Eco-efficiency evaluation in wastewater treatment plants considering greenhouse gas emissions through the data envelopment analysis-tolerance model.

The eco-efficiency evaluation in wastewater treatment plants (WWTPs) is used to know and improve the environmental and economic efficiency of these processes, systems, products, and services. The eco-efficiency evaluations in WWTP contemplate the inputs to be minimized, the desirable results to be maximized, and the undesired results to be minimized. Data envelopment analysis (DEA) is a widely used method to evaluate the eco-efficiency of WWTPs; integrating several approaches in a single index, traditional DEA models do not take into account the uncertainty in the data. This study evaluates the eco-efficiency of a sample of Catalan WWTPs, considering the uncertainty of the data (DEA tolerance model), and it is for the first time that together with CO2, other greenhouse gas (GHG) such as CH4 and N2O are considered as part of the process outputs. GHG emissions were quantified using methods reported in the literature. Seven hundred twenty-nine eco-efficiency scores were estimated for each WWTP instead of a single score like conventional DEA models, analyzing optimistic and pessimistic scenarios. The WWTPs were classified according to the estimated eco-efficiency scores, accounting for the uncertainty in each of the scenarios, and demonstrating the changes in the performance of the WWTPs in the different scenarios. Only two WWTPs were eco-efficient in all the scenarios evaluated. This approach provides essential information to improve efficiency and innovation in the wastewater sector.

Towards an in situ, full-power gauge of the focal-volume intensity of petawatt-class lasers.

About 50 years ago, Sarachick and Schappert [Phys. Rev. D. 1, 2738-2752 (1970)] showed that relativistic Thomson scattering leads to wavelength shifts that are proportional to the laser intensity. About 28 years later, Chen et al. [Nature 396, 653-655 (1998)] used these shifts to estimate their laser intensity near 1018 W/cm 2. More recently, there have been several theoretical studies aimed at exploiting nonlinear Thomson scattering as a tool for direct measurement of intensities well into the relativistic regime. We present the first quantitative study of this approach for intensities between 1018 and 1019 W/cm 2. We show that the spectral shifts are in reasonable agreement with estimates of the peak intensity extracted from images of the focal area obtained at reduced power. Finally, we discuss the viability of the approach, its range of usefulness and how it might be extended to gauge intensities well in excess of 1019 W/cm 2.

Trajectories of attention-deficit/hyperactivity disorder dimensions in adults.

OBJECTIVE: There is a lack of available information on the trajectories of attention-deficit/hyperactivity disorder (ADHD) dimensions during adulthood. This study investigates the course and the predictors of change for each ADHD domain in a clinical sample of adults with ADHD. METHOD: Adults with ADHD (n = 344) were followed up for 7 years, with a final retention rate of 66.0%. Trajectories of inattention, hyperactivity, and impulsivity and their potential predictors were examined. RESULTS: On average, symptoms declined in all ADHD domains during follow-up. Despite this, rises in inattentive, hyperactive, and impulsive symptoms were observed in approximately 13%, 25%, and 17% of patients respectively. Different predictors influenced the trajectory of each ADHD dimension. Oppositional defiant disorder and social phobia were associated with the maintenance of symptoms, while alcohol use disorder was associated with both maintenance and rise of symptoms. CONCLUSION: Unexpectedly, a rise in the symptoms after 7 years was not uncommon in adults with ADHD. Prevalent comorbidities have the potential to influence the neurodevelopment and the trajectory of ADHD. Therefore, such predictors should be investigated in population cohorts to better characterize the course of ADHD. Additionally, these findings may be relevant in prevention studies and in strategies for ADHD treatment.

Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study.

BACKGROUND: Course and predictors of persistence of attention deficit hyperactivity disorder (ADHD) in adults are still largely unknown. Neurobiological and clinical differences between child and adult ADHD raise the need for follow-up studies of patients diagnosed during adulthood. This study investigates predictors of ADHD persistence and the possibility of full remission 7 years after baseline assessment. METHOD: A 7-year follow-up study of adults with ADHD (n = 344, mean age 34.1 years, 49.9% males) was conducted. Variables from different domains (social demographics, co-morbidities, temperament, medication status, ADHD measures) were explored with the aim of finding potential predictors of ADHD persistence. RESULTS: Retention rate was 66% (n = 227). Approximately a third of the sample (n = 70, 30.2%) did not maintain ADHD criteria and 28 (12.4%) presented full remission (<4 symptoms), independently of changes in co-morbidity or cognitive demand profiles. Baseline predictors of diagnostic persistence were higher number of inattention symptoms [odds ratio (OR) 8.05, 95% confidence interval (CI) 2.54-25.45, p < 0.001], number of hyperactivity/impulsivity symptoms (OR 1.18, 95% CI 1.04-1.34, p = 0.01), oppositional defiant disorder (OR 3.12, 95% CI 1.20-8.11, p = 0.02), and social phobia (OR 3.59, 95% CI 1.12-11.47, p = 0.03). CONCLUSIONS: Despite the stage of brain maturation in adults suggests stability, approximately one third of the sample did not keep full DSM-IV diagnosis at follow-up, regardless if at early, middle or older adulthood. Although full remission is less common than in childhood, it should be considered as a possible outcome among adults.

