Tn Levels Research Articles

The Role of Troponin in the Diagnosis and Treatment of Acute Pulmonary Embolism: Mechanisms of Elevation, Prognostic Evaluation, and Clinical Decision-Making.

Acute pulmonary embolism (APE) is a cardiovascular disease with severe consequences, wherein cardiac troponin (Tn) plays a pivotal role in diagnosis and treatment. This article reviews the various roles of Tn in managing APE. It looks at how Tn levels increase, their importance in predicting outcomes, and their use in making clinical decisions. Studies indicate that an elevation in Tn is primarily associated with right ventricular overload, ischemia, and necrosis, changes that directly reflect the extent of right ventricular dysfunction and myocardial injury. Elevated levels of Tn are significantly correlated with both short-term and long-term mortality risks in patients with APE, serving as crucial indicators for prognostic assessment and guiding therapeutic strategies. International guidelines recommend integrating Tn testing with clinical scoring and echocardiography to optimize treatment decisions in patients with APE. Despite the significant value of Tn determination in the management of APE, further research is needed to standardize its application. This paper emphasizes future research directions, including exploring the application of Tn in different patient subgroups withAPE and its potential combined use with other biomarkers.

Impact of engineering measures on water exchange and water quality in semi-closed bay: A model study in Zhelin Bay

Coastal aquatic environments are increasingly polluted due to human activities such as engineering, fishing, and agriculture. Semi-enclosed bays are particularly vulnerable to this issue due to weaker tidal currents and water circulation than open coastal areas. Although engineering measures, such as tidal channel dredging, have been implemented, their impact on semi-enclosed bays remains inadequately quantified. This study aimed to investigate the water exchange and water quality of Zhelin Bay, a semi-enclosed bay, after the implementation of two engineering measures: dredging the LG (Ligang) Channel and upgrading the SBM (Sanbaimen) Gate. The finite element model TELEMAC was used to simulate hydrodynamic processes before and after these two measures. The LG Channel dredging project increased flow velocity and tracer discharge during ebbing tides. The watergate project significantly reduced the semi-exchange time of adjacent waters. The combined two measures could enhance water exchange by up to 15 %. Furthermore, the projects slightly impacted spatial distribution of COD, while TP and TN levels near the SBM Gate decreased over by 80 %. This study represents the first effort to evaluate the water exchange improvement strategy of Zhelin Bay, a semi-enclosed bay with multiple tidal channels, and provides valuable insights for future research in marine ecology protection.

Clinical Value of Troponin Levels to Cardiac Function and Prognosis in Patients with Fulminant Myocarditis.

Troponin (Tn) is a biomarker related to myocardial necrosis and is elevated in patients with myocarditis. This study aimed to investigate the association between cardiac Tn levels and the course of cardiac function, and prognosis in patients with fulminant myocarditis (FM) receiving percutaneous mechanical circulatory support (MCS).We used data from a multicenter retrospective registry, CHANGE PUMP 2, which included 216 patients with FM who required MCS. Among them, 141 patients whose Tn levels were available were analyzed. The patients were divided into low and high Tn groups according to the median values of TnT and TnI.The median age was 54 years, and 59.6% were male. The TnT and TnI on day 1 (at MCS initiation) were 3.8 (1.4-10.0) and 21.4 (8.4-68.8) ng/mL. While the left ventricular ejection fraction (LVEF) was similar on day 1 (25.0% versus 24.5%), the low Tn group showed better LVEF improvement on day 7 than the high Tn group (45.0% versus 25.3%, P < 0.001). LVEF at 1 year after admission was higher in the low Tn group (65.0% versus 59.7%, P = 0.039). The low Tn group had a better 90-day composite endpoint in death, durable left ventricular assist device implantation, and heart transplantation compared to the high Tn group (hazard ratio 0.47, 95% CI 0.23-0.95).Tn levels were associated with short- and long-term cardiac recovery and adverse outcomes in patients with FM receiving MCS due to cardiogenic shock.

Occurrence of antibiotics and antibiotic-resistant bacteria in the Lebanese polluted Litani River.

