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Guidelines classify sacubitril/valsartan as a significant part of medical treatment of heart failure with reduced ejection fraction (HFrEF). Data have shown that the HbA1c levels in patients with diabetes mellitus could be impacted by sacubitril/valsartan. A possible positive effect in diabetes patients treated with sacubitril/valsartan on outcome and echocardiography parameters is not well studied yet.The aim of the present study was to compare the impact of sacubitril/valsartan on life-threatening arrhythmias, atrial fibrillation, different echocardiography parameters and congestion rate in patients suffering from HFrEF according to the diagnosis diabetes mellitus or no diabetes mellitus.Consecutive 240 patients with HFrEF from 2016 to 2020 were treated with sacubitril/valsartan and separated to concomitant diabetes mellitus (n = 87, median age 68 years interquartile range (IQR) [32-87]) or no diabetes mellitus (n = 153, median age 66 year IQR [34-89]). Different comorbidities and outcome data were evaluated over a follow-up period of 24 months. Arterial hypertension (87% vs. 64%; P 0.01) and coronary artery disease (74% vs. 60%; P = 0.03) were more often documented in patients with diabetes mellitus compared with patients without diabetes mellitus. Over the follow-up of 24 months several changes were noted in both subgroups: Median left ventricular ejection fraction (EF) increased significantly in non-diabetes (27% IQR [3-44] at baseline to 35% IQR [13-64]; P 0.001), but not in diabetic patients (29% IQR [10-65] at baseline to 30% IQR [13-55]; P = 0.11). Accordingly, NT-proBNP and troponin-I levels decreased significantly in non-diabetes patients (NT-brain natriuretic peptide [NT-proBNP] from median 1445 pg/mL IQR [12.6-74 676] to 491 pg/mL IQR [13-4571]; P 0.001, troponin-I levels from 0.099 ng/mL IQR [0.009-138.69] to 0.023 ng/mL IQR [0.006-0.635]; P 0.001), but not in diabetic patients (NT-proBNP from 1395 pg/mL IQR [100-29 924] to 885 pg/mL IQR [159-4331]; P = 0.06, troponin-I levels from 0.05 ng/mL IQR [0.013-103.0] to 0.020 ng/mL IQR [0.015-0.514]; P = 0.27). No significant change of laboratory parameters e. g. glomerular filtration rate, potassium level and creatinine levels were found in diabetes or non-diabetes patients. Comparing further echocardiography data, left atrial surface area, right atrial surface area, E/A ratio did not show a significant change either in the diabetes or non-diabetes group. However, the tricuspid annular plane systolic excursion was significantly increased in non-diabetes mellitus patients (from 17 mm IQR [3-31] to 18 mm [2.5-31]; P = 0.04), and not in diabetic s patients (17.5 mm IQR [8-30] to 18 mm IQR [14-31]; P = 0.70); the systolic pulmonary artery pressure remained unchanged in both groups. During follow-up, a similar rate of ventricular tachyarrhythmias was observed in both groups. The congestion rate decreased significantly in both groups, in diabetes patients (44.4% before sacubitril/valsartan and 13.5% after 24 months treatment; P = 0.0009) and in non-diabetic patients (28.4% before sacubitril/valsartan and 8.4% after 24 months treatment; P = 0.0004). The all-cause mortality rate was higher in patients with diabetes mellitus as compared with those without diabetes (25% vs. 8.1%; P 0.01).Sacubitril/valsartan reverses cardiac remodelling in non-diabetes patients. However, it reduces the congestion rate in diabetes and non-diabetes patients. The rates of ventricular tachyarrhythmias were similar in DM compared with non-DM over follow-up. The mortality rate remained to be over follow-up higher in diabetes patients compared with non-diabetes; however, it was lower compared with published data on diabetes and concomitant HFrEF not treated with sacubitril/valsartan.

