Background: Patients with chronic obstructive pulmonary disease (COPD) often present with severe acute exacerbations requiring hospital treatment. However, little is known about the prognostic ...consequences of these exacerbations. A study was undertaken to investigate whether severe acute exacerbations of COPD exert a direct effect on mortality. Methods: Multivariate techniques were used to analyse the prognostic influence of acute exacerbations of COPD treated in hospital (visits to the emergency service and admissions), patient age, smoking, body mass index, co-morbidity, long term oxygen therapy, forced spirometric parameters, and arterial blood gas tensions in a prospective cohort of 304 men with COPD followed up for 5 years. The mean (SD) age of the patients was 71 (9) years and forced expiratory volume in 1 second was 46 (17)%. Results: Only older age (hazard ratio (HR) 5.28, 95% CI 1.75 to 15.93), arterial carbon dioxide tension (HR 1.07, 95% CI 1.02 to 1.12), and acute exacerbations of COPD were found to be independent indicators of a poor prognosis. The patients with the greatest mortality risk were those with three or more acute COPD exacerbations (HR 4.13, 95% CI 1.80 to 9.41). Conclusions: This study shows for the first time that severe acute exacerbations of COPD have an independent negative impact on patient prognosis. Mortality increases with the frequency of severe exacerbations, particularly if these require admission to hospital.
Patients with chronic obstructive pulmonary disease (COPD) often present with severe acute exacerbations requiring hospital treatment. However, little is known about the prognostic consequences of ...these exacerbations. A study was undertaken to investigate whether severe acute exacerbations of COPD exert a direct effect on mortality.
Multivariate techniques were used to analyse the prognostic influence of acute exacerbations of COPD treated in hospital (visits to the emergency service and admissions), patient age, smoking, body mass index, co-morbidity, long-term oxygen therapy, forced spirometric parameters, and arterial blood gas tensions in a prospective cohort of 304 men with COPD followed up for 5 years. The mean (
sd) age of the patients was 71 (9) years and forced expiratory volume in 1
s was 46 (17)%.
Only older age (hazard ratio (HR) 5.28, 95% CI 1.75–15.93), arterial carbon dioxide tension (HR 1.07, 95% CI 1.02–1.12), and acute exacerbations of COPD were found to be independent indicators of a poor prognosis. The patients with the greatest mortality risk were those with three or more acute COPD exacerbations (HR 4.13, 95% CI 1.80–9.41).
This study shows for the first time that severe acute exacerbations of COPD have an independent negative impact on patient prognosis. Mortality increases with the frequency of severe exacerbations, particularly if these require admission to hospital.
Reproduced with permission from the BMJ Publishing Group.
A study is made of the ultrastructure and variations in pinealocyte caryometric indices in 45 male albino rats (240 +/- 40 gm). Fifteen animals were subjected to exposed pineal body irradiation for 6 ...continuous minutes with soft He-Ne laser light. The irradiated rats were sacrificed in groups of five 3, 6 and 15 days post-irradiation. The control and sham-operated (craniotomy without irradiation) groups consisted of the same number of animals as the experimental groups. The results show a significant decrease in indices (p less than 0.0005) in all experimental groups in relation to the control and sham-operated animals, although in terms of the latter p for the three days post-irradiation group was 0.002. A progressive and significant decrease (p less than 0.002) was also observed between the experimental groups after 3 and 15 days and after 6 and 15 days, but not between the experimental groups after 3 and 6 days. Ultrastructurally, there were signs of secretory activity increase in the groups after 3 and 6 days, and decrease in such activity after 15 days--along with the appearance of cells of mesoglial lineage. A significant increase was observed in the number of peri-canalicular dark cells. The results are discussed and compared with those of other authors and different light energies.
Interleukin-23 (IL-23) responsive group 3 innate lymphoid cells (ILC3s) have been implicated in immune homeostasis and pathogenesis in the adult, but little is known about their roles in the newborn. ...Here we show that IL-23 promotes conversion of embryonic intestinal Lin(-)IL-23R(+)Thy1(+) cells into IL-22-producing Thy1(+)Sca-1(hi) ILC3s in vitro. Gut-specific expression of IL-23 also activated and expanded Thy1(+)Sca-1(hi) ILC3s, which produced IL-22, IL-17, interferon gamma (IFN-γ), and granulocyte-macrophage colony-stimulating factor (GM-CSF) and were distinct from canonical CD4(+) lymphoid tissue inducer (LTi) cells. These ILC3s accumulated under the epithelium in intercellular adhesion molecule (ICAM)-1-positive cell aggregates together with neutrophils that disrupted the epithelium, leading to the formation of discrete intestinal erosions, bleeding, and neonatal death. Genetic and antibody depletion of ILC3s rescued the mice from neonatal death. Antibiotic treatment of pregnant mothers and offspring prolonged survival of IL-23 transgenic mice, suggesting a role for the commensal flora on ILC3-induced pathogenesis. Our results reveal a novel role for the IL-23-ILC3s axis in the pathogenesis of neonatal intestinal inflammation.
•Treatment of wastewater produced in the mills to make the whole process sustainable.•Centrifugation was the most effective pretreatment in terms of TSS abatement and no phenolic compounds loss.•This ...pretreatment enhanced NF membrane flux (64.52L/hm2) and EC+COD rejections.•A stream rich in phenolic compounds concentrated 8.33 times in volume was yielded.•A permeate practically free of phenolic content and COD reduced 86.76% was obtained.
