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Heavy metal oxides (HMOs) can enhance the physical, optical, and radiation shielding properties of glass. Through the comprehensive consideration of the absorption edge, the fast neutron removal cross-section, and transmittance of heavy metal oxides, the rapid determination of the shielding material system is achieved. Herein, B 2 O 3 –TeO 2 –BaO-MO (M = Bi, W, Cd, Mo) glasses are synthesized by the melt quenching method, and the effects of various heavy metal oxides on the glass performance are investigated. The physical and optical property results show that the addition of Bi 2 O 3 provides glass with greater stiffness, a more densified glass network, and a relatively wide indirect optical bandgap compared to other oxides. Subsequently, the photon attenuation behavior of the B 2 O 3 –TeO 2 –BaO-MO glasses was evaluated using the MCNPX, Phy-X and XCOM. Compared to the shielding materials in service, all the four metal oxide glasses exhibit excellent shielding capabilities against X-rays, gamma rays, and fast neutron. Particularly, due to the higher density and effective atomic number of Bi 2 O 3 , its modified glass will have more extra-nuclear electrons per unit volume, which increases the probability of collision with incident photons, and thus exhibits superior radiation shielding properties than other glasses. The Bi 2 O 3 -modified glass exhibits an average specific lead equivalent of 0.441 mmPb/mm in the medical X-ray energy range (0.03–0.08 MeV), and only requires a thickness of 0.8 cm to achieve complete protection against this incident photon, which far exceeded the specific lead equivalent requirement of 0.22 mmPb/mm for "protection devices against diagnostic medical X-radiation". [ABSTRACT FROM AUTHOR]

Traditional Chinese Medicine (TCM), renowned for its holistic approach with a 2000-year history of utilizing natural remedies, offers unique advantages in disease prevention and treatment. Berberine, found in various Chinese herbs, has been employed for many years, primarily for addressing conditions such as diarrhea and dysentery. Berberine has recently become a research focus owing to its pharmacological activities and benefits to human bodies. However, little is known about the anti-inflammatory mechanism of berberine. To summarize recent findings regarding the pharmacological effects and mechanisms of berberine anti-inflammation and highlight and predict the potential therapeutic effects and systematic mechanism of berberine. Recent studies (2013–2023) on the pharmacological effects and mechanisms of berberine anti-inflammation were retrieved from Web of Science, PubMed, Google Scholar, and Scopus up to July 2023 using relevant keywords. Network pharmacology and bioinformatics analysis were employed to predict the therapeutic effects and mechanisms of berberine against potential diseases. The related pharmacological mechanisms of berberine anti-inflammation include the inhibition of inflammatory cytokine production (e.g., IL-1β, IL-6, TNF-α), thereby attenuating the inflammatory response; Inhibiting the activation of NF-κB signaling pathway and IκBα degradation; Inhibiting the activation of MAPK signaling pathway; Enhancing the activation of the STAT1 signaling pathway; Berberine interacts directly with cell membranes through a variety of pathways, thereby influencing cellular physiological activities. Berberine enhances human immunity and modulates immune system function, which is integral to addressing certain autoimmune and tumour-related health concerns. This study expounds on the correlation between berberine and inflammatory diseases, encapsulating the mechanisms through which berberine treats select typical inflammatory ailments. Furthermore, it delves into a deeper understanding of berberine's effectiveness by integrating network pharmacology and molecular docking techniques in the context of treating inflammatory diseases. It provides guidance and reference for berberine's subsequent revelation of the modern scientific connotation of Chinese medicine. [ABSTRACT FROM AUTHOR]

