Characterization of scrubber water discharges from ships using comprehensive suspect screening strategies based on GC-APCI-HRMS.

An extended suspect screening approach for the comprehensive chemical characterization of scrubber discharge waters from exhaust gas cleaning systems (EGCSs), used to reduce atmospheric shipping emissions of sulphur oxides, was developed. The suspect screening was based on gas chromatography coupled with high-resolution mass spectrometry (GC-HRMS) and focused on the identification of polycyclic aromatic hydrocarbons (PAHs) and their alkylated derivatives (alkyl-PAHs), which are among the most frequent and potentially toxic organic contaminants detected in these matrices. Although alkyl-PAHs can be even more abundant than parent compounds, information regarding their occurrence in scrubber waters is scarce. For compound identification, an in-house compound database was built, with 26 suspect groups, including 25 parent PAHs and 23 alkyl-PAH homologues. With this approach, 7 PAHs and 12 clusters of alkyl-PAHs were tentatively identified, whose occurrence was finally confirmed by target analysis using GC coupled with tandem mass spectrometry (GC-MS/MS). Finally, a retrospective analysis was performed to identify other relevant (poly)cyclic aromatic compounds (PACs) of potential concern in scrubber waters. According to it, 18 suspect groups were tentatively identified, including biphenyls, dibenzofurans, dibenzothiophenes and oxygenated PAHs derivatives. All these compounds could be used as relevant markers of scrubber water contamination in heavy traffic marine areas and be considered as potential stressors when evaluating scrubber water toxicity.

An offset-free MPC formulation for nonlinear systems using adaptive integral controller.

This paper investigates a novel offset-free control scheme based on a multiple model predictive controller (MMPC) and an adaptive integral action controller for nonlinear processes. Firstly, the multiple model description captures the essence of the nonlinear process, while keeping the MPC optimization linear. Multiple models also enable the controller to deal with the uncertainty associated with changing setpoint. Then, a min-max approach is utilized to counter the effect of parametric uncertainty between the linear models and the nonlinear process. Finally, to deal with other uncertainties, such as input and output disturbances, an adaptive integral action controller is run in parallel to the MMPC. Thus creating a novel offset-free approach for nonlinear systems that is more easily tuned than observer-based MPC. Simulation results for a pH-controller, which acts as an example of a nonlinear process, are presented to demonstrate the usefulness of the technique compared to using an observer-based MPC.

Interconnectivity imaged in three dimensions: Nano-particulate silica-hydrogel structure revealed using electron tomography.

We have used Electron Tomography (ET) to reveal the detailed three-dimensional structure of particulate hydrogels, a material category common in e.g. controlled release, food science, battery and biomedical applications. A full understanding of the transport properties of these gels requires knowledge about the pore structure and in particular the interconnectivity in three dimensions, since the transport takes the path of lowest resistance. The image series for ET were recorded using High-Angle Annular Dark Field Scanning Transmission Electron Microscopy (HAADF-STEM). We have studied three different particulate silica hydrogels based on primary particles with sizes ranging from 3.6nm to 22nm and with pore-size averages from 18nm to 310nm. Here, we highlight the nanostructure of the particle network and the interpenetrating pore network in two and three dimensions. The interconnectivity and distribution of width of the porous channels were obtained from the three-dimensional tomography studies while they cannot unambiguously be obtained from the two-dimensional data. Using ET, we compared the interconnectivity and accessible pore volume fraction as a function of pore size, based on direct images on the nanoscale of three different hydrogels. From this comparison, it was clear that the finest of the gels differentiated from the other two. Despite the almost identical flow properties of the two finer gels, they showed large differences concerning the accessible pore volume fraction for probes corresponding to their (two-dimensional) mean pore size. Using 2D pore size data, the finest gel provided an accessible pore volume fraction of over 90%, but for the other two gels the equivalent was only 10-20%. However, all the gels provided an accessible pore volume fraction of 30-40% when taking the third dimension into account.

Effectiveness of photodynamic therapy in Bowen's disease: a retrospective observational study in 423 lesions.

