Physiological Tools Research Articles

Failure of an effective physiologic threshold compliance tool to demonstrate benefit in a clinical trial of traumatic brain injury patients

BackgroundBetter physiologic threshold compliance holds promise for improving outcomes in neurocritical care patients. MethodsOur group developed a threshold compliance tool. This software computes and displays the proportion of values out of range in real time. We captured intracranial pressure (ICP) measures in our patients before and after implementation of this technology. Ten months after the threshold compliance tool was introduced we initiated a randomized controlled trial involving acute traumatic brain injury (TBI) patients to assess whether the tool was effective at reducing out-of-range ICP values. ResultsA total of 54 patients with ICP monitors were included in our analysis, 42 of whom sustained a TBI. Implementation of the threshold compliance tool was associated with an 85.3% reduction in ICP values exceeding 22 mmHg in neurocritical care patients (p = 0.004) and a 76.8% reduction in patients with TBI (p = 0.043). Out-of-range values in an area-under-the-curve analysis were reduced by 78.8% in all patients (p = 0.009) and in TBI patients by 77.9% (p = 0.051). Out-of-range values were not further reduced during our randomized controlled trial examining the threshold compliance tool, and a difference between treatment groups was not suggested. ConclusionsImplementation of a threshold compliance tool was associated with a marked and significant reduction in out-of-range ICP values. Benefit was, however, not evident in a randomized controlled trial. Our analysis provides a unique perspective on our failure to detect an apparent true difference and may provide insights into other neurotrauma trial failures.

Marker-Less Motion Capture of Insect Locomotion With Deep Neural Networks Pre-trained on Synthetic Videos.

Motion capture of unrestrained moving animals is a major analytic tool in neuroethology and behavioral physiology. At present, several motion capture methodologies have been developed, all of which have particular limitations regarding experimental application. Whereas marker-based motion capture systems are very robust and easily adjusted to suit different setups, tracked species, or body parts, they cannot be applied in experimental situations where markers obstruct the natural behavior (e.g., when tracking delicate, elastic, and/or sensitive body structures). On the other hand, marker-less motion capture systems typically require setup- and animal-specific adjustments, for example by means of tailored image processing, decision heuristics, and/or machine learning of specific sample data. Among the latter, deep-learning approaches have become very popular because of their applicability to virtually any sample of video data. Nevertheless, concise evaluation of their training requirements has rarely been done, particularly with regard to the transfer of trained networks from one application to another. To address this issue, the present study uses insect locomotion as a showcase example for systematic evaluation of variation and augmentation of the training data. For that, we use artificially generated video sequences with known combinations of observed, real animal postures and randomized body position, orientation, and size. Moreover, we evaluate the generalization ability of networks that have been pre-trained on synthetic videos to video recordings of real walking insects, and estimate the benefit in terms of reduced requirement for manual annotation. We show that tracking performance is affected only little by scaling factors ranging from 0.5 to 1.5. As expected from convolutional networks, the translation of the animal has no effect. On the other hand, we show that sufficient variation of rotation in the training data is essential for performance, and make concise suggestions about how much variation is required. Our results on transfer from synthetic to real videos show that pre-training reduces the amount of necessary manual annotation by about 50%.

EVALUATING USER EXPERIENCE WITH PHYSIOLOGICAL MONITORING: A SYSTEMATIC LITERATURE REVIEW

ABSTRACT: User Experience (UX) is a key factor and an opportunity for improvement in digital interfaces. Traditionally, it has been evaluated retrospectively through surveys and interviews. However, this is not always the optimal approach, as it does not measure UX at the moment of human-machine interaction and is therefore prone to human error due to inaccurate recall. Thus, physiological monitoring is emerging as a promising technique to assess UX during interactions. This paper aims to identify UX case studies carried out with physiological monitoring by means of a Systematic Literature Review (SLR). The results of the 33 UX case studies reviewed show that interest in incorporating physiological technologies in UX studies is growing and expanding into different fields. The electroencephalogram (EEG) was found to be the most used physiological tool, and the most used set of tools was the Galvanic Skin Response (GSR) with the electrocardiogram (ECG). In addition, the average number of participants was obtained depending on the physiological tool used. The research opportunities identified are: 1) the combination of different methods and tools in the assessment of UX, and 2), the validation of a sample size for UX tests performed with physiological monitoring Keywords: User Experience (UX), evaluation, Systematic Literature Review (SLR), physiological monitorization

