Organic Reserves Research Articles

Optimization of treatment strategies for elderly patients with advanced non-small cell lung cancer.

Lung cancer stands as a malignant neoplasm bearing the highest burden of morbidity and mortality within the elderly population on a global scale. Among the lung cancer subtypes, non-small cell lung cancer (NSCLC) prevails as the most prevalent. As age advances, elderly patients often present with an increased prevalence of comorbidities, diminished organ reserve function, and alterations in drug pharmacokinetics, including absorption, distribution, metabolism, and clearance. These factors collectively contribute to a reduction in their capacity to tolerate therapeutic interventions. Regrettably, there exists a paucity of research data and evidence regarding the management of elderly patients afflicted by advanced lung cancer. This article endeavors to compile and elucidate strategies for the enhancement of treatment approaches, with the aim of aiding clinical decision-making. Prior to the selection of clinical treatment modalities for elderly patients with advanced NSCLC, a comprehensive assessment should be conducted, taking into account various facets, including tumor characteristics, patient age, physiological status, and the presence of comorbidities. The treatment strategy should be implemented in a tiered fashion, thereby affording the opportunity for the tailoring of individualized therapeutic approaches for elderly patients afflicted by advanced NSCLC. The demographic of elderly patients confronting advanced NSCLC presents a complex landscape marked by intricate underlying conditions, necessitating the imperative optimization of treatment strategies.

Qualea grandiflora Mart. (Vochysiaceae) seed reserves and aluminum: Usage and mobilization during germination and seedling development

AbstractQualea grandiflora Mart. is an aluminum (Al)‐accumulating Cerrado species with a metabolic dependency on Al. This study aimed to determine the presence and concentration of Al and other reserve components in Q. grandiflora seeds, as well as their respective distribution patterns, mobilization, and usage during germination and seedling growth. Thus, the concentration of Al and other minerals in seeds, seedlings, and soils was measured. Also, histochemical and energy‐dispersive X‐ray spectroscopy (EDS) analyses were performed to observe the distribution of Al, proteins, and lipids in Q. grandiflora seeds and seedlings. Additionally, the concentration of proteins and lipids was assessed as well. Hence, even in soils with low exchangeable Al3+, Q. grandiflora seeds accumulated about 6.43 g of Al/kg of dry matter (DM) together with considerable concentrations of N, P, K, Ca, and Mg. Exogenous Al had no effect on the germination properties of Q. grandiflora seeds. Furthermore, approximately 60% of the seed Al was translocated to seedling leaves. Proteins and lipids were the main organic reserves in Q. grandiflora seeds. The histochemical analysis revealed that the bulk of Al in seeds was in the cotyledons, which were also the location sites of proteins and lipids. Proteins and lipids were the primary source of energy and carbon for seedling growth. Therefore, fatty acids, proteins, and Al could play a central role during seed germination and seedling establishment, which could help to explain why this species is one of the most widespread plants in the Cerrado.

Physiology and pharmacology of glucagon-like peptide-1 receptor

Modern approaches to the treatment of type 2 diabetes mellitus (T2DM) are aimed not only at glycemic control, but also at reducing cardiovascular risks. The increasing prevalence of the disease and the need for effective treatment options highlight the importance of glucagon-like peptide-1 (GLP-1) receptor agonists in the pharmacotherapy structure.The aim of the work was to review the literature regarding the physiology of GLP-1 and the therapeutic potential and development trends of its agonists.Materials and methods. The search for the review materials was carried out using the abstract databases of PubMed, Google Scholar and e-Library. The search was carried out for publications from 2000 to 2023, using the following keywords: “GLP-1”; “GLP-1R agonists”; “GIP”; “exenatide”; “liraglutide”; “dulaglutide”; “semaglutide”; “lixisenatide”; “albiglutide”; “taspoglutide” taking into account various spellings.Results. The interaction of almost all food components with enteroendocrine cells of the intestine leads to the secretion of incretins (primarily GLP-1) into the blood, triggering a complex of physiological reactions aimed primarily at the rapid utilization of incoming glucose (regulation of insulin and glucagon secretion), as well as the central regulation of dietary behavior (slowing gastric emptying and the formation of a feeling of satiety). A wide distribution of the GLP-1 receptor in various tissues and organs, its connection with intracellular signaling cascades aimed at launching energy-consuming remodeling (recovery) processes in endothelial cells, heart, neurons, beta cells, etc., is the basis for a wide range of pleiotropic effects of GLP-1 unrelated to its hypoglycemic effect. The discovery of synthetic GLP-1 receptor agonists with a long period of action has made it possible not only to therapeutically influence various parts of carbohydrate metabolism disorders, but also to increase the functional reserves of the target diabetes organs, reducing the risk of developing complications of the disease. Incretin-like drugs are well tolerated, with nausea being the most common side effect. The factors limiting a wider use of the drugs include their high cost and the preferred form of a subcutaneous solution. The current research is focused on the development of long-acting, oral, dual and triple agonists, fixed-dose combinations, and small molecule drugs.Conclusion. GLP-1 receptor agonists are a class of effective and safe drugs for the treatment of diabetes and obesity, which is rapidly developing in the most advanced areas of pharmacy. A further development of this group and the solution of the identified problems will open up new opportunities for the treatment of diabetes and its complications.