BACKGROUND: Photodynamic therapy (PDT) is a well-known technique that is often used for treating superficial precancerous and cancerous skin lesions. However, only a handful of studies, with a relatively small number of treated lesions, have been carried out on the effectiveness of PDT for Bowen's disease (BD). OBJECTIVES: This study aimed to assess the effectiveness and recurrence risk of PDT in the treatment of BD. The secondary objectives were to determine what factors affected the response rates and the cosmetic result of the treatment. METHOD: In this retrospective observational study, the electronic patient charts at Sahlgrenska University Hospital (SUH) in Gothenburg, Sweden, were searched to find all patients diagnosed with BD who were treated with PDT between 1 January 2002 and 31 December 2014. Data were collected regarding clinical response at the first follow-up visit, recurrences during later follow-up visits and other relevant patient and tumour characteristics. RESULTS: In total, 423 BD lesions in 335 patients were included in the study. The mean FU duration was 11.2 months (range 0.2-151 months). The complete response rate at the first FU visit was 77.5% for all BD lesions. During later FU visits, another 60 recurrences were observed, which resulted in a recurrence rate of 18.3%. Thus, the overall clearance rate after FU was 63.4% for all BD lesions. Significant risk factors for unsuccessful treatment in this study were large lesion size (>2 cm) and a single PDT session. CONCLUSION: This study shows that PDT is a relatively effective treatment modality for BD.

Vaccination against T-cell epitopes of native ApoB100 reduces vascular inflammation and disease in a humanized mouse model of atherosclerosis.

BACKGROUND AND OBJECTIVES: The T-cell response to low-density lipoprotein (LDL) in the vessel wall plays a critical role in atherosclerotic plaque formation and stability. In this study, we used a new translational approach to investigate epitopes from human apolipoprotein B100 (ApoB100), the protein component of LDL, which triggers T-cell activation. We also evaluated the potential of two selected native ApoB100 epitopes to modulate atherosclerosis in human ApoB100-transgenic Ldlr-/- (HuBL) mice. METHODS AND RESULTS: HuBL mice were immunized with human atherosclerotic plaque homogenate to boost cellular autoimmune response to tissue-derived ApoB100 epitopes. In vitro challenge of splenocytes from immunized mice with a library of overlapping native peptides covering human ApoB100 revealed several sequences eliciting T-cell proliferation. Of these sequences, peptide (P) 265 and P295 were predicted to bind several human leucocyte antigen (HLA) haplotypes and induced high levels of interferon (IFN)-γ. Vaccination of HuBL mice with these peptides mounted a strong adaptive immune response to native ApoB100, including high levels of epitope-specific plasma IgGs. Interestingly, P265 and P295 vaccines significantly decreased plaque size, reduced macrophage infiltration and increased IgG1 deposition in the plaques. Purified IgGs from vaccinated mice displayed anti-inflammatory properties against macrophages in vitro, reducing their response to LPS in a dose-dependent manner. CONCLUSION: We identified two specific epitopes from human native ApoB100 that trigger T-cell activation and protect HuBL mice against atherosclerosis when used in a vaccine. Our data suggest that vaccination-induced protective mechanisms may be mediated at least in part through specific antibody responses to LDL that inhibit macrophage activation.

Infants under the age of six months with acute mastoiditis. A descriptive study of 15 years in Sweden.

OBJECTIVE: To investigate the occurrence, clinical signs and outcome of acute mastoiditis in infants under the age of 6 months in Sweden between the years 1993-2007. METHODS: All ENT departments in Sweden reported children 0-5 months treated for acute mastoiditis 1993-2007 and all records were reviewed. The clinical course and various characteristics were recorded. RESULTS: Seventeen young infants with acute mastoiditis were identified. Three patients had suffered acute otitis media earlier, otherwise the children were previously healthy. Preceding the episode of acute mastoiditis, the children had an upper respiratory tract infection or fever for seven days in mean (median three days) and the mean number of days with ear-symptoms was three days (median two days). Three patients were treated with antibiotics prior to admittance. Almost all children presented with clear retroauricular signs with protruding ear and redness behind the ear. The children were hospitalised for six days (mean and median). Eight patients (47%) suffered from a subperiosteal abscess. All but one patient underwent surgery: myringotomy (13); incision or punction of the mastoid (5); mastoidectomy (3). Streptococcus pneumoniae was the most frequent bacterium identified in cultures. No intracranial complications or other severe complications were found. CONCLUSION: Acute mastoiditis is extremely rare in infants under the age of 6 months. The patients in this study did not have any predisposing diseases. An upper respiratory tract infection had preceded the episode of acute mastoiditis for some time in the majority of cases, but the time from first ear symptoms to hospitalization was very short. Acute mastoiditis is a potentially life-threatening disease, but the timely administration of intravenous antibiotics and surgical intervention prevented the occurrence of severe complications in these young infants.

