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Nutrient reduction is an essential environmental policy for water quality remediation, but climate change can offset the ecological benefits of nutrient reduction and lead to the difficulty of environmental evaluation. Here, based on the records of three lipid microalgal biomarkers and stable isotopes of carbon and nitrogen in two sediment cores from the embayment of Perth, Australia, we reconstructed the microalgal biomasses (diatoms, dinoflagellates and coccolithophores) over the past century and evaluated the ecological effects of nutrient reduction on them, using Change Point Modeling (CPM) and redundancy analysis (RDA). The CPM result showed that total microalgal biomarkers increased by 25% and 51% in deep and shallow areas, respectively, due to nutrient enrichment caused by industrial wastewater in the 1950s and the causeway construction in the 1970s, and dinoflagellates were beneficiaries of eutrophication. The nutrient reduction policy since the 1980s had not decreased total microalgal biomass, and diatoms were beneficiaries of this period. RDA based on time series of sediment cores and water monitoring data revealed that the increase of sea-surface temperature and the decrease of rainfall since the 1980s may be important factors sustaining the high total microalgal biomass and increasing the degree of diatom dominance. The result also indicated that the variations of microalgal assemblages may better explain the effect of nutrient reduction rather than total microalgal biomass. [Display omitted] • The decadal patterns of microalgae have been reconstructed. • Dinoflagellates profited from the eutrophic conditions. • Diatoms benefited from nutrient reduction. • Microalgal biomass did not decrease following nutrient reduction. • Climate change can cause non-linear responses in primary producers. [ABSTRACT FROM AUTHOR]

Background An elevated body mass index (>30 kg/m2) has been a relative contraindication for living kidney donation; however, such donors have become more common. Given the association between obesity and development of diabetes, hypertension, and end-stage renal disease, there is concern about the long-term health of obese donors. Methods Donor and recipient demographics, intraoperative parameters, complications, and short- and long-term outcomes were compared between contemporaneous donors—obese donors (body mass index ≥30 kg/m2) versus nonobese donors (body mass index <30 kg/m2). Results Between the years 1975 and 2014, we performed 3,752 donor nephrectomies; 656 (17.5%) were obese donors. On univariate analysis, obese donors were more likely to be older (P <.01) and African American (P <.01) and were less likely to be a smoker at the time of donation (P =.01). Estimated glomerular filtration rate at donation was higher in obese donors (115 ± 36 mL/min/1.73m2) versus nonobese donors (97 ± 22 mL/min/1.73m2; P <.001). There was no difference between groups in intraoperative and postoperative complications; but intraoperative time was longer for obese donors (adjusted P <.001). Adjusted postoperative length of stay (LOS) was longer (adjusted P =.01), but after adjustment for donation year, incision type, age, sex, and race, there were no differences in short-term (<30 days) and long-term (>30 days) readmissions. Estimated glomerular filtration rate and rates of end-stage renal disease were not significantly different between donor groups >20 years after donation (P =.71). However, long-term development of diabetes mellitus (adjusted hazard ratio (HR) 3.14; P <.001) and hypertension (adjusted hazard ratio (HR) 1.75; P <.001) was greater among obese donors and both occurred earlier (diabetes mellitus: 12 vs 18 years postnephrectomy; hypertension: 11 vs 15 years). Conclusion Obese donors develop diabetes mellitus and hypertension more frequently and earlier than nonobese donors after donation, raising concerns about increased rates of end-stage renal disease. [ABSTRACT FROM AUTHOR]

Highlights • Molecular composition of Posidonia oceanica and P. australis seagrasses compared. • Lignin of P. oceanica has an extraordinary abundance of p -hydroxybenzoic acid. • p -hydroxybenzoates attach to the γ-OH of the lignin side-chains. • Lignin composition may explain higher carbon storage capacity of P. oceanica. Abstract There is considerable variability in the ability of seagrass ecosystems to sequester organic carbon (C org) in their sediments, which act as natural carbon sinks contributing to climate change mitigation. In this work, we studied the chemistry of two Posidonia seagrass species aiming to elucidate whether differences in chemical composition might explain differences in their C org sequestration capacity. Pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) and Thermally assisted Hydrolysis and Methylation (THM) GC-MS data showed a remarkable difference in phenolic compound patterns between P. oceanica and P. australis bulk plants and individual organs (leaves, sheaths, roots and rhizomes). The lignin of P. australis generates a series of p -hydroxyphenyl (H), guaiacyl (G) and syringyl (S) products that are typical of herbaceous plants, whereas P. oceanica is particularly rich in p -hydroxybenzoic acid (p BA) derivatives. The structural characteristics of the lignins were further investigated by two-dimensional Nuclear Magnetic Resonance (2D-NMR) spectroscopy and Derivatization Followed by Reductive Cleavage (DFRC), focusing on sheath tissues. The analyses confirmed important differences in the lignin content (19.8% in P. australis and 29.5% in P. oceanica) and composition between the two species; intriguingly, the cell-walls of P. oceanica sheaths were highly enriched in p BA, a component that was completely absent in P. australis. 2D-NMR and DFRC data further revealed that p BA was esterified to the lignin, acylating the γ-OH of the lignin side-chain. Interestingly, P. oceanica lignin presented an extremely high degree of p -hydroxybenzoylation in both guaiacyl (73%) and syringyl (61%) lignin units; the highest p -hydroxybenzoylation degree reported in plant lignins to date. It is tempting to conclude that the higher C org storage capacity of P. oceanica ecosystems might be related to the higher abundance of p BA-rich lignin and its recalcitrant nature. [ABSTRACT FROM AUTHOR]

