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IntroductionGroundcover management plays a crucial role in improving water retention and soil nutrition in orchard systems, thereby preventing environmental constrains by non-point source pollution. However, effectiveness of groundcover management in citrus orchards developed on sloping farmland with eroded purple soil has not been studied in detail. In particular, information on the soil nutrient losses, e.g., nitrogen (N) and phosphorus (P), through interflow and its effects on growth and nutrition of citrus plants has not been reported.MethodsThe present study evaluated the effects of different cover crops, i.e., Lolium perenne L. (Lolium), Vicia villosa Roth (Vicia) and Orychophragmus violaceus (Ory), on nutrition and growth of citrus trees as well as water, soil and nutrient retention in an orchard developed in sloping farmland during two consecutive years.Results and discussionThe results show that the groundcover species Lolium and Vicia mediated nursing effects on nutrition and growth of citrus trees. These nursing effects included enhanced foliar levels of carbon(C), N and P as well as increased tree height, stem diameter, and crown width. Groundcover management generally reduced the annual surface runoff, interflow, soil loss, total N loss and total P loss. Among the cover crop species studied, Lolium and Vicia were overall more efficient than Ory in this context. Lolium reduced the average annual total loss of N and P by 42.53% and 49.23%, respectively, compared with clean tillage. The estimated annual reduction potentials of soil, N and P losses in Southwestern China were 16.3, 3.4 and 8.5 million tons yr-1, respectively. Obviously, Lolium and Vicia provide highly beneficial ground coverage on sloping farmland and, thus, can be used for future sustainable development of citrus orchards.

Abstract Background Stroke is a severe complication of infective endocarditis (IE), associated with high rates of mortality. Data on how IE patients with and without stroke differ may help to improve understanding contributing mechanisms. Methods All patients treated for IE between 2019 and 2021 with and without associated stroke were identified from the medical records of three academic tertiary care hospitals in Germany, all part of Charité – Universitätsmedizin Berlin, Germany. Multivariable logistic regression analyses were performed to identify variables associated with the occurrence of stroke. Results The study population consisted of 353 patients diagnosed with IE. Concomitant stroke occurred in 96/353 (27.2%) patients. Acute stroke was independently associated with co-occurring extracerebral arterial embolism [adjusted Odds ratio (aOR = 2.52; 95% confidence interval (CI) 1.35–4.71)], acute liver failure (aOR = 2.62; 95% CI 1.06–6.50), dental focus of infection (aOR = 3.14; 95% CI 1.21–8.12) and left-sided IE (aOR = 28.26; 95% CI 3.59-222.19). Stroke was found less often in IE patients with congenital heart disease (aOR = 0.20; 95% CI 0.04–0.99) and atypical pathogens isolated from blood culture (aOR = 0.31; 95% CI 0.14–0.72). Conclusions Stroke is more likely to occur in individuals with systemic complications affecting other organs, too. Special attention should be addressed to dental status. The low incidence of stroke in patients with congenital heart disease may reflect awareness and prophylactic measures.

Drought stress is a major environmental factor limiting citrus productivity. Still, differences in drought sensitivity between citrus hybrids of different maturation periods have so far not been reported. Here, we selected a medium-maturing (Fertile orange: FO (Citrus reticulata cv. Fertile orange) and a late-maturing citrus hybrid (Newhall Navel orange: NO (Citrus sinensis Osbeck cv. Newhall) and determined the physiological and biochemical traits of leaves, roots, wood and bark. Our results showed that drought significantly decreased net photosynthetic rate (Pn), stomatal conductance (Gs) and transpiration rate (Tr) of citrus leaves. Oxidative stress upon drought was indicated by enhanced foliar malondialdehyde (MDA) and hydrogen peroxide contents, as well as a stimulation of the anti-oxidative system. This stimulation included the contents of dehydroascorbic acid (DHA), glutathione (GSH) and oxidized glutathione (GSSG) in leaves, roots, wood and bark, as well as activities of antioxidative enzymes of glutathione reductase (GR), dehydroascorbate reductase (DHAR), superoxide dismutase (SOD) and peroxidase (POD). The late maturing NO hybrid not only showed better general physiological performance as indicated by increased Pn in leaves, but also higher biochemical ROS scavenging and osmotic capacity as indicated by increased ascorbic acids (ASA), DHA, and proline contents, as well as activities of enzymes of SOD, POD, ASA/DHA and GSH/GSSG ratios in the investigated tissues compared to the FO hybrid under drought and control conditions. Analysis of molecular mechanisms of signaling, regulatory and functional genes expression are suggested for future studies to elucidate the complex interplay of molecular, biochemical and physiological responses of citrus hybrids to drought.