Antibiotic contamination in polluted rivers is well recognized as an environmental and public health challenge. In this study, the occurrence, distribution, and ecological risk assessment of three commonly used antibiotics (amoxicillin, ciprofloxacin, and azithromycin) were assessed in the Litani River, the most important and highly polluted river in Lebanon. Physicochemical and microbiological water quality parameters including the antibiotic-resistant ones were in parallel determined in the same sites. Water samples from five sites stretching across the river upper basin were analyzed for the antibiotics under study using high-performance liquid chromatography, with both fluorometric and UV detectors post-extraction using a solid-phase method with a hydrophilic-lipophilic balance cartridges. The disc diffusion method and standardized water quality methods were used for antibiotic-resistant bacteria and water quality assessment, respectively. Amoxicillin and ciprofloxacin were found at concentrations of 250 ng/L and 107.2 ng/L, while azithromycin was not detected in any of the sites under study. Varying levels of antibiotic resistance were detected with the isolated Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa) while the total coliforms showed resistance to multiple antibiotics. COD, TP, PO43-, TN, NO3-, NH4 + , E. coli, total coliform, P. aeruginosa, and Cd levels surpassed permissible levels. Correlation analysis with water quality parameters (COD, total phosphate, phosphate, total nitrogen, and cadmium) showed a significant positive correlation with ciprofloxacin (r > 0.5, p value < 0.05). Also, the resistant P. aeruginosa showed a significant positive correlation with cadmium (r > 0.5, p value < 0.05) while the resistant E. coli was positively correlated with total nitrogen, nitrate, and lead levels (r > 0.5, p value < 0.05). The ecological risk assessment revealed that all the tested antibiotics pose low risks (ecological risk quotient RQ < 0.1) except ciprofloxacin, which could pose a medium risk (0.1 < RQ < 1). Future research concerning the long-term assessment of antibiotics' residues and the identification of resistance genes in the river is recommended.

Application of Biofilm Water Conservation and Emission Reduction Technology in the Pond Culture of Largemouth Bass and Japanese Eel

This study investigates the water-saving and emission-reduction effects of biofilm technology on the pond culture of largemouth bass (Micropterus pallidus) and Japanese eel (Anguilla japonica) using a combination of biofilm water purification grids and a complex microbial preparation. The results show that during the 150-day largemouth bass aquaculture trial, the TN, TAN, TP, nitrite, and LP in the treatment group were significantly lower than those in the control group by 26.2%, 74.7%, 53.9%, 30.7%, and 59.1% (p &lt; 0.01), respectively. During the 145-day aquaculture trial of Japanese eel, the TN, TAN, and TP levels in the treatment group were significantly lower than those in the control group by 30.1%, 68.6%, and 18.7% (p &lt; 0.01), respectively. The nitrite and COD levels were also significantly lower in the treatment group than in the control group by 18.3% and 16.0% (p &lt; 0.05). In addition, largemouth bass and Japanese eel tailwater nitrogen and phosphorus discharges were significantly reduced and culture yields were significantly increased. This biofilm pond culture technology has advantages such as low cost, water saving and emission reduction, increased production, ease of operation, and a wide range of applications.

Spatial–temporal distribution characteristics and traceability analysis of organic matter in Shahe Reservoir (Beijing, China)

Shahe Reservoir is a key node in the upstream of the North Canal, and the water quality has gradually improved after the implementation of low water operation in 2018. The organic matter(OM) in the sediment decreased from 16.66 to 14.22%.In this study, the FI index and parallel factor method were used to investigate the traceability of OM and dissolved organic matter (DOM) in the Shahe Reservoir before and during low water level operation(LWLO), and the results showed that the terrestrial source fraction of OM in sediments was mainly related to organic-rich terrestrial plant residues carried by tributaries and overflows/outfalls during the rainy season, and the FI index indicated that the organic matter (OM) in the Shahe Reservoir before and during LWLO in each DOM in the area is derived from authigenic sources of autotrophic microorganisms, algae, etc. The parallel factor method shows that more than most of the pollutants in the DOM are input from endogenous sources and a small proportion of pollutants are input from exogenous sources. Nutrients in both sediment and interstitial water increased during the LWLO, with TN and TP levels increasing by 262.38 and 204.45 mg·kg−1 in sediment, NH4+–N, PO43−−P, TN and TP in interstitial water increasing by 0.98, 1.36, 2.07 and 4.33 mg·L−1, respectively. Pearson correlation analysis and principal component analysis showed that OM was significantly correlated with nutrients: OM and TN (p < 0.01) and OM and TP (p < 0.05) in the pre-LWLO; OM and TN and TP (p < 0.01) in the LWLO.The results suggested that organic matter pollution control should be mainly carried out from the perspective of endogenous input, focusing on controlling the release of nutrients in sediments.

