The effect of adsorbent textural and functional properties on model naphthenic acid adsorption.

Naphthenic acids, NAs, are a major contaminant of concern and a focus of much research around remediation of oil sand process affected waters, OSPW. Using activated carbon adsorbents are an attractive option given their low cost of fabrication and implementation. A deeper evaluation of the effect NA structural differences have on uptake affinity is warranted. Here we provide an in-depth exploration of NA adsorption including many more model NA species than have been assessed previously with evaluation of adsorption kinetics and isotherms at the relevant alkaline pH of OSPW using several different carbon adsorbents with pH buffering to simulate the behaviour of real OSPW. Uptake for the NA varied considerably regardless of the activated carbon used, ranging from 350 mg/g to near zero highlighting recalcitrant NAs. The equilibrium data was explored to identify structural features of these species and key physiochemical properties that influence adsorption. We found that certain NA will be resistant to adsorption when hydrophobic adsorbents are used. Adsorption isotherm modelling helped explore interactions occurring at the interface between NA and adsorbent surfaces. We identified the importance of NA hydrophobicity for activated carbon uptake. Evidence is also presented that indicates favorable hydrogen bonding between certain NA and surface site hydroxyl groups, demonstrating the importance of adsorbent surface functionality for NA uptake. This research highlights the challenges associated with removing NAs from OSPW through adsorption and also identifies how adsorbent surface chemistry modification can be used to increase the removal efficiency of recalcitrant NA species.

Referral Sources Across Racial and Ethnic Groups at Alzheimer's Disease Research Centers.

Background: Despite the need to increase engagement of underrepresented groups (URG) in Alzheimer's disease and related dementias (ADRD) studies, enrollment remains low. Objective: Compare referral sources across racial and ethnic groups among participants enrolled in ADRC studies. Methods: Data for this cross-sectional secondary analysis were extracted from the National Alzheimer's Coordinating Center Uniform Data Set. We performed mixed effects logistic regression models using generalized estimating equations for professional referral versus non-professional referral by racial and ethnic group, adjusted for age, gender, education, visit year, and Clinical Dementia Rating scale (CDR) with a random effect for study site. Results: Included in the analysis were 48,330 participants across 46 ADRCs (mean [SD] age, 71.3 [10.5] years; 20,767 female [57%]; 4,138 Hispanic [8.6%]; 1,392 non-Hispanic Asian [2.9%]; 6,766 non-Hispanic Black [14%] individuals; and 676 individuals [1.4%] of other races. Non-Hispanic Black and Asian participants had lower odds of being referred by a professional contact compared to non-Hispanic White participants (Black: adjusted OR = 0.61, 95% CI = 0.44-0.86, p = 0.005; Asian: adjusted OR = 0.65, 95% CI, p = 0.004). In participants who had completed an MRI, there was no significant difference in referral source across ethnic and racial groups. Conclusions: Further studies are needed to better understand the systemic and structural factors that contribute to differences in referral sources and disparities in recruitment of URG into ADRD studies.

Unlocking the potential of cultivated meat through cell line engineering.

Cultivated meat has the potential to revolutionize food production, but its progress is hindered by fundamental shortcomings of mammalian cells with respect to industrial-scale bioprocesses. Here, we discuss the essential role of cell line engineering in overcoming these limitations, highlighting the balance between the benefits of enhanced cellular traits and the associated regulatory and consumer acceptance challenges. We believe that careful selection of cell engineering strategies, including both genetic and non-genetic modifications, can address this trade-off and is essential to advancing the field.

Impact of the COVID-19 Pandemic on the Incidence, Etiology, Demographics, and Treatment of Craniomaxillofacial Trauma.

OBJECTIVE: To compare the incidence, etiology, demographics, and treatment of craniomaxillofacial (CMF) trauma before, during, and after COVID-19. STUDY DESIGN: Retrospective cohort. SETTING: Eighty-three health care organizations across the United States. METHODS: The TriNetX Research Network identified 77,977,880 patients during 2017 to 2022. CMF fractures and soft tissue injuries during March to August of each year, aligning with the 2020 pandemic lockdown, were analyzed. RESULTS: In 2020, compared to immediately prepandemic in 2019, there were significant reductions of -17.5% in facial fractures and -19.0% in soft tissue injuries (P < .001). Conversely, in 2021, both injury types increased by +16.7% and +16.3%, respectively, compared to 2020 (P < .001). Changes in injury mechanisms in 2020 included significant decreases in athletic injuries (-57.6%), falls (-16.8%), assaults (-15.5%), motor vehicle collisions (-8.7%), and pedestrian accidents (-6.9%) (P < .01), while off-road vehicle (+48.4%), bicycle (+16.2%), and motorcycle (+8.9%) accidents increased (P < .01). The 10- to 14- and 5- to 9-year-old age groups experienced the most substantial reductions in facial fractures (-39.7% and -29.9%, respectively) and soft tissue injuries (-29.2% and -28.3%, respectively) in 2020 compared to 2019 (P < .001). Operative management of fractures and soft tissue injuries dropped by -20.3% and -12.4%, respectively, in 2020 versus 2019, and then rebounded with +15.8% and +14.6% increases in 2021 compared to 2020 (P < .001). In 2022, compared to prepandemic rates of 2019, there were fewer patients with facial fractures (-2.8%), soft tissue injuries (-4.5%), and operative repairs (-6.9% for fractures, -1.2% for soft tissue injuries) (P < .03). CONCLUSION: CMF trauma decreased in 2020, with subsequent years showing a rebound to levels slightly below those immediately prior to pandemic onset. Changes in etiology, demographics, and treatment highlight the complex dynamics of traumatic injuries during periods of societal disruption.

