Groundwater discharge along streams exerts an important influence on biogeochemistry and thermal regimes of aquatic ecosystems. A common approach for predicting locations of shallow lateral ...groundwater discharge is to use digital elevation models (DEMs) combined with upslope contributing area algorithms. We evaluated a topography‐based prediction of subsurface discharge zones along a 1500 m headwater stream reach using temperature and water isotope tracers. We deployed fiber‐optic distributed temperature sensing instrumentation to monitor stream temperature at 0.25 m intervals along the reach. We also collected samples of stream water for the analysis of its water isotope composition at 50 m intervals on five occasions representing distinct streamflow conditions before, during, and after a major rain event. The combined tracer evaluation showed that topography‐predicted locations of groundwater discharge were generally accurate; however, predicted magnitude of groundwater inflows estimated from upslope contributing area did not always agree with tracer estimates. At the catchment scale, lateral inflows were an important source of streamflow at base flow and peak flow during a major rain event; however, water from a headwater lake was the dominant water source during the event hydrograph recession. Overall, this study highlights potential utility and limitations of predicting locations and contributions of lateral groundwater discharge zones using topography‐based approaches in humid boreal regions.
Key Points
Topography‐based predicted locations of discrete lateral subsurface inflow along a boreal stream agreed with tracer estimates
Topography‐based predicted magnitude of lateral subsurface inflow did not always agree with tracer estimates
Flow from a headwater lake was much greater than lateral subsurface inflow contributions to streamflow following a rain event
Impact of plasmapheresis on severe COVID-19 Fonseca-González, G; Alamilla-Sánchez, M; García-Macas, V ...
Scientific reports,
01/2023, Letnik:
13, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 ...infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071-0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO
/FiO
indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events.
Summary
Background
Coeliac disease is a substantially underdiagnosed disorder, with clinical testing currently guided by case finding.
Aim
To determine the presence of indications for diagnostic ...testing and frequency of clinical testing in undiagnosed coeliac disease.
Methods
This was a case‐control study of adults without prior diagnosis of coeliac disease. Undiagnosed cases were identified through sequential serology, and unaffected age‐ and gender‐matched controls were selected. Medical records were systematically reviewed for indications for and evidence of clinical testing.
Results
Of 47 557 adults, 408 cases of undiagnosed coeliac disease were identified. 408 serology negative matched controls were selected. Eight‐matched pairs were excluded, leading to 800 included individuals (61% female; median age 44.2 years). The odds of any indication for clinical testing were similar among undiagnosed coeliac disease and controls (odds ratio (OR) 1.18; 95% CI: 0.85‐1.63, P = 0.32). Most individual indications were not associated with serologic status. Exceptions to this include hypothyroidism, which was more likely in cases of undiagnosed coeliac disease, and dyspepsia and chronic diarrhoea, which were less likely. Cases of undiagnosed coeliac disease were more likely to develop osteoporosis (P = 0.005), dermatitis herpetiformis (P = 0.006), chronic fatigue (P = 0.033), thyroiditis (P = 0.003), autoimmune diseases (P = 0.008), and have a family member diagnosed with coeliac disease (P = 0.001).
Conclusion
This study strongly suggests that current case finding is not effective in detecting undiagnosed coeliac disease. Individuals with undiagnosed coeliac disease were more likely than controls to develop indications for testing overtime. A more effective method for detection of coeliac disease is needed.
Linked ContentThis article is linked to Lebwohl and Green paper. To view this article visit https://doi.org/10.1111/apt.14670.
Refractory coeliac disease (RCD) is defined by persistent or recurrent malabsorptive symptoms and villous atrophy despite strict adherence to a gluten-free diet (GFD) for at least 6-12 months in the ...absence of other causes of non-responsive treated coeliac disease and overt malignancy. Symptoms are often severe and require additional therapeutic intervention besides a GFD. RCD can be classified as type 1 (normal intraepithelial lymphocyte phenotype), or type 2 (defined by the presence of abnormal (clonal) intraepithelial lymphocyte phenotype). Patients with RCD may never have responded to a GFD or may have relapsed despite adherence and initial response to the GFD. RCD type 1 usually improves after treatment with a combination of aggressive nutritional support, adherence to a GFD, and alternative pharmacological therapies. By contrast, clinical response to alternative therapies in RCD type 2 is less certain and the prognosis is poor. Severe complications such as ulcerative jejunitis and enteropathy-associated T cell lymphoma may occur in a subgroup of patients with RCD. The aims of this article are to (1) review recent advances in the diagnosis and management of patients with RCD, and (2) describe current and novel methods for classification of patients with RCD into categories that are useful to predict outcome and direct treatment.
The objective of this study is to analyse how educational differentials in traffic mortality changed during economic fluctuations in four Argentinian provinces.
Retrospective quantitative analysis of ...secondary data.
Data on fatalities due to traffic injuries (all traffic injuries, pedestrians/cyclists, motorcyclists, car users and unspecified road users) in four Argentinian provinces between 1999 and 2013 were linked to population data and information on the educational level of the deceased to compute mortality rates by educational level. Negative binomial models were estimated using age, sex, year, province of residence, year of economic expansion or recession and educational level as explanatory variables.
Annual traffic mortality differentials by educational level were lower during the period of economic crisis. An absolute increase in traffic mortality was observed in individuals of low educational level during economic expansions, but here, there were no traffic mortality differences for individuals of medium to high educational level. The educational gap in motorcyclist mortality widened during the period of quick economic expansion between 2005 and 2013.
