A feasibility study of a handmade ultrasound-guided phantom for paracentesis.

BACKGROUND: Simulation-based training is effective for ultrasound (US)-guided procedures. However, commercially developed simulators are costly. This study aims to evaluate the feasibility of a hand-made phantom for US-guided paracentesis. METHODS: We described the recipe to prepare an agar phantom. We collected the US performance data of 50 novices, including 22 postgraduate-year (PGY) residents and 28 undergraduate-year (UGY) students, who used the phantom for training, as well as 12 emergency residents with prior US-guided experience. We obtained the feedback after using the phantom with the Likert 5-point scale. The data were presented with medians and interquartile ranges (IQRs) and analyzed by the Wilcoxon rank sum test. RESULTS: While emergency residents demonstrated superior performance compared to trainees, all trainees exhibited acceptable proficiency (global rating of ≥ 3, 50/50 vs. 12/12, p = 1.000) and comparable needle steadiness [5 (5) vs. 5 (5), p = 0.223]. No significant difference in performance was observed between PGYs [5 (4-5)] and UGYs [5 (4-5), p = 0.825]. No significant differences were observed in terms of image stimulation, puncture texture, needle visualization, drainage simulation, and endurance of the phantom between emergency residents and trainees. However, experienced residents rated puncture texture and draining fluid as "neutral" (3/5 on the Likert scale). The cost of the paracentesis phantom is US$16.00 for at least 30 simulations, reducing it to US$6.00 without a container. CONCLUSIONS: The paracentesis phantom proves to be a practical and cost-effective training tool. It enables novices to acquire paracentesis skills, enhances their US proficiency, and boosts their confidence. Nevertheless, further investigation is needed to assess its long-term impact on clinical performance in real patients. TRIAL REGISTRATION: NCT04792203 at the ClinicalTrials.gov.

The effects of online peer-facilitated learning and distributed pair programming on students' learning.

The COVID-19 pandemic has forced universities and schools around the world to adopt online learning. Teachers may wonder if their students can attain satisfactory learning performance in an online learning environment without teachers' on-the-spot attention. In order to develop students' skills in programming, promote their enjoyment of learning and intention to learn to program, the researchers integrated two innovative teaching approaches, using online peer-facilitated learning and distributed pair programming, and investigated the effects of these on students' online learning performance. This study conducted an experiment that included 128 undergraduates from four class sections of Department of Finance. Thus, the experimental design in this research was a 2 (Peer-facilitated learning vs. non-peer-facilitated learning) × 2 (Distributed pair programming vs. non-distributed pair programming) factorial pretest/post-test design. The participants in this research mainly consisted of four classes of students from a non-computer or information department who took a compulsory course on programming design.' Both quantitative and qualitative data were collected in this study. According to the results, the peer-facilitated learning group exhibited significantly better development of programming skills, enjoyment of learning, and intention to learn, than the non-peer-facilitated learning group. However, expected effects of enhancing the learning of the students in this study who received the distributed pair programming were not found. The design of online pedagogy can be a reference for online educators. The implications of applying online peer-facilitated learning and distributed pair programming to support students' learning and the design of online programming courses are discussed.

Catheter ablation in Asian patients with atrial fibrillation and hypertrophic cardiomyopathy: electrophysiological characteristics of recurrence and long-term clinical outcomes.

Background: Catheter ablation (CA) is a treatment strategy for atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). We investigated the electrophysiological characteristics of recurrence in a tertiary referral center and compared long-term clinical outcomes after CA therapy with patients who did not undergo CA. Methods: Patients with HCM and AF who underwent CA (group 1, n = 60) or pharmacological treatment (group 2, n = 298) between 2006 and 2021 were enrolled in this study. The baseline characteristics and electrophysiological characteristics of group 1 patients were examined to elucidate the reason for the recurrence of AF after CA therapy. The clinical results of the patients in Group 1 and Group 2 were compared using a propensity score (PS)-matched method. Results: The most common cause of recurrence was pulmonary vein reconnection (86.5%), followed by non-pulmonary vein triggers (40.5%), cavotricuspid isthmus flutter (29.7%), and atypical flutter (24.3%). Thyroid disease (HR, 14.713; P < 0.01), diabetes (HR, 3.074; P = 0.03), and non-paroxysmal AF (HR, 4.012; P = 0.01); these factors independently predicted recurrence. After the first recurrence, patients who underwent repeat CA showed a better arrhythmia-free state (74.1%) than those who underwent drug escalation therapy (29.4%, P < 0.01). After matching, PS-group 1 patients showed significantly better outcomes in all-cause mortality, heart failure hospitalization, and left atrial reverse remodeling than PS-group 2 patients. Conclusions: Patients who underwent CA showed better clinical outcomes than those who underwent drug therapy. The main predictors of recurrence were thyroid disease, diabetes, and non-paroxysmal AF.

