinal interest. Melia azedarach produces high quality timber and has insecticidal and medicinal properties. However, the impact of WS on M. azedarach has not yet been studied. Two-month old M. azedarach plants were exposed to WS during 20 days. After this period, plant's growth, water potential, photosynthetic performance and antioxidant capacity were evaluated. WS did not affect plants' growth, but induced stomatal closure, reduced net CO₂ assimilation rate (A) and the intercellular CO₂ availability in mesophyll (C(i)). WS also reduced the photosynthetic efficiency of PSII but not the pigment levels. WS up-regulated the antioxidant enzymes and stimulated the production of antioxidant metabolites, preventing lipid peroxidation. Therefore, despite some repression of photosynthetic parameters by WS, they did not compromise plant growth, and plants increased their antioxidant capacity. Our data demonstrate that M. azedarach juvenile plants have the potential to acclimate to water shortage conditions, opening new perspectives to the use of this species in reforestation/afforestation programs of drought prone areas.

Effects of fluctuating temperature and silicate supply on the growth, biochemical composition and lipid accumulation of Nitzschia sp

Nitzschia sp. (Bacillariophyceae) was grown under temperature and photoperiods mimicking those, typical during summer, spring/fall and winter conditions in the southern United States, and using five silicate (Si) concentrations. In general, higher Si concentrations resulted in higher growth rates in summer and spring/fall conditions and lower organic content. Si-deficient Nitzschia sp. had higher levels of neutral lipid compared to those growing in Si replete media. Under summer conditions, the proportion of saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) was relatively stable compared with spring/fall and winter conditions, and the proportion of polyunsaturated fatty acids (PUFA) was low. In the winter condition, SFA and MUFA showed a gradient of decreasing abundance while PUFA gradients increased with increasing Si concentrations in the medium. Cumulative productivity (optimization of growth and lipid content) would be best in the spring/fall but less so in the other conditions for this strain of Nitzschia sp.

High temperatures limit plant growth but hasten flowering in root chicory (Cichorium intybus) independently of vernalisation

An increase in mean and extreme summer temperatures is expected as a consequence of climate changes and this might have an impact on plant development in numerous species. Root chicory (Cichorium intybus L.) is a major crop in northern Europe, and it is cultivated as a source of inulin. This polysaccharide is stored in the tap root during the first growing season when the plant grows as a leafy rosette, whereas bolting and flowering occur in the second year after winter vernalisation. The impact of heat stress on plant phenology, water status, photosynthesis-related parameters, and inulin content was studied in the field and under controlled phytotron conditions. In the field, plants of the Crescendo cultivar were cultivated under a closed plastic-panelled greenhouse to investigate heat-stress conditions, while the control plants were shielded with a similar, but open, structure. In the phytotrons, the Crescendo and Fredonia cultivars were exposed to high temperatures (35°C day/28°C night) and compared to control conditions (17°C) over 10 weeks. In the field, heat reduced the root weight, the inulin content of the root and its degree of polymerisation in non-bolting plants. Flowering was observed in 12% of the heat stressed plants during the first growing season in the field. In the phytotron, the heat stress increased the total number of leaves per plant, but reduced the mean leaf area. Photosynthesis efficiency was increased in these plants, whereas osmotic potential was decreased. High temperature was also found to induced flowering of up to 50% of these plants, especially for the Fredonia cultivar. In conclusion, high temperatures induced a reduction in the growth of root chicory, although photosynthesis is not affected. Flowering was also induced, which indicates that high temperatures can partly substitute for the vernalisation requirement for the flowering of root chicory.

Putrescine, a fast-acting switch for tolerance against osmotic stress

During the last decade we showed clearly that abiotic stress changes the cellular composition of polyamines, which in turn regulate the photochemical and non-photochemical quenching of the received light energy in the photosynthetic apparatus and that modulate substantially the level of plant tolerance. In the present contribution, we tried to change the bioenergetics of the leaf discs before the exposure to osmotic stress only by exogenously supplied putrescine, in order to enhance quickly the tolerance against the abiotic stress. Tobacco leaf discs treated with polyethylene-glycol reduced their water content about 24% within 1h. This relatively mild osmotic stress increased endogenous putrescine about 83% and decreased maximum photosystem II photochemical efficiency about 14%. In line with this, here we show that treatment with 1mM exogenous putrescine 1h before polyethylene-glycol addition protects the photochemical capacity and inhibits loss of water, confirming the key role of putrescine in the modulation of plant tolerance against osmotic stress. Furthermore, our recent works indicate that putrescine is accumulated in lumen during light reactions and may act as a permeable buffer and an osmolyte.