We found less educational inequality in traffic mortality during an economic crisis in a developing country. However, the educational inequalities for different subtypes of traffic mortality show different patterns of evolution during the cycle of economic expansion and recession. Considering deaths due to traffic injuries, economic growth seems to be riskier for individuals of lower educational level compared with those of medium-high educational level.
•Educational differences in traffic mortality decreased during an economic crisis in a developing country.•Road users with low educational levels are more at risk of dying during economic expansions than more educated users.•Differences in motorcyclist mortality rates by educational level were the smallest during economic crisis.•Educational differences in pedestrian and cyclist mortality decreased during years of economic expansion.
Summary
Background
Villous atrophy (VA) with intraepithelial lymphocytosis is the histological hallmark of coeliac disease (CD), but reported rates of mucosal recovery are variable.
Aim
To determine ...the impact of age and other demographic variables on the probability of persistent VA on follow‐up biopsy.
Methods
We identified patients with VA on duodenal histology at all 28 Swedish pathology departments during the years spanning 1969–2008. We examined age, gender, calendar period, duration of disease and educational attainment to determine predictors of persistent VA.
Results
Of 7648 patients with CD who underwent follow‐up biopsy, persistent VA was present in 3317 (43%; 95% CI 42–44%). The effect of age on persistent VA varied according to time period; among those biopsied in the years spanning 2000–2008, the prevalence of persistent VA was 31%, and increasing age was associated with increasing rates of persistent VA (17% among those younger than 2 years compared to 56% among those ≥70 years). In contrast, persistent VA did not vary widely by age in earlier years. On multivariate analysis (restricted to the calendar period 2000–2008, 2–5 years after CD diagnosis), persistent VA was more common among males (OR 1.43; 95% CI 1.07–1.90) and less common among patients with higher educational attainment (OR for college degree vs. <2 years of high school 0.52, 95% CI 0.35–0.78).
Conclusions
The prevalence of persistent villous atrophy has changed over time, with greater rates of healing in recent years. Social differences in persistent villous atrophy suggest that access and/or education regarding the gluten‐free diet impact mucosal healing.
While, for a long time, the role of mitochondria in sperm physiology and pathology has been largely ignored, recent research points out the mitochondria as a major organelle with key roles in sperm ...function both under physiological and biotechnological conditions. This paper briefly reviews these novel findings regarding the role of mitochondria in sperm, paying special attention to the most practical, readily applicable, aspects of the topic such as their role as a major source of the sublethal damage that sperm experiments after cryopreservation.
Macroautophagy (hereafter autophagy) is an evolutionarily highly conserved cellular process that participates in the maintenance of intracellular homeostasis through the degradation of most ...long-lived proteins and entire organelles. Autophagy participates in some reproductive events; however, there are not reports regarding the role of autophagy in the regulation of sperm physiology. Hence, the aim of this study was to investigate whether autophagy-related proteins are present and functionally active in human spermatozoa. Proteins related to autophagy/mitophagy process (LC3, Atg5, Atg16, Beclin 1, p62, m-TOR, AMPKα 1/2, and PINK1) were present in human spermatozoa. LC3 colocalized with p62 in the middle piece of the spermatozoa. Autophagy activation induced a significant increase in motility and a decrease in PINK1, TOM20 expression and caspase 3/7 activation. In contrast, autophagy inhibition resulted in decreased motility, viability, ATP and intracellular calcium concentration whereas PINK1, TOM20 expression, AMPK phosphorylation and caspase 3/7 activation were significantly increased. In conclusion our results show that autophagy related proteins and upstream regulators are present and functional in human spermatozoa. Modification of mitochondrial proteins expression after autophagy activation/inhibition may be indicating that a specialized form of autophagy named mitophagy may be regulating sperm function such as motility and viability and may be cooperating with apoptosis.
Much attention has been drawn to the possible involvement of hypothalamic inflammation in the pathogenesis of metabolic disorders, especially in response to a high‐fat diet. Microglia, the ...macrophages of the central nervous system, can be activated by proinflammatory signals resulting in the local production of specific interleukins and cytokines, which in turn could exacerbate the pathogenic process. Because obesity itself is considered to be a state of chronic inflammation, we evaluated whether being overweight results in microglial activation in the hypothalamus of rats on a normal diet. Accordingly, we used a model of neonatal overnutrition that entailed adjustment of litter size at birth (small litters: four pups/dam versus normal litters: 12 pups/dam) and resulted in a 15% increase in bodyweight and increased circulating leptin levels at postnatal day 60. Rats that were overnourished during neonatal life had an increased number of activated microglia in specific hypothalamic areas such as the ventromedial hypothalamus, which is an important site for metabolic control. However, this effect was not confined to the hypothalamus because significant microglial activation was also observed in the cerebellar white matter. There was no change in circulating tumour necrosis factor (TNF) α levels or TNFα mRNA levels in either the hypothalamus or cerebellum. Interleukin (IL)6 protein levels were higher in both the hypothalamus and cerebellum, with no change in IL6 mRNA levels. Because circulating IL6 levels were elevated, this rise in central IL6 could be a result of increased uptake. Thus, activation of microglia occurs in adult rats exposed to neonatal overnutrition and a moderate increase in weight gain on a normal diet, possibly representing a secondary response to systemic inflammation. Moreover, this activation could result in local changes in specific hypothalamic nuclei that in turn further deregulate metabolic homeostasis.
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