Complex coastal currents control early-stage larval dispersal from intertidal populations, and late-stage settlement patterns, but are often poorly resolved in larval dispersal models. Generally, there is high uncertainty in the timing of larval spawning, which markedly affects larval dispersal. In this study, we describe the physical parameters that induce spawning events in the blue mussel, Mytilus edulis, using a variation of the Condition Index (which relates the mass of meat to the mass of the shell) as a proxy. We developed a high-resolution Eulerian coastal hydrodynamic model, coupled with a Lagrangian particle tracking model, to quantify the potential dispersal of early-stage mussel larvae based on differing spawning dates obtained from field data. Our results showed that (1) the timings of larval spawning cannot be explained solely by ‘thermal shocks’ in the sea or air temperatures (i.e. fluctuations in temperature causing stress); (2) larger spawning events generally occurred during neap tides; (3) the simulated larval dispersal was largely but not always predicted by averaged current pathways (calculated over two weeks period); and (4) simulated self-recruitment was low at sites associated with strong tidal currents. These results have important implications for shellfisheries stock management and sustainability. Specific to this study, simulated mussels from shellfishery beds off North Wales dispersed more than 25 km in one week and so could feasibly contribute to the wider population throughout the northern part of the Irish Sea.

Marine plastic pollution is one of the most visible environmental problems in and around the coastal regions of South East Asia. To fully address the marine plastic pollution problem, there must be a source-to-sink approach, reducing litter at each stage of its pathway to the open ocean. Mangroves are an important and widespread ecosystem in South East Asia on the interface between terrestrial and marine environments, and a key habitat and nursery for a number of species. Mangroves have also been reported to trap plastic litter, potentially acting as secondary sources to coastal marine environments. The Philippines are particularly vulnerable to compound hydrological events due to the seasonal monsoon and typhoons which regularly cross the region. South East Asia is a complex region oceanographically and hydrologically with high loads of plastic litter being exported into the regional seas. To correctly estimate local plastic pollution budgets and understand the transboundary movement of plastic from land to sea, modelling studies must account for the different environmental drivers and strong seasonality of the region. Here, we present preliminary results of a modelling study investigating the impact of Typhoon Rai on the retention and contribution of plastic litter by mangrove ecosystems of Cebu Island, the Philippines. The results of a three-dimensional, hydrodynamic model (ROMS) with wind, tidal and wave forcing will be presented. Future plans to apply a Lagrangian particle tracking model informed by in-situ measurements to investigate the behaviour of plastic litter within this typhoon weather system will also be outlined. This will help to understand how plastic litter is retained or exported during extreme events around Cebu Island and assess the likelihood of mangroves to act like a temporary sink or secondary source during extreme and mean events. Understanding the role of mangroves under different environmental conditions could clarify another step in the source-pathway-sink model of plastic litter in the region.

Accurate ocean data (i.e., tide, current velocity and direction, wave) are essential for numerous environmental studies: 1) development of marine renewable energy (e.g., maximize the efficiency of energy conversion); 2) aquaculture (e.g., offshore development); 3) anthropic pollution (e.g., plastic/pollutant dispersal); and 4) ecology (e.g., spread of invasive species).The exponential increase of computational power has made numerical models, such as Eularian hydrodynamic models and Lagrangian particle tracking models (PTM) useful tools to characterize physical oceanographic parameters. However, methods to validate PTMs appear less developed due the complexity of biophysical process interactions; for example, uncertainty remains on the impact of wind on surface currents and how the effects of wind are propagated through the water columnHere, we use a novel set of data representing the travel of drifters in the Irish Sea during two consecutive years (summer 2021 and 2022). The experiment aim is to reduce the near surface flow uncertainty influencing particle dispersal. Data were collecting using a range of drifters released in coastal and offshore locations of a tidally dominate shelf-sea (Irish Sea): 1) variation of drogue depth between 1m and 5m; 2) variation of period from tidal cycles to spring-neap cycles; and 3) some with reduced “windage” designs (no drogue and minimal exposure above surface).Preliminary results show the importance of wind driven current between the surface and 5 m depth, which should be take into account when considering the development of PTM. Furthermore, we find some scales of oceanographic processes that affect transport, such as turbulent eddies and waves, were not resolved - and yet our predictions broadly matched observations.