Antibacterial activity and biocompatibility of three-dimensional nanostructured porous granules of hydroxyapatite and zinc oxide nanoparticles--an in vitro and in vivo study.

Ceramic scaffolds are widely studied in the bone tissue engineering field due to their potential in regenerative medicine. However, adhesion of microorganisms on biomaterials with subsequent formation of antibiotic-resistant biofilms is a critical factor in implant-related infections. Therefore, new strategies are needed to address this problem. In the present study, three-dimensional and interconnected porous granules of nanostructured hydroxyapatite (nanoHA) incorporated with different amounts of zinc oxide (ZnO) nanoparticles were produced using a simple polymer sponge replication method. As in vitro experiments, granules were exposed to Staphylococcus aureus and Staphylococcus epidermidis and, after 24 h, the planktonic and sessile populations were assessed. Cytocompatibility towards osteoblast-like cells (MG63 cell line) was also evaluated for a period of 1 and 3 days, through resazurin assay and imaging flow cytometry analysis. As in vivo experiments, nanoHA porous granules with and without ZnO nanoparticles were implanted into the subcutaneous tissue in rats and their inflammatory response after 3, 7 and 30 days was examined, as well as their antibacterial activity after 1 and 3 days of S. aureus inoculation. The developed composites proved to be especially effective at reducing bacterial activity in vitro and in vivo for a weight percentage of 2% ZnO, with a low cell growth inhibition in vitro and no differences in the connective tissue growth and inflammatory response in vivo. Altogether, these results suggest that nanoHA-ZnO porous granules have a great potential to be used in orthopaedic and dental applications as a template for bone regeneration and, simultaneously, to restrain biomaterial-associated infections.

Carriage of virulence factors and molecular characteristics of Staphylococcus aureus isolates associated with bloodstream, and skin and soft tissue infections in children.

We investigated the virulence gene carriage and molecular type characteristics of Staphylococcus aureus isolates from bloodstream infections (BSIs) and skin and soft tissue infections (SSTIs) in children. A total of 71 isolates, 16 of which were methicillin-resistant S. aureus (MRSA), were investigated by PCR for virulence-associated gene profiles, sequence type and spa type. This revealed that 76.7% and 53.7% of the SSTI and BSI isolates, respectively, exhibited simultaneous carriage of o10 virulence genes. Compared to BSI isolates, carriage rates for hla, hlb, cna, clfA, seb, sec and pvl genes were significantly higher in SSTI isolates. By contrast, carriage of eta, etb and sea was significantly higher for BSI isolates. Thirty-four sequence types (STs) and 36 spa types were identified in the 71 isolates and included 14 novel STs and four novel spa types. ST59-MRSA-IV/V-t437 was the most common clone in the MRSA isolates. We concluded that virulence determinants are widely distributed in isolates of S. aureus strains from children with BSIs and SSTIs, with an unexpectedly high rate in SSTI isolates. Future profiling of S. aureus virulence determinants may allow the prediction of severity and outcome for children with these infections.

Study of candidate genes for dyslexia in Brazilian individuals.

Dyslexia or reading disability (RD) is the most common childhood learning disorder and a significantly heritable trait. Many recent studies have investigated the genetic basis of dyslexia, and several candidate genes have been proposed. Among these, DCDC2 and KIAA0319 have emerged as the strongest candidate genes for dyslexia; however studies have not provided uniformly supportive results. The aim of this study was to assess the contribution of proposed candidate genes to the molecular etiology of dyslexia in a Brazilian sample. Large deletions and duplications in the candidate genes DCDC2, KIAA0319, and ROBO1 were investigated in 51 dyslexic subjects. Furthermore, a family-based association study was performed to investigate whether associations observed in other populations with variants in the DCDC2 and KIAA0319 genes were reproducible in Brazilian dyslexic individuals. Our analysis did not detect any deletions or duplications in the genes studied, and we found no evidence that the allelic variants in the two candidate genes were significantly associated with RD in our sample. Our data do not support a role of the DCDC2/KIAA0319 locus in influencing dyslexia as a categorical trait. Given the genetic complexity of dyslexia, it is plausible that both genes contribute to an increased risk, but the relative influence of these 2 genes on RD varies in different study samples, and/or depends on analytical approaches.

