Age-dependent impairment of the erythropoietin response to reduced central venous pressure in HFpEF patients

Despite growing research interest in the pathophysiology of heart failure with preserved ejection fraction (HFpEF), it remains unknown whether central hemodynamic alterations inherently present in this condition do affect blood pressure and blood volume (BV) regulation. The present study sought to determine hemodynamic and endocrine responses to prolonged orthostatic stress in HFpEF patients. Central venous pressure (CVP) assessed via the internal jugular vein (IJV) aspect ratio with ultrasonography, arterial pressure and heart rate were determined at supine rest and during 2 hours of moderate (25-30°) head-up tilt (HUT) in 18 stable HFpEF patients (71.2 ± 7.3 years), 14 elderly (EC), and 10 young (YC) healthy controls. Parallel endocrine measurements comprised main BV-regulating hormones: pro-atrial natriuretic peptide, copeptin, aldosterone, and erythropoietin (EPO). At supine rest, the IJV aspect ratio was higher (>30%) in HFpEF patients compared with EC and YC, while mean arterial pressure was elevated in HFpEF patients (98.0 ± 13.1 mm Hg) and EC (95.6 ± 8.3 mm Hg) versus YC (87.3 ± 5.0 mm Hg) (P < 0.05). HUT increased heart rate (+10%) and reduced the IJV aspect ratio (-52%), with similar hemodynamic effects in all groups (P for interaction ≥ 0.322). The analysis of endocrine responses to HUT revealed a group×time interaction for circulating EPO, which was increased in YC (+10%) but remained unaltered in HFpEF patients and EC. The EPO response to a given reduction in CVP is similarly impaired in HFpEF patients and elderly controls, suggesting an age-dependent dissociation of EPO production from hemodynamic regulation in the HFpEF condition

Peatland protection and restoration are key for climate change mitigation

Peatlands cover only about 3% the global land area, but store about twice as much carbon as global forest biomass. If intact peatlands are drained for agriculture or other human uses, peat oxidation can result in considerable CO2 emissions and other greenhouse gases (GHG) for decades or even centuries. Despite their importance, emissions from degraded peatlands have so far not been included explicitly in mitigation pathways compatible with the Paris Agreement. Such pathways include land-demanding mitigation options like bioenergy or afforestation with substantial consequences for the land system. Therefore, besides GHG emissions owing to the historic conversion of intact peatlands, the increased demand for land in current mitigation pathways could result in drainage of presently intact peatlands, e.g. for bioenergy production. Here, we present the first quantitative model-based projections of future peatland dynamics and associated GHG emissions in the context of a 2 °C mitigation pathway. Our spatially explicit land-use modelling approach with global coverage simultaneously accounts for future food demand, based on population and income projections, and land-based mitigation measures. Without dedicated peatland policy and even in the case of peatland protection, our results indicate that the land system would remain a net source of CO2 throughout the 21st century. This result is in contrast to the outcome of current mitigation pathways, in which the land system turns into a net carbon sink by 2100. However, our results indicate that it is possible to reconcile land use and GHG emissions in mitigation pathways through a peatland protection and restoration policy. According to our results, the land system would turn into a global net carbon sink by 2100, as projected by current mitigation pathways, if about 60% of present-day degraded peatlands would be rewetted in the coming decades, next to the protection of intact peatlands

Peatland protection and restoration are key for climate change mitigation

Peatlands cover only about 3% the global land area, but store about twice as much carbon as global forest biomass. If intact peatlands are drained for agriculture or other human uses, peat oxidation can result in considerable CO2 emissions and other greenhouse gases (GHG) for decades or even centuries. Despite their importance, emissions from degraded peatlands have so far not been included explicitly in mitigation pathways compatible with the Paris Agreement. Such pathways include land-demanding mitigation options like bioenergy or afforestation with substantial consequences for the land system. Therefore, besides GHG emissions owing to the historic conversion of intact peatlands, the increased demand for land in current mitigation pathways could result in drainage of presently intact peatlands, e.g. for bioenergy production. Here, we present the first quantitative model-based projections of future peatland dynamics and associated GHG emissions in the context of a 2 °C mitigation pathway. Our spatially explicit land-use modelling approach with global coverage simultaneously accounts for future food demand, based on population and income projections, and land-based mitigation measures. Without dedicated peatland policy and even in the case of peatland protection, our results indicate that the land system would remain a net source of CO2 throughout the 21st century. This result is in contrast to the outcome of current mitigation pathways, in which the land system turns into a net carbon sink by 2100. However, our results indicate that it is possible to reconcile land use and GHG emissions in mitigation pathways through a peatland protection and restoration policy. According to our results, the land system would turn into a global net carbon sink by 2100, as projected by current mitigation pathways, if about 60% of present-day degraded peatlands would be rewetted in the coming decades, next to the protection of intact peatlands.DFG Priority Program “Climate Engineering: Risks, Challenges, Opportunities?” (SPP 1689)Horizon 2020 Framework Programmehttp://dx.doi.org/10.13039/100010661Peer Reviewe

