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Abstract Introduction Congestive heart failure (CHF) is a known complication after anthracyclines and radiotherapy for classical Hodgkin lymphoma (cHL). Contemporary cHL treatment may be associated with less risk because radiotherapy use and techniques have changed substantially over time. Methods In this study, Swedish cHL patients diagnosed in 2000–2018, and treated with adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, Adriamycin [doxorubicin], cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), were matched 1:10 to the general population on birth year and sex to investigate relative rates and cumulative risks of CHF. Results A total of 1994 cHL patients were included, with a median age of 34 years. The median follow‐up was 8.1 years. The CHF rate was higher for patients versus comparators (adjusted hazard ratio [HR] = 3.02, 95% confidence interval [CI]: 2.26–4.02). Patients treated with ≤200 mg/m2 of anthracyclines had HR of 2.89 (95% CI: 1.51–3.47) versus 3.91 (95% CI: 2.72–5.60) for >200 mg/m2. Treatment with ABVD was associated with a significantly higher CHF rate (adjusted HR = 3.25, 95% CI: 2.31–4.23), while BEACOPP was not (adjusted HR = 1.95, 95% CI: 0.91–4.16). The increase in relative rates translated to the absolute scale, with an increased risk persisting up to 18 years for low cumulative doses. Conclusion These findings highlight that cHL survivors still face a substantial excess risk of CHF in the modern treatment era and that focus on cardiovascular health remains relevant.

Background and purpose: The Swedish Lymphoma Register (SLR) was initiated in the year 2000 with the aim to monitor quality of care in diagnostics, treatment and outcome of all lymphomas diagnosed nationally among adults. Here, we present the first systematic validation of SLR records as a basis for improved register quality and patient care. Patients and methods: We evaluated timeliness and completeness of register records among patients diagnosed with lymphoma in the SLR (n = 16,905) compared with the National Cancer Register for the period 2013–2020. Comparability was assessed through evaluation of coding routines against national and international guidelines. Accuracy of 42 variables was evaluated through re-abstraction of data from medical records among 600 randomly selected patients diagnosed in 2016–2017 and treated across all six Swedish healthcare regions. Results: Completeness was high, >95% per year for the period 2013–2018, and >89% for 2019–2020 compared to the National Cancer Register. One in four patients was registered within 3 months, and 89.9% within 2 years of diagnosis. Registration instructions and coding procedures followed the prespecified guidelines. Missingness was generally low (80% for 24/34 variables), especially for treatment-related data (>80% for 17/19 variables). Interpretation: Completeness and accuracy are high in the SLR, while timeliness could be improved. Finetuning of variable registration guided by this validation can further improve reliability of register reports and advance service to lymphoma patients and health care in the future.

Background & purpose: The COVID-19 pandemic posed a large challenge for healthcare systems across the world. Comprehensive data on the impact of the COVID-19 pandemic on incidence and mortality in lymphoma are lacking. Patients/methods: Using data from the Swedish lymphoma register, we compare incidence and 1-year survival of lymphoma patients in Sweden before (2017–2019) and during the pandemic (2020 and 2021). Results: Fewer patients were diagnosed with lymphomas during March–June 2020, but the annual incidence rates for 2020 and 2021 were similar to those of 2017–2019. A larger proportion of patients presented with stage IV disease during 2021. There were no differences in other base-line characteristics nor application of active treatment in pre-pandemic and pandemic years. One-year overall survival was not inferior among lymphoma patients during the pandemic years compared to pre-pandemic years i.e., 2017–2019. Interpretation: The COVID-19 pandemic had limited impact on the incidence and mortality of lymphoma in Sweden.

Early cancer detection, guided by whole-body imaging, is important for the overall survival and well-being of the patients. While various computer-assisted systems have been developed to expedite and enhance cancer diagnostics and longitudinal monitoring, the detection and segmentation of tumors, especially from whole-body scans, remain challenging. To address this, we propose a novel end-to-end automated framework that first generates a tumor probability distribution map (TPDM), incorporating prior information about the tumor characteristics (e.g. size, shape, location). Subsequently, the TPDM is integrated with a state-of-the-art 3D segmentation network along with the original PET/CT or PET/MR images. This aims to produce more meaningful tumor segmentation masks compared to using the baseline 3D segmentation network alone. The proposed method was evaluated on three independent cohorts (autoPET, CAR-T, cHL) of images containing different cancer forms, obtained with different imaging modalities, and acquisition parameters and lesions annotated by different experts. The evaluation demonstrated the superiority of our proposed method over the baseline model by significant margins in terms of Dice coefficient, and lesion-wise sensitivity and precision. Many of the extremely small tumor lesions (i.e. the most difficult to segment) were missed by the baseline model but detected by the proposed model without additional false positives, resulting in clinically more relevant assessments. On average, an improvement of 0.0251 (autoPET), 0.144 (CAR-T), and 0.0528 (cHL) in overall Dice was observed. In conclusion, the proposed TPDM-based approach can be integrated with any state-of-the-art 3D UNET with potentially more accurate and robust segmentation results.

