Search

Background: The prevalence of older (>60 years) people with multiple sclerosis (pwMS) is increasing. This introduces numerous challenges, as both MS and ageing independently contribute to the deterioration of neuromuscular function., Aim: The aim was to compare the neuromuscular function in pwMS and healthy controls (HC) across three age groups: young, middle-aged, and old., Methods: Using a cross-sectional study design, the maximal muscle strength (Fmax) and rate of force development (RFD) of the knee extensors (KE) and plantar flexors (PF) were assessed using an isokinetic dynamometer. In addition, voluntary activation (VA) and resting twitch (RT) were measured using the interpolated twitch technique., Results: The Fmax, RFD, and VA of the KE were reduced in pwMS compared to HC across age groups. In pwMS, reductions were observed in PF Fmax, RFD, and RT, predominantly in the middle-aged and old age groups. Reductions increased with age in KE for both groups (except for VA) but in PF only for pwMS. The "trajectory" differed between pwMS and HC, as pwMS showed reductions from young to middle age, while HC showed reductions from middle to old age in KE., Conclusion: The combined negative effects of MS and ageing on neuromuscular function were especially present in the PF but also substantial in the KE. RFD showed large deficits for pwMS compared to HC across age groups. The findings can partly be explained by a reduction in VA and RT, but further investigations of neural regulation are needed to explain large RFD deficits., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tobias Gaemelke reports was provided by Aarhus University Department of Public Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Membrane fouling significantly reduces membrane permeability, leading to higher operational expenses. In situ monitoring of membrane fouling can potentially be used to reduce operation cost by optimizing operational parameters and cleaning conditions. In this study, a platinum wire with a diameter of 20 µm was attached to the surface of a ceramic ultrafiltration membrane, and by measuring the voltage across the wire while applying an AC current, the amplitude of the third harmonic wave, the so-called 3ω signal, was obtained. Results showed increasing 3ω signals during formation of fouling layers, which correlates directly to the hydraulic resistance of the formed fouling layer in semi-dead end filtration of polymeric core shell particles and crossflow filtration of diluted milk. This is explained by the insulating effect of the fouling layers which reduces heat convection by crossflow and the different thermal conductivity in the fouling layer compared with the feed. After membrane cleaning, the permeability and the magnitude of the 3ω signal were partly restored, showing that the 3ω method can be used to monitor the effect of cleaning. The frequency of the AC current was varied so it was possible to measure the heat conductivity in the fouling layer (high frequency) and heat convection due to cross-flow (low frequency). This may potentially be used to get information of the type of fouling (heat conductivity) and thickness of the fouling layer (AC frequency where heat conductivity becomes dominating)., (© 2023. Springer Nature Limited.)