Hypertension in frail older adults: current perspectives.

Hypertension is one of the most common chronic diseases in older people, and the prevalence is on the rise as the global population ages. Hypertension is closely associated with many adverse health outcomes, including cardiovascular disease, chronic kidney disease and mortality, which poses a substantial threat to global public health. Reasonable blood pressure (BP) management is very important for reducing the occurrence of adverse events. Frailty is an age-related geriatric syndrome, characterized by decreased physiological reserves of multiple organs and systems and increased sensitivity to stressors, which increases the risk of falls, hospitalization, fractures, and mortality in older people. With the aging of the global population and the important impact of frailty on clinical practice, frailty has attracted increasing attention in recent years. In older people, frailty and hypertension often coexist. Frailty has a negative impact on BP management and the prognosis of older hypertensive patients, while hypertension may increase the risk of frailty in older people. However, the causal relationship between frailty and hypertension remains unclear, and there is a paucity of research regarding the efficacious management of hypertension in frail elderly patients. The management of hypertension in frail elderly patients still faces significant challenges. The benefits of treatment, the optimal BP target, and the choice of antihypertensive drugs for older hypertensive patients with frailty remain subjects of ongoing debate. This review provides a brief overview of hypertension in frail older adults, especially for the management of BP in this population, which may help in offering valuable ideas for future research in this field.

A High-Dose Corticosteroid Treatment Increases Coronavirus Disease of 2019 Mortality in Intensive Care Units.

The study is aimed to investigate the association between different corticosteroid treatment regimens and clinical status, complications, mechanical ventilation requirement, and intensive care unit (ICU) mortality in individuals diagnosed with Coronavirus Disease of 2019 (COVID-19). This is a descriptive retrospective study. Patients admitted to the ICU for COVID-19 and treated with low- or medium-dose corticosteroid therapy (methylprednisolone at a dose of 0.5-1 mg/kg for 7-10 days) were compared with patients treated with high-dose pulse corticosteroid therapy (methylprednisolone at varying doses of 250 mg, 500 mg or 1000 mg for 3-7 days) in addition to standard therapy because of increased pulmonary infiltrate and elevated inflammatory markers during clinical monitoring. All demographic and clinical data, including age, sex, clinical course, laboratory findings, discharge status, 28-day mortality, intubation status, acute physiological assessment and chronic health evaluation II score, Charlson Comorbidity Index, and sequential organ failure assessment score, were recorded. Corticosteroid treatment was administered to 689 (88.3%) of 780 COVID-19 ICU patients between April 2020 and October 2021. The overall mortality rate was 45.1% (n= 352). When the mortality rates of patients were compared according to the corticosteroid dose, the mortality rate in the low-to-medium-dose group (40%) was significantly lower than that in the high-dose group (76%). In addition, significant deterioration in laboratory and clinical parameters was observed in the high-dose corticosteroid group. High mortality, adverse effects, and complications were significantly increased when high-dose corticosteroids were administered. Corticosteroid therapy should be used cautiously according to the patient's clinical condition, disease stage, comorbidities, and systemic or organ reserves.

Renal Outcome of PCR Confirmed Covid Patient with Renal Impairment-A Hospital Based Observational Study

The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be at increased risk for infection due to viral transmission next to an enhanced risk for mortality as compared to the general population, even in the face of an often apparently mild clinical presentation. Derangements in the innate and adaptive immune systems may be responsible for a reduced antiviral response, whereas chronic activation of the innate immune system and endothelial dysfunction provide a background for a more severe course. The presence of severe comorbidity, older age, and a reduction of organ reserve may lead to a rapid deterioration of the clinical situation of the patients in case of severe infection. Secondly, patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity of the clinical disease. The presence of AKI, and especially the need for renal replacement therapy (RRT), is associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct viral invasion of kidney cells, activation of the renin-angiotensin aldosterone system, a hyperinflammatory response, hypercoagulability, and nonspecific factors such as hypotension and hypoxemia may be involved. Apart from logistic challenges and the need for strict hygiene within units, treatment of patients with ESRD and COVID-19 is not different from that of the general population. Extracorporeal treatment of patients with AKI with RRT can be complicated by frequent filter clotting due to the hypercoagulable state, for which regional citrate coagulation provides a reasonable solution. Also, acute peritoneal dialysis may be a reasonable option in these patients. Whether adjuncts to extracorporeal therapies, such as hemoadsorption, provide additional benefits in the case of severely ill COVID-19 patients needs to be addressed in controlled studies.

