Short-term physiological plasticity.Trade-off between drought and recovery responses in three Mediterranean cistus species

Short-term physiological plasticity allows plants to thrive in highly variable environments such as the Mediterranean ecosystems. In such context, plants that maximize physiological performance under favorable conditions, such as Cistus spp., are generally reported to have a great cost in terms of plasticity (i.e., a high short-term physiological plasticity) due to the severe reduction of physiological performance when stress factors occur. However, Cistus spp. also show a noticeable resilience ability in response to stress factors. We hypothesized that in Cistus species the short-term physiological response to stress and that to subsequent recovery can show a positive trade-off to offset the costs of the photosynthetic decline under drought. Gas exchange, chlorophyll fluorescence, and water relations were measured in C. salvifolius, C. monspeliensis, and C. creticus subsp. eriocephalus during an imposed experimental drought and subsequent recovery. Plants were grown outdoor in common garden conditions from seeds of different provenances. The short-term physiological response to stress and that to recovery were quantified via phenotypic plasticity index (PIstress and PIrecovery, respectively). A linear regression analysis was used to identify the hypothesized trade-off PIstress-PIrecovery. Accordingly, we found a positive trade-off between PIstress and PIrecovery, which was consistent across species and provenances. This result contributes in explaining the profit, more than the cost, of a higher physiological plasticity in response to short-term stress imposition for Cistus spp because the costs of a higher PIstress are payed back by an as much higher PIrecovery. The absence of leaf shedding during short-term drought supports this view. The trade-off well described the relative variations of gas exchange and water relation parameters. Moreover, the results were in accordance with the ecology of this species and provide the first evidence of a consistent trade-off between the short-term physiological responses to drought and recovery phases in Mediterranean species

Ultrastructure of neurovascular changes in human diabetic retinopathy

The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Müller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures

Minimally invasive vs. open segmental resection of the splenic flexure for cancer: a nationwide study of the Italian Society of Surgical Oncology-Colorectal Cancer Network (SICO-CNN)

Background Evidence on the efficacy of minimally invasive (MI) segmental resection of splenic flexure cancer (SFC) is not available, mostly due to the rarity of this tumor. This study aimed to determine the survival outcomes of MI and open treatment, and to investigate whether MI is noninferior to open procedure regarding short-term outcomes. Methods This nationwide retrospective cohort study included all consecutive SFC segmental resections performed in 30 referral centers between 2006 and 2016. The primary endpoint assessing efficacy was the overall survival (OS). The secondary endpoints included cancer-specific mortality (CSM), recurrence rate (RR), short-term clinical outcomes (a composite of Clavien-Dindo > 2 complications and 30-day mortality), and pathological outcomes (a composite of lymph nodes removed >= 12, and proximal and distal free resection margins length >= 5 cm). For these composites, a 6% noninferiority margin was chosen based on clinical relevance estimate. Results A total of 606 patients underwent either an open (208, 34.3%) or a MI (398, 65.7%) SFC segmental resection. At univariable analysis, OS and CSM were improved in the MI group (log-rank test p = 0.004 and Gray's tests p = 0.004, respectively), while recurrences were comparable (Gray's tests p = 0.434). Cox multivariable analysis did not support that OS and CSM were better in the MI group (p = 0.109 and p = 0.163, respectively). Successful pathological outcome, observed in 53.2% of open and 58.3% of MI resections, supported noninferiority (difference 5.1%; 1-sided 95%CI - 4.7% to infinity). Successful short-term clinical outcome was documented in 93.3% of Open and 93.0% of MI procedures, and supported noninferiority as well (difference - 0.3%; 1-sided 95%CI - 5.0% to infinity). Conclusions Among patients with SFC, the minimally invasive approach met the criterion for noninferiority for postoperative complications and pathological outcomes, and was found to provide results of OS, CSM, and RR comparable to those of open resection

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Temperature responsiveness of seedlings maximum relative growth rate in three Mediterranean Cistus species

