Phytoremediation of metals in oil sands process affected water by native wetland species.

Process affected water and other industrial wastewaters are a major environmental concern. During oil sands mining, large amounts of oil sands process affected water (OSPW) are generated and stored in ponds until reclaimed and ready for surface water discharge. While much research has focused on organics in process waters, trace metals at high concentrations may also pose environmental risks. Phytoremediation is a cost effective and sustainable approach that employs plants to extract and reduce contaminants in water. The research was undertaken in mesocosm scale constructed wetlands with plants exposed to OSPW for 60 days. The objective was to screen seven native emergent wetland species for their ability to tolerate high metal concentrations (arsenic, cadmium, copper, chromium, copper, nickel, selenium, zinc), and then to evaluate the best performing species for OSPW phytoremediation. All native plant species, except Glyceria grandis, tolerated and grew in OSPW. Carex aquatilis (water sedge), Juncus balticus (baltic rush), and Typha latifolia (cattail) had highest survival and growth, and had high metal removal efficiencies for arsenic (81-87 %), chromium (78-86 %), and cadmium (74-84 %), relative to other metals; and greater than 91 % of the dissolved portions were removed. The native plant species were efficient accumulators of all metals, as demonstrated by high root and shoot bioaccumulation factors; root accumulation was greater than shoot accumulation. Translocation factor values were greater than one for Juncus balticus (chromium, zinc) and Carex aquatilis (cadmium, chromium, cobalt, nickel). The results demonstrate the potential suitability of these species for phytoremediation of a number of metals of concern and could provide an effective and environmentally sound remediation approach for wastewaters.

A deep learning system for quantitative assessment of microvascular abnormalities in nailfold capillary images.

OBJECTIVES: Nailfold capillaroscopy is key to timely diagnosis of SSc, but is often not used in rheumatology clinics because the images are difficult to interpret. We aimed to develop and validate a fully automated image analysis system to fill this gap. METHODS: We mimicked the image interpretation strategies of SSc experts, using deep learning networks to detect each capillary in the distal row of vessels and make morphological measurements. We combined measurements from multiple fingers to give a subject-level probability of SSc.We trained the system using high-resolution images from 111 subjects (group A) and tested on images from subjects not in the training set: 132 imaged at high-resolution (group B); 66 imaged with a low-cost digital microscope (group C). Roughly half of each group had confirmed SSc, and half were healthy controls or had primary RP ('normal'). We also estimated the performance of SSc experts. RESULTS: We compared automated SSc probabilities with the known clinical status of patients (SSc versus 'normal'), generating receiver operating characteristic curves (ROCs). For group B, the area under the ROC (AUC) was 97% (94-99%) [median (90% CI)], with equal sensitivity/specificity 91% (86-95%). For group C, the AUC was 95% (88-99%), with equal sensitivity/specificity 89% (82-95%). SSc expert consensus achieved sensitivity 82% and specificity 73%. CONCLUSION: Fully automated analysis using deep learning can achieve diagnostic performance at least as good as SSc experts, and is sufficiently robust to work with low-cost digital microscope images.

Nailfold capillaroscopy: a survey of current UK practice and 'next steps' to increase uptake among rheumatologists.

OBJECTIVES: To identify barriers to the use of nailfold capillaroscopy as a diagnostic tool for patients presenting with Raynaud's phenomenon in UK rheumatology centres and to obtain rheumatologists' views on a proposed internet-based standardized system for clinical reporting of nailfold capillaroscopy images. METHODS: An online survey was developed using expert opinion from clinicians, scientists and health service researchers. The survey was piloted and sent to UK-based rheumatologists using established electronic mailing lists between October 2020 and March 2021. Survey data were analysed using descriptive statistics. RESULTS: A total of 104 rheumatologists representing rheumatology centres across the UK responded to the survey. Wide variations in terms of workloads and practices were described. Thirty-four (33%) respondents reported using nailfold capillaroscopy only at their own centre, 33 (32%) referred to other centres, 9 (9%) did both and 28 (27%) did not use capillaroscopy at all. Of the 43 respondents using capillaroscopy on site, 25 (58%) used either a dermatoscope or universal serial bus microscope and 9 (21%) used videocapillaroscopy. Among the 61 respondents not undertaking capillaroscopy on site, barriers included lack of equipment (85%), lack of experience in acquiring images (69%) and lack of expertise in interpreting images (67%). Sixty-six respondents (63%) expressed interest in an internet-based, standardized automated system for reporting images. CONCLUSION: Most UK rheumatologists currently do not perform nailfold capillaroscopy on site. An internet-based nailfold capillaroscopy system for use with low-cost microscopes as well as with videocapillaroscopy could help increase uptake of capillaroscopy and thereby facilitate early diagnosis of SSc across the UK.