Effects of the bio-psycho-social frailty dimensions on healthcare utilisation among elderly in Europe: A cross-country longitudinal analysis

Frailty represents an emerging challenge and has major implications for clinical practice, public health, and the sustainability of health systems. It is a geriatric condition, related to but distinct from disability and multimorbidity and characterized by a diminished physiological reserve of multiple organs. Despite limited consensus and evidence, it has been argued that cognitive and social aspects influence the condition. Therefore, we aim to provide evidence on the importance of taking a broader approach in defining frailty, by investigating the role of its physical, social, and psychological subdomains to predict healthcare utilisation in elderly Europeans.The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE), and uses 185,169 total observations from 12 European countries included in wave 4, 5, 6, and 8. The analysis investigates the influence of the physical frailty index (a proxy of the Frailty Phenotype definition), psychological and social frailty indexes (built to proxy the Tilburg Frailty Index) on the likelihood of hospitalisation and the number of doctor visits.We addressed missing values due to item non-response with fully conditional specification multivariate imputation and exploited the longitudinal structure of the data to control for time-fixed unobserved characteristics. In addition, our two multivariate models included regressors to correct for demand side factors (health status, socio-economic status, and behavioral risk) as well as for country-specific characteristics.Physical and psychological frailty positively influence the likelihood of hospitalisation (OR = 1.90 and OR = 1.31, respectively) and the number of doctor visits (IRR = 1.30 and IRR = 1.07), while social frailty reduces the two types of health services utilisation (OR = 0.53 and IRR = 0.90).The three frailty dimensions are relevant risk stratification factors in elderly Europeans, and health policies should focus more on the psycho-social aspects of this condition, as a strategy to both contain expenditures and avoid potential healthcare inequalities.

Feasibility and Safety of the First-in-Human Chemotherapy-Light Combination of Rituximab, Polatuzumab Vedotin and Glofitamab in Previously Untreated Aggressive B-Cell Lymphoma Patients Above 60 Years of Age Ineligible for a Fully Dosed R-CHOP - R-Pola-Glo/Ikf-t062, a Study of the Austrian Group for Medical Tumor Therapy (AGMT-NHL-16) and the German Lymphoma Alliance (GLA2022-10)