National assessment of validity of coding of acute mastoiditis: a standardised reassessment of 1966 records.

OBJECTIVES: To investigate the internal validity of the diagnosis code used at discharge after treatment of acute mastoiditis. DESIGN: Retrospective national re-evaluation study of patient records 1993-2007 and make comparison with the original ICD codes. SETTING: All ENT departments at university hospitals and one large county hospital department in Sweden. PARTICIPANTS: A total of 1966 records were reviewed for patients with ICD codes for in-patient treatment of acute (529), chronic (44) and unspecified mastoiditis (21) and acute otitis media (1372). MAIN OUTCOME MEASURES: ICD codes were reviewed by the authors with a defined protocol for the clinical diagnosis of acute mastoiditis. Those not satisfying the diagnosis were given an alternative diagnosis. RESULTS: Of 529 records with ICD coding for acute mastoiditis, 397 (75%) were found to meet the definition of acute mastoiditis used in this study, while 18% were not diagnosed as having any type of mastoiditis after review. Review of the in-patients treated for acute media otitis identified an additional 60 cases fulfilling the definition of acute mastoiditis. Overdiagnosis was common, and many patients with a diagnostic code indicating acute mastoiditis had been treated for external otitis or otorrhoea with transmyringeal drainage. CONCLUSIONS: The internal validity of the diagnosis acute mastoiditis is dependent on the use of standardised, well-defined criteria. Reliability of diagnosis is fundamental for the comparison of results from different studies. Inadequate reliability in the diagnosis of acute mastoiditis also affects calculations of incidence rates and statistical power and may also affect the conclusions drawn from the results.

Water mobility in heterogeneous emulsions determined by a new combination of confocal laser scanning microscopy, image analysis, nuclear magnetic resonance diffusometry, and finite element method simulation.

Nuclear magnetic resonance (NMR) diffusometry and confocal laser scanning microscopy (CLSM) were combined in a quantitative way in finite element calculations of water propagation in CLSM images obtained from a very heterogeneous emulsion. The propagators calculated on the basis of microstructure were Fourier transformed and subsequently compared with the echo decays obtained by the NMR diffusometry method. The results showed very good agreement between microstructure based calculations and experiments, indicating that the short gradient pulse approximation in the NMR diffusometry experiment holds for a certain q range. Furthermore, the CLSM was able to achieve a relevant two-dimensional microstructure although some discrepancy at low q values was noted. This effect is attributed to the inherent three-dimensional connectivity between the water domains in this type of structures, making the calculations slightly underestimate the water diffusion at longer distances.

Survival with pain: an eight-year follow-up of war-wounded refugees.

The aim of this study was to investigate the nature of chronic pain in male war-wounded refugees and to examine the relationship between chronic pain and psychiatric symptoms. A culturally heterogeneous group of 44 war-wounded refugees were investigated during hospitalization, shortly after arrival, and followed up after two years. This study is an additional follow-up after eight years. The data collection methods used were structured interviews and physical examination. The measures of outcome were: Visual Analogue Scale (VAS) grading of pain; clinical categorization of pain into nociceptive or neurogenic; Hopkins Symptom Check List (HSCL-25); Post Traumatic Symptom Scale (PTSS-10). Chronic pain was found in 32 (73%) out of 44 subjects. The pain was purely nociceptive and neurogenic in 53% and 25%, respectively. The frequency of psychiatric symptoms was significantly related to the mean intensity of pain. War-wounded refugees display psychiatric symptoms and chronic pain in a complex pattern. Further research is needed as a basis for pain rehabilitation programmes suitable for this group.

Short-term penicillin-V prophylaxis did not prevent acute otitis media in infants.