Abstract Seagrass meadows provide multiple ecosystem services, yet they are among the most threatened ecosystems on earth. Because of their role as carbon sinks, protection and restoration of seagrass meadows contribute to climate change mitigation. Blue Carbon strategies aim to enhance CO 2 sequestration and avoid greenhouse gasses emissions through the management of coastal vegetated ecosystems, including seagrass meadows. The implementation of Blue Carbon strategies requires a good understanding of the habitat characteristics that influence C org sequestration. Here, we review the existing knowledge on Blue Carbon research in seagrass meadows to identify the key habitat characteristics that influence C org sequestration in seagrass meadows, those factors that threaten this function and those with unclear effects. We demonstrate that not all seagrass habitats have the same potential, identify research priorities and describe the implications of the results found for the implementation and development of efficient Blue Carbon strategies based on seagrass meadows. Highlights • We review the effects of habitat characteristics on seagrass C org sequestration. • Habitat characteristics that enhance or reduce C org sequestration are provided. • Habitat characteristics with unresolved effects are identified for future research. • Implications for the development of efficient Blue Carbon strategies are indicated. [ABSTRACT FROM AUTHOR]

Background: Post-transplant malignancy (PTM) remains a concern among pediatric kidney transplant (PKT) recipients.Study Design: Between 1963 and 2015, 884 pediatric (age 0 to 17 years old) patients received 1,055 PKTs at our institution. Cox proportional hazards models were constructed to identify risk factors for PTM after PKT with time-to-first-PTM as a primary outcome. Secondly, the hazard of death or graft loss was calculated in patients who developed PTM.Results: Median patient survival was 33 years (interquartile range [IQR] 18.7 to 47 years); 260 patients died during the study period and 47 had been diagnosed with PTM. There were 235 PTMs that occurred in 136 (15.4%) recipients at a median age of 29 years (IQR 17.8 to 37 years). The percentages of patients with PTM were 13% at 20 years post-PKT and 26% at 30 years post-PKT. Of PTM patients who died, 63.8% died of PTM. Among those who developed PTM, there was a higher hazard of death or graft loss (hazard ratio [HR] 1.62; 95% CI 1.11 to 2.38). In multivariable proportional hazards models, factors associated with PTM were increasing age at PKT (adjusted HR [AHR] 3.14; 95% CI 1.80 to 5.48 for 14 to 17 year-olds compared with children less than 3 years), having a living unrelated donor (LURD; AHR 3.25; 95% CI 1.27 to 8.35 compared with a living related donor), or implanting an Epstein-Barr virus (EBV)-positive allograft in an EBV-negative recipient (AHR 5.66; 95% CI 1.11 to 29.0). Compared with the general population, the cancer rate for PKT recipients was 6 times higher (126 vs 21 per 100,000 person-years).Conclusions: Pediatric kidney transplant recipients are at increased risk of PTM, which adversely affects survival. Children receiving transplants at an older age, from a LURD, or who receive an EBV-positive organ, should be monitored closely for the development of PTM. [ABSTRACT FROM AUTHOR]

Introduction Sclerosing Encapsulating Peritonitis (SEP) is a rare condition with an incidence of up to 3% and a mortality of up to 51% among peritoneal dialysis (PD) patients (Brown et al., Korte et al. and Kawanishi et al.). In the last ten years, the incidence of SEP in kidney transplant recipients has increased (Nakamoto, de Sousa et al. and Korte et al.). Presentation of case A 31-year old male with a 15 years history of PD and later kidney retransplantation was admitted to the emergency service after experiencing several weeks of diffuse abdominal pain which had escalated to include vomiting and diarrhea during the 24 h previous to admission. The patient underwent an exploratory laparotomy where severe peritoneal thickening was found, in addition to signs of chronic inflammation and blocked intestinal loops. Histopathologic findings were suggestive of sclerosing peritonitis. After two months of treatment in hospital, the patient presented an obstructed intestine, with a rigid and thickened peritoneum compromising all the intestinal loops. Discussion Despite being rare, SEP, represents a significant complication due to its high mortality and recurrence. It is insidious in its early stages and culminates in an intestinal obstruction (Fieren). Risk factors for its development in kidney transplant recipients include a history of prolonged treatment with PD and the use of calcineurin inhibitors as an immunosuppressive treatment (Korte et al.). Conclusion Given the increase in the incidence of SEP in kidney transplant recipients, the clinician should be alert to the presence of this complication. A greater number of multi-centre studies are required to identify the risk factors for SEP that are inherent in renal transplant recipients. [ABSTRACT FROM AUTHOR]

• Climate change was identified as the main threat for seagrass soil CO 2 emissions. • Direct threats have the highest potential risk for CO 2 emissions at a local scale. • Empirical data on seagrass CO 2 emissions following disturbance is scarce. • Ranking of threats for seagrass CO 2 emissions can aid management and policy. Seagrass meadows are natural carbon storage hotspots at risk from global change threats, and their loss can result in the remineralization of soil carbon stocks and CO 2 emissions fueling climate change. Here we used expert elicitation and empirical evidence to assess the risk of CO 2 emissions from seagrass soils caused by multiple human-induced, biological and climate change threats. Judgments from 41 experts were synthesized into a seagrass CO 2 emission risk score based on vulnerability factors (i.e., spatial scale, frequency, magnitude, resistance and recovery) to seagrass soil organic carbon stocks. Experts perceived that climate change threats (e.g., gradual ocean warming and increased storminess) have the highest risk for CO 2 emissions at global spatial scales, while direct threats (i.e., dredging and building of a marina or jetty) have the largest CO 2 emission risks at local spatial scales. A review of existing peer-reviewed literature showed a scarcity of studies assessing CO 2 emissions following seagrass disturbance, but the limited empirical evidence partly confirmed the opinion of experts. The literature review indicated that direct and long-term disturbances have the greatest negative impact on soil carbon stocks per unit area, highlighting that immediate management actions after disturbances to recover the seagrass canopy can significantly reduce soil CO 2 emissions. We conclude that further empirical evidence assessing global change threats on the seagrass carbon sink capacity is required to aid broader uptake of seagrass into blue carbon policy frameworks. The preliminary findings from this study can be used to estimate the potential risk of CO 2 emissions from seagrass habitats under threat and guide nature-based solutions for climate change mitigation. [ABSTRACT FROM AUTHOR]

