Rapid detection of colored and colorless macro- and micro-plastics in complex environment via near-infrared spectroscopy and machine learning.

To better understand the migration behavior of plastic fragments in the environment, development of rapid non-destructive methods for in-situ identification and characterization of plastic fragments is necessary. However, most of the studies had focused only on colored plastic fragments, ignoring colorless plastic fragments and the effects of different environmental media (backgrounds), thus underestimating their abundance. To address this issue, the present study used near-infrared spectroscopy to compare the identification of colored and colorless plastic fragments based on partial least squares-discriminant analysis (PLS-DA), extreme gradient boost, support vector machine and random forest classifier. The effects of polymer color, type, thickness, and background on the plastic fragments classification were evaluated. PLS-DA presented the best and most stable outcome, with higher robustness and lower misclassification rate. All models frequently misinterpreted colorless plastic fragments and its background when the fragment thickness was less than 0.1mm. A two-stage modeling method, which first distinguishes the plastic types and then identifies colorless plastic fragments that had been misclassified as background, was proposed. The method presented an accuracy higher than 99% in different backgrounds. In summary, this study developed a novel method for rapid and synchronous identification of colored and colorless plastic fragments under complex environmental backgrounds.

Anammox-based technologies: A review of recent advances, mechanism, and bottlenecks.

The removal of nitrogen via the ANAMMOX process is a promising green wastewater treatment technology, with numerous benefits. The incessant studies on the ANAMMOX process over the years due to its long start-up and high operational cost has positively influenced its technological advancement, even though at a rather slow pace. At the moment, relatively new ANAMMOX technologies are being developed with the goal of treating low carbon wastewater at low temperatures, tackling nitrite and nitrate accumulation and methane utilization from digestates while also recovering resources (phosphorus) in a sustainable manner. This review compares and contrasts the handful of ANAMMOX -based processes developed thus far with plausible solutions for addressing their respective bottlenecks hindering full-scale implementation. Ultimately, future prospects for advancing understanding of mechanisms and engineering application of ANAMMOX process are posited. As a whole, technological advances in process design and patents have greatly contributed to better understanding of the ANAMMOX process, which has greatly aided in the optimization and industrialization of the ANAMMOX process. This review is intended to provide researchers with an overview of the present state of research and technological development of the ANAMMOX process, thus serving as a guide for realizing energy autarkic future practical applications.

Targeted metabolomics study of fatty-acid metabolism in lean metabolic-associated fatty liver disease patients.

BACKGROUND: The annual incidence of metabolic-associated fatty liver disease (MAFLD) in China has been increasing and is often overlooked owing to its insidious characteristics. Approximately 50% of the patients have a normal weight or are not obese. They are said to have lean-type MAFLD, and few studies of such patients are available. Because MAFLD is associated with abnormal lipid metabolism, lipid-targeted metabolomics was used in this study to provide experimental evidence for early diagnosis and pathogenesis. AIM: To investigate the serum fatty-acid metabolic characteristics in lean-type MAFLD patients using targeted serum metabolomic technology. METHODS: Between January and June 2022, serum samples were collected from MAFLD patients and healthy individuals who were treated at Shanghai Putuo District Central Hospital for serum metabolomics analysis. Principal component analysis and orthogonal partial least squares-discriminant analysis models were developed, and univariate analysis was used to screen for biomarkers of lean-type MAFLD and analyze metabolic pathways. UPLC-Q-Orbitrap/MS content determination was used to determine serum palmitic acid (PA), oleic acid (OA), linoleic acid (LA), and arachidonic acid (AA) levels in lean-type MAFLD patients. RESULTS: Urea nitrogen and uric acid levels were higher in lean-type MAFLD patients than in healthy individuals (P < 0.05). Alanine transaminase and cholinesterase levels were higher in lean-type MAFLD patients than in healthy individuals (P < 0.01). The expression of high-density lipoprotein and apolipoprotein A-1 were lower in lean-type MAFLD patients than in healthy individuals (P < 0.05) and the expression of triglycerides and fasting blood glucose were increased (P < 0.01). A total of 65 biomarkers that affected the synthesis and metabolism of fatty acids were found with P < 0.05 and variable importance in projection > 1". The levels of PA, OA, LA, and AA were significantly increased compared with healthy individuals. CONCLUSION: The metabolic profiles of lean-type MAFLD patients and healthy participants differed significantly, yielding 65 identified biomarkers. PA, OA, LA, and AA exhibited the most significant changes, offering valuable clinical guidance for prevention and treatment of lean-type MAFLD.