Ce-doped SrFeO 3 perovskite-type compounds are known as good thermocatalysts for the abatement of wastewater contaminants of emerging concern. In this work, Sr 0.86 Ce 0.14 FeO 3 -CeO 2 perovskite-oxide systems with increasing amounts of cerium excess (0, 5, 10 and 15 mol% Ce), with respect to its maximum solubility in the perovskite, were prepared in one-pot by solution combustion synthesis and the effects of cerium excess on the chemical physical properties and thermocatalytic activity in the bisphenol A degradation were evaluated. The powders were characterized by powder X-ray diffraction combined with Rietveld refinement, X-ray photoelectron spectroscopy, thermal gravimetry, temperature programmed reduction, nitrogen adsorption, scanning electron microscopy and energy dispersive X-ray spectroscopy techniques. Results highlight that the perovskite structural, redox, surface, and morphological properties are affected by the in situ co-growth of the main perovskite phase and ceria and that a larger cerium excess has a beneficial effect on the thermocatalytic performance of the perovskite oxide-ceria biphasic system, although ceria is not active as a thermocatalyst itself. Perovskite properties and performance are enhanced by the tetragonal distortion induced by the introduction of cerium excess in the synthesis. It is supposed that a larger oxygen mobility and an easier reducibility are among the most relevant features that contribute to superior thermocatalytic properties of these perovskite oxide-based systems. These results also suggest new perspectives in the nanocomposite preparation and their catalytic applications., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Emerging evidence suggest that quantitative sensory testing (QST) may predict the treatment response to pain-relieving therapies. This systematic review and meta-analysis focus on the predictive value of QST for pain management of knee osteoarthritis (OA). MEDLINE and EMBASE were systematically searched for all studies from year 2000 to 2023 on pretreatment QST and treatment of OA including surgical, pharmaceutical, and nonsurgical and nonpharmaceutical therapies. Preclinical studies and reviews were excluded. The systematic review followed the PRISMA guidelines and was pre-registered on the Open Science Framework website (link: https://osf.io/4FETK/, Identifier: DOI 10.17605/OSF.IO/4FETK). Meta-analysis were conducted to demonstrate the strength of the pre-treatment QST predictions on pain outcomes after OA treatments. Sixteen surgical (all on total knee arthroplasty [TKA], N = 1967), 5 pharmaceutical (4 on non-steroidal anti-inflammatory drugs [NSAIDs], N = 271), and 4 exercise-based therapy studies (N = 232) were identified. Pretreatment QST parameters predicted pain-relieving treatment outcomes in 81% of surgical, 100% of pharmaceutical, and 50% of exercise-based therapy studies. Meta-analyses found pretreatment QST profiles to predicted pain outcomes after TKA (random effects: 0.309, 95% confidence interval [CI]: 0.206-0.405, P < 0.001), NSAIDs (random effects: 0.323, 95% CI: 0.194-0.441, P < 0.001), and exercise-based therapies (random effects: 0.417, 95% CI: 0.138-0.635, P = 0.004). The overall risk of bias for the included studies was low to moderate. This systematic review and meta-analysis demonstrate weak-to-moderate associations between pretreatment QST and pain outcomes after standard OA pain treatments. Based on this work, it is hypothesized that a subset of specific pain sensitive patients with OA exist and that these patients do not respond adequately to standard OA pain treatments., Competing Interests: The authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)

Background: Neurodegeneration is an inevitable consequence of multiple sclerosis (MS) leading to impaired neuromuscular function, especially of the lower extremities. Whilst maximal muscle strength (or force; Fmax) is the most examined feature of neuromuscular function, the ability to rapidly increase muscle force (= rate of force development; RFD) appear to be preferentially sensitive towards neurodegeneration and potentially also of great importance for physical function. The purpose of the present study was to comprehensively examine and compare different outcome measures of neuromuscular function (with specific emphasis given to RFD) across disability status in persons with MS (pwMS), and in comparison, to age- and sex-matched healthy controls (HC)., Methods: A total of n=34 HC and n=99 pwMS were enrolled in the study, with the latter being divided into Expanded Disability Status Scale (EDSS) subgroups: MS mild (EDSS 0-2.5, n=51), MS moderate (EDSS 3.0-4.5, n=33), and MS severe (EDSS 5-6.5, n=15). Knee extensor neuromuscular function was assessed by Fmax and RFD (RFD 50ms and RFD 200ms , respectively; calculated in the interval 0-50 ms and 0-200 ms relative to the onset of contraction) with simultaneous electromyography (maximal EMG (EMG Fmax ) and rate of EMG rise (rEMG 50ms and rEMG 200ms , respectively)). Voluntary muscle activation derived from the interpolated twitch technique was also determined during additional Fmax trials. Lastly, physical function was assessed by the 5 x sit-to-stand test (5STS), the timed 25-foot walk test (T25FWT), and the 2-min walking test (2MWT)., Results: Substantial differences (∼deficits) (p<0.05) were observed for all pwMS subgroups compared to HC across all neuromuscular function outcome measures; RFD 50ms (MS mild -22%, MS moderate -36%, MS severe -66%), RFD 200ms (-12%, -21%, -51%), and Fmax (-11%, -14%, -33%). Somewhat comparable differences (∼deficits) (p<0.05) were observed for voluntary muscle activation (rEMG 50ms , rEMG 200ms , EMG Fmax , and activation) and for physical function (5STS, T25FWT, and 2MT). Deficits in neuromuscular function were strongly associated with EDSS (p<0.05) (RFD 50ms : slope steepness -13% per 1 point increase in EDSS, r 2 =0.79; RFD 200ms : slope steepness -10%, r 2 =0.84; Fmax: slope steepness -6%, r 2 =0.82). Fmax and RFD were associated with physical function outcome measures (p<0.05) to a comparable extent (r 2 -values ranging from 0.21 to 0.35)., Conclusion: Lower extremity neuromuscular function is impaired in pwMS compared to HC with differences (∼deficits) becoming greater with increasing disability status. RFD was preferentially sensitive in capturing differences (∼deficits) across disability status and by showing strong associations with EDSS. Altogether, knee extensor RFD could serve as a simple objective marker of disability status or even progression in pwMS, that may be helpful to both researchers and clinicians., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Due to progressive limitation of access to clean drinkable water, it is nowadays a priority to find an effective method of water purification from those emerging organic contaminants, which might have potentially harmful and irreversible effects on living organisms and environment. This manuscript reports the development of a new strategy for water purification, which combines a novel and recently developed Al 2 O 3 -doped silica nanofiltration membrane with a thermocatalytic perovskite, namely cerium-doped strontium ferrate (CSF). The thermocatalytic activity of CSF offers the opportunity to degrade organic pollutants with no light and without input of chemical oxidants, providing simplicity of operation. Moreover, our studies on real samples of secondary effluent from wastewater treatment showed that the thermocatalyst has the ability to degrade also part of the non-toxic organic matter, which allows for reducing the chemical oxygen demand of the retentate and mitigating membrane fouling during filtration. Therefore, the new technology is effective in the production of clean feed and permeate and has a potential to be used in degradation of micropollutants in water treatment.