The Physiological and Biochemical Effects on Napier Grass Plants Following Napier Grass Stunt Phytoplasma Infection

Napier grass stunt (NGS) phytoplasma, a phloem-limited bacterium, infects Napier grass leading to severe yield losses in East Africa. The infected plants are strongly inhibited in growth and biomass production. In this study, phytoplasma-induced morphological changes of the vascular system and physiological changes were analyzed and compared with uninfected plants. The study showed that the phytoplasmas are more abundant in source leaves and range from 103 bacteria/μg total DNA in infected roots to 106 in mature Napier grass leaves. Using microscopical, biochemical, and physiological tools, we demonstrated that the ultrastructure of the phloem and sieve elements is severely altered in the infected plants, which results in the reduction of both the mass flow and the translocation of photoassimilates in the infected leaves. The reduced transport rate inhibits the photochemistry of photosystem II in the infected plants, which is accompanied by loss of chloroplastic pigments in response to the phytoplasma infection stress eventually resulting in yellowing of diseased plants. The phytoplasma infection stress also causes imbalances in the levels of defense-related antioxidants, glutathione, ascorbic acid, reactive oxygen species (ROS), and-in particular-hydrogen peroxide. This study shows that the infection of NGS phytoplasma in the phloem of Napier grass has an impact on the primary metabolism and activates a ROS-dependent defense response.

Are Sarcopenia and Cognitive Dysfunction Comorbid after Stroke in the Context of Brain–Muscle Crosstalk?

Stroke is a leading cause of death and disability and is responsible for a significant economic burden. Sarcopenia and cognitive dysfunction are common consequences of stroke, but there is less awareness of the concurrency of these conditions. In addition, few reviews are available to guide clinicians and researchers on how to approach sarcopenia and cognitive dysfunction as comorbidities after stroke, including how to assess and manage them and implement interventions to improve health outcomes. This review synthesises current knowledge about the relationship between post-stroke sarcopenia and cognitive dysfunction, including the physiological pathways, assessment tools, and interventions involved.

Myosteatosis predicts higher complications and reduced overall survival following radical oesophageal and gastric cancer surgery

IntroductionLow muscle attenuation, as governed by increased intramuscular fat infiltration (myosteatosis), may associate with adverse surgical outcomes. We aimed to determine whether myosteatosis is associated with an increased risk of postoperative complications and reduced long-term survival after oesophago-gastric (OG) cancer surgery. MethodsPatients who underwent radical OG cancer surgery with preoperative abdominal computed tomography (CT) imaging were included. Myosteatosis was evaluated using previously defined cut-points for low skeletal muscle attenuation measured by CT. Oncological, surgical, complications, and outcome data were obtained from a prospective database. ResultsOf 108 patients, 56% (n = 61) had myosteatosis. Patients with myosteatosis were older (69.1 ± 9.1 vs. 62.8 ± 9.8 years, p = 0.001) and had a similar body mass index (BMI) (23.4 ± 5.3 vs. 25.9 ± 6.7 kg/m2, p = 0.766) compared to patients with normal muscle attenuation. Patients with myosteatosis had a higher rate of anastomotic leaks (15% vs. 2%, p = 0.041). On multivariate analysis, myosteatosis was an independent predictor of overall (OR 3.03, 95% CI 1.31–6.99, p = 0.009) and severe complications (OR 4.33, 95% CI 1.26–14.9, p = 0.020). Patients with myosteatosis had reduced 5 year overall (54.1% vs. 83%, p = 0.004) and disease-free (55.2% vs. 87.2%, p = 0.007) survival. ConclusionMyosteatosis is associated with a significantly increased risk of overall and severe complications as well as substantially reduced long-term survival. Assessment of muscle attenuation provides analysis beyond standard anthropometrics and may form part of preoperative physiological staging tools used to improve surgical outcomes.