State-of-the-art technologies provide new insights linking skin and blood vessel abnormalities in SSc-related disorders.

OBJECTIVE: A key unanswered question in systemic sclerosis (SSc) is how microvascular abnormality and fibrosis inter-relate. Our aim was to use state-of-the-art non-invasive imaging methods to gain new insights into pathophysiology, comparing patients with different subtypes of SSc, including early dcSSc, not only to healthy controls but also to patients with causes of Raynaud's phenomenon not progressing to fibrosis. METHODS: Laser Doppler imaging, nailfold capillaroscopy, spectroscopy, and ultrasound measured (respectively) perfusion, microvascular structure, oxygenation/oxidative stress, and skin thickening in the hands of 265 subjects: 31 patients with primary Raynaud's phenomenon (PRP), 35 with undifferentiated connective tissue disease (UCTD), 93 with limited cutaneous SSc (lcSSc), 46 with diffuse cutaneous SSc (dcSSc, including 27 'early') and 60 healthy controls. RESULTS: Mean perfusion was reduced in SSc groups compared to controls (lcSSc 172 perfusion units [standard deviation 157], late-dcSSc 90 [145], early-dcSSc 68 [137] vs. controls 211 [146]; p = 0.0002) as was finger-oxygenation (lcSSc 12.1 [13.6] arbitrary units [AU], late-dcSSc 12.2 [8.4], early-dcSSc 11.1 [11.3] vs controls 14.9 [10.5]; p = 0.0049). Oxidative stress was increased at the hand-dorsum in SSc groups (p = 0.0007). Perfusion positively correlated with oxygenation (r = 0.23, p < 0.001), and capillary density negatively with skin thickness (r = -0.26, p < 0.001). CONCLUSION: Our findings lend support to the hypothesis that in SSc, particularly early dcSSc, (but not in PRP or UCTD), reduced perfusion (together with structural microvascular abnormality) associates with reduced oxygenation, with oxidative stress and with skin thickening/fibrosis, most likely driving a vicious cycle which ultimately results in irreversible tissue injury. Findings in skin may mirror alterations in internal organs.

Methyl cap binding protein 2: a key epigenetic protein in systemic sclerosis.

OBJECTIVE: SSc is an autoimmune connective tissue disease that results in skin fibrosis and currently has no effective treatment. Epigenetic modifications have been described and these may be key in initiating and driving fibroblast activation. Among these epigenetic modifications methylation may be of central importance. The aim of this study was to examine the role of methyl cap binding protein-2 (MeCP2) in SSc fibrosis. METHODS: We used healthy and SSc dermal fibroblasts to examine the role of MeCP2, using both small interfering RNA silencing and lentiviral overexpression to determine its effects. We also examined the expression of MeCP2 in SSc fibroblasts by immunoblotting. miRNA132 was quantified by Taqman real time PCR. RESULTS: We demonstrated that TGF-ß1 induced the expression of MeCP2 in normal cells, and showed that SSc fibroblasts expressed high levels of MeCP2 under basal conditions. MeCP2 positively regulated the expression of extracellular matrix through epigenetic repression of the Wnt antagonist sFRP-1, leading to enhanced Wnt signalling. This mediated fibrosis through glycolysis, as the glycolysis inhibitor 2-deoxyglucose diminished the Wnt-mediated collagen expression. MiR132 expression was reduced in SSc fibroblasts. CONCLUSION: The results suggest that an epigenetic loop exists mediating fibrosis. Targeting of MeCP2, as a key epigenetic regulator, may be a promising therapeutic approach, as would targeting the metabolic reprogramming that occurs through aerobic glycolysis.

