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Summary: Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (

Neonicotinoids (NEOs) are synthetic insecticides with broad-spectrum insecticidal activity and outstanding efficacy. However, their extensive use and persistence in the environment have resulted in the accumulation and biomagnification of NEOs, posing significant risks to non-target organisms and humans. This review provides a summary of research history, advancements, and highlighted topics in NEOs remediation technologies and mechanisms. Various remediation approaches have been developed, including physiochemical, microbial, and phytoremediation, with microbial and physicochemical remediation being the most extensively studied. Recent advances in physiochemical remediation have led to the development of innovative adsorbents, photocatalysts, and optimized treatment processes. High-efficiency degrading strains with well-characterized metabolic pathways have been successfully isolated and cultured for microbial remediation, while many plant species have shown great potential for phytoremediation. However, significant challenges and gaps remain in this field. Future research should prioritize isolating, domesticating or engineering high efficiency, broad-spectrum microbial strains for NEO degradation, as well as developing synergistic remediation techniques to enhance removal efficiency on multiple NEOs with varying concentrations in different environmental media. Furthermore, a shift from pipe-end treatment to pollution prevention strategies is needed, including the development of green and economically efficient alternatives such as biological insecticides. Integrated remediation technologies and case-specific strategies that can be applied to practical remediation projects need to be developed, along with clarifying NEO degradation mechanisms to improve remediation efficiency. The successful implementation of these strategies will help reduce the negative impact of NEOs on the environment and human health.

The co-contamination of soils by microplastics (MPs) and cadmium (Cd), one of the most perilous heavy metals, is emerging as a significant global concern, posing risks to plant productivity and human health. However, there remains a gap in the literature concerning comprehensive evaluations of the combined effects of MPs and Cd on soil-plant-human systems. This review examines the interactions and co-impacts of MPs and Cd in soil-plant-human systems, elucidating their mechanisms and synergistic effects on plant development and health risks. We also review the origins and contamination levels of MPs and Cd, revealing that sewage, atmospheric deposition, and biosolid applications are contributors to the contamination of soil with MPs and Cd. Our meta-analysis demonstrates that MPs significantly (p<0.05) increase the bioavailability of soil Cd and the accumulation of Cd in plant shoots by 6.9 and 9.3 %, respectively. The MPs facilitate Cd desorption from soils through direct adsorption via surface complexation and physical adsorption, as well as indirectly by modifying soil physicochemical properties, such as pH and dissolved organic carbon, and altering soil microbial diversity. These interactions augment the bioavailability of Cd, along with MPs, adversely affect plant growth and its physiological functions. Moreover, the ingestion of MPs and Cd through the food chain significantly enhances the bioaccessibility of Cd and exacerbates histopathological alterations in human tissues, thereby amplifying the associated health risks. This review provides insights into the coexistence of MPs and Cd and their synergistic effects on soil-plant-human systems, emphasizing the need for further research in this critical subject area., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Biochar-derived dissolved organic matter (BDOM), is extensively involved in the recrystallization of minerals and the speciation alteration of associated toxic metals. This study investigates how BDOM extracted from tobacco petiole (TP) or tobacco stalk (TS) biochar influences the speciation repartitioning of Cr(VI) in environments impacted by acid mine drainage (AMD), focusing on interactions with secondary minerals during Schwertmannite (Sch) dissolution and recrystallization. TP-BDOM, rich in lignin-like substances, slowed down the Cr-Sch dissolution and Cr release under acidic conditions compared to TS-BDOM. TP-BDOM's higher O/C component exerts a delayed impact on Cr-Sch stability and Cr(VI) reduction. In-situ ATR-FTIR and 2D-COS analysis showed that carboxylic and aromatic N-OH groups in BDOM could interact with Cr-Sch surfaces, affecting sulfate and Cr(VI) release. It was also observed that slight recrystallization occurred from Cr-Sch to goethite, along with increased Cr incorporation into secondary minerals within TS-BDOM. This enhances our understanding of BDOM's role in Cr(VI) speciation changes in AMD-contaminated sites., 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 © 2024 Elsevier B.V. All rights reserved.)