Aims: Relative growth rate (RGR) is an indicator of the extent to which a species is using its photosynthates for growth and it is affected by environmental factors, including temperature. Nevertheless, most of plant growth studies have been carried out at a single growth temperature or at different temperature treatments, resulting in the lack of information on the relationship between RGR and changing mean daily air temperature. We analyzed the temporal changes in RGR during early growth stages in three Cistus species grown outdoor in a common garden from seeds of different provenances. Moreover, we wanted to define the relationship between daily changes in RGR and mean daily air temperature for the considered provenances. The hypothesis that intra-specific temporal variations in RGR can reflect differences in the behavior to maximize RGR (RGRmax) in response to temperature was tested. Methods: Seedlings of C. salvifolius, C. monspeliensis and C. creticus subsp. eriocephalus were grown outdoor in the experimental garden of the Sapienza University of Rome under a Mediterranean climate. We analyzed early growth with non-linear growth models and calculated function-derived RGRs as the derivative with respect to time of the parameterized functions used to predict height divided by current height. The relationships between function-derived RGRs and mean daily air temperature were analyzed by linear and non-linear models, which were ranked according to their standard errors and correlation coefficients. The temperature dependency of RGRmax per each provenance was evaluated through the relationship between RGRmax and the coefficients of the best regression model obtained. Important Findings: A parameter that could summarize the temperature dependency of RGR up to RGRmax during the early growth stages for the selected provenances was defined. This allowed us to highlight that a greater RGR temperature responsiveness was related to a delay in the time to reach RGRmax independently by the species. Nevertheless, a greater temperature sensitivity of RGR lead to a reduced maximum height which reflects a negative trade-off between the length of the developmental phases and the extent of RGR temperature responsiveness. Thus, variations in temperature responsiveness of RGR up to RGRmax have a significant role in shaping the early growth for the investigated species. Our findings quantitatively define provenance dependent strategies by which the selected species cope with daily air temperature variations during early growth

Drought_Plasticity_Dataset

The dataset “Drought_Plasticity_Dataset” by Puglielli et al. reports data on the drought response of three Cistus species (C. salvifolius, C. creticus subsp. eriocephalus and C. monspeliensis). The plants were grown from seeds of different provenances under common garden conditions (provenances are reported in the second column of the dataset). The dataset includes data for Control (C) and stress (S) treatment with five replicates per each provenance. The parameters are explicitly labeled within the dataset along with the abbreviations used in the paper and their units. The values of the Phenotypic Plasticity Index sensu Valladares et al. (New Phytologist 148, 79–91) for the drought (PIstress) and recovery (PIrecovery) responses are reported in columns 17 and 18. Each values is associated to the specific parameter and provenance

Data from: Short-term physiological plasticity: trade-off between drought and recovery responses in three Mediterranean Cistus species

Short-term physiological plasticity allows plants to thrive in highly variable environments such as the Mediterranean ecosystems. In such context, plants that maximize physiological performance under favorable conditions, such as Cistus spp., are generally reported to have a great cost in terms of plasticity (i.e. a high short-term physiological plasticity) due to the severe reduction of physiological performance when stress factors occur. However, Cistus spp. also show a noticeable resilience ability in response to stress factors. We hypothesized that in Cistus species the short-term physiological response to stress and that to subsequent recovery can show a positive trade-off to offset the costs of the photosynthetic decline under drought. Gas exchange, chlorophyll fluorescence and water relations were measured in C. salvifolius, C. monspeliensis and C. creticus subsp. eriocephalus during an imposed experimental drought and subsequent recovery. Plants were grown outdoor in common garden conditions from seeds of different provenances. The short-term physiological response to stress and that to recovery were quantified via phenotypic plasticity index (PIstress and PIrecovery, respectively). A linear regression analysis was used to identify the hypothesized trade-off PIstress-PIrecovery. Accordingly, we found a positive trade-off between PIstress and PIrecovery, which was consistent across species and provenances. This result contributes in explaining the profit, more than the cost, of a higher physiological plasticity in response to short-term stress imposition for Cistus spp since the costs of a higher PIstress are payed back by an as much higher PIrecovery. Absence of leaf shedding during short-term drought supports this view. The trade-off well described the relative variations of gas exchange and water relation parameters. Moreover, the results were in accordance with the ecology of this species and provide the first evidence of a consistent trade-off between the short-term physiological responses to drought and recovery phases in Mediterranean species

Age Related Changes Seen in Human Cornea in Formalin Fixed Sections and on Biomicroscopy in Living Subjects-A Comparison

The purpose of our experimental research was to assess the effects of aging on the main corneal structures in healthy corneas. Small, human cornea samples were collected from 20 Caucasian subjects during surgery for traumatic lesions to the eye. Ten subjects were adults (mean age 28 years) and ten were elderly (mean age 76 years). Morphological analysis was carried out using light microscopy and electron microscopy. Another 40 patients (20 young: mean age ˂ 30 yrs; 20 elderly: mean age ˃ 70yrs) were studied in vivo by confocal microscopy. The resulting images were analyzed qualitatively, quantitatively, and statistically. The basic light microscope revealed a decrease in endothelial cell density with age accompanied by an increase in endothelial cell size. Transmission electron microscopy revealed a corneal thinning and a decrease in the number of corneal stromal cells. A marked decrease in stromal nerve fibers was observed in the older subjects compared to the younger ones. Variable pressure scanning electron microscopy (VP-SEM) was used to make surface morphological observations and to determine the chemical composition of in vivo hydrated human corneas. Our results showed the effects of aging on normal corneal morphology highlighting the structural diversity of the corneal layers and revealing an age-related reduction in nerve fibers, thus explaining the decreased corneal sensitivity that may be observed in the elderly. This article is protected by copyright. All rights reserved