Functional Assessment of Coronary Artery Lesions-Old and New Kids on the Block.

Angiography is inaccurate in assessing functional significance of coronary lesions, and often stenoses deemed severe on angiographic assessment do not restrict coronary blood flow at rest or with maximal dilatation. Angiography-guided revascularization has not shown improvement in hard clinical outcomes in stable ischemic heart disease (SIHD). Most current guidelines for SIHD recommend invasive functional assessment of lesions to guide revascularization if prior evidence of ischemia is not available. There has been several recent advances and development of novel methods in this arena. Various contemporary clinical trials have been undertaken for validation of these indices. Here we review the physiological basis, tools, techniques, and evidence base for various invasive (resting as well as hyperemic) and noninvasive methods for functional assessment of coronary lesions. Left main stenosis, bifurcation lesions, serial stenosis, and acute coronary syndrome each causes unique disequilibrium that may affect measurements and require special considerations for accurate functional assessment.

Immunocompetent Human 3D Organ-Specific Hormone-Responding Vaginal Mucosa Model of HIV-1 Infection

The lack of appropriate experimental models often limits our ability to investigate the establishment of infections in specific tissues. To reproduce the structural and spatial organization of vaginal mucosae to study human immunodeficiency virus type-1 (HIV-1) infection, we used the self-assembly technique to bioengineer tridimensional vaginal mucosae using human cells extracted from HIV-1-negative healthy pre- and postmenopausal donors. We produced a stroma, free of exogenous material, that can be adapted to generate near-to-native vaginal tissue with the best complexity obtained with seeded epithelial cells on the organ-specific stroma. The autologous engineered tissues had mechanical properties close to native mucosa and shared similar glycogen production, which declined in reconstructed tissues of the postmenopausal donor. The in vitro-engineered tissues were also rendered immune competent by adding human monocyte-derived macrophages (MDMs) on the epithelium or in the stroma layers. The model was infected with HIV-1, and viral replication and transcytosis were observed when immunocompetent reconstructed vaginal mucosa tissue has incorporated MDMs into the stroma and infected with free HIV-1 green fluorescent protein (GFP) viral particles. These data illustrate a natural permissiveness of immunocompetent untransformed human vaginal mucosae to HIV-1 infection. This model offers a physiological tool to explore viral load, HIV-1 transmission in an environment that may contribute to the virus propagation, and new antiviral treatments in vitro. Impact statement This study introduces an innovative immunocompetent three-dimensional human organ-specific vaginal mucosa free of exogenous material for in vitro modeling of human immunodeficiency virus type-1 (HIV-1) infection. The proposed model is histologically close to native tissue, especially by presenting glycogen accumulation in the epithelium's superficial cells, responsive to estrogen, and able to sustain a monocyte-derived macrophage population infected or not by HIV-1 during ∼2 months.

The Effect of Cold Application on Unconscious Patients’ Physiological Parameters during Arterial Puncture