Background. Diffuse large B-cell lymphoma is the most common aggressive B-cell lymphoma mainly affecting elderly patients. The treatment goal is usually cure, however, older and frail patients typically exhibit a growing number of comorbidities that significantly increase treatment-related morbidity and mortality thus limiting the treatment goal due to switching to less effective treatments. Particular in the frail population there is an urgent medical need to establish highly effective therapies suitable for patients with limited functional organ reserve. To this end, we developed the chemotherapy-light combination therapy R-Pola-Glo, which is composed of the anti-CD20 antibody rituximab in combination with the antibody-drug conjugate polatuzumab vedotin (anti-CD79b) and the bispecific antibody glofitamab (CD20×CD3). Here, we report the safety data report of the run-in phase following treatment of the first 10 patients with this first-in-human chemotherapy-light combination. Methods. R-Pola-Glo (EudraCT No.: 2022-003398-51) is a prospective, bi-national (Germany/Austrian), multicenter, one arm, phase II trial designed to estimate the 1-year progression free survival of the chemotherapy-light combination rituximab, polatuzumab vedotin and glofitamab as the primary endpoint. Previously untreated DLBCL patients above 60 years of age, who are not eligible for a fully dosed R-CHOP-like therapy were eligible for enrollment, including patients with a lymphoma-related ECOG 3 and reduced kidney function. The study treatment plan includes a mandatory prephase with prednisolone or dexamethasone followed by 12 treatment cycles of 3 weeks each (Fig. 1). The step-up cycle (cycle 1) is comprised of intravenous (i.v.) application of obinutuzumab 1000 mg on D1, followed by i.v. application of polatuzumab vedotin 1.8 mg/kg on D2 and i.v. application of glofitamab in escalating doses of 2.5 mg on D8 and 10 mg on D15. This is followed by the target dose phase (cycles 2-6). Each of the 5 target dose cycles included rituximab 375 mg/m 2 and polatuzumab 1.8 mg/kg, both administered i.v. on D1 and i.v. glofitamab 30 mg on D2. The consolidation phase (cycles 7-12) comprises 6 cycles of glofitamab 30 mg administered intravenously on D1. As this is the first in human combination of these antibodies, the initial 10 patients were analyzed in a planned safety run-in phase and are reported here. Results. The median age of the first 10 patients was 79 years (range 69-81), with 70% of patients presenting with stage III/IV disease and elevated LDH; ECOG of all patients was <3 (ECOG 0: 4 patients; ECOG 1: 4 patients; ECOG 2: 2 patients). Extranodal involvement was present in 40%. Overall, 70% patients had a high-intermediate/high-risk IPI representing a high-risk population. The median follow-up time presented here from registration to time of data cut July 20, 2023 is 62 days (range 38-122) and longer follow-up will be presented at the time of the meeting. We observed 34 adverse events (AEs) including infections (6/10 patients; grade 1: 2; grade 2: 2; grade 3:2; no grade 4/5), neuropsychiatric issues (prednisone induced psychosis, fatigue, dysgeusia (4/10; all grade 1), CRS (3/10; all grade 1), cardiovascular side effects (3/10; all grade 2), infusion related reactions (2/10; grade 2), anemia (1/10; grade 2), bleeding (1/10; grade 3), and renal toxicity (1/10; grade 3). Notably, so far neither polyneuropathy nor ICANs were reported. Ten of the AEs occurring in 5 patients over all courses administered so far required hospitalization and were therefore classified as serious AEs and included infections (4 in two patients, peribronchitis and urosepsis) CRS (2), renal toxicity (1), deep vein thrombosis (1) and bleeding (1). Neither of the events were life threatening and no death occurred. Conclusion. R-Pola-Glo is a chemotherapy-light treatment regimen that exhibits an excellent safety profile in a vulnerable patient population. Specifically, no life-threating adverse events, ICANS, high grade polyneuropathy or deaths of any cause occurred, and CRS events were limited to grade 1. Acknowledgements. Study sponsor of R-Pola-Glo (EudraCT No.: 2022-003398-51) is the Institut für Klinische Krebsforschung (IKF) Frankfurt, Germany; financial support is provided by F. Hoffmann-La Roche Ltd. TM and RWK contributed equally as first authors; RG and BC contributed equally as senior authors.

Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old.

Background: An increasing proportion of the population of patients with cancer presents at an advanced age, increasing the challenges of successful and well-tolerated treatments. In the older spectrum of the geriatric cancer patients, those older than 80 years old, challenges are even higher because of increasing comorbidities and decreasing organ function reserves. Methods: Studies regarding colorectal cancer presentation, treatment, and prognosis in patients older than 80 years old available in the literature were evaluated and were compiled within a narrative review. Molecular attributes of colorectal cancer in the subset of patients older than 80 years old in published genomic cohorts were also reviewed and were compared with similar attributes in younger patients. Results: Characteristics of colorectal cancer in octogenarians are in many aspects similar to younger patients, but patients older than 80 years old present more often with right colon cancers. Surgical treatment of colorectal cancer in selected patients over 80 years old is feasible and should be pursued. Adjuvant chemotherapy is under-utilized in this population. Although combination chemotherapy is in most cases not advisable, monotherapy with fluoropyrimidine derivatives is feasible and efficacious. Conclusions: Outcomes of colorectal cancer patients over the age of 80 years old may be optimized with a combination of standard treatments adjusted to the individual patient's functional status and organ reserves. Increased support for the older age group during their colorectal cancer treatment modalities would improve oncologic outcomes with decreasing adverse outcomes of therapies.

Research progress of AMP-activated protein kinase and cardiac aging.

The process of aging is marked by a gradual deterioration in the physiological functions and functional reserves of various tissues and organs, leading to an increased susceptibility to diseases and even death. Aging manifests in a tissue- and organ-specific manner, and is characterized by varying rates and direct and indirect interactions among different tissues and organs. Cardiovascular disease (CVD) is the leading cause of death globally, with older adults (aged >70 years) accounting for approximately two-thirds of CVD-related deaths. The prevalence of CVD increases exponentially with an individual's age. Aging is a critical independent risk factor for the development of CVD. AMP-activated protein kinase (AMPK) activation exerts cardioprotective effects in the heart and restores cellular metabolic functions by modulating gene expression and regulating protein levels through its interaction with multiple target proteins. Additionally, AMPK enhances mitochondrial function and cellular energy status by facilitating the utilization of energy substrates. This review focuses on the role of AMPK in the process of cardiac aging and maintaining normal metabolic levels and redox homeostasis in the heart, particularly in the presence of oxidative stress and the invasion of inflammatory factors.