Sodium-Glucose Cotransporter 2 Inhibitors First Strategy Improve Decongestion in Patients with Symptomatic Heart Failure and Reduced Ejection Fraction When Compared to Angiotensin Receptor Neprilysin Inhibitor First Strategy.

BACKGROUND: Angiotensin receptor neprilysin inhibitor (ARNI) and sodium-glucose cotransporter 2 inhibitor (SGLT2i) are emerging medical treatments for decompensated heart failure (HF) with reduced ejection fraction. In clinical practice, the combination of ARNI and SGLT2i cannot be administered owing to the poor hemodynamic status in patients with HF with reduced ejection fraction (HFrEF). This study aimed to compare different strategies of HF management for ARNI first or SGLT2i first in such a population. METHODS: From January 2016 to December 2021, 165 patients were diagnosed with HFrEF and New York Heart Association functional class ≥II and already received optimal medical treatment. Ninety-five patients received the ARNI-first strategy, and 70 patients received the SGLT2i-first strategy according to the physician's choice. Age, sex, hemodynamic condition, etiologies of HF, comorbidities, serum creatinine, N-terminal pro-B-type natriuretic peptide (NT-ProBNP), echocardiographic parameters, and clinical outcomes were compared between the ARNI and SGLT2i-first strategy groups. RESULTS: In the SGLT2i-first group, the median interval between the addition of the second medication was longer (ARNI-first vs. SGLT2i-first; 74 [49-100] days vs. 112 [86-138] days; p = 0.044). Improvement in left ventricular ejection fraction (LVEF), change in left atrial dimension, and change in left ventricular end-diastolic and end-systolic volume (LVESV) did not differ between the two groups. The incidence of HF hospitalization, cardiovascular mortality, and all-cause mortality did not differ between the two groups. A non-significant trend of lower NT-proBNP levels (ARNI-first vs. SGLT2i-first; 1383 [319-2507] pg/mL vs. 570 [206-1314] pg/mL; p = 0.055) and significantly higher discontinuation rate of diuretic agents (ARNI-first vs. SGLT2i- first; 6.8% vs. 17.5%; p = 0.039) were noted in the SGLT2i-first group. When early combination (≤14D) compared to late combination (>14D), better positive remodeling of LVESV presented significantly in early combination subgroups. CONCLUSIONS: In patients with symptomatic HFrEF, SGLT2i-first strategy may provide a higher possibility of discontinuing diuretic agents than the ARNI-first strategy. Changes in LV performance, progression of renal function, and clinical outcomes did not differ between the two groups. Early combination (≤14D) provided better LV remodeling.

Integrating online meta-cognitive learning strategy and team regulation to develop students' programming skills, academic motivation, and refusal self-efficacy of Internet use in a cloud classroom.