Routine Coagulation.

The term 'routine coagulation' typically applies to hemostasis tests routinely performed in hematology laboratories, often available 24/7, and potentially ordered urgently. These tests would comprise of the prothrombin time (PT), the PT converted to an international normalized ratio, the activated partial thromboplastin time (often called partial thromboplastin time in North American laboratories) and potentially the thrombin time, the D-dimer assay, and fibrinogen assays. Although other tests could feasibly be offered (testing feasible), there are good reasons for not including all of these other tests in all routine coagulation laboratories.

Evaluating the Effect of MarginProbe® Use on Re-excisions After Partial Mastectomy: A Single-Institution Analysis.

BACKGROUND: Breast conservation therapy is a widely accepted approach in treating breast cancer, yet the average re-excision rates are approximately 25% despite surgical advancements. The Food and Drug Administration (FDA)-approved MarginProbe® device uses radiofrequency spectroscopy for intraoperative margin assessment, potentially reducing re-excision rates. This study evaluated the effectiveness of MarginProbe® in reducing re-excisions compared with standard of care (SOC). METHODS: A prospective cohort with MarginProbe® usage during partial mastectomies from June 2019 to July 2023 (153 patients) was compared with a retrospective control group without the device from January 2015 to May 2019 (300 patients). Both groups underwent partial mastectomies performed by two breast surgeons. Positive margins were defined as tumor on ink for invasive cancers and within 2 mm for ductal carcinoma in situ. RESULTS: When control was used for patient demographics and tumor characteristics, the findings showed that MarginProbe® significantly decreased the probability of re-excision by 58% (p < 0.001), although it led to a higher shave volume, with an average of 9.8 cc additional tissue removed compared with SOC (p < 0.001). Human epidermal growth factor 2 (HER2) positivity was significantly associated with increased odds of re-excision (p = 0.036). MarginProbe® demonstrated a sensitivity of 70.1% and a specificity of 47.5%. CONCLUSIONS: MarginProbe® is an effective adjunct for intraoperative margin assessment to decrease re-excision rates. However, patient selection is paramount. Given its significant increase in shave volume, women with small breasts may be at higher risk for poor cosmesis. Surgeons should exercise clinical judgement when determining the suitability of MarginProbe® use for patients undergoing breast conservation. Further research is necessary to refine MarginProbe®'s specificity and to optimize its clinical application.

Development of a determination method for quality control markers utilizing metabolic profiling and its application on processed Zingiber officinale Roscoe rhizome.

This study established an Orthogonal Partial Least Squares (OPLS) model combining 1H-NMR and GC-MS data to identify characteristic metabolites in complex extracts. Both in metabolomics studies, and natural product chemistry, the reliable identification of marker metabolites usually requires laborious isolation and purification steps, which remains a bottleneck in many studies. Both ginger (GR) and processed ginger (PGR) are listed in the Japanese pharmacopeia. The plant of origin, the rhizome of Zingiber officinale Roscoe, is differently processed for these crude drugs. Notably, the quality of crude drugs is affected by genetic and environmental factors, making it difficult to maintain a certain quality standard. Therefore, characteristic markers for the quality control of GR and PGR are required. Metabolomic analysis using 1H-NMR was able to discriminate between GR and PGR, but there were unidentified signals that were difficult to distinguish based on NMR data alone. Therefore, we combined 1H-NMR and GC-MS analytical data to identify them by OPLS. As a result, αr-curcumene was found to be a useful marker for these identifications. This new approach enabled rapid identification of characteristic marker compounds and reduced the labor involved in the isolation process.

Combining effects of submerged macrophytes and lanthanum-modified bentonite on sediment enzyme activity: Evidence from mesocosm study.