[Display omitted] • The superiority of ethanol-path anaerobic digestion was clarified via various means. • Liquid product presents higher recovery potential than gas product in carbon flux view. • The dominant microorganisms in the anaerobic digestion system are identified. To rapidly treat and stably utilize great quantities of fruit and vegetable waste (FVW), the strategies in anaerobic digestion pattern have been constantly improved. In this work, the efficiencies and capacities of carbon conversion in different FVW anaerobic digestion systems were studied. Compared to butyrate-path (BD) two-phase and single-phase anaerobic digestion (SD), the ethanol-path two-phase anaerobic digestion (ED) system showed the highest rate of converting insoluble into soluble carbon formation (82.2%) and methane yield conversed from soluble carbon which is 0.14 gCOD CH4 (gVSS d)−1. It was also found that the coexistence of Bacillus and Methanococcus in the methanogenic phase maintained fatty acids and methane generation. The advantage of carbon conversion efficiency in ED can be elucidated from the highest acetification rate (704.10 mgCOD (L h)−1) which means more converted acetate can be smoothly used for methane generation. Compared to methanogenesis converted from butyrate and propionate, the thermodynamic condition of methanogenesis converted from ethanol was more feasible. Also, the highest capacity of max methane production (197773.7 mL) of ED was simulated. ED might be an efficient and advantageous option for FVW methane digestion. Furthermore, comparison of acidogenic product and methane in conversion efficiency revealed that fatty acids should think as ideal anaerobic product rather than methane. [ABSTRACT FROM AUTHOR]

Corneal injuries, such as alkali burn, are a common ocular trauma worldwide and usually cause corneal opacification and even loss of sight, if without timely treatments. Eye drops have long been regarded as the best media for treating ocular surface diseases. However, their effectiveness was seriously dampened by natural self-cleaning mechanism of the eye. Herein, we designed and prepared polyamino acid-based poly-S-nitrosothiols (PGlu-TEPA-SNAP) as long-acting eye drops to treat corneal alkali burns. The cationic polymeric NO donor demonstrated good retention on the negatively charged surface of cornea without causing obvious biotoxicity. Meanwhile, the polymer can release NO in a temperature-dependent manner, by remaining relatively stable at 4 ℃ and 25 ℃, while rapidly releasing NO at around 35 ℃. In vivo study proved that the eye-drop with proper concentration effectively mitigated alkali-induced corneal damage in mice, via leptin related STAT3/MAPK/AKT signaling pathway. It selectively promoted epithelium regeneration without inducing neovascularization by utilization of the difference in cell sensitivity towards NO. Overall, the combined strategy of temperature-dependent drug release and strong retention of carriers can indeed fasten the healing of damaged cornea. It may serve as an inspiration for future NO or leptin-based work for ocular surface therapy. [Display omitted] • The supra-cation improved availability of topical administrated drugs, via resistance against the self-cleaning of the eye. • The body temperature responsiveness endows preferred balance between stability and controlled release of NO on ocular surface. • The sensitivity difference between HUVECs and HCECs towards NO treatment was exploited to selectively enhance cornea healing. • Corneal injury was alleviated by proper NO therapy via leptin related STAT3/MAPK/AKT signaling pathway. [ABSTRACT FROM AUTHOR]

• An existing activated sludge system was upgraded to a continuous-flow AGS system. • Shear forces, combined with feast/famine conditions, induced granulation. • Organic matter and nutrients were removed simultaneously within microaerobic tanks. • A 38.2 % reduction in footprint and one-third savings in reflux energy were achieved. Aerobic granular sludge (AGS) has been successfully used in sequencing batch reactors. However, their application to existing continuous-flow systems remains challenging. In this study, a novel microaerobic-aerobic configuration with internal separators was implemented in a full-scale municipal wastewater treatment facility with a nominal capacity of 2.5 × 104 m3 d−1. Sludge characteristics, pollutant removal and associated pathways, shifts in the microbial community, and underlying granulation mechanisms were investigated. Following a two-month operation period, the transition from flocculent-activated sludge to well-defined AGS with distinct boundaries and compact structures was successfully achieved. The average size of sludge increased from 31.9 to 138.5 μm, with granules larger than 200 μm constituting 28.9 % of the total sludge and SVI 30 averaging 51.4 ± 8.2 mL g−1. The 95th percentile effluent COD, NH 4 +-N, and TN concentrations were 35.0, 1.2, and 13.3 mg L−1, respectively. The primary pathways for pollutant removal were identified as simultaneous nitrification, denitrification, and phosphorus removal within the microaerobic tanks. The enrichment of denitrifying phosphorus-accumulating organisms, including Hydrogenophaga, Accumulibacter, Azospira, Dechloromonas , and Pseudomonas , provides an essential microbial foundation. Furthermore, computational fluid dynamics modeling revealed that the incorporation of internal separators in aerobic tanks induced shifts in the flow pattern, transitioning from a single-circulation cell to multiple vortical cells. This alteration amplified the local velocity gradients, generating the required shear forces to drive granulation. Moreover, mass balance analysis revealed that the microaerobic and aerobic tanks operated under feast and famine conditions, respectively, creating a microbial selection pressure that favored granulation. This process eliminates the need for external clarifiers, resulting in a footprint reduction of 38.2 % and one-third energy savings for sludge reflux. This study offers valuable insights into the application of continuous-flow AGS to upgrade existing activated sludge systems with limited retrofitting requirements. [Display omitted] [ABSTRACT FROM AUTHOR]