Abstract Whole-body positron emission tomography-computed tomography (PET-CT) imaging in oncology provides comprehensive information of each patient’s disease status. However, image interpretation of volumetric data is a complex and time-consuming task. In this work, an image registration method targeted towards computer-aided voxel-wise analysis of whole-body PET-CT data was developed. The method used both CT images and tissue segmentation masks in parallel to spatially align images step-by-step. To evaluate its performance, a set of baseline PET-CT images of 131 classical Hodgkin lymphoma (cHL) patients and longitudinal image series of 135 head and neck cancer (HNC) patients were registered between and within subjects according to the proposed method. Results showed that major organs and anatomical structures generally were registered correctly. Whole-body inverse consistency vector and intensity magnitude errors were on average less than 5 mm and 45 Hounsfield units respectively in both registration tasks. Image registration was feasible in time and the nearly automatic pipeline enabled efficient image processing. Metabolic tumor volumes of the cHL patients and registration-derived therapy-related tissue volume change of the HNC patients mapped to template spaces confirmed proof-of-concept. In conclusion, the method established a robust point-correspondence and enabled quantitative visualization of group-wise image features on voxel level.

Abstract Treatment for patients > 60 years with classical Hodgkin lymphoma (cHL) is problematic; there is no gold standard, and outcome is poor. Using the Swedish Lymphoma Registry, we analysed all Swedish patients diagnosed with cHL between 2000 and 2014 (N = 2345; median age 42 years; 691 patients were >60 years). The median follow‐up time was 6.7 years. Treatment for elderly patients consisted mainly of ABVD or CHOP, and the younger patients were treated with ABVD or BEACOPP (with no survival difference). In multivariable analysis of patients > 60 years, ABVD correlated with better survival than CHOP (p = 0.027), and ABVD became more common over time among patients aged 61–70 years (p = 0.0206). Coinciding with the implementation of FDG‐PET/CT, the fraction of advanced‐stage disease increased in later calendar periods, also in the older patient group. Survival has improved in cHL patients > 60 years (p = 0.027), for whom ABVD seems superior to CHOP.

Background: Thymidine kinase 1 (TK1) is an intracellular protein associated with DNA synthesis, expressed during the G1 phase and remained elevated through the M phase, with a potential as a biomarker for cell proliferation. In this study, we explore the possible use of TK1 in Hodgkin lymphoma (HL). Methods: Serum concentrations of TK1 (S-TK1) were measured in 46 newly diagnosed HL patients using prospectively collected biobanked serum samples. The samples were analyzed using a novel antibody-based TK1 immunosorbent assay (ELISA). Results: The concentrations of S-TK1 were elevated in HL patients compared with healthy controls (median 0.32 μg/L vs. 0.24 μg/L, P = 0.003). A further increase in S-TK1 was observed during the treatment. The S-TK1 concentrations were higher in patients with advanced stage disease, low B-Hb, elevated P-LD and in those with B-symptoms. A high ESR correlated with low S-TK1. Conclusions: The study results suggest that S-TK1, measured using a novel antibody-based assay, has the potential to be a biomarker in HL. However, while S-TK1 levels are elevated at baseline compared with healthy controls, a limited number of patients and comparatively short follow-up time render reliable conclusions difficult.