Lanthanum-modified bentonite (LMB) combined with submerged macrophytes (SM) has been a conventional means of eutrophication management in lakes in recent years, and is one of the most important methods for P removal. However, trends in nutrients and sediment enzymes at the water-sediment interface during this process have not been systematically assessed, and there are still some gaps in how abiotic properties drive changes in enzyme activity. Here, we show changes in aquatic environmental conditions under the action of different ratios of modified bentonite (0, 10%, 20%, and 30%) in combination with SM (Vallisneria natans, Potamogeton lucens, and Hydrilla verticillate) and quantify their effects on sediment enzyme activities. The results showed that the nutrient cycling at the water-sediment interface was facilitated by the combined effect of SM and LMB, which effectively reduced the overlying water nutrient concentration, increased the sediment enzyme activity and enhanced the N cycling process. Partial least squares structural equation model (PLS-SEM) showed that sediment parameters strongly influenced changes in enzyme activity, with NO3-N as the main controlling factors. Our study fills in the process of changing environmental conditions in lake water under geoengineered materials combined with macrophyte measures, especially the changes in biological properties enzyme activities, which contributes to a clearer understanding of nutrient fluxes during the management of eutrophication in lakes.

Rigdelet neural network and improved partial reinforcement effect optimizer for music genre classification from sound spectrum images.

In this paper, a new approach has been introduced for classifying the music genres. The proposed approach involves transforming an audio signal into a unified representation known as a sound spectrum, from which texture features have been extracted using an enhanced Rigdelet Neural Network (RNN). Additionally, the RNN has been optimized using an improved version of the partial reinforcement effect optimizer (IPREO) that effectively avoids local optima and enhances the RNN's generalization capability. The GTZAN dataset has been utilized in experiments to assess the effectiveness of the proposed RNN/IPREO model for music genre classification. The results show an impressive accuracy of 92 % by incorporating a combination of spectral centroid, Mel-spectrogram, and Mel-frequency cepstral coefficients (MFCCs) as features. This performance significantly outperformed K-Means (58 %) and Support Vector Machines (up to 68 %). Furthermore, the RNN/IPREO model outshined various deep learning architectures such as Neural Networks (65 %), RNNs (84 %), CNNs (88 %), DNNs (86 %), VGG-16 (91 %), and ResNet-50 (90 %). It is worth noting that the RNN/IPREO model was able to achieve comparable results to well-known deep models like VGG-16, ResNet-50, and RNN-LSTM, sometimes even surpassing their scores. This highlights the strength of its hybrid CNN-Bi-directional RNN design in conjunction with the IPREO parameter optimization algorithm for extracting intricate and sequential auditory data.

Arterial input function estimation compensating for inflow and partial voluming in dynamic contrast-enhanced MRI.

Both inflow and the partial volume effect (PVE) are sources of error when measuring the arterial input function (AIF) in dynamic contrast-enhanced (DCE) MRI. This is relevant, as errors in the AIF can propagate into pharmacokinetic parameter estimations from the DCE data. A method was introduced for flow correction by estimating and compensating the number of the perceived pulse of spins during inflow. We hypothesized that the PVE has an impact on concentration-time curves similar to inflow. Therefore, we aimed to study the efficiency of this method to compensate for both effects simultaneously. We first simulated an AIF with different levels of inflow and PVE contamination. The peak, full width at half-maximum (FWHM), and area under curve (AUC) of the reconstructed AIFs were compared with the true (simulated) AIF. In clinical data, the PVE was included in AIFs artificially by averaging the signal in voxels surrounding a manually selected point in an artery. Subsequently, the artificial partial volume AIFs were corrected and compared with the AIF from the selected point. Additionally, corrected AIFs from the internal carotid artery (ICA), the middle cerebral artery (MCA), and the venous output function (VOF) estimated from the superior sagittal sinus (SSS) were compared. As such, we aimed to investigate the effectiveness of the correction method with different levels of inflow and PVE in clinical data. The simulation data demonstrated that the corrected AIFs had only marginal bias in peak value, FWHM, and AUC. Also, the algorithm yielded highly correlated reconstructed curves over increasingly larger neighbourhoods surrounding selected arterial points in clinical data. Furthermore, AIFs measured from the ICA and MCA produced similar peak height and FWHM, whereas a significantly larger peak and lower FWHM was found compared with the VOF. Our findings indicate that the proposed method has high potential to compensate for PVE and inflow simultaneously. The corrected AIFs could thereby provide a stable input source for DCE analysis.