Variability in the energy reserves of swordfish (Xiphias gladius) of the southeastern Pacific Ocean: A temporal and intra-individual perspective

The temporal dynamics of energy reserves are associated with the physiological processes (i.e., reproduction) in marine fishes, in which storage organs play a key role for efficient energy investment. We evaluated the temporal (i.e., seasons) and intra-individual (i.e., organs) dynamics of adult female swordfish (Xiphias gladius) during its feeding period off the Chilean coast in the southeastern Pacific Ocean (SEPO). The biochemical composition (i.e., lipids, proteins, and glucose), energy content and fatty acid profile of the muscle, liver and gonad were evaluated during the austral autumn, winter, and spring. Our results showed principally an intra-individual effect in both the muscle and liver in the autumn and spring. Herein, a trend of higher amounts of lipids and total energy were found in the muscle, while the liver showed greater protein and glucose contents. Consequently, the muscle showed a higher saturated, monounsaturated, and polyunsaturated fatty acid contents than the liver. Although the gonad showed no significant temporal effect in the lipids and proteins contents, an increasing trend of each biochemical constituent, fatty acid group and gonadosomatic index were found from autumn to winter. Consistently, the glucose and total energy content as well Fulton's condition factor were significantly higher in winter. These findings reflect the spatial-temporal physiological dynamic of swordfish based on the storage of energy reserves in different organs during its feeding period. In this way, the products obtained from swordfish could have an added value depending on the season and capture zone, which could benefit the exploitation and regulation measures of this resource under an ecological approach of conservation and sustainability in the SEPO.

EFFICACY OF ONE-STAGE AND TWO-STAGE EXTENSIVE SURGICAL RESECTIONS IN LIVER ECHINOCOCCOSIS

Surgery is the main effective way to treat liver echinococcosis. The problem of choosing a surgical technique for treating liver echinococcosis under impaired liver functional reserve and development of post- hepatectomy liver failure remains relevant.
 The aim of the study is to analyze the effectiveness of extensive surgical resections while treating patients with liver echinococcosis.
 Materials and Methods. The article presents the results of surgical treatment of 85 patients with liver echinococcosis from 2006 to 2022. All patient underwent extensive liver resection: 61 patients (71.8 %) were operated on according to one-stage extensive surgical resection protocol; 24 patients (28.2 %) were operated on according to two-stage extensive surgical resection protocol. 
 Results. The applied surgical step-by-step methods for prevention of post-resection liver failure were effective in 24 patients (100 %), Group 2. Three deaths (3.5 %) were recorded in the total mass of the trial patients. Progressive post-resection liver failure was the cause of deaths. After the introduction of a new examination protocol into clinical practice, the authors observed no deaths after extensive surgery resections because of the development of post-resection liver failure. Moreover, no relapses were observed after extensive surgery resections.
 Conclusion. Extensive surgical resections in patients with liver echinococcosis are effective and sufficiently safe when performed in specialized hepatological centers using an in-depth preoperative protocol. Two-stage surgical resections can be recommended in case of initial significant deficit in the volume of the future liver remnant and functional organ reserves.