Vitamin C may reduce troponin and CKMB levels after PCI and CABG: a meta-analysis

BackgroundIschemia/reperfusion injury contributes to periprocedural myocardial injury (PMI) in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PMI can be estimated by the elevation of troponin (Tn) and creatine kinase-MB (CKMB) plasma levels, and it is associated with increased risk of cardiovascular events and mortality. Vitamin C might have a beneficial effect on PMI by improving endothelial function, improving myocardial perfusion, and by reducing oxidative stress generated during/after reperfusion. In several small animal models of cardiac stress, vitamin C reduced the increase in Tn and CKMB levels. The aim of this meta-analysis was to investigate whether vitamin C administration may have an effect on Tn and CKMB levels in patients undergoing PCI or CABG.MethodsWe searched PubMed, Cochrane, Embase and Scopus databases for controlled clinical trials reporting on Tn and CKMB levels in adult patients who underwent PCI or CABG and received vitamin C. As secondary outcomes we collected data on biomarkers of oxidative stress in the included trials. In our meta-analysis, we used the relative scale and estimated the effect as the ratio of means.ResultsWe found seven controlled trials which included 872 patients. All included trials administered vitamin C intravenously, with a range from 1 to 16 g/day, and all initiated vitamin administration prior to the procedure. Vitamin C decreased peak Tn plasma levels in four trials on average by 43% (95% CI: 13 to 63%, p = 0.01) and peak CKMB plasma levels in five trials by 14% (95% CI: 8 to 21%, p < 0.001). Vitamin C also significantly decreased the biomarkers of oxidative stress.ConclusionsVitamin C may decrease cardiac enzyme levels in patients undergoing elective PCI or CABG. This may be explained partially by its antioxidant effects. Our findings encourage further research on vitamin C administration during cardiac procedures and in other clinical contexts that increase the level of cardiac enzymes. Future studies should search for an optimal dosing regimen, taking baseline and follow-up plasma vitamin C levels into account.

Coupling network of hydrogen sulfide precursors and bacteria in kitchen waste composting

This study was focused on the changes of hydrogen sulfide (H2S), its precursors, and microorganisms associated with its transformation during the composting process of kitchen waste. The results showed that the content of cysteine (Cys) and methionine (Met) decreased by 32.3 % and 57.5 % respectively, while the content of sulfate (SO42-) changed little during composting. The main release period of H2S was during the high-temperature period of composting, Cys was its main precursor. Based on network analysis, a total of 15 core genera associated with the conversion of H2S precursors were identified, and the transformation of the H2S precursor was mainly influenced by Filomicrobium. Temperature, pH, and TN levels had a positive effect on Filomicrobium. It could find a balance point by controlling these three factors to reduce the production of H2S.

Subclinical dysfunction of remote myocardium is related to high NT-proBNP and affects global contractility at follow-up, independently of infarct area.

