The infiltration rate and therefore the principal function of a sand based vertical flow constructed wetland (VFCW) is influenced by the content of suspended solids (SS) and chemical oxygen demand ...(COD) of the waste water supply. In this study there were three operating conditions defined as "No Clogging"; "Partly Clogging" and "Clogging". Investigations on 21 VFCWs approved analytical differences between these conditions. The content of SS and especially particles > 50 microm are considered to play a key role. These particles are of the same size as the pores in which seepage mainly occurs. Thus their potential for surface blocking is high. It is concluded that the construction and size of the primary settling has to ensure that the mean concentration of SS after settling does not exceed 100 mg l(-1). The results of this study indicate that the area of the VFCW should be designed for a maximum loading rate of 5 g m(-2) d(-1) and the COD load should not exceed 20 g m(-2) d(-1).
Characterizing the long-term kinetics of maternally derived and vaccine-induced measles immunity is critical for informing measles immunization strategies moving forward. Based on two prospective ...cohorts of children in China, we estimate that maternally derived immunity against measles persists for 2.4 months. Following two-dose series of measles-containing vaccine (MCV) at 8 and 18 months of age, the immune protection against measles is not lifelong, and antibody concentrations are extrapolated to fall below the protective threshold of 200 mIU/ml at 14.3 years. A catch-up MCV dose in addition to the routine doses between 8 months and 5 years reduce the cumulative incidence of seroreversion by 79.3-88.7% by the age of 6 years. Our findings also support a good immune response after the first MCV vaccination at 8 months. These findings, coupled with the effectiveness of a catch-up dose in addition to the routine doses, could be instrumental to relevant stakeholders when planning routine immunization schedules and supplemental immunization activities.
Pseudoaneurysms of the posterior circulation pose a unique management challenge. The fragile nature of the pseudoaneurysm wall presents a high risk of rupture and demands treatment. Small ...vasculature, particularly distal in the posterior circulation, can preclude management with traditional flow diverters, where the alternative of vessel sacrifice is unacceptable. Small stents can have flow-diversion properties and can be used in these high-risk, difficult-to-access aneurysms.
We describe a 40-year-old woman presenting with a ruptured dissecting right superior cerebellar artery pseudoaneurysm after minor trauma. Given the aneurysm’s small size and morphology, it was not amenable to coiling and parent vessel sacrifice was potentially morbid. The pseudoaneurysm was initially stabilized with a Low-Profile Visualized Intraluminal Support Junior (LVIS Jr.) stent due to its reported flow-diverting properties.
At six-month follow-up the pseudoaneurysm was stable and the vasospasm had resolved. At this point, definitive treatment with a “FRED Jr.” (Flow Re-Direction Endoluminal Device Junior) flow diverter was pursued. Complete obliteration of the pseudoaneurysm was seen at 12 months’ follow-up after staged treatment.
Due to the unique challenges associated with ruptured pseudoaneurysms located on small-caliber vessels, the options for definitive treatment are limited. The small size of the LVIS Jr. stent and its flow-diverting properties make it a practical treatment option in a difficult situation. This case report provides further support for the flow-diverting properties of the LVIS Jr. and its potential application in the treatment of ruptured pseudoaneurysms in small-caliber intracranial vessels.
Explosively driven shock wave radius versus time profiles are frequently used to document energy release and relative explosive performance. Recently, two universal shock wave radius versus time ...profiles have been presented in the literature, which demonstrate the ability to represent explosively driven shock wave profiles for all explosive sources in any fluid environment. These two universal shock wave profiles are examined here relative to each other and relative to a commonly used nonlinear shock wave profile, which is fit to experimental data for individual explosive materials. The nonlinear profile, originally developed by Dewey, is examined here, and a universal non-dimensional form of the equation is proposed. The universal shock wave profiles are all found to be relatively similar, but with slight variations in a transition region of non-dimensional radii
0.15
≲
R
∗
≲
2
. The variations in this region result in different estimations of energy release or blast strength between the curve fits.
Musculoskeletal pain affects nearly half of all adults, most of whom are vitamin D deficient. Previous findings demonstrated that putative nociceptors ("pain-sensing" nerves) express vitamin D ...receptors (VDRs), suggesting responsiveness to 1,25-dihydroxyvitamin D. In the present study, rats receiving vitamin D-deficient diets for 2-4 weeks showed mechanical deep muscle hypersensitivity, but not cutaneous hypersensitivity. Muscle hypersensitivity was accompanied by balance deficits and occurred before onset of overt muscle or bone pathology. Hypersensitivity was not due to hypocalcemia and was actually accelerated by increased dietary calcium. Morphometry of skeletal muscle innervation showed increased numbers of presumptive nociceptor axons (peripherin-positive axons containing calcitonin gene-related peptide), without changes in sympathetic or skeletal muscle motor innervation. Similarly, there was no change in epidermal innervation. In culture, sensory neurons displayed enriched VDR expression in growth cones, and sprouting was regulated by VDR-mediated rapid response signaling pathways, while sympathetic outgrowth was not affected by different concentrations of 1,25-dihydroxyvitamin D. These findings indicate that vitamin D deficiency can lead to selective alterations in target innervation, resulting in presumptive nociceptor hyperinnervation of skeletal muscle, which in turn is likely to contribute to muscular hypersensitivity and pain.