Olive oil industry is concerned to make the whole production process environmentally friendly, and this includes the treatment of the wastewater produced in the mills. In the present work, concentration and recovery of high-added value compounds (phenolic fraction) from two-phase olive-oil washing wastewater (OOWW) and the simultaneous treatment of the effluent by nanofiltration (NF) with a polymeric membrane was studied. Primarily, different pretreatments upstream the membrane unit were examined, adequating the effluent characteristics, that is, reducing the organic and inorganic concentration without compromising the phenolic content for its ulterior recovery. Among them, centrifugation was the most effective in terms of TSS abatement, no phenolic compounds loss, and subsequent highest EC and COD NF rejection. The availability of the centrifuges in the olive mills already, implying minimization of fix costs and needless of chemicals (flocculants), reinforces the proposed process. Moreover, this pretreatment enhanced the downstream stable membrane flux, up to 64.52L/hm2, concentrating the feed up to 8.33 times. The obtention of a permeate stream with very good saline quality, COD reduced 86.76% and practically free of phenolic content, thus minimized in its recalcitrant and phytotoxic potential, and a concentrate pool enriched in these high added-value antioxidant compounds (up to 1315.7mg/L) would allow to counter-balance the economic feasibility of the reclamation process.
A hallmark of autoimmunity in murine models of lupus is the formation of germinal centers (GCs) in lymphoid tissues where self-reactive B cells expand and differentiate. In the host response to ...foreign antigens, follicular dendritic cells (FDCs) maintain GCs through the uptake and cycling of complement-opsonized immune complexes. Here, we examined whether FDCs retain self-antigens and the impact of this process in autoantibody secretion in lupus. We found that FDCs took up and retained self-immune complexes composed of ribonucleotide proteins, autoantibody, and complement. This uptake, mediated through CD21, triggered endosomal TLR7 and led to the secretion of interferon (IFN) α via an IRF5-dependent pathway. Blocking of FDC secretion of IFN-α restored B cell tolerance and reduced the amount of GCs and pathogenic autoantibody. Thus, FDCs are a critical source of the IFN-α driving autoimmunity in this lupus model. This pathway is conserved in humans, suggesting that it may be a viable therapeutic target in systemic lupus erythematosus.
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•Internalization of RNP complexes via CD21 triggers TLR7 and IFN-α in mouse and human FDCs•GC maintenance and α anti-nuclear antibody production are dependent on TLR7 pathway in FDCs•Loss of B cell tolerance in RNP-specific lupus mice is IFNAR dependent•FDCs are an essential source of type I IFN in lupus mice
Follicular dendritic cells (FDCs) maintain germinal centers through the uptake and cycling of complement-opsonized immune complexes. Das et al. show that in a murine model of lupus, uptake of self-immune complexes by FDCs activates TLR7 and that these stromal cells are a critical source of the IFN-α driving autoimmunity.
•Two-phase olive-oil-washing wastewater valorization and purification by NF.•Factorial design used for NF process optimization.•Membrane fouling build-up was minimized.•NF process was subsequently ...modelled by second-grade quadratic fitting model equation.•Feasible and sustainable compliance of the irrigation standards were achieved.
The core of the present work was to model and optimize an environmentally friendly nanofiltration (NF) treatment process for two-phase olive-oil-washing wastewater (OOWW) valorization throughout the concentration and recovery of its phenolic fraction and the obtention of a purified permeate stream. For this objective, a factorial design was used for the optimization of the process. Results were interpreted by means of the response surface methodology. A statistical multifactorial analysis was performed in order to quantify all the potential complex conjugated effects of the input parameters in the NF process. The process was subsequently modelled by means of a second-grade quadratic fitting model equation. Finally, the parametric quality standards that permit to reuse the purified stream for irrigation, recycling or even discharge in-site reuse purposes were checked. To the author’s knowledge, no previous work on the optimization and statistical modelling of membrane processes for OOWW purification and valorization can be found up to the present. The optimized parameters for the proposed OOWW purification process – operating pressure of 26.5 bar, tangential velocity 32.7 m s−1, system temperature 35 °C and pH of 3.7 – ensured high and stable membrane flux (106.2 L h−1 m−2). The obtained optimized data are very relevant for the feasible scale-up of the proposed process in the mills, since the NF membrane (TFC polyamide/polysulfone, MWCO 300 Da) was highly efficient at ambient temperature conditions and raw effluent pH. The optimized conditions provided a permeate stream that could be reused for irrigation purposes and a retantate stream concentrated in volume up to 6.5 times, with a total phenolic content of minimum 1315.7 mg/L.
Abstract A pellet-induced enhanced confinement (PiEC) phase, with general characteristics similar to those reported for the stellarator W7-X, is observed after single pellet injection (>10 19 H ...atoms) into the neutral beam injection heated phase of plasmas in the mid-sized heliac-type stellarator TJ-II. In addition to a step-like increase in density, plasma diamagnetic energy content rises significantly with respect to that of reference discharges, energy confinement time is similarly enhanced when compared to International Stellarator Scaling law predictions (Yamada et al 2005 Nucl. Fusion 45 1684) renormalized for TJ-II, and the triple product, n e · T i · τ E , exhibits a clear bifurcation towards an improved confinement branch when compared to the branch product predicted by the same law. In this work, multiple pellets are injected in series into NBI-heated plasmas in the TJ-II and post-injection plasma performance is reported and discussed. For instance, a charge-exchange recombination spectroscopy diagnostic reveals significantly increased core ion temperatures after pellet injection compared to temperatures achieved in comparable reference plasmas, this pointing to increased ion energy content and improved ion energy confinement during a PiEC phase. It is also found that enhanced performance is independent of whether co- or counter-NBI heating beam is employed. Finally, record stored diamagnetic energy content and plasma beta values are achieved when the largest available pellets are employed. The results indicate that pellet injections extend the operational regime well beyond limits previously achieved in TJ-II without pellets.
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