Search

Competing Interests: Disclosures Dr Di Biase is a consultant for Biosense Webster, Boston Scientific, Stereotaxis, and St. Jude Medical; and has received speaker honoraria from Medtronic, AtriCure, EPiEP, and Biotronik. Dr Natale is a consultant for Biosense Webster, Stereotaxis, and Abbott Medical; and has received speaker honoraria/travel from Medtronic, AtriCure, Biotronik, and Janssen. All other authors have no conflicts of interest to disclose.

Competing Interests: This Commission receives funding from the Bill & Melinda Gates Foundation. PBS is the Chair of the CHH–Lancet Commission for Health, Conflict and Forced Displacement and OK, KB, and C-CU are the Commission Co-Chairs. The Commissioners are Aula Abbara, Arwa Abdelhay, Houssam al-Nahhas, Huda Omer Basaleem, Ghislain Bisimwa, Ietza Bojorquez, Francesco Checchi, Fouad Fouad, Kemish Kenneth Alier, Joanne Liu, Daniel Maxwell, Nicolas Meda, Andres Moya, Linda Adhiambo Oucho, Sara Pantuliano, Sabina Faiz Rashid, Hugo Slim, and Muhammad Zaman. AM is an Executive Editor and RH is the Editor-in-Chief at The Lancet. We declare no competing interests.

Competing Interests: This Commission has received financial support from Cornell University. PPATS is an initiative of Dalberg Catalyst. The Spillover Prevention Accelerator has received financial support from the Novo Nordisk Foundation and the Gordon and Betty Moore Foundation. NMV is a board member of Health in Harmony (unpaid) and reports honoraria from Mt Sinai School of Medicine and the American Academy of Neurology. LH is Coordinator of Malaysia One Health University Network, an executive board member of the Southeast Asia One Health University Network, a member of Regional Public Health Laboratory Network expert panel, a member of the International Board of One Health Education, a member of the steering committee of INGSA-NASEM Countering Zoonotic Spillover of High Consequence Pathogens, and reports grants from the USAID-SEAHOUN One Health Workforce and One Health Workforce Next Generation. RKP reports grants from the US National Institutes of Health and the National Science Foundation and is a member of the US National Academies of Science, Engineering, and Medicine Committee for Countering Zoonotic Spillover of High Consequence Pathogens, the National Science Foundation (NSF) Advisory Committee for Environmental Research and Education, and the IUCN World Commission on Protected Areas. SC reports institutional grants from the Gordon and Betty Moore Foundation, the Climate and Land Use Alliance, the Novo Nordisk Foundation, the ClimateWorks Foundation, the Flora L Thornton Foundation, the Good Energies Foundation, the Dalberg Trust, and GIZ. AB reports support from the Harvard Global Health Institute; grants from Biogen, Johnson and Johnson, the MacArthur Foundation, and Climate Central; honoraria from Amgen, the American Association of Medical Colleges, the University of Miami, and Saint Anselm College; and is Chair of the Council on Environmental Health and Climate Change, American Academy of Pediatrics (unpaid) and Chair of the Board, US Green Building Council (unpaid). SC and NS are co-founders of the Coalition for Preventing Pandemics at the Source, and NS is its Executive Director. RH is Editor-in-Chief of The Lancet. The Co-Chairs of the Lancet–Coalition for Preventing Pandemics at the Source Commission on Prevention of Viral Spillover are Latiffah Hassan, Raina K Plowright, and Neil M Vora. The Commissioners are: Robyn Alders, John H Amuasi, Sania Ashraf, Daniel Becker, Salome A Bukachi, Sakib Burza, Sarah Cleaveland, Omnia El Omrani, Jacques B O Emina, Ngozi A Erondu, Juliana Machado Ferreira, Emily S Gurley, Menna Jones, Binbin Li, James Lloyd-Smith, Ted Loch-Temzelides, Wanda Markotter, Osondu Ogbuoji, Malik Peiris, Dirk Pfeiffer, Alexander Popp, Nicole Redvers, Benjamin Roche, John E Scanlon, Nigel Sizer, Mariana Vale, Chris Walzer, and Sejal Worah.