Revisiting Preaddiction.

ABSTRACT: The directors of the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism have proposed new efforts to enable earlier identification and intervention for harmful substance use and its consequences. As editors of The ASAM Principles of Addiction Medicine, we fully support this goal. The word "preaddiction" has been suggested as a diagnostic label to describe individuals who would be targeted for early intervention. In this commentary, we offer that "unhealthy substance use" would be a better descriptor than "preaddiction" and review several potential barriers to be addressed in order to maximize the impact of introducing this new paradigm.

Roles and responsibilities of participants, researchers, and the media in the communication of vaccine trials: Experience from the United Kingdom's first COVID-19 vaccine trial.

BACKGROUND: The media have played an important part in presenting arguments for and against vaccination. The potential for the media to influence public attitudes to vaccines is becoming increasingly crucial to address. METHODS: To understand the differing roles and responsibilities in the communication of vaccine trials we draw insight from a retrospective study of 349 survey responses and 102 semi-structured interviews conducted in 2020 with participants in the United Kingdom's first-in-human clinical trial of the Oxford-AstraZeneca COVID-19 vaccine. RESULTS: We found that trial participants had mixed views as to whether their participation conferred responsibility to communicate more widely about their trial experiences. Some participants perceived themselves to have an altruistic obligation to communicate to the media about the trial, and others felt that those who did share their participation had 'attention-seeking' motives. When participants did speak out they preferred to do so anonymously. Frustration was also reported with sensationalised and false media stories. Social media was viewed as a means to accelerate misinformation or as a force for recruitment and public education about trials. Participants were pleased to see trial investigators and trial team playing prominent roles in the media and this instilled confidence in the vaccine and the trial. We discuss these evolving roles and responsibilities for trial communication, concentrating on the views of participants about experiences, opportunities, and risks. CONCLUSIONS: We argue that the pandemic has demonstrated the need for clinical trials to be made more transparent as a scientific practice that requires better public understanding and engagement. For high-profile vaccine trials we recommend; (1) explicit and comprehensive guidance aimed at all participants for interactions with the media; (2) prioritising having open and effectively expressed accounts of trial composition, processes, and participation; (3) offering support and a direct communication channel for journalists to report trials by utilising internal press officers to engage with journalists.

Quantifying the relative importance of agricultural land use as a predictor of catchment nitrogen and phosphorus concentrations.

Agriculture is a major source of nitrogen (N) and phosphorus (P) in freshwater ecosystems, and different management strategies exist to reduce farmland nutrient losses and thus mitigate freshwater eutrophication. The importance of agricultural sources of N and P as drivers of water quality is known to vary spatially, but quantification of the relative importance of the nutrient sources shaping this variability remains challenging, especially with reference to inputs from waste water treatment works. Addressing this knowledge gap is key for targeting management strategies to where they are likely to have the greatest effect. To advance our understanding in this area, this study assesses the impact of population density as a driver of the relative importance of agricultural land use for predicting mean Total Oxidised Nitrogen (TON) and Reactive Phosphorus (RP) concentrations in rivers in England, using two different data-driven, statistical approaches: a generalised linear model and random forest. Our results show that agricultural N and P sources dominate in catchments with low population density, where stream water concentrations are lower and waste water treatment works are numerous, but smaller in terms of the population equivalent served. Agricultural N and P sources are not important predictors of N and P in catchments with high population density, where contributions from waste water treatment works dominate. These results require cautious interpretation, as model validation outcomes show that high TON and RP concentrations are consistently underpredicted. Altogether, our results suggest that the relative contribution of agricultural sources may be overestimated in densely populated catchments, relative to point sources from waste water treatment works, and that management strategies to reduce the contribution of agriculture to N and P in rivers may be better targeted towards catchments with lower population density, as this is where agricultural land use is the primary source of N and P.