Cardiovascular Challenges in Geriatric Anesthesia after Induction of GA

Background: Advanced age is associated with the physiologic process of aging and decreased functional reserve of organs. These patients are often frail and have several comorbid conditions. The physiological changes in the aging cardiovascular system affect the arterial and venous vasculature, myocardium, and autonomic nervous system, making the older person more prone to cardiovascular instability. In addition to the physiological changes, the cardiovascular status of the older person tends to be compromised by associated pathological conditions that are more common with increasing age. This study aimed to analyze cardiovascular challenges in geriatric anesthesia after induction of GA. Material Methods: This prospective study was conducted at the Department of Anesthesia, Combined Military Hospital (CMH), Dhaka, Bangladesh. The study was carried out from April 2016 to September 2016. A total of 60 subjects were selected as per inclusion criteria. Subjects were divided into 2 groups to compare the parameters among the non-elderly and elderly respondents, Group A (age ≤60 years) and Group B (age >60 years). Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-17) software. Results: In this study, 30 (50%) patients belonged to group A with ≤60 years of age and 30 (50%) patients belonged to group B with >60 years of age. Among the respondents 20 were male and 10 were female in group A, and 23 were male and 7 were female in group B. Regarding pre-existing cardiovascular co-morbid conditions, most patients (5, 16.67%) suffered from hypertension, followed by atherosclerosis (2, 6.67%) and 1 patient (3.33%) had cardiac arrhythmias in group A. Most of the patients (7, 23.33%) suffered from hypertension followed by congestive heart failure (6, 20.0%), 5 patients (16.67%) had atherosclerosis, 5 patients (16.67%) had coronary artery disease, 4 patients (13.33%) went through cardiac arrhythmias and the rest 3 (10.0%) patients suffered from aortic stenosis. The mean difference of SBP between the groups 20 minutes before and after induction of general anesthesia showed a statistically significant difference at 5,10,15 and 20th-minute follow-ups. (P=<0.05). The mean difference of DBP between the groups 20 minutes before and after giving general anesthesia showed a statistically significant difference at 5, 10, 15, and 20th-minute follow-up. (P=<0.05) The mean difference in heart rate between the groups 20 minutes before and after induction of general anesthesia showed statistically significant differences at 10, 15, and 20th minute follow up. (P=<0.05). Conclusion: T This study revealed that elderly patients suffered the most from hypertension followed by heart failure and coronary artery diseases. These pre-existing cardiovascular diseases along with hemodynamic instability during the surgical procedure after general anesthesia pointed towards a great challenge. Thus, care of the elderly patient requires thorough preoperative assessment and planning regarding both anesthetic and surgical techniques and the involvement of a multidisciplinary clinical team knowledgeable about and interested in the management of the elderly surgical patient.

POTENTIAL WEED INFESTATION OF SOIL IN DIFFERENT TECHNOLOGIES OF CROP CULTIVATION

Исследования проводили с целью определения эффективности разных технологий возделывания культур в управлении потенциальной засорённостью пахотного слоя дерново-подзолистой глееватой среднесуглинистой почвы в условиях Ярославского региона. Работу выполняли в 2021–2022 гг. Исследования проводили на трёх системах основной обработки почвы – отвальной, поверхностно-отвальной и поверхностной, по четырём системам удобрений – без удобрений, солома 3 т/га, солома 3 т/га + NPK, NPK, а также по двум системам защиты растений от сорняков – без гербицидов и с гербицидами. Для расчётов использовали усреднённые по системам основной обработки почвы, удобрений и защиты растений данные. Исходное содержание семян сорных растений в момент закладки опыта (1995 г.) составляло 217,8 млн шт./га. К 2022 году произошло увеличение количества генеративных органов размножения сорняков приблизительно в 2,5 раза (на О1 – 549,9 млн шт./га; О3 – 539,9 млн шт./га). В настоящее время на опытном поле в структуре сорного компонента агрофитоценоза преобладают малолетние виды, за счёт уменьшения количества многолетних видов, которые преобладали на момент закладки опыта. За период 2001–2022 гг. наблюдалось уменьшение длины вегетативных органов размножения сорных растений в 24,0 раза на отвальной системе обработки (в 2001 г. – 410,2 см/м2, в 2022 г. – 17,1 см/м2) и 15,7 раза – на поверхностно-отвальной системе обработки (в 2001 г. – 431,1 см/м2, в 2022 г. – 27,5 см/м2). Поверхностно-отвальная обработка почвы способствует очищению пахотного горизонта от органов генеративного и вегетативного размножения на уровне отвальной. Органические и минеральные удобрения оказывали неоднозначное влияние на потенциальную засорённость почвы. Воздействие гербицидных обработок на банк семян и запасы вегетативных органов размножения сорных растений в почве не выявлено. The researches were conducted in order to determine the effectiveness of different crop cultivation technologies in managing the potential weed infestation of the arable layer of soddy podzolic gleyic middle loamy soil in the conditions of the Yaroslavl region. The work was carried out in 2021–2022. The studies were carried out on three systems of the main tillage – moldboard, surface-moldboard and surface on four fertilizer systems – without fertilizers, straw 3 t/ha, straw 3 t/ha + NPK, NPK, as well as on two systems of plant protection against weeds – without herbicides and with herbicides. Data averaged over the systems of basic tillage, fertilizers, and plant protection were used for calculations. The initial content of weed seeds at the time of the trial establishment (1995) was 217.8 million pieces/ha. By 2022 there was an increase in the number of generative reproductive organs of weeds by approximately 2.5 times (by O1– 549.9 million pieces/ha; O3 – 539.9 million pieces/ha). At present young species prevail in the structure of the weed component of agrophytocenosis on the experimental field, due to a decrease in the number of perennial species that prevailed at the time of trial establishment. During the period 2001–2022 there was a decrease in the length of the vegetative reproductive organs of weeds by 24.0 times on the moldboard tillage system (in 2001 – 410.2 cm/m2, in 2022 – 17.1 cm/m2) and 15.7 times on the surface-moldboard tillage system (in 2001 – 431.1 cm/m2, in 2022 – 27.5 cm/m2). Surface-moldboard tillage contributes to the purification of the plough-layer from the organs of generative and vegetative reproduction at the level of the moldboard one. Organic and mineral fertilizers had an ambiguous effect on the potential weed infestation of the soil. The impact of herbicidal treatments on the seed bank and the reserves of vegetative reproductive organs of weed plants in the soil was not revealed.

