Frequency-modulated atomic force microscopy localises viscoelastic remodelling in the ageing sheep aorta

We gratefully acknowledge funding from the Royal Society for the provision of an International Travel Grant for Collaboration (R112205) to RA, and Wellcome Trust Value in People Award to RA and MJS. MJS and BD gratefully acknowledge the support of the Medical Research Council (www.mrc.ac.uk: grant reference G1001398)

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

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Not AvailableAbiotic stresses such as drought, high salinity, and extreme temperatures are common adverse environmental conditions that significantly reduce the crop productivity. Plants have the capability to sense and adjust to abiotic stresses, although the degree of adaptability to specific stresses varies from species to species. The adaptability to environmental stresses is controlled by either simple or complex cascades of molecular networks. Transcription factors (TFs) play vital regulatory roles in abiotic stress responses in plants by interacting with cis elements present in the promoter region of various abiotic stress responsive genes. The identification and molecular tailoring of novel TFs involved in environmental stress responses have the potential to overcome a number of important limitations encountered in the generation of transgenic crop plants with superior yield under stress conditions. This opens an excellent opportunity to develop stress tolerant crops in future. This review summarizes the role of various transcription factors in crop improvement through transgenic technology.Not Availabl

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Not AvailableMany plant genes are regulated in response to abiotic stresses such as drought, high salinity, heat and cold, and their gene products function in stress response and tolerance. The whole process of plant adaptation to these environmental stresses is controlled by orchestration of complex molecular networks. In the present study, eight genes showing significant difference of expression on exposure to artificial drought stress in tomato, were selected from the previously performed microarray experiment. Expression analysis of the genes was done semi-quantitatively as well as quantitatively under artificially imposed drought stress and the results were almost similar to those of microarray experiment. Tissue-specific analysis of the genes, performed on tolerant line, revealed fairly a similar pattern of expression in root, stem and leaf with notable differences in flower, which experienced the least influence of drought. The results confirmed that SlPRP16, SlCYP51-17, SlMCPI19 and SlGDSL20 were downregulated in both the lines with stronger downregulation in sensitive line. SlWRKY4 was downregulated in both the lines with more folds of downregulation in tolerant line. SlEFH12 and SlSNF4-15 were upregulated in tolerant line. SlUSPA9 was upregulated in both the lines with relatively more folds of upregulation in sensitive line.Not Availabl

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Not AvailableThe poor mobility of soil inorganic phosphorus is due to the large reactivity of phosphate ions with numerous chemical, mineralogical and biological soil constituents. Adsorption-desorption and precipitation-dissolution equilibria control the concentration of P in the soil solution and P chemical mobility. P bioavailability depends on soil pH, concentrations of anions that compete with P ions for ligand exchange and metals that can coprecipitate with P ions. The mineralization and hydrolysis of organic phosphorus also maintain the phosphorus solution concentration. Thus, only a marginal proportion of soil phosphorus is present as P ions in the soil solution. Due to lack of appropriate methods for studying its speciation and biogeochemical behavior, the mobility of inorganic P in most soils is still poorly understood and hardly predictable. This is even worse when considering the problem of the bioavailability of P to plants. The characterisation and quantification of soil phosphorus and the factors that control the availability of P to plants are of utmost importance to define the bioavailability of soil P. Thus, the measurement of intensity and capacity factors together can describe P supply with considerable precision. Phosphorus flux to the root system is mainly controled by diffusion. Soil water content and diffusion coefficient, including the soil buffer power are key factors in the diffusion of P to plant roots. Root systems have the ability to increase the bioavailable pool of P due to their influence on soil chemistry either directly by the activity of plant roots or indirectly by enhancing the activity of rhizospheric microflora. Phosphorus uptake by roots, effect of soil pH, anion/cation balance, gaseous exchanges and release of root exudates are major rhizosphere processes controling the bioavailability of soil P. Soil P bioavailability can also vary with plant species or genotypes, plant nutritional status and ambient soil conditions. Various extractions procedures are now widely used to assess P bioavailability based on the knowledge of phosphorus dynamics in soils and P mobilization by plants. Furthermore, physiological processes occurring in the rhizosphere also provide a better understanding of P availability. 31P-NMR technique clearly indicates the distribution of inorganic phosphorus in living cell. Kinetics have elucidated the functional characteristics of plasma membrane and tonoplast inorganic phosphate transporters. Molecular studies have confirmed the presence of multiple genes encoding phosphate transporters. Modeling the P bioavailability is a logical approach to understand the complexity of the P nutrition. Though, the authenticity of the models will largely depends on the accuracy and quality of input data that are very subjective to varying soil conditions. Inclusion of bioavailability of P as a parameter in crop modeling will help in solving the large black box of processes and mechanisms of P uptake from soil that has perplexing and hitherto not well understood. The aim of this chapter is to give an overview of P uptake processes and mechanisms involved in plants and the chemical processes that are directly induced by plant roots which can affect the concentration of P in soil solution and, ultimately, the bioavailability of soil phosphorus to plants.Not Availabl

Influence of Texture on Mechanical Behavior of Friction-stir-processed Magnesium Alloy

Friction stir processing (FSP) improves the mechanical properties of metallic materials. In this study, a magnesium alloy AZ31B was friction stir processed by using single and multiple pass. The friction-stir-processed magnesium alloy exhibits higher tensile strength and ductility in the transverse direction (TD) compared to the longitudinal direction (LD). Both single pass and multiple (two) pass friction-stir-processed material show similar anisotropy in tensile properties, but the multiple pass friction-stir-processed material shows fine-grained microstructure with higher tensile strength and ductility. The tensile anisotropy in the friction-stir-processed AZ31B originated from the textured microstructure that evolved during FSP