Cochlear implantation and partial deafness - A retrospective review on processor programming.

BACKGROUND: To decide what programming parameters to use for cochlear implants (CIs) in partial deaf patients can be challenging. OBJECTIVE: The processor programming form, categorised as electrical complement (EC), electro-acoustic-stimulation (EAS) or electric stimulation (ES), and difficulties switching programming form were investigated. METHODS: A retrospective investigation of medical records and audiograms was conducted in adult patients intended for EC and EAS. RESULTS: Eighty-four ears (80 patients) were included. Twenty ears were initially fitted with EC, 32 with EAS, 30 with ES and 2 with both EC and EAS. Sixty-four ears met the criteria to use EC or EAS at initial fitting, however only 54 ears were fitted with EC or EAS initially. Twenty-eight patients altered between at least two programming forms and six of those experienced difficulties to adapt to a new form when their low-frequency hearing deteriorated. Twenty-five percent of patients initially fitted with EC or EAS switched programming form within two years. DISCUSSION: Further studies on how to choose the most beneficial sound processor programming parameters for EC and EAS, and when to change between programming forms, are warranted as well as clear guidance on choosing the right candidates for EC and EAS.

Patterns of persistence: Genetic and behavioral population complexity of winter flounder amid population declines.

Winter flounder Pseudopleuronectes americanus (Walbaum 1792) are a coastal flatfish species of economic and cultural importance that have dwindled to <15, % of their historic abundance in the southern New England/Mid-Atlantic region of the United States, with evidence indicating near-extirpation of certain local populations. This species exhibits intricate behaviors in spawning and migration that contribute to population complexity and resilience. These behaviors encompass full or partial philopatry to natal estuaries, the generation of multiple pulses of larval delivery, and partial migration. The patterns of genetic diversity within and among estuaries and cohorts presented here carry important implications in understanding the susceptibility to demographic shocks, even if the full extent of genetic diversity within and among winter flounder stocks on the US East Coast remains unresolved. Our findings reveal connectivity between estuaries in Long Island, New York, suggesting the potential for genetic rescue of depleted subpopulations. Family reconstruction and relatedness analysis indicate that split cohorts and migration contingents are not the result of genetically distinct lineages. We found no evidence for genetic structure separating these groups, and in some instances, we were able to detect closely related individuals that belonged to different migratory contingents or cohorts. Characterizing the spatial and behavioral organization of this species at the population level is crucial for comprehending its potential for recovery, not only in terms of biomass but also in reinstating the complex population structure that supports resilience. The search for generality in winter flounder spawning and migration behavior remains elusive, but perhaps the lack of generalities within this species is what has allowed it to persist in the face of decades of environmental and anthropogenic stressors.

Effectiveness of soft coagulation in robot-assisted partial nephrectomy in preventing pseudoaneurysms and its influence on renal function based on propensity score-matched analysis.

Background: Renal artery pseudoaneurysm (RAP) is one of the most stressful and life-threatening complications of partial nephrectomy, the standard treatment for small renal cell carcinoma. The use of a monopolar soft coagulation system for hemostasis during robot-assisted partial nephrectomy (RAPN) is expected to prevent post-surgical RAP development. In this study, we aimed to investigate how the use of a soft coagulation system in RAPN reduces postoperative pseudoaneurysms and changes renal function over time. Methods: The incidence of pseudoaneurysms and postoperative renal function were compared in 208 partial nephrectomies performed between May 2016 and March 2023 at a single institution, with propensity score matching to balance patient backgrounds. Outcomes were analyzed using multivariate logistic or linear regression analyses. Results: In total, 80 matched pairs were analyzed. One (1.2%) and eighteen (22.5%) pseudoaneurysms were found in the soft coagulation users and non-users, respectively (P<0.001). Compared to the non-user group, postoperative estimated glomerular filtration rates (eGFRs) in the user group were 89% vs. 96% (P<0.001), 87% vs. 93% (P=0.009), and 88% vs. 92% (P=0.15) at 1, 3, and 12 months, respectively. Subsequent multivariate analyses showed a lower incidence of pseudoaneurysms in the user group with an odds ratio of 0.05 [95% confidence interval (CI): 0.01 to 0.44; P=0.007], and no significant difference in the rate of change in renal function at 12 months postoperatively (-1.1%, 95% CI: -5.5% to 3.3%; P=0.61). Conclusions: The use of a soft coagulation system reduces pseudoaneurysm occurrence after partial nephrectomy. Although renal function decreased in the short-term for the use group, no long-term differences were observed.

