The Stormwater Treatment Areas (STAs) are large wetlands constructed for phosphorus (P) retention for Everglades restoration in south Florida (USA), and include areas of submerged aquatic vegetation ...(SAV) at a globally unprecedented scale (~12,000 ha). The goal of this study was to elucidate the fate of P retained in large-scale SAV wetlands, and the associated temporal trends in P removal and retention. In a well-performing, 929-ha SAV-dominated STA surface water flow-through treatment wetland, measurements of accrued soil depth and soil P storage performed every ~4–6 years revealed a steady-state longitudinal soil P enrichment profile established within the first ~4 years of flow-through operation. Subsequently, the SAV soils accrued P at a relatively steady rate (1.13 g P m−2 yr−1 for the entire 17-year period) without indication of temporal P enrichment, spatial expansion of soil P enrichment in the inflow region, or impairment of water column P removal efficiency. Phosphorus sequestration occurred via accumulation of new sedimentary material (0.9–1.5 cm yr−1), rather than enrichment of existing soil. These soil surveys were accompanied by measurements of porewater SRP concentrations, soil P release under anoxia, and soil P fractions, which demonstrated that soil P release potential and concentrations of highly labile soil P generally decreased over time. These findings demonstrate that the P retention mechanisms operating within this large SAV wetland can be sustainable under managed steady-state conditions. Susceptibility of SAV to extreme environmental perturbations in this and other wetlands, however, remains a research priority.
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•Whether soil P enrichment could impair treatment wetland performance is an overriding concern.•This SAV-dominated wetland did not become P-saturated under stable operational conditions of low to moderate loadings and continuous hydration.•SAV soils accrued P at a relatively steady rate over the entire 17-yr period.•Close agreement in the soil-water P mass balance confirms the methods used were sufficient to characterize the soils.•Limitations to indefinite P removal are extreme perturbations and accumulation of particles.
Introduction:There is no consensus on the pharmacological treatment of alcoholic hepatitis. The Glasgow alcoholic hepatitis score (GAHS) has been shown to be more accurate than the modified Maddrey’s ...discriminant function (mDF) in the prediction of outcome from alcoholic hepatitis. This study aimed to determine whether the GAHS was able to identify those patients who would benefit from corticosteroids.Methods:225 patients with an mDF greater than or equal to 32 from five hospital centres in the United Kingdom were reviewed. Patient survival relative to the GAHS and the use of corticosteroids was recorded.Results:144 patients with an mDF greater than or equal to 32 (64%) also had a GAHS greater than or equal to 9. There was no difference in survival between untreated or corticosteroid-treated patients for those with a GAHS less than 9. For patients with a GAHS greater than or equal to 9 the 28-day survival for untreated and corticosteroid-treated patients was 52% and 78% (p = 0.002), and 84-day survival was 38% and 59% (p = 0.02), respectively.Conclusions:Among patients with an mDF greater than or equal to 32, there was no appreciable benefit from treatment with corticosteroids in patients with a GAHS less than 9. Patients with a GAHS greater than or equal to 9 have an extremely poor prognosis if they are not treated with corticosteroids, or if such treatment is contraindicated.
Guidelines exist for the management of alcohol withdrawal syndrome (AWS) but few have been assessed as to their suitability for general hospitals. The Glasgow Assessment and Management guideline for ...alcohol has been specifically developed for use in this context.
To determine if this alcohol assessment guideline aids the management of AWS in general hospitals.
The four components of the Glasgow Assessment and Management of Alcohol guideline were evaluated. This included the use of the Fast Alcohol Screening Test (FAST) to identify at risk patients, a risk stratification strategy to indicate fixed dose or symptom-triggered benzodiazepine treatment, the Glasgow Modified Alcohol Withdrawal Scale (GMAWS) for symptom-triggered treatment and a clear recommendation for vitamin prophylaxis of Wernicke's encephalopathy.