Genetic parameters for birthweight environmental variability in mice.

Data from a divergent experiment for birthweight (BrW) environmental variability were used to estimate genetic parameters for BrW trait and its environmental variability by fitting both homoscedastic (HO) and heteroscedastic (HE) models. A total of 5 475 records of BrW from animals born from inbred dams, and 7 140 pedigree records were used. The heritability of BrW using the model HO was 0.27, with the litter effect much more important, 0.43. The model HE provided a genetic correlation between the trait and its environmental variability that was very high and negative, -0.97, and a high value for the additive genetic variance for environmental variability, suggesting an artefact in the model. The residual skewness was found to be essentially null. A model considering the genetic correlation null was also fitted, and used to obtain the breeding values for the selection process. Moreover, the trait was considered as maternal resulting in similar estimates under the model HO, but more reasonable for the genetic correlation between the trait and its environmental variability of 0.48 with a value of 0.25 for the additive genetic variance regarding environmental variability under the model HE. This led to the conclusion that environmental variability of BrW in mice must be selected via dams. Estimated parameters in a reduced dataset without inbred animals did not substantially change this conclusion.

[Hibernoma and cervical rib: two rare diseases, the same manifestation]. / Hibernoma y costilla cervical: dos enfermedades raras, la misma manifestación.

The hibernoma is a rare benign tumor of soft tissue, derived from remnants of fetal brown adipose tissue. A cervical rib is a supernumerary or accessory rib derived from the 7th cervical vertebra. CLINCAL CASE: 2-year-old girl, previously healthy, referenced to Pediatrics consultation, for left supraclavicular mass. No history of infectious diseases or systemic symptoms. At exam presented mass in supraclavicular left region, 1.5 to 2 cm in diameter, hard, mobile, non-adherent to the deep planes. Laboratory tests exclude an infectious or lymphoproliferative disease. In cervical radiograph we observed bilateral cervical ribs. Cervical ultrasound revealed calcified nodule 0.8 cm, compatible with calcified adenopathy. Biopsy was performed and histology revealed a hibernoma, which was completely removed surgically. This case illustrates the association of two diagnoses, uncommon in children. These were made during the investigation of lymphadenopathies, a frequent reason for pediatrics consultation.

Preload dependence of gated cardiac SPECT-derived ventricular volumes in hemodialysis patients.

BACKGROUND: In hemodialysis (HD) patients, the intravascular volume expansion of the pre-HD state leads to a high preload. We aim to examine its effect on myocardial perfusion gated SPECT (MPGS)-derived left ventricular (LV) volumes. METHODS: The study comprised 50 end-stage renal disease (ESRD) patients on HD with normal 2-day stress/rest MPGS performed for kidney transplantation risk assessment. Patients (pts) comprised 23 men/27 women, with mean age of 59.4 ± 7.1 years. The time elapsed from the last HD session in hours was calculated on both days, and patients were classified according to whether it was higher (group A: 19 pts), lower (group B: 27 pts), or equal (group C: 4 pts) on the stress vs the rest day. End-diastolic, end-systolic volumes (EDV, ESV), and left ventricular ejection fraction (LVEF) were determined using QGS™ software. Transient ischemic dilation (TID) ratios were derived from the nongated images using QPS™ software. RESULTS: Volumes were significantly higher at stress in group A, at rest in group B, and similar in group C. TID ratios were significantly higher in group A vs groups B and C. CONCLUSIONS: MPGS-derived ventricular volumes are preload dependent. The high preload of the pre-HD state may mimic ischemic TID if occurring on the stress day and create confusion if coinciding with the rest day.

[Intranodal myofibroblastoma: a case report]. / Miofibroblastoma intraganglionar: a propósito de un caso.

