Climate change and the kidney

The worldwide increase in temperature has resulted in a marked increase in heat waves (heat extremes) that carries a markedly increased risk for morbidity and mortality. The kidney has a unique role not only in protecting the host from heat and dehydration but also is an important site of heat-associated disease. Here we review the potential impact of global warming and heat extremes on kidney diseases. High temperatures can result in increased core temperatures, dehydration, and blood hyperosmolality. Heatstroke (both clinical and subclinical whole-body hyperthermia) may have a major role in causing both acute kidney disease, leading to increased risk of acute kidney injury from rhabdomyolysis, or heat-induced inflammatory injury to the kidney. Recurrent heat and dehydration can result in chronic kidney disease (CKD) in animals and theoretically plays a role in epidemics of CKD developing in hot regions of the world where workers are exposed to extreme heat. Heat stress and dehydration also has a role in kidney stone formation, and poor hydration habits may increase the risk for recurrent urinary tract infections. The resultant social and economic consequences include disability and loss of productivity and employment. Given the rise in world temperatures, there is a major need to better understand how heat stress can induce kidney disease, how best to provide adequate hydration, and ways to reduce the negative effects of chronic heat exposure.Published versio

A genomic catalog of Earth’s microbiomes

The reconstruction of bacterial and archaeal genomes from shotgun metagenomes has enabled insights into the ecology and evolution of environmental and host-associated microbiomes. Here we applied this approach to >10,000 metagenomes collected from diverse habitats covering all of Earth’s continents and oceans, including metagenomes from human and animal hosts, engineered environments, and natural and agricultural soils, to capture extant microbial, metabolic and functional potential. This comprehensive catalog includes 52,515 metagenome-assembled genomes representing 12,556 novel candidate species-level operational taxonomic units spanning 135 phyla. The catalog expands the known phylogenetic diversity of bacteria and archaea by 44% and is broadly available for streamlined comparative analyses, interactive exploration, metabolic modeling and bulk download. We demonstrate the utility of this collection for understanding secondary-metabolite biosynthetic potential and for resolving thousands of new host linkages to uncultivated viruses. This resource underscores the value of genome-centric approaches for revealing genomic properties of uncultivated microorganisms that affect ecosystem processes

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Aplicación de la técnica de MABA (Multiple Antigen Blot Assay): una metodología para el diagnóstico simultáneo de agentes infecciosos

Resume

Colombia Diversidad Biótica XI : Patrones de la estructura y de la riqueza de la vegetación en Colombia