Objectives: Continuous peripheral nerve blocks (cPNBs) have shown promising results in pain management after orthopaedic surgeries. However, they can be associated with some risks and limitations. The purpose of this study is to describe our experience with the cPNBs regarding efficacy and adverse events in patients undergoing orthopedic surgeries on the lower extremity in different subspecialties., Methods: This is a prospective cohort study on collected data from perineural catheters for pain management after orthopedic surgeries in lower limbs. Catheters were placed by experienced anesthesiologists using sterile technique. After an initial bolus dose of 10-20 mL ropivacaine 0.5% (weight adjusted), the catheters were secured and connected to disposable mechanical infusion pumps with ropivacaine 0.2% (basal infusion rate = 6 mL/h; weight adjusted (0.2 mL/kg/h)). After catheterization, the patients were examined daily, by specially educated acute pain service nurses. Pro re nata (PRN) or fixed boluses (10 mL bupivacaine 0.25%; weight adjusted) with an upper limit of 4 times/day, were administered if indicated. Patients' demographic data, physiological status, and pre-op intake of opioids and other analgesics were registered. The severity of post-operative pain was assessed with 'Numeric Rating Scale' (NRS) and 'Face, legs, Activity, Cry, Consolability' (FLACC) scale for adults and children, respectively. The need for additional opioids and possible complications were registered., Results: We included 547 catheters of 246 patients (Range 1-10 catheters per patient). Overall, 115 (21%) femoral, 162 (30%) saphenous, 66 (12%) sciatic, and 204 (37%) popliteal sciatic nerve catheter were used. 452 (83%) catheters were inserted by a primary procedure, 61(11%) catheters employed as a replacement, and 34 catheters (6.2%) used as a supplement. For guiding the catheterization, ultrasound was applied in 451 catheters (82%), nerve stimulator in 90 catheters (16%), and both methods in 6 catheters (1.1%). The median duration a catheter remained in place was 3 days (IQR = 2-5). The proportion of catheters with a duration of two days was 81, 79, 73, and 71% for femoral, sciatic, saphenous, and popliteal nerve, respectively. In different subspecialties, 91% of catheters in wound and amputations, 89% in pediatric surgery, 76% in trauma, 64% in foot and ankle surgery, and 59% in limb reconstructive surgery remained more than two days. During first 10 days after catheterization, the proportion of pain-free patients were 77-95% at rest and 63-88% during mobilization, 79-92% of the patients did not require increased opioid doses, and 50-67% did not require opioid PRN doses. In addition to 416 catheters (76%), which were removed as planned, the reason for catheter removal was leaving the hospital in 27 (4.9%), loss of efficacy in 69 (13%), dislodgement in 23 (4.2%), leakage in 8 (1.5%), and erythema in 4 catheters (0.73%). No major complication occurred., Conclusions: After orthopaedic procedures, cPNBs can be considered as an efficient method for improving pain control and minimizing the use of additional opioids. However, the catheters sometimes might need to be replaced to achieve the desired efficacy., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Nutrients were extracted from digester supernatant sampled from a full-scale enhanced biological phosphorus removal (EBPR) wastewater treatment plant. A four-compartment selectrodialysis setup was used to extract ammonium and phosphate in two separate compartments. The initial phosphate recovery rate was measured to be 0.072 mmol m -2  s -1 and the initial ammonium recovery rate was measured to be 1.31 mmol m -2  s -1 . The ammonium recovery rate was 18 times higher than that for phosphate, whereas the molar concentration of ammonium in the feed was 10 times higher than that of phosphate. An average recovery of 72 ± 1% and 90 ± 10% for ammonium and phosphate was observed after 3 h of operation. A monovalent anion selective (MVA) membrane was used to avoid ammonium and reduce the concentration of monovalent anions in the phosphorus stream. The pH in the phosphorus stream was kept at 10 so phosphate did not pass the MVA membrane. A membrane area of 26 m 2 per m 3 digester supernatant was required to recover 70% of phosphate and ammonium for the digester supernatant that contained 6 mM phosphate and 105 mM ammonium.

