Effect of formulations over a Periodic Capacitated Vehicle Routing Problem with multiple depots, heterogeneous fleet, and hard time-windows.

This article presents a novel contribution to the Periodic Vehicle Routing Problem (PVRP) by introducing two new problem formulations which differ in the usage of the crucial flow variable. The formulations are tailored to meet the specific demands of the vending machine industry in Medellín, Colombia, and require considering a PVRP with time windows, a heterogeneous fleet, and multiple depots. This scenario, tailored to address real-world complexity and computational challenges, brings to light an exponential surge in integer variables as customer numbers increase. The research presents an analysis of PVRPs that include the four mentioned attributes, compares their similarities, and delves into their nuances. From the analysis it is derived that the variant of the PVRP presented has not been considered previously, taking into account not only these attributes, but also the restrictions involved. Empirical experiments are conducted to examine the intricate interplay between the two proposed formulations, highlighting their impact on the performance of the GUROBI solver. The study provides valuable insights into problem-specific adaptations and algorithmic approaches, emphasizing the significance of the proposed formulations in addressing multifaceted PVRPs. In essence, this research positions the introduction of these two formulations as a pioneering step, offering a new paradigm for approaching the PVRP.

Fermentation and its effect on the physicochemical and sensory attributes of cocoa beans in the Colombian Amazon.

Cocoa (Theobroma cacao L.) is the basic raw material to produce chocolate and other derivatives such as cocoa butter, cocoa powder and cocoa liquor (cocoa paste), which requires a fermentation process that affects its chemical composition and sensory profile. The objective of this study was to monitor the biochemical, physical and sensory changes during fermentation of cocoa beans in cocoa bean processing plants in the department of Caquetá, Colombia. During fermentation, the temperature of the mass and the pH of the pulp and beans were monitored at the different cocoa bean processing plants (Sites ASOACASAN ASA, COMICACAO CMI, COMCAP COC). Also, at two points during fermentation (days 4 and 7), physical properties of the bean were determined, such as variables related to bromatological composition, polyphenolic compounds and antioxidant activity as sensory attributes at the different sites. An increase in dough temperature was found, however the pH of the cotyledon decreased during the fermentation process and the fat and moisture content varied with fermentation time. At the site level, total polyphenol content (TPC), total flavonoids (TF), 1,1-diphenyl-2-picrylhydrazil (DPPH) and ferric reducing antioxidant power (FRAP) contents were statistically different, with COC being different from the other sites. The TPC was higher at the COC site (507 mg gallic acid equivalent GAE/g Cocoa) with respect to the other sites (< 360 mg GAE/g Cocoa). The TF content followed a similar behavior to TPC, with significant differences between sites and differences between fermentation times for ASA. The TF was higher in COC (309.1 mg catechin/g cocoa) with respect to CMI (215.6 mg catechin/g cocoa) and ASA (185.7 mg catechin/g cocoa). Values in DPPH ranged from 5869.3 to 7781.8 µmol Trolox/g cocoa and for the FRAP assay ranged from 369.8 to 606.7 mg ascorbic acid AA/g cocoa among the sites. It was found that the time and management of the fermentation process has a significant impact on the parameters (biochemical, physical and sensory) of cocoa beans. Therefore, it is necessary to standardize the fermentation process to achieve a quality product that meets the needs of the market.

Breaking Down Silos Within a Multihospital System: Lessons From the California Department of State Hospitals Response to the COVID-19 Pandemic.

The California Department of State Hospitals and Department of Public Health collaborated to develop infection control programs in five inpatient psychiatric hospitals in response to COVID-19. In the retrospective observational study described here, conducted from March 2020 through February 2023, we calculated seven-day rolling averages of COVID-19 cases overlaid with key interventions, communication strategies, and policies implemented to break down silos for a consistent and coordinated response. Our findings may inform others regarding effective strategies and partnerships with public health experts during future outbreaks. (Am J Public Health. Published online ahead of print October 3, 2024:e1-e5. https://doi.org/10.2105/AJPH.2024.307846).

The biogeography of the Amazonian tree flora.

We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Within-plot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central-eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia.

Development and characterization of segment-specific enteroids from the pig small intestine in Matrigel and transwell inserts: insights into susceptibility to porcine epidemic diarrhea Virus.