The application of laparoscopic ultrasound-guided intervention in renal hybrid surgery: case report.

Background: Conventional vascular interventions and hybrid surgery relied on digital subtraction angiography (DSA). Previously our center explored hybrid partial nephrectomy with DSA guidance, which demonstrates the superiority of omitting the dissection of renal hilum. However, this approach is limited to scarce hybrid operating rooms, involves radiation exposure, and poses compatibility issues with robotic surgery platforms. Laparoscopic ultrasound (LUS) can assist in robotic surgery. This study explored the application of LUS-guided occlusion of renal artery blood supply with a Fogarty balloon catheter, particularly in hybrid partial nephrectomy for renal tumor treatment. Case Description: The LUS-guided renal artery balloon catheter occluded hybrid partial nephrectomy (UBo-HPN) involved several steps: trans-femoral artery cannulation, placement of the balloon catheter into the renal artery via the femoral vascular sheath, occlusion of the renal blood supply by inflating the balloon catheter, completion of zero-ischemia partial nephrectomy with arterial flow occluded, withdrawal of the balloon catheter after deflation. For all three patients, the balloon catheter was successfully and accurately placed into the selected renal artery under LUS guidance. Intraoperative occlusion of the renal blood supply was confirmed to be complete and reversible. No complications were observed during follow-up. Conclusions: LUS guidance presents a safe alternative to DSA guidance for assisting in hybrid surgery. LUS-guided hybrid partial nephrectomy is safe and feasible.

Understanding driving forces of food waste separation intention to enhance regional and local solid waste planning: application of PLS-SEM and multi-group analysis.

This study extended the theory of planned behaviour (TPB) and applied it to analyse influencing factors of food waste separation intention (FSI) among households in central Vietnam. Partial least squares structural equation modelling (PLS-SEM) was employed to analyse the data. The heterogeneity of factors contributing to FSI in cities of three levels was examined using multi-group analysis (MGA). The results indicate that attitudes, subjective norms (SN), perceived behavioural control (PBC), awareness of benefit (AB), information publicity (IP), facility availability (FA), and trust significantly affected FSI of households. MGA results indicated the heterogeneity of impacts of PBC and attitude on FSI of households among three municipal levels. The results will serve as basic data for waste officers, solid-waste management project leaders, non-governmental organisations (NGOs), and other related stakeholders to lay the foundation of food waste management planning in terms of regional scale and local scale. This study will also aid the creation of a circular economy by providing a scientific base for enhancing food waste separation at source in central Vietnam.

Perioperative, functional and oncologic outcomes of percutaneous ablation versus minimally invasive partial nephrectomy for clinical T1 renal tumors: outcomes from a pooled analysis.

The objective of this study was to perform a comprehensive pooled analysis aimed at comparing the efficacy and safety of percutaneous ablation (PCA) versus minimally invasive partial nephrectomy (MIPN), including robotic and laparoscopic approaches, in patients diagnosed with cT1 renal tumors. We conducted a comprehensive search across four major electronic databases: PubMed, Embase, Web of Science, and the Cochrane Library, targeting studies published in English up to April 2024. The primary outcomes evaluated in this analysis included perioperative outcomes, functional outcomes, and oncological outcomes. A total of 2449 patients across 17 studies were included in the analysis. PCA demonstrated superior outcomes compared to MIPN in terms of shorter hospital stays (WMD: - 2.13 days; 95% Confidence Interval [CI]: - 3.29, - 0.97; p = 0.0003), reduced operative times (WMD: - 109.99 min; 95% CI: - 141.40, - 78.59; p < 0.00001), and lower overall complication rates (OR: 0.54; 95% CI: 0.40, 0.74; p = 0.0001). However, PCA was associated with a higher rate of local recurrence when compared to MIPN (OR: 3.81; 95% CI: 2.45, 5.92; p < 0.00001). Additionally, no significant differences were observed in major complications, estimated glomerular filtration rate decline, creatinine variation, overall survival, recurrence-free survival, and disease-free survival between the two treatment modalities. PCA presents a notable disadvantage regarding local recurrence rates in comparison to MIPN. However, PCA offers several advantages over MIPN, including shorter durations of hospital stay, reduced operative times, and lower complication rates, while achieving similar outcomes in other oncologic metrics.

