Abstract Evaluation of specific antibody (Ab) response to polysaccharide antigens is essential for diagnosis of primary immunodeficiencies. We assessed the specific Ab responses to the ...pneumococcal-polysaccharide (PPV) and to Salmonella typhi-polysaccharide (TyphimVi) vaccines in a prospective study (EMPATHY) in patients with common variable immunodeficiency (CVID-Group, n = 22), hypogammaglobulinemia (HYPOG-Group; n = 27) and healthy controls (HC-Group; n = 16). Specific Ab concentrations in response to PPV and to TyphimVi vaccines were measured by ELISA (The Binding Site, UK), defining 3-fold increase as normal response (Ratio:3 ×). The RatioTyphimVi:3 × was significantly greater in HC than in CVID-Group ( p < 0.0001), but not than HYPOG-Group ( p = 0.138). However, the RatioPPV:3 × showed no significant differences among the three groups. By ROC analysis, TyphimVi better differentiated HC from CVID (AUC:0.893, IC95%: 0.791–0.996, p < 0.0001) than PPV. Our results suggest that the use of specific Ab response to TyphimVi could represent a complementary assay for the diagnosis of anti -polysaccharide Ab production deficiency in patients with CVID.
To analyse the risk of reulceration caused by the transfer of lesions in patients with diabetes, undergoing resection of at least one metatarsal head.
A total of 119 patients with diabetes from the ...Diabetic Foot Unit (Complutense University, Madrid, Spain), who underwent resection of at least one metatarsal head were analysed prospectively from November 2006 to December 2011 to assess reulceration in the other metatarsal head.
Seven patients were excluded for being subjected to a pan-metatarsal head resection and 11 patients dropped out. During a median follow-up period of 13.1 months (interquartile range 6.1-22.8 months), 41% of patients suffered from reulcerations. Reulceration frequency in patients operated on the 1st, 2nd, 3rd, 4th, 5th and several metatarsal heads was 9 (69%), 8 (44%), 12 (52%), 2 (25%), 6 (19%) and 4 (50%) events, respectively. The Cox regression model showed hazard ratios that were significant for the location of the metatarsal resection. The first metatarsal showed the highest risk for reulceration (hazard ratio 3.307; 1.472-7.430) and the fifth metatarsal showed the lowest risk (hazard ratio 0.339; 0.138-0.832).
Reulceration is a frequent event following resection of a metatarsal head and should be regarded as an implicit complication of the intervention. The location of the resection determines the risk of reulceration, which is highest for patients operated on the first metatarsal head and lowest for patients operated on the fifth metatarsal head.
We compared the effects of two resistance training (RT) programs only differing in the repetition velocity loss allowed in each set: 20% (VL20) vs 40% (VL40) on muscle structural and functional ...adaptations. Twenty‐two young males were randomly assigned to a VL20 (n = 12) or VL40 (n = 10) group. Subjects followed an 8‐week velocity‐based RT program using the squat exercise while monitoring repetition velocity. Pre‐ and post‐training assessments included: magnetic resonance imaging, vastus lateralis biopsies for muscle cross‐sectional area (CSA) and fiber type analyses, one‐repetition maximum strength and full load‐velocity squat profile, countermovement jump (CMJ), and 20‐m sprint running. VL20 resulted in similar squat strength gains than VL40 and greater improvements in CMJ (9.5% vs 3.5%, P < 0.05), despite VL20 performing 40% fewer repetitions. Although both groups increased mean fiber CSA and whole quadriceps muscle volume, VL40 training elicited a greater hypertrophy of vastus lateralis and intermedius than VL20. Training resulted in a reduction of myosin heavy chain IIX percentage in VL40, whereas it was preserved in VL20. In conclusion, the progressive accumulation of muscle fatigue as indicated by a more pronounced repetition velocity loss appears as an important variable in the configuration of the resistance exercise stimulus as it influences functional and structural neuromuscular adaptations.
