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OBJECTIVES: Dysbetalipoproteinemia (DBL) is a combined dyslipidemia associated with an increased risk of atherosclerotic cardiovascular diseases mostly occurring in ε2ε2 subjects and infrequently in subjects with rare APOE variants. Several algorithms have been proposed to screen DBL. In this work, we compared the diagnostic performances of nine algorithms including a new one. METHODS: Patients were divided into 3 groups according to their APOE genotype: ε2ε2 ("ε2ε2", n=49), carriers of rare variants ("APOEmut", n=20) and non-carriers of ε2ε2 nor APOE rare variant ("controls", n=115). The algorithms compared were those from Fredrickson, Sniderman, Boot, Paquette, De Graaf, Sampson, eSampson, Bea and ours, the "Hospices Civils de Lyon (HCL) algorithm". Our gold standard was the presence of a ε2ε2 genotype or of a rare variant associated with triglycerides (TG) >1.7â¯mmol/L. A replication in the UK Biobank and a robustness analysis were performed by considering only subjects with both TG and low-density lipoprotein-cholesterol (LDLc) >90th percentile. RESULTS: Total cholesterol (TC)/ApoB and NHDLC/ApoB are the best ratios to suspect DBL. In ε2ε2, according to their likelihood ratios (LR), the most clinically efficient algorithms were the HCL, Sniderman and De Graaf's. In APOEmut, Sniderman's algorithm exhibited the lowest negative LR (0.07) whereas the HCL's exhibited the highest positive LR (29). In both cohorts, the HCL algorithm had the best LR. CONCLUSIONS: We proposed a powerful algorithm based on ApoB concentration and the routine lipid profile, which performs remarkably well in detecting ε2ε2 or APOE variant-related DBL. Additional studies are needed to further evaluate algorithms performances in DBL carriers of infrequent APOE variants.
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Since 2020, hybrid exhaust gas cleaning systems have been installed on container ships to be in line with the International Maritime Organisation regulations. This technology allows the removal of gaseous sulphur oxide compound before atmospheric rejection of exhaust gas with a concentration lower than 0.1% sulphur equivalent. To be also compliant with water discharge criteria, membrane processes used as a water treatment system have been complementary installed onboard maritime vessels. Objectives of our research are to demonstrate the membrane efficiency and performances for this field of application and their reliability for reaching future regulations. Half industrial scale experiments are first carried out in controlled areas. Results allow optimum parameter definition for a sustainable long-term operation as a permeate flux of 60 L h-1 m-2 and a backwash frequency of 40 min. Experiments are scaled up to onboarded units, and previous settings have been validated. The fleet autonomy for a longer period of closed-loop operation is highlighted. Consequently, the fleet is well prepared and able to overcome new regulation for the future sulphur emission area defined for the Mediterranean Sea in 2025. In addition, the usage of membrane processes allows the reduction of pollutants as suspended solid and heavy metal rejection inside the natural environment with a respective retention higher than 100 and 95%.
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BACKGROUND AND AIMS: Prognosis and management differ between familial chylomicronaemia syndrome (FCS), a rare autosomal recessive disorder, and multifactorial chylomicronaemia syndrome (MCS) or severe mixed hyperlipidaemia. A clinical scoring tool to differentiate these conditions has been devised but not been validated in other populations. The objective of this study was to validate this score in the UK population and identify any additional factors that might improve it. METHODS: A retrospective validation study was conducted using data from 151 patients comprising 75 FCS and 76 MCS patients. All participants had undergone genetic testing for genes implicated in FCS. Validation was performed by standard methods. Additional variables were identified from clinical data by logistic regression analysis. RESULTS: At the recommended FCS score threshold ≥10 points, the sensitivity and specificity of the score in the UK population were 96% and 75%, respectively. The receiver operating characteristic (ROC) curve analysis yielded an area under the curve (AUC) of 0.88 (95% CI 0.83-0.94, p < 0.001). This study identified non-European (predominantly South Asian) ethnicity, parental consanguinity, body mass index (BMI) < 25 kg/m2, and recurrent pancreatitis as additional positive predictors, while BMI >30 kg/m2 was found to be a negative predictor for FCS. However, inclusion of additional FCS predictors had no significant impact on performance of standard FCS score. CONCLUSIONS: Our study validates the FCS score in the UK population to distinguish FCS from MCS. While additional FCS predictors were identified, they did not improve further the score diagnostic performance.
Assuntos
Hiperlipoproteinemia Tipo I , Humanos , Estudos Retrospectivos , Hiperlipoproteinemia Tipo I/diagnóstico , Hiperlipoproteinemia Tipo I/genética , Sensibilidade e Especificidade , Curva ROC , Reino Unido/epidemiologiaAssuntos
Carcinoma Hepatocelular , Heterozigoto , Lipase , Cirrose Hepática , Neoplasias Hepáticas , Proteínas de Membrana , Mutação , Humanos , Proteínas de Membrana/genética , Carcinoma Hepatocelular/genética , Lipase/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Fígado Gorduroso/genética , Masculino , Feminino , Apolipoproteína B-100/genética , Pessoa de Meia-Idade , Aciltransferases , Fosfolipases A2 Independentes de CálcioRESUMO
Stabilized landfill leachates are characterized by a high chemical oxygen demand and limited biodegradability. This study investigates the removal of the organic fraction (chemical oxygen demand and total organic carbon) using a treatment approach that couples membrane processes and wet air oxidation (operating at 200-300 °C and 18 MPa). The aim is to address the challenges posed by landfill leachate membrane concentrates considering variations throughout the year across three different seasons. The efficiency of the treatment path was assessed through the removal of the chemical oxygen demand and total organic carbon, with additional insights provided by fluorescence spectroscopy to evaluate the degradation of the organic compounds' complexity. The most favorable results were achieved at the highest temperature (300 °C) with removals over 90% for total organic carbon and 87% for chemical oxygen demand, along with a complete elimination of fluorescence. The coupling of membrane processes and wet air oxidation has demonstrated its effectiveness in degrading the organic compounds of landfill leachates. The overall mass balance on the treatment path indicates the feasibility of discharging the treated effluent into the environment, meeting regulatory thresholds for total organic carbon and chemical oxygen concentrations.