In ST-segment elevation myocardial infarction (STEMI), predictors of subclinical dysfunction of remote myocardium are unknown. We prospectively aimed at identifying clinical and biochemical correlates of remote subclinical dysfunction and its impact on left ventricular ejection fraction (LVEF). One-hundred thirty-three patients (63.9 ± 12.1 years, 68% male) with first successfully treated (54% anterior, 46% non-anterior, p = 0.19) STEMI underwent echocardiography at 5 ± 2 days after onset and at 8 ± 2-month follow-up, and were compared to 13 age and sex-matched (63.3 ± 11.4) healthy controls. All 16 left ventricular (LV) segments were grouped into ischemic, border, and remote myocardium: mean value of longitudinal strain (LS) within grouped segments were expressed as iLS, bLS, rLS, respectively. LV end-diastolic (EDV), end-systolic (ESV) volumes indexed for body surface area (EDVi, ESVi, respectively), LVEF and global LS (GLS) were determined. Creatinine, glomerular filtration rate, admission level of NT-pro-brain-natriuretic peptide (NT-proBNP) and troponin peaks were considered for the analysis. At baseline, rLS (15.5 ± 4.4) was better than iLS (12.9 ± 4.8, p < 0.001), but lower than that in controls (19.1 ± 2.7, p < 0.001) and similar to bLS (15 ± 5.4, p = ns), and did not differ between patients with single or multivessel coronary artery disease (CAD). At multivariate regression analysis, only admission NT-proBNP levels but not peak Tn levels independently predicted rLS (β = -0.58, p = 0.001), as well as iLS (β = -0.52, p = 0.001). Both at baseline and at follow-up, rLS correlated to LVEF similarly to iLS and bLS (p < 0.001 for all). Median value of rLS at baseline was 15%: compared to patients with rLS ≥ 15% at baseline, patients with rLS < 15% showed lower LVEF (52.3 ± 9.4 vs. 58.6 ± 7.6, p < 0.001) and GLS (16.3 ± 3.9 vs. 19.9 ± 3.2), and higher EDVi (62.3 ± 19.9 vs. 54 ± 12, p = 0.009) and ESVi (30.6 ± 15.5 vs. 22.3 ± 7.6, p < 0.001) at follow-up. In optimally treated STEMI, dysfunction of remote myocardium assessed by LS: (1) is predicted by elevated NT-proBNP; (2) could be independent of CAD extent and infarct size; (3) is associated to worse LV morphological and functional indexes at follow-up.

Using cell-free supernatant of Bacillus sp. AK3 in combination with Chlorella to remove harmful algal bloom species, TP, TN, and COD from water

The harmful algal bloom (HAB) issue is intensifying and affecting water supplies around the world. The cell-free supernatant (CFS) of algicidal bacteria has been extensively used for HAB control. However, the remaining nutrients in the water may cause the HAB species to bloom again. In this study, we used the CFS of Bacillus sp. AK3 obtained from nutrient broth medium (NB-CFS) and M9 minimal medium (M9-CFS), to eradicate HAB species. Based on extracellular metabolomics data, seven antimicrobial compounds, i.e., cyclo (leu-pro), cyclo (phe-pro), norharman, trans-3-indoleacrylic acid, hypoxanthine, kanosamine, and betaine, were detected in both NB-CFS and M9-CFS, albeit at different intensities. In the treatment of HAB water, NB-CFS and M9-CFS exhibited strong Microcystis and Pseudanabaena (harmful cyanobacteria) growth inhibition, whereas Chlorella (green algae) growth was promoted, indicating a specific inhibitory effect of CFS. The TP, TN, and COD levels in the water significantly increased after adding both CFSs. Interestingly, NB-CFS proved superior in promoting the beneficial Chlorella species, which can completely remove TP (100%) and effectively reduce TN and COD in HAB water at the end of the experiment. The combination of species-specific algicidal compounds with Chlorella may be a feasible strategy for the simultaneous elimination of HAB species and nutrients from water.

Onion (Allium cepa L.) Performance as Influenced by Manure and Fertilizer in Titanium Mined Soils