Introduction Liver angiosarcoma is a very uncommon tumour of mesenchymal origin, representing between 0.1–2% of all primary tumours of the liver, affecting mainly men in their sixth or seventh decade of life, with a high mortality in the first years (Chaudhary et al., 2015). Literature reports of its surgical treatment vary from a total or partial hepatectomy with or without liver transplant. Presentation of case A 37 year old male, with a 7 year history of a fatty liver, was found to have a 12 cm diameter tumour in a cirrhotic liver, during an abdominal Computed Tomography (CT) scan. Patient was asymptomatic with negative tumour markers, yet tumour liver biopsy revealed a Liver Angiosarcoma with positive immunohistochemistry for neoplastic cells CD31 and CD34. Patient was deemed candidate for a partial hepatectomy of the affected liver segments which was done without complications and no evidence of other tumour lesions was found during surgery. Patient continued oncologic management with ongoing chemotherapy. Discusion Liver Angiosarcoma, although rare, persists with a high mortality due to its aggressive nature. Never the less liver transplantation, although proven to be an effective treatment for many pathologies that culminate in liver failure, fails to improve patients’ survival and prognosis, when compared to partial hepatectomy as surgical management to for liver Angiosarcoma, Conclusion Partial hepatectomy as surgical management, followed by adjuvant therapy, for Liver Angiosarcoma continues to prove favourable results and prognosis compared to Liver Transplantation. [ABSTRACT FROM AUTHOR]

Introduction One of the frequent complications suffered by patients with chronic renal failure is the lack of vascular access due to venous thrombosis. This means that the transplant surgeon must have a detailed knowledge of the intra-abdominal venous system, and other alternative surgeries, at the time of performing the renal graft implant, in order to ensure a good venous drainage. Presentation of the case This article provides a case report regarding a patient with no vascular access and with surgical difficulties at the time of the kidney transplant, in whom a renal-portal venous drainage was performed with very good outcome. Discusion Renal-portal venous drainage is a way to performe kidney transplant with good outcome. In Fundación Valle del Lili we have overcome the lack of vascular access in patients that need a renal transplant by new surgical technics that improve the patients quality of life and survival. Conclusion We can conclude that new surgical alternatives exist for those patients with chronic renal failure that have no vascular access. These patients are a priority for kidney transplants and the surgeon must take in to account the need for a new surgical assessment. [ABSTRACT FROM AUTHOR]

Posidonia oceanica forms extensive peat-like deposits (mats) in Mediterranean coastal waters, which have a potential as carbon sinks and archives of environmental change. Nonetheless, the organic chemistry of both P. oceanica plant materials, as well as the environmental and diagenetic effects on the composition of its detritus, is poorly understood. We analyzed plant organs of P. oceanica and the coarse organic matter from a mat core spanning 750 yrs using pyrolysis techniques (PY-GC–MS and THM-GC–MS) to improve our understanding of their molecular properties and their preservation upon mat development. It appeared that leaf sheaths, roots and the outer parts of rhizomes were composed predominantly of phenolic constituents based on p -hydroxybenzoic acid ( p -HBA), which is atypical for vascular plants, in addition to carbohydrates and lignin. The inner rhizome and leaf blades had a different composition, with predominance of carbohydrates. The seagrass detritus in the mat was composed mainly of p -HBA phenolic material and carbohydrates, confirming earlier studies showing that the coarse detritus in the mat originates largely from Posidonia sheath, root and rhizome debris. The intermolecular arrangement of the p -HBA remains unclear, as they seem to correspond to ester-bound phenols yet their persistence in the mat attributes them a refractory nature. Variations in molecular composition within the mat are probably associated with diagenetic alteration of P. oceanica detritus, such as the decomposition of minor amounts of fatty acids, chlorophyll and syringyl lignin, and selective preservation of p -HBA relative to carbohydrates. This work lays the foundations for a molecular understanding of carbon storage within the mats and the environmental changes recorded therein. [ABSTRACT FROM AUTHOR]

Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as one of the most effective treatments for morbid obesity. Surgical site infections are the most common complication after LRYGB surgery. Objective To compare the superficial surgical site infections (sSSI) rate before and after the implementation of our intraoperative technique. Setting Academic medical center. Methods Our intraoperative technique relies on sterile coverage of the circular stapler, sterile specimen-bag retrieval of the gastrojejunostomy enteric remnant, and port site Penrose drainage. We analyzed our sSSI outcomes before and after implementation of our technique in all LRYGBs performed by a single surgeon from 2009 to 2015. We took into account patient age; sex; baseline body mass index (BMI); smoking status; and co-morbidities such as diabetes, hypertension, and hyperlipidemia. χ 2 and multivariate analysis were performed. Results We performed 486 LRYGBs in 2009–2015. The cohort before implementation of our technique (group 1) included 164 patients (33.7%) and the cohort after implementation (group 2) included 322 patients (66.3%). Both groups were similar in age, sex, smoking status, and rates of diabetes and hyperlipidemia but differed in BMI, operative time, and prevalence of hypertension. Hypertension was not a confounder for sSSI ( P = .35). The sSSI rate was 9.15% for group 1 and 3.42% for group 2 ( P = .0079). Controlling for BMI and operative time, multivariate analysis revealed a significant reduction in sSSI (odds ratio 2.98 [95% CI 1.33–6.69]) with our technique. Conclusions We describe a reproducible intraoperative technique that significantly reduces sSSI in LRYGB procedures. Our technique has the potential of hastening postoperative recovery. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery has been established as the most effective long-term treatment for morbid obesity and obesity-related comorbidities. Despite its success, there is a paucity of data on the outcomes of bariatric surgery on Hispanic patients.Study Design: We performed a retrospective review of obese patients treated at our institute between 2008 and 2014. We identified self-reported Hispanic patients who underwent a laparoscopic gastric bypass (LGBP), sleeve gastrectomy (LSG), or gastric band (LGB) procedure. The primary end point was excess weight loss (EWL) at 6, 12, 24, and 36 months. Secondary end points included improvement of obesity-related metabolic parameters at 1 year. We performed a repeated measures analysis of variance to calculate statistical significance throughout our study time period.Results: We identified 2002 Hispanic patients who underwent bariatric surgery (1,235 LGBP, 600 LSG, 167 LGB) at our institute from 2008 to 2014. Follow-ups at 6, 12, 24, and 36 months were 62.2%, 54.5%, 36.2%, and 19.8%, respectively. Mean preoperative BMIs were 47.0 ± 7.2 kg/m2, 46.1 ± 7.8 kg/m2, and 44.9 ± 6.0 kg/m2 for the LGBP, LSG, and LGB cohorts, respectively. Excess weight loss was significantly more pronounced in the LGBP and the LSG groups than in the LGB group; this difference was accentuated over time (p < 0.0001). Obesity-related metabolic parameters and the need for comorbidity medical therapy decreased in all 3 surgical groups.Conclusions: Bariatric surgery is highly successful in Hispanic obese patients. In the largest series to date, LGBP and LSG seem to yield more effective EWL and reduction of cardiometabolic parameters than LGB among Hispanics; however, outcomes are still markedly reduced when compared with those in non-Hispanic populations. [ABSTRACT FROM AUTHOR]

The study of a Posidonia australis sedimentary archive has provided a record of changes in element concentrations (Al, Fe, Mn, Pb, Zn, Cr, Cd, Co, As, Cu, Ni and S) over the last 3000 years in the Australian marine environment. Human-derived contamination in Oyster Harbor (SW Australia) started ~ 100 years ago (AD ~ 1900) and exponentially increased until present. This appears to be related to European colonization of Australia and the subsequent impact of human activities, namely mining, coal and metal production, and extensive agriculture. Two contamination periods of different magnitude have been identified: Expansion period (EXP, AD ~ 1900–1970) and Establishment period (EST, AD ~ 1970 to present). Enrichments of chemical elements with respect to baseline concentrations (in samples older than ~ 115 cal years BP) were found for all elements studied in both periods, except for Ni, As and S. The highest enrichment factors were obtained for the EST period (ranging from 1.3-fold increase in Cu to 7.2-fold in Zn concentrations) compared to the EXP period (1.1-fold increase for Cu and Cr to 2.4-fold increase for Pb). Zinc, Pb, Mn and Co concentrations during both periods were 2- to 7-fold higher than baseline levels. This study demonstrates the value of Posidonia mats as long-term archives of element concentrations and trends in coastal ecosystems. We also provide preliminary evidence on the potential for Posidonia meadows to act as significant long-term biogeochemical sinks of chemical elements. [ABSTRACT FROM AUTHOR]

Because 5-year survival rates for patients with metastatic melanoma remain below 25%, there is continued need for new therapeutic approaches. For some tumors, pharmacologic ascorbate treatment may have a beneficial antitumor effect and may work synergistically with standard chemotherapeutics. To investigate this possibility in melanoma, we examined the effect of pharmacologic ascorbate on B16-F10 cells. Murine models were employed to compare tumor size following treatment with ascorbate, and the chemotherapeutic agents dacarbazine or valproic acid, alone or in combination with ascorbate. Results indicated that nearly all melanoma cell lines were susceptible to ascorbate-mediated cytotoxicity. Compared to saline controls, pharmacologic ascorbate decreased tumor size in both C57BL/6 ( P <0.0001) and NOD- scid tumor bearing mice ( P <0.0001). Pharmacologic ascorbate was superior or equivalent to dacarbazine as an antitumor agent. Synergy was not apparent when ascorbate was combined with either dacarbazine or valproic acid; the latter combination may have additional toxicities. Pharmacologic ascorbate induced DNA damage in melanoma cells, as evidenced by increased phosphorylation of the histone variant, H2A.X. Differences were not evident in tumor samples from C57BL/6 mice treated with pharmacologic ascorbate compared to tumors from saline-treated controls. Together, these results suggest that pharmacologic ascorbate has a cytotoxic effect against melanoma that is largely independent of lymphocytic immune functions and that continued investigation of pharmacologic ascorbate in cancer treatment is warranted. [ABSTRACT FROM AUTHOR]