Mesenchymal stromal cells (MSC) have shown promising results in the treatment of tendinopathy in equine medicine, making this therapeutic approach seem favorable for translation to human medicine. ...Having demonstrated that MSC engraft within the tendon lesions after local injection in an equine model, we hypothesized that they would improve tendon healing superior to serum injection alone.
Quadrilateral tendon lesions were induced in six horses by mechanical tissue disruption combined with collagenase application 3 weeks before treatment. Adipose-derived MSC suspended in serum or serum alone were then injected intralesionally. Clinical examinations, ultrasound and magnetic resonance imaging were performed over 24 weeks. Tendon biopsies for histological assessment were taken from the hindlimbs 3 weeks after treatment. Horses were sacrificed after 24 weeks and forelimb tendons were subjected to macroscopic and histological examination as well as analysis of musculoskeletal marker expression.
Tendons injected with MSC showed a transient increase in inflammation and lesion size, as indicated by clinical and imaging parameters between week 3 and 6 (p < 0.05). Thereafter, symptoms decreased in both groups and, except that in MSC-treated tendons, mean lesion signal intensity as seen in T2w magnetic resonance imaging and cellularity as seen in the histology (p < 0.05) were lower, no major differences could be found at week 24.
These data suggest that MSC have influenced the inflammatory reaction in a way not described in tendinopathy studies before. However, at the endpoint of the current study, 24 weeks after treatment, no distinct improvement was observed in MSC-treated tendons compared to the serum-injected controls. Future studies are necessary to elucidate whether and under which conditions MSC are beneficial for tendon healing before translation into human medicine.
The implantation of an alloplastic total temporomandibular joint (TMJ) prosthesis is an innovative approach for the treatment of end-stage TMJ disorders. Two types of system exist: prefabricated ...(stock) and customized computer-aided design/computer-aided manufacturing (CAD/CAM) devices. A clinical study was performed to evaluate the effectiveness of these two designs. Twenty-eight patients treated between 2015 and 2017 were included and assigned to two groups: stock prostheses (group 1) and customized CAD/CAM prostheses (group 2). Clinical evaluations were performed at five time-points up to 6 months postoperative. Parameters included maximum interincisal opening, pain, diet, complications, and subjective well-being at the end of follow-up. Differences between pre-surgery and 6-month post-surgery values were highly significant (P<0.001). No patient required a liquid diet at the end of treatment, and 66% of group 1 patients and 100% of group 2 patients reported improved well-being. Complications were observed in 32% of patients and included temporary paralysis of the facial nerve. In conclusion, clinical outcomes of stock and CAD/CAM prostheses suggested great improvements in mouth opening and reduction of pain as a result of the rehabilitation of TMJ function. Results showed comparable data for the two types of prosthesis design at 6 months postoperative.
C
and crassulacean acid metabolism (CAM) have evolved in the order Caryophyllales many times but neither C
nor CAM have been recorded for the Basellaceae, a small family in the CAM-rich sub-order ...Portulacineae. 24 h gas exchange and day-night changes in titratable acidity were measured in leaves of Anredera baselloides exposed to wet-dry-wet cycles. While net CO
uptake was restricted to the light period in well-watered plants, net CO
fixation in the dark, accompanied by significant nocturnal increases in leaf acidity, developed in droughted plants. Plants reverted to solely C
photosynthesis upon rewatering. The reversible induction of nocturnal net CO
uptake by drought stress indicates that this species is able to exhibit CAM in a facultative manner. This is the first report of CAM in a member of the Basellaceae.
Objectives
To describe the long‐term effects of ivacaftor (Kalydeco®) in individuals with cystic fibrosis (CF) on body mass index (BMI), body composition (BC), pulmonary function (PF), resting energy ...expenditure (REE), and exercise capacity (EC) after ≥12 months of treatment.
Working Hypothesis
BMI, lean and fat mass, PF, and EC will increase and REE will decrease after treatment.
Study Design
Observational study.
Methodology
Seven individuals with CF (mean age 15.4 ± 5.8 years) heterozygous for S1251N mutation, starting with ivacaftor, were included. Paired t tests were performed to assess the effects of ivacaftor. Height and weight were used to calculate BMI and BMI Z‐scores. Dual‐energy X‐ray absorptiometry was used to assess BC. Spirometry and body plethysmography were used to assess PF. Indirect calorimetry was used to measure REE and cardiopulmonary exercise testing (CPET) was used to measure oxygen uptake (VO2peak), peak work rate (Wpeak), and other CPET variables.
Results
After a median of 15 (interquartile range: 13‐16) months of treatment, BMI increased significantly (P = .03), but not BMI Z‐score (P = .23) or BC. Significant improvements were found for several PF variables, especially measures of hyperinflation (P = .02). Absolute VO2peak (P = .01), VO2peak related to body weight (P = .00), and oxygen cost of work (P = .01) decreased. Absolute Wpeak (P = .59) and Wpeak related to body weight (P = .31) remained stable.
Conclusions
The results showed that long‐term treatment of ivacaftor is associated with improvement of BMI and PF, but not of BC and REE. Oxygen uptake reduced after treatment, which may be due to a decrease in work of breathing.
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