With the development of technology and demand for online courses, there have been considerable quantities of online, blended, or flipped courses designed and provided. However, in the technology-enhanced learning environments, which are also full of social networking websites, shopping websites, and free online games, it is challenging to focus students' attention and help them achieve satisfactory learning performance. In addition, the instruction of programming courses constantly challenges both teachers and students, particularly in online learning environments. To overcome and solve these problems and to facilitate students' learning, the researchers in this study integrated two teaching approaches, using meta-cognitive learning strategy (MCLS) and team regulation (TR), to develop students' regular learning habits and further contribute to their programming skills, academic motivation, and refusal self-efficacy of Internet use, in a cloud classroom. In this research, a quasi-experiment was conducted to investigate the effects of MCLS and TR adopting the experimental design of a 2 (MCLS vs. non-MCLS) × 2 (TR vs. non-TR) factorial pre-test/post-test. In this research, the participants consisted of four classes of university students from non-information or computer departments enrolled in programming design, a required course. The experimental groups comprised three of the classes, labelled as G1, G2, and G3. G1 concurrently received both the online MCLS and TR intervention, while G2 only received the online MCLS intervention, and G3 only received the online TR intervention. Serving as the control group, the fourth class (G4) received traditional teaching. This study investigated the effects of MCLS, TR, and their combination, on improving students' programming skills, academic motivation, and refusal self-efficacy of Internet use in an online computing course. According to the results, students who received online TR significantly enhanced their programming design skills and their refusal self-efficacy of Internet use a cloud classroom. However, the expected effects of MCLS on developing students' programming skills, academic motivation, and refusal self-efficacy of Internet use were not found in this study. The teaching strategy of integrating MCLS and TR in an online programming course in this study can serve as a reference for educators when conducting online, blended, or flipped courses during the COVID-19 pandemic.

TIAM-1 differentially regulates dendritic and axonal microtubule organization in patterning neuronal development through its multiple domains.

Axon and dendrite development require the cooperation of actin and microtubule cytoskeletons. Microtubules form a well-organized network to direct polarized trafficking and support neuronal processes formation with distinct actin structures. However, it is largely unknown how cytoskeleton regulators differentially regulate microtubule organization in axon and dendrite development. Here, we characterize the role of actin regulators in axon and dendrite development and show that the RacGEF TIAM-1 regulates dendritic patterns through its N-terminal domains and suppresses axon growth through its C-terminal domains. TIAM-1 maintains plus-end-out microtubule orientation in posterior dendrites and prevents the accumulation of microtubules in the axon. In somatodendritic regions, TIAM-1 interacts with UNC-119 and stabilizes the organization between actin filaments and microtubules. UNC-119 is required for TIAM-1 to control axon growth, and its expression levels determine axon length. Taken together, TIAM-1 regulates neuronal microtubule organization and patterns axon and dendrite development respectively through its different domains.

Graphene Family Nanomaterials (GFN)-TiO2 for the Photocatalytic Removal of Water and Air Pollutants: Synthesis, Characterization, and Applications.

Given the industrial revolutions and resource scarcity, the development of green technologies which aims to conserve resources and reduce the negative impacts of technology on the environment has become a critical issue of concern. One example is heterogeneous photocatalytic degradation. Titanium dioxide (TiO2) has been intensively researched given its low toxicity and photocatalytic effects under ultraviolet (UV) light irradiation. The advantages conferred by the physical and electrochemical properties of graphene family nanomaterials (GFN) have contributed to the combination of GFN and TiO2 as well as the current variety of GFN-TiO2 catalysts that have exhibited improved characteristics such as greater electron transfer and narrower bandgaps for more potential applications, including those under visible light irradiation. In this review, points of view on the intrinsic properties of TiO2, GFNs (pristine graphene, graphene oxide (GO), reduced GO, and graphene quantum dots (GQDs)), and GFN-TiO2 are presented. This review also explains practical synthesis techniques along with perspective characteristics of these TiO2- and/or graphene-based materials. The enhancement of the photocatalytic activity by using GFN-TiO2 and its improved photocatalytic reactions for the treatment of organic, inorganic, and biological pollutants in water and air phases are reported. It is expected that this review can provide insights into the key to optimizing the photocatalytic activity of GFN-TiO2 and possible directions for future development in these fields.

Prevalence and risk factors for Salmonella spp. contamination of slaughtered chickens in Taiwan.