This study examined the effectiveness of pristine biochar (BC) and Fe-functionalized biochar (FBC) in remediating As-Sb co-contaminated soil, and revealed the resulting impact on soil enzymatic activities and bacterial communities. Results from incubation experiments showed that the 1.5% FBC treatment reduced the bioavailable As and Sb concentration by 13.5% and 27.1%, respectively, in compared to the control, and reduced the proportion of specifically adsorbed and amorphous Fe-Mn oxide-bound metal(loid) fractions in the treated soil. Among the BC treatments, only the 1.5% BC treatment resulted in a reduction of bioavailable As by 11.7% and Sb by 21.4%. The 0.5% BC treatment showed no significant difference. The FBC achieved high As/Sb immobilization efficiency through Fe-induced electrostatic attraction, π-π electron donor-acceptor coordination, and complexation (Fe-O(H)-As/Sb) mechanisms. Additionally, the 1.5% FBC treatment led to a 108.2% and 367.4% increase in the activities of N-acetyl-β-glucosaminidase and urease in soils, respectively, compared to the control. Furthermore, it significantly increased the abundance of Proteobacteria (15.2%), Actinobacteriota (37.0%), Chloroflexi (21.4%), and Gemmatimonadota (43.6%) at the phylum level. Co-occurrence network analysis showed that FBC was better than BC in increasing the complexity of bacterial communities. Partial least squares path modeling further indicated that the addition of biochar treatments can affect soil enzyme activities by altering soil bacterial composition. This study suggests that FBC application offers advantages in simultaneous As and Sb immobilization and restructuring the bacterial community composition in metal(loid)-contaminated soil., 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 © 2024 Elsevier B.V. All rights reserved.)

The escalating problem of compound arsenic (As) and cadmium (Cd) contamination in agricultural soils necessitates the urgency for effective remediation strategies. This is compounded by the opposing geochemical behaviors of As and Cd in soil, and the efficacy of biochar treatment remains unclear. This pioneering study integrated 3780 observation pairs referred from 92 peer-reviewed articles to investigate the impact of iron-modified biochar on As and Cd responses across diverse soil environments. Regarding the treatments, 1) biochar significantly decreased the exchangeable and acid-soluble fraction of As (AsF1, 20.9%) and Cd (CdF1, 24.0%) in paddy fields; 2) iron-modified biochar significantly decreased AsF1 (32.0%) and CdF1 (27.4%); 3) iron-modified biochar in paddy fields contributed to the morphological changes in As and Cd, mainly characterized by a decrease in AsF1 (36.5%) and CdF1 (36.3%) and an increase in the reducible fraction of As (19.7%) and Cd (39.2%); and 4) iron-modified biochar in paddy fields increased As (43.1%) and Cd (53.7%) concentrations in the iron plaque on root surfaces. We conclude that iron-modified biochar treatment of paddy fields is promising in remediating As and Cd contamination by promoting the formation of iron plaque., 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 © 2024 Elsevier B.V. All rights reserved.)

Biochar, an environmentally friendly material, was found to passivate lead (Pb) in contaminated soil effectively. This study utilized spectroscopic investigations and partial least squares path modeling (PLS-PM) analysis to examine the impact of coconut-fiber biochar (CFB) on the translocation, accumulation, and detoxification mechanisms of Pb in soil-rice systems. The results demonstrated a significant decrease (p < 0.05) in bioavailable Pb concentration in paddy soils with CFB amendment, as well as reduced Pb concentrations in rice roots, shoots, and brown rice. Synchrotron-based micro X-ray fluorescence analyses revealed that CFB application inhibited the migration of Pb to the rhizospheric soil region, leading to reduced Pb uptake by rice roots. Additionally, the CFB treatment decreased Pb concentrations in the cellular protoplasm of both roots and shoots, and enhanced the activity of antioxidant enzymes in rice plants, improving their Pb stress tolerance. PLS-PM analyses quantified the effects of CFB on the accumulation and detoxification pathways of Pb in the soil-rice system. Understanding how biochar influences the immobilization and detoxification of Pb in soil-rice systems could provide valuable insights for strategically using biochar to address hazardous elements in complex agricultural settings., 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 © 2024 Elsevier B.V. All rights reserved.)