Aims/hypothesis We analysed the factors that determine the outcomes of surgical treatment of osteomyelitis of the foot in diabetic patients given early surgical treatment within 12 h of admission and ...treated with prioritisation of foot-sparing surgery and avoidance of amputation. Methods A consecutive series of 185 diabetic patients with foot osteomyelitis and histopathological confirmation of bone involvement were followed until healing, amputation or death. Results Probing to bone was positive in 175 cases (94.5%) and radiological signs of osteomyelitis were found in 157 cases (84.8%). Staphylococcus aureus was the organism isolated in the majority of cultures (51.3%), and in 35 cases (36.8%) it proved to be methicillin-resistant. The surgical treatment performed included 91 conservative surgical procedures, which were defined as those where no amputation of any part of the foot was undertaken (49.1%). A total of 94 patients received some degree of amputation, consisting of 79 foot-level (minor) amputations (42.4%) and 15 major amputations (8%). Five patients died during the perioperative period (2.7%). Histopathological analysis revealed 94 cases (50.8%) of acute osteomyelitis, 43 cases (23.2%) of chronic osteomyelitis, 45 cases (24.3%) of acute exacerbation of chronic osteomyelitis and three remaining cases (1.6%) designated as 'other'. The risks of failure in the case of conservative surgery were exposed bone, the presence of ischaemia and necrotising soft tissue infection. Conclusions/interpretation Conservative surgery without local or high-level amputation is successful in almost half of the cases of diabetic foot osteomyelitis. Prospective trials should be undertaken to determine the relative roles of conservative surgery versus other approaches.
•Two-phase olive-mill waste and cattle manure were anaerobically co-digested.•Start-up and stabilization stages were studied in semicontinuous stirred tank reactor.•Propionic accumulation was the key ...factor in the methanogenic phase inhibition.•Total period of 140 days was required to start-up and stabilization the process.•During the stable period the methane productivity was 0.34 LCH4/LRd at 40-d HRT.
In this work, the start-up and stabilization stages of mesophilic anaerobic co-digestion of 2POMW and CM in a semi-continuously fed stirred tank reactor (SSTR) were analyzed. Volatile fatty acids (VFAs) were monitored and used as the main control parameter for the start-up and stabilization stages, as well as to evaluate the potential inhibition episodes. The results showed that accumulation of propionic acid was the key factor in the inhibition of the methanogenic phase, leading to process imbalance. To avoid the problems associated with inhibition by high VFA concentrations, several reinoculations were performed using a suitable inoculum adapted to VFA degradation. The start-up phase was carried out in batch conditions for 97 days, reaching a final concentration of propionic acid of 12.77 mg/L. From that moment, the reactor was fed in a semi-continuous mode with a hydraulic retention time (HRT) of 40 days. A total period of 140 days was required to achieve a stable performance of the reactor with a methane productivity of 0.34 LCH4/LRd.
The consumption of plastic raw materials has been exponentially growing throughout the world in the last decade and so has, in the same proportion, their associated waste. Recycling through the ...mechanical treatment of the heavy fraction of these plastics is the most economic and the safest alternative to use this waste and to recirculate it for reuse within the same industry or for other related industries located near the place where the waste is generated. In this paper, a study of characterization and post-processing of recycled high density polyethylene received by a hazardous waste manager in southern Spain is presented, an area in which containers, Intermediate Bulk Containers, and drums, originally used for oil products from refineries and petrochemical industries nearby, are employed. These high density polyethylene materials are validated to meet the requirements of the harmonized standards to be used as self-supply in the production of manhole covers. EN 124–6:2015 standard allows the use of plastic materials such as PE or PP, even using material externally reprocessed, such as material derived from thermoplastic products that have not been previously used as lids or manhole covers. Class A-15 and B-125 of the standard are oriented for the construction of these types of elements to cover or close in certain urban spaces such as pedestrian areas, parking areas or multi-story car parks for vehicles. The study shows that the recycled material fully complies with the density; it keeps unalterable during fire test after application of the coating, there are no adverse effects on artificial ageing; the decrease of the average value of the tensile impact strength by 21.84%; and achieves 6 mm of maximum deflection against the test load Fp (45.3 MPa). Therefore, it can be considered a valid scenario for the effective use of solid plastic waste in products that make up part of the urban or industrial areas, as an example of complete circularity material and offers a valid alternative to the end-of-waste condition.
