Removal of Quebracho and Tara tannins in fungal bioreactors: Performance and biofilm stability analysis.

Tannins are polyphenolic compounds produced by plants that are used in the vegetable tanning of leather at industrial scale. Quebracho tannin and Tara tannin are intensively used by the tanning industry and are two of the most recalcitrant compounds that can be found in tannery wastewaters. In this study two reactors fed with Quebracho tannin and Tara tannin, respectively, were inoculated with polyurethane foam cubes colonized with a fungal strain biofilm of Aspergillus tubingensis MUT 990. A stable biofilm was maintained in the reactor fed with Quebracho tannin during 180 days of operation. Instead, biofilm got detached from the foam cubes during the start-up of the reactor fed with Tara tannin and a bacterial-based suspended culture was developed and preserved along the operational period (226 days). Soluble chemical oxygen demand removals up to 53% and 90% and maximum elimination capacities of 9.1 g sCOD m-3 h-1 and 37.9 g sCOD m-3 h-1 of Quebracho and Tara tannins, respectively, were achieved in the reactors without the addition of co-substrates. Next generation sequencing analysis for bacteria and fungi showed that a fungal consortium was developed in the reactor fed with Quebracho tannin while fungi were outcompeted by bacteria in the reactor fed with Tara tannin. Furthermore, Quebracho and Tara tannins were successfully co-treated in a single reactor where both fungi and bacteria were preserved.

Observational study of the effectiveness of spinal cord injury rehabilitation using the Spinal Cord Injury-Ability Realization Measurement Index.

STUDY DESIGN: Retrospective observational study. OBJECTIVES: The objective of this study was to determine the rehabilitation potential and the extent to which it is realized in a cohort of spinal cord injury patients using the Spinal Cord Injury-Ability Realization Measurement Index (SCI-ARMI) and to study the clinical factors that influence this realization. SETTING: Two spinal units in Italy. METHODS: Consecutive patients were assessed at the end of an in-patient rehabilitation program using the Spinal Cord Independence Measure and the International Standards for Neurological Classification of Spinal Cord Injury. On the basis of these data and of the age and gender of the patients, we calculated the SCI-ARMI score. Regression analyses were performed to study the relationship between clinical factors and the extent to which rehabilitation potential is realized. RESULTS: We examined the data for 306 patients. Most patients were discharged without having reached their rehabilitation potential, with an SCI-ARMI score <80%. SCI-ARMI scores at discharge were positively influenced by etiology and the lesion level and correlated negatively with lesion severity and the presence of complications during rehabilitation. CONCLUSION: The SCI-ARMI is an effective tool that can be used to measure the achievement of rehabilitation potential in SCI patients and to identify groups of patients who are at risk of not meeting their rehabilitative potential.

Validation of the Italian version of the Spinal Cord Independence Measure (SCIM III) Self-Report.

STUDY DESIGN: Cross-sectional validation study. OBJECTIVES: To validate the Italian version of the Spinal Cord Independence Measure Self-Report (SCIM SR). SETTING: Two spinal cord injury (SCI) rehabilitation facilities in Italy. METHODS: The SCIM III comprises items on 19 daily tasks, grouped into three subscales: 'Self-care,' 'Respiration and sphincter management' and 'Mobility'. The total SCIM score ranges between 0 and 100. The Italian self-reported version (SCIM SR) was translated from the German tool. We studied 116 patients on their first hospitalization for rehabilitation after an SCI. At the time of discharge, patients were evaluated by the rehabilitation team using the SCIM III and self-assessed their independence with regard to activities of daily living using the SCIM SR. Pearson's correlation, Bland-Altman method, and stratified and regression analyses were used to examine the differences between evaluations. RESULTS: On the basis of Pearson's correlation, there was good agreement between the data from the SCIM III and SCIM SR (r=0.918 for 'Self-care,' 0.806 for 'Respiration and sphincter management,' 0.906 for 'Mobility' and 0.934 for total scores). By Bland-Altman analysis, patients rated their functioning nearly the same as professionals-the mean difference between SCIM III and SCIM SR scores was approximately 0 for all subscales and total scores. The stratified and regression analyses failed to identify any specific factor that was associated with differences between SCIM III and SCIM SR scores. CONCLUSIONS: These results support the validity of the Italian version of the SCIM SR, which can facilitate longer-term evaluations of the independence of individuals with SCIs.

