Effects of UV radiation on aquatic ecosystems and interactions with climate change

The health of freshwater and marine ecosystems is critical to life on Earth. The impact of solar UV-B radiation is one potential stress factor that can have a negative impact on the health of certain species within these ecosystems. Although there is a paucity of data and information regarding the effect of UV-B radiation on total ecosystem structure and function, several recent studies have addressed the effects on various species within each trophic level. Climate change, acid deposition, and changes in other anthropogenic stressors such as pollutants alter UV exposure levels in inland and coastal marine waters. These factors potentially have important consequences for a variety of aquatic organisms including waterborne human pathogens. Recent results have demonstrated the negative impacts of exposure to UV-B radiation on primary producers, including effects on cyanobacteria, phytoplankton, macroalgae and aquatic plants. UV-B radiation is an environmental stressor for many aquatic consumers, including zooplankton, crustaceans, amphibians, fish, and corals. Many aquatic producers and consumers rely on avoidance strategies, repair mechanisms and the synthesis of UV-absorbing substances for protection. However, there has been relatively little information generated regarding the impact of solar UV-B radiation on species composition within natural ecosystems or on the interaction of organisms between trophic levels within those ecosystems. There remains the question as to whether a decrease in population size of the more sensitive primary producers would be compensated for by an increase in the population size of more tolerant species, and therefore whether there would be a net negative impact on the absorption of atmospheric carbon dioxide by these ecosystems. Another question is whether there would be a significant impact on the quantity and quality of nutrients cycling through the food web, including the generation of food proteins for humans. Interactive effects of UV radiation with changes in other stressors, including climate change and pollutants, are likely to be particularly important.Fil: Häder, D. P.. No especifíca;Fil: Helbling, Eduardo Walter. Fundación Playa Unión. Estación de Fotobiología Playa Unión; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Williamson, C. E.. Miami University; Estados UnidosFil: Worrest, R. C.. No especifíca

Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results

Background: Following Lichtenstein hernia repair, up to 25% of patients experience prolonged postoperative and chronic pain as well as discomfort in the groin. One of the underlying causes of these complaints are the compression or irritation of nerves by the sutures used to fixate the mesh. We compared the level and rate of chronic pain in patients operated with the classical Lichtenstein technique fixated by sutures to patients with sutureless mesh fixation technique. Methods: A two-armed randomized trial with 264 male patients was performed. After consent, patients were randomized preoperatively. For the fixation of the mesh we used either sutures with slow-absorbing material (PDS 2.0) (group I, n=133) or tissue glue (Histoacryl) (group II, n=131). Follow-up examinations were performed after 3, 12months and after 5years. Results: Patient characteristics in the two groups were similar. No cross-over between groups was observed. After 5years, long-term follow-up could be completed for 59% of subjects. After 5years, 10/85 (11.7%) patients in group I and 3/70 (4.2%) in group II suffered from chronic pain in the groin region (P=0.108). The operation time was significantly shorter in group II (79min vs 73min, P=0.01). One early recurrence occurred in group II (3months). The recurrence rate was 0 and 0% after 12months and 5.9% (5/85) and 10% (7/70) after 5years in group I and group II, respectively (P=0.379). Conclusion: After 5years, the two techniques of mesh fixation resulted in similar rates of chronic pain. Whereas recurrence rates were comparable, fixation of the mesh with tissue glue decreased operating room time significantly. Hence, suture less mesh fixation with Histoacryl is a sensible alternative to suture fixation and should be especially considered for patients prone to pai

One-Pot Synthesis of 2-Methylfurans from 3- (Trimethylsilyl)propargyl Acetates Promoted by Trimethylsilyl Trifluoromethanesulfonate

In the presence of trimethylsilyl trifluoromethanesulfonate (TMSOTf) and triethylamine, 3-(trimethylsilyl)propargyl carboxylates undergo a one-pot alkylation-cyclization- desilylation reaction with ketones to produce 2-methylfurans. Alkylation at 0 °C in methylene chloride, followed by acid-catalyzed cyclization at room temperature, provides the furans in 52-86% yield. Cyclization and desilylation appear to be promoted by triflic acid generated in situ from the exposure of the reaction mixture to water upon completion of the initial substitution reaction

Outcome of treatment of pulmonary tuberculosis in Switzerland in 1996.