Innovative insights into the roasting-driven transformation of volatile compounds and quality markers in flaxseed (Linum usitatissimum L.) oil.

Roasting is essential for developing the characteristic aroma of flaxseed oil (FSO), yet its impact on oil quality remains underexplored. This study employed headspace-gas chromatography-mass spectrometry coupled with multivariate analysis to elucidate the dynamic changes in volatile compounds and quality characteristics of FSO subjected to varying roasting temperatures. Our findings revealed that seven key aroma compounds, identified through the variable importance in the projection scores of partial least square-discrimination analysis models and relative aroma activity value, served as molecular markers indicative of distinct roasting temperatures. These compounds included 2,5-dimethylpyrazine, 2-pentylfuran, (E)-2-pentenal, 2-ethyl-3,6-dimethylpyrazine, heptanal, octanal, and 2-hexenal. Notably, roasting at 200°C was found to enhance oil stability and antioxidant capacity, with phenolic compounds and Maillard reaction products playing synergistic roles in bolstering these qualities. Network analysis further uncovered significant correlations between these key aroma compounds and quality characteristics, offering novel perspectives for assessing FSO quality under diverse roasting conditions. This research not only enriched our understanding of the roasting process's impact on FSO but also provided valuable guidance for the optimization of industrial roasting practices. This study would provide important practical applications in aroma regulation and process optimization of flaxseed oil. .

Deep learning applications for quantitative and qualitative PET in PET/MR: technical and clinical unmet needs.

We aim to provide an overview of technical and clinical unmet needs in deep learning (DL) applications for quantitative and qualitative PET in PET/MR, with a focus on attenuation correction, image enhancement, motion correction, kinetic modeling, and simulated data generation. (1) DL-based attenuation correction (DLAC) remains an area of limited exploration for pediatric whole-body PET/MR and lung-specific DLAC due to data shortages and technical limitations. (2) DL-based image enhancement approximating MR-guided regularized reconstruction with a high-resolution MR prior has shown promise in enhancing PET image quality. However, its clinical value has not been thoroughly evaluated across various radiotracers, and applications outside the head may pose challenges due to motion artifacts. (3) Robust training for DL-based motion correction requires pairs of motion-corrupted and motion-corrected PET/MR data. However, these pairs are rare. (4) DL-based approaches can address the limitations of dynamic PET, such as long scan durations that may cause patient discomfort and motion, providing new research opportunities. (5) Monte-Carlo simulations using anthropomorphic digital phantoms can provide extensive datasets to address the shortage of clinical data. This summary of technical/clinical challenges and potential solutions may provide research opportunities for the research community towards the clinical translation of DL solutions.

[The use of «growing¼ endoprostheses in the complex treatment of children with post-resection mandibular defects]. / Primenenie «rastushchikh¼ endoprotezov v kompleksnom lechenii detei s postrezektsionnymi defektami nizhnei chelyusti.

THE AIM OF THE STUDY: To develop and implement a comprehensive algorithm for the rehabilitation of patients after partial resection of the mandible using a titanium «growing¼ endoprosthesis. MATERIAL AND METHODS: The study included 16 patients aged 2 to 7 years, with benign (6 cases) and malignant (10 cases) tumors of the mandible. The patients were divided into 2 groups depending on the time of fixation of the endoprosthesis. Group 1 included patients with simultaneous installation of a prosthesis (7 people). Group 2 included patients with delayed installation of an endoprosthesis (9 people). For the reconstruction of the mandible, «growing¼ titanium endoprostheses made of Ti6Al4V alloy of various designs were used. Removable orthodontic devices of mechanical and functional type of action, standard elastic mouthguards were used in the process of dental treatment. RESULTS: A comprehensive algorithm has been developed for the rehabilitation of children after partial resection of the mandible, depending on the time of fixation of the prosthesis and the volume of surgical intervention. CONCLUSION: The developed algorithm of complex rehabilitation using a «growing¼ endoprosthesis and dental support at the pre and postoperative stages allows to reduce the volume of secondary deformation of facial structures and dentition.