Globally, soil contamination with arsenic (As) and lead (Pb) has become a severe environmental issue. Herein, a pot experiment was conducted using pak choi (Brassica chinensis L.) to investigate the effects of biochars derived from crawfish (Procambarus clarkia) shells (CSB) and Chinese banyan (Ficus microcarpa) branches (CBB) on the phytoavailability of As and Pb, and bacterial community composition in soils. Our results showed that the application of CSB and CBB decreased the concentrations of DTPA-extractable Pb in soils ranging from 26.8 % to 28.8 %, whereas CSB increased the concentration of NH 4 H 2 PO 4 -extractable As in soils, compared to the control. Application of both biochars reduced the uptake of As and Pb in the edible part of pak choi. In addition, application of CBB significantly (P < 0.05) increased the activities of α-glucosidase, β-glucosidase, cellobiohydrolase, and acid phosphomonoesterase by 55.0 %, 54.4 %, 195.1 %, and 76.7 %, respectively, compared to the control. High-throughput sequencing analysis revealed that the predominant bacteria at the phyla level in both biochar-treated soils were Firmicutes, Proteobacteria, and Actinobacteriota. Redundancy and correlation analyses showed that the changes in bacterial community composition could be related to soil organic carbon content, As availability, and nutrient availability in soils. Overall, the Chinese banyan branch biochar was more suitable than the crawfish shell biochar as a potential amendment for the remediation of soils co-contaminated with As and Pb., 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 © 2022 Elsevier B.V. All rights reserved.)

The N losses and agronomic performances of newly developed slow-releasing fertilisers (SRFs; Epox5 and Poly5) were tested against conventional N fertilisers, urea and diammonium phosphate (DAP), in a climate-controlled lysimeter system. The dry matter (DM) yield and N losses of SRFs were not significantly different from urea and DAP. However, nitrate leaching and nitrous oxide (N 2 O) losses were unexpectedly low and therefore, it was inferred that nitrate underwent a chemical transformation. It was observed that a thick fibreglass wick interrupted drainage and created an anaerobic condition in the soil. The subsoil was found to have a high extractable total iron and it was postulated that iron played a role in the observed low level of N losses. An investigation was carried out with a factorial design using sand types and rates of N application as the main factors. Two types of sand; with high and low iron concentration and four levels of N applications; 0 (control), 50, 100 and 200 kg N ha -1 were employed in a leaching column and nitrate and N 2 O losses were measured. The nitrate leaching was significantly (P < 0.05) affected by sand types wherein a lower nitrate level was recorded for high‑iron concentration sand than for low-iron concentration sand at all N application levels. The N 2 O emission was significantly (P < 0.05) lower for high-iron sand than for low-iron sand for the 200 N treatment, but not significantly different between sand types for other treatments. These observations provide evidence for the involvement of iron in nitrate transformation under anaerobic conditions and it was hypothesised path was dissimilar nitrate reduction (DNR). Further studies are recommended, to identify the underlying mechanism responsible for nitrate reduction with iron-rich sand., Competing Interests: Declaration of competing interest Authors have declared that they have no potential conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Soil washing is an efficient, economical, and green remediation technology for removing several heavy metal (loid)s from contaminated industrial sites. The extraction of green and efficient washing agents from low-cost feedback is crucially important. In this study, a soluble humic substance (HS) extracted from leonardite was first tested to wash soils (red soil, fluvo-aquic soil, and black soil) heavily contaminated with arsenic (As) and cadmium (Cd). A D-optimal mixture design was investigated to optimize the washing parameters. The optimum removal efficiencies of As and Cd by single HS washing were found to be 52.58%-60.20% and 58.52%-86.69%, respectively. Furthermore, a two-step sequential washing with chemical reductant NH 2 OH•HCl coupled with HS (NH 2 OH•HCl + HS) was performed to improve the removal efficiency of As and Cd. The two-step sequential washing significantly enhanced the removal of As and Cd to 75.25%-81.53% and 64.53%-97.64%, which makes the residual As and Cd in soil below the risk control standards for construction land. The two-step sequential washing also effectively controlled the mobility and bioavailability of residual As and Cd. However, the activities of soil catalase and urease significantly decreased after the NH 2 OH•HCl + HS washing. Follow-up measures such as soil neutralization could be applied to relieve and restore the soil enzyme activity. In general, the two-step sequential soil washing with NH 2 OH•HCl + HS is a fast and efficient method for simultaneously removing high content of As and Cd from contaminated soils., 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 © 2022 Elsevier Inc. All rights reserved.)