Lagrangian Particle Tracking Models (PTMs) have a wide range of applications in the marine environment, from predicting the dispersal of microplastics to larval transport. In two decades computational power have increased exponentially allowing PTMs to move from probabilistic approaches (e.g. advection and random walk) to more deterministic methods (e.g. including animal behaviour and buoyancy).Validation of hydrodynamic models simulating oceanographic processes has allowed confidence in their accuracy at simulating mean-flow fields (i.e. at the order of tens of metres and minutes). However, methods to validate PTMs appear less developed due the complexity of biophysical process interactions; for example, wind and wave combined impact on surface currents and larvae behaviour such as vertical and horizontal swimming.Here, we use a novel set of data representing the travel of drifters in the Irish Sea during summer 2021. The experiment aim is to reduce the near surface flow uncertainty influencing particle dispersal (i.e. larvae, microplastics and pollutant). Data were collecting using a range of drifters designs released in coastal, estuarine and offshore locations of a tidally dominate shelf-sea (Irish Sea): 1) variation of drogue depth between 1m and 5m; 2) variation of period from tidal cycles to spring-neap cycles; and 3) some with reduced “windage” designs (no drogue and minimal exposure above surface).The results allowed us to measure the difference of dispersal between PTM created associated to high-resolution 3D hydrodynamic model and data collected. The validation of a deterministic PTM created will be presented, with a discussion of wind and wave impact on surface current flow and uncertainty of the PTM. For example, we find some scales of oceanographic processes that affect transport, such as turbulent eddies and waves, were not resolved - and yet our predictions broadly matched observations.

The effects of sacubitril/valsartan in patients with chronic heart failure with reduced ejection fraction (HFrEF) were recently reported. However, the hemodynamic impact of this well-established treatment in patients with HFrEF has been poorly systematically researched.We aimed to investigate the hemodynamic effects of sacubitril/valsartan among patients with HFrEF.Between 2016 and 2020, we retrospectively collected data for patients with HFrEF treated at the University Medical Center Mannheim, Germany. Data for 240 patients with HFrEF were available. We systematically analyzed echocardiographic parameters, all-cause hospitalization, and congestion rate.The left ventricular ejection fraction (LVEF) improved from a median (minimum; maximum) of 28% (3; 65) before initiation of sacubitril/valsartan to a median of 34% (13; 64) at 24-month follow-up (p 0.001). Systolic pulmonary atrial pressure (PAPsys) decreased from a median of 30 mmHg (13; 115) to 25 mmHg (20; 80) at 24-month follow-up (p = 0.005). The median (minimum; maximum) tricuspid annular plane systolic excursion improved from 17 mm (3; 31) at baseline to 20 mm (9; 30) at 12-month follow-up (p = 0.007). The incidence of severe and moderate mitral, tricuspid, and aortic valvular insufficiency improved after treatment. Hospitalization and congestion rates reduced at 24-month follow-up. The mortality rate in echocardiographic and functional nonresponders was higher than in responders (12.1 vs. 5.2%; p = 0.1 and 11.3 vs. 3.1%; p = 0.01, respectively).Follow-up 24 months after starting treatment with sacubitril/valsartan revealed sustained improvements in echocardiographic parameters, including LVEF, PAPsys, and cardiac valvular insufficiency. Rates of all-cause hospitalization and congestion had decreased significantly at follow-up. The mortality rate was higher in echocardiographic and functional nonresponders.