Abstract Background Cardiovascular toxicity is a notorious complication of doxorubicin (DXR) therapy for diffuse large B-cell lymphoma (DLBCL). Although surveillance of well-known biological markers for cardiovascular disease (CVD) as NTproBNP and Troponins may be helpful, there are no established markers to monitor for evolving CVD during treatment. New possibilities have arisen with the emergence of newer techniques allowing for analysis of plasma proteins that can be associated with cardiovascular disease. Proximity Extension Assay is one of them. Objectives We aimed to illustrate the incidence of CVD in DLBCL patients treated with DXR and to establish whether there are plasma proteins associated with pre-existing or emerging CVD. Methods In 95 patients, 182 different proteins from OLINK panels, NTproBNP, Troponin I and CRP were assessed prior to, during and after treatment. For comparison, samples from controls were analyzed. Results In the DLBCL cohort, 33.3% had pre-treatment CVD compared to 5.0% in the controls and 23.2% developed new CVD. Of the 32.6% who died during follow up, CVD was the cause in 4 patients. Spondin-1 (SPON-1) correlated to pre-treatment CVD (1.22 fold change, 95% CI 1.10–1.35, p = 0.00025, q = 0.045). Interleukin-1 receptor type 1 (IL-1RT1) was associated to emerging CVD (1.24 fold change, 95% CI 1.10–1.39, p = 0.00044, q = 0.082). Conclusion We observed a higher prevalence of CVD in DLBCL patients compared to controls prior to DXR therapy. Two proteins, SPON-1 and IL-1RT1, were related to pre-existing and emerging CVD in DXR treated patients. If confirmed in larger cohorts, IL-1RT1 may emerge as a reliable biomarker for unfolding CVD in DLBCL.

Background: Hodgkin lymphoma (HL) patients have a good prognosis after adequate treatment. Previous treatment with mantle field irradiation has been accompanied by an increased long-term risk of cardiovascular disease (CVD). This study identified co-morbidity factors for the development of cardiovascular side effects and initiated an intervention study aimed to decrease morbidity and mortality of CVD in HL survivors. Design: Hodgkin lymphoma patients aged ≤45 years diagnosed between 1965 and 1995 were invited to participate. In total, 453 patients completed a questionnaire that addressed co-morbidity factors and clinical symptoms. Of these, 319 accepted to participate in a structured clinical visit. The statistical analyses compared individuals with CVD with those with no CVD. Results: Cardiovascular disease was reported by 27.9%. Radiotherapy (odds ratio [OR]: 3.27), hypertension and hypercholesterolemia were shown to be independent risk factors for the development of CVD. The OR for CVD and valve disease in patients who received radiotherapy towards mediastinum was 4.48 and 6.07, respectively. At clinical visits, 42% of the patients were referred for further investigation and 24% of these had a cardiac ultrasound performed due to previously unknown heart murmurs. Conclusion: Radiotherapy towards mediastinum was an independent risk factor for CVD as well as hypercholesterolemia and hypertension. A reasonable approach as intervention for this cohort of patients is regular monitoring of hypertension and hypercholesterolemia and referral to adequate investigation when cardiac symptoms appear. Broad knowledge about the side effects from radiotherapy in the medical community and well-structured information regarding late side effects to the patients are all reasonable approaches as late effects can occur even 40 years after cancer treatment.

Background. In cancer, regulatory T-cells (Tregs) were previously believed to inhibit tumor immunity, leading to reduced survival. However, in hematologic malignancies, including T-cell lymphoma (TCL), a correlation between increased numbers of tumor-infiltrating Tregs and a favorable prognosis has been reported. We aimed to investigate the expression of the Treg biomarker forkhead box protein 3 (FoxP3) in TCL in immunocompetent individuals and explore a possible correlation to overall survival. Methods. In total, 35 diagnostic biopsies of TCL were stained using a FoxP3-specific monoclonal antibody (clone 236A/E7). Visual scoring was performed by counting positive cells in 15 high-power fields. Clinical data were collected retrospectively from medical records. Results. All the TCLs contained FoxP3+ cells, median 342 FoxP3+ cells/mm2 (range 1–3047). The degree of intratumoral expression of FoxP3 varied between the different subtypes of TCL, with the highest frequency found in angioimmunoblastic TCL. The frequency of intratumoral FoxP3+ cells had no impact on overall survival; neither when using a cutoff value of 200 FoxP3+ cells/mm2 (P = 0.84) nor with FoxP3 as a continuous variable (P = 0.63). Conclusions. Intratumoral Tregs are frequently found in TCL in immunocompetent individuals. In this heterogeneous group of TCL, there was no correlation between the density of intratumoral FoxP3+ cells and overall survival.