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•Two-phase olive-mill waste and cattle manure were anaerobically co-digested.•Biogas production was optimized in semicontinuous regime of feeding.•Optimal and critical hydraulic retention time (HRT) ...were determined for the process.•Maximum methane productivity (0.94 LCH4/LRd) was obtained at 15-day HRT (optimal).•Methane production and organic matter removal decrease at 12-day HRT (critical).
Anaerobic co-digestion of organic wastes is an effective technology for the management of two or more substrates with different characteristics. In this context, the main objective of this work was the optimization of biogas production for the treatment of a mixture of two-phase olive-mill waste (2POMW) and cattle manure (CM) (60:40 w/w) at mesophilic temperature range (35 °C). The effect of hydraulic retention time (HRT) on the performance and stability of the digestion process was studied. A decreasing series of HRTs in the range of 40–12 days was analyzed. The corresponding organic loading rates (OLR) were in the range 2.01–6.07 gVS/LR·d. Pseudo steady-state operation of the reactor was established for HRTs between 40 and 15 days. For 15-days HRT, the maximum values of methane productivity (0.94 LCH4/LR·d) and specific methane yield (0.52 LCH4/gVSremoved) were obtained while total acidity (measured as acetic acid) in the effluent were<150 mg/L, verifying process stability. In addition, the removal efficiencies of volatile solids (VS) and dissolved organic carbon (DOC) were 38 and 67 %, respectively. At 12-days HRT, decreases in methane production and organic matter removal efficiencies were observed, with values of 27 and 47 % for VS and DOC removal, respectively. Therefore, 12-days HRT was considered as inadequate for the anaerobic co-digestion of 2POMW and CM because a clear increase in volatile fatty acids was observed at the end of this period, leading to process destabilization and a decrease in biogas production.
The effect of low glycerol supplementation (<1% v/v) in the thermophilic anaerobic digestion (AD) of real municipal solid waste (RMSW) on methane production (MP) is not known. This study explores the ...effect of five different glycerol supplementations (0%, 0.1%, 0.25%, 0.5% and 1%) on effluent characteristics, anaerobic consortia and MP. Specifically, by adding 0.25% v/v crude glycerol to the feed, the methane production rate increased by 48% (from 7.40±1.17 l CH4/l to 11.01±1.66 l CH4/l), in line with the increase in total volatile solids (TVS) removal (from 65±7% to 81±7) and methanogenic activity (from 110∗10−12±17∗10−12 l CH4/cell to 156∗10−12±24∗10−12 l CH4/cell). Extra glycerol added to the feed (0.5% or 1%) was shown to be non-feasible for thermophilic AD of RMSW, as inhibition of methanogenesis was observed. Fluorescent in situ hybridization (FISH) studies showed that the percentages of Eubacteria, Archaea, H2-utilising methanogens (HUM) and acetate-utilising methanogens (AUM) were stable within the 94.0–97.0%, 6.0–3.0%, 1.8–3.6% and 0.6–2.8% ranges, respectively.
The purpose of this study was to investigate the effect of glycerol supplementation (1% v/v) on the hydrogen production (HP) steps in thermophilic-dry dark fermentation of industrial municipal solid ...waste (IMSW) in batch mode. For this purpose, physicochemical and microbiological parameters were considered. The rates of HP and specific hydrogen production (SHP) almost doubled when adding 1% v/v crude glycerol to the IMSW. This result was in keeping with the high values of hydrolysis yield (75±4%) and microbial activity (7.3∗10−12±0.9∗10−12lH2/cell). Microbiological studies showed that the percentages of Eubacteria decreased slightly after the dark fermentation process. Archaea contents were not significant and the biogas produced was methane-free.
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