Introduction: The critical early stages of infection and innate immune responses to porcine epidemic diarrhea virus (PEDV) at the intestinal epithelium remain underexplored due to the limitations of traditional cell culture and animal models. This study aims to establish a porcine enteroid culture model to investigate potential differences in susceptibility to infection across segments of the porcine small intestine (duodenum, jejunum, and ileum). Methods: Intestinal crypt cells from nursery pigs were cultured in Matrigel to differentiate into porcine enteroid monolayer cultures (PEMCs). Following characterization, PEMCs were enzymatically dissociated and subcultured on transwell inserts (PETCs) for apical surface exposure and infection studies. Characterization of region-specific PEMCs and PETCs included assessment of morphology, proliferation, viability, and cellular phenotyping via immunohistochemistry/immunocytochemistry and gene expression analysis. Subsequently, PETCs were inoculated with 105 TCID50 (50% tissue culture infectious dose)/mL of a high pathogenic PEDV non-S INDEL strain and incubated for 24 h. Infection outcomes were assessed by cytopathic effect, PEDV N protein expression (immunofluorescence assay, IFA), and PEDV N-gene detection (quantitative reverse transcription polymerase chain reaction, RT-qPCR). Results: No significant morphological and phenotypical differences were observed among PEMCs and PETCs across intestinal regions, resembling the porcine intestinal epithelium. Although PETCs established from different segments of the small intestine were susceptible to PEDV infection, jejunum-derived PETCs exhibited higher PEDV replication, confirmed by IFA and RT-qPCR. Discussion: This segment-specific enteroid culture model provides a reliable platform for virological studies, offering a controlled environment that overcomes the limitations of in vivo and traditional cell culture methods. Standardizing culture conditions and characterizing the model are essential for advancing enteroid-based infection models.

Effects of a plank-based strength training programme on muscle activation in patients with long COVID: a case series.

BACKGROUND: This study aimed to analyse the effects of a plank-based strength training programme on muscle activation in patients with long COVID. SUBJECTS AND METHODS: Case series study that included patients with long COVID who participated in a 12-week trunk and pelvic muscle strength training programme. Clinical variables and the modified fatigue impact scale (MFIS) were used to assess fatigue levels. Percentage of muscle activation during a core muscle plank was measured via surface electromyography. Pre- and post-intervention results were compared using the Wilcoxon signed-rank test and evaluated with Cohen's D effect size (ES). RESULTS: Twenty-one subjects participated in the study; 81% female, mean age 47.5 years (range: 28-55 years), and median duration of symptoms 21 months (range: 5-24 months); 90.5% of the participants experienced fatigue (MFIS score = 38). Muscle activation during plank exercises improved across all muscles after the intervention, with significant increases in the left (p = 0.011, medium ES) and right external oblique (p =0.039, small ES) muscles and the right latissimus dorsi muscle (p = 0.039, small ES). Additionally, significant reductions in fatigue were observed in the total MFIS score (p = 0.004, medium ES) and in the physical (p < 0.001, large ES) and psychosocial subscales (p = 0.033, small ES). CONCLUSIONS: Results suggest that a plank-based strength training programme may be effective in enhancing trunk and pelvic muscle activation in individuals with long COVID.

The case for eliminating excessive worry as a requirement for generalized anxiety disorder: a cross-national investigation.

BACKGROUND: Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not 'excessive' relative to the context. We carried out the first large-scale, cross-national study to explore the implications of removing this excessiveness requirement. METHODS: Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 criteria for GAD were compared to respondents meeting all criteria for GAD, and to respondents without GAD, on clinically-relevant correlates. RESULTS: Removing the excessiveness requirement increases the global lifetime prevalence of GAD from 2.6% to 4.0%, with larger increases in LMICs than HICs. Non-excessive and excessive GAD cases worry about many of the same things, although non-excessive cases worry more about health/welfare of loved ones, and less about personal or non-specific concerns, than excessive cases. Non-excessive cases closely resemble excessive cases in socio-demographic characteristics, family history of GAD, and risk of temporally secondary comorbidity and suicidality. Although non-excessive cases are less severe on average, they report impairment comparable to excessive cases and often seek treatment for GAD symptoms. CONCLUSIONS: Individuals with non-excessive worry who meet all other DSM-5 criteria for GAD are clinically significant cases. Eliminating the excessiveness requirement would lead to a more defensible GAD diagnosis.