Purpose: Examine the association between physical activity and neuromuscular and physical function in patients with multiple sclerosis when also considering disease severity., Methods: 91 patients with multiple sclerosis were enrolled. Assessments included physical activity by 7-day thigh-worn accelerometry, knee extensor neuromuscular function by dynamometry (maximal isometric muscle strength, rate of force development (0-50 ms)), and physical function by 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test. Physical activity tertile comparisons along with simple and multiple regressions (adjusting for age, gender, EDSS, time since diagnosis) were performed., Results: Physical activity tertiles revealed differences ( p  < 0.05) in maximal muscle strength (1.77 ≈ 1.97 < 2.28 Nm/kg), rate of force development (4.66 < 8.03 ≈ 10.55 Nm/kg/s), 5× sit-to-stand (11.4 ≈ 9.7 > 8.5 s), 2-min walk test (153 < 183 < 207 m), and timed 25 ft walk test (6.3 > 4.4 > 4.3 s). Moreover, physical activity was associated ( p  < 0.05) with maximal muscle strength and rate of force development ( r 2   =  0.13-0.15) along with 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test ( r 2  = 0.18-0.24), also after adjusting for age + gender + EDSS + time since diagnosis ( r 2  = 0.25-0.37 and 0.24-0.52), with physical activity consistently being a strong predictor., Conclusions: Higher levels of physical activity are associated with greater neuromuscular and physical function in ambulatory patients with multiple sclerosis independent of disease severity. These findings emphasize the importance of performing regular physical activity at all stages of multiple sclerosis.IMPLICATIONS FOR REHABILITATIONPhysical activity is associated with neuromuscular and physical function, independent of disease severity.Physical activity may be important in improving or preserving neuromuscular and physical function at all stages of ambulatory multiple sclerosis patients, yet longitudinal studies are warranted.Clinicians and rehabilitation professionals should encourage ambulatory patients at all stages of their disease to be as physically active as possible.