Low-grade chronic inflammation, also known as metabolic inflammation, promotes the development of metabolic diseases. Increasing evidence suggests that changes in gut microbes and metabolites disrupt the integrity of the gut barrier and exert significant effects on the metabolism of various tissues, including the liver and adipose tissue, thereby contributing to metabolic inflammation. We observed that IL-22 is a key signaling molecule that serves as a bridge between intestinal microbes and the host, effectively alleviating metabolic inflammation by modulating the host immunomodulatory network. Here, we focused on elucidating the underlying mechanisms by which the gut microbiota and their metabolites reduce inflammation via IL-22, highlighting the favorable impact of IL-22 on metabolic inflammation. Furthermore, we discuss the potential of IL-22 as a therapeutic target for the management of metabolic inflammation and related diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

• The microalgae was immobilized with sodium alginate for NH 4 +-N removal. • The performances of free and immobilized microalgae were compared. • Mixotrophic microalgae showed better performance than heterotrophic mode. • Assimilation of NH 4 +-N was the main pathway resulting the synthesis of protein. In this study, the immobilization with sodium alginate (SA) for cultivating microalgae in entrapped matrix gel beads was conducted for separating it from water. Batch experiments with a period of 5 days were carried out for free and immobilized Scenedesmus obliquus simultaneously under two trophic modes, to compare the removal performances of different initial ammonium (NH 4 +-N) concentrations. In both free and immobilized form, the positive C-dependent effect in mixotrophy and the negative N-dependent effect in heterotrophy were observed. And the performances of immobilized form were all superior to that of free form, which showed greater tolerance to high concentration, maximally representing 96.6 ± 0.1% removal in 50 mg/L of NH 4 +-N in mixotrophy. Assimilation of NH 4 +-N was the main removal pathway resulting the protein synthesis with the dominant component including glutamic acid (Glu), cystine (Cys), arginine (Arg) and proline (Pro). The results demonstrated a systematic understanding for NH 4 +-N removal in microalgae-based system. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to evaluate whether transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 valve (S3-TAVR) results in improved quality of life (QoL) compared with previous-generation TAVR devices or surgical aortic valve replacement (SAVR). Background In patients with severe aortic stenosis at intermediate surgical risk, TAVR using the SAPIEN XT valve (XT-TAVR) results in similar QoL compared with SAVR. Compared with SAPIEN XT, the SAPIEN 3 valve offers a lower delivery profile and modifications to reduce paravalvular regurgitation. Methods Between February and December 2014, 1,078 patients at intermediate surgical risk with severe aortic stenosis were treated with S3-TAVR in the PARTNER S3i (Placement of Aortic Transcatheter Valve) trial. QoL was assessed at baseline, 1 month, and 1 year using the Kansas City Cardiomyopathy Questionnaire, Medical Outcomes Study Short Form-36, and EQ-5D. QoL outcomes of S3-TAVR patients were compared with those in the SAVR and XT-TAVR arms of the PARTNER 2A trial using propensity score stratification to adjust for differences between the treatment groups. Results Over 1 year, S3-TAVR was associated with substantial improvements in QoL compared with baseline. At 1 month, S3-TAVR was associated with better QoL than either SAVR or XT-TAVR (adjusted differences in Kansas City Cardiomyopathy Questionnaire overall summary score 15.6 and 3.7 points, respectively; p < 0.001). At 1 year, the differences in QoL between S3-TAVR and both SAVR and XT-TAVR were reduced but remained statistically significant (adjusted differences 2.0 and 2.2 points, respectively; p < 0.05). Similar results were seen for generic QoL outcomes. Conclusions Among patients at intermediate surgical risk with severe aortic stenosis, S3-TAVR resulted in improved QoL at both 1 month and 1 year compared with both XT-TAVR and SAVR. [ABSTRACT FROM AUTHOR]