Effect of Lactiplantibacillus plantarum cell-free culture on bacterial pathogens isolated from cystic fibrosis patients: in vitro and in vivo studies.

This study aimed to investigate the effects of the cell-free supernatant of Lactiplantibacillus plantarum ATCC® 10241TM on the biofilm-forming capacity of Pseudomonas aeruginosa strains isolated from cystic fibrosis (CF) patients. In addition, the study evaluated the in vivo potential of the cell-free supernatant to modulate inflammation and reduce lung damage in mice infected with P. aeruginosa strains or co-challenged with P. aeruginosa and the Streptococcus milleri group (SMG). The results showed that CF-derived P. aeruginosa strains can infect the respiratory tract of adult mice, inducing local inflammation and lung damage. The severity of these infections was exacerbated when P. aeruginosa was co-administered with SMG. Notably, nebulization with the cell-free supernatant of L. plantarum produced beneficial effects, reducing respiratory infection severity and inflammatory responses induced by P. aeruginosa, both alone or in combination with SMG. Reduced bacterial loads and lung damage were observed in supernatant-treated mice compared to controls. Although further mechanistic studies are necessary, the results show that the cell-free supernatant of L. plantarum ATCC® 10241TM is an interesting adjuvant alternative to treat P. aeruginosa respiratory infections and superinfections in CF patients.

Spanish Validation of the Brief Pornography Screen Within a Clinical Sample of Individuals with Gambling Disorder.

Problematic pornography use (PPU) shares characteristics with behavioral addictions, such as gambling disorder (GD), and PPU and GD may frequently co-occur. In order to fill existing gaps in screening instruments for PPU validated in GD, the study examined the psychometric properties of the Spanish version of the Brief Pornography Screen (BPS) within a clinical sample of individuals with GD. A total of 200 individuals seeking treatment for GD were consecutively recruited. The psychometric properties of the BPS were examined by performing confirmatory factor analysis (CFA) and testing for evidence of convergent and discriminant validity. The CFA supported a one-factor solution showing high internal consistency (α = 0.81). The BPS showed convergent validity and correlated with psychological distress, general psychopathology, impulsive tendencies, and low self-directedness. The BPS demonstrated adequate psychometric properties and is therefore recommended as a brief screening tool for identifying probable PPU in individuals seeking treatment for GD.

Revascularization and outcomes in ischaemic left ventricular dysfunction after heart failure admission: The RevascHeart study.

AIMS: Despite numerous trials on revascularization in patients with heart failure (HF) and ischaemic left ventricular (LV) dysfunction, its role remains unsettled. Guideline-directed medical therapy (GDMT) for HF has shown benefits on outcomes. This multicentre study aims to compare long-term mortality between revascularization and GDMT in patients with ischaemic LV dysfunction following admission for HF. METHODS AND RESULTS: Between 2012 and 2023, 408 patients admitted for HF with a LV ejection fraction (LVEF) of 40% or less and documented coronary artery disease (CAD) were included. Patients were categorized into two groups based on their initial treatment decision: revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass graft [CABG]) or GDMT. The primary outcome was rate of all-cause or cardiovascular mortality, and secondary outcomes included type of revascularization (PCI vs. CABG) and LV reverse remodelling. After a median 44.6-month follow-up, 100 patients (33%) died in the revascularization group, compared to 44 (43%) in the GDMT group. Multivariate analysis showed no significant benefit of revascularization on all-cause mortality (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.48-1.39, p = 0.45) or cardiovascular mortality (HR 0.97, 95% CI 0.62-1.52, p = 0.90) compared to GDMT. Neither CABG (HR 0.74, 95% CI 0.51-1.08, p = 0.13) nor PCI (HR 0.98, 95% CI 0.62-1.55, p = 0.93) demonstrated a mortality reduction compared to GDMT. Both groups experienced significant reductions in LV size and improvements in LVEF, greater in the revascularization group. CONCLUSION: Revascularization did not outperform GDMT in ischaemic LV dysfunction following HF admission in this retrospective analysis. Larger prospective studies are needed to clarify the potential role of revascularization in improving outcomes.

What over the counter (OTC) products have been evaluated for anxiety in adults aged 18-60? A scoping review.