INTRODUCTION: Myofibroblastomas are part of the heterogeneous group of myofibroblastic tumours, having first been described in 1989. They may be malignant or present a benign behaviour. Clinically they appear as a painless progressively growing mass in the soft tissue. CASE REPORT: A 12-year-old female teenager was referred to our hospital with a 1-year history of a painless growing mass in the inguinal region. A surgical excision was performed; its histological study revealed a proliferation of spindle cells arrayed in a fascicular pattern and with nuclear palisading, occupying the lymph nodes. Immunohistochemichal analysis demonstrated reactivity for vimentin, focally positive for CD34 and smooth muscle actin. She was then diagnosed with intranodal myofibroblastoma. Two years after the surgical excision there was a local recurrence followed by another resection. There have been no new recurrences 3 years after the second intervention. CONCLUSION: The intranodal myofibroblastoma is a rare benign mesenchymal neoplasm, without known pediatric cases and presenting differential diagnosis with other soft tissue tumours. Immunohistochemical studies are essential to establish its myofibroblastic nature.

Use of gamma radiation and artificial neural network techniques to monitor characteristics of polyduct transport of petroleum by-products.

This study presents a methodology based on the dual-mode gamma densitometry technique in combination with artificial neural networks to simultaneously determine type and quantity of four different fluids (Gasoline, Glycerol, Kerosene and Fuel Oil) to assist operators of a fluid transport system in pipelines commonly found in the petrochemical industry, as it is necessary to continuously monitor information about the fluids being transferred. The detection system is composed of a 661.657 keV (137Cs) gamma-ray emitting source and two NaI(Tl) scintillation detectors to record transmitted and scattered photons. The information recorded in both detectors was directly applied as input data for the artificial neural networks. The proposed intelligent system consists of three artificial neural networks capable of predicting the fluid volume percentages (purity level) with 94.6% of all data with errors less than 5% and MRE of 1.12%, as well as identifying the pair of fluids moving in the pipeline with 95.9% accuracy.

Restricting inbreeding while maintaining selection response for weight gain in Mus musculus.

An experiment with mice was designed to test the relative efficiency of three selection methods that help to minimize the rate of inbreeding during selection. A common house mice (Mus musculus) population was selected for 17 generations to increase the weight gain between 21 and 42 days. The population was split at random into three lines A, B and C where three selection methods were applied: individual selection and random mating, weighted selection with random mating and individual selection with minimum coancestry mating, respectively. There were three replicates for each line. Cumulated selection response was similar in the three lines, but there were differences in the level of inbreeding attained (in percentage): 31.24 (method A), 24.72 (method B) and 27.88 (method C). As consequence, lines B and C (weighted selection and minimum coancestry) showed a lower value of deterioration of fitness traits (the intrauterine mortality and the mortality at birth) than line A (random mating).

[Sudden abdominal pain...is it a surprise? Necrosis of an ectopic spleen]. / Súlbito dolor abdominal...¿una sorpresa? Necrosis de un bazo ectópico.

An ectopic/wandering spleen is rare in children. It results from the absence or laxity of the supporting ligaments which may cause torsion of the splenic pedicle with subsequent infarction. We present a case of a six-year-old girl, with history of onphalocele, dextrocardia and ectopic spleen (incidentally discovered three years ago as an abdominal mass on physical examination), with acute abdominal pain and signs of peritoneal irritation. Sonography showed an enlarged ectopic spleen in the pelvis. Computed tomography scan did not enable visualization of the spleen and allowed the identification of a pelvic mass without uptake of intravenous contrast. Splenectomy was performed due to splenic infarction. In the presence of a wandering spleen, even if asymptomatic, splenopexy may be performed to minimize complications, and together with acute abdominal pain, torsion of splenic pedicle may be considered.

Optimization of a flow regime identification system and prediction of volume fractions in three-phase systems using gamma-rays and artificial neural network.

This study presents a method based on gamma-ray densitometry using only one multilayer perceptron artificial neural network (ANN) to identify flow regime and predict volume fraction of gas, water, and oil in multiphase flow, simultaneously, making the prediction independent of the flow regime. Two NaI(Tl) detectors to record the transmission and scattering beams and a source with two gamma-ray energies comprise the detection geometry. The spectra of gamma-ray recorded by both detectors were chosen as ANN input data. Stratified, homogeneous, and annular flow regimes with (5 to 95%) various volume fractions were simulated by the MCNP6 code, in order to obtain an adequate data set for training and assessing the generalization capacity of ANN. All three regimes were correctly distinguished for 98% of the investigated patterns and the volume fraction in multiphase systems was predicted with a relative error of less than 5% for the gas and water phases.

Risks for methicillin-resistant Staphylococcus aureus colonization or infection among patients with HIV infection.