Penatalaksanaan Anestesi Neonatus yang Menjalani Pembedahan Koreksi Giant Unruptured Occipital Meningoencephalocele

Meningoencephalocele is a rare congenital abnormality where duramater and cranium failed to close completely, leaving part of intracranial tissues outside the cranium wrapped in a sac. Neonate’s airway management, pose many challenges due to immaturity of airway anatomy, limited respiratory organ reserve and extreme head-to-body ratios. Occipital meningoencephalocele will also complicate the intubation and airway control during anesthesia and surgery. A nine days old male patient with an occipital lump measuring 17x12x8 cm underwent meningoencephalocele resection. Induction of anesthesia was performed by sevoflurane inhalation, rocuronium to facilitate videolaryngoscopy and intubation in supine position, supported by doughnut-shape pads which fits the size of the cele. Videolaryngoscope was chosen because it provides optimal visualization without hyperextension and over manipulation than conventional laryngoscope, therefore intubation can be done in supine position. Anesthesia and surgery duration was 2 hours and 15 minutes. The patient was treated in the neonatal intensive care unit after surgery, extubated 24 hours later, and discharged home 10 days after surgery. The greatest challenge in anesthesia management for occipital meningoencephalocele resection is securing the airway while ensuring the sac is not ruptured during airway manipulation and positional changes during anesthesia and surgery.

Evaluation of the Carry-Over Effect of the “Crop-Forcing” Technique and Water Deficit in Grapevine ‘Tempranillo’

“Crop-forcing” is an effective technique to delay grape maturation to a period of lower temperatures, and in this way, improve grape quality. Because of the aggressiveness of this technique (removal of leaves and fruit to reinitiate a second vegetative cycle), it may affect the level of reserves and could provoke progressive vine exhaustion. The aim of the present work is to evaluate the short- and medium-term evolution of carbohydrate reserves in different plant organs and the effect of “crop-forcing” under different irrigation regimes on seasonal biomass production and its distribution. The study was carried out over a four years period (2017–2020), applying “crop-forcing” in three consecutive years (2017–2019) to the same vines on two different dates and using two irrigation strategies. The application of “crop-forcing” did not decrease root reserve levels in either the year of application or the following year, but did modify starch and soluble sugar levels in shoots and leaves in some moments of the vegetative cycle during the years of “crop-forcing” application. Total biomass production in terms of grams per vine was lower in the “crop-forcing” treatments and continued to be so when “crop-forcing” was no longer applied. The percentage of biomass in vegetative organs increased at the expense of productive organs.

Soil organic carbon and nitrogen storage estimated with the root-zone enrichment method under conventional and conservation land management across North Carolina

Agriculture is a globally dominating land use, so efforts to restore soil organic carbon (C) and nitrogen (N) lost through historical degradation could have enormous benefits to production and the environment, particularly by storing an organic reserve of nutrients in soil and avoiding the return of a small portion of biologically cycling C to the atmosphere. Estimates of soil organic C and N storage from conservation agricultural management are still limited when considered in proportion to the large diversity of environmental and edaphic conditions. A study was undertaken to determine the total, baseline, and root-zone enrichment stocks of soil organic C and N as affected by land use on 25 research stations distributed throughout North Carolina. Root-zone enrichment of organic matter is that portion influenced by contemporary management, and baseline is that portion dominated by pedogenesis. These fractions were compared with more traditional estimation procedures. Soil organic C and N were strongly negatively associated with sand concentration. Although physiographic region influenced overall soil C and N contents, variations in soil type and research station management within a region were equally influential. Soil organic C and N stocks were strongly affected by land use, which did not interact with the soil textural effect. Across the 25 research station locations, root-zone enrichment of soil organic C followed the order (<i>p</i> &lt; 0.01) conventional-till cropland (11.1 Mg C ha⁻¹) &lt; no-till cropland (21.5 Mg C ha⁻¹) &lt; grassland (29.6 Mg C ha⁻¹) &lt; woodland (38.6 Mg C ha⁻¹). Root-zone enrichment of total soil N followed a similar order, except grassland and woodland effects were reversed. Root-zone enrichment provided an integrated soil-profile assessment and a more targeted response of soil organic C and N change than did more traditional paired land use approaches, primarily due to separation of a variable pedogenic influence among sites. These point-in-time results gave a clear indication that conservation agricultural management approaches will foster surface soil organic C and N restoration across a diversity of soil types in the southeastern United States.