Pinctada margaritifera is an economically important marine bivalve species for cultured pearl production in French Polynesian aquaculture. In order to evaluate the influence of donor oyster age on pearl quality traits, experiments were conducted over 6 years using both grafts and surgreffe operations. At harvest, 6 pearl quality traits were recorded and compared: surface defects, luster, grade, darkness level, and visual color. Analyzing the quality traits of pearls harvested in the initial graft process and those of pearls obtained from surgreffe experiments allowed a comparison of the influence of pearl sac cells originating from the initial mantle graft, which aged together with their recipient oysters. The results demonstrated a significant decrease between these successive grafts in luster, grade (A-B-C,) darkness level, and green color – traits that are of major importance in the pearl market. The duplicated graft experiment allowed the comparison of donor oyster families at 2 and 5 years old, where a mantle graft was inserted into recipient oysters aged 2.5 years old. The results showed the same tendencies to a lesser extent, with 1) an improved pearl grade, predominantly through a most important rate of 0 surface defect category, and 2) a green / grey ratio in favor of the younger donor. A comparison between the graft-surgreffe and the duplicated graft experiments also highlighted: 1) the indirect role played by the younger recipient oysters, which must be optimized for optimal pearl quality realization, and 2) the complex interplay between donor and recipient oysters.

Cultured pearls produced with Pinctada margaritifera, using the surgreffe method (implantation of a second nucleus following pearl harvest) were studied for the first time to: (1) examine family effect on nacre thickness, nacre weight and nacre deposition speed and (2) compare variation in these three traits with that obtained from the cultured pearls previously harvested after the corresponding initial grafts. A surgreffe experiment using 783 recipient oysters was realized in Rangiroa atoll (French Polynesia). After 24 months of culture, 389 cultured pearls were harvested. Significant donor family effect was found for the harvested pearl rate from surgreffe (P = 0.046). Highly significant donor family effect was recorded for nacre thickness (P = 0.004). Very highly significant donor family effects were recorded for nacre weight and nacre deposition speed (P

Production of larger, rounder, high-quality cultured pearls with fewer circles is one of the main challenges of Pinctada margaritifera aquaculture faced by every pearl farm in French Polynesia. Although bigger pearl sizes can be achieved through surgreffe operations (implantation of a second nucleus following pearl harvest), control of the development of pearl circles and shapes still remains unclear, as illustrated by grafter’s empirical rules, where often the surgreffe process is only performed after production of uncircled and round pearl shapes. The present study was designed with a real pearl by pearl traceability to reveal for the first time the development of circles and shapes from graft and surgreffe, in relation to the size of the pearl sac. This was indirectly assessed by measuring the differences in diameter (DD) and weight (DW) between standardized surgreffe nuclei and the pearl that had been harvested following the initial graft. An experimental graft and surgreffe experiment was designed using the same criteria: grafter, location, nuclei brand and size for graft and surgreffe, and donor oysters from 10 bi-parental families produced in a hatchery system. We studied the differences between pearls harvested following graft and surgreffe on the same recipient oysters (N = 295 for both graft and surgreffe) in relation to three classes of DD and DW in which the surgreffe nuclei, were: 1) bigger / heavier, 2) equivalent to or 3) smaller/lighter than the harvested pearl. Results revealed that to increase the rate of uncircled pearls following surgreffe, insertion of a nucleus larger than the harvested pearl may be advisable. Indeed, the formation of uncircled pearls following surgreffe was enhanced by inserting bigger / heavier second nucleus, both in animals that had produced a uncircled pearl after the initial graft and in those that had produced a circled pearl . For pearl shape, significantly more round shape pearls were produced after surgreffe, following initial oval and baroque samples from graft, by inserting smaller/lighter and bigger/heavier second nucleus, respectively. Inserting a larger second nucleus will significantly increase the rate of both uncircled and round-shaped pearls. This finding has important implications for surgreffe practices, where recipient oysters with undesirable circle or baroque pearls could now be used in this second stage of production.