Multimedia exposures to arsenic and lead for children near an inactive mine tailings and smelter site.

Children living near contaminated mining waste areas may have high exposures to metals from the environment. This study investigates whether exposure to arsenic and lead is higher in children in a community near a legacy mine and smelter site in Arizona compared to children in other parts of the United States and the relationship of that exposure to the site. Arsenic and lead were measured in residential soil, house dust, tap water, urine, and toenail samples from 70 children in 34 households up to 7 miles from the site. Soil and house dust were sieved, digested, and analyzed via ICP-MS. Tap water and urine were analyzed without digestion, while toenails were washed, digested and analyzed. Blood lead was analyzed by an independent, certified laboratory. Spearman correlation coefficients were calculated between each environmental media and urine and toenails for arsenic and lead. Geometric mean arsenic (standard deviation) concentrations for each matrix were: 22.1 (2.59) ppm and 12.4 (2.27)ppm for soil and house dust (<63µm), 5.71 (6.55)ppb for tap water, 14.0 (2.01)µg/L for specific gravity-corrected total urinary arsenic, 0.543 (3.22)ppm for toenails. Soil and vacuumed dust lead concentrations were 16.9 (2.03)ppm and 21.6 (1.90) ppm. The majority of blood lead levels were below the limit of quantification. Arsenic and lead concentrations in soil and house dust decreased with distance from the site. Concentrations in soil, house dust, tap water, along with floor dust loading were significantly associated with toenail and urinary arsenic but not lead. Mixed models showed that soil and tap water best predicted urinary arsenic. In our study, despite being present in mine tailings at similar levels, internal lead exposure was not high, but arsenic exposure was of concern, particularly from soil and tap water. Naturally occurring sources may be an additional important contributor to exposures in certain legacy mining areas.

The social media revolution is changing the conference experience: analytics and trends from eight international meetings.

OBJECTIVE: To analyse the use of Twitter at urology conferences to enhance the social media conference experience. MATERIALS AND METHODS: We prospectively registered the hashtags of eight international urology conferences taking place in 2013, using the social media metrics website, Symplur.com. In addition, we prospectively registered the hashtag for the European Association of Urology (EAU) Annual Congress for 3 consecutive years (2012-2014) to analyse the trend in the use of Twitter at a particular meeting. Metrics including number of 'tweets', number of participants, tweet traffic per day, and overall digital impressions, which were captured for 5 days before each conference, the conference itself, and the following 2 days. We also measured corresponding social media activity at a very large non-urology meeting (the American Society of Clinical Oncology) for comparative purposes. RESULTS: Twitter activity was noted at all eight conferences in 2013. In all, 12,363 tweets were sent generating over 14 million impressions. The number of participants tweeting at each meeting varied from 80 (Congress of the Société Internationale d'Urologie, #SIU2013) to 573 (the American Urological Association, #AUA13). Overall, the AUA meeting (#AUA13) generated the most Twitter activity with >8.6 million impressions and a total of 4663 tweets over the peri-conference period. It also had the most impressions and tweets per day over this period, at 717,000 and 389, respectively. The EAU Annual Congress 2013 (#EAU13) generated 1.74 million impressions from a total of 1762 tweets from 236 participants. For trends in Twitter use, there was a very sharp rise in Twitter activity at the EAU Annual Congress between 2012 and 2014. Over this 3-year period, the number of participants increased almost 10-fold, leading to an increase in the number of tweets from 347 to almost 6000. At #EAU14, digital impressions reached 7.35 million with 5903 tweets sent by 797 participants. CONCLUSIONS: Urological conferences, to a varying extent, have adopted social media as a means of amplifying the conference experience to a wider audience, generating international engagement and global reach. Twitter is a very powerful tool that amplifies the content of scientific meetings, and conference organisers should put in place strategies to capitalise on this.

Mitochondria and redox homoeostasis as chemotherapeutic targets.