Background: Arterial puncture is a common procedure performed for unconscious patients in intensive care units to assess their respiratory conditions. It is usually associated with pain resulting in significant physiological changes that can affect patients’ recovery and progression. Pain killers are the first choice for controlling pain in intensive care units but medications themselves have many adverse physiological effects on the body. Non-pharmacological pain management strategies have been advocated to control pain and avoid the side effects of medications. Aim: This study aimed to investigate the effect of the cold application on unconscious patients’ physiological parameters during arterial puncture. Method: A quasi-experimental research design was utilized to conduct this study among 86 unconscious patients in the surgical intensive care unit of the Critical Care and Convalescence Hospital at Mansoura University in Egypt. One tool was used to collect data for this study; unconscious patients’ physiological parameters assessment tool. Results: A statistically significant improvement was noted in the participants’ heart rate, respiratory rate, and oxygen saturation post-implementation of the cold application (p ≤0.05). However, there were no significant changes in the participants’ systolic or diastolic blood pressure after the cold application. Conclusion and Recommendations: Cold application is an effective method for improving unconscious patients’ physiological parameters during arterial puncture. Hence, critical care nurses can include the cold application in the routine nursing care of arterial puncture for unconscious patients in intensive care units.

Invasive Coronary Physiology After StentImplantation: Another Step Toward Precision Medicine.

Intracoronary physiology is routinely used in setting the indication for percutaneous coronary intervention (PCI) but seldom in assessing procedural results. This attitude is increasingly challenged by accumulated evidence demonstrating the value of post-PCI functional assessment in predicting long-term patient outcomes. Besides fractional flow reserve, a number of new indexes recently incorporated to clinical practice, including nonhyperemic pressure and functional angiographic indexes, provide new opportunities for the physiological assessment of PCI results. Largely, the benefit of these tools is derived from longitudinal analysis of the treated vessel, which allows precise identification of the vessel segment accounting for a suboptimal functional result and enabling operators to perform accurate PCI optimization. In this document the authors review available evidence supporting why physiological assessment should be extended to immediate post-PCI with the aim of improving patient outcomes. A step-by-step guide on how available physiological tools can be used for such purpose is provided.

Predicting synchronous firing of large neural populations from sequential recordings.

A major goal in neuroscience is to understand how populations of neurons code for stimuli or actions. While the number of neurons that can be recorded simultaneously is increasing at a fast pace, in most cases these recordings cannot access a complete population: some neurons that carry relevant information remain unrecorded. In particular, it is hard to simultaneously record all the neurons of the same type in a given area. Recent progress have made possible to profile each recorded neuron in a given area thanks to genetic and physiological tools, and to pool together recordings from neurons of the same type across different experimental sessions. However, it is unclear how to infer the activity of a full population of neurons of the same type from these sequential recordings. Neural networks exhibit collective behaviour, e.g. noise correlations and synchronous activity, that are not directly captured by a conditionally-independent model that would just put together the spike trains from sequential recordings. Here we show that we can infer the activity of a full population of retina ganglion cells from sequential recordings, using a novel method based on copula distributions and maximum entropy modeling. From just the spiking response of each ganglion cell to a repeated stimulus, and a few pairwise recordings, we could predict the noise correlations using copulas, and then the full activity of a large population of ganglion cells of the same type using maximum entropy modeling. Remarkably, we could generalize to predict the population responses to different stimuli with similar light conditions and even to different experiments. We could therefore use our method to construct a very large population merging cells’ responses from different experiments. We predicted that synchronous activity in ganglion cell populations saturates only for patches larger than 1.5mm in radius, beyond what is today experimentally accessible.