Background: For patients with severe aortic stenosis (AS) at extreme surgical risk, transcatheter aortic valve replacement (TAVR) leads to improved survival and health status when compared with medical therapy. Whether the early health status benefits of TAVR in these patients are sustained beyond 1 year of follow-up is unknown.Methods and Results: Six hundred thirty-nine patients with severe AS at extreme surgical risk underwent TAVR in the CoreValve US Extreme Risk Pivotal trial. Health status was evaluated at baseline and at 1, 6, 12, 24, and 36 months using the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Short-Form-12, and the EuroQoL-5D. Analyses were performed using pattern mixture models to account for both death and missing data and were stratified by iliofemoral (IF) and non-iliofemoral (non-IF) access. After TAVR, there was substantial health status improvement in disease-specific and generic scales by 6 to 12 months. Although there were small declines in health status after 12 months, the initial benefits of TAVR were largely sustained through 3 years for both IF and non-IF cohorts (change from baseline in KCCQ Overall Summary score 19.0 points in IF patients and 14.9 points in non-IF patients; P<.01 for both comparisons). Among surviving patients, clinically meaningful (≥10 point) improvements in the KCCQ Overall Summary Score at 3 years were observed in 85.0% and 83.4% of IF and non-IF patients respectively.Conclusions: Among extreme risk patients with severe AS, TAVR resulted in large initial health status benefits that were sustained through 3-year follow-up. Although late mortality was high in this population, these findings demonstrate that TAVR offers substantial and durable health status improvements for surviving patients. [ABSTRACT FROM AUTHOR]

To address the poor high-temperature oxidation resistance of tungsten, a new high temperature protective gallium coating (O Ga) is designed in this paper. This O Ga material is modified with liquid metallic gallium by a mechanical stirring process, and a mixture of Ga x O y (Ga 2 O 3 and Ga 2 O) and Ga is obtained. Not only does it have good flexibility and adhesion, but it can also be easily printed to form a coating on tungsten surfaces. After isothermal oxidation at 800 °C for 24 h, the weight gain of the coating sample is 0.96 mg·cm−2, much lower than that of tungsten. This is attributed to the oxidation of the gallium coating on the tungsten surface to produce a βGa 2 O 3 layer, which prevents oxygen contact with the internal O Ga and W substrates. In addition, the inherent flexibility of the intermediate layer of O Ga prevents a mismatch in the coefficient of thermal expansion (CTE) between the βGa 2 O 3 layer and the W substrate, ensuring the integrity of the coating. Gallium coatings are expected to be an alternative to conventional protection systems. • The gallium is used as a coating to protect tungsten from oxidation in high temperature. • The oxidation weight gain of the coating was only 0.96 mg·cm−2 in air at 800 °C for 24 h. [ABSTRACT FROM AUTHOR]

Background Novel anticoagulants, such as factor Xa inhibitors, have entered clinical practice as alternatives to warfarin for the prevention of stroke and systemic embolic event (SEE) in patients with atrial fibrillation (AF). It is not known whether edoxaban, the fourth-to-market factor Xa inhibitor approved for this indication, will be cost-effective in Taiwan, where the cost of warfarin monitoring is prohibitive. Methods A Markov model projecting lifetime results of edoxaban 60 mg/30 mg dose-reduced versus warfarin in patients with nonvalvular AF, based on the ENGAGE AF – TIMI 48 trial, found edoxaban to be of high value relative to warfarin, from the perspective of the US health care system. We applied Taiwan-specific cost inputs to this model structure to assess the relative cost-effectiveness of edoxaban versus warfarin from the perspective of the Taiwanese health care system. Event rates and hazard ratios from the ENGAGE AF – TIMI 48 East Asian subpopulation were explored in sensitivity analyses. Results Edoxaban was found to be highly cost-effective compared with warfarin, based on guidelines proposed by the World Health Organization (WHO), with a base case incremental cost-effectiveness ratio of $12,902 per quality-adjusted life year gained. These results were robust to variation of key model parameters, including assumptions regarding the cost and quality-of-life impact of stroke and bleeding events, and assuming East Asian-specific (as opposed to full-trial-population) rates for combinations of ischemic stroke, SEE, and major bleeding. Conclusions Despite its higher acquisition cost, edoxaban is an economically attractive alternative to warfarin for the prevention of stroke and SEE in patients with AF in Taiwan. [ABSTRACT FROM AUTHOR]