The present study was designed to estimate the prevalence of Salmonella contamination in Taiwanese broilers at slaughter and to identify risk factors associated with the presence of Salmonella in processed batches of broilers. Carcass rinse samples from 362 batches of broilers were collected from 45 chicken abattoirs in Taiwan between February 2013 and November 2014. Univariate analyses and multivariable logistic regression analyses were conducted to identify putative risk factors for contamination. Salmonella was detected in 32.6 % (95 % CI: 30.4-34.8) of individual broilers and 56.4 % (95 % CI: 51.1-61.5) of the sampled batches. The multivariable logistic regression model identified season (July to November) (OR = 1.95; 95 % CI: 1.2-3.2) as increasing the risk of infection. Abattoirs in the southern region (Taichung and Kaohsiung) (OR = 0.45; 95 % CI: 0.3-0.8); batches scalded for > 90 s (OR = 0.2; 95 % CI: 0.1-0.3) and batches of commercial white broilers (BR) (OR = 0.21; 95 % CI: 0.1-0.4) all had a decreased risk of contamination compared to abattoirs from the northern region, scalding < 90 s and Taiwan native chickens (TNC), respectively. This study highlights the influence of environmental conditions and poultry breed on the risk of Salmonella contamination of chickens during slaughter.

Performance and educational training of radiographers in lung nodule or mass detection: Retrospective comparison with different deep learning algorithms.

ABSTRACT: The aim of this investigation was to compare the diagnostic performance of radiographers and deep learning algorithms in pulmonary nodule/mass detection on chest radiograph.A test set of 100 chest radiographs containing 53 cases with no pathology (normal) and 47 abnormal cases (pulmonary nodules/masses) independently interpreted by 6 trained radiographers and deep learning algorithems in a random order. The diagnostic performances of both deep learning algorithms and trained radiographers for pulmonary nodules/masses detection were compared.QUIBIM Chest X-ray Classifier, a deep learning through mass algorithm that performs superiorly to practicing radiographers in the detection of pulmonary nodules/masses (AUCMass: 0.916 vs AUCTrained radiographer: 0.778, P < .001). In addition, heat-map algorithm could automatically detect and localize pulmonary nodules/masses in chest radiographs with high specificity.In conclusion, the deep-learning based computer-aided diagnosis system through 4 algorithms could potentially assist trained radiographers by increasing the confidence and access to chest radiograph interpretation in the age of digital age with the growing demand of medical imaging usage and radiologist burnout.

Off-label reduced-dose apixaban does not reduce hemorrhagic risk in Taiwanese patients with nonvalvular atrial fibrillation: A retrospective, observational study.

ABSTRACT: East Asians are reportedly at high risk of anticoagulant-related bleeding; therefore, some physicians prefer to prescribe low-dose direct oral anticoagulants (DOACs). Little is known about the therapeutic effectiveness and safety of off-label reduced-dose apixaban in East Asians with nonvalvular atrial fibrillation (AF). We aimed to investigate the effectiveness and safety of off-label reduced-dose apixaban in Taiwanese patients with nonvalvular AF.This retrospective cohort study enrolled 1073 patients with nonvalvular AF who took apixaban between July 2014 and October 2018 from 4 medical centers in southern Taiwan. The primary outcomes included thromboembolic events (stroke/transient ischemic attack or systemic embolism), major bleeding, and all-cause mortality.Among all patients, 826 (77%) patients were classified as the "per-label adequate-dose" treatment group (i.e., consistent with the Food and Drug Administration label recommendations) while 247 (23%) patients were the "off-label reduced-dose" treatment group. The mean follow-up period was 17.5 ±â€Š13 months. The "off-label reduced-dose" group did not have a lower major bleeding rate than the "per-label adequate-dose" group (4.8% vs 3.8%, adjusted hazard ratio [HR] 1.20, 95% confidence interval [CI] 0.69-2.09), but had a nonsignificantly higher incidence of thromboembolic events (4.23% vs 3.05%, adjusted HR: 1.29, 95% CI: 0.71-2.34).An off-label reduced-dose apixaban treatment strategy may not provide incremental benefits or safety for Taiwanese patients with nonvalvular AF.

Increasing responsivity-bandwidth margin of germanium waveguide photodetector with simple corner reflector.

The external bandwidth of germanium waveguide photodetectors (PDs) decreases with the device length due to the load and parasitic effects even if the internal one is less affected. Shortening PDs raises the external bandwidth but lowers the responsivity, introducing a trade-off between the two figures of merits. Here, we present a scheme of waveguide PDs based on total internal reflections of corner reflectors. The reflector can be easily fabricated with the standard photolithography at the end of PDs to efficiently reflect optical power back to germanium for additional absorption, allowing for further size reduction. The structure may render the optimization of PDs more flexible.