OBJECTIVE: To determine whether prophylactic, short-term penicillin V treatment during upper respiratory tract infections can prevent the occurrence of recurrent acute otitis media in young children. METHODS: Seventy children were studied in a prospective, double-blind, placebo-controlled study. All children had suffered their first episode of acute otitis media before the age of 6 months. After inclusion in the study group, administration of penicillin V or placebo was initiated by the parents at subsequent upper respiratory tract infections. The children were examined by otomicroscopy within 3 days after treatment was initiated. The children were scheduled for a total follow-up period of 12 months, including bimonthly visits for check-up irrespective of treatment periods. RESULTS: There were 304 treated episodes of upper respiratory tract infection. There was no significant difference in the number of acute otitis episodes between groups. CONCLUSION: Initiation of penicillin V prophylaxis at upper respiratory tract infection in small children did not prevent recurrent acute otitis media in this study.

Goblet cell density in acute otitis media caused by Moraxella catarrhalis.

HYPOTHESIS AND BACKGROUND: Secretory otitis media is associated with a highly increased goblet cell density, confirming the secretory pathogenesis of this disease. Previous studies have shown that the middle ear goblet cell density, and thus the secretory capacity, are massively increased during experimental acute otitis media and at least 6 months thereafter, conceivably predisposing to the subsequent development of secretory otitis media. These studies used middle ear inoculation of either Streptococcus pneumoniae, nontypeable Haemophilus influenzae, or H. influenzae type b. The present study aimed at determining the goblet cell density during and after acute otitis media caused by Moraxella catarrhalis to clarify whether this bacterium induces an equivalently enhanced secretory capacity. METHODS: Twenty-five 25 rat middle ears were inoculated with M. catarrhalis. Five rats were killed on days 4, 8, 16, 60, and 180 after inoculation, followed by staining, dissection, and whole-mount embedding of the middle ear mucosae. The goblet cell density was determined by counting in 24 fields, covering the entire middle ear. RESULTS: In comparison with 25 normal middle ears, the goblet cell density was significantly increased in almost all counting localities, from day 4 and < or = 2 months after inoculation. The goblet cell density peaked on day 16, subsided thereafter, and in some areas reached a normal level 6 months after the acute incident. Mucosal areas containing goblet cells were consistently enlarged, thus leaving the middle ear with an increased secretory capacity during and 6 months after inoculation. CONCLUSION: The goblet cell density of the middle ear mucosa is increased during acute otitis media caused by M. catarrhalis and up to several months thereafter. This may predispose to the subsequent development of secretory otitis media. However, in comparison with acute otitis media caused by other bacteria, M. catarrhalis induced only modest changes in goblet cell density.

Aging of whey protein films and the effect on mechanical and barrier properties.

This work focuses on the aging of whey protein isolate (WPI) films plasticized with glycerol (G) and sorbitol (S). The films were cast from heated aqueous solutions at pH 7 and dried at 23 degrees C and 50% relative humidity (RH) for 16 h. They were stored in a climate room (23 degrees C, 50% RH) for 120 days, and the film properties were measured at regular intervals. The moisture content (MC) of the WPI/G films decreased from 22% (2 days) to 15% (45 days) and was thereafter constant at 15% (up to 120 days). This affected the mechanical properties and caused an increased stress at break (from 2.7 to 8.3 MPa), a decreased strain at break (from 33 to 4%), and an increased glass transition temperature (T(g)) (from -56 to -45 degrees C). The barrier properties were, however, unaffected, with constant water vapor permeability and a uniform film thickness. The MC of the WPI/S films was constant at approximately 9%, which gave no change in film properties.

Quantification of ammonia-oxidizing bacteria in arable soil by real-time PCR.

Real-time PCR was used to quantify populations of ammonia-oxidizing bacteria representing the beta subdivision of the class Proteobacteria in samples of arable soil, both nitrogen fertilized and unfertilized, from Mellby, Sweden. Primers and probes targeting a 16S ribosomal DNA region of the ammonia-oxidizing bacteria were designed and used. In the fertilized soil there were approximately 6.2 x 10(7) ammonia-oxidizing bacteria per g of soil, three times more than the number of bacteria in the unfertilized soil. The lytic efficiency of bead beating in these soils was investigated by using populations of free or loosely attached bacteria, bacteria tightly bound to particles, and bacteria in nonfractionated samples. The shapes of the curves generated in these tests showed that the concentration of template DNA released at various times remained constant after 10 to 100 s of bead beating.

What do we know about the dying patient? Awareness as a means to improve palliative care.