Characteristics of cancer cells include a more oxidized redox environment, metabolic reprogramming and apoptosis resistance. Our studies with a lymphoma model have explored connections between the cellular redox environment and cancer cell phenotypes. Alterations seen in lymphoma cells made resistant to oxidative stress include: a more oxidized redox environment despite increased expression of antioxidant enzymes, enhanced net tumour growth, metabolic changes involving the mitochondria and resistance to the mitochondrial pathway to apoptosis. Of particular importance, the cells show cross-resistance to multiple chemotherapeutic agents used to treat aggressive lymphomas. Analyses of clinical and tumour data reveal the worst prognosis when patients' lymphomas have gene expression patterns consistent with the most oxidized redox environment. Lymphomas from patients with the worst survival outcomes express increased levels of proteins involved in oxidative phosphorylation, including cytochrome c. This is consistent with these cells functioning as metabolic opportunists. Using lymphoma cell models and primary lymphoma cultures, we observed enhanced killing using genetic and drug approaches which further oxidize the cellular redox environment. These approaches include increased expression of SOD2 (superoxide dismutase 2), treatment with a manganoporphyrin that oxidizes the glutathione redox couple, or treatment with a copper chelator that inhibits SOD1 and leads to peroxynitrite-dependent cell death. The latter approach effectively kills lymphoma cells that overexpress the anti-apoptotic protein Bcl-2. Given the central role of mitochondria in redox homoeostasis, metabolism and the intrinsic pathway to apoptosis, our studies support the development of new anti-cancer drugs to target this organelle.

Smartphones and pediatric apps to mobilize the medical home.

OBJECTIVES: To assess digital access and mobile health in urban pediatric clinics by measuring demographics of smartphone ownership, primary uses of mobile devices by teens vs parents/caregivers, and interest levels in using smartphone health apps. STUDY DESIGN: This cross-sectional survey studied teenagers and caregivers from 2 urban pediatric practices in Bronx, New York; 148 surveys were administered verbally in waiting rooms using a 24-item "iHealthNYC" questionnaire. A demonstration of smartphone health apps was then conducted and data analyzed using bivariate analysis and χ(2) statistics. RESULTS: Overall, 84% of subjects were smartphone owners, with 57% using smartphones as their primary internet source. There was no statistical difference in smartphone ownership between age groups or demographics of sex, ethnicity, and socioeconomic status. Smartphone users had a mean 14.5 apps, with 70.4% accessing apps >3 times a day. The majority of participants stated interest in medical apps, although caregivers were significantly more motivated. Likewise, caregivers are more likely to search health topics via their phone (76.7% vs 47.9%, P < .01) and own medical apps vs teens (35.1% vs 16.9%, P = .02). CONCLUSION: The prevalence of smartphone and app use in urban pediatric populations is high. With increased interest in mobile health, smartphones are an attractive modality for patient education, disease management, and streamlining health care communication in diverse settings, thus "mobilizing" the medical home. Further research is needed so that pediatricians can promote evidence-based apps, thus enabling patients to take ownership of their health.

Partial plasma cell differentiation as a mechanism of lost major histocompatibility complex class II expression in diffuse large B-cell lymphoma.

Loss of major histocompatibility complex class II (MHC II) expression is associated with poor patient outcome in diffuse large B-cell lymphoma (DLBCL). As MHC II molecules are lost with plasmacytic differentiation in normal cells, we asked whether MHC II loss in DLBCL is associated with an altered differentiation state. We used gene expression profiling, quantum dots, and immunohistochemistry to study the relationship between MHC II and plasma cell markers in DLBCL and plasmablastic lymphoma (PBL). Results demonstrate that MHC II(-) DLBCL immunophenotypically overlap with PBL and demonstrate an inverse correlation between MHC II and plasma cell markers MUM1, PRDM1/Blimp1, and XBP1s. In addition, MHC II expression is significantly higher in germinal center-DLBCL than activated B cell-DLBCL. A minor subset of cases with an unusual pattern of mislocalized punctate MHC II staining and intermediate levels of mRNA is also described. Finally, we show that PBL is negative for MHC II. The results imply a spectrum of MHC II expression that is more frequently diminished in tumors derived from B cells at the later stages of differentiation (with complete loss in PBL). Our observations provide a possible unifying concept that may contribute to the poor outcome reported in all MHC II(-) B-cell tumors.

Building patient safety culture by using interprofessional simulation with nursing, paramedic and emergency telecommunication students: A mixed-methods research study.