Abstract Date palm (Phoenix dactylifera L.) is able to grow and complete its life cycle while being rooted in highly saline soils. Which of the many well‐known salt‐tolerance strategies are combined to fine‐tune this remarkable resilience is unknown. The precise location, whether in the shoot or the root, where these strategies are employed remains uncertain, leaving us unaware of how the various known salt‐tolerance mechanisms are integrated to fine‐tune this remarkable resilience. To address this shortcoming, we exposed date palm to a salt stress dose equivalent to seawater for up to 4 weeks and applied integrative multi‐omics analyses followed by targeted metabolomics, hormone, and ion analyses. Integration of proteomic into transcriptomic data allowed a view beyond simple correlation, revealing a remarkably high degree of convergence between gene expression and protein abundance. This sheds a clear light on the acclimatization mechanisms employed, which depend on reprogramming of protein biosynthesis. For growth in highly saline habitats, date palm effectively combines various salt‐tolerance mechanisms found in both halophytes and glycophytes: “avoidance” by efficient sodium and chloride exclusion at the roots, and “acclimation” by osmotic adjustment, reactive oxygen species scavenging in leaves, and remodeling of the ribosome‐associated proteome in salt‐exposed root cells. Combined efficiently as in P. dactylifera L., these sets of mechanisms seem to explain the palm's excellent salt stress tolerance.

Background Subclinical myocardial injury in form of hs‐cTn (high‐sensitivity cardiac troponin) levels has been associated with cognitive impairment and imaging markers of cerebral small vessel disease (SVD) in population‐based and cardiovascular cohorts. Whether hs‐cTn is associated with domain‐specific cognitive decline and SVD burden in patients with stroke remains unknown. Methods and Results We analyzed patients with acute stroke without premorbid dementia from the prospective multicenter DEMDAS (DZNE [German Center for Neurodegenerative Disease]‐Mechanisms of Dementia after Stroke) study. Patients underwent neuropsychological testing 6 and 12 months after the index event. Test results were classified into 5 cognitive domains (language, memory, executive function, attention, and visuospatial function). SVD markers (lacunes, cerebral microbleeds, white matter hyperintensities, and enlarged perivascular spaces) were assessed on cranial magnetic resonance imaging to constitute a global SVD score. We examined the association between hs‐cTnT (hs‐cTn T levels) and cognitive domains as well as the global SVD score and individual SVD markers, respectively. Measurement of cognitive and SVD‐marker analyses were performed in 385 and 466 patients with available hs‐cTnT levels, respectively. In analyses adjusted for demographic characteristics, cardiovascular risk factors, and cognitive status at baseline, higher hs‐cTnT was negatively associated with the cognitive domains “attention” up to 12 months of follow‐up (beta‐coefficient, −0.273 [95% CI, −0.436 to −0.109]) and “executive function” after 12 months. Higher hs‐cTnT was associated with the global SVD score (adjusted odds ratio, 1.95 [95% CI, 1.27–3.00]) and the white matter hyperintensities and lacune subscores. Conclusions In patients with stroke, hs‐cTnT is associated with a higher burden of SVD markers and cognitive function in domains linked to vascular cognitive impairment. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01334749.

Background Sex differences in presentation, treatment, and prognosis of cardiovascular disorders are well recognized. Although an association between acute myocardial injury and mortality after ischemic stroke has been demonstrated, it is unclear whether prevalence and outcome of poststroke acute myocardial injury differ between women and men. Methods and Results We prospectively screened consecutive patients with acute ischemic stroke and serial high‐sensitivity cardiac troponin T measurements admitted to our center. Acute myocardial injury was defined as at least 1 high‐sensitivity cardiac troponin T value above the upper reference limit (14 ng/L) with a rise/fall of >20%. Rates of acute myocardial injury were also calculated using sex‐specific high‐sensitivity cardiac troponin T cutoffs (women upper reference limit, 9 ng/L; men upper reference limit, 16 ng/L). Logistic regression analyses were performed to evaluate the association between acute myocardial injury and outcomes. Of 1067 patients included, 494 were women (46%). Women were older, had a higher rate of known atrial fibrillation, were more likely to be functionally dependent before admission, had higher stroke severity, and more often had cardioembolic strokes (all P values