With the Hospice movement palliative care has been improved in dramatic ways. But there is also evidence that although the nursing staff is aware of the medical and physical care needs, they may have insufficient knowledge about the patient as a person, which is a prerequisite for individualized patient centered care. Avery Weisman and co-workers used six questions in post-mortem sessions where the patients' terminal period was evaluated. They used the expression Psychological autopsy for this and stressed the importance of gathering information about psycho-social aspects in the end of life experience. In a hospice-related project in Sweden, Weisman's questions were transformed into the following keywords: Symptom Control, Self-determination, Social Relations, Self-image, Synthesis, and Surrender. These were used prospectively in nursing documentation as well as in follow-up sessions after death with staff and in interviews with the patients' family members. This contributed to a greater awareness of the patients' total situation at the end of life.

Relationship between the microstructure and the mechanical and barrier properties of whey protein films.

This work was focused on the relationship between the microstructure and the mechanical and barrier properties of whey protein isolate (WPI) films. Sorbitol (S) and glycerol (G) were used as plasticizers and the pH was varied between 7 and 9. The films were cast from heated aqueous solutions and dried in a climate room at 23 degrees C and 50% relative humidity for 16 h. The microstructure of the films was found to be dependent on the concentration, the plasticizers, and the pH. When the concentration increased, a more aggregated structure was formed, with a denser protein network and larger pores. This resulted in increased water vapor permeability (WVP) and decreased oxygen permeability (OP). When G was used as a plasticizer instead of S, the microstructure was different, and the moisture content and WVP approximately doubled. When the pH increased from 7 to 9, a denser protein structure was formed, the strain at break increased, and the OP decreased.

Experimental study of the virulence of Streptococcus pneumoniae with reduced susceptibility to penicillin.

Streptococcus pneumoniae is a major cause of morbidity and mortality in all age groups. In a few years, penicillin non-susceptible pneumococci (PNSP) have emerged worldwide as a new threat. In order to better understand the mechanisms behind the rapid expansion of these strains, the virulence of 10 clinical and two transformed PNSP strains were compared with the virulence of three fully susceptible strains in a mouse model of bacteremia and a rat model of acute otitis media. Serotype, antibiotic susceptibility, and to some extent also genetic profile and growth rate of the strains were investigated before inoculation. The animals were monitored for up to 7 days after challenge by clinical examinations/otomicroscopy and cultures from middle ears and blood. The results of the study demonstrated that the PNSP strains had a significantly reduced ability to persist at the infectious site, and to some extent also to induce infections, compared with fully susceptible strains. The reduction was most evident for strains isolated from sources other than blood. It is therefore possible that other factors than virulence factors are of importance for the ability of PNSP strains to expand.

Phase separation and gel formation in kinetically trapped gelatin/maltodextrin gels.

The kinetics of phase separation and gel formation of gelatin/maltodextrin mixtures have been studied using confocal laser scanning microscopy (CLSM), transmission electron microscopy (TEM), stereological image analysis and rheology. The quantified microstructural parameters were the volume-weighted mean volume and the interfacial area. The temperature of phase separation was defined as the temperature where the first signs of phase separation were observed in CLSM. The gelatin concentration varied between 4 (wt.) and 5% and the maltodextrin concentration varied between 2 and 6%. Maltodextrin was labelled covalently with RITC to improve the contrast between the gelatin phase and the maltodextrin phase. The solutions were cooled from 60 to 10 degrees C, and the cooling rates used were 0.4, 1 and 3 degrees C/min. All systems were found to be gelatin continuous under the experimental conditions used. The results showed that the temperature of phase separation (TPS) increased both with the gelatin concentration and the maltodextrin concentration, but particularly with the former. The size of the maltodextrin inclusions increased with TPS, and the interfacial area decreased with increasing TPS. The diameter of the maltodextrin inclusions varied between 1.6 and 8.5 microm at 1 degrees C/min. The size of the maltodextrin inclusions was found to increase with decreasing cooling rate and was largest at 0.4 degrees C/min. The TPS was compared with the gelation temperature (Tgel) at three different concentrations of gelatin and maltodextrin (4/3, 4/5, 5/5%). CLSM micrographs and TEM micrographs showed that these three concentrations of gelatin and maltodextrin had different microstructures. At a TPS above Tgel (5/5%), the phase separation proceeded faster than the gel formation and the microstructure had few, large maltodextrin inclusions and a clean continuous gelatin phase. At a TPS comparable with Tgel (4/5%), phase separation occurred during gel formation, which led to a varying microstructure and competition between the phase separation and the gel formation. At a TPS below Tgel (4/3%), gel formation proceeded faster than the phase separation and the microstructure had many, small inclusions and a diffuse microstructure, and the phase separation was incomplete. It was established that the microstructure was determined by the relative rates of the phase separation and the gel formation. Three different zones of phase separation could be distinguished based on comparisons of TPS and Tgel, and results from CLSM, TEM and image analysis.