Both immanently high active iron contents and increased root ferrous uptake in response to low iron stress contribute to the iron deficiency tolerance in Malus xiaojinensis

To better understand the mechanism of low-iron stress tolerance in Malus xiaojinensis, the differences in physiological parameters and gene expression between an iron deficiency-sensitive species, Malus baccata, and an iron deficiency-tolerant species, M. xiaojinensis were investigated under low-iron (4 μM Fe) conditions. Under iron sufficient conditions, the expressions of iron uptake- and transport-related genes, i.e. FIT1, IRT1, CS1, FRD3 and NRMAP1, and the immanent leaf and root active iron contents were higher in M. xiaojinensis than those in M. baccata. However, on the first three days of low iron stress, the rhizospheric pH decreased and the root ferric chelate reductase (FCR) activity and the expression of ferrous uptake- and iron transport-related genes in the roots increased significantly only in M. xiaojinensis. Leaf chlorosis occurred on the 3rd and the 9th day after low-iron treatment in M. baccata and M. xiaojinensis, respectively. The expression of iron relocalization-related genes, such as NAS1, FRD3 and NRMAP3, increased after the 5th or 6th day of low iron stress in leaves of M. xiaojinensis, whereas the expression of NAS1, FRD3 and NRMAP3 in the leaves of M. baccata increased immediately after the onset of low iron treatment. Conclusively, the relative high active iron contents caused by the immanently active root ferrous uptake and the increased root ferrous uptake in response to low iron stress were the dominant mechanisms for the tolerance to iron deficiency in M. xiaojinensis.

Differential induction of antioxidant stilbenoids in hairy roots of Vitis rotundifolia treated with methyl jasmonate and hydrogen peroxide

Stilbenoids are polyphenolic phytoalexins that exhibit potential health applications in humans. Hairy root cultures of muscadine grape (Vitis rotundifolia Michx.) were used to study the biochemical and molecular regulation of stilbenoid biosynthesis upon treatment with 100 μM methyl jasmonate (MeJA) or 10 mM hydrogen peroxide (H2O2) over a 96-h period. Resveratrol, piceid, and ε-viniferin were identified in higher concentrations in the tissue whereas resveratrol was the most abundant stilbenoid in the medium under either treatment. An earlier increase in resveratrol accumulation was observed for the MeJA-treated group showing a maximum at 12 h in the tissue and 18 h in the medium. Furthermore, the antioxidant capacity of extracts from the tissue and medium was determined by the 2,2'-azinobis[3-ethylbenzthiazoline sulfonic acid] (ABTS) and the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays showing correlation with the stilbenoid content. Fourteen candidate reference genes for qPCR were tested under the described experimental conditions and resulted in the selection of 5 reference genes. Quantitative analyses of transcripts for phenylalanine ammonia-lyase (PAL), resveratrol synthase (RS), and two stilbene synthases (STS and STS2) showed the highest RNA level induction at 3 h for both treatments with a higher induction for the MeJA treatment. In contrast, the flavonoid-related chalcone synthase (CHS) transcripts showed induction and a decrease in expression for MeJA and H2O2 treatments, respectively. The observed responses could be related to an oxidative burst triggered by the exposure to abiotic stressor compounds with signaling function such as MeJA and H2O2 which have been previously related to the synthesis of secondary metabolites.

Alleviation of salt stress in citrus seedlings inoculated with arbuscular mycorrhizal fungi depends on the rootstock salt tolerance

Seedlings of Cleopatra mandarin (Citrus reshni Hort. ex Tan.) and Alemow (Citrus macrophylla Wester) were inoculated with a mixture of AM fungi (Rhizophagus irregularis and Funneliformis mosseae) (+AM), or left non-inoculated (-AM). From forty-five days after fungal inoculation onwards, half of +AM or -AM plants were irrigated with nutrient solution containing 50 mM NaCl. Three months later, AM significantly increased plant growth in both Cleopatra mandarin and Alemow rootstocks. Plant growth was higher in salinized +AM plants than in non-salinized -AM plants, demonstrating that AM compensates the growth limitations imposed by salinity. Whereas AM-inoculated Cleopatra mandarin seedlings had a very good response under saline treatment, inoculation in Alemow did not alleviate the negative effect of salinity. The beneficial effect of mycorrhization is unrelated with protection against the uptake of Na or Cl and the effect of AM on these ions did not explain the different response of rootstocks. This response was related with the nutritional status since our findings confirm that AM fungi can alter host responses to salinity stress, improving more the P, K, Fe and Cu plant nutrition in Cleopatra mandarin than in Alemow plants. AM inoculation under saline treatments also increased root Mg concentration but it was higher in Cleopatra mandarin than in Alemow. This could explain why AM fungus did not completely recovered chlorophyll concentrations in Alemow and consequently it had lower photosynthesis rate than control plants. AM fungi play an essential role in citrus rootstock growth and biomass production although the intensity of this response depends on the rootstock salinity tolerance.

Application of Fourier transform infrared (FT-IR) spectroscopy in determination of microalgal compositions

Fourier transform infrared spectroscopy (FT-IR) was applied in algal strain screening and monitoring cell composition dynamics in a marine microalga Isochrysis zhangjiangensis during algal cultivation. The content of lipid, carbohydrate and protein of samples determined by traditional methods had validated the accuracy of FT-IR method. For algal screening, the band absorption ratios of lipid/amide I and carbo/amide I from FT-IR measurements allowed for the selection of Isochrysis sp. and Tetraselmis subcordiformis as the most potential lipid and carbohydrate producers, respectively. The cell composition dynamics of I. zhangjiangensis measured by FT-IR revealed the diversion of carbon allocation from protein to carbohydrate and neutral lipid when nitrogen-replete cells were subjected to nitrogen limitation. The carbo/amide I band absorption ratio had also been demonstrated to depict physiological status under nutrient stress in T. subcordiformis. FT-IR serves as a tool for the simultaneous measurement of lipid, carbohydrate, and protein content in cell.