Positive skeletal effects of cladrin, a naturally occurring dimethoxydaidzein, in osteopenic rats that were maintained after treatment discontinuation.

UNLABELLED: Effects of cladrin treatment and withdrawal in osteopenic rats were studied. Cladrin improved trabecular microarchitecture, increased lumbar vertebral compressive strength, augmented coupled remodeling, and increased bone osteogenic genes. A significant skeletal gain was maintained 4 weeks after cladrin withdrawal. Findings suggest that cladrin has significant positive skeletal effects. INTRODUCTION: We showed that a standardized extract of Butea monosperma preserved trabecular bone mass in ovariectomized (OVx) rats. Cladrin, the most abundant bioactive compound of the extract, promoted peak bone mass achievement in growing rats by stimulating osteoblast function. Here, we studied the effects of cladrin treatment and withdrawal on the osteopenic bones. METHODS: Adult female Sprague-Dawley rats were OVx and left untreated for 12 weeks to allow for significant estrogen deficiency-induced bone loss, at which point cladrin (1 and 10 mg/kg/day) was administered orally for another 12 weeks. Half of the rats were killed at the end of the treatments and the other half at 4 weeks after treatment withdrawal. Sham-operated rats and OVx rats treated with PTH or 17ß-estradiol (E2) served as various controls. Efficacy was evaluated by bone microarchitecture using microcomputed tomographic analysis and fluorescent labeling of bone. qPCR and western blotting measured mRNA and protein levels in bone and uterus. Specific ELISA was used for measuring levels of serum PINP and urinary CTx. RESULTS: In osteopenic rats, cladrin treatment dose dependently improved trabecular microarchitecture, increased lumbar vertebral compression strength, bone formation rate (BFR), cortical thickness (Cs.Th), serum PINP levels, and expression of osteogenic genes in bones; and reduced expression of bone osteoclastogenic genes and urinary CTx levels. Cladrin had no uterine estrogenicity. Cladrin at 10 mg/kg maintained acquired skeletal gains 4 weeks after withdrawal. CONCLUSION: Cladrin had positive skeletal effects in osteopenic rats that were maintained after treatment withdrawal.

Teaching and learning in the operating theatre: a framework for trainers and advanced trainees in obstetrics and gynaecology.

Surgical training of 'advanced trainees' in Obstetrics and Gynaecology currently occurs in a rather unstructured fashion. This is even more complicated by reduced training time of doctors necessitated by the European working time directive. Teaching and learning in theatre is a combination of art and science. This paper attempts to address the issues hampering effective theatre training and suggests ways to overcome them. The 'operating theatre' plan includes a needs assessment of trainees, goal setting and instructional methodologies. Various learning styles could potentially be adopted, although it might be difficult to choose a learning style suitable for a particular trainee. Additionally, team working skills and experiential learning need to be facilitated.

Mirena intrauterine system in the treatment of menstrual disorders: a survey of UK patients' experience, acceptability and satisfaction.

Our study investigated the personal experience and satisfaction of patients with menstrual disorders treated with the Mirena intrauterine system in secondary care. A retrospective questionnaire was sent to all 1,100 women treated with a Mirena intrauterine system in the Menstrual Disorders Clinic between 1995-2003 at the Queens' Medical Centre, Nottingham, England. A total of 1,056 (96%) women responded and were included in the study. The majority (73%) of women continued to use the Mirena. The women reported a decrease in the heaviness, frequency and pain associated with their period. The commonest side-effect experienced was spotting (19%). Women ranked their satisfaction on a scale of 1-10, with a mean score of 7.07/10. The majority of women are satisfied with the Mirena as a treatment for menstrual disorders. Less than 5% of the women required subsequent operative treatment for menstrual disorders following treatment with the Mirena.