Abstract Background The cactus family (Cactaceae) has been reported to have evolved a minimal photosynthetic plastome size, with the loss of inverted-repeat (IR) regions and NDH gene suites. However, there are very limited genomic data on the family, especially Cereoideae, the largest subfamily of cacti. Results In the present study, we assembled and annotated 35 plastomes, 33 of which were representatives of Cereoideae, alongside 2 previously published plastomes. We analyzed the organelle genomes of 35 genera in the subfamily. These plastomes have variations rarely observed in those of other angiosperms, including size differences (with ~ 30 kb between the shortest and longest), dramatic dynamic changes in IR boundaries, frequent plastome inversions, and rearrangements. These results suggested that cacti have the most complex plastome evolution among angiosperms. Conclusion These results provide unique insight into the dynamic evolutionary history of Cereoideae plastomes and refine current knowledge of the relationships within the subfamily.

Deforestation is one of the most serious environmental problems facing humankind. It continues to escalate rapidly across many regions of the world, thereby deteriorating the forest soil quality. This has prompted a large number of field-based studies aimed at understanding the impacts of deforestation on soil properties. However, the lack of comprehensive meta-analyses that utilized these studies has limited our deeper understanding of how different soil properties, including the soil organic carbon (SOC) pool, respond to deforestation. To address this critical knowledge gap, we conducted a meta-analysis of 144 studies to explore the impacts of deforestation on soil chemical, physical, and biological properties, with special emphasis on the long-term changes in SOC, such as concentrations, stocks, and sequestration. The results revealed that deforestation significantly decreased soil organic matter, electrical conductivity, and base saturation by 52%, 50%, and 98%, respectively. While deforestation increased soil total nitrogen content and decreased available phosphorus content by 51% and 99%, respectively, it resulted in slight decreases in some chemical properties, including soil pH (1%) and base cations (1%–13%). Deforestation significantly increased bulk density by 27% and soil erosion by 47%, but significantly decreased soil aggregate stability by 39% and saturated hydraulic conductivity by 63%. Soil microbial biomass C and N concentrations and enzyme activities were significantly decreased as a consequence of deforestation. Soil biological properties were much more affected by deforestation than soil physical and chemical properties. Regarding the SOC, the land use conversion from forest to pasture significantly increased SOC concentrations, stocks, and sequestration rates (11%–13%), whereas the land use conversions from forest to both plantation and cropland significantly decreased SOC concentrations, stocks, and sequestration rates (10%–43%). This observed decline in SOC accumulations decreased with increasing years after deforestation. The SOC dynamics following deforestation were predominantly regulated by microbial biomass concentrations, dehydrogenase activity, soil erosion, saturated hydraulic conductivity, aggregate stability, as well as concentrations of total organic carbon, total nitrogen, total phosphorus and organic matter. The present meta-analytical study provides compelling evidence that deforestation can induce profound changes in soil characteristics, including soil C contents, and has significant implications for soil health sustainability and climate change mitigation.

The plant microbiota can affect plant health and fitness by promoting methylmercury (MeHg) production in paddy soil. Although most well-known mercury (Hg) methylators are observed in the soil, it remains unclear how rice rhizosphere assemblages alter MeHg production. Here, we used network analyses of microbial diversity to identify bulk soil (BS), rhizosphere (RS) and root bacterial networks during rice development at Hg gradients. Hg gradients greatly impacted the niche-sharing of taxa significantly relating to MeHg/THg, while plant development had little effect. In RS networks, Hg gradients increased the proportion of MeHg-related nodes in total nodes from 37.88% to 45.76%, but plant development enhanced from 48.59% to 50.41%. The module hub and connector in RS networks included taxa positively (Nitrososphaeracea, Vicinamibacteraceae and Oxalobacteraceae) and negatively (Gracilibacteraceae) correlating with MeHg/THg at the blooming stage. In BS networks, Deinococcaceae and Paludibacteraceae were positively related to MeHg/THg, and constituted the connector at the reviving stage and the module hub at the blooming stage. Soil with an Hg concentration of 30 mg kg−1 increased the complexity and connectivity of root microbial networks, although microbial community structure in roots was less affected by Hg gradients and plant development. As most frequent connector in root microbial networks, Desulfovibrionaceae did not significantly correlate with MeHg/THg, but was likely to play an important role in the response to Hg stress.