Mining is an important economic activity that promotes income generation, job creation, and industrialization globally. In spite its economic importance, it is classified as land degradation form that disrupts natural ecosystem through loss of biota and soil health. Paucity of information regarding the performance of reclaimed mined soils in supporting crop production abound in Kenya. To contribute to this knowledge gap, a study was conducted at Base titanium limited -Kwale to investigate the response of performance of bulb onions (red creole onion variety) to farmyard manure and inorganic fertilizer application on post mined soils. The experiment was laid out in a Randomized Complete Block Design (RCBD) with three replicates Treatments included: inorganic fertilizer, farmyard manure, inorganic fertilizer +farmyard manure and control. Obtained data that included: soil characterization, onion growth and yield parameters was subjected to analysis of variance (ANOVA) using R packages and means separated using the Fisher&amp;rsquo;s protected least significant difference (LSD) at (P&amp;le;0.05). Results showed that the soils had low TN, exchangeable P, K, S, Bo and Cu levels. Manure+ fertilizer significantly (P&amp;le;0.05) increased plant height by 38%, bulb diameter by 44%, neck thickness by 19.5% total bulb yield by 89% and marketable yield by 88% compared to control. A significant positive relationship between manure, fertilizer, fertilizer+ manure with plant height, number of leaves, bulb diameter, neck thickness and total yield was observed indicating that manure + fertilizer can support optimal onion production in these post mined soils. Further research is however, required to ascertain production approaches that promote sustainable soil development and onion yield.

Multi-spatial scale effects of multidimensional landscape pattern on stream water nitrogen pollution in a subtropical agricultural watershed

Multidimensional (coupled land use, soil properties, and topography) landscape effects on stream water nitrogen (N) are complex and scale-dependent. However, studies that identify critical buffer zones that explain large variations in riverine N, and estimate specific thresholds of multidimensional landscape patterns at the class level, result in a sudden changes in riverine N pollution, are still limited. Here, a new multidimensional landscape metric that combined land use, soil properties, and topography effects was applied to various riparian buffer zones and sub-watershed scales, and their relationships to riverine N levels were investigated. We used stream water ammonium−N, nitrate−N, and total−N concentrations datasets, from 2010 to 2017, in the nine subtropical sub-watersheds in China. The results of model selection and model averaging in ordinary least squares regressions, indicated that the riparian buffer zone with widths of 400 m, had more pronounced influence on water NH4–N and TN levels than at other scales. Within the 400 m buffer zone, the key landscape metrics for NH4–N, NO3–N and TN concentrations in stream water were different, and explained up to 43.35%–76.55% (adjusted R2) of the total variation in river N levels. When ENN_MNClass17 below 39–56 m, PDClass8 above 4.63–6.55 n/km2, PLANDClass27 above 23–29%, and CONTIG_MNClass42 below 0.35–0.37% within the 400 m buffer zone, riverine NH4–N and TN would be abruptly increased. This study provided practical ideas for regulation regarding landscape management linked to watershed structure, and identified reference thresholds for multidimensional landscape metrics, which should help reduce riverine N pollution in subtropical China.

C87 THE SHORT–TERM PROGNOSTIC SIGNIFICANCE OF BASELINE TROPONIN LEVELS IN PATIENTS HOSPITALIZED FOR COVID–19

BackgroundTroponin (TN) is the biomarker of choice for the detection of cardiomyocite injury. Elevation of TN has been noted in COVID–19 patients (pts), implicating myocardial injury as a possible pathogenic mechanism contributing to disease severity.AimTo assess the in–hospital prognostic significance of baseline TN levels in COVID–19 pts. Methods. The data of 192 consecutive COVID–19 individuals (mean age 70±15 yrs, 54.6% males) hospitalized in a single institution were retrospectively analysed. According to the baseline TN–I levels (normal value up to 34 pg/ml), the whole population was divided into normal (Group A) and elevated (Group B) TN–I. Demographic parameters, clinical history, pharmacological treatments and laboratory data at the admission were evaluated. The length–of–stay, rate of orotracheal intubation, non–invasive ventilation and in–hospital mortality were considered as prognostic parameters.ResultsOne–hundred–fifty–seven pts belonged to Group A, while thirty–five pts to Group B. Group A pts were significantly younger (67±14 vs 79 ±12 yrs, p < 0.001). As expected, a better renal profile was observed in pts with normal TN–I levels (eGFR 82±25 ml/m’ in Group A vs 48±30 ml/m’ in Group B, p < 0.001). No differences were noted between the two groups in the prevalence of diabetes, previous CAD, hypertension, ACE/ARBs treatment. The length–of–stay was similar (21±11days in Group A vs 19±17 days in Group B, respectively, p=ns). Also, the need for orotracheal intubation (11.4% vs 11.5% p=ns) and non–invasive ventilation (26.8% vs 28.6%, p=ns), were not significantly different between Group A and Group B. However, the in–hospital mortality was considerably lower in pts with normal baseline TN–I, as compared to those with a definite level of cardiomyocyte damage (20/157 Group A pts, 12.7%, vs 15/35 Group B pts, 42.9%, p < 0.001).ConclusionOur data demonstrate that high TN–I baseline level upon admission should be considered as a strong prognostic parameter in pts hospitalized for COVID–19. In our population, this observation seems not to be related to the different comorbidities, except for the renal function profile.