Outcome of Pediatric Cataract Surgeries in a Tertiary Center in Switzerland

Purpose. To determine and to analyze the outcome of pediatric cataract surgery. Methods. A retrospective chart review of individuals aged up to 10 years who underwent cataract surgery between January 1, 2004, and December 31, 2014, at the UniversityHospital Zurich, Switzerland. Results. 63 children (94 affected eyes) with bilateral (68/94) or unilateral (26/94) cataract were identified. Surgery was performed at a median age of 1.5 months (IQR: 1.3–2.6 months) for the aphakic group (45/94) and of 50.7 months (IQR: 38.0–78.4 months) for the IOL group (49/94). At the last follow-up visit (median 31.1 months, IQR: 18.4–50.2 months), visual acuity was better in bilateral than in unilateral cataract cases. Posterior capsular opacification (PCO) was diagnosed in 30.9% of eyes without a significant difference in the IOL and aphakic groups (p=0.12). Aphakic glaucoma was diagnosed in 12/45 eyes at a median of 6.8 months (IQR 2.1–13.3 months) after surgery. Microcornea (5/12) and anterior segment anomalies (8/12) were associated with glaucoma development (p<0.05). Conclusion. Laterality and timing of surgery influence the outcome of pediatric cataract surgery. PCO was the most frequent postoperative complication. Aphakic glaucoma is often associated with ocular developmental abnormalities and a poor visual outcome

Endocrine hormone imbalance in heart failure with reduced ejection fraction: A cross-sectional study

BACKGROUND AND AIMS Sustained neurohormonal activation plays a central role in the progression of heart failure (HF). Other endocrine axes may also be affected. It was the aim of this study to examine the endocrine profile (thyroid, parathyroid, glucocorticoid, and sex hormones) in a contemporary sample of patients with HF and reduced ejection fraction (EF) on established disease-modifying therapy. METHODS This study prospectively measured morning fasting hormones in 52 ambulatory and stable HF patients with EF < 50% on disease-modifying therapy (mean age 63 ± 11 years, 29% female, mean LVEF 32 ± 9.6%) and compared them to 54 patients at elevated risk for HF (61 ± 12 years, 28% female) and 62 healthy controls (HC; 61 ± 13 years, 27% female). Main comparisons were performed using one-way analysis of variance. Associations with biomarkers were studied with linear regression. RESULTS HF patients showed a reduced free triiodothyronine (fT3)/free thyroxine (fT4) ratio compared to HC (0.30 ± 0.06 vs. 0.33 ± 0.05, p = 0.046). Parathyroid hormone (PTH) and cortisol were increased in HF compared to both HC (median [IQR] 59 [50-84] vs. 46 [37-52] ng/L, p < 0.001 and 497 ± 150 vs. 436 ± 108 nmol/L, p = 0.03, respectively) and patients at risk (both p < 0.001). Total testosterone was reduced in male HF compared to HC (14.4 ± 6.6 vs. 18.6 ± 5.3 nmol/L; p = 0.01). No differences in TSH, estradiol, progesterone, and prolactin were found. Lower fT3 levels were found in HF with EF < 40% versus EF 40%-49% (4.6 ± 0.3 vs. 5.2 ± 0.7 pmol/L, p = 0.009). In HF patients, fT3 was an independent predictor of NT-proBNP and high-sensitivity troponin T in multiple regression analysis. PTH was positively associated with NT-proBNP. CONCLUSION There is evidence of endocrine hormonal imbalance in HF with reduced EF beyond principal neurohormones and despite the use of disease-modifying therapy

