Lung transplantation is a life-saving treatment for patients with end-stage lung disease; however, it is infrequently considered for patients with acute respiratory distress syndrome (ARDS) ...attributable to infectious causes. We aimed to describe the course of disease and early post-transplantation outcomes in critically ill patients with COVID-19 who failed to show lung recovery despite optimal medical management and were deemed to be at imminent risk of dying due to pulmonary complications.
We established a multi-institutional case series that included the first consecutive transplants for severe COVID-19-associated ARDS known to us in the USA, Italy, Austria, and India. De-identified data from participating centres-including information relating to patient demographics and pre-COVID-19 characteristics, pretransplantation disease course, perioperative challenges, pathology of explanted lungs, and post-transplantation outcomes-were collected by Northwestern University (Chicago, IL, USA) and analysed.
Between May 1 and Sept 30, 2020, 12 patients with COVID-19-associated ARDS underwent bilateral lung transplantation at six high-volume transplant centres in the USA (eight recipients at three centres), Italy (two recipients at one centre), Austria (one recipient), and India (one recipient). The median age of recipients was 48 years (IQR 41-51); three of the 12 patients were female. Chest imaging before transplantation showed severe lung damage that did not improve despite prolonged mechanical ventilation and extracorporeal membrane oxygenation. The lung transplant procedure was technically challenging, with severe pleural adhesions, hilar lymphadenopathy, and increased intraoperative transfusion requirements. Pathology of the explanted lungs showed extensive, ongoing acute lung injury with features of lung fibrosis. There was no recurrence of SARS-CoV-2 in the allografts. All patients with COVID-19 could be weaned off extracorporeal support and showed short-term survival similar to that of transplant recipients without COVID-19.
The findings from our report show that lung transplantation is the only option for survival in some patients with severe, unresolving COVID-19-associated ARDS, and that the procedure can be done successfully, with good early post-transplantation outcomes, in carefully selected patients.
National Institutes of Health. VIDEO ABSTRACT.
The 3 x 2 m spacing currently used for eucalyptus plantations in the state of Andhra Pradesh, southern India does not permit intercropping from the second year. This discourages small landholders who ...need regular income from taking up eucalyptus plantations and benefiting from the expanding market for pulpwood. Therefore, on-farm experiments were conducted near Bhadrachalam, Khammam district (Andhra Pradesh) for over 4 years from August 2001 to November 2005 to examine whether wide-row planting and grouping of certain tree rows will facilitate extended intercropping without sacrificing wood yield. Eucalyptus planted in five-spatial arrangements in agroforestry 3 x 2 m (farmers' practice), 6 x 1 m, 7 x 1.5 m paired rows (7 x 1.5 PR), 11 x 1 m paired rows (11 x 1 PR) and 10 x 1.5 m triple rows (10 x 1.5 TR) was compared with sole tree stands at a constant density of 1,666 trees ha⁻¹. Cowpea (Vigna unguiculata) was intercropped during the post-rainy seasons from 2001 to 2004, and fodder grasses (Panicum maximum and Brachiaria ruziziensis) were intercropped during both the seasons of 2005. At 51 months after planting, different spatial arrangements did not significantly affect height and diameter at breast height (dbh). Total dry biomass of eucalyptus in different spatial arrangements ranged between 59.5 and 52.9 Mg ha⁻¹, the highest being with 6 x 1 m and the lowest with 10 x 1.5 TR, but treatment differences were not significant. The widely spaced paired row (11 x 1 PR) and triple row (10 x 1.5 TR) arrangements produced 62-73% of sole cowpea yield in 2003, 59-66% of sole cowpea yield in 2004, and 79-94% of sole fodder in 2005. In contrast, the 3 x 2 m spacing allowed only 17-45% of sole crop yields in these years. The better performance of intercrops in widely spaced eucalyptus was likely because of limited competition from trees for light and water. Intercropping of eucalyptus in these wider rows gave 14% greater net returns compared with intercropping in eucalyptus spaced at 3 x 2 m, 19% greater returns compared with that from sole tree woodlot and 263% greater returns compared with that from sole crops. Therefore, in regions where annual rainfall is around 1,000 mm and soils are fairly good, eucalyptus at a density of 1,666 plants per ha can be planted in uniformly spaced wide-rows (6 m) or paired rows at an inter-pair spacing of 7-11 m for improving intercrop performance without sacrificing wood production.