ilustraciones, fotografías, mapasLas contribuciones de este volumen tienen como base varias tesis de postgrado, a saber: la tesis de doctorado de Edgard E. Cantillo: La estructura de la vegetación en colombia: una síntesis preliminar, la tesis de maestría de Rubén Darío Patiño sobre la vegetación de la estación Primates, Colosó. El capítulo de Paramillo es una contribución derivada del proyecto de investigación sobre síntesis de la biodiversidad del Caribe. La información básica de campo de los tratamientos sobre las cordilleras Occidental, Central y Oriental proviene del grupo de investigación sobre el proyecto Estudio de Ecosistemas Tropandinos-Ecoandes. (texto tomado de la fuente)INTRODUCCIÓN --EL ALCANCE DEL TRABAJO -- REGIÓN ANDINA -- LA ESTRUCTURA Y LA RIQUEZA DE LOS BOSQUES DEL MACIZO DEL TATAMÁ / J. Orlando Rangel-Ch. & Edgard E. Cantillo-H. -- ESTUDIO DE CASO COMPOSICIÓN FLORÍSTICA Y ASPECTOS DE LA ESTRUCTURA DE LA VEGETACIÓN EN LA RESERVA NATURAL YOTOCO (VALLE DEL CAUCA) / Edgard E. Cantillo H. & Amarfi Fajardo G. -- CORDILLERA CENTRAL LA ESTRUCTURA Y EL PATRÓN DE RIQUEZA DE LA VEGETACIÓN DEL PARQUE NACIONAL NATURAL LOS NEVADOS / Edgard E. Cantillo-H. & J. Orlando Rangel-Ch. -- ESTUDIO DE CASO ASPECTOS DE LA ESTRUCTURA Y DINÁMICA DE LA SUCESIÓN VEGETAL EN LOCALIDADES DEL MUNICIPIO DE NORCASIA, CALDAS / Edgard E. Cantillo-H. & J. Orlando Rangel-Ch. -- CORDILLERA ORIENTAL LA ESTRUCTURA Y LA RIQUEZA DE LOS BOSQUES DEL MACIZO DEL SUMAPAZ / Edgard E. Cantillo-H. & J. Orlando Rangel-Ch. -- ESTUDIO DE CASO COMPOSICIÓN FLORÍSTICA Y ESTRUCTURA DE LOS BOSQUES DE LA RESERVA FORESTAL CÁRPATOS, GUASCA-CUNDINAMARCA / Edgard E. Cantillo-H., Karla Rodríguez-R. & Andrés Avella-M. -- REGIÓN CARIBE -- LA ESTRUCTURA Y EL PATRÓN DE RIQUEZA DE LA VEGETACIÓN EN LOCALIDADES DEL DEPARTAMENTO DE CÓRDOBA / J. Orlando Rangel-Ch., Edgard E. Cantillo-H. & Harol Garay / ESTUDIO DE CASO LA VEGETACIÓN BOSCOSA EN LA ESTACIÓN DE PRIMATES COLOSO- SUCRE / Ruben D. Patiño U. & J. Orlando Rangel-Ch. -- ESTUDIO DE CASO ESTRUCTURA Y COMPOSICION FLORISTICA DE LOS BOSQUES INUNDABLES DEL PARQUE NACIONAL NATURAL PARAMILLO (CÓRDOBA, COLOMBIA) / Ana Cristina Estupiñán-G., Néstor David Jiménez-E., Andrés Avella-M. & J. Orlando Rangel-Ch. -- ESTUDIO DE CASO MACIZO MONTAÑOSO DEL CARIBE: ASPECTOS DE LA ESTRUCTURA Y DEL PATRÓN DE RIQUEZA DE LA VEGETACIÓN DE LA SERRANÍA DE PERIJÁ / Edgard E. Cantillo-H., Henry Arellano & J. Orlando Rangel-Ch. -- REGIÓN AMAZÓNICA -- LA ESTRUCTURA Y LA RIQUEZA EN BOSQUES DEL AMAZONAS COLOMBIANO -- SÍNTESIS -- / Edgard E. Cantillo-H. & J. Orlando Rangel-Ch. -- REGIÓN PACÍFICA -- ASPECTOS DE LA ESTRUCTURA Y DEL PATRÓN DE RIQUEZA DE LA VEGETACIÓN ARBÓREA DEL BAJO RÍO SAN JUAN - PACÍFICO COLOMBIANO / Edgard E. Cantillo-H. & J. Orlando Rangel-Ch. -- REGIÓN ORINOQUIA -- COMPOSICIÓN FLORÍSTICA Y PATRÓN DE LA ESTRUCTURA DE LA VEGETACIÓN EN EL SECTOR NOR-ORIENTAL DE LA SERRANÍA DE LA MACARENA, SAN JUAN DE ARAMA - META / M. Viviana Romero-V., Germán Téllez-M. & Edgard E. Cantillo-H. -- SUCESIÓN VEGETAL Y RESTAURACIÓN ECOLÓGICA EN LA RESERVA FORESTAL CÁRPATOS (GUASCA, CUNDINAMARCA) / Edgard E. Cantillo-H., Alberto Lozada & Julián Pinzón -- LOS PATRONES DE LA ESTRUCTURA Y DE LA RIQUEZA DE LA VEGETACIÓN BOSCOSA DE COLOMBIA -- SÍNTESIS /Edgard E. Cantillo-H. & J. Orlando Rangel-Ch.primera edició

Evolocumab and clinical outcomes in patients with cardiovascular disease

peer reviewedBACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (including new-onset diabetes and neurocognitive events), with the exception of injection-site reactions, which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets. © 2017 Massachusetts Medical Society

A genomic catalog of Earth’s microbiomes

The reconstruction of bacterial and archaeal genomes from shotgun metagenomes has enabled insights into the ecology and evolution of environmental and host-associated microbiomes. Here we applied this approach to >10,000 metagenomes collected from diverse habitats covering all of Earth’s continents and oceans, including metagenomes from human and animal hosts, engineered environments, and natural and agricultural soils, to capture extant microbial, metabolic and functional potential. This comprehensive catalog includes 52,515 metagenome-assembled genomes representing 12,556 novel candidate species-level operational taxonomic units spanning 135 phyla. The catalog expands the known phylogenetic diversity of bacteria and archaea by 44% and is broadly available for streamlined comparative analyses, interactive exploration, metabolic modeling and bulk download. We demonstrate the utility of this collection for understanding secondary-metabolite biosynthetic potential and for resolving thousands of new host linkages to uncultivated viruses. This resource underscores the value of genome-centric approaches for revealing genomic properties of uncultivated microorganisms that affect ecosystem processes. © 2020, The Author(s)