Soil acidification is the main cause for aggravation of soil cadmium (Cd) pollution. Biochar treatment can increase the soil pH and decrease the Cd availability in soils. However, there is limited information in literature on the comprehensive assessment of the response of Cd fractions to biochar. Therefore, in the present meta-analysis study, we evaluate the response of Cd fractions to biochar application in soils with different pH and to further examine the effect of physicochemical properties of biochar on Cd. Results from the overall analysis indicated that biochar treatment increased the soil pH by 7.0%, thereby decreasing the amount of available Cd (37.3%). In acidic soil, biochar significantly reduced the acid-soluble fraction (Acid-Cd) of Cd by 36.8%, while Oxidizable fraction of Cd (Oxid-Cd, 20.9%) and Residual fraction of Cd (Resid-Cd, 22.2%) were significantly increased. In neutral soils, only Acid-Cd was significantly reduced (33.0%) in the presence of biochar. In alkaline soils, biochar caused significant reduction in Acid-Cd of 12.4% and an increase in Oxid-Cd and Resid-Cd of 26.6% and 47.8%, respectively. Further, our findings showed that biochar with cation exchange capacity >100 cmol + /kg effectively decreased Acid-Cd (32.4%), while biochar with the percentage of hydrogen <2% was more contributory in increasing Resid-Cd (64.3%). These results demonstrate the importance of soil pH in regulating the biological effectiveness of Cd in soil and the complexation between the functional groups of biochar and Cd, and provide key information for the remediation of Cd pollution in soils with different pH by biochar., 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 © 2022 Elsevier Inc. All rights reserved.)

The excessive accumulation of wheat grain metals and metalloids caused by ambient air contamination has drawn an increasing concern. However, at present, the differences in the pathways of cadmium and lead accumulation in wheat grains in an air-soil-wheat system are not clear. In this study, wheat was grown around a lead‑zinc smelting area and exposed to different soil Pb and Cd levels and different ambient air Pb and Cd levels. Lead and Cd accumulation in wheat grains was examined in this study. Two models of wheat grain Pb and Cd concentrations were established based on the 3 variables including soil Pb and Cd concentration, ambient air Pb and Cd concentration, and soil pH. The results showed that total suspended particulate (TSP), soil, and wheat grains exhibited different degrees of Pb and Cd contamination in the study area, and the contamination of Cd is more serious than Pb contamination. The Pb in wheat grains was more likely to derive from ambient air than from soil, whereas the impact of ambient air on the accumulation of Cd in wheat grains might be very limited. This speculation was confirmed by the results of the predictor variable relative weight method based on the multiple regression analysis. Introduction of ambient air factor (TSP Pb and Cd) greatly improved the modeling effect of wheat grains Pb, while the modeling of grain Cd was more dependent on soil pH and total soil Cd. This research suggests that the reduction in wheat grain Pb is likely to be achieved by the control over ambient air Pb, whereas the reduction in the wheat grain Cd by the remediation of soil pollutants., 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 © 2022. Published by Elsevier B.V.)