The increasing footprints of lithium (Li) in agroecosystems combined with limited recycling options have raised uncertain consequences for important crops. Nitrogen (N 2 )-fixation by legumes is an important biological response process, but the cause and effect of Li exposure on plant root-nodule symbiosis and biological N 2 -fixation (BNF) potential are still unclear. Soybean as a model plant was exposed to Li at low (25 mg kg -1 ), medium (50 mg kg -1 ), and high (100 mg kg -1 ) concentrations. We found that soybean growth and nodulation capacity had a concentration-dependent response to Li. Li at 100 mg kg -1 reduced the nodule numbers, weight, and BNF potential of soybean in comparison to the low and medium levels. Significant shift in soybean growth and BNF after exposure to Li were associated with alteration in the nodule metabolic pathways involved in nitrogen uptake and metabolism (urea, glutamine and glutamate). Importantly, poor soybean nodulation after high Li exposure was due in part to a decreased abundance of bacterium Ensifer in the nodule bacterial community. Also, the dominant N 2 -fixing bacterium Ensifer was significantly correlated with carbon and nitrogen metabolic pathways. The findings of our study offer mechanistic insights into the environmental and biological impacts of Li on soybean root-nodule symbiosis and N 2 -acquisition and provide a pathway to develop strategies to mitigate the challenges posed by Li in agroecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: The Amulet (Abbott) left atrial appendage occluder investigational device exemption trial is the largest randomized trial evaluating the safety and effectiveness of the Amulet left atrial appendage occluder compared with the Watchman 2.5 device (Boston Scientific) through 5 years., Objectives: This analysis evaluated the device effect on 3-year outcomes in the Amulet investigational device exemption trial., Methods: The medication regimen and key clinical outcomes were reported through 3 years including: 1) the composite of ischemic stroke or systemic embolism (SE); 2) the composite of all strokes, SE, or cardiovascular (CV) death; 3) major bleeding; and 4) all-cause death and CV death., Results: A total of 1,878 patients at 108 sites were randomized. A significantly higher percentage of patients were free of oral anticoagulation usage at 3 years with Amulet (96.2%) vs Watchman (92.5%) (P < 0.01). Clinical outcomes were comparable for the composite of ischemic stroke or SE (5.0% vs 4.6%; P = 0.69); the composite of all strokes, SE, or CV death (11.1% vs 12.7%; P = 0.31); major bleeding (16.1% vs 14.7%; P = 0.46); all-cause death (14.6% vs 17.9%; P = 0.08); and CV death (6.6% vs 8.5%; P = 0.14) for Amulet and Watchman, respectively. Through 3 years, device factors (device-related thrombus or peridevice leak ≥3 mm) preceded ischemic stroke events and CV deaths more frequently in Watchman compared with Amulet patients., Conclusions: The Amulet occluder demonstrated continued safety and effectiveness with over 96% free of oral anticoagulation usage through 3 years in a high-risk population compared to the Watchman device. (AMPLATZER Amulet LAA Occluder Trial [Amulet IDE]; NCT02879448)., Competing Interests: Funding Support and Author Disclosures Abbott funded the Amulet IDE Trial. No funding was provided for this analysis. Dr Lakkireddy has received research and educational grants to the institution from Abbott, AtriCure, Alta Thera, Medtronic, Biosense Webster, Biotronik, and Boston Scientific; and has received speaker honorarium from Abbott, Medtronic, Biotronik, and Boston Scientific. Dr Thaler has received consulting fees from Abbott and Occlutech; and has received institutional research grants for clinical trials from Abbott and the National Institutes of Health. Dr Ellis has received institutional research grants from Boehringer-Ingelheim Inc, Medtronic, and Boston Scientific; and has received consulting/advisory fees from, Abbott Medical Inc, Boston Scientific, and AtriCure Inc. Dr Swarup has received consulting fees from Biosense Webster, Boston Scientific, and Abbott. Dr Gambhir has received consulting fees from Abbott, Biosense Webster, and Boston Scientific, and speaker honorarium from Boston Scientific. Dr Hermiller serves as a consultant to Abbott, Edwards Lifesciences, and Medtronic. Dr Nielsen-Kudsk has received institutional research grants from Abbott and Boston Scientific. Dr Worthley has performed consultancy and proctoring for Edwards Lifesciences and Abbott; and is a shareholder for Three Peaks Medical. Dr Nair has received research grants and support from Medtronic, Boston Scientific, Abbott, Biosense Webster, and Adagio; is on the advisory board for Medtronic, Boston Scientific, Abbott, Biosense Webster, and Adagio; is a consultant for Medtronic, Boston Scientific, Abbott, Biosense Webster, and Adagio; and has received honoraria from Medtronic, Boston Scientific, Abbott, Biosense Webster, and Adagio. Dr Schmidt has received speaker honorarium and consulting fees from Abbott, Boston Scientific, Biosense Webster, and Medtronic. Dr Horton is a consultant for Boston Scientific, Biosense Webster, St. Jude/Abbott Medical, Biotronik, Baylis, and Medtronic. Dr Gupta has received institutional research grants from Medtronic, Boston Scientific, Abbott, and CVRx Inc. Dr Anderson is an employee of Abbott. Mr Gage is an employee of Abbott. Dr Alkhouli serves as a consultant to Boston Scientific and Abbott. Dr Windecker reports research, travel, or educational grants to the institution from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Sanofi, Servier, Sinomed, Terumo, Vifor, and V-Wave; serves as an advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis with payments to the institution but no personal payments; and is a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)