AIM: The aim of this study was to investigate student attitudes toward interprofessional education and collaborative practice and their perceptions of simulation design elements after participating in an interprofessional simulation educational activity. BACKGROUND: Patient safety continues to be an international healthcare priority. However, critical incidents to patients continue to persist due to poor communication between professionals and poor teamwork. DESIGN: A mixed methods design. METHOD: The study sample consisted of Bachelor of Nursing (n=81), Paramedic (n=38) and Emergency Telecommunication (n=11) students randomized into interprofessional groups. Following the interprofessional learning experience, students completed two standardized self-reporting instruments, Students Perceptions of Interprofessional Clinical Education, National League for Nursing Simulation Design Scale and open-ended questions of their perceptions on teamwork and collaboration, communication skills, transfer of care and patient safety. RESULTS: Students in each program reported high scores for attitudes toward the importance of teamwork and collaborative practice. There were significant differences in scores between programs for the ranking factors 'Teamwork and Team-Based Practice' (BN=4.74 SD 0.72, PM=4.66 SD 0.81, ET=4.95 SD 0.15 *; p = 0.00005) and 'Roles & Responsibilities' (BN=3.78 SD 1.12, PM=3.55 SD 0.92, ET=4.67 SD 0.85*; p= 0.012). Themes included: communication and collaboration in teamwork; roles, responsibilities and leadership; patient-centred care and safety; and emotional dynamics and professional growth. CONCLUSION: An interprofessional simulation is an effective strategy to practice teamwork and collaboration and communication skills during transfer of care. Ensuring earlier education of roles and responsibilities during transfer of care needs review as do strategies for structured handover communication tools.

Potential of biochar and humic substances for phytoremediation of trace metals in oil sands process affected water.

Oil sands process affected water (OSPW) is produced during bitumen extraction and typically contains high concentrations of trace metals. Constructed wetlands have emerged as a cost effective and green technology for the treatment of metals in wastewaters. Whether the addition of amendments to constructed wetlands can improve metal removal efficiency is unknown. We investigated the synergistic effects of carbon based amendments and wetland plant species in removal of arsenic, cadmium, cobalt, chromium, copper, nickel, and selenium from OSPW. Three native wetland species (Carex aquatilis, Juncus balticus, Scirpus validus) and two amendments (canola straw biochar, nano humus) were investigated in constructed wetland mesocosms over 60 days. Amendment effect on metal removal efficiency was not significant, while plant species effect was. Phytoremediation resulted in removal efficiencies of 78.61-96.31 % for arsenic, cadmium, and cobalt. Carex aquatilis had the highest removal efficiencies for all metals. Amendments alone performed well in removing some metals and were comparable to phytoremediation for cadmium, cobalt, copper, and nickel. Metals were primarily distributed in roots with negligible translocation to shoots. Our work provides insights into the role of plants and amendments during metal remediation and their complex interactions in constructed treatment wetlands.

Serological Investigation for Brucella ceti in Cetaceans from the Northwestern Mediterranean Sea.

Neurobrucellosis in cetaceans, caused by Brucella ceti, is a relevant cause of death in striped dolphins (Stenella coeruleoalba) from the Mediterranean Sea. Serological tests are not used as a routinary technique for the diagnosis of this infection. We briefly describe the pathological findings of nine free-ranging stranded cetaceans diagnosed with Brucella disease or infection in our veterinary necropsy service from 2012 to 2022. The findings included focal diskospondylitis and non-suppurative meningitis, choroiditis and radiculitis. Additionally, an exploratory serological study was conducted in sixty-six frozen sera collected in the period 2012-2022 from fifty-seven striped dolphins, five Risso's dolphins (Grampus griseus), two common bottlenose dolphins (Tursiops truncatus), one common dolphin (Delphinus delphis) and one pilot whale (Globicephala melas) to compare antibody levels in Brucella-infected (n = 8) and non-infected (n = 58) animals, classified by the cause of death, sex, age class and cetacean morbillivirus (CeMV) infection status. The authors hypothesized that active infection in cases of neurobrucellosis would elicit a stronger, detectable humoral response compared to subclinical infections. We performed a commercial competition ELISA (cELISA) using serial serum dilutions for each sample, considering a percentage of inhibition (PI) of ≥40% as positive. A titer of 1:160 was arbitrarily determined as the seropositivity threshold. Seropositive species included striped dolphins and Risso's dolphins. Seroprevalence was higher in animals with neurobrucellosis (87.5%) compared to the overall seroprevalence (31.8%) and to other causes of death, indicating, likely, a high sensitivity but low specificity for neurobrucellosis. Animals with chronic CeMV seemed to have higher seroprevalences, as well as juveniles, which also had a higher disease prevalence. These results indicate, as in other studies, that antibodies are not decisive against clinical brucellosis, although they may indicate a carrier state, and that CeMV may influence Brucella epidemiology. More research is required to elucidate the epidemiology and pathogenesis and to resolve the complicated host-pathogen interaction in Brucella species.

