It has been proved in the context of quantum fields in Minkowski spacetime that the vacuum state is a thermal state according to uniformly accelerated observers-a seminal result known as the Unruh ...effect. Recent claims, however, have challenged the validity of this result for extended systems, thus casting doubts on its physical reality. Here, we study the dynamics of an extended system, uniformly accelerated in the vacuum. We show that its reduced density matrix evolves to a Gibbs thermal state with local temperature given by the Unruh temperature Formula: see text, where a is the system's spatial-dependent proper acceleration-c is the speed of light and k
and Formula: see text are the Boltzmann's and the reduced Planck's constants, respectively. This proves that the vacuum state does induce thermalization of an accelerated extended system-which is all one can expect of a legitimate thermal reservoir.
The presence of antibiotic resistant bacteria (ARB) in wastewater was investigated and the role of wastewater treatment plants (WWTPs) in promoting or limiting antibiotic resistance was assessed. ...Escherichia coli (E. coli) and total heterotrophic bacteria (THB) resistance to ampicillin, chloramphenicol and tetracycline was monitored in three WWTPs located in Milan urban area (Italy), differing among them for the operating parameters of biological process, for the disinfection processes (based on sodium hypochlorite, UV radiation, peracetic acid) and for the discharge limits to be met. Wastewater was collected from three sampling points along the treatment sequence (WWTP influent, effluent from sand filtration, WWTP effluent).
Antibiotic resistance to ampicillin was observed both for E. coli and for THB. Ampicillin resistant bacteria in the WWTP influents were 20–47% of E. coli and 16–25% of THB counts. A limited resistance to chloramphenicol was observed only for E. coli, while neither for E. coli nor for THB tetracycline resistance was observed. The biological treatment and sand filtration led to a decrease in the maximum percentage of ampicillin-resistant bacteria (20–29% for E. coli, 11–21% for THB). However, the conventionally adopted parameters did not seem adequate to support an interpretation of WWTP role in ARB spread. Peracetic acid was effective in selectively acting on antibiotic resistant THB, unlike UV radiation and sodium hypochlorite. The low counts of E. coli in WWTP final effluents in case of agricultural reuse did not allow to compare the effect of the different disinfection processes on antibiotic resistance.
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•Resistance to 3 antibiotics was assessed in 3 municipal wastewater treatment plants.•E. coli and total heterotrophic bacteria (THB) were selected as microbial indicators.•A relevant quote of resistant E. coli and THB was observed only for ampicillin.•Biological treatment and sand filtration influenced the presence of resistant bacteria.•Peracetic acid reduced resistant THB, unlike UV radiation and sodium hypochlorite.
Phosphorus is a non-renewable resource going to be exhausted in the future. Sewage sludge ash is a promising secondary raw material due to its high phosphorus content. In this work, the distribution ...of 19 elements in bottom and cyclone ashes from pilot-scale grate furnace have been monitored to determine the suitability for the phosphorus acid extraction. Moreover, the influence of some parameters beyond wet chemical leaching conditions were investigated. Experimental results showed that bottom ash presented lower contamination in comparison to cyclone ash and low co-dissolution of heavy metals (especially Cr, Pb and Ni), while high phosphorus extraction efficiencies (76-86%) were achieved. High Al content in the bottom ash (9.4%) negatively affected the phosphorus extraction efficiency as well as loss on ignition, while the particle size reduction was necessary for ensuring a suitable contact surface. The typology of precipitating agents did not strongly affect the phosphorus precipitation, while pH was the key parameter. At pH 3.5-5, phosphorus precipitation efficiencies higher than 90% were achieved, with a mean phosphorus content in the recovered material equal to 16-17%, comparable to commercial fertilizers. Instead, the co-precipitation of Fe and Al had a detrimental effect on the recovered material, indicating the need for additional treatments.