FAST scores were assessed along with the CAGE (cut down, annoyed, guilty and eye-opener) screening tool to ascertain if a single screening tool could identify hazardous and dependent drinking. The GMAWS and Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) were compared between two medical units. A staff survey of the two AWS tools was also carried out.
FAST was able to identify both probable hazardous and dependent drinking. The GMAWS was reliable and gauged both physical and cognitive aspects of AWS. Staff generally preferred the GMAWS-based treatment as opposed to CIWA-Ar management and welcomed the Guideline as a whole.
The Glasgow Guideline aids the management of patients with AWS in an acute hospital setting. It allows early identification of at risk patients and directs effective therapeutic intervention.
Summary
Background
Alcoholic hepatitis is a severe acute manifestation of alcoholic liver disease with a high mortality. Management of patients with this condition has been a matter of controversy ...for many years; however, recent clinical studies have sought to improve the clinical approach to these patients.
Aim
To use these recent studies in order to guide clinical management.
Methods
A MeSH search of Medline was performed to specifically identify recent studies which influenced clinical diagnosis, assessment and management of alcoholic hepatitis.
Results
Fulfilment of clear clinical criteria including a minimum threshold of bilirubin, defined periods of jaundice and alcohol ingestion negates the need for liver biopsy in most patients. Corticosteroids improve short‐term mortality only (28 day) with other factors such as abstinence likely to be significant in long‐term outcome. Pentoxifylline is not an effective treatment. The Glasgow Alcoholic Hepatitis Score (GAHS) score can identify those patients likely to benefit from corticosteroids, but scores that include the evolution of bilirubin over 1 week of such treatment (such as the Lille Score) define “response”. Underlying infection may contribute towards corticosteroid nonresponse and needs to be actively sought out and treated. Liver transplant remains controversial; however, it has been shown to be feasible in alcoholic hepatitis.
Conclusions
Recent studies have helped to define patients who may benefit from corticosteroid treatment. However, there remains a need for more accurate scores of prognosis and treatment response, and a clear need for alternative treatments for those patients not responding to corticosteroid therapy.
DNA methylation is a key epigenetic mark in mammalian organisms that plays key roles in chromatin organization and gene expression. Although DNA methylation in gene promoters is generally associated ...with gene repression, recent studies demonstrate that DNA methylation in gene bodies and intergenic regions of the genome may result in distinct modes of gene regulation. Furthermore, the molecular mechanisms underlying the establishment and maintenance of DNA methylation in human health and disease remain to be fully elucidated. We recently demonstrated that a subset of long non-coding RNAs (lncRNAs) associates with the major DNA methyltransferase DNMT1 in human colon cancer cells, and the dysregulation of such lncRNAs contribute to aberrant DNA methylation patterns.
In the current study, we assessed the impact of a key DNMT1-associated lncRNA, DACOR1, on genome-wide DNA methylation using reduced representation bisulfite sequencing (RRBS). Our findings demonstrated that induction of DACOR1 in colon cancer cells restores DNA methylation at thousands of CpG sites throughout the genome including promoters, gene bodies, and intergenic regions. Importantly, these sites overlap with regions of the genome that become hypomethylated in colon tumors. Furthermore, induction of DACOR1 results in repression of FOS and JUN and, consequently, reduced AP-1 transcription factor activity.
Collectively, our results demonstrate a key role of lncRNAs in regulating DNA methylation in human cells, and the dysregulation of such lncRNAs could emerge as a key mechanism by which DNA methylation patterns become altered in human tumors.