BACKGROUND: Anxiety symptoms and disorders are common in the UK. Whilst waiting for, or alongside, treatments such as anxiolytics or psychological therapies, people often self-manage anxiety symptoms with products purchased over-the-counter (OTC), such as herbal medicines or dietary supplements. However, the evidence for these products is often presented across different reviews and is not easy for patients or healthcare professionals to compare and understand. AIMS: To determine the nature and size of the evidence base available for these products. METHODS: A scoping review. CENTRAL, MEDLINE, EMBASE, PsycInfo, and AMED (inception-Dec 2022) were searched for RCTs assessing OTC products in people aged 18-60 with symptoms or a diagnosis of anxiety. RESULTS: In total 69 papers assessing a range of products were found, which mostly focussed on kava, lavender, saffron, probiotics, Galphimia glauca and valerian. Studies used varying dosages. Compared to herbal medicine studies, there were much fewer dietary supplement studies and homeopathic remedy studies, despite some of use of these by the general public. CONCLUSION: Future research needs to investigate commonly used but less evaluated products (e.g. chamomile, St John's Wort) and to evaluate products against or alongside conventional treatments to better reflect patient decision making.

Two draft genomes of fungal leaf endophytes from tropical gymnosperms.

Two ascomycetes, Neofusicoccum sp. and Xylaria sp., were isolated from healthy leaves of the tropical gymnosperms Zamia pseudoparasitica (Z2) and Zamia nana (Z50) from Panama. The two draft genomes possess a broad predicted repertoire of carbohydrate-degrading CAZymes, peptidases, and secondary metabolites, with more secondary metabolite clusters in the Xylaria isolate.

Novel Antarctic Endo-Polygalacturonase for Pectin Extraction and Vegetal Tissue Maceration at Mild Temperatures.

The aim of the present work was to partially purify and characterize an Antarctic polygalacturonase and to determine the enzyme's potential in pectin extraction and vegetal maceration at 20 °C. Polygalacturonase was purified by chromatography to obtain an enzymatic preparation of specific activity 30.3 U.mg-1. Optimal conditions for the polygalacturonase activity were 45 °C and pH 5.0-6.0, and the activation energy for the reaction was 41.8 kJ.mol-1. Of the enzyme activity, 100% was retained after 3 h at 40 °C. The enzyme was remarkably stable for an hour over a wide range of pH (2.0-12.0). Polygalacturonase activity was slightly reduced in the presence of Ca+2, Fe+3, K+, Mn+2, and Zn+2, whereas Hg+2 reduced the activity by 60%, suggesting a thiol-dependent catalysis. The apparent molecular weight of the enzyme was 33 kDa. The kinetic constants evaluated against polygalacturonic acid were 0.17 mg.ml-1 (Km), 480 s-1 (Kcat), and 7.9 µmol.mg-1.min-1 (Vmax). The enzyme was active against different pectic substrates. Thin-layer chromatography revealed an endo-mechanism of action. Polygalacturonase digested lime pomace to aid the extraction of high-methoxylated pectin at 20 °C and increased the vegetal maceration of Capsicum annuum by 24% over the control values.

Depression and Anxiety Among US Children and Young Adults.

Importance: Data from surveys show increased mental health disorders in youths. However, little is known about clinical diagnosis over time. Objective: To assess the incidence, prevalence, and changes from 2017 to 2021 for depression and anxiety diagnosed clinically among children, adolescents, and young adults and to identify potential disparities. Design, Setting, and Participants: This cohort study included approximately 1.7 million individuals aged 5 to 22 years in Southern California. Data were extracted from electronic medical records; International Statistical Classification of Diseases, Tenth Revision (ICD-10), codes were used to identify depression and/or anxiety diagnosis for each study year from January 1, 2017, to December 31, 2021. Rates were stratified by age, gender, race and ethnicity, estimated household income, weight status, and comorbidity history. Changes over time and association with these variables were assessed using Poisson regression. Data were analyzed between June 1, 2022, and November 29, 2023. Main Outcomes and Measures: Clinical diagnosis of (1) depression and (2) anxiety without a depression diagnosis using ICD-10 codes. Results: Among the 1.7 million participants, mean (SD) age was approximately 14 (5) years, and 51% were male. In terms of race and ethnicity for each study year, approximately 50% of participants were Hispanic; 8%, non-Hispanic Asian; 8%, non-Hispanic Black; and 23%, non-Hispanic White. From 2017 to 2021, depression diagnosis increased by 55.6% (from 1.35% to 2.10%) for incidence and 60.0% (from 2.55% to 4.08%) for prevalence; anxiety without depression diagnosis increased by 31.1% (from 1.77% to 2.32%) for incidence and 35.2% (from 3.13% to 4.22%) for prevalence (P < .001 for trend). The increases in rates were higher during the COVID-19 pandemic (2020-2021) than before the pandemic (2017-2019), except for depression incidence. Rates increased across all subgroups. Rates were highest for subgroups aged 14 to 17 and 18 to 22 years; female participants; those of non-Hispanic American Indian or Alaska Native, non-Hispanic White, or multiple races or ethnicities; and subgroups with higher household income, obesity (and underweight for anxiety without depression), or comorbidities. Among these factors, age was the most important factor for depression diagnosis, whereas weight status was the most important factor for anxiety without depression diagnosis. Conclusions and Relevance: This cohort study, using electronic medical record data from a large integrated health care system, found an increase in clinically diagnosed depression from 2017 to 2021, with a higher increase during the COVID-19 pandemic and higher rates in some subgroups. Equally important, this study identified high rates and an increase in clinical diagnosis of anxiety without a depression diagnosis. These results support the increased need in public health and health care effort to combat the mental health crisis in youths.

