Background and purpose
Subclinical atrial fibrillation (AF) is known to underlie a number of cases of cryptogenic stroke (CrS). However, there is need to define the most effective strategy for AF ...detection. The diagnostic usefulness was analysed of a strategy based on ultra‐early continuous monitoring in patients with CrS in terms of AF detection, oral anticoagulation treatment and stroke recurrence, in comparison to a standard outpatient strategy.
Methods
Patients with ischaemic stroke of undetermined origin and confirmed to be cryptogenic after extensive work‐up were searched for AF with (i) a conventional strategy (historical cohort, n = 101) with serial electrocardiograms and 24‐h Holter monitoring or (ii) an ultra‐early monitoring strategy with insertable cardiac monitor (ICM) implanted before discharge (prospective cohort, n = 90). AF episodes lasting >1 min, anticoagulant treatment and stroke recurrence were recorded.
Results
During admission, AF was similarly detected in both cohorts (24% of patients). After discharge (mean follow‐up 30 ± 10 months), AF detection rates were 17/80 (21.3%) and 38/65 (58.5%) for patients in the conventional versus the ultra‐early ICM group (P < 0.001). Up to 41% of AF cases in the ICM cohort were detected within the first month. Oral anticoagulation was initiated in 37.6% versus 65.5% (P < 0.001) and stroke recurrence was recorded in 10.9% versus 3.3% (P 0.04) in the conventional versus the ICM cohort.
Conclusions
Pre‐discharge ICM implant allows detection of AF during follow‐up in up to 58% of selected patients with CrS. Compared to a conventional strategy, ultra‐early ICM implant results in higher anticoagulation rates and a decrease in stroke recurrence.
Display omitted
•Database gathering performance data on more than 60 full-scale digestate separators.•Classification of separators into low and high-performance equipment.•Very distinct profiles of ...digestate components separation.•Dependency of separator choice and AD feedstock.•Simple approach to predict digestate separation based on equipment and AD feedstock.
Digestate mechanical separation is present in numerous anaerobic digestion plants. In this study, data from literature and from unpublished analysis were gathered to evaluate digestate separation efficiency for different mechanical separators. For the first time, efficiency indicators allowed the definition of two mass distribution profiles. The low-performance profile was characterized by each component being mainly destined to the liquid fraction, excluding P, Mg and Ca in a few cases. Screw presses represented 68% of these separators and 78% of digestates came from mainly fibrous inputs such as cow manure and silage. In the high-performance profile, digestate compounds were effectively concentrated in the solid fraction, except nitrogen. The great majority of separators were decanting centrifuges, and the anaerobic digestion inputs were principally non-fibrous such as pig slurry, sludge and agro-industrial waste. This study represents a source for benchmarking digestate separation and opens a possibility to forecast more realistically digestate separation performance.
The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 ...(SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of ‘airborne’ whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six ‘myths’ are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.
A new stellar library developed for stellar population synthesis modelling is presented. The library consists of 985 stars spanning a large range in atmospheric parameters. The spectra were obtained ...at the 2.5-m Isaac Newton Telescope and cover the range λλ 3525–7500 Å at 2.3 Å (full width at half-maximum) spectral resolution. The spectral resolution, spectral-type coverage, flux-calibration accuracy and number of stars represent a substantial improvement over previous libraries used in population-synthesis models.
The antifungal mode of action of chitosan has been studied for the last 30 years, but is still little understood. We have found that the plasma membrane forms a barrier to chitosan in ...chitosan-resistant but not chitosan-sensitive fungi. The plasma membranes of chitosan-sensitive fungi were shown to have more polyunsaturated fatty acids than chitosan-resistant fungi, suggesting that their permeabilization by chitosan may be dependent on membrane fluidity. A fatty acid desaturase mutant of Neurospora crassa with reduced plasma membrane fluidity exhibited increased resistance to chitosan. Steady-state fluorescence anisotropy measurements on artificial membranes showed that chitosan binds to negatively charged phospholipids that alter plasma membrane fluidity and induces membrane permeabilization, which was greatest in membranes containing more polyunsaturated lipids. Phylogenetic analysis of fungi with known sensitivity to chitosan suggests that chitosan resistance may have evolved in nematophagous and entomopathogenic fungi, which naturally encounter chitosan during infection of arthropods and nematodes. Our findings provide a method to predict the sensitivity of a fungus to chitosan based on its plasma membrane composition, and suggests a new strategy for antifungal therapy, which involves treatments that increase plasma membrane fluidity to make fungi more sensitive to fungicides such as chitosan.
PDF