Production advantages, environmental benefits and increasing parasite resistance are changing the composition of New Zealand pastures. Traditional ryegrass/clover pasture mixes are being replaced by forage herb crops such as lucerne, chicory and plantain that accumulate a higher concentration of contaminants such as cadmium (Cd). To explore the relationship between Cd in forage crops and the Cd concentration accumulated by animals, four-month-old lambs at four farms across the central North Island of New Zealand were grazed on different forage crops (ryegrass, chicory, lucerne and plantain) between weaning and slaughter. Soil and pasture samples, and sequential liver biopsies, were collected and analysed for total Cd. There were significant differences in Cd concentration between the forage crops (chicory > plantain > lucerne > ryegrass) and this ordering was repeated for Cd in liver. There was no exceedance of maximum limits (ML) for Cd in offal set by the EU and NZ/Australia food safety standards authorities for animals of this study, although the highest concentration of Cd in chicory (0.85 mg/kg DW) was considerably lower than has been recorded elsewhere in New Zealand (4.5 mg/kg DW). Provisional Soil Management Values (SMVs) were developed to explore compliance of liver with EU food standards as a function of grazing chicory. For a soil pH of 5, exceedance might occur at a soil cadmium concentration of 0.34 mg/kg. This concentration falls within Tier 0 of the New Zealand Tiered Fertiliser Management System which seeks to ensure soil Cd remains within acceptable limits over the next 100 years and beyond. Increased Cd uptake by fodder crops and its management in these Tier 0 pastoral soils is therefore an emerging issue for pastoral agriculture. The risk of ML exceedance for animals grazing forage crops such as chicory on low Cd soils should be further considered to ensure uninterrupted access to export markets., 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 © 2022. Published by Elsevier B.V.)

The minimization of Cd pollution in wheat is urgently needed in many parts of the world. Thus, the aims of the present study were to evaluate the feasibility of popular technologies (i.e., soil amendment and low-Cd wheat cultivar) at sites with different Cd risk levels (high and low) and to propose a risk-based strategy for safe grain production. At a high-Cd site, wheat variety JM22 yielded significantly lower grain Cd than SX828, regardless of soil amendment (biochar, sepiolite, and microbial agent YZ1). Neither biochar nor sepiolite amendment reduced grain Cd, DTPA-Cd, or bioconcentration factors, possibly due to low dosage. Metagenomic sequencing and quantitative PCR showed that YZ1 colonization had little effect on rhizospheric fungal community structure and could not be sustained through winter. At a low-Cd site, significantly lower grain Cd was observed in JM22, LX99, and JM262, which could be used as low-Cd cultivars in the study area. Interestingly, the grain Cd of JM22 was linearly correlated with soil Cd (R 2  = 0.84), which allowed the inference of a soil Cd threshold of 1.55 mg·kg -1 , below which JM22 alone was capable of producing safe grain. Cost-benefit analysis also indicated that the use of low-Cd cultivars is promising for pollution control. This study provides viable technical solutions for minimizing the grain Cd of wheat grown in northern China., 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 © 2021 Elsevier B.V. All rights reserved.)