Adequate treatment of pulmonary tuberculosis cures patients and reduces transmission. The study assesses treatment outcomes under current conditions in Switzerland. Retrospective cohort study including all TB cases with positive sputum cultures notified to the national surveillance system between July 1996 and June 1997. Ten months after notification, treating physicians reported the outcomes using WHO categories. Of 265 patients, 209 (79%) completed at least 6 months' treatment, 3 (1%) were treatment failures, 23 (9%) died, 8 (3%) defaulted from treatment and 22 (8%) left the country. The proportion of successful treatments did not significantly differ between the 103 Swiss-born (80%) and the 162 foreign-born (78%) patients. There were 19 deaths (18%) in the Swiss-born and 4 (2%) in the foreign-born groups; death was caused by TB in two patients, 10 died of other causes (cause unknown in 11). In the foreign-born group there were 31 (19%) potentially unsatisfactory outcomes (treatment failure, default from treatment, transfer abroad) and in the Swiss-born group 2 (2%). Default from treatment involved 8 patients, 6 of whom were asylum seekers. In a multivariate analysis potentially unsatisfactory outcomes were not significantly associated with foreign origin but with status as a foreigner of irregular or unknown legal status (adj. OR 8.8; 95% CI 1.4 to 53.7). Overall treatment success rates are satisfactory and similar to those of other western European countries. Potentially unsatisfactory outcomes are more common in foreign-born persons of irregular legal status. Tracking of non-adherent patients by health workers could further improve outcomes

Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study.

High pre-pregnancy weight and body mass index (BMI) increase the risk of gestational diabetes mellitus (GDM) and diabetes after pregnancy. To tackle weight and metabolic health problems, there is a need to investigate novel lifestyle approaches. Outside of pregnancy, higher adherence to intuitive eating (IE) is associated with lower BMI and improved glycemic control. This study investigated the association between IE and metabolic health during pregnancy and in the early postpartum period among women with GDM. Two-hundred and fourteen consecutive women aged ≥18, diagnosed with GDM between 2015 and 2017 and completed the "Eating for Physical rather than Emotional Reasons (EPR)" and "Reliance on Hunger and Satiety cues (RHSC) subscales" of the French Intuitive Eating Scale-2 (IES-2) questionnaire at the first GDM clinic visit were included in this study. Participants' mean age was 33.32 ± 5.20 years. Their weight and BMI before pregnancy were 68.18 ± 14.83 kg and 25.30 ± 5.19 kg/m <sup>2</sup> respectively. After adjusting for confounding variables, the cross-sectional analyses showed that the two subscales of IES-2 at the first GDM visit were associated with lower weight and BMI before pregnancy, and lower weight at the first GDM visit (β = -0.181 to -0.215, all p ≤ 0.008). In addition, the EPR subscale was associated with HbA1c and fasting plasma glucose at the first GDM visit (β = -0.170 and to -0.196; all p ≤ 0.016). In the longitudinal analyses, both subscales of IES-2 at first GDM visit were associated with lower weight at the end of pregnancy, BMI and fasting plasma glucose at 6-8 weeks postpartum (β = -0.143 to -0.218, all p ≤ 0.040) after adjusting for confounders. Increase adherence to IE could represent a novel approach to weight and glucose control during and after pregnancy in women with GDM

Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality-A Retrospective, Monocentric Cohort Study