Abstract: Immune checkpoint inhibition targeting the programmed death receptor (PD)-1 pathway is a novel treatment approach in relapsed and refractory classical Hodgkin lymphoma (cHL). Identifying patients with a high risk of treatment failure could support the use of PD-1 inhibitors as front-line treatment. Our aim was to investigate the prognostic impact of PD-1, programmed death-ligand 1 (PD-L1), and PD-L2 in the tumor microenvironment in diagnostic biopsies of patients with cHL. Patients from Denmark and Sweden, diagnosed between 1990 and 2007 and ages 15 to 86 years, were included. Tissue microarray samples were available from 387 patients. Immunohistochemistry was used to detect PD-1, PD-L1, and PD-L2, and the proportions of positive cells were calculated. Event-free survival (EFS; time to treatment failure) and overall survival (OS) were analyzed using Cox proportional hazards regression. High proportions of both PD-1+ (hazard ratio [HR], 1.77; 95% confidence interval [CI], 1.10-2.86) and PD-L1+ (HR = 1.89; 95% CI, 1.08-3.30) leukocytes in the microenvironment were associated with inferior EFS in a multivariate analysis (adjusted for white blood cell count >15 × 109/L, hemoglobin

Background: As the patents of originator biologics are expiring, biosimilar versions are becoming available for the treatment of inflammatory bowel disease (IBD). However, published switch studies of the first infliximab biosimilar, CT-P13, have delivered ambiguous results that could be interpreted as showing a trend towards inferior effectiveness in Crohn’s disease (CD) compared with ulcerative colitis (UC). The aim of this study was to investigate the effectiveness and safety of switching IBD patients from treatment with Remicade to CT-P13. Methods: In this prospective observational cohort study, all adult IBD patients on Remicade treatment, at four hospitals, were switched to CT-P13. The primary endpoint was change in clinical disease activity at 2, 6, and 12 months after the switch. Secondary endpoints were subgroup analyses of patients with and without concomitant immunomodulators; changes in biomarkers, quality of life, drug trough levels and anti-drug antibodies (ADAbs); and adverse events. Results: A total of 313 IBD patients were switched (195 CD; 118 UC). There were no significant changes in clinical disease activity, quality of life, biomarkers (except a small but significant increase in albumin in CD) including F-calprotectin, drug trough levels, or proportion of patients in remission. Disease worsening rates were 14.0% for CD and 13.8% for UC; and 2.7% developed ADAbs and 2.2% developed serious adverse events. Conclusions: This is the largest study of switched IBD patients published to date, and it demonstrates that switching from Remicade to CT-P13 may be done with preserved therapeutic effectiveness and safety in both CD and UC.

High expression of programmed death receptor 1 (PD-1) and its ligand (PD-L1) by leukocytes in primary classical Hodgkin lymphoma (cHL) is associated with inferior outcome. However, it is unclear how expression varies during disease progression, and in the event of relapse. Our aim was to study PD-1 and PD-L1 in consecutive biopsies from untreated and treated cHL patients. We screened pathology registries from 3500 cHL patients. Eleven patients had a diagnostic cHL biopsy and a previous benign lymph node biopsy reclassified as cHL when reviewed and designated as the untreated. Thirty patients had a primary and a relapse biopsy, designated as the treated. Biopsies were immunostained to detect PD-1+ and PD-L1+ leukocytes, and PD-L1+ tumor cells. In the untreated, none of the markers were statistically significantly different when biopsies 1 and 2 were compared. In the treated, 19, 22, and 18 of 30 cases had increased proportions of PD-1+ leukocytes, PD-L1+ leukocytes and PD-L1+ tumor cells, respectively, and were all statistically significantly increased when primary and relapse biopsies were compared. PD-1 and PD-L1 most likely increase due to primary treatment with chemotherapy and radiotherapy, which could have implications regarding treatment with PD-1 inhibitors.

This article addresses the complex challenge of simultaneously enhancing contrast and detail in an image, where improving one property often compromises the other. This trade-off is tackled using a multi-objective optimization approach. Specifically, the proposal’s model integrates the sigmoid transformation function and unsharp masking highboost filtering with the NSGA-II algorithm. Additionally, a posterior preference articulation is introduced to select three key solutions from the Pareto front: the maximum contrast solution, the maximum detail solution, and the knee point solution. The proposed technique is evaluated on a range of image types, including medical and natural scenes. The final solutions demonstrated significant superiority in terms of contrast and detail compared to the original images. The three selected solutions, although all are optimal, captured distinct characteristics within the images, offering different solutions according to field preferences. This highlights the method’s effectiveness across different types and enhancement requirements and emphasizes the importance of the proposed preferences in different contexts.