Mesenchymal hamartoma is the second most frequent benign liver tumor in young children and usually occurs in the first two years of life. Currently, the gold standard for treatment is a complete surgical resection. We report a 17-month old patient with a giant mesenchymal hamartoma who, due to the impossibility of resection and the risk of malignant transformation, received liver transplantation from a living donor with a satisfactory outcome in the first year post-transplant. In this report, we show that liver transplantation is a viable therapeutic alternative for this pathology, in patients who have no possibility of receiving another type of treatment due to their clinical characteristics. [ABSTRACT FROM AUTHOR]

The number of published papers in biomedical research makes it rather impossible for a researcher to keep up to date. This is where manually curated databases contribute facilitating the access to knowledge. However, the structure required by databases strongly limits the type of valuable information that can be incorporated. Here, we present Lisen&Curate, a curation system that facilitates linking sentences or part of sentences (both considered sources) in articles with their corresponding curated objects, so that rich additional information of these objects is easily available to users. These sources are going to be offered both within RegulonDB and a new database, L-Regulon. To show the relevance of our work, two senior curators performed a curation of 31 articles on the regulation of transcription initiation of E. coli using Lisen&Curate. As a result, 194 objects were curated and 781 sources were recorded. We also found that these sources are useful to develop automatic approaches to detect objects in articles by observing word frequency patterns and by carrying out an open information extraction task. Sources may help to elaborate a controlled vocabulary of experimental methods. Finally, we discuss our ecosystem of interconnected applications, RegulonDB, L-Regulon, and Lisen&Curate, to facilitate the access to knowledge on regulation of transcription initiation in bacteria. We see our proposal as the starting point to change the way experimentalists connect a piece of knowledge with its evidence using RegulonDB. • Lisen&Curate is a platform to assist curation of transcriptional regulation. • Lisen&Curate links curated objects with their supporting evidence in articles. • Lisen&Curate changes traditional access to knowledge by textual sources of evidence. • Lisen&Curate helps to develop text mining approaches and controlled vocabularies. • Lisen&Curate is a new interconnected application to facilitate access to knowledge. [ABSTRACT FROM AUTHOR]

The study of a Posidonia sinuosa sedimentary archive has delivered a millenary record of environmental change in Cockburn Sound (Western Australia). Ecosystem change is a major environmental problem challenging sustainable coastal development worldwide, and this study shows baseline trends and shifts in ecological processes in coastal ecosystems under environmental stress. The concentrations and fluxes of biogeochemical elements over the last 3,500 years indicate that important changes in ecosystem dynamics occurred over the last 1,000 years, in particular after ~1900's, probably related to establishment of seagrass meadows in the area and to local and regional human activities (industry and coastal development), respectively. The establishment of seagrasses ~1,000 years ago in the area of study is supported by the appearance of Posidonia fibres from ~40 cm soil depth until the core top, higher δ13C values indicating a larger contribution of seagrass-matter to the soil organic carbon pool, and increased concentration of fine sediments driven by the effect of seagrass canopy in enhancing sedimentation. The comparison of organic carbon, nutrients and metal concentrations and fluxes between pre- and post-establishment of seagrasses shows that seagrass establishment resulted in up to 9-fold increase in the soil biogeochemical sink. In ~1900's, shifts in the concentrations of metals, carbonates, organic carbon, sediment grain size, and δ13C and δ15N values of the organic matter were detected, demonstrating an alteration in seagrass ecosystem functioning following the onset of European settlement. Anthropogenic activities, and in particular the construction of a causeway in 1970's, enhanced seagrass soil organic carbon and metal accumulation rates by 36- and 39-fold, respectively, showing that human-made structures can enhance the biogeochemical sink capacity of seagrasses. Here we reconstruct the impact of human activities on seagrass ecosystem dynamics and blue carbon, which can inform local management of Cockburn Sound and seagrass conservation for climate change mitigation and adaptation. • Seagrass archives help to understand and better manage ecological change. • Seagrass establishment ~1,000 years ago increased biogeochemical sink capacity. • Ecosystem shifts followed European settlement in an Australian embayment. • Human-made structures can enhance seagrass carbon and metal sequestration. [ABSTRACT FROM AUTHOR]

Blue Carbon (BC) strategy refers to the approaches that mitigate and adapt to climate change through the conservation and restoration of seagrass, saltmarsh and mangrove ecosystems and, in some BC programs, also through the expansion of seaweed aquaculture. The major losses of coastal habitats in combination with the commitments of China under the Paris Agreement provide unique opportunity and necessity to develop a strong Chinese BC program. Here, we (1) characterize China's BC habitats, examine their changes since 1950 along with the drivers of changes; (2) consider the expansion of seaweed aquaculture and how this may be managed to become an emerging BC resource in China, along with the engineering solutions required to enhance its potential; and (3) provide the rationale and elements for BC program in China. We find China currently has 1326–2149 km2 wild and 2–15 km2 created mangrove, saltmarsh and seagrass habitats, while 9236–10059 km2 (77–87%) has been lost since 1950, mainly due to land reclamation. The current area of farmed seaweed habitat is 1252–1265 km2, which is close to the area of wild mangrove, saltmarsh and seagrass habitats. We conclude that BC strategies have potentials yet to be fully developed in China, particularly through climate change adaptation benefits such as coastal protection and eco-environmental co-benefits of seaweed farming such as habitat creation for fish and other biota, alleviation of eutrophication, hypoxia and acidification, and the generation of direct and value added products with lower environmental impact relative to land-based production. On this basis, we provide a roadmap for BC strategies adjusted to the unique characteristics and capacities of China. Blue Carbon (BC) plays important roles in climate change mitigation/adaptation. In this paper, we 1) characterize China's BC habitats and examine their changes since 1950 along with the drivers of changes; 2) consider the expansion of seaweed aquaculture and how this may be managed to become an emerging BC resource in China, along with the engineering solutions required to enhance its potential; 3) provide the rationale and elements for BC program in China; and 4) draw a roadmap for BC strategies adjusted to the unique characteristics and capacities of China.Porphyra farm in Dongtou, Wenzhou city, Zhejiang province, China. Image 1 • China's Blue Carbon (BC) habitats, changes and the drivers of changes since 1950. • Potential BC resources, seaweed aquaculture expansion with engineering solutions. • BC Benefits for climate adaptation and co-benefits for environment and economy. • Great potential of China's BC strategies through climate change adaptation benefits. • A roadmap for BC strategies adjusted to the China's characteristics and capacities. [ABSTRACT FROM AUTHOR]