A DNA vaccine against the hepatitis B virus (HBV), enhanced by IL‐2/IFN‐γ fusion protein expression from a plasmid construct and mediated by in vivo electroporation, was evaluated in a total of 39 ...HBeAg‐positive patients with chronic hepatitis B (CHB). The six of 39 patients with a serum alanine aminotransferase (ALT) value of 1–2 times upper limit of normal (ULN) were assigned to the open‐label arm (Group01) receiving vaccine monotherapy; the remaining 33 patients with an ALT of more than two times ULN were enroled to the randomized and controlled arm (Group02) receiving lamivudine (LAM) monotherapy (LAM+placebo) or combined therapy (LAM+DNA vaccine) in 1:2 ratio. In Group01, a significant elevation of HBV‐specific IFN‐γ‐secreting T‐cell counts in comparison with baseline was observed. In Group02, the proportion of patients with HBV DNA suppression was higher with LAM+DNA vaccine than with LAM monotherapy at each visit time point after the final injection of DNA vaccine at week 36, revealing a significant difference between the two groups (P = 0.03) at week 60. The incidence of dual‐site mutations of rtM204/I/S+rtL180M was significantly lower (P = 0.03) with an identified lower virological breakthrough (VBT) rate (P = 0.03) in patients receiving LAM+DNA vaccine than LAM monotherapy, accompanied with a significant higher positive T‐cell response rate in patients receiving LAM+DNA vaccine (P = 0.03). In conclusion, this study provides evidence that HBV DNA vaccination is safe and immunologically effective, and that the HBV‐specific T‐cell responses induced by DNA vaccination under LAM chemotherapy showed a correlation with the suppression of viral replication in patients with CHB.
Leucaena leucocephala is widely used as raw material for the manufacture of paper and packaging material and in biomass based power plants in the state of Andhra Pradesh, Southern India. Experiments ...were conducted to study the affect of tree density on the growth, biomass partitioning and wood productivity. Six treatments 1 × 1 m, 1.3 × 1.3 m, 3 × 0.75 m, 3 × 1 m, 5 × 0.8 m and 3 × 2 m corresponding to a tree density of 10,000, 6666, 4444, 3333, 2500 and 1666 were evaluated with leucaena variety K636. At 51 months after planting, spacings significantly influenced tree height, diameter at breast height (DBH), number of branches and biomass partitioning. Wider tree rows resulted in greater tree height and diameter growth resulting in higher per plant productivity. At harvest, 70% of trees in 3 × 2 m attained a diameter of more than 7.5 cm, while 35% of the trees attained the same DBH in 1 × 1 m spacing. Increased spacing levels decreased the relative amount of growth allocated to the bole of the tree. Marketable biomass yield was highest with 1 × 1 m spacing. Spacing of 3 × 0.75 m produced marketable biomass comparable to that of 1 × 1 m and greater proportion of stems with more than 5 cm diameter. Leucaena can be grown at 3 × 0.75 m spacing either for pulpwood or fuelwood depending on the prevailing market prices and demand.
Summary
To date, no intervention studies have been published demonstrating the effect of the antioxidant lycopene on bone. Postmenopausal women supplemented with lycopene had significantly increased ...antioxidant capacity and decreased oxidative stress and the bone resorption marker N-telopeptide (NTx). Lycopene decreases bone resorption markers and may reduce the risk of osteoporosis.
Introduction
We have previously shown in vitro and in vivo that lycopene from tomato is associated with a protective effect on bone, but lycopene intervention studies have not been reported. Our aim was to carry out a randomized controlled intervention study to determine whether lycopene would act as an antioxidant to decrease oxidative stress parameters, resulting in decreased bone turnover markers, thus reducing the risk of osteoporosis in postmenopausal women.
Methods
Sixty postmenopausal women, 50–60 years old, were recruited. Following a 1-month washout without lycopene consumption, participants consumed either (
N
= 15/group): (1) regular tomato juice, (2) lycopene-rich tomato juice, (3) tomato Lyc-O-Mato® lycopene capsules, or (4) placebo capsules, twice daily for total lycopene intakes of 30, 70, 30, and 0 mg/day respectively for 4 months. Serum collected after the washout, 2 and 4 months of supplementation, was assayed for cross-linked aminoterminal N-telopeptide, carotenoid content, total antioxidant capacity (TAC), lipid, and protein oxidation.
Results
Participants who consumed juice or lycopene capsules were analyzed in one group designated “LYCOPENE-supplemented”. Repeated measures ANOVA showed that LYCOPENE-supplementation for 4 months significantly increased serum lycopene compared to placebo (
p
< 0.001). LYCOPENE-supplementation for 4 months resulted in significantly increased TAC (
p
< 0.05) and decreased lipid peroxidation (
p
< 0.001), protein oxidation (
p
< 0.001), and NTx (
p
< 0.001). These decreases in lipid peroxidation, protein oxidation, and NTx were significantly different from the corresponding changes resulting from placebo supplementation (
p
< 0.05,
p
< 0.005, and
p
< 0.02, respectively).