Mixed integer nonlinear programming (MINLP) addresses optimization problems that involve continuous and discrete/integer decision variables, as well as nonlinear functions. These problems often exhibit multiple discontinuous feasible parts due to the presence of integer variables. Discontinuous feasible parts can be analyzed as subproblems, some of which may be highly constrained. This significantly impacts the performance of evolutionary algorithms (EAs), whose operators are generally insensitive to constraints, leading to the generation of numerous infeasible solutions. In this article, a variant of the differential evolution algorithm (DE) with a gradient-based repair method for MINLP problems (G-DEmi) is proposed. The aim of the repair method is to fix promising infeasible solutions in different subproblems using the gradient information of the constraint set. Extensive experiments were conducted to evaluate the performance of G-DEmi on a set of MINLP benchmark problems and a real-world case. The results demonstrated that G-DEmi outperformed several state-of-the-art algorithms. Notably, G-DEmi did not require novel improvement strategies in the variation operators to promote diversity; instead, an effective exploration within each subproblem is under consideration. Furthermore, the gradient-based repair method was successfully extended to other DE variants, emphasizing its capacity in a more general context.

Background. Fine root production and turnover are the fundamental processes of net primary productivity in forest ecosystems. Fine root production and turnover rates can vary with the successional gradients of the forest ecosystems created by land use changes. Objective. To evaluate the variations in fine root production and turnover along the successional gradients of tropical secondary forests and compare them with adjacent primary forests. Methodology. A total of 256 cylindrical ingrowth bags (of 8 cm diameter and 30 cm depth) were established in 16 forest stands representing four stages of succession. Four ingrowth bags from each stand were collected at an interval of about three months. Live and dead fine roots (≤2 mm diameter) were separated, washed, oven-dried, and weighed. Results. There was no significant difference in annual fine root productivity between secondary forests and primary forests but the fine root turnover rates were higher in secondary forests than in primary forests. Fine root production rates varied from 1.9 to 2.8 Mg of dry biomass ha-1 yr-1 while fine root turnover over rates ranged from 1.1 to 1.5 yr-1. Fine root production was higher in the dry season compared to the wet season. Implications. The results on fine root dynamics can be useful in modeling below-ground mechanisms of carbon sequestration in forest ecosystems during succession. Conclusions. Fine root productivity did not vary with forest age but the relative turnover rates were higher in secondary forests than in primary forests. Tree basal area was a significant predictor of fine root production.

This work presents a methodology to solve optimization problems with dynamic-size solution vectors containing continuous and integer variables. It is achieved by reformulating the original problem through a bilevel optimization approach and implementing metaheuristic techniques to solve it. In the selected case study, the optimization problem corresponds to tuning a neuro-fuzzy controller (NFC) that operates in a biodiesel production system for controlling temperature. The NFC performs well and is especially robust to disturbances, but due to its complexity, it is difficult to determine the best set of parameters for its use. This has led to biased searches based on criteria such as the experiences of designers. With the proposed method, it was possible to obtain a tuning that—when implemented in a simulation—led to results that surpassed those documented in the literature. Finally, the proposal offers flexibility for implementation with other controllers that have similar architectures and can be integrated into various other plants or processes.

Genetic parentage tests have great relevance in breed registration processes in equine specimens. In addition, these tests are used to verify progeny genetic accuracy, using microsatellite molecular markers (STR) as a method for individual identification and kinship between individuals. Specifically, we evaluated a Colombian Creole breed equine population, using blood, saliva, and hair samples as sources of DNA. The samples were extracted using Chelex chelating resins. DNA quantification was performed by NanoDrop and amplified by PCR using the 17 STRs included in the Equine Genotypes panel 1.1 kit. Subsequently, electrophoresis was performed and stained with SYBR safe, and genotypes were determined using capillary electrophoresis. Additionally, the allelic and genotypic frequencies were calculated using the GENEPOP software and the previously obtained genetic profiles. Also, the HWE, heterozygosity per locus, inbreeding, and gametic imbalance were estimated. As a result, some genetic markers such as ASB23, ASB17, and LEX3 were not suitable for executing the tests since they biased the population parameters. However, we recommend expanding the equine population and using more STRs to obtain better results in these genetic tests in future population studies.