• We assess the potential inclusion of blue carbon within Australia's Emissions Reduction Fund, emphasizing issues and approaches that have global relevance. • We identify twelve potential management actions then quantify and discuss the five most promising activities, encompassing the protection, restoration and creation of mangroves, tidal marshes and seagrasses. • On a per area basis, mean abatement intensity of organic carbon was highest for the management activity ' (re)introduction of tidal flow' which may result in mean annual abatement of 13 – 15 Mg C org ha−1 yr−1 for mangrove and 6 – 8 Mg C org ha−1 yr−1 for tidal marsh. • Our approach offers a template that uses best available information to identify options for carbon abatement through management of coastal landscapes. There is increasing interest in protecting, restoring and creating 'blue carbon' ecosystems (BCE; mangroves, tidal marshes and seagrasses) to sequester atmospheric CO 2 -C and thereby contribute to climate change mitigation. While a growing number of countries aspire to report greenhouse gas emission and carbon sequestration changes from these ecosystems under voluntary international reporting requirements, few countries have domestic policy frameworks that specifically support the quantification and financing of carbon emission abatement through BCE management. Australia, as home to approximately 5–11% of global blue carbon stocks, has a substantial interest in the development of blue carbon policy. Here we assess the potential inclusion of blue carbon within Australia's Emissions Reduction Fund, emphasizing issues and approaches that have global relevance. We used a participatory workshop of scientific experts and carbon industry stakeholders to identify blue carbon management actions that would meet the requirements of the Fund. In total, twelve actions were assessed for their greenhouse gas emission abatement potential and the ability to measure abatement reliably, using a combination of available data and qualitative and quantitative methods, including expert knowledge. We identify and discuss the five most relevant and promising activities, encompassing the protection, restoration and creation of mangroves, tidal marshes and seagrasses. On a per area basis, mean abatement intensity of organic carbon (C org) was highest for the (re)introduction of tidal flow resulting in establishment of mangrove (13–15 Mg C org ha−1 yr−1) and tidal marsh (6–8 Mg C org ha−1 yr−1), followed by land use planning for sea-level rise for the creation of new mangrove habitat (8 Mg C org ha−1 yr−1). The avoided disturbance of existing mangroves, tidal marshes and seagrasses has the twofold benefit of avoiding remineralisation of existing stocks, plus the future annual abatement associated with the net sequestration of atmospheric CO 2 -C as C org with the continued functioning of these BCE. Our approach offers a template that uses best available information to identify options for carbon abatement through management of coastal landscapes, and details current knowledge gaps and important technical aspects that need to be considered for implementation in carbon crediting schemes. [ABSTRACT FROM AUTHOR]

• Molecular analysis of 3200 yr Posidonia australis seagrass soil record (Australia). • Tracing diagenetic effects on sheaths and root/rhizome detritus. • Ageing-induced selective degradation of polysaccharides and enrichment of lignin. • Minor constituents cutin, suberin and tannin also preferentially depleted. • Overall C storage capacity associated with lignocellulose chemical recalcitrance. Seagrass ecosystems are recognised for their role in climate change mitigation, due to their capacity to form organic-rich sediments. The chemical recalcitrance of seagrass organs is one characteristic driving carbon storage, but the molecular background of this feature is poorly understood. We assessed molecular composition changes of Posidonia australis sheaths (SH) and roots plus rhizomes (RR) along a sediment core, encompassing 3200 cal. yr BP, by means of nuclear magnetic resonance spectroscopy (13C NMR), conventional analytical pyrolysis (Py-GC–MS) and thermally assisted hydrolysis and methylation (THM-GC–MS). Significant trends with depth (age) in the composition of both SH and RR remains of P. australis were observed from all methods. In general terms, polysaccharides become depleted (degraded) and lignin enriched (selectively preserved) as age increases, and the minor constituents cutin, suberin and condensed tannin are also preferentially depleted during ageing in both fractions. Molecular changes with ageing were smaller in SH, especially regarding polysaccharides, indicative of a superior stability compared to RR. The molecular changes observed are most pronounced within the first 75 cm of the record, which reflects the recalcitrance of P. australis detritus once it is buried below that depth (corresponding to approximately 700 cal. yr BP). The capacity of P. australis to act as a long-term carbon sink seems to be mainly related to the resistance of buried lignocellulose materials to decomposition. The results on diagenetic effects on the molecular fingerprint of seagrass detritus contribute to our understanding of carbon sequestration in Blue Carbon ecosystems. Furthermore, data comparison of the methods applied using principal component analysis (PCA) allowed us to identify consistencies, discrepancies and complementarities. [ABSTRACT FROM AUTHOR]