IntroductionNumerous authors have proposed “responder” criteria for patients with schizophrenia treated with antipsychotic monotherapy (Leucht, S et al 2009; 438 7-14; Suzuki T et al, 2012; 197 1-6; ...Kane J et al 1988; 45 789-96). These suggest reductions greater than 30% on the PANSS total score, improvements of 1 category or more on the CGI-S, or CGI-C ratings of very much, much or minimally improved, as well as various permutations and combinations of the above. No study has met the responder definition of Kane et al in the last 30 years in monotherapy studies in TRS patients. However, a widely accepted definition of response in patients with TRS treated with a putative antipsychotic added to their background antipsychotic monotherapy, is not currently available, and more work is needed on this highly relevant topic (Suzuki, T et al 2011; 133 1-3).ObjectivesCombining PANSS (30-item anchored scale), CGI-C and CGI-S (both 7-point Likert scales), three of the most accepted scales to evaluate patients with schizophrenia worldwide, we propose two different definitions of response in TRS populationMethodsStudy 014 was designed to evaluate the safety and preliminary evidence of efficacy of evenamide, a NCE added to an antipsychotic monotherapy, given orally at 3 fixed doses (7.5, 15 and 30 mg bid) in patients with TRS not adequately responding to a therapeutic dose of an AP. Assessment of efficacy was based on changes of the PANSS and CGI-S/C. We reviewed the efficacy data of the first 100 patients at various timepoints up to 30 weeks.ResultsWe assessed multiple definitions involving all the three measures (PANSS, CGI-S, and CGI-C) to determine one that would define a “responder” by categories that may be clinically meaningful. Review of the data indicated two definitions of responders based on the different combinations of the individual measures. “Full responder” was defined as PANSS total score improvement ≥ 20%; CGI-C at least much improved (i.e. 1,2); CGI-S at least one point improvement and reaching at least mildly ill (i.e. a score of at least 3 or less). “Partial responder” was defined as PANSS total score improvement ≥ 15%; CGI-C rated as any improvement (i.e. 1,2,3); CGI-S at least one point improvement. These two categories are alternatively true and patients not fulfilling the criteria for the above categories are considered as “non-responders”. Further descriptive analysis will be presented.ConclusionsThese definitions may change the selection of compounds used as add-on therapy for TRS patients as well as the study designs to evaluate them.Disclosure of InterestNone Declared
Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb in post-stroke ...subjects has shown promising results in terms of improvement of arm function and motor control achieved by reassembling muscle synergies into a set more similar to that of healthy people. However, in stroke survivors the potentially neurophysiological changes induced by robot-mediated learning versus usual care have not yet been investigated. We quantified upper limb motor deficits and the changes induced by rehabilitation in 32 post-stroke subjects through the movement analysis of two virtual untrained tasks of object placing and pronation. The sample analyzed in this study is part of a larger bi-center study and included all subjects who underwent kinematic analysis and were randomized into robot and usual care groups. Post-stroke subjects who followed robotic rehabilitation showed larger improvements in axial-to-proximal muscle synergies with respect to those who underwent usual care. This was associated to a significant improvement of the proximal kinematics. Both treatments had negative effects in muscle synergies controlling the distal district. This study supports the definition of new rehabilitative treatments for improving the neurophysiological recovery after stroke.
This study compared the effects of inpatient-based rehabilitation program of patients with chronic obstructive pulmonary disease (COPD) using non-immersive virtual reality (VR) training with a ...traditional pulmonary rehabilitation program. The aims of this study were to determine 1) whether rehabilitation featuring both VR as well as exercise training provides benefits over exercise training (ET) alone and 2) whether rehabilitation featuring VR training instead of exercise training provides equivalent benefits.
The study recruited 106 patients with COPD to a 2-week high-intensity, five times a week intervention. Randomized into three groups, 34 patients participated in a traditional pulmonary rehabilitation program including endurance exercise training (ET), 38 patients participated in traditional pulmonary rehabilitation, including both endurance exercise training and virtual reality training (ET+VR) and 34 patients participated in pulmonary rehabilitation program including virtual reality training but no endurance exercise training (VR). The traditional pulmonary rehabilitation program consisted of fitness exercises, resistance respiratory muscle and relaxation training. Xbox 360
and Kinect
Adventures software were used for the VR training of lower and upper body strength, endurance, trunk control and dynamic balance. Comparison of the changes in the Senior Fitness Test was the primary outcome. Analysis was performed using linear mixed-effects models.
The comparison between ET and ET+VR groups showed that ET+VR group was superior to ET group in Arm Curl (p<0.003), Chair stand (p<0.008), Back scratch (p<0.002), Chair sit and reach (p<0.001), Up and go (p<0.000), 6-min walk test (p<0.011). Whereas, the comparison between ET and VR groups showed that VR group was superior to ET group in Arm Curl (p<0.000), Chair stand (p<0.001), 6-min walk test (p<0.031).
Results suggest that pulmonary rehabilitation program supplemented with VR training is beneficial intervention to improve physical fitness in patients with COPD.
Metal-based flocculants are commonly used for biomass harvesting in microalgae-based bio-refineries. Besides the high separation efficiency, additional aspects should be considered, related to the ...toxicity of metals for the algal biomass. Partitioning tests for commonly used flocculants (i.e., FeCl3 and Al2(SO4)3) showed that metals were mostly transferred to the solid phase with more than 95% of dosed metal ending up into the biomass, and low metal concentrations in the liquid effluent (lower than 0.4 mg L−1 for both metals), thus allowing for water reuse. Photosynthesis inhibition was tested on microalgae and microalgae-bacteria cultures, using a standardized photo-respirometry protocol in which typical concentrations used during coagulation-flocculation were assessed. Modelling dose-response curves, concentrations corresponding to 50% inhibition (IC50) were obtained, describing short-term effects. The obtained IC50 ranged from 13.7 to 28.3 mg Al L−1 for Al, and from 127.9 to 195.8 mg Fe L−1 for Fe, showing a higher toxicity for the Al-based flocculant. The recovery of photosynthesis inhibition was also quantified, to evaluate the possibility of reusing/recycling the harvested biomass. The results highlighted that the residual photosynthetic activities, evaluated after 1 h and 24 h of exposure to metals were partially recovered, especially for Al, passing from 67.3% to 94.6% activity, respectively, while long-term Fe effects were stronger (passing from 64.9% to 77.6% activity). A non-toxic flocculant (cationic starch) was finally tested, excluding potential effects due to biomass aggregation, as the reduction of photosynthetic activity only reached 3.4%, compared to control. Relevant modifications to the light availability and the optical properties of algal suspensions were assessed, identifying a strong effect of iron which caused an increase of the light absorbance up to approximately 40% at high Fe concentrations. Possible implications of dosing metallic flocculants in MBWWT processes are discussed, and suggestions are given to perform inhibition tests on flocculating chemicals.