Objectives During the COVID-19 pandemic, the staff in the intensive care unit (ICU) was materially, physically and emotionally challenged. This qualitative study investigated the effects that ICU staff experienced and were considered of value to be permanently implemented.Setting ICU in an university medical centre during the first wave of the COVID-19 pandemic.Design An opportunity-centric approach was applied in individual semi-structured interviews to optimise the achieved results and was guided by the theoretical model of appreciative inquiry (AI).Participants Fifteen ICU staff members (8 nurses and 7 intensivists) participated.Results Working during the COVID-19 pandemic catalysed interprofessional collaboration and team learning in the ICU on an individual and team level, centred around a common goal: taking care of critically ill patients with COVID-19. The effect of interprofessional collaboration was that provisions were taken care of quicker than usual, without bureaucratic delays. However, this effect was experienced to be transient. Also, ICU staff perceived limited possibilities to help patients and families around the palliative phase, and they perceived a lack of appreciation from higher management. This is a point of future attention: how to make this perceived lack of appreciation more visible to all (ICU) staff.Conclusion Regarding our primary question, the ICU staff voiced that the direct communication and collaboration are the most important elements of the COVID-19 peak they would like to preserve. Furthermore, it was learnt that consolation and support for family members should not be forgotten. Considering the results, we believe that further research concerning team reflexivity might contribute to (or enhance) our knowledge about working together during and after a crisis.

Introduction: Groundcover management plays a crucial role in improving water retention and soil nutrition in orchard systems, thereby preventing environmental constrains by non-point source pollution. However, effectiveness of groundcover management in citrus orchards developed on sloping farmland with eroded purple soil has not been studied in detail. In particular, information on the soil nutrient losses, e.g. , nitrogen (N) and phosphorus (P), through interflow and its effects on growth and nutrition of citrus plants has not been reported. Methods: The present study evaluated the effects of different cover crops, i.e. , Lolium perenne L. (Lolium), Vicia villosa Roth (Vicia) and Orychophragmus violaceus (Ory), on nutrition and growth of citrus trees as well as water, soil and nutrient retention in an orchard developed in sloping farmland during two consecutive years. Results and discussion: The results show that the groundcover species Lolium and Vicia mediated nursing effects on nutrition and growth of citrus trees. These nursing effects included enhanced foliar levels of carbon(C), N and P as well as increased tree height, stem diameter, and crown width. Groundcover management generally reduced the annual surface runoff, interflow, soil loss, total N loss and total P loss. Among the cover crop species studied, Lolium and Vicia were overall more efficient than Ory in this context. Lolium reduced the average annual total loss of N and P by 42.53% and 49.23%, respectively, compared with clean tillage. The estimated annual reduction potentials of soil, N and P losses in Southwestern China were 16.3, 3.4 and 8.5 million tons yr-1, respectively. Obviously, Lolium and Vicia provide highly beneficial ground coverage on sloping farmland and, thus, can be used for future sustainable development of citrus orchards. [ABSTRACT FROM AUTHOR]

Background Cerebral microbleeds (CMBs) are increasingly recognized as “covert” brain lesions indicating increased risk of future neurological events. However, data on CMBs in patients undergoing catheter‐based structural heart interventions are scarce. Therefore, we assessed occurrence and predictors of new CMBs in patients undergoing catheter‐based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Methods and Results We conducted an exploratory analysis using data derived from 2 prospective, observational studies. Eligible patients underwent cerebral magnetic resonance imaging (3 Tesla) examinations and cognitive tests (using the Montreal Cognitive Assessment) before and after catheter‐based left atrial appendage closure and percutaneous mitral valve repair. Forty‐seven patients (53% men; median age, 77 years) were included. New CMBs occurred in 17 of 47 patients (36%) following catheter‐based structural heart interventions. Occurrences of new CMBs did not differ significantly between patients undergoing catheter‐based left atrial appendage closure and percutaneous mitral valve repair (7/25 versus 10/22; P=0.348). In univariable analysis, longer procedure time was significantly associated with new CMBs. Adjustment for heparin attenuated this association (adjusted odds ratio [per 30 minutes]: 1.77 [95% CI, 0.92–3.83]; P=0.090). Conclusions New CMBs occur in approximately one‐third of patients after catheter‐based left atrial appendage closure and percutaneous mitral valve repair using the MitraClip System. Our data suggest that longer duration of the procedure may be a risk factor for new CMBs. Future studies in larger populations are needed to further investigate their clinical relevance. Clinical Trial Registration German Clinical Trials Register: DRKS00010300 (https://drks.de/search/en/trial/DRKS00010300); ClinicalTrials.gov : NCT03104556 (https://clinicaltrials.gov/ct2/show/NCT03104556?term=NCT03104556&draw=2&rank=1).