Background: In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization.Objectives: This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD.Methods: Between 2005 and 2007, the SYNTAX trial randomized 1,800 patients with 3-vessel or left main CAD to either CABG or DES-PCI. Health status was assessed at baseline and at 1, 6, 12, 36, and 60 months by using the Seattle Angina Questionnaire (SAQ) and the 36-Item Short Form Health Survey.Results: At 5-year follow-up, CABG was superior to DES-PCI on several SAQ domains including angina frequency and physical function, as well as the role physical and role emotional scales of the 36-Item Short Form Health Survey. Subgroup analysis demonstrated a significant interaction between angiographic complexity (as assessed by the SYNTAX score) and angina relief (mean difference in the SAQ angina frequency score for CABG vs. PCI of -0.9, 3.3, and 3.9 points for low, intermediate, and high SYNTAX score patients, respectively; p = 0.048 for interaction).Conclusions: Among patients with 3-vessel or left main CAD, both CABG and DES-PCI were associated with substantial and sustained quality-of-life benefits over 5 years of follow-up. In general, CABG resulted in greater angina relief, although the absolute treatment benefit was small. Angina relief at 5 years was enhanced with CABG among patients with high SYNTAX scores, a finding reinforcing the recommendation that CABG should be strongly preferred for such patients. (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery [SYNTAX]; NCT00114972). [ABSTRACT FROM AUTHOR]

Background: In 21,105 patients with atrial fibrillation (AF), the ENGAGE AF-TIMI 48 trial demonstrated that both higher dose (60mg/30mg dose reduced) and lower dose (30mg/15mg dose reduced) once-daily regimens of edoxaban were non-inferior to warfarin for the prevention of stroke or systemic embolism (SE), with significantly lower rates of bleeding and cardiovascular death. Higher dose edoxaban was associated with a greater reduction in the risk of ischemic stroke than lower dose edoxaban, and the FDA approved higher dose edoxaban in patients with creatinine clearance ≤95mL/min. This study evaluated the economic value of higher dose edoxaban vs warfarin based on data from patients in ENGAGE within the FDA-approved population.Methods: We assessed the cost-effectiveness of edoxaban vs warfarin over a lifetime horizon from the US healthcare system perspective using a Markov model based on a combination of ENGAGE AF-TIMI 48 trial data, US life tables, and published literature on the costs and long-term outcomes of non-fatal cardiovascular and bleeding events. Data from the ENGAGE AF-TIMI 48 trial were used to calculate age-adjusted event rates for warfarin and hazard ratios (HRs) for the relative impact of edoxaban on embolic and bleeding complications. Based on the wholesale acquisition price, edoxaban and warfarin were assumed to cost $9.24 and $0.36/day, respectively.Results: For edoxaban vs warfarin, lifetime incremental costs and QALYs were $16,384 and 0.444, respectively, yielding an incremental cost-effectiveness ratio (ICER) of $36,862/QALY gained, using data from patients with creatinine clearance ≤95mL/min in ENGAGE AF-TIMI 48. ICERs were more favorable for patients without compared to those with prior warfarin use; ICERs differed minimally by CHADS2 score.Conclusions: Despite its higher acquisition cost, edoxaban is an economically attractive alternative to warfarin for the prevention of stroke and SE in patients with atrial fibrillation and creatinine clearance ≤95mL/min. These results were robust to variation of key model parameters, including assumptions regarding the cost and quality-of-life impact of stroke and bleeding events, and were favorable across both CHADS2 score stroke-risk categories. [ABSTRACT FROM AUTHOR]