QsMYB1 expression is modulated in response to heat and drought stresses and during plant recovery in Quercus suber

Cork oak is an economically important forest species showing a great tolerance to high temperatures and shortage of water. However, the mechanisms underlying this plasticity are still poorly understood. Among the stress regulators, transcription factors (TFs) are especially important since they can control a wide range of stress-inducible genes, which make them powerful targets for genetic engineering of stress tolerance. Here we evaluated the influence of increasing temperatures (up to 55 °C) or drought (18% field capacity, FC) on the expression profile of an R2R3-MYB transcription factor of cork oak, the QsMYB1. QsMYB1 was previously identified as being preferentially expressed in cork tissues and as having an associated alternative splicing mechanism, which results in two different transcripts (QsMYB1.1 and QsMYB1.2). Expression analysis by reverse transcription quantitative PCR (RT-qPCR) revealed that increasing temperatures led to a gradual down-regulation of QsMYB1 transcripts with more effect on QsMYB1.1 abundance. On the other hand, under drought condition, expression of QsMYB1 variants, mainly the QsMYB1.2, was transiently up-regulated shortly after the stress imposition. Recovery from each stress has also resulted in a differential response by both QsMYB1 transcripts. Several physiological and biochemical parameters (plant water status, chlorophyll fluorescence, lipid peroxidation and proline content) were determined in order to monitor the plant performance under stress and recovery. In conclusion, this report provides the first evidence that QsMYB1 TF may have a putative function in the regulatory network of cork oak response to heat and drought stresses and during plant recovery.

Manganese-mitigation of cadmium toxicity to seedling growth of Phytolacca acinosa Roxb. is controlled by the manganese/cadmium molar ratio under hydroponic conditions

Manganese (Mn) can interact with cadmium (Cd) in environments and influence the toxic effect of Cd on plants. However, few studies have investigated the relationship between the Mn/Cd ratio and plant Cd-toxicity along Cd concentrations. In this paper, we studied the effects of external Mn/Cd molar ratios (0, 10, 30, 50 and 60) on Cd toxicity in the Mn hyperaccumulator and Cd tolerant plant, Phytolacca acinosa Roxb., at three Cd levels (50, 100 and 200 μM) under hydroponic conditions. Our result showed that seedling growth (y) under Cd stress was strongly positively related to the solution Mn/Cd molar ratio (SMCR). The relationship between the two variables under solution Cd concentrations was well explained by the linear regression model y=a+b1 (SMCR)+b2 (Solution-Cd). Increasing SMCR significantly reduced the Cd concentration and increased the Mn concentration in plant tissues. However, seedling growth was consistent with the shoot Mn/Cd molar ratio rather than with the Mn or Cd concentrations in plant tissues. At low levels of SMCR (e.g. 0 and 10), elevation of Mn distribution in shoot tissues might be a mechanism in P. acinosa seedlings to defend against Cd-toxicity. In comparison with low levels of SMCR, high levels of SMCR (e.g. 50 and 60) greatly alleviated lipid peroxidation and plant water-loss, and enhanced photosynthesis. However, the alleviated lipid peroxidation in the Mn-mitigation of Cd toxicity was likely to be the secondary effect resulting from the antagonism between Mn and Cd in the plant.

Accumulation of brachycerine, an antioxidant glucosidic indole alkaloid, is induced by abscisic acid, heavy metal, and osmotic stress in leaves of Psychotria brachyceras

Psychotria brachyceras Muell. Arg. produces the antioxidant monoterpene indole alkaloid (MIA) brachycerine, which, besides retaining a glucose residue, has its terpenoid moiety derived not from secologanin, but probably from epiloganin, representing a new subclass of MIAs. In this work we showed that osmotic stress agents, such as sodium chloride, sorbitol and polyethylene glycol (PEG), induced brachycerine accumulation in leaf disks of P. brachyceras. Other oxidative stress inducers, such as exposure to aluminum and silver, also increased brachycerine content. Abscisic acid (ABA) treatment was shown to increase brachycerine yield, suggesting its involvement in brachycerine induction during osmotic stress. Ascorbate peroxidase activity was induced in PEG-treated leaf disks, whereas superoxide dismutase (SOD) activity remained unaltered. Assays with specific inhibitors of the cytosolic mevalonate (MVA) and plastidic 2-C-methyl-D-erythritol 4-phosphate (MEP) pathways showed that the terpenoid moiety of brachycerine derived predominantly from the MEP pathway. These results suggest a potential involvement of brachycerine in plant defense against osmotic/oxidative stress damage, possibly contributing to detoxification of hydroxyl radical and superoxide anion as a SOD-like molecule.