Introduction to early clinical exposure as learning tool in physiology

Objectives: Early years of undergraduate medical education (especially the first 2 years) are critical for the academic success of medical students. In the traditional curricula of medical education, students learn theoretical knowledge without contact with the patient in a clinical context. Early clinical exposure (ECE) has been suggested to help medical fresh students overcome their stresses and motivate them to develop better insight and awareness to the medical profession. Materials and Methods: We devised a teaching-learning ECE intervention study module in endocrine physiology, which comprised traditional didactic lectures, supplemented with an ECE program in a hospital setting, a hospital visit to see patients. The study group was given the intervention of ECE, through the ECE designed module. The outcomes and effectiveness of this intervention were assessed by a multiple-choice pretest/post-test model of learning knowledge gain and effectiveness of the educational intervention by calculating learning matrices. Students feedback toward ECE was assessed by a 5 point Likert-scale responses and their views through a validated questionnaire. Results: Mean pre-test and post-test scores of students learning improved significantly from 9.6 ± 2.58 (48%) to 13.2 ± 2.53 (66%), (P = 0.043) in the study group. The learning gain (gi) for individual students was tabulated and average single student normalised gain Gi(avg) was calculated. For the study group, it was 29 ± 33% and control group 7 ± 14%. To assess the intervention effectiveness class average normalised gain G was found to be 34%, in the study group and 13% in the control group (P < 0.05). The study group students (96.4%) gave an overall rating of good/excellent to ECE on a five-point Likert scale. The mean score was (4.3 ± 1.4) showing that the overall rating of ECE was good to excellent. Conclusion: The pre-test/post-test model with a calculation of various measures of learning gain provides an objective and informative means to document learner performance and demonstrate the effectiveness of the educational intervention. The students’ satisfaction and their positive attitude toward ECE suggested that this interventional study improves the quality of basic science courses and adds substantial relevance to clinical application.

Assessment of blood pressure measurement technique by objective structured practical examination in the 1st year MBBS students

Background: This topic has been chosen for educational research project, because as per newly introduced competency-based medical education, we have to introduce the new assessment method for practical examination that is objective structured practical examination (OSPE) in our institution. Hence, we will introduce it and we will assess the feasibility of OSPE. Aims and Objectives: This study aims to know the feasibility of OSPE for blood pressure measurement as an assessment tool in physiology and to obtain students and teachers feedback on OSPE to know its strengths and weaknesses. Materials and Methods: This is an observational study conducted in the month of February 2020 in the Department of Physiology at Shri Vasantrao Naik Government Medical College, Yavatmal. We assessed the 1st year medical students by OSPE for blood pressure measurement by palpatory and auscultatory method. After the OSPE, the perception of students and teachers regarding OSPE was taken in percentage form on 5-point Likert’s scale. Results: One hundred and sixty-one 1st year medical students participated in the study as the participation was voluntary. We observed the performance of the students for blood pressure measurement by OSPE for palpatory and auscultatory method and feedback for the same was taken from them on 5-point Likert’s scale. The majority of the students and faculty (90–95%) found that OSPE is a better method for practical assessment as compared to traditional practical methods. Conclusion: We conclude that OSPE for blood pressure measurement is a very useful method of assessment of practical skills in undergraduate training, as it gives feedback to the students and to the teachers and provides integration in teaching and evaluation.

Reactive scope model and emergency life history stage provide useful tools for evaluating the stress responses of native Australian lizards living in disturbed landscapes.

Glucocorticoids (GCs) are used as biomarkers of physiological stress response in reptiles. Fundamental stress physiology tools including the emergency life history stage (ELHS) and the reactive scope model (RSM) can be useful to determine how individual variation of stress responses shape population ecology. In this perspective, we applied the RSM and ELHS into the context of two urban-dwelling small native Australian reptile species to compare the stress-response patterns in short- and long-breeding lizards. Firstly, by drawing inferences from the ELHS, we presented hypothetical scenarios using sample GC data for a short-breeding species (e.g. common blue-tongue lizard). We showed that activation of the physiological stress response would be non-adaptive due to the consequences of stress on reproduction. Therefore, blue-tongue lizards may become exposed to acute and chronic environmental stressors (e.g. human disturbance and habitat clearance) during the breeding season as they prefer not to activate their hypothalamo-pituitary interrenal (HPI) axis in support of their short-breeding season. On the contrary, long-breeding lizards (e.g. bearded dragons), which have multiple breeding opportunities and are accustomed to living around humans and altered urban environments, tended to operate above the critical adaptive value of the ELHS during their breeding period. This suggests that any future changes to the dynamics of habitat availability and breeding opportunities may favour the dragon differently over the blue-tongue lizard. To further capture the dynamics of stress responses along spatial and temporal scales, we suggested that researchers should collect field data (e.g. blood plasma or faecal GCs) and then use the ELHS and RSM to understand how the environment is shaping the animal's stress physiology. The application of field stress monitoring and data visualization using the ELHS and RSM could guide environmental monitoring and conservation programs of native wildlife species.