Inflammatory Gene Expression in Livers Undergoing Ex Situ Normothermic Perfusion Is Attenuated by Leukocyte Removal From the Perfusate.

BACKGROUND: Ex situ normothermic perfusion (ESNP) is a method to evaluate and potentially recondition organs before transplantation. However, increased expression of inflammatory molecules, including by tissue-resident immune cells, may occur during the perfusion process, potentially negating the beneficial effects of perfusion. METHODS: We used RNA sequencing to assess gene expression in 31 livers undergoing ESNP, including 23 donated after circulatory death (DCD) and 8 donated after brain death. In 7 DCD livers, a leucocyte filter was added to the circuit during perfusion. Biopsies were available for transcriptomic assessment in all cases at the start of perfusion and at varying time points postperfusion. RESULTS: During ESNP in DCD livers, we observed an increase in proinflammatory, profibrinolytic, and prorepair pathway genes. SERPINE1, encoding plasminogen activator inhibitor-1, was among the genes most significantly upregulated during perfusion in DCD livers, potentially promoting fibrin clot persistence in vasculature. We also found increased expression of monocyte and neutrophil recruiting chemokine and proinflammatory cytokine transcripts during ESNP, but several prorepair molecules, including thymic stromal lymphopoietin, were also upregulated. In both DCD and donation after brain death livers, interferon-gamma response genes were enriched, whereas oxidative phosphorylation genes decreased in organs with high perfusate alanine transaminase, a biomarker associated with adverse clinical outcomes. The inclusion of a leukocyte filter in the perfusion circuit mitigated the induction of inflammation/immune pathway genes during perfusion and was associated with enrichment in oxidative phosphorylation genes. CONCLUSIONS: Leukocyte removal during ESNP abrogates transcriptional changes that are associated with unfavorable clinical outcomes, potentially benefiting human livers undergoing ESNP.

Lymphedema: Current Strategies for Diagnostics and Management.

ABSTRACT: Lymphedema (LE) is characterized by the accumulation of lymph in the extremities, impairing functionality and quality of life. Despite its prevalence, accurate diagnoses and management remains complex because of inconsistencies in diagnostic criteria and limited epidemiological studies. This review aims to address this gap by providing a comprehensive overview of LE classifications, diagnostic approaches, and current management strategies. By synthesizing existing knowledge, this study seeks to contribute to a deeper understanding of LE for improvement of clinical consistency and education.

Tethered cord prevalence among patients with prenatal or postnatal myelomeningocele repair.

BACKGROUND: Myelomeningocele (MMC) is a severe form of spina bifida characterized by spinal cord extrusion into a cerebrospinal fluid (CSF) filled sac which may lead to lifelong disability. Repair of these lesions have classically occurred shortly after birth, but more recently, prenatal myelomeningocele repair techniques have been elucidated. This study aimed to investigate the outcome of surgery, particularly with subsequent spinal cord tethering, in patients with prenatal myelomeningocele closure and those with postnatal repair surgery. MATERIALS AND METHODS: In this retrospective study which assessed patients from April 2002 to April 2020, the data of 18 total patients with MMC were reviewed. Nine patients from each group were included, closed prenatally or postnatally, respectively. Demographic information including age and sex, birth week, infant comorbidities, presence of dermoid or lipoma, cutaneous stigmata, total number and timing of detethering procedures, presence of Chiari malformation, and need for VPS was obtained. RESULTS: Eighteen patients including nine infants closed prenatally and nine infants with myelomeningoceles closed postnatally were reviewed. The mean age was 4 ± 3 years and 6.22 ± 2.4 in prenatal and postnatal retrospectively. There was a significant relationship between the number of detethering procedures (p-value = 0.03) and the need for a ventriculoperitoneal shunt (VPS) (p-value = 0.01) between the groups, with the prenatal closure group having lower rates of each. There was no significant difference between the groups in regard to the mean age at the detethering procedure (p = 0.4), sex (p = 0.09), birth week (p = 0.8), comorbidities (p = 0.8), presence of intraspinal dermoid or lipoma (p = 0.09), presence of cutaneous stigma (p = 0.08), Chiari (p = 0.6), fatty filum (p = 0.08), syrinx (p = 0.4), bone anomaly (p = 0.4), and spina bifida neurological scale (p = 0.66). CONCLUSION: There was a significant relationship between the two groups in terms of the number of detethering procedures, and the need for VPS. Our data represents a possible difference in the need for detethering surgeries and ventriculoperitoneal shunt placements between patients with prenatal and postnatal myelomeningocele closures.