Among people infected with SARS-CoV-2, the determination of clinical features associated with poor outcome is essential to identify those at high risk of deterioration. Here, we aimed to investigate clinical phenotypes of patients hospitalized due to COVID-19 and to examine the predictive value of the neutrophil-to-lymphocyte ratio (NLR) in a representative patient collective of the Swiss population. We conducted a retrospective monocentriccohort study with patients hospitalized due to COVID-19 between 27 February and 31 December 2020. Data were analyzed descriptively, using the binary logistic regression model, proportional odds logistic regression model, competing risk analysis, and summary measure analysis. A total of 454 patients were included in our study. Dyspnea, elevated respiratory rate, low oxygen saturation at baseline, age, and presence of multiple comorbidities were associated with a more severe course of the disease. A high NLR at baseline was significantly associated with disease severity, unfavorable outcome, and mortality. In non-survivors, NLR further increased during hospital stay, whereas in survivors, NLR decreased. In conclusion, our data emphasize the importance of accurate history taking and clinical examination upon admission and confirm the role of baseline NLR as a surrogate marker for increased disease severity, unfavorable outcome, and mortality in patients hospitalized due to infection with SARS-CoV-2

The AIFELL Score as a Predictor of Coronavirus Disease 2019 (COVID-19) Severity and Progression in Hospitalized Patients

Since the beginning of the COVID-19 pandemic, SARS-CoV-2 has caused a global burden for health care systems due to high morbidity and mortality rates, leading to caseloads that episodically surpass hospital resources. Due to different disease manifestations, the triage of patients at high risk for a poor outcome continues to be a major challenge for clinicians. The AIFELL score was developed as a simple decision instrument for emergency rooms to distinguish COVID-19 patients in severe disease stages from less severe COVID-19 and non-COVID-19 cases. In the present study, we aimed to evaluate the AIFELL score as a prediction tool for clinical deterioration and disease severity in hospitalized COVID-19 patients. During the second wave of the COVID-19 pandemic in Switzerland, we analyzed consecutively hospitalized patients at the Triemli Hospital Zurich from the end of November 2020 until mid-February 2021. Statistical analyses were performed for group comparisons and to evaluate significance. AIFELL scores of patients developing severe COVID-19 stages IIb and III during hospitalization were significantly higher upon admission compared to those patients not surpassing stages I and IIa. Group comparisons indicated significantly different AIFELL scores between each stage. In conclusion, the AIFELL score at admission was useful to predict the disease severity and progression in hospitalized COVID-19 patients

Synergistic effects of UVR and simulated stratification on commensalistic phytoplankton–bacteria relationship in two optically contrasting oligotrophic Mediterranean lakes

An indirect effect of global warming is a reduction in the depth of the upper mixed layer (UML) causing organisms to be exposed to higher levels of ultraviolet (UVR, 280–400 nm) and photosynthetically active radiation (PAR, 400–700 nm). This can affect primary and bacterial production as well as the commensalistic phytoplankton–bacteria relationship. The combined effects of UVR and reduction in the depth of the UML were assessed on variables related to the metabolism of phytoplankton and bacteria, during in situ experiments performed with natural pico- and nanoplankton communities from two oligotrophic lakes with contrasting UVR transparency (high-UVR versus low-UVR waters) of southern Spain. The negative UVR effects on epilimnetic primary production (PP) and on heterotrophic bacterial production (HBP), intensified under increased stratification, were higher in the low-UVR than in the high-UVR lake, and stronger on the phytoplanktonic than on the heterotrophic bacterial communities. Under UVR and increased stratification, the commensalistic phytoplankton–bacteria relationship was strengthened in the high-UVR lake where excretion of organic carbon (EOC) rates exceeded the bacterial carbon demand (BCD; i.e., BCD : EOC(%) ratio 100). The greater UVR damage to phytoplankton and bacteria and the weakening of their commensalistic interaction found in the low-UVR lake indicates that these ecosystems would be especially vulnerable to UVR and increased stratification as stressors related to global climate change. Thus, our findings may have important implications for the carbon cycle in oligotrophic lakes of the Mediterranean region.This study was supported by the Ministerio Español de Medio Ambiente, Rural y Marino (PN2009/067), Ciencia e Innovación (CGL2011-23681), Junta de Andalucía (Excelencia CVI-02598 and P09-RNM-5376), Consejo Nacional de Investigaciones Científicas y Técnicas – CONICET (PIP no. 112-201001-00228), and Fundación Playa Unión. G. Herrera and C. Durán were supported by a Formación de Profesorado Universitario grant from the Spanish government. The authors are indebted to the staff of Sierra Nevada National Park and Lagunas de Ruidera Natural Park for permission to work, to E. Jiménez-Coll for the bacterial production analysis, and to D. Nesbitt for writing assistance in English