Neuromarketing research in the last five years: a bibliometric analysis

Neuromarketing (NM) is an application of neuroimaging and physiological tools to record the neural correlates of consumers’ behaviour (e.g., decision-making, emotion, attention, and memory) toward ...

Researcher perspectives on challenges and opportunities in conservation physiology revealed from an online survey.

Conservation physiology represents a recently emerging arm of conservation science that applies physiological tools and techniques to understand and solve conservation issues. While a multi-disciplinary toolbox can only help to address the global biodiversity crisis, any field can face challenges while becoming established, particularly highly applied disciplines that require multi-stakeholder involvement. Gaining first-hand knowledge of the challenges that conservation physiologists are facing can help characterize the current state of the field and build a better foundation for determining how it can grow. Through an online survey of 468 scientists working at the intersection of physiology and conservation, we aimed to identify characteristics of those engaging in conservation physiology research (e.g. demographics, primary taxa of study), gauge conservation physiology's role in contributing to on-the-ground conservation action, identify the perceived barriers to achieving success and determine how difficult any identified barriers are to overcome. Despite all participants having experience combining physiology and conservation, only one-third considered themselves to be 'conservation physiologists'. Moreover, there was a general perception that conservation physiology does not yet regularly lead to tangible conservation success. Respondents identified the recent conceptualization of the field and the broader issue of adequately translating science into management action as the primary reasons for these deficits. Other significant barriers that respondents have faced when integrating physiology and conservation science included a lack of funding, logistical constraints (e.g. sample sizes, obtaining permits) and a lack of physiological baseline data (i.e. reference ranges of a physiological metric's 'normal' or pre-environmental change levels). We identified 12 actions based on suggestions of survey participants that we anticipate will help deconstruct the barriers and continue to develop a narrative of physiology that is relevant to conservation science, policy and practice.

Geographical Distribution and Selection of European Honey Bees Resistant to Varroa destructor.

Simple SummaryThe parasitic mite Varroa destructor is a major challenge to honey bee populations worldwide. Some honey bee populations are resistant to the mite, but most of the commercially used stocks are not and rely on chemical treatment. In this article, we describe known varroa-resistant populations and the mechanisms which have been identified as responsible for survival of colonies without beekeeper intervention to control the mite. We review traits that have potential in breeding programs, discuss the role played by V. destructor as a vector for virus infections, and the changes in mite and virus virulence which could play a role in colony resistance. We also describe results of surveys carried out (mostly within Europe) on the presence of naturally surviving honey bee populations, on the commercial availability of mite resistant stock and on the traits considered in breeding programs. We found that there is a growing interest and awareness among beekeepers, but that there are very few commercially available resistant lines; some from breeding programs and some from naturally selected populations. The most commonly considered traits for assessing varroa resistance are linked to mite reproduction and specific hygienic behavior of the bees. Developing resistance to the varroa mite in honey bees is a major goal for apicultural science and practice, the development of selection strategies and the availability of resistant stock. Here we present an extended literature review and survey of resistant populations and selection programs in the EU and elsewhere, including expert interviews. We illustrate the practical experiences of scientists, beekeepers, and breeders in search of resistant bees. We describe numerous resistant populations surviving without acaricide treatments, most of which developed under natural infestation pressure. Their common characteristics: reduced brood development; limited mite population growth; and low mite reproduction, may cause conflict with the interests of commercial beekeeping. Since environmental factors affect varroa mite resistance, particular honey bee strains must be evaluated under different local conditions and colony management. The resistance traits of grooming, hygienic behavior and mite reproduction, together with simple testing of mite population development and colony survival, are significant in recent selection programs. Advanced breeding techniques and genetic and physiological selection tools will be essential in the future. Despite huge demand, there is no well-established market for resistant stock in Europe. Moreover, reliable experience or experimental evidence regarding the resistance of stocks under different environmental and management conditions is still lacking.