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•Fe- and Al-based flocculants inhibited algal photosynthesis in the short-term.•Mixed algae-bacteria cultures were more resistant than algal monocultures.•Al inhibition was higher than Fe, but with faster recovery and lower light effects.•Biomass coagulation using cationic starch did not impact algal photosynthesis.•Metallic flocculants were predominantly transferred to the solid phase.
IntroductionTreatment resistance schizophrenia (TRS) develops in ~ 30% of patients in about 5 years from starting treatment with 5-HT2/D2 APs, resulting in increased morbidity, suicidality, and ...mortality. Findings from neurochemistry, neurometabolism, functional imaging in TRS patients indicate abnormalities in glutamatergic neurotransmission (Moghaddam B et al 2012; 37 4-15) rather than excess of dopamine synthesis (Demjaha A et al 2014; 75 11-3; Mouchlianitis E et al 2016; 42 744-52), suggesting the need to add a drug that attenuates glutamate release. Evenamide, a selective inhibitor of voltage-gated Na+ channels, is devoid of biological activity at >130 CNS targets, normalizes glutamate release without affecting basal levels, and demonstrated benefits in animal models of psychosis as monotherapy and as an add on to APs (including clozapine), reversing deficits produced by amphetamine, scopolamine, phencyclidine, or ketamineObjectivesStudies 014/015 were designed to evaluate the safety and preliminary efficacy of evenamide given orally at 3 fixed doses (7.5, 15 and 30 mg bid) in patients with TRS not responding to a therapeutic dose of an AP. Assessment of efficacy was based on changes of PANSS and CGI-S/C, while tolerability was assessed based on all safety measuresMethodsStudy 014 is a 6-week, randomized, rater-blinded, international study with completers continuing assigned doses for an additional 46 weeks in an extension study (Study 015). Patients were initially randomized to 7.5 or 15 mg bid; the Independent Safety Monitoring Board (ISMB) allowed randomization to 30 mg bid after reviewing safety data from the first 50 patients. At baseline, patients were moderately to severely ill (CGI-S of 4 to 6), with a PANSS total score of 70-90 and predominant positive symptoms (score of 4 or more on at least 2 core symptoms and a PANSS positive total score ≥ 20), along with functional deficits (GAF ≤50). Efficacy ratings were performed by a psychiatrist blinded to the evenamide dose. Data were analyzed as a single group using descriptive statistics to assess changes from baseline to endpoint (Week 30)ResultsInterim, group-blinded, 30-week results for safety and efficacy data (PANSS and CGI) for the first 100 patients (including 6 on 30 mg bid) will be presented. Patients randomized to 7.5, 15, and 30 mg bid had all safety and efficacy data pooled in a single group to maintain the blind in the study. All results will be submitted to the ISMB, relevant health authorities and the FDAConclusionsThis trial is the first international TRS trial of an NCE AP used as an add-on to a single typical or atypical AP. Results of this study may change the treatment of future TRS patientsDisclosure of InterestNone Declared
The paper is a review of previous research on secondary effluent disinfection by peracetic acid (PAA) integrated with new data about the effect of a preliminary flash-mixing step. The process was ...studied at bench and pilot scale to assess its performance for discharge in surface water and agricultural reuse (target microorganisms: Escherichia coli and faecal coliform bacteria). The purposes of the research were: (1) determining PAA decay and disinfection kinetics as a function of operating parameters, (2) evaluating PAA suitability as a disinfectant, (3) assessing long-term disinfection efficiency, (4) investigating disinfected effluent biological toxicity on some aquatic indicator organisms (Vibrio fischeri, Daphnia magna and Selenastrum capricornutum), (5) comparing PAA with conventional disinfectants (sodium hypochlorite, UV irradiation). PAA disinfection was capable of complying with Italian regulations on reuse (10 CFU/100 mL for E. coli) and was competitive with benchmarks. No regrowth phenomena were observed, as long as needed for agricultural reuse (29 h after disinfection), even at negligible concentrations of residual disinfectant. The toxic effect of PAA on the aquatic environment was due to the residual disinfectant in the water, rather than to chemical modification of the effluent.
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