Retos y estrategias en el manejo de la trombosis de la vena porta / Challenges and strategies in the management of portal vein thrombosis

La trombosis de la vena porta (TVP) en pacientes con o sin cirrosis hepática (CH) se define como una obstrucción de la vena porta debido a la formación de un trombo que puede extenderse a las venas mesentéricas superiores y esplénica. Esta es una complicación común de la enfermedad hepática avanzada. Se creía que la TVP se producía predominantemente debido al potencial protrombótico del paciente con CH, ya que se observaba una mayor incidencia de TVP en CH con una puntuación MELD y Child-Pugh más altas, con una prevalencia informada del 10 % al 25%.

Portal vein thrombosis (PVT) in patients with or without hepatic cirrhosis (CH) is defined as an obstruction of the portal vein due to the formation of a thrombus that may extend to the superior mesenteric and splenic veins. This is a common complication of advanced liver disease. It was believed that PVT predominantly occurred due to the prothrombotic potential of the patient with CH, as a higher incidence of PVT was observed in CH with higher MELD and Child-Pugh scores, with a reported prevalence of 10% to 25%.

Melanoma Breslow Thickness Classification using Ensemble-based Knowledge Distillation with Semi-supervised Convolutional Neural Networks.

Melanoma is considered a global public health challenge and is responsible for more than 90% deaths related to skin cancer. Although the diagnosis of early melanoma is the main goal of dermoscopy, the discrimination between dermoscopic images of in situ and invasive melanomas can be a difficult task even for experienced dermatologists. Recent advances in artificial intelligence in the field of medical image analysis show that its application to dermoscopy with the aim of supporting and providing a second opinion to the medical expert could be of great interest. In this work, four datasets from different sources were used to train and evaluate deep learning models on in situ versus invasive melanoma classification and on Breslow thickness prediction. Supervised learning and semi-supervised learning using a multi-teacher ensemble knowledge distillation approach were considered and evaluated using a stratified 5-fold cross-validation scheme. The best models achieved AUCs of 0.6186 ±0.0410 and of 0.7501 ±0.0674 on the former and latter classification tasks, respectively. The best results were obtained using semi-supervised learning, with the best model achieving 0.7751 and 0.8164 AUC, respectively. The results obtained show that semi-supervised learning could improve the performance of trained models in different melanoma classification tasks compared to supervised learning. Automatic deep learning-based diagnosis systems could support medical professionals in their decision, serving as a second opinion or as a triage tool for medical centers.

Prenatal Ultrasound Diagnosis of Unilateral Pulmonary Agenesis.

Pulmonary agenesis (PA) is a rare developmental malformation, with a frequency of approximately 1 in 10-15,000 pregnancies. Unilateral PA is often associated with other congenital anomalies, whereas bilateral PA is fatal. Prenatal diagnosis is rare and is diagnosed more frequently in the postnatal period than in the prenatal period. Is a challenge that may be difficult as it shares similar features with other more common pathologies. Ultrasound plays a crucial role in early diagnosis and management. Ultrasonographic findings for a correct prenatal diagnosis include mediastinum displacement with the absence of parenchymal or cystic tissue, decreased thoracic volume, an elevated diaphragm, cardiac axis deviation, and a hemithoracic cavity largely occupied by the heart. Cases of right PA have a worse prognosis compared to left PA, probably due to higher frequency of cardiac and great vessel abnormalities. A rare case of early prenatal ultrasound diagnosis of unilateral fetal PA, at 18 weeks of gestation, is reported.