• Ethnic minorities are disproportionally affected by liver failure. • Hispanics have improved liver transplant outcomes. • African Americans have poorer survival after liver transplant. Racial and ethnic minorities are disproportionally affected by end-stage liver disease. Unfortunately, disparities in referrals to liver transplantation (LT), organ allocation, and posttransplant outcomes exist in this population. We performed a retrospective analysis of patients over the age of 18 years undergoing LT in the United States using the Scientific Registry of Transplant Recipients from 2002 to 2016. We evaluated factors associated with patient and graft outcomes and explored the effect of race and ethnicity along with social variables. During the study time period, 78,999 patients received LT. Of these, 60,102 were non-Hispanic White (NHW), 7988 were African American (AA), and 10,909 were Hispanic. AA had significantly lower patient survival, graft survival, and death-censored graft survival at both 1 and 5 years when compared to NHW. Conversely, at 1 and 5 years, patient survival and graft survival were significantly higher for Hispanics compared to NWH. In addition, AA had significantly lower survival outcomes compared to Hispanics. On multivariate analysis after controlling for race/ethnicity, age, AA race, diagnosis, and deceased donor were independent risk factors for patient death and graft failure. Despite socioeconomic disadvantages seen among Hispanics, this population appears to have improved short- and long-term survival after LT compared to NHW and AA. [ABSTRACT FROM AUTHOR]

Acute myeloid leukemia (AML) is a rare malignancy with increased incidence in the kidney transplantation (KT) population for which immunosuppression has been implicated as a putative cause. The average time interval from KT to AML development is 5 years. We present the case of a 61-year-old man who was found to have peripheral blood blasts on a postoperative day 20 routine blood draw after an uneventful unrelated living donor kidney transplant. He subsequently had a bone marrow biopsy and next-generation sequencing (NGS)-based molecular testing, which demonstrated AML characterized by SMC1A and TET2 mutations. He received induction chemotherapy followed by hematopoietic cell transplantation (HCT) from the kidney donor, who happened to be matched at one haplotype. At 12 months after his HCT and 15 months after his KT, his AML remained in remission, normal renal function was preserved, no active graft-versus-host disease was present, and immunosuppression was tapering. With full donor-derived hematopoietic chimerism, we expect to be able to discontinue immunosuppression shortly, thereby achieving tolerance. The short time interval between KT and development of AML suggests the malignancy was likely present before KT. Modern NGS-based analysis offers a promising method of identifying transplant candidates with unexplained hematologic abnormalities on pre-KT testing who may benefit from formal hematologic evaluation. [ABSTRACT FROM AUTHOR]

In December 2014, the Kidney Donor Profile Index (KDPI) was developed to give more precise information on donor kidney quality. Kidneys with KDPI scores ≥ 85 (K ≥ 85) have been reported to have inferior outcomes to kidneys with KDPI scores < 85. After the implementation of the new Kidney Allocation System, we developed a protocol to evaluate K ≥ 85 use. We analyzed the safety and efficacy of our institutional criteria and evaluated post-transplant outcomes. K ≥ 85 recipients were stratified based on their 1-year creatinine and estimated glomerular filtration rates to elucidate characteristics associated with serum creatinine < 1.7 mg/dL or estimated glomerular filtration rates ≤ 45 mL/min/1.73 m2. From December 2014 to December 2019, 304 deceased donor kidney transplants were performed at Hartford Hospital; 58 (19%) were K ≥ 85 with an average KDPI of 91%. There were 4 graft losses; 2 were death censored. Prolonged cold ischemia time and black recipient race were associated with inferior recipient graft function at 1 year. High KDPI kidney use requires a multifaceted evaluation that takes into account donor and recipient characteristics for an ideal match. We have identified several characteristics that may predict optimal post-transplant kidney function. [ABSTRACT FROM AUTHOR]

Background: Living liver donation is one of the most selfless and humane acts a person can perform. Few single-center reports have been published specifically evaluating complications and quality of life post-donation.Study Design: We conducted a retrospective analysis of outcomes of 176 living liver donors at our center to determine the incidence, type, and Clavien grade of complications, as well as long-term quality of life.Results: Of 176 living donors, 154 underwent right hepatectomy, 4 underwent left hepatectomy lobectomy, and 18 underwent left lateral segmentectomy. Mean follow-up time was 4.8 years. Complications were more frequent among right-lobe donors than left-lateral segmentectomy and left-lobe donors (p = 0.003). Of note, 82% of complications were Clavien grade 1 or 2. Of the 154 right-lobe donors, 3 had Clavien grade 3a complications, 9 had grade 3b complications (4 had bile leaks, 3 had intra-abdominal bleeding, and 2 had pleural effusions). No donor had complications that were Clavien grade 4 or higher. Per multivariate regression, resected graft volume (p = 0.0498) and post-donation international normalized ratio >2 (p = 0.00499) were significantly associated with a higher risk of Clavien grade 3 complications; however, sex, age, previous abdominal operation, post-donation bilirubin >6 mg/dL, and aspartate transaminase >650 IU/L were not. Per our 36-item Short-Form Health Survey results, donors (mean 8.3 years post-donation) reported above-average quality of life compared with standard US population. In a liver donation survey sent between 1 and 15 years post-donation, the most frequently reported problems were incisional discomfort and intolerance to fatty meals.Conclusions: In our single-center study, early complication rates were comparable with those of multicenter reports. Most complications (82%) were Clavien grade 1 or 2. During a long follow-up period, our donors continue to have improved quality of life. [ABSTRACT FROM AUTHOR]