Membrane bioreactors (MBRs) for wastewater treatment show great potentials in the sustainable development of urban environments. However, fouling of membranes remains the largest challenge of MBR technology. Dissolved extracellular polymeric substances (EPS) are often assumed be the main foulant in MBRs. However, single bacterial cells are often erroneously measured as EPS in traditional spectrophotometric analysis of EPS in activated sludge, so we hypothesized that single cells in many cases could be the true foulants in MBRs for wastewater treatment. To study this, raw MBR sludge and sludge supernatant with varying concentrations of planktonic cells were filtered on microfiltration (MF) membranes, and we found a direct correlation between the cell count and rate of flux decline. Addition of planktonic cells to fresh MBR sludge dramatically increased the flux decline. The identity of the most abundant planktonic cells in a full-scale MBR water resource recovery facility was determined by DNA fingerprinting. Many of these genera are known to be abundant in influent wastewater suggesting that the influent bacterial cells may have a direct effect on the fouling propensity in MBR systems. This new knowledge may lead to new anti-fouling strategies targeting incoming planktonic bacteria from the wastewater feed. PRACTITIONER POINTS: Planktonic cells constituted up to 60% of the total protein content of "soluble extracellular polymeric substances" in membrane bioreactor sludge. Planktonic cells are hidden under a surrogate concentration of extracellular polymeric substances which is often associated with fouling. Membrane fouling rate is directly proportional to amount of free planktonic cells suspended in sludge. Several influent bacterial genera are enriched in the water phase of membrane bioreactor sludge. Removing these may mitigate fouling., (© 2020 Water Environment Federation.)

Fouling of membranes is still an important limiting factor in the application of membrane technology. Therefore, there is still a need for an in-depth understanding of which parameters affect the (ir)removability of fouling layers, as well as the mechanisms behind fouling. In this study, fluid dynamic gauging (FDG) was used to investigate the influence of charge effects between negatively charged foulant particles and cations on cake cohesive strength. Fouling cakes' thicknesses and cohesive strengths were estimated during membrane operations, where microfiltration (MF) membranes were fouled in a feed-and-bleed cross-flow filtration system with low and highly negatively charged polystyrene-polyacrylic acid core-shell particles. In addition, an added procedure to determine the irremovability of cakes using FDG was also proposed. Comparing layers formed in the presence and absence of calcium ions revealed that layers formed without calcium ions had significantly lower cohesive strength than layers formed in the presence of calcium ions, which is explained by the bridging effect between negatively charged particles and calcium ions. Results also confirmed more cohesive cakes formed by high negative charge particles in the presence of calcium compared to lower negative charge particles. Hence, it was demonstrated that FDG can be used to assess the cohesive strength ((ir)removability) of cake layers, and to study how cake cohesive strength depends on foulant surface charge and ionic composition of the solution.

A methodology was developed for direct observation and analysis of particle movements near a microfiltration membrane. A high speed camera (1196 frames per second) was mounted on a microscope to record a hollow fiber membrane in a filtration cell with a transparent wall. Filtrations were conducted at varying pressure and crossflow velocities using synthetic core-shell particles (diameter 1.6 μm) of no and high negative surface charge. MATLAB scripts were developed to track the particle positions and calculate velocities of particle movements across and towards the membrane surface. Data showed that the velocity of particles along the membrane increases with distance from the membrane surface which correlates well with a fluid velocity profile obtained from CFD modelling. Particle track and trace was used to calculate the particle count profiles towards the membrane and document a higher concentration of particles near the membrane surface than in the bulk. Calculation of particle velocity towards and away from the membrane showed a region within 3-80 μm from the membrane surface with particle velocities higher than expected from the velocity of water through the membrane, thus the permeation drag underpredicts the actual velocity of particles towards the membrane. Near the membrane, particle velocities shift direction and move away. This is not described in classical filtration theory, but it has been speculated that this is an effect of particle rotation or due to membrane vibration or change in flow pattern close to the membrane.

Objective: We evaluated the diagnostic value of cerebrospinal fluid oligoclonal bands in individuals less than 18 years of age., Methods: In a nationwide population-based setting, we retrieved data on 2055 children's oligoclonal band examination, including concordant cerebrospinal fluid biomarkers, during 1994 to 2017. Case ascertainment was by review of medical records and diagnostic codes. We used Fisher's exact test to explore distribution differences of oligoclonal band positivity in acquired demyelinating syndromes (ADS) before and after age 12 years and calculated the sensitivity, specificity, positive predictive value, and negative predictive value of oligoclonal bands to distinguish ADS from the other diagnostic groups., Results: Median age at oligoclonal band examination was 15.2 years (range = 1.8 to 18.0), and 10% had presence of cerebrospinal fluid oligoclonal bands. Oligoclonal band positivity was the highest in ADS (52%), but it was age dependent: 21% in children with ADS before age 12 years and 68% in children aged 12 through 17 years (P < 0.0001) owing to the higher incidence of multiple sclerosis in the latter. Cerebrospinal fluid oligoclonal bands were not predictive of ADS before age 12 years compared with the other diagnostic groups. However, cerebrospinal fluid oligoclonal bands in children aged 12 through 17 years were highly predictive of ADS compared with central nervous system infections and non-ADS immune-mediated central nervous system diseases (positive predictive value: 0.89; 95% confidence interval = 0.82 to 0.94; P < 0.0001), but negative oligoclonal bands were not discriminatory (negative predictive value: P = 0.17)., Conclusions: In a clinical setting, cerebrospinal fluid oligoclonal band examination may be of higher yield in children aged 12 through 17 years if there is clinical suspicion of multiple sclerosis, and in such circumstances a positive test supports a diagnosis of multiple sclerosis., (Copyright © 2019 Elsevier Inc. All rights reserved.)