A cohort analysis of familial partial lipodystrophy from two Mediterranean countries.

AIM: To assess the disease burden of familial partial lipodystrophy (FPLD) caused by LMNA (FPLD2) and PPARG (FPLD3) variants to augment the knowledge of these rare disorders characterized by selective fat loss and metabolic complications. MATERIALS AND METHODS: An observational longitudinal study, including 157 patients (FPLD2: 139 patients, mean age 46 ± 17 years, 70% women; FPLD3: 18 patients, mean age: 44 ± 17 years, 78% women) from 66 independent families in two countries (83 from Turkey and 74 from Spain), was conducted. RESULTS: Patients were diagnosed at a mean age of 39 ± 19 years, 20 ± 16 years after the first clinical signs appeared. Men reported symptoms later than women. Symptom onset was earlier in FPLD2. Fat loss was less prominent in FPLD3. In total, 92 subjects (59%) had diabetes (age at diagnosis: 34 ± 1 years). Retinopathy was more commonly detected in FPLD3 (P < .05). Severe hypertriglyceridaemia was more frequent among patients with FPLD3 (44% vs. 17%, P = .01). Hepatic steatosis was detected in 100 subjects (66%) (age at diagnosis: 36 ± 2 years). Coronary artery disease developed in 26 patients (17%) and 17 (11%) suffered from a myocardial infarction. Turkish patients had a lower body mass index, a higher prevalence of hepatic steatosis, greater triglyceride levels and a tendency towards a higher prevalence of coronary artery disease. A total of 17 patients died, with a mean time to death of 75 ± 3 years, which was shorter in the Turkish cohort (68 ± 2 vs. 83 ± 4 years, P = .01). Cardiovascular events were a major cause of death. CONCLUSIONS: Our analysis highlights severe organ complications in patients with FPLD, showing differences between genotypes and Mediterranean countries. FPLD3 presents a milder phenotype than FPLD2, but with comparable or even greater severity of metabolic disturbances.

Molecular evidence of internal carbon-driven partial denitrification in a mainstream pilot A-B system coupled with side-stream EBPR treating municipal wastewater.

Achieving mainstream short-cut nitrogen removal via nitrite has become a carbon and energy efficient way, but still remains challenging for low-strength municipal wastewaters. This study integrated sidestream enhanced biological phosphorus removal system in a pilot-scale adsorption/bio-oxidation (A-B) process (named A-B-S2EBPR system) and nitrite accumulation was successfully achieved for treating the municipal wastewater. Nitrite could accumulate to 5.5 ± 0.3 mg N/L in the intermittently aerated tanks of B-stage with the nitrite accumulation ratio (NAR) of 79.1 ± 6.5 %. The final effluent concentration and removal efficiency of total inorganic nitrogen (TIN) were 4.6 ± 1.8 mg N/L and 84.9 ± 5.6 %, respectively. In-situ process performance of nitrogen conversions, routine batch nitrification/denitrification activity tests and functional gene abundance of nitrifiers collectively suggested that the nitrite accumulation was mainly caused by partial denitrification rather than out-selection of nitrite oxidizing bacteria (NOB). Moreover, the single-cell Raman spectroscopy analysis first demonstrated that there was a specific microbial population that could utilize polyhydroxyalkanoates (PHA) as the potential internal carbon source during the partial denitrification process. The integration of S2EBPR brings unique features to the conventional A-B process, such as extended anaerobic retention time, lower oxidation-reduction potential (ORP), much higher and complex volatile fatty acids (VFAs) etc., which can largely reshape the microbial communities. The dominant genera were Acinetobacter and Comamonadaceae, which accounted for (17.8 ± 15.5)% and (6.7 ± 3.4)%, respectively, while the relative abundance of conventional nitrifiers was less than 0.2%. This study provides insights into phylogenetic and phenotypic shifts of microbial communities when incorporating S2EBPR into the sustainable A-B process to achieve mainstream short-cut nitrogen removal.