Conclusions
Our findings suggest that the antioxidant lycopene is beneficial in reducing oxidative stress parameters and the bone resorption marker NTx.
A clean synthesis of 1,8-dioxo-octahydroxanthenes as potential anticancer agents, structure elaboration of one compound and crystal structure analysis of another compound is presented.
Molecular ...iodine facilitated the reaction of 5,5-dimethyl-1,3-cyclohexanedione with aromatic aldehydes in iso-propanol affording a variety of 1,8-dioxo-octahydroxanthenes in high yields. Most of the compounds synthesized showed good anti-proliferative properties in vitro against three cancer cell lines and 9-(2-hydroxyphenyl)-3,3,6,6-tetramethyl-3,4,5,6,7,9-hexahydro-1H-xanthene-1,8(2H)-dione possessing a 2-hydroxy phenyl group at C-9 position was found to be promising. Further structure elaboration of the same compound and the crystal structure analysis and hydrogen bonding patterns of another compound that is, 9-(4-methoxyphenyl)-3,3,6,6-tetramethyl-3,4,5,6,7,9-hexahydro-1H-xanthene-1,8(2H)-dione prepared by using this methodology is presented.
Data centers evolve constantly in size, complexity, and power consumption. Energy management in cloud data centers is a critical and challenging research issue. It becomes necessary to minimize the ...operational costs as well as environmental impact and to guarantee the service-level agreements for the services provided by the data centers. We propose a modified discrete particle swarm optimization based on the characteristic particle swarm optimization for the initial placement of virtual machines and a novel virtual machine selection algorithm for optimizing the current allocation based on memory utilization, bandwidth utilization, and size of the virtual machine. By means of simulations, we observe that the proposed method not only saves the energy significantly than the other approaches, but also minimizes the violations of service-level agreements.
Previous studies have reported on the glucose and lipid-lowering effects of ferulic acid (FA) but its anti-obesity potential has not yet been firmly established. This study investigated the possible ...anti-obesitogenic effects of FA in mice fed a high-fat diet (HFD) for 15 weeks. To assess the antiobesity potential of FA, 32 male Swiss mice, weighing 20-25 g (n=6-8 per group) were fed a normal diet (ND) or HFD, treated orally or not with either FA (10 mg/kg) or sibutramine (10 mg/kg) for 15 weeks and at the end of this period, the body weights of animals, visceral fat accumulation, plasma levels of glucose and insulin hormone, amylase and lipase activities, the satiety hormones ghrelin and leptin, and tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCH-1) were analyzed. Results revealed that FA could effectively suppress the HFD-associated increase in visceral fat accumulation, adipocyte size and body weight gain, similar to sibutramine, the positive control. FA also significantly (P<0.05) decreased the HFD-induced elevations in serum lipid profiles, amylase and lipase activities, and the levels of blood glucose and insulin hormone. The markedly elevated leptin and decreased ghrelin levels seen in HFD-fed control mice were significantly (P<0.05) reversed by FA treatment, almost reaching the values seen in ND-fed mice. Furthermore, FA demonstrated significant (P<0.05) inhibition of serum levels of inflammatory mediators TNF-α, and MCH-1. These results suggest that FA could be beneficial in lowering the risk of HFD-induced obesity via modulation of enzymatic, hormonal and inflammatory responses.
Adsorption of copper using groundnut seed cake power, sesame seed cake powder and coconut cake powders as bioadsorbents was optimized at a pH of 5, temperature of 40 °C, initial metal concentration ...of 10 mg/L, contact time of 30 min and adsorbent dosage 0.75 g for groundnut seed cake powder and 1.0 g of sesame seed cake powder and coconut cake powder. From the results of kinetic studies, it was concluded that the adsorption process followed pseudo-second-order kinetics. Langmuir adsorption isotherm fit perfect for the adsorption of Cu(II) using the three adsorbents. Maximum adsorption capacity was found to be 4.24 mg/g. Artificial neural network modeling which was adopted for the predication of adsorption of Cu(II) using groundnut seed cake powder, sesame seed cake powder and coconut cake powder was carried out by using back-propagation algorithm. Correlation plot drawn for the experimental and ANN predicted values showed a strong correlation coefficient of 0.989, indicating that the network trained fit apt for the prediction of adsorption process.
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