A range of parameters affecting floc characteristics, sludge composition and filtration properties was investigated by analyzing 29 sludge samples from municipal and industrial conventional activated sludge systems and municipal membrane bioreactors (MBR). Samples were characterized by physico-chemical parameters, composition of ions and EPS, degree of flocculation, settling properties, dewatering properties, and filtration properties. By analyzing the interplay between various metrics instead of single parameters, a unified understanding of the influence of sludge composition and characteristics was developed. From this, a conceptual model was proposed to describe the interplay between sludge composition, characteristics, and filtration properties. The article shows three major results contributing to describe the interplay between sludge characteristics and fouling propensity: First, the degree of flocculation could be quantified by the ratio between floc size and residual turbidity and was a key parameter to assess fouling propensity. Second, extracted EPS to polyvalent cations ratio was used as an indicator of the flocculation. A high ratio combined with a high concentration of EPS resulted in large, loosely bound, and weak flocs that were easily deformed, hence giving compressible fouling layers. Finally, high amounts of carbohydrates in both total and extracted EPS resulted in more pronounced fouling, which may be explained by carbohydrates forming poorer flocs than humic substances and proteins. Accordingly, samples with high humic content showed lower specific resistance to filtration due to better floc structure. The amount of carbohydrates in EPS correlated positively to the influent COD/N ratio, which may explain why systems with high influent COD/N ratio demonstrated higher fouling propensity., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

A filtration devise was developed to assess compressibility of fouling layers in membrane bioreactors. The system consists of a flat sheet membrane with air scouring operated at constant transmembrane pressure to assess the influence of pressure on resistance of fouling layers. By fitting a mathematical model, three model parameters were obtained; a back transport parameter describing the kinetics of fouling layer formation, a specific fouling layer resistance, and a compressibility parameter. This stands out from other on-site filterability tests as model parameters to simulate filtration performance are obtained together with a characterization of compressibility. Tests on membrane bioreactor sludge showed high reproducibility. The methodology's ability to assess compressibility was tested by filtrations of sludges from membrane bioreactors and conventional activated sludge wastewater treatment plants from three different sites. These proved that membrane bioreactor sludge showed higher compressibility than conventional activated sludge. In addition, detailed information on the underlying mechanisms of the difference in fouling propensity were obtained, as conventional activated sludge showed slower fouling formation, lower specific resistance and lower compressibility of fouling layers, which is explained by a higher degree of flocculation.