Resumen: Introducción: La mediastinitis es una de las complicaciones más temidas de la cirugía cardíaca, y su incidencia va del 0,9 al 5%, llegando a veces hasta el 20%. Se caracteriza por infección grave, absceso retroesternal, osteomielitis y dehiscencia esternal macroscópica con alta mortalidad. Material y métodos: Se revisaron pacientes sometidos a esternotomía media para cirugía cardiaca durante 10 años en el Hospital de Pemex en México. Se estudiaron las variables edad, sexo, diabetes mellitus, hipertensión, índice de masa corporal, cirugía primaria, afectación renal, diálisis previa, tipo de cierre esternal, estancia hospitalaria prequirúrgica, resultado de los cultivos y mortalidad. Resultados: De 2.242 esternotomías, se incluyeron 33 casos; en promedio, 3 por año: 24 hombres y 9 mujeres, la mayoría entre los 71 y los 80 años; 25 diabéticos y 24 hipertensos. El 45,3% presentaban peso normal o sobrepeso, y el 54,5%, obesidad grado I-II. Veintisiete eran isquémicos y 6 con cirugía de válvula simple o procedimiento mixto; el 22,2% tuvieron antecedente de reexploración urgente por sangrado. El 44,4% de los pacientes eran nefrópatas, y 2 de ellos se encontraban en hemodiálisis.Hubo dos técnicas de cierre esternal: grupo 1 con puntos simples, y grupo 2 con Hemi-Robicsek. El tipo 1 se utilizó en 1.499 pacientes, con dehiscencia del 1,8%, y el tipo 2 en 743 pacientes, con dehiscencia del 0,6%. Conclusiones: Las infecciones mediastínicas devastadoras postesternotomía son cada vez más raras en nuestro hospital. Un estricto apego a la técnica, el cierre esternal al que llamamos Hemi-Robicsek, así como la detección temprana de la dehiscencia para resutura, nos han llevado a cero mediastinitis. Abstract: Introduction: Mediastinitis is one of the most feared complications of cardiac surgery. It's incidence ranges from 0.9 to 5% and sometimes up to 20%. It is characterized by severe infection, retrosternal abscess, osteomyelitis, and gross sternal dehiscence with high mortality. Material and methods: Patients undergoing median sternotomy for cardiac surgery during a ten years period at the Pemex Hospital in Mexico were reviewed. The variables age, sex, diabetes mellitus, hypertension, body mass index, primary surgery, renal involvement, previous dialysis, type of sternal closure, pre-surgical hospital stay, result of cultures and mortality were studied. Results: Of 2,242 sternotomies, 33 cases were included. There was an average of 3 cases per year. 24 men and 9 women, the majority between 71 and 80 years old, 25 diabetic and 24 hypertensives. 45.3% with normal weight or overweight and 54.5% with grade I-II obesity. 27 had a history of ischemia and 6 had a history of simple valve surgery or mixed procedure, 22.2% had a history of urgent reexploration for bleeding. 44.4% of the patients were nephropaths, 2 on hemodialysis.There were two sternal closure techniques, group 1 with simple stitches and group 2 with Hemi-Robicsek. Type 1 was used in 1499 patients, with 1.8% dehiscence, type 2 in 743 patients, with 0.6% dehiscence. Conclusions: Post-sternotomy devastating mediastinal infections are increasingly rare in our hospital. A strict adherence to the technique, the sternal closure that we call Hemi-Robicsek, as well as the early detection of dehiscence for resuturing has led us to zero cases of mediastinitis.

Wastewater Treatment Plants (WWTPs) are considered as an Ultra Low Head (ULH) hydraulic resource. This has provoked an inadequate extraction of its potential energy by Micro Hydroelectric Plants (MHP) due to the improper relationship between the size and performance of the turbine. Thus, this work proposes the optimized design of a turbine composed of an intake-runner-diffuser, which looks for the maximum energy extraction from this kind of hydraulic resource. The annual Flow Duration Curve (FDC) of a WWTP effluent was examined to determine the flow rate with which the maximal available energy could be extracted through an adequate runner design. A 3D computational model of the intake-runner-diffuser was optimized by coupling a Computational Fluid Dynamics (CFD) software with a Multi Island Genetic Algorithm, while the pressure and flow field of the selected cases were qualitative and quantitatively analyzed. It was found that with the lowest Reaction Degree (RD), a propeller turbine reached its highest efficiency and pressure ratio coefficient, extracting 76% of the annual available energy of the hydraulic resource. In this way, the maximal exploitation of a ULH resource through the turbine design of the MHP system instead of adapting turbines from Large Hydropower Plants (LHP) could help to establish an actual and attractive project cost-benefit ratio.