Root systems reserve under humid conditions of floodplain meadows of the Ob River in the subzone of the southern taiga

The results of the study of the underground phytomass of the floodplain meadow communities in the Middle Ob obtained from three permanent sample plots in the area of the Kaibasovo research station of Tomsk University (Kri-vosheinsky district of the Tomsk region) are presented. The functioning and productivity of grassland ecosystems should be carefully studied, especially in the light of ongoing climate change, as they are actively involved in the carbon cycle. However, the belowground phytomass is given much less attention in the literature than the aboveground part, despite the fact that they are equally important for the study of the cycle. The study of vegetation cover in order to analyze the biological cycle of flood-plain ecosystems, the production and destruction of plant matter in this area was practically not carried out. The goal was to assess the structure and stock of root phytomass in the meadows of the Ob floodplain. In the course of the work, the hydro-climatic conditions of the growing season of the current and previous years were characterized in order to assess their impact on root development. The reserves of underground organs in the 0-20 cm soil layer were determined, the limits of fluctuations of the total reserves of roots in the 0-20 cm layer between the sampling periods in June and August were established.&#x0D; Key words. Belowground biomass, flood, floodplain meadows, productivity, roots, Western Siberia.

Abstract 11503: Obesity-Related Biomarkers Associations With HFpEF and Exercise Intolerance

Background: Obesity and adiposity are associated with risk of heart failure with preserved ejection fraction (HFpEF), yet the role of adipokines and other obesity related pathways as contributors to HFpEF remains unclear. Objectives: We sought to examine the association of obesity and obesity related biomarkers including adipokines, inflammatory markers, and insulin resistance with HFpEF and specific cardiac and extracardiac organ reserve measures among patients who underwent CPET. Methods: We studied 509 consecutive patients with LVEF ≥ 50% and NYHA class II - III symptoms, who underwent clinically indicated CPET with invasive hemodynamic monitoring. Fasting blood samples at the time of CPET were used to assay obesity-related biomarkers, including leptin, adiponectin, resistin, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), glucose and insulin to estimate insulin resistance (HOMA-IR). We examined the association of biomarkers with physiologic HFpEF and exercise traits using multivariable regression models. Results: Among 509 patients (mean age 55 years, 61% women, 38% obese), 223 met hemodynamic criteria for HFpEF. Obesity was associated with more than 2-fold higher odds of HFpEF (OR 2.08, 95% CI 1.38-3.14). We found that higher levels of leptin, hsCRP and HOMA-IR were associated with greater odds of HFpEF (P ≤ 0.01, Figure 1). By contrast, resistin and adiponectin were not associated with HFpEF (P&gt;0.05). In secondary analyses, we observed associations of obesity related biomarkers with measures of impaired exercise capacity, such as lower peak VO 2 (P&lt;0.05), higher blood pressure response (leptin, HOMA-IR), and impaired heart rate response (hsCRP, HOMA-IR, IL-6, resistin). Conclusions: Obesity related biomarkers were associated with HFpEF and impaired exercise capacity. These findings highlight potential pathways underlying the association of obesity and cardiometabolic disease with development of HFpEF.

Expert consensus on liver transplantation perioperative evaluation and rehabilitation for acute-on-chronic liver failure

Acute-on-chronic liver failure (ACLF) can be cured by liver transplantation; however, perioperative complications still affect posttransplant outcomes. In recent years, early rehabilitation for critical illness, liver disease, and surgery have significantly improved organ reserve function, surgery tolerance, and postoperative quality of life. They could also be applied in the perioperative period of liver transplantation in patients with ACLF. Therefore, the Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association, the Organ Transplant Committee of China Association Rehabilitation Medicine, and the Guangdong Medical Doctor Association of Organ Transplantation conducted a comprehensive review of rehabilitation in end-stage liver disease, critical illness and surgical patients by summarizing current evidence and best clinical practices and proposed a practice consensus on evaluation of cardiopulmonary and physical function, rehabilitation or physiotherapies, as well as the safety concerns in perioperative liver transplant recipients. It will be a valuable resource for hepatologists, transplant surgeons, and intensivists as they care for ACLF patients during transplantation.