Comparative Outcomes of Day-Case Percutaneous Nephrolithotomy vs Conventional Inpatient Surgery: A Systematic Review and Meta-Analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of PCNL performed as a day-case surgery in comparison to inpatient PCNL. METHODS: Databases were searched up to January 27, 2024, for randomized and non-randomized studies comparing outcomes between day case PCNL and inpatient PCNL. Pooled data were analyzed using a Random-Effects (RE) model when Higgins I2% heterogeneity values were >50%; otherwise, a Fixed-Effects model was employed. The results were reported as odds ratios (OR), mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05. RESULTS: One randomized controlled trial (RCT) and fourteen observational studies totaling 1574 patients were included. Pooled results revealed that patients in the day-case PCNL group experienced reduced blood loss (SMD -0.71 95% CI: [-1.31, -0.12] p 0.02) and transfusion rates (OR 0.10 95% CI: [0.03, 0.39], p 0.0008), lower overall and minor complications (OR 0.56, 95% CI: [0.42, 0.76], p 0.0002, and OR 0.52, 95% CI: [0.37, 0-73], p 0.0002, respectively), shorter operative time (MD -11.46, 95% CI: [-17.41, -5-50], p < 0.00001), and reduced total costs (MD -1597.18, 95% CI [-2436.42, -757.93], p 0.0002). Major complications, stone-free rate (SFR), emergency department (ED) visits, and readmission rates were similar between the groups. CONCLUSION: Day-case PCNL is a feasible and safe alternative to inpatient PCNL surgery in carefully selected patients, without increasing the risk of complications or readmission rates, and is likely to reduce total costs.

Depurative capacity toward medium molecules of the dialyzer Toray NV-U® Hydrolink™: A new hydrophilic membrane to perform online hemodiafiltration.

INTRODUCTION: New dialysis membranes with new properties are being developed to improve efficacy and tolerance. The hemocompatibility of a polymeric biomaterial is influenced by the layer of water at the blood membrane interface. The new dialyzer TORAY NV-U® has a membrane Hydrolink™, designed to suppress platelet adhesion and to improve the hemocompatibility. Until now, there is no experience in online hemodiafiltration (OL-HDF).The objective of the present study is to evaluate the efficacy of this new membrane in OL-HDF therapy compared to another membrane commonly used. Other objectives are to evaluate the inflammatory response, hemodynamic tolerance, and the anticoagulation regimes. METHODS: This is a prospective pilot study performed in five anuric patients receiving OL-HDF. For 1 month patients were kept with their usual dialyzer FX1000® (FMC). Subsequently, the dialyzer was changed to TORAY NV-U® (Hydrolink®) for 1 month. In the last dialysis session of each dialyzer, blood tests were performed to evaluate inflammation and depurative capacity. RESULTS: We did not find differences in medium size removal molecules and convective volume: FX1000®: 31 ± 9 l per session and Hydrolink™ 30 ± 8 l; p = 0.7); ß2microglobulin reduction ratio (RR) FX1000® FMC 83 ± 3%; Hydrolink™ 79 ± 4; p = 0.14; Myoglobin RR FX1000® FMC 72 ± 7%; Hydrolink™ 76 ± 4; p = 0.28. We did not find differences in inflammation parameters: serum IL6 with FX1000® 6.0 ± 4.2 pg/mL; Hydrolink™ 7.6 ± 5.0 pg/mL; p = 0.3.During all sessions with the two dialyzers there was adequate plasmatic filling, reaching 85 % filling. All patients had "good" dialyzer status in all dialysis sessions with TORAY NV-U®, while the dialyzer status with FX1000® was "good" in 20% of the sessions, "medium" in 30%, and "dirty" in the remaining 50% dialysis sessions. CONCLUSIONS: The new dialyzer Hydrolink™, TORAY NV-U® is not inferior to perform OL-HDF compared to dialyzers usually used for this therapy, and could allow decrease heparin doses. Further studies with a bigger sample size and longer follow-up will answer if Hydrolink improves inflammation and assess a better hemodynamic tolerance.