Assessing performance of local materials for the treatment of dry weather flows in open drains: Results of semi-controlled field experiment research in Bangalore, India

The efficacy of two low-cost locally available aggregate filter materials (gravel and terracotta rubble) were tested in a semi-controlled pilot setup deployed to treat dry weather flows in an open stormwater drain in Bangalore, India. The treatment setups were operated at a similar hydraulic loading rate (HLR) of 265 mm/day using dry weather flows (DWF) in open stormwater drains from surrounding land uses for a period of 14 months. Significant variability in the quality dry weather flows was observed during the testing period. The average COD, BOD5, TN and TP levels of 1528 mg/l, 439 mg/l, 28.6 mg/l and 9.8 mg/l respectively were observed corresponding to high strength wastewater. Differences in porosity resulted in different hydraulic retention times (HRT), with 1.21 days and 1.52 days for the gravel and terracotta setup. While no significant difference was observed in the quality of effluent from both setups, the KBOD5 estimated for gravel setup (0.89) was significantly higher than the terracotta setup (0.70). Similar BOD5 mass removed per day (MMR) efficiency of 78% was observed for both setups. Data suggests the usefulness of gravel material in treating inflows rich in organic matter. Terracotta setup provided higher MRR reduction of 48%, 24% and 43% for DCOD, TP and TN, whereas higher MRR reduction of 70% and 65% for TSS and COD was observed in gravel setup. Neither materials were effective at removing Fecal Coliform (FC), particularly in the later stages of the study. Ammonium-N levels showed periodic increases in both setups, which could be attributed to low HRT leading to incomplete nitrification-denitrification processes. While outflows did not meet discharge standards, specified by India's Central Pollution Control Board (CPCB), the results suggest that a significant reduction in common contaminants can be achieved informing future interventions and modelling studies promoting sustainable urban water management in the megacity context. Study shows that an average BOD5 and COD mass loading rate (MLR) of 28 g/m2/day and 138 g/m2/day respectively should be targeted as a baseline condition in inflows to meet national discharge standards set by the CPCB (30 mg/l and 250 mg/l respectively).

Assessing the environmental risk and pollution status of soil and water resources in the vicinity of municipal solid waste dumpsites.

Municipal solid waste management remains a major challenge for many developing countries where unsanitary and environmentally damaging practices, such as open dumping and burning of wastes, are consistently utilized as means of waste disposal. This study aimed to assess the impact of local dumpsites in a region in Southern Lebanon and to assess/determine the level of pollution they cause on local ecosystems and the concomitant risks to public health. Accordingly, soil and water samples were collected from the seven dumpsites that were investigated over the course of two seasons. Several biological, chemical, and physical parameters were examined, with the results being utilized to calculate a number of environmental indices. Results indicated that several soil parameters including TN (700-2400mg/kg), pH (8.3-8.7), COD (39-1995mg/kg), and sulfate levels (17.8-301.6mg/kg) were altered by the dumpsites. Heavy metal concentrations varied between dumpsites; however, the most commonly prevalent metals across all dumps were Fe (992-41,500mg/kg), Cr (17.4-139.5mg/kg), Zn (24.1-177.4mg/kg), Cu (9.42-148.2mg/kg), and Mn (25.2-776.5mg/kg), though recorded concentrations exceeded permissible limits only in certain instances. Evidently, soil samples collected at dumpsites had higher concentrations compared to the samples collected away from dumpsites reaching 27 times more in certain locations. The altered parameters have a direct effect on soil fertility and, if biomagnified, could disrupt crop yields and impact human health. Physiochemical properties and heavy metal concentrations in water samples were not significantly altered and were found to be within permissible limits. However, it is crucial to develop a monitoring and remediation plan to decrease the percolation of leachate to water resources.