As humankind expands its footprint in the solar system, it is increasingly important to make use of the resources already in our solar system to make these missions economically feasible and ...sustainable. In-Situ Resource Utilization (ISRU), the science of using resources at a destination to support exploration missions, unlocks potential destinations by significantly reducing the amount of resources that need to be launched from Earth. Carbon dioxide is an example of an in-situ resource that comprises 96% of the Martian atmosphere and can be used as a source of oxygen for propellant and life support systems. The Mars Oxygen ISRU Experiment (MOXIE) is a payload being developed for NASA's upcoming Mars 2020 rover. MOXIE will produce oxygen from the Martian atmosphere using solid oxide electrolysis (SOXE). MOXIE is on the order of magnitude of a 1% scale model of an oxygen processing plant that might enable a human expedition to Mars in the 2030s through the production of the oxygen needed for the propellant of a Mars ascent vehicle. MOXIE is essentially an energy conversion system that draws energy from the Mars 2020 rover's radioisotope thermoelectric generator and ultimately converts it to stored energy in oxygen and carbon monoxide molecules. A thermodynamic model of this novel system is used to understand this process in order to derive operating parameters for the experiment. This paper specifically describes the model of the SOXE component. Assumptions and idealizations are addressed, including 1D and 2D simplifications. Operating points are discussed as well as impacts of flow rates and production.
To determine whether the provision of additional genetic counseling support could improve the uptake of genetic services by “at-risk” relatives of probands.
The Tasmanian Clinical Genetics Service ...implemented a specific counseling intervention to a cohort of patients who were diagnosed with a genetic condition with familial implications and compared this with a control cohort who had not experienced the specific counseling intervention. The study involved 150 family members in 19 different kindreds across the two cohorts. The principal outcome measure was the proportion of at-risk relatives who had made contact with the clinical genetics service within 2 years of the diagnosis in the index patient.
The proportion of at-risk relatives who made contact with the genetics service was 61% in the intervention cohort compared with 36% in the control cohort (P = 0.01). After controlling for the gender of the at-risk relatives, relatives in the intervention cohort were 2.6 times more likely to make contact with the genetics service (P = 0.02).
The provision of increased genetic counseling support significantly increased the proportion of at-risk relatives who made contact with the genetic service. This suggests that the communication of genetic information within families can be enhanced by the provision of increased genetic counseling support.
The umbilical cord (UC) matrix is a source of multipotent mesenchymal stem cells (MSCs) that have adipogenic potential and thus can be a model to study adipogenesis. However, existing variability in ...adipocytic differentiation outcomes may be due to discrepancies in methods utilized for adipogenic differentiation. Additionally, functional characterization of UCMSCs as adipocytes has not been described. We tested the potential of three well-established adipogenic cocktails containing IBMX, dexamethasone, and insulin (MDI) plus indomethacin (MDI-I) or rosiglitazone (MDI-R) to stimulate adipocyte differentiation in UCMSCs. MDI, MDI-I, and MDI-R treatment significantly increased peroxisome proliferator-activated receptor gamma (PPARγ) and CCAAT-enhancer binding protein alpha (C/EBPα) mRNA and induced lipid droplet formation. However, MDI-I had the greatest impact on mRNA expression of PPARγ, C/EBPα, FABP4, GPD1, PLIN1, PLIN2, and ADIPOQ and lipid accumulation, whereas MDI showed the least. Interestingly, there were no treatment group differences in the amount of PPARγ protein. However, MDI-I treated cells had significantly more C/EBPα protein compared to MDI or MDI-R, suggesting that indomethacin-dependent increased C/EBPα may contribute to the adipogenesis-inducing potency of MDI-I. Additionally, bone morphogenetic protein 4 (BMP4) treatment of UCMSCs did not enhance responsiveness to MDI-induced differentiation. Finally to characterize adipocyte function, differentiated UCMSCs were stimulated with insulin and downstream signaling was assessed. Differentiated UCMSCs were responsive to insulin at two weeks but showed decreased sensitivity by five weeks following differentiation, suggesting that long-term differentiation may induce insulin resistance. Together, these data indicate that UCMSCs undergo adipogenesis when differentiated in MDI, MDI-I, and MDI-R, however the presence of indomethacin greatly enhances their adipogenic potential beyond that of rosiglitazone. Furthermore, our results suggest that insulin signaling pathways of differentiated UCMSCs are functionally similar to adipocytes.
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