BackgroundMechanical thrombectomy (MT) is highly effective in large vessel occlusion (LVO) stroke. In north-east Germany, many rural hospitals do not have continuous neurological expertise onsite and secondary transport to MT capable comprehensive stroke centers (CSC) is necessary. In metropolitan areas, small hospitals often have neurology departments, but cannot perform MT. Thus, interhospital transport to CSCs is also required. Here, we compare time-to-care metrics and outcomes in patients receiving MT after interhospital transfer from primary stroke centers (PCSs) to CSCs in rural vs. metropolitan areas.MethodsPatients from ten rural telestroke centers (RTCs) and nine CSCs participated in this study under the quality assurance registry for thrombectomies of the Acute Neurological care in North-east Germany with TeleMedicine (ANNOTeM) telestroke network. For the metropolitan area, we included patients admitted to 13 hospitals without thrombectomy capabilities (metropolitan primary stroke centers, MPSCs) and transferred to two CSCs. We compared groups regarding baseline variables, time-to-care metrics, clinical, and technical outcomes.ResultsBetween October 2018 and June 2022, 50 patients were transferred from RTCs within the ANNOTeM network and 42 from MPSCs within the Berlin metropolitan area. RTC patients were older (77 vs. 72 yrs, p = 0.05) and had more severe strokes (NIHSS 17 vs. 10 pts., p < 0.01). In patients with intravenous thrombolysis (IVT; 34.0 and 40.5%, respectively), time from arrival at the primary stroke center to start of IVT was longer in RTCs (65 vs. 37 min, p < 0.01). However, RTC patients significantly quicker underwent groin puncture at CSCs (door-to-groin time: 42 vs. 60 min, p < 0.01). Despite longer transport distances from RTCs to CSCs (55 vs. 22 km, p < 0.001), there was no significant difference of times between arrival at the PSC and groin puncture (210 vs. 208 min, p = 0.96). In adjusted analyses, there was no significant difference in clinical and technical outcomes.ConclusionDespite considerable differences in the setting of stroke treatment in rural and metropolitan areas, overall time-to-care metrics were similar. Targets of process improvement should be door-to-needle times in RTCs, transfer organization, and door-to-groin times in CSCs wherever such process times are above best-practice models.

Abstract Cardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was ≤ 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness.

Abstract Background Vitamin K is associated with reduced cardiovascular disease risk such as heart failure, possibly by carboxylation of matrix-gla protein (MGP), a potent inhibitor of vascular calcification. The relationship of vitamin K intake or status with cardiac structure and function is largely unknown. Therefore this study aims to investigate the prospective association of vitamin K status and intake with echocardiographic measures. Methods This study included 427 participants from the Hoorn Study, a population-based cohort. Vitamin K status was assessed at baseline by plasma desphospho-uncarboxylated MGP (dp-ucMGP) with higher concentrations reflecting lower vitamin K status. Vitamin K intake was assessed at baseline with a validated food-frequency questionnaire. Echocardiography was performed at baseline and after a mean follow-up time of 7.6, SD=±0.7 years. We used linear regression for the association of vitamin K status and intake with left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and left ventricular mass index (LVMI), adjusted for potential confounders. Results The mean age was 66.8, SD=±6.1 years (51% were male). A high vitamin K status was prospectively associated with decreased LVMI (change from baseline to follow-up: -5.0, 95% CI: -10.5;0.4 g/m2.7) for the highest quartile compared to the lowest in women (P-interaction sex=0.07). No association was found in men. Vitamin K status was not associated with LVEF or LAVI. Vitamin K intake was not associated with any of the echocardiographic measures. Conclusions This study showed a high vitamin K status being associated with decreased LVMI only in women, while intakes of vitamin K were not associated with any cardiac structure or function measures. These results extend previous findings for a role of vitamin K status to decrease heart failure risk.