Introduction: Platelet count is used to determine bleeding risk and monitoring thrombopoiesis. While abnormal platelet counts are associated with mortality and morbidity, it is unclear whether it also apply to platelet counts within reference range. We investigated the relationship between platelet count (100-450×10 9 /L) and mortality, development of future cardiovascular disease (myocardial infarction, ischaemic stroke, or peripheral vascular disease), venous thromboembolism, bleeding or cancer in the general population., Material and Methods: We conducted a register-based cohort study of 21,252 adults (≥20years) from the Danish General Suburban Population Study (GESUS). Laboratory results from GESUS were linked to information from national registers regarding morbidity and death. Cox proportional hazard regression was conducted with adjustment for age, sex, smoking status, haemoglobin, leukocyte count, C-reactive protein and Charlson comorbidity index., Results: We found a U-shaped relationship between mortality and platelet count. Mortality was significantly increased for platelet count <175×10 9 /L or >300×10 9 /L. When categorizing platelet count using the interval 201-250×10 9 /L as reference group, platelet count 301-450×10 9 /L was associated with mortality, adjusted hazard ratio (HR)=1.42(95% CI 1.06-1.90) and cardiovascular disease, adjusted HR=1.32 (95% CI 1.03-1.69). Platelet count 100-200×10 9 /L was associated with future cancer, adjusted HR=1.28(95% CI 1.05-1.57), but not with future bleeding or venous thromboembolism., Conclusions: Platelet count is associated with mortality, future cardiovascular disease, and future cancer., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Biological wastewater treatment removes organic materials, nitrogen, and phosphorus from wastewater using microbial biomass (activated sludge, biofilm, granules) which is separated from the liquid in a clarifier or by a membrane. Part of this biomass (excess sludge) is transported to digesters for bioenergy production and then dewatered, it is dewatered directly, often by using belt filters or decanter centrifuges before further handling, or it is dewatered by sludge mineralization beds. Sludge is generally difficult to dewater, but great variations in dewaterability are observed for sludges from different wastewater treatment plants as a consequence of differences in plant design and physical-chemical factors. This review gives an overview of key parameters affecting sludge dewatering, i.e. filtration and consolidation. The best dewaterability is observed for activated sludge that contains strong, compact flocs without single cells and dissolved extracellular polymeric substances. Polyvalent ions such as calcium ions improve floc strength and dewaterability, whereas sodium ions (e.g. from road salt, sea water intrusion, and industry) reduce dewaterability because flocs disintegrate at high conductivity. Dewaterability dramatically decreases at high pH due to floc disintegration. Storage under anaerobic conditions lowers dewaterability. High shear levels destroy the flocs and reduce dewaterability. Thus, pumping and mixing should be gentle and in pipes without sharp bends., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Fouling is inevitable in membrane bioreactors (MBRs) due to the complex nature of activated sludge, which contains a broad variety of potential foulants. Filter cakes that build up from sludge particles are traditionally highly compressible due to both the deformation of the individual sludge particles and the rearrangement of these particles in the cake. However, this phenomenon has been little examined in studies of fouling mechanisms in MBR systems. This study examines the properties of the cake layer, modeling the cake buildup and specific cake resistance (α), including compressibility, in terms of pressure-dependent α. The changes in fouling resistance during transmembrane pressure (TMP)-step filtration in an MBR setup were simulated using an empirical pressure dependence of the specific cake resistance and a simple mass balance model. The total change in fouling resistance in each TMP step could be divided into an initial rapid change in specific cake resistance due to filter cake compression followed by simple cake buildup. By including cake compression in this simple model, the model fitted the data with high precision. We demonstrated that compressibility should be considered when describing cake fouling in MBRs., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Links are well established between both family history of diabetes and reduced birthweight and increased risk of diabetes in adulthood., Objectives: 1) To investigate the influence of parental history of type 2 diabetes (T2DM) on offspring birthweight and adult offspring glucose tolerance status in non-diabetic offspring of patients with T2DM and 2) to study the associations of birthweight with measures of pancreatic beta-cell function and insulin sensitivity., Design: Family cohort study., Population: Offspring of patients with verified T2DM diagnosed after age 40 years with a spouse without known diabetes., Methods: Oral glucose tolerance tests and frequently sampled intravenous glucose tolerance tests (FSIGT) in non-diabetic offspring. Birthweight and length obtained from birth records., Results: Among 122 offspring with maternal history of T2DM, 14.8% had diabetes compared to 8.0% in 137 offspring with paternal history of diabetes, p=0.09. Offspring with maternal history of T2DM had a mean birthweight 196 g higher than offspring with paternal T2DM (3,651 ± 640 g (mean ± SD) vs. 3,456 ± 472g (p=0.01)). Non-diabetic offspring with birthweights in the lowest tertile had significantly higher plasma glucose levels after an oral glucose tolerance test (OGTT) [Area under the curve(glucOGTT) , mean (95%CI), 1 795 (1 725-1 866) vs. 1 683 (1 613-1 753) mmol/L/min, p=0.02], and lower insulin sensitivity index calculated from a frequently sampled intravenous glucose tolerance test - Si 9.60 [10(-5) (min*pmol/L)(-1) ] (8.23-10.97) vs. 11.79 (10.41-13.18), p=0.02 - in adulthood compared to offspring with birthweights in the upper tertile., Conclusions: Offspring with a family history of maternal T2DM have higher birthweights than those with paternal T2DM. Low birthweight associates with elevated plasma glucose levels after an oral glucose load and decreased insulin sensitivity in adulthood., (© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.)