Soil amendments of black bone (BB), biochar (BC), silicon fertilizer (SI), and leaf fertilizer (LF) play vital roles in decreasing cadmium (Cd) availability, thereby supporting healthy plant growth and food security in agroecosystems. However, the effect of their additions on soil microbial community and the resulting soil Cd bioavailability, plant Cd uptake and health growth are still unknown. Therefore, in this study, BB, BC, SI, and LF were selected to evaluate Cd amelioration in wheat grown in Cd-contaminated soils. The results showed that relative to the control, all amendments significantly decreased both soil Cd bioavailability and its uptake in plant tissues, promoting healthy wheat growth and yield. This induced-decrease effect in seeds was the most obvious, wherein the effect was the highest in SI (52.54%), followed by LF (43.31%), and lowest in BC (35.24%) and BB (31.98%). Moreover, the induced decrease in soil Cd bioavailability was the highest in SI (29.56%), followed by BC (28.85%), lowest in LF (17.55%), and BB (15.30%). The significant effect in SI likely resulted from a significant increase in both the soil bioavailable Si and microbial community (Acidobacteria and Thaumarchaeota), which significantly decreased soil Cd bioavailability towards plant roots. In particular, a co-occurrence network analysis indicated that soil microbes played a substantial role in wheat yield under Si amendment. Therefore, supplying Si alters the soil microbial community, positively and significantly interacting with soil bioavailable Si and decreasing Cd bioavailability in soils, thereby sustaining healthy crop development and food quality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier B.V.)

The application of biochar to soils contaminated with potentially toxic elements (PTEs) has received particular attention due to its ability to reduce PTE uptake by the plants. Therefore, we conducted a meta-analysis to identify Cd and Pb concentrations in plant shoots and roots in response to biochar application and soil properties. We collected data from 65 peer-reviewed journal articles published from 2009 to 2020 in which 66% of manuscripts were published from 2015 to 2020. The data were processed using OpenMEE software. The results pinpointed that addition of biochar to soil caused a significant decrease in shoot and root Cd and Pb concentrations as compared to untreated soils with biochar (control), and the reduction rate was affected by plant types and both biochar and soil properties. The biochar size less than 2 mm, biochar pH higher than 10, pyrolysis temperature of 401-600 °C, and the application rate higher than 2% appeared to be effective in reducing shoot and root Cd and Pb concentration. Soil properties such as pH, SOC, and texture influenced the efficiency of biochar for reducing plant Cd and Pb uptake. Biochar application increased SOC (54.3%), CEC (48.0%), pH (0.08), and EC (59.4%), and reduced soil extractable Cd (42.1%) and Pb (47.1%) concentration in comparison to control. A detailed study on the rhizosphere chemistry and uptake mechanism will help to underpin the biochar application rates and their efficiency reducing PTE mobility and plant uptake., 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 © 2020 Elsevier B.V. All rights reserved.)