Hedgehog signaling is active in human prostate cancer stroma and regulates proliferation and differentiation of adjacent epithelium.

BACKGROUND: Contribution of stromal Hedgehog (Hh) signaling is evident in the prostate gland in mice, but needs translation to human tissues if Hh therapeutics are to be used effectively. Our goal was to determine if primary human prostate fibroblasts contain cilia, and respond to prostate Hh signaling. METHODS: Primary human prostate cancer-associated (CAFs), and adjacent non-malignant (NPFs) fibroblasts isolated from human tissue specimens were analyzed using immunofluorescence, real-time PCR, and available array data. Cell culture and tissue recombination were used to determine responsiveness of human fibroblasts to Hh pathway manipulation and the paracrine effects of stromal Hh signaling, respectively. RESULTS: Prostatic fibroblasts were capable of forming primary cilia, with the capacity for active Hh signaling as seen by Smo co-localization to the tip of the primary cilium. Expression of genes known to represent a signature of active Hh signaling in the prostate (especially Fgf5 and Igfbp6) were increased in CAFs compared to NPFs. The level of canonical Hh genes and prostate Hh signature genes were rarely synchronous; with lower doses of Purmorphamine/BMS-833923 regulating canonical transcription factors, and higher doses effecting prostate Hh signature genes. Grafts consisting of NPFs with constitutively active Hh signaling induced increased proliferation and dedifferentiation of adjacent non-malignant BPH-1 epithelial cells. CONCLUSIONS: These data show that human prostatic fibroblasts have the capacity for Hh signaling and manipulation. Increased expression of a signature of prostatic Hh genes in the prostate tumor microenvironment suggests a role in the epithelial transformations driving prostate cancer (PCa).

Can we build better compost? Use of waste drywall to enhance plant growth on reclamation sites.

Compost is a readily available source of organic matter and nutrients and is produced large scale in many jurisdictions. Novel advancements in composting include addition of construction waste, such as drywall, to address its disposal while potentially improving compost quality for use in land reclamation. Varying compositions (15-30% by weight) of coarse and ground waste drywall were added to manure and biosolids during composting. Six composts were applied at four rates (0, 50, 100, 200 Mg ha(-1)) to three reclamation soils (agricultural, urban clean fill, oil sands tailings). Response to composts was assessed in the greenhouse with three plant species (Hordeum vulgare L. (barley), Agropyron trachycaulum (Link) Malte (slender wheat grass) and Festuca saximontana Rydb. (rocky mountain fescue). Drywall added to biosolids or manure during composting had no detrimental effects on vegetation; any negative effects of compost occurred with and without drywall. In agricultural soil and clean fill, biosolids composts with 15% coarse and 18% ground drywall improved native grass response, particularly biomass, relative to biosolids compost without drywall. Drywall manure composts reduced native grass response relative to manure compost without drywall. Only low quality tailings sand was improved by 30% coarse drywall. Compost rate significantly affected above and below ground biomass in agricultural soil and reduced performance of native species at highest rates, suggesting a threshold beyond which conditions will not be suitable for reclamation. Grinding drywall did not significantly improve plant performance and use of coarse drywall would eliminate the need for specialized equipment and resources. This initial research demonstrates that drywall composts are appropriate soil amendments for establishment of native and non native plant species on reclamation sites with consideration of substrate properties and plant species tolerances to dictate which additional feed stocks should be used.