The predictive value of global longitudinal strain in patients with heart failure mid-range ejection fraction.

BACKGROUND: Heart failure (HF) with mid-range ejection fraction (HFmrEF) is defined as HF with a left ventricular (LV) ejection fraction (LVEF) of 41-49%. However, the change in LV function and the subsequent prognosis in these patients remain unclear. We aimed to investigate whether LV global longitudinal strain (LV GLS) could differentiate the changes in LVEF and predict the clinical outcomes in patients with HFmrEF. METHODS: According to the changes in LVEF on follow-up echocardiography, 273 outpatients with HFmrEF were divided into 3 groups: HFwEF (HF with worse EF: <40%), HFsEF (HF with similar EF: 40-49%), and HFrecEF (HF with recovered EF: >50%). Further, the LV GLS at diagnosis was evaluated. RESULTS: The average follow-up duration was 31 months. Among patients with HFmrEF, the more impaired the LV GLS at baseline, the higher probability of HFwEF development. In comparison with patients with HFwEF and HFsEF, those with HFrecEF had a lower risk of hospitalization for HF. At a cut-off value of -11%, LV GLS differentiated the subsequent risk of cardiovascular death in patients with HFmrEF. In Cox regression, patients with LV GLS >-11% had a high risk of cardiovascular death. CONCLUSION: In patients with HFmrEF, LV GLS is associated with LVEF changes and subsequent cardiovascular death. Patients with HFrecEF had a lower risk of hospitalization for HF.

Climate-induced interannual variability and projected change of two harmful algal bloom taxa in Chesapeake Bay, USA.

Retrospective analysis of water quality monitoring data reveals strong interannual shifts in the spatial distribution of two harmful algal species (Prorocentrum minimum and Karlodinium veneficum) in eutrophic Chesapeake Bay. A habitat model, based on the temperature and salinity tolerance of the two species as well as their nutrient preferences, provides a good interpretation for the observed seasonal progression and spatial distribution of these taxa. It also points to climate-induced variability in the hydrological forcing as a mechanism driving the interannual shifts in the algal distributions: both P. minimum and K. veneficum shift downstream during wetter years but upstream during dry years. Climate downscaling simulations using the habitat model show upstream shifts of the two species in the estuary and longer blooming seasons by the mid-21st century. Salt intrusion due to sea level rise will raise salinity in the estuary and cause these HAB species to migrate upstream, but increasing winter-spring flows may also drive favorable salinity habitat downstream. Warming leads to longer growing seasons of P. minimum and K. veneficum but may suppress bloom habitat during their respective peak bloom periods.

Catalytic degradation of chlorpheniramine over GO-Fe3O4 in the presence of H2O2 in water: The synergistic effect of adsorption.

Chlorpheniramine is a pharmaceutical widely used and found in water environments. Besides hormone disruption and adverse environmental effects, chlorpheniramine forms carcinogenic nitrosamines during disinfection. We have demonstrated previously the efficient adsorption of chlorpheniramine from aqueous solution onto graphene oxide-magnetite composite (GO-Fe3O4). The present study focused on the elimination of chlorpheniramine and the formation of nitrosamine byproducts during reaction with H2O2 over GO-Fe3O4 catalyst. The effects of the morphology of GO-Fe3O4 in terms of iron fraction, pH, concentrations of H2O2 and organic matters on chlorpheniramine removal in the GO-Fe3O4-H2O2 system were investigated. Chlorpheniramine was efficiently removed at pH 9 when GO-Fe3O4 had a higher micropore volume and surface area. Kinetics study showed that both oxidation (k = 5.1(±0.2) × 10-3 (mg g-1)-1 min-1) and adsorption reactions (k = 2.7(±0.1) × 10-3 (mg g-1)-1 min-1) fitted well with the second-order kinetics model. The adsorption sites on the GO-Fe3O4 surface could be different from those involved during catalytic oxidation. Chlorpheniramine removal decreased by 44.9% in the 5th cycle without regeneration due to the structural fracture of GO-Fe3O4. A tentative pathway of chlorpheniramine degradation and nitrosamine formation by GO-Fe3O4-H2O2 was proposed. GO-Fe3O4 was an adsorbent and effective catalyst in chlorpheniramine degradation by H2O2 that exhibited limited nitrosamine formation at moderate reaction time.