The Influence of Deterioration of Kidney Function on the Diagnostic Power of Laboratory Parameters Used in the Prognostic Classification of AL Amyloidosis.

There is a possibility that renal dysfunction may potentially reduce the diagnostic power of the laboratory parameters Tn, NT-proBNP and sFLC levels, used in the current prognostic classification of AL amyloidosis and the diagnosis of heart involvement by amyloid. In this study, the impact of lowering the eGFR value on the usefulness of these parameters in the prognosis and diagnosis of the presence of amyloid in the myocardium was assessed in a group of 71 patients with newly diagnosed primary amyloidosis. The assessment of diagnostic power of laboratory parameters was performed on the entire study group, and in the ranges of eGFR ≥ 60 and < 60 mL/min/1.73 m2. It has been proven that, with a decrease in the eGFR value, the concentrations of NT-proBNP and the κ uninvolved light chains increase significantly (p < 0.001). To assess the diagnostic power of laboratory parameters used in the diagnosis of myocardial involvement in patients with AL amyloidosis, an ROC analysis was performed. The highest values of AUC were obtained for the NT-proBNP concentration (AUC = 0.906). The lowest values of the AUC and Youden’s index were obtained for the dFLC values (AUC = 0.723), and involved κ FLC concentration (AUC = 0.613). For all compared parameters, the smallest values of the AUC were obtained for eGFR (<60 mL/min/1.73 m2). It seems that the most suitable cardiac parameter used in the prognostic classification of AL amyloidosis, independent of renal function, is TnI. It should be noted that a concentration of involved λ chains hada higher diagnostic power to assess the heart involvement, compared to the routinely used “cardiac parameters”, TnI and NT-proBNP. It can therefore be an additional parameter used to assess the presence of amyloid in the myocardium. A decrease in eGFR value influenced the change in the diagnostic cut-off points of the most analyzed laboratory parameters. Finally, it is concluded that lowering the eGFR value reduces the utility of laboratory parameters used in the prognostic classification of AL amyloidosis.

Mulch versus brash: a case study of in situ harvesting residue treatment and its effects on C and nutrients in soil and plant uptake during natural rewilding

Western hemlock brash decay was investigated over seven years on a UK lowland clay soil site, clear-felled in 2002 for broadleaf restoration. Two brash loadings (9.3 (Heavy) and 5.6 (Light) kg m − 2), a chipped mulch (9.4 kg .m − 2), a seeded grass and a bare soil treatment were incorporated in a fenced split block design. In situ decay of Mulch and Brash was followed by field sampling, and a three year litterbag study of needles, twigs and small branch decay. Natural plant recolonisation was followed in repeated ground surveys within each treatment. Heavy Brash residue lost weight through rain leaching, whilst Light Brash and Mulch gained through the action of decay fungi (Basiodiomycete spp) . The N resource in the Mulch residue 2006 (1660 kg ha−1 of N) was twice that of the Heavy Brash in 2005 (748 kg ha−1of N) from similar initial loadings, with subsequent N and C release from the Mulch resulting in significantly higher soil TN and DOC levels. Above ground uptake was determined using allometric relations of birch height: biomass and ground cover: biomass in 2007. N uptake was initially rapid in the seeded grass plots, where soil TN values were significantly the lowest and soil pH the highest of all treatments in 2005 - an indication that sown grass can be an effective sink for leached N after harvesting. Birch (Betula pendula L) subsequently sequestered >75 kg ha−1 of N in the Light Brash treatments with a further 30 kg ha−1 in the shrub/grass under storey by 2007, representing ~28% of the Light Brash residue N resource. N uptake on the Mulch, with < 50% plant cover, represented <3% of the Mulch resource.Conclusions: Mulching brash in situ produced a tidy site, but the deep layer (~14 cm) resulted in an increased resource of N and C in the residue through fungal action, locking up nutrients for three years. Subsequently (yr 4–7) significantly higher levels of DOC and TN were released to the soil, compared to all other treatments. Total mineral soil C and N stock in year 7 was high but not significantly different under Mulch and Heavy Brash, indicating that this excess N was not retained in the topsoil. A deep layer of mulched material cannot be recommended as a treatment for harvesting residue on N sensitive sites, or for rewilding projects where natural plant colonisation is expected.