Objectives This study sought to compare the health status outcomes for patients treated with either self-expanding transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (AVR). Background In patients at increased surgical risk, TAVR with a self-expanding bioprosthesis is associated with improved 1-year survival compared with AVR. However, elderly patients may be just as concerned with quality-of-life improvement as with prolonged survival as a goal of treatment. Methods Between 2011 and 2012, 795 patients with severe aortic stenosis at increased surgical risk were randomized to TAVR or AVR in the CoreValve US Pivotal Trial. Health status was assessed at baseline, 1 month, 6 months, and 1 year using the Kansas City Cardiomyopathy Questionnaire, Medical Outcomes Study Short-Form 12 Questionnaire, and EuroQOL 5-dimension questionnaire; growth curve models were used to examine changes over time. Results Over the 1-year follow-up period, disease-specific and generic health status improved substantially for both treatment groups. At 1 month, there was a significant interaction between the benefit of TAVR over AVR and access site. Among surviving patients eligible for iliofemoral (IF) access, there was a clinically relevant early benefit with TAVR across all disease-specific and generic health status measures. Among the non-IF cohort, however, most health status measures were similar for TAVR and AVR, although there was a trend toward early benefit with TAVR on the Short-Form 12 Questionnaire’s physical health scale. There were no consistent differences in health status between TAVR and AVR at the later time points. Conclusions Health status improved substantially in surviving patients with increased surgical risk who were treated with either self-expanding TAVR or AVR. TAVR via the IF route was associated with better early health status compared with AVR, but there was no early health status benefit with non-IF TAVR compared with AVR. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902 ) [ABSTRACT FROM AUTHOR]

Objective Cranial nerve injury (CNI) is the most common neurologic complication of carotid endarterectomy (CEA) and can cause significant chronic disability. Data from prior randomized trials are limited and provide no health-related quality of life (HRQOL) outcomes specific to CNI. Incidence of CNIs and their outcomes for patients in the Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) were examined to identify factors predictive of CNI and their impact on HRQOL. Methods Incidence of CNIs, baseline and procedural characteristics, outcomes, and HRQOL scores were evaluated in the 1151 patients randomized to CEA and undergoing surgery ≤30 days. Patients with CNI were identified and classified using case report forms, adverse event data, and clinical notes. Baseline and procedural characteristics were compared using descriptive statistics. Clinical outcomes at 1 and 12 months were analyzed. All data were adjudicated by two neurologists and a vascular surgeon. HRQOL was evaluated using the Medical Outcomes Short-Form 36 (SF-36) Health Survey to assess general health and Likert scales for disease-specific outcomes at 2 weeks, 4 weeks, and 12 months after CEA. The effect of CNI on SF-36 subscales was evaluated using random effects growth curve models, and Likert scale data were compared by ordinal logistic regression. Results CNI was identified in 53 patients (4.6%). Cranial nerves injured were VII (30.2%), XII (24.5%), and IX/X (41.5%), and 3.8% had Horner syndrome. CNI occurred in 52 of 1040 patients (5.0%) receiving general anesthesia and in one of 111 patients (0.9%) operated on under local anesthesia ( P = .05). No other predictive baseline or procedural factors were identified. Deficits resolved in 18 patients (34%) at 1 month and in 42 of 52 patients (80.8%) by 1 year. One patient died before the 1-year follow-up visit. The HRQOL evaluation showed no statistical difference between groups with and without CNI at any interval. By Likert scale analysis, the group with CNI showed a significant difference in the difficulty eating/swallowing parameter at 2 and 4 weeks ( P < .001) but not at 1 year. Conclusions In CREST, CNI occurred in 4.6% of patients undergoing CEA, with 34% resolution at 30 days and 80.8% at 1 year. The incidence of CNI was significantly higher in patients undergoing general anesthesia. CNI had a small and transient effect on HRQOL, negatively affecting only difficulty eating/swallowing at 2 and 4 weeks but not at 1 year. On the basis of these findings, we conclude that CNI is not a trivial consequence of CEA but rarely results in significant long-term disability. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to characterize health status outcomes after transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis among patients at extreme surgical risk and to identify pre-procedural patient characteristics associated with a poor outcome. Background For many patients considering TAVR, improvement in quality of life may be of even greater importance than prolonged survival. Methods Patients with severe, symptomatic aortic stenosis who were considered to be at prohibitive risk for surgical aortic valve replacement were enrolled in the single-arm CoreValve U.S. Extreme Risk Study. Health status was assessed at baseline and at 1, 6, and 12 months after TAVR using the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Short Form-12, and the EuroQol-5D. The overall summary scale of the KCCQ (range 0 to 100; higher scores = better health) was the primary health status outcome. A poor outcome after TAVR was defined as death, a KCCQ overall summary score (OS) <45, or a decline in KCCQ-OS of 10 points at 6-month follow-up. Results A total of 471 patients underwent TAVR via the transfemoral approach, of whom 436 (93%) completed the baseline health status survey. All health status measures demonstrated considerable impairment at baseline. After TAVR, there was substantial improvement in both disease-specific and generic health status measures, with an increase in the KCCQ-OS of 23.9 points (95% confidence interval [CI]: 20.3 to 27.5 points) at 1 month, 27.4 points (95% CI: 24.2 to 30.6 points) at 6 months, 27.4 points (95% CI: 24.1 to 30.8 points) at 12 months, along with substantial increases in Short Form-12 scores and EuroQol-5D utilities (all p < 0.003 compared with baseline). Nonetheless, 39% of patients had a poor outcome after TAVR. Baseline factors independently associated with poor outcome included wheelchair dependency, lower mean aortic valve gradient, prior coronary artery bypass grafting, oxygen dependency, very high predicted mortality with surgical aortic valve replacement, and low serum albumin. Conclusions Among patients with severe aortic stenosis, TAVR with a self-expanding bioprosthesis resulted in substantial improvements in both disease-specific and generic health-related quality of life, but there remained a large minority of patients who died or had very poor quality of life despite TAVR. Predictive models based on a combination of clinical factors as well as disability and frailty may provide insight into the optimal patient population for whom TAVR is beneficial. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902 ) [ABSTRACT FROM AUTHOR]