Direct and indirect effects of vertical mixing, nutrients and ultraviolet radiation on the bacterioplankton metabolism in high-mountain lakes from southern Europe

As a consequence of global change, modifications in the interaction among abiotic stressors on aquatic ecosystems have been predicted. Among other factors, UVR transparency, nutrient inputs and shallower epilimnetic layers could alter the trophic links in the microbial food web. Currently, there are some evidences of higher sensitiveness of aquatic microbial organisms to UVR in opaque lakes. Our aim was to assess the interactive direct and indirect effects of UVR (through the excretion of organic carbon – EOC – by algae), mixing regime and nutrient input on bacterial metabolism. We performed in situ short-term experiments under the following treatments: full sunlight (UVR + PAR, >280 nm) vs. UVR exclusion (PAR only, >400 nm); ambient vs. nutrient addition (phosphorus (P; 30 μg PL−1) and nitrogen (N; up to final N : P molar ratio of 31)); and static vs. mixed regime. The experiments were conducted in three high-mountain lakes of Spain: Enol [LE], Las Yeguas [LY] and La Caldera [LC] which had contrasting UVR transparency characteristics (opaque (LE) vs. clear lakes (LY and LC)). Under ambient nutrient conditions and static regimes, UVR exerted a stimulatory effect on heterotrophic bacterial production (HBP) in the opaque lake but not in the clear ones. Under UVR, vertical mixing and nutrient addition HBP values were lower than under the static and ambient nutrient conditions, and the stimulatory effect that UVR exerted on HBP in the opaque lake disappeared. By contrast, vertical mixing and nutrient addition increased HBP values in the clear lakes, highlighting for a photoinhibitory effect of UVR on HBP. Mixed regime and nutrient addition resulted in negative effects of UVR on HBP more in the opaque than in the clear lakes. Moreover, in the opaque lake, bacterial respiration (BR) increased and EOC did not support the bacterial carbon demand (BCD). In contrast, bacterial metabolic costs did not increase in the clear lakes and the increased nutrient availability even led to higher HBP. Consequently, EOC satisfied BCD in the clear lakes, particularly in the clearest one [LC]. Our results suggest that the higher vulnerability of bacteria to the damaging effects of UVR may be particularly accentuated in the opaque lakes and further recognizes the relevance of light exposure history and biotic interactions on bacterioplankton metabolism when coping with fluctuating radiation and nutrient inputs.Fil: Durán, C.. Universidad de Granada; EspañaFil: Medina Sánchez, J. M.. Universidad de Granada; EspañaFil: Herrera, G.. Universidad de Granada; EspañaFil: Villar Argaiz , M.. Universidad de Granada; EspañaFil: Villafañe, Virginia Estela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico; ArgentinaFil: Helbling, Eduardo Walter. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico; ArgentinaFil: Carrillo, P.. Universidad de Granada; Españ

Heterogeneity within AML with CEBPA mutations; only CEBPA double mutations, but not single CEBPA mutations are associated with favourable prognosis

CCAAT/enhancer binding protein alpha (CEBPA) mutations in AML are associated with favourable prognosis and are divided into N- and C-terminal mutations. The majority of AML patients have both types of mutations. We assessed the prognostic significance of single (n=7) and double (n=12) CEBPA mutations among 224 AML patients. Double CEBPA mutations conferred a decisively favourable overall (P=0.006) and disease-free survival (P=0.013). However, clinical outcome of patients with single CEBPA mutations was not different from CEBPA wild-type patients. In a multivariable analysis, only double – but not single – CEBPA mutations were identified as independent prognostic factors. These findings indicate heterogeneity within AML patients with CEBPA mutations