Ciprofloxacin has been frequently detected in water environment, and its removal has become a significant public concern. Biochar-supported nanoscale zero-valent iron (BC/nZVI) to activate hydrogen peroxide (H 2 O 2 ) has many advantages on promoting the removal of organic contaminants. In this paper, the BC/nZVI activating H 2 O 2 degradation of ciprofloxacin was systematically investigated by experimental and theoretical approaches. The morphologies and property analysis showed that nZVI particles distributed uniformly on the biochar surface, which mainly include  - OH, >CO and COC and CO groups. Different reaction conditions were compared to define the optimal conditions for ciprofloxacin removal in BC/nZVI/H 2 O 2 system. More than 70% of ciprofloxacin was removed in the optimal conditions: acidic condition (pH 3∼4), low doses of H 2 O 2 (20 mM), and temperature of 298 K. The hydroxyl radical ( • OH) oxidation was the primary pathway in BC/nZVI/H 2 O 2 degradation of ciprofloxacin process. The theoretical calculation indicated that hydrogen atom abstraction (HAA) pathways were the dominant oxidation pathways contributing 92.3% in overall second‒order rate constants (k) of • OH and ciprofloxacin. The current results are valuable to evaluate the application of BC/nZVI activating H 2 O 2 degradation of ciprofloxacin and other fluoroquinolone antibiotics in water treatment plants., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The rise in LDL with egg feeding in lean insulin-sensitive (LIS) participants is 2- and 3-fold greater than in lean insulin-resistant (LIR) and obese insulin-resistant (OIR) participants, respectively., Objective: We determined whether differences in cholesterol absorption, synthesis, or both could be responsible for these differences by measuring plasma sterols as indexes of cholesterol absorption and endogenous synthesis., Design: Plasma sterols were measured by gas chromatography-mass spectrometry in a random subset of 34 LIS, 37 LIR, and 37 OIR participants defined by the insulin sensitivity index (S(I)) and by BMI criteria selected from a parent group of 197 participants. Cholestanol and plant sterols provide a measure of cholesterol absorption, and lathosterol provides a measure of cholesterol synthesis., Results: The mean (±SD) ratio of plasma total absorption biomarker sterols to cholesterol was 4.48 ± 1.74 in LIS, 3.25 ± 1.06 in LIR, and 2.82 ± 1.08 in OIR participants. After adjustment for age and sex, the relations of the absorption sterol-cholesterol ratios were as follows: LIS > OIR (P < 0.001), LIS > LIR (P < 0.001), and LIR > OIR (P = 0.11). Lathosterol-cholesterol ratios were 0.71 ± 0.32 in the LIS participants, 0.95 ± 0.47 in the LIR participants, and 1.29 ± 0.55 in the OIR participants. After adjustment for age and sex, the relations of lathosterol-cholesterol ratios were as follows: LIS < OIR (P < 0.001), LIS < LIR (P = 0.03), and LIR < OIR (P = 0.002). Total sterol concentrations were positively associated with S(I) and negatively associated with obesity, whereas lathosterol correlations were the opposite., Conclusions: Cholesterol absorption was highest in the LIS participants, whereas cholesterol synthesis was highest in the LIR and OIR participants. Therapeutic diets for hyperlipidemia should emphasize low-cholesterol diets in LIS persons and weight loss to improve S(I) and to decrease cholesterol overproduction in LIR and OIR persons.

Objective: We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery., Study Design: Data on singleton infants were obtained from the 2004-2005 Healthcare Cost and Utilization Project Nationwide Inpatient Sample., Results: The rates of Agency for Healthcare Research and Quality PSI and all birth trauma were 2.45 and 25.85 per 1000 births, respectively. Compared with vaginal, cesarean delivery was associated with increased odds of PSI birth trauma (odds ratio [OR], 1.71), primarily due to an increased risk for "other specified birth trauma" (OR, 2.61). Conversely, cesarean delivery was associated with decreased odds of all birth trauma (OR, 0.55), due to decreased odds of clavicle fractures (OR, 0.07), brachial plexus (OR, 0.10), and scalp injuries (OR, 0.55)., Conclusion: Infants delivered by cesarean are at risk for different types of birth trauma from infants delivered vaginally., (Copyright 2010 Mosby, Inc. All rights reserved.)

Background: It is well known that cardiovascular disease is the number one killer of men and women in the United States and in many parts of the developed world. However, early detection of atherosclerosis remains a challenging area of research and development. Stress echo and myocardial perfusion studies were not designed to be screening tests and the majority of literature using these tests is in populations with a high probability of disease. It must be emphasized that negative stress echo and stress MPI tests only imply a lack of flow limiting disease; they do not indicate lack of atherosclerotic disease. It is important to remember that when these tests are "negative," the implication is favorable short-term prognosis rather than any implication regarding lack of disease. In contrast, carotid intima-media thickness (CIMT) scanning protocols can detect atherosclerotic disease in early and asymptomatic stages. For a number of reasons reviewed in this article, CIMT may be a more optimal screening and risk-stratifying technology: CIMT directly visualizes vasculature unlike biomarkers such as LDL cholesterol, hsCRP, or PLA2., Methods: We performed medline searches for original articles and reviews of carotid IMT from 1985 to the present. We particularly emphasized large multi-center epidemiologic studies of the natural history of patients with carotid IMT measurements., Conclusion: There is substantial evidence that CIMT is a suitable surrogate for the coronary tree. CIMT is also (along with coronary calcium scoring) recognized by the American Heart Association as a surrogate marker for coronary artery disease. A recent commentary by Stein, et al reviewed the comparison of CIMT to coronary calcium scoring, with favorable findings for CIMT especially in the healthy young and middle-aged populations, as well as women and African American individuals where coronary calcification has more limited utility. Recent findings of the Multi-Ethnic Study of Atherosclerosis indicate further that increased CIMT predicted CVD events in individuals without coronary calcification., (Copyright © 2010. Published by Elsevier Inc.)