Detection of chicken carcasses contaminated with Salmonella enterica serovar in the abattoir environment of Taiwan.

Although a nation-wide microbiological screening program of chicken carcasses after chilling in Taiwanese chicken abattoirs has been undertaken since 2006, little is known regarding the potential sources of the Salmonella during the slaughter process. The present study provides data on the detection and serotypes of Salmonella isolated from broilers during processing and from the environment in six abattoirs in Taiwan. Overall, Salmonella were detected in 156 of 622 samples (25.1%; 95% CI: 21.7-28.7) collected. The prevalence of Salmonella varied between sampling sites with 5.8, 17.6, 31.3 and 35.5% of cloacal swabs, environmental samples prior to processing, environmental samples during processing and carcass rinse fluid, respectively, being positive (χ2 = 51.3, p < 0.0001). A total of 15 serotypes were identified from the 156 Salmonella isolates with S. Albany (41.7%) S. Schwarzengrund (20.5%), S. Kentucky (12.8%) and S. Tennessee (5.1%) being the most commonly isolated serotypes. Characterization of 156 isolates by Pulse Field Gel Electrophoresis (PFGE) identified 50 PFGE types. Typing confirmed the presence of the same PFGE type at multiple stages during processing including plucking, evisceration, chilling and post-chilling. The abattoir environment and intestinal contents of chickens are important sources of Salmonella in broiler chicken abattoirs, with the same PFGE types detected at different stages of processing both before and during slaughtering. It is concluded that Salmonella isolates present in the environment and intestinal contents of processed birds survived in the abattoir environment resulting in subsequent carcass contamination along the processing chain including plucking, evisceration, chilling and post-chilling.

Growth of Less than 20 nm SnO Nanowires Using an Anodic Aluminum Oxide Template for Gas Sensing.

Stannous oxide (SnO) nanowires were synthesized by a template and catalyst-free thermal oxidation process. After annealing a Sn nanowires-embedded anodic aluminum oxide (AAO) template in air, we obtained a large amount of SnO nanowires. SnO nanowires were first prepared by electrochemical deposition and an oxidization method based on an AAO template. The preparation of SnO nanowires used aluminum sheet (purity 99.999%) and then a two-step anodization procedure to obtain a raw alumina mold. Finally, transparent alumina molds (AAO template) were obtained by reaming, soaking with phosphoric acid for 20 min, and a stripping process. We got a pore size of < 20 nm on the transparent alumina mold. In order to meet electroplating needs, we produced a platinum film on the bottom surface of the AAO template by using a sputtering method as the electrode of electroplating deposition. The structure was characterized by X-ray diffraction (XRD). High resolution transmission electron microscopy (HRTEM) and field emission scanning electron microscopy (FESEM) with X-ray energy dispersive spectrometer (EDS) were used to observe the morphology. The EDS spectrum showed that components of the materials were Sn and O. FE-SEM results showed the synthesized SnO nanowires have an approximate length of ~10-20 µm with a highly aspect ratio of > 500. SnO nanowires with a Sn/O atomic ratio of ~1:1 were observed from EDS. The crystal structure of SnO nanowires showed that all the peaks within the spectrum lead to SnO with a tetragonal structure. This study may lead to the use of the 1D structure nanowires into electronic nanodevices and/or sensors, thus leading to nano-based functional structures.

Removal of chlorpheniramine and variations of nitrosamine formation potentials in municipal wastewaters by adsorption onto the GO-Fe3O4.