BACKGROUND: Risks for methicillin-resistant Staphylococcus aureus (MRSA) among those with HIV infection have been found to vary, and the epidemiology of USA-300 community-acquired (CA) MRSA has not been adequately described. METHODS: We conducted a retrospective review of HIV-infected out-patients from January 2002 to December 2007 and employed multivariate logistic regression (MLR) to identify risks for MRSA colonization or infection. Pulsed-field gel electrophoresis (PFGE) was used to identify USA-300 strains. RESULTS: Seventy-two (8%) of 900 HIV-infected patients were colonized or infected with MRSA. MLR identified antibiotic exposure within the past year [odds ratio (OR) 3.4; 95% confidence interval (CI) 1.5-7.7] and nadir CD4 count <200 cells/microL (OR 2.5; 95% CI 1.2-5.3) as risks for MRSA colonization or infection. Receipt of antiretroviral therapy (ART) within the past year was associated with decreased risk (OR 0.16; 95% CI 0.07-0.4). Eighty-nine percent of available strains were USA-300. MLR identified skin or soft tissue infection (SSTI) as the only predictor for infection with USA-300 (OR 5.9; 95% CI 1.4-24.3). CONCLUSION: Significant risks for MRSA among HIV-infected patients were CD4 count nadir <200 cells/microL and antibiotic exposure. Only the presence of an SSTI was associated with having USA-300, and thus the use of patient characteristics to predict those with USA-300 was limited. In addition, ART within the previous year significantly reduced the risk of MRSA colonization or infection.

The association between antibiotic use and resistance: the role of secondary antibiotics.

Using susceptibility rates of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae over time as markers, we assessed the significance of the change of susceptibility rates to imipenem, ceftriaxone, cefepime, piperacillin/tazobactam, and ciprofloxacin over time and the relationship to antibiotic use for the period 2000-2006. Antibiotic use-susceptibility relationships were assessed using longitudinal regression analysis. The variables "time" and define daily doses (DDD)/1,000 patient days for the specific drug related to the susceptibility rates of that particular model's dependent variable were considered as the main effects, with significance determined at the 0.05 level. Decreases in susceptibility of the target organisms were common over the period of observation. Decreasing susceptibility trends over time were not statistically associated with the primary drug (e.g., organism susceptibility rate to imipenem with imipenem usage). However, secondary drug use was associated with susceptibility rates (e.g., susceptibility of E. cloacae to cefepime with piperacillin/tazobactam usage). These results suggest that antibiotic use-resistance relationships are influenced by the use of secondary antibiotics. Thus, a resistance problem may not be adequately addressed by simply altering the utilization of the primary antibiotic.

Geographical information systems and tropical medicine.

In terms of their applicability to the field of tropical medicine, geographical information systems (GIS) have developed enormously in the last two decades. This article reviews some of the pertinent and representative applications of GIS, including the use of such systems and remote sensing for the mapping of Chagas disease and human helminthiases, the use of GIS in vaccine trials, and the global applications of GIS for health-information management, disease epidemiology, and pandemic planning. The future use of GIS as a decision-making tool and some barriers to the widespread implementation of such systems in developing settings are also discussed.

[Quantitative salivary gland scintigraphy in head and neck cancer patients following radiotherapy]. / Gammagrafía salival cuantitativa en pacientes con cáncer de cabeza y cuello tratados con radioterapia.

OBJECTIVE: To assess the role of quantitative salivary gland scintigraphy (SGS) in the detection of functional impairment of salivary glands in patients with head and neck cancer treated with radiotherapy (RT). MATERIAL AND METHODS: We studied 19 patients (17 men), mean age 62.4 years (44-75). Three studies were performed to each patient: baseline, 3 and 18 months after RT. SGS was acquired for 25 minutes following injection of 3.7 MBq/kg of (99m)Tc-pertechnetate with lemon juice at the end of minute 15. Excretion fraction (EF), counts per minute/pixel/MBq (CMPM) and uptake percentage were obtained from time-activity curves from ROIs placed over parotid (PG) and submandibular glands (SMG) and related to the doses received by the PG. RESULTS: EF showed a significant reduction from the baseline to the 3 months study (p<0.001) for the PG and SMG and from the baseline to the 18 months study for the SMG (p<0.001). A significant improvement of EF was seen from the 3 months to the 18 months study for the PG (p<0.05). CMPM did not change significantly from the baseline to the 3 months and 18 months studies for the PG and showed a significant reduction (p<0.01) for the SMG from the baseline to 18 months study. The uptake percentage did not change significantly between studies. A moderate association was observed between the doses to PG and the 3m study parameters. CONCLUSIONS: EF was more sensitive than uptake in assessing post-RT impairment of salivary function. In addition, it reflected functional recovery of parotid glands over time.