Innovative methods for biogas upgrading based on biological/in-situ concepts have started to arouse considerable interest. Bioelectrochemical removal of CO 2 for biogas upgrading was proposed here and demonstrated in both batch and continuous experiments. The in-situ biogas upgrading system seemed to perform better than the ex-situ one, but CO 2 content was kept below 10% in both systems. The in-situ system’s performance was further enhanced under continuous operation. Hydrogenotrophic methanogenesis and alkali production with CO 2 absorption could be major contributors to biogas upgrading. Molecular studies showed that all the biocathodes associated with biogas upgrading were dominated by sequences most similar to the same hydrogenotrophic methanogen species, Methanobacterium petrolearium (97–99% sequence identity). Conclusively, bioelectrochemical removal of CO 2 showed great potential for biogas upgrading. [ABSTRACT FROM AUTHOR]

[Display omitted] • BGD from the iron-making process was first utilized as an accelerant in AD. • BGD accelerant (0.5–2.5 wt.%) can increase methane yield by 22.6%–51.3%. • Digestate with 2 wt.% BGD showed optimal stability (57.9%) and fertility (4.86%). • The electron transfer ability of the AD system was enhanced with BGD. • A strategy for understanding BGD added to boost AD performance was proposed. Plenty of refractory and environmentally hazardous bag-filter gas dust (BGD) is produced in the iron-making process. The effects of untreated BGD on anaerobic digestion (AD) with cattle manure were investigated. The BGD had the potential to boost the methane yield and digestate utilization considerably. The digester with 2.0 wt% BGD gained the highest methane yield (256.3 mL/g VS) and chemical oxygen demand removal rate (56.8%), 51.3% and 20.1% higher than that (169.4 mL/g VS, 47.3%) of the control group, respectively. The digestates with BGD possessed a utilization potential with the stability of 49.5–57.9% and fertility of 4.65–4.86%. Electrochemical measurements demonstrated that 2.0 wt% BGD improved the electron transport capacity of the AD system and increased the limiting current and redox peak current by 40.3% and 12.9%, respectively. A strategy for understanding the BGD reinforcing methanogenesis was proposed. This work also provides a technical support for recycling the BGD. [ABSTRACT FROM AUTHOR]