BACKGROUND: The combination of niacin and statin has proven value in hyperlipidemia management and heart disease prevention. However, the efficacy of the non-prescription time-release niacin, Slo-Niacin®, is little studied alone and not at all with atorvastatin. We gave Slo-Niacin® and atorvastatin, singly and together to determine efficacy on the combined abnormalities of triglyceride, LDL and HDL. METHODS: 42 men and women with LDL-C>130mg/dL HDL-C <45 (men or 55mg/dL (women) were randomized to 3 months of atorvastatin 10 mg/day or incremental doses of Slo-Niacin® to 1500 mg/day. The alternate drug was added in the next 3-month segment. Lipid profiles and transaminases were measured monthly and other measures at baseline and the end of each treatment sequence. RESULTS: Mean entry lipids (mg/dL) were: TG 187, LDL-C 171, and HDL-C 39. Mean BMI was 32.6 Kg/m(2). Monotherapy with Slo-Niacin® decreased median triglyceride 15%, mean LDL-C 12% and non-HDL-C 15% and increased HDL-C 8%. Atorvastatin decreased median triglyceride 26%, and mean LDL-C 36%, non-HDL-C 36% and increased HDL-C 6%. Combined therapy decreased median triglyceride 33% and mean LDL-C and non-HDL-C each 43%. HDL-C increased 10% (all p<0.001). Median remnant-like lipoprotein-C decreased 55%, mean apo-B 40%, median hsCRP 23% (all p<0.05), TNFa 12% and no change in IL-6. Mean LDL buoyancy increased 15%, apo-A-I 5% and median HDL(2)-C 20% (all p<0.05). ALT declined with Slo-Niacin® treatment alone compared to atorvastatin and also decreased when Slo-Niacin® was added to atorvastatin. Six subjects dropped out, 3 for niacin related symptoms. CONCLUSIONS: Slo-Niacin® 1.5g/day with atorvastatin 10 mg/day improved lipoprotein lipids, apoproteins and inflammation markers without hepatotoxicity. Slo-Niacin® deserves further study as a cost-effective treatment of hyperlipidemia.

Objective: The purpose of this study was to describe the prevalence of human papillomavirus infection and the likelihood of human papillomavirus expression and Papanicolaou test abnormalities among women who have and who are at risk of having human immunodeficiency virus infection., Study Design: Cross-sectional analysis of 767 women who had human immunodeficiency virus infection and 390 women who were at risk of having human immunodeficiency virus infection in 4 cities in the United States., Results: Women who were infected with human immunodeficiency virus were more likely than women who were not infected to have human papillomavirus infection (prevalence ratio, 2.3; 95% CI, 2.0-2.8) but had similar human papillomavirus types. Among women who tested positive for human papillomavirus by polymerase chain reaction, human immunodeficiency virus infection was associated with a high level of human papillomavirus expression (prevalence ratio, 1.3-1.6) and multiple human papillomavirus infections (prevalence ratio, 1.9). However, among women with a high level of human papillomavirus expression or infection with multiple types, there was no association between human immunodeficiency virus serostatus and risk of cervical dysplasia., Conclusion: Through its association with a high level of expression and multiple human papillomavirus infections, human immunodeficiency virus infection may increase the risk of cervical dysplasia in women who are infected with human papillomavirus.