Middle ear secretory capacity after acute otitis media caused by Streptococcus pneumoniae, Moraxella catarrhalis, non-typeable or type B Haemophilus influenzae. A comparative analysis based on goblet cell density.

To investigate whether the type of bacteria is correlated with an increase in goblet cell density during and after acute otitis media, we inoculated the middle ear of 25 rats with either Streptococcus pneumoniae, Moraxella catarrhalis, non-typeable or type b Haemophilus influenzae. Mucosal goblet cell density was determined by a whole-mount method on days 4, 8, 16, 60 and 180 post-inoculation. The goblet cell density was increased on all days of sacrifice, employing either bacteria, except M. catarrhalis 6 months after the acute incident. Type b H. influenzae induced the highest increase, followed by non-typeable H. influenzae, S. pneumoniae and M. catarrhalis. The mucosal area containing goblet cells was enlarged on all examination days, employing either bacteria. We conclude, that mucosal secretory capacity is highly increased during and up to 6 months after acute middle ear infection caused by either bacteria, conceivably predisposing a subsequent development of secretory otitis media. The results indicate that type b H. influenzae seems to be the bacteria most likely to induce a subsequent secretory condition.

Effect of penicillin on experimental acute otitis media. A histopathological study of goblet cell density, bone modelling dynamics, polyp and adhesion formation.

Clinical studies have shown that the effect of antibiotic treatment on acute otitis media is modest. Experimental acute otitis media induces a number of histopathological changes in the middle ear mucosa. Among these are increased goblet cell density, polyp and adhesion formation, as well as massive osteoneogenesis. To investigate the effect of penicillin administration on these histopathological features, we employed a rat model of acute pneumococcal otitis media. Five of 25 rats were sacrificed on days 4, 8, 16, 90 and 180 post-inoculation, preceded by oral administration of penicillin V 100 mg/kg/day, initiated on day 2 and lasting 5 days. Using a light microscope, qualitative and quantitative histopathology of middle ear goblet cell density, bone-modelling dynamics, polyp and adhesion formation was registered and compared with previous studies of untreated animals. Increase in goblet cell density and new bone formation was reduced significantly by treatment, whereas polyp and adhesion formation was unaffected by penicillin administration. It is concluded that penicillin reduces middle ear secretory capacity and new bone formation during and following acute otitis media, conceivably preventing subsequent development of secretory otitis media, leaving polyp and adhesion formation unchanged.

Smad7 mediates apoptosis induced by transforming growth factor beta in prostatic carcinoma cells.

Transforming growth factor beta (TGF-beta) is an important regulator of apoptosis in some cell types, but the underlying molecular mechanisms are largely unknown. TGF-beta signals through type I and type II receptors and downstream effector proteins, termed Smads. TGF-beta induces the phosphorylation of Smad2 and Smad3 (receptor-activated Smads) which associate with Smad4 and translocate to the nucleus, where they regulate gene transcription [1]. Smad7 protein is induced by TGF-beta1 and has been classified as an inhibitory Smad. Smad7 prevents phosphorylation of receptor-activated Smads, thereby inhibiting TGF-beta-induced signaling responses [1]. Smad7 expression is increased in rat prostatic epithelial cells undergoing apoptosis as a result of castration [2]. Here we have shown that TGF-beta1 treatment or ectopic expression of Smad7 in human prostatic carcinoma cells (PC-3U) induces apoptosis. Furthermore, TGF-beta1-induced apoptosis was prevented by inhibition of Smad7 expression, by antisense mRNA in stably transfected cell lines or upon transient transfection with antisense oligonucleotides in several investigated cell lines. These findings provide evidence for a new effector function for Smad7 in TGF-beta1 signaling.