Driven by the emergence of Graphics Processing Units (GPUs), the solution of increasingly large and intricate numerical problems has become feasible. Yet, the integration of GPUs into Computational Fluid Dynamics (CFD) codes still presents a significant challenge. This study undertakes an evaluation of the computational performance of GPUs for CFD applications. Two Compute Unified Device Architecture (CUDA)-based implementations within the Open Field Operation and Manipulation (OpenFOAM) environment were employed for the numerical solution of a 3D Kaplan turbine draft tube workbench. A series of tests were conducted to assess the fixed-size grid problem speedup in accordance with Amdahl’s Law. Additionally, tests were performed to identify the optimal configuration utilizing various linear solvers, preconditioners, and smoothers, along with an analysis of memory usage.

Background: Methicillin-resistant S. aureus (MRSA) especially ST398, is a zoonotic agent. This study aimed to determine the prevalence of methicillin-susceptible S. aureus (MSSA) and MRSA among workers in the pork production chain. Methods: 659 workers associated with 123 pig farms, livestock transporters, one pig slaughterhouse, pork transporters and 23 pork butcheries were studied for S. aureus recovery, and all isolates were characterized (antibiotic resistance, MLST and spa-typing). Results: The prevalence of S. aureus was 35.5%, 75.6% of isolates being MRSA. The prevalence of MRSA was 68.7% (149/217) among pig farm, 33.9% (19/56) livestock transporters, 2.9% (9/306) slaughterhouse, 0% in pork transporters (0/36) and butchery workers (0/44). Of the 234 S. aureus-positive workers, 100% (149/149) of pig farm workers, 82.6% (19/23) of livestock transporters, and 16.4% (9/55) of slaughterhouse workers carried MRSA isolates (p

Abstract Background Meeting physical activity and screen time guidelines has been associated with improved health in children. Research has shown that lifestyle behaviours happen in combination and can be tracked into later life. Thus, a complex approach is needed to identify the effects of physical activity and screen time altogether. This study aims to identify clusters of both behaviours in a cohort of Irish 3-year-old children (n = 8833) and determine the association with sociodemographic characteristics and behaviours at age 5 and 7-8. Methods Data from the “Growing Up in Ireland” study collected between 2010 and 2016 was used in this study. Two-step cluster analysis was used to understand how physical activity and recreational screen time behaviours group together among 3-year-old children. Binary logistic regressions were conducted to examine if cluster placement at age 3 determined physical activity and recreational screen time behaviours at age 5 and 7-8 years, while controlling for gender of child, gender, age and employment status of the primary caregiver. Results Six clusters were identified in 9771 (49.3% female) 3-year-old children with the majority falling into a “High Active & Mixed Screen Time” (23.2%). Those in the “High Active & Mixed Screen Time” cluster at age 3 were more likely to engage in all physical activities reported at age 5 (p

Abstract The effect of helmet use on reducing the risk of death in cyclists appears to be distorted by some variables (potential confounders, effect modifiers, or both). Our aim was to provide evidence for or against the hypothesis that cycling area may act as a confounder and effect modifier of the association between helmet use and risk of death of cyclists involved in road crashes. Data were analysed for 24,605 cyclists involved in road crashes in Spain. A multiple imputation procedure was used to mitigate the effect of missing values. We used multilevel Poisson regression with province as the group level to estimate the crude association between helmet use and risk of death, and also three adjusted analyses: (1) for cycling area only, (2) for the remaining variables which may act as confounders, and (3) for all variables. Incidence–density ratios (IDR) and their 95% confidence intervals were calculated. Crude IDR was 1.10, but stratifying by cycling area disclosed a protective, differential effect of helmet use: IDR = 0.67 in urban areas, IDR = 0.34 on open roads. Adjusting for all variables except cycling area yielded similar results in both strata, albeit with a smaller difference between them. Adjusting for cycling area only yielded a strong association (IDR = 0.42), which was slightly lower in the adjusted analysis for all variables (IDR = 0.45). Cycling area can act as a confounder and also appears to act as an effect modifier (albeit to a lesser extent) of the risk of cyclists’ death after a crash.