Blue carbon ecosystems (BCE) include mangrove forests, tidal marshes, and seagrass meadows, all of which are currently under threat, putting their contribution to mitigating climate change at risk. Although certain challenges and trade-offs exist, remote sensing offers a promising avenue for transparent, replicable, and cost-effective accounting of many BCE at unprecedented temporal and spatial scales. The United Nations Framework Convention on Climate Change (UNFCCC) has issued guidelines for developing blue carbon inventories to incorporate into Nationally Determined Contributions (NDCs). Yet, there is little guidance on remote sensing techniques for monitoring, reporting, and verifying blue carbon assets. This review constructs a unified roadmap for applying remote sensing technologies to develop cost-effective carbon inventories for BCE – from local to global scales. We summarise and discuss (1) current standard guidelines for blue carbon inventories; (2) traditional and cutting-edge remote sensing technologies for mapping blue carbon habitats; (3) methods for translating habitat maps into carbon estimates; and (4) a decision tree to assist users in determining the most suitable approach depending on their areas of interest, budget, and required accuracy of blue carbon assessment. We designed this work to support UNFCCC-approved IPCC guidelines with specific recommendations on remote sensing techniques for GHG inventories. Overall, remote sensing technologies are robust and cost-effective tools for monitoring, reporting, and verifying blue carbon assets and projects. Increased appreciation of these techniques can promote a technological shift towards greater policy and industry uptake, enhancing the scalability of blue carbon as a Natural Climate Solution worldwide. • Blue carbon ecosystems (BCE) play a key role in climate change mitigation. • Remote sensing techniques are cost-effective for monitoring BCE extent and carbon stocks. • A tradeoff exists between spatial resolution and historical coverage of remotely sensed data. • New technologies can facilitate the inclusion of BCE in national inventories and Nationally Determined Contributions (NDCs). • Our decision tree guides the choice of remote sensing methods for monitoring BCE. [ABSTRACT FROM AUTHOR]

Seagrass meadows store significant carbon stocks at a global scale, but land-use change and other anthropogenic activities can alter the natural process of organic carbon (C org) accumulation. Here, we assessed the carbon accumulation history of two seagrass meadows in Zanzibar (Tanzania) that have experienced different degrees of disturbance. The meadow at Stone Town has been highly exposed to urban development during the 20th century, while the Mbweni meadow is located in an area with relatively low impacts but historical clearing of adjacent mangroves. The results showed that the two sites had similar sedimentary C org accumulation rates (22–25 g m−2 yr−1) since the 1940s, while during the last two decades (∼1998 until 2018) they exhibited 24–30% higher accumulation of C org , which was linked to shifts in C org sources. The increase in the δ13C isotopic signature of sedimentary C org (towards a higher seagrass contribution) at the Stone Town site since 1998 points to improved seagrass meadow conditions and C org accumulation capacity of the meadow after the relocation of a major sewage outlet in the mid–1990s. In contrast, the decrease in the δ13C signatures of sedimentary C org in the Mbweni meadow since the early 2010s was likely linked to increased C org run-off of mangrove/terrestrial material following mangrove deforestation. This study exemplifies two different pathways by which land-based human activities can alter the carbon storage capacity of seagrass meadows (i.e. sewage waste management and mangrove deforestation) and showcases opportunities for management of vegetated coastal C org sinks. [Display omitted] • The seagrass carbon accumulation rate was 22–25 g C org m−2 yr−1. • The rate of carbon accumulation had increased by 24–30% during the last ∼20 years. • The increase in carbon storage was likely due to land-use change. • This study highlights the importance of land-sea connectivity for blue carbon sinks. [ABSTRACT FROM AUTHOR]

Blue carbon ecosystems (BCE) play an essential role in the global carbon cycle by removing atmospheric carbon dioxide and storing it as organic carbon (OC) in biomass and sediments. However, organic matter (OM) deposition and degradation/preservation processes are poorly understood, especially on the long-term and at molecular scales. We analysed sediment samples from six cores collected in tidal marshes, mangroves and seagrasses (up to 150 cm long cores spanning up to 10,000 yrs of OC accumulation) from Spencer Gulf (South Australia), by pyrolysis (Py-GC–MS and THM-GC–MS), and we compared the results with elemental and stable isotope data, to decipher OM provenance and to assess degradation/preservation dynamics. The results showed that: (1) the major biopolymers preserved were polysaccharides, polyphenolic moieties (lignin and tannin) and polymethylenic moieties (e.g. cutin, suberin, chlorophyll) with smaller apportions of proteins and resins; (2) the OM originates predominantly from vascular plant materials (in particular lignocellulose) that have been well-preserved, even in some of the oldest sediments; (3) mangroves were found to be the most efficient OC sinks, partially explained by syringyl lignin preservation; (4) seagrasses were shown to store polysaccharide-enriched OM; (5) large proportions of polycyclic aromatic hydrocarbons (PAHs) in surficial tidal marsh and mangrove sediments probably reflect pyrogenic OM from industrial combustion, and; (6) "ecosystem shifts", i.e. mangrove encroachment in tidal marsh and transition from seagrass to mangrove, were detected. Deposition environment and source vegetation control OC sequestration and there is no specific recalcitrant form of OM that is selectively preserved. For the first time, we demonstrate how analytical pyrolysis in combination with stable isotope analysis can be used to reconstruct (palaeo-)ecological shifts between different BCE. This study improves our knowledge on OC accumulation dynamics and the response of BCE to environmental change, which can inform the implementation of strategies for climate change mitigation. Unlabelled Image • Organic matter (OM) sources in blue carbon ecosystems studied by molecular analysis • Preservation of OM allows deciphering ecosystem shifts on a millennial timescale. • Polysaccharides, lignin and suberin moieties are major OM constituents. • Mangrove encroachment in marsh and seagrass-mangrove transition enhanced C storage. • Industrial activities and possibly palaeofires were revealed by molecular analysis. [ABSTRACT FROM AUTHOR]