Distribution of carbon and nitrogen cycle microbes along permafrost peatland profile in Northeast China

AbstractMicroorganisms play critical roles in carbon (C) and nitrogen (N) cycles. However, our understanding of the distribution of C‐ and N‐cycling microbial communities along the permafrost peatland profile was limited. We characterized changes in the abundances of bacteria, fungi, archaea, methanogen, methanotroph, ammonia‐oxidizing bacteria, and denitrifying bacteria along a soil profile in the permafrost peatland of the Great Hing'an Mountains, China. Maximum values of bacteria, fungi, archaea, methanotroph, and nirK‐type denitrifying bacteria abundances were found for the 0–40 cm layer and minimum values for the 100–150 cm layer. Bacteria, fungi, archaea, methanotroph, and nirK‐type denitrifying bacteria gradually decreased in terms of abundance with increasing soil depths. Methanogen, ammonia‐oxidizing bacteria, and nirS‐type denitrifying bacteria all showed the highest abundances in the 40–80 cm layer. Abundances of bacteria, fungi, archaea, methanogen, methanotroph, and nirK‐type denitrifying bacteria were all significantly negatively correlated with pH and C:N values, but significantly positively correlated with TC, TN, and TP levels. In the context of climate change, microbial distribution characteristics in the active, transition, and frozen layers in permafrost peatlands will change, and then affect C and N cycles. Results in this study highlighted the importance of sampling deeper soil depths in the study of microbial distribution and C/N cycles in peatland ecosystems.

Cardiac troponin and infective endocarditis prognosis: a systematic review and meta-analysis.

Infective endocarditis (IE) is associated with high mortality and morbidity. Cardiac troponin (Tn) elevation seems to be common in patients with IE and could be associated with a poor prognosis. The aim of this study was to synthesize the prognostic value of Tn in patients with IE. We searched in MEDLINE, EMBASE, and the Cochrane library, including the Cochrane Central Register of Controlled Trials (CENTRAL) until February 2020. Observational studies reporting on the association between Tn and in-hospital and 1-year mortality, and IE complications were considered eligible. As each centre uses different conventional or ultra-sensitive Tn, with different normality threshold, we considered them as normal or elevated according to the criteria specified in each article. Articles were systematically selected, assessed for bias, and, when possible, meta-analysed using a random effect model. After retrieving 542 articles, 18 were included for qualitative synthesis and 9 for quantitative meta-analysis. Compared with patients with normal Tn levels, patients with Tn elevation presented higher in-hospital mortality [odds ratio (OR) 5.96, 95% confidence interval (CI) 3.46-10.26; P < 0.0001], 1-year mortality (OR 2.67, 95% CI 1.42-5.02; P = 0.002), and surgery rates (OR 2.34, 95% CI 1.42-3.85; P = 0.0008). They also suffered more frequent complications: central nervous system events (OR 8.85, 95% CI 3.23-24.26; P < 0.0001) and cardiac abscesses (OR 4.96, 95% CI 1.94-12.70; P = 0.0008). Tn elevation is associated with a poor prognosis in patients with IE. Troponin determination seems to provide additional help in the prognostic assessment of these patients.

Research on Efficiency of Improved IFAS Process in Treating Rural Sewage

Based on researches of a wastewater treatment plant for rural sewage treatment in Tongzhou District, Beijing city, efficiency of IFAS process was studied to support its broad-wide use in rural area. The results showed that, for the influents with COD, ammonia, TN and TP levels of 60-203mg/L, 9.5-40mg/L, 16-45mg/L and 1.2-4.7mg/L, highest removals of 91%, 98%, 78% and 93% can be obtained with levels of effluents below than 40mg/L, 1.5mg/L, 15mg/L and 1.0mg/L. Removals of the contaminants were low under low temperatures in winters.