Chlorpheniramine is a pharmaceutical pollutant and a precursor of carcinogenic nitrosamines during disinfection/oxidation. In our previous study, graphene oxide coated with magnetite (GO-Fe3O4) was capable of removing chlorpheniramine in deionized water by adsorption. This study investigated the removal of chlorpheniramine and its nitrosamine formation potentials (FPs) by adsorption onto magnetic GO-Fe3O4, with respect to the influence by using real municipal wastewaters as the background. In the results, the adsorption performances of chlorpheniramine in wastewaters decreased in the order: GO-Fe3O4 suspension > GO-Fe3O4 particles > activated carbon. Chlorpheniramine adsorptions on GO-Fe3O4 particles and activated carbon were reduced by using real wastewaters as the background, whereas chlorpheniramine adsorption on GO-Fe3O4 suspension was enhanced due to the effects of surface charge on GO-Fe3O4 and ionic strength variation in water. The fittings of adsorption isotherms indicated that the wastewater background reduced the surface heterogeneity of GO-Fe3O4 suspension and improved the adsorption performance. Appreciable removal efficiencies of NDMA and other nitrosamine FPs were observed when GO-Fe3O4 particles were added in real wastewaters. However, when chlorpheniramine was present in wastewaters, chlorpheniramine adsorption and degradation reaction simultaneously occurred on the surface of GO-Fe3O4, increasing NDMA and other nitrosamine FPs in wastewaters after GO-Fe3O4 addition for chlorpheniramine adsorption. The assumption was further demonstrated by observing the NDMA-FP increase during chlorpheniramine adsorption on GO-Fe3O4 in deionized water. GO-Fe3O4 is a potential adsorbent for chlorpheniramine removal. Nevertheless, the low treatment efficiencies at high doses limit its application for nitrosamine FP adsorptions in real wastewaters.

Time series models of decadal trends in the harmful algal species Karlodinium veneficum in Chesapeake Bay.

The harmful dinoflagellate, Karlodnium veneficum, has been implicated in fish-kill and other toxic, harmful algal bloom (HAB) events in waters worldwide. Blooms of K. veneficum are known to be related to coastal nutrient enrichment but the relationship is complex because this HAB taxon relies not only on dissolved nutrients but also particulate prey, both of which have also changed over time. Here, applying cross-correlations of climate-related physical factors, nutrients and prey, with abundance of K. veneficum over a 10-year (2002-2011) period, a synthesis of the interactive effects of multiple factors on this species was developed for Chesapeake Bay, where blooms of the HAB have been increasing. Significant upward trends in the time series of K. veneficum were observed in the mesohaline stations of the Bay, but not in oligohaline tributary stations. For the mesohaline regions, riverine sources of nutrients with seasonal lags, together with particulate prey with zero lag, explained 15%-46% of the variation in the K. veneficum time series. For the oligohaline regions, nutrients and particulate prey generally showed significant decreasing trends with time, likely a reflection of nutrient reduction efforts. A conceptual model of mid-Bay blooms is presented, in which K. veneficum, derived from the oceanic end member of the Bay, may experience enhanced growth if it encounters prey originating from the tributaries with different patterns of nutrient loading and which are enriched in nitrogen. For all correlation models developed herein, prey abundance was a primary factor in predicting K. veneficum abundance.

Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile.

Threatened miscarriage is the most common gynecological emergency, occurring in about 20% of pregnant women. Approximately one in four of these patients go on to have spontaneous miscarriage and the etiology of miscarriage still remains elusive. In a bid to identify possible biomarkers and novel treatment targets, many studies have been undertaken to elucidate the pathways that lead to a miscarriage. Luteal phase deficiency has been shown to contribute to miscarriages, and the measurement of serum progesterone as a prognostic marker and the prescription of progesterone supplementation has been proposed as possible diagnostic and treatment methods. However, luteal phase deficiency only accounts for 35% of miscarriages. In order to understand the other causes of spontaneous miscarriage and possible novel urine biomarkers for miscarriage, we looked at the changes in urinary metabolites in women with threatened miscarriage. To this end, we performed a case-control study of eighty patients who presented with threatened miscarriage between 6 and 10 weeks gestation. Urine metabolomics analyses of forty patients with spontaneous miscarriages and forty patients with ongoing pregnancies at 16 weeks gestation point to an impaired placental mitochondrial ß-oxidation of fatty acids as the possible cause of spontaneous miscarriage. This study also highlighted the potential of urine metabolites as a non-invasive screening tool for the risk stratification of women presenting with threatened miscarriage.