Purpose: Volumetric modulated arc therapy (VMAT) includes features such as a variable dose rate and gantry speed in addition to the beam modulation achieved with multileaf collimator (MLC) motion patterns employed in intensity modulated radiotherapy. Three tests have previously been proposed for the evaluation of the performance of VMAT delivery. In order to enable a convenient and accurate routine machine quality control (QC) program, the present study proposes tolerance levels for these tests based on a department-wide implementation of an electronic portal imaging device (EPID)-based QC., Methods: Three different VMAT tests--a picket fence (PF) test, a dose rate versus gantry speed (DRGS) test, and a dose rate versus MLC leaf speed (DRMLC) test--were performed on nine accelerators using two different EPIDs (aS1000 and aS500, Varian Medical Systems). All tests were repeated six times for each accelerator. The images were analyzed using an in-house-developed software. For the PF test, the positions and widths of individual MLC leaf gaps were compared to the mean value. In the DRGS and DRMLC tests, different combinations of dose rate, gantry speed, and MLC leaf speed were used to deliver identical doses to separate parts of the EPID. The tests were evaluated by looking for deviations in the constancy of the measured dose for the preset combinations of dose rate, gantry speed, and MLC leaf speed., Results: For the PF test, a 0.3 mm tolerance level was suggested for the positioning of the MLC leaves. The tolerance level for the gap width was 0.5 mm. For the DRGS and DRMLC tests, a 3% tolerance level was proposed., Conclusions: With the adapted levels of tolerance for an EPID-based approach, the PF, the DRGS, and the DRMLC tests offer a convenient and accurate machine QC program for linear accelerators used for VMAT.

Introduction: Primary lactose malabsorption, adult type, is associated with the genotype CC in a lactase gene regulatory sequence (LCT-13910). In contrast, the genotype CT or TT in this position correlates with normal lactose absorption. Genotyping was implemented for routine testing of patients for primary lactose intolerance. We estimated the frequency of genotypes in a group of blood donors and compared it with the frequency among patients., Materials and Methods: In total, 478 patients admitted to a hospital or to a specialist in gastroenterology and 100 blood donors were genotyped. DNA was obtained, and the relevant DNA sequence was amplified by real-time polymerase chain reaction (PCR) and analysed by the use of melting curve analysis., Results: Among blood donors, the allelic distribution was 8% CC, 38% CT and 54% TT, whereas 14% CC, 37% CT, 48% TT was found in the patient group., Conclusion: Compared with the control group, the frequency of the CC genotype is almost doubled in the genotyped patients. Genotyping proved to be a convenient tool for routine clinical testing.

Background: For most sequenced prokaryotic genomes, about a third of the protein coding genes annotated are "orphan proteins", that is, they lack homology to known proteins. These hypothetical genes are typically short and randomly scattered throughout the genome. This trend is seen for most of the bacterial and archaeal genomes published to date., Results: In contrast we have found that a large fraction of the genes coding for such orphan proteins in the Methanopyrus kandleri AV19 genome occur within two large regions. These genes have no known homologs except from other M. kandleri genes. However, analysis of their lengths, codon usage, and Ribosomal Binding Site (RBS) sequences shows that they are most likely true protein coding genes and not random open reading frames., Conclusions: Although these regions can be considered as candidates for massive lateral gene transfer, our bioinformatics analysis suggests that this is not the case. We predict many of the organism specific proteins to be transmembrane and belong to protein families that are non-randomly distributed between the regions. Consistent with this, we suggest that the two regions are most likely unrelated, and that they may be integrated plasmids.