SYSTOMONAS — an integrated database for systems biology analysis of Pseudomonas

To provide an integrated bioinformatics platform for a systems biology approach to the biology of pseudomonads in infection and biotechnology the database SYSTOMONAS (SYSTems biology of pseudOMONAS) was established. Besides our own experimental metabolome, proteome and transcriptome data, various additional predictions of cellular processes, such as gene-regulatory networks were stored. Reconstruction of metabolic networks in SYSTOMONAS was achieved via comparative genomics. Broad data integration is realized using SOAP interfaces for the well established databases BRENDA, KEGG and PRODORIC. Several tools for the analysis of stored data and for the visualization of the corresponding results are provided, enabling a quick understanding of metabolic pathways, genomic arrangements or promoter structures of interest. The focus of SYSTOMONAS is on pseudomonads and in particular Pseudomonas aeruginosa, an opportunistic human pathogen. With this database we would like to encourage the Pseudomonas community to elucidate cellular processes of interest using an integrated systems biology strategy. The database is accessible at

Regolith science with the cameras on the MMX Rover

The JAXA Martian Moons Exploration (MMX) mission [1] has a primary objective to study the formation and origins of Phobos and Deimos. The MMX spacecraft will also deploy a CNES/DLR rover to the surface of Phobos [2,3]. This rover will be the first of its kind to attempt wheeled-locomotion on a low gravity surface. As such, this rover provides a unique opportunity to study not only the surface properties of Phobos, but also regolith dynamics on small-bodies. This information is valuable for understanding the surface processes and geological history of Phobos in addition to being of high importance to the landing (and sampling) operations of the main MMX spacecraft [1]

Hypovolemia and reduced hemoglobin mass in patients with heart failure and preserved ejection fraction

A fundamental tenet of heart failure (HF) pathophysiology hinges on a propensity for fluid retention leading to blood volume (BV) expansion and hemodilution. Whether this can be applied to heart failure patients with preserved ejection fraction (HFpEF) remains uncertain. The present study sought to determine BV status and key hormones regulating fluid homeostasis and erythropoiesis in HFpEF patients. BV and hemoglobin mass (Hb$_{mass}$ ) were determined with high-precision, automated carbon monoxide (CO) rebreathing in 20 stable HFpEF patients (71.5 ± 7.3 years, left ventricular ejection fraction = 55.7 ± 4.0%) and 15 healthy age- and sex-matched control individuals. Additional measurements comprised key circulating BV-regulating hormones such as pro-atrial natriuretic peptide (proANP), copeptin, aldosterone and erythropoietin (EPO), as well as central hemodynamics and arterial stiffness via carotid-femoral pulse wave velocity (PWV). Carotid-femoral PWV was increased (+20%) in HFpEF patients versus control individuals. With respect to hematological variables, plasma volume (PV) did not differ between groups, whereas BV was decreased (-14%) in HFpEF patients. In consonance with the hypovolemic status, Hb$_{mass}$ was reduced (-27%) in HFpEF patients, despite they presented more than a twofold elevation of circulating EPO (+119%). Plasma concentrations of BV-regulating hormones, including proANP (+106%), copeptin (+99%), and aldosterone (+62%), were substantially augmented in HFpEF patients. HFpEF patients may present with hypovolemia and markedly reduced Hb$_{mass}$ , underpinned by a generalized overactivation of endocrine systems regulating fluid homeostasis and erythropoiesis. These findings provide a novel perspective on the pathophysiological basis of the HFpEF condition

Endothelial dysfunction in cardiovascular disease and Flammer syndrome-similarities and differences

The endothelium has increasingly been recognized as a smart barrier and a key regulator of blood flow in micro- and macrovascular beds. Endothelial dysfunction marks a stage of atherosclerosis and is an important prognostic marker for cardiovascular disease. Yet, some people who tend to be slim and physically active and with rather low blood pressure show a propensity to respond to certain stimuli such as emotional stress with endothelial-mediated vascular dysregulation (Flammer syndrome). This leads to characteristic vascular symptoms such as cold hands but also a risk for vascular-mediated diseases such as normal-tension glaucoma. It is the aim of this review to delineate the differences between Flammer syndrome and its "counterpart" endothelial dysfunction in the context of cardiovascular diseases