Leaf proteome modulation and cytological features of seagrass Cymodocea nodosa in response to long-term high CO2 exposure in volcanic vents

Seagrass Cymodocea nodosa was sampled off the Vulcano island, in the vicinity of a submarine volcanic vent. Leaf samples were collected from plants growing in a naturally acidified site, influenced by the long-term exposure to high CO2 emissions, and compared with others collected in a nearby meadow living at normal pCO2 conditions. The differential accumulated proteins in leaves growing in the two contrasting pCO2 environments was investigated. Acidified leaf tissues had less total protein content and the semi-quantitative proteomic comparison revealed a strong general depletion of proteins belonging to the carbon metabolism and protein metabolism. A very large accumulation of proteins related to the cell respiration and to light harvesting process was found in acidified leaves in comparison with those growing in the normal pCO2 site. The metabolic pathways linked to cytoskeleton turnover also seemed affected by the acidified condition, since a strong reduction in the concentration of cytoskeleton structural proteins was found in comparison with the normal pCO2 leaves. Results coming from the comparative proteomics were validated by the histological and cytological measurements, suggesting that the long lasting exposure and acclimation of C. nodosa to the vents involved phenotypic adjustments that can offer physiological and structural tools to survive the suboptimal conditions at the vents vicinity.

Salicylic acid and H2O2 seed priming alleviates Fe deficiency through the modulation of growth, root acidification capacity and photosynthetic performance in Sulla carnosa

Iron (Fe) is one of the essential nutrients for plant growth which is involved in several physiological functions. Hence, there are intensive efforts to improve plant tolerance to Fe deficiency, by genotypic screening and by the use of adapted physiological tools. The intend of the current study was to explore the seed priming effect with salicylic acid (SA 0.25 mM) and hydrogen peroxide (H2O2 20 mM), either separately applied or combined, on plant growth, nutritional elements status (Fe and potassium K), root acidification and photosynthetic activity in two S. carnosa cultivars (Sidi Khlif and Kalbia) with different tolerance to such constraint. Under unprimed conditions, Fe deficiency decreased plant growth, chlorophyll concentration, in addition to Fe and K contents. Moreover, it affected the photosynthetic activity by inhibiting the net CO2 assimilation rate and increasing the transpiration rate of both cultivars, following a reduced water use efficiency. The changes above described were much less pronounced in Sidi Khlif than in Kalbia. The stomatal conductance increased in Fe-deficient leaves of both cultivars, suggesting that the photosynthesis impairment should be attributed to non-stomatal factors. Interestingly, priming seeds with both agents significantly improved the growth performance and the rhizosphere acidification of deficient S. carnosa plants. However, the D + SA + H2O2 treatment had the most beneficial effect on S. carnosa plant growth. The degree of this stimulation may vary depending on the cultivar, the tissue and the priming agent applied. This could be owing to the photosynthetic performance modulation, leading to more efficient nutrient uptake.

Utilidad de la reserva de flujo fraccional para guiar la revascularización en paciente con síndrome coronario agudo sin elevación del segmento ST

Fractional flow reserve is the gold standard for evaluating the functional severity of an epicardial coronary stenosis. Coronary physiology-guided revascularization has been shown to be useful in stable heart disease, but also in acute coronary syndrome. We present the case of a 58 year-old patient with acute coronary syndrome, who presented two angiographically significant stenosis. We decided to perform revascularization guided by coronary physiology. Using fractional flow reserve, the need to revascularize only one of the lesions was determined, leading to a change in therapeutic behavior that exemplifies the virtue of having coronary physiology tools for decision-making.