Integrated full-scale solar CPC/UV-LED-filtration system as a tertiary treatment in a conventional WWTP for agricultural reuse purposes.

Today, the emergence of increasingly restrictive treatment and reuse policies make the implementation of full-scale tertiary treatment, capable of improving the quality of water, a priority. Full-scale TiO2 photocatalysis systems are resulting in a promising option, since TiO2 is commercially available. However, questions such as how to work continuously during day/night irradiation cycle, or the removing of TiO2 in outlet flow are still unresolved. In this work, a full-scale system integrating a solar CPC/UV-LED step combined with commercial microfiltration membranes was installed in a conventional WWTP for agricultural reuse purposes. After optimization, 0.5 g/L of catalyst and combined SOLAR + UV-LED showing the highest pharmaceutical removal percentages, while a self-designed UV-LED included in the own reaction tank resulting in higher efficiencies compared with commercial lamps. Longer membrane surface area decreased fouling problems in the system. However, 60 min of irradiation time was necessary to reach the most restrictive water quality values according with (EU 2020/741). After optimization step, total costs were reduced by 45%. However, it was shown that a reduction in operating and maintenance costs, along with the development of more effective and economical commercial filtration membranes is a key factor; therefore, working on these aspects is essential in the treated water cost reduction.

Reliability analysis of smart laminated composite plates under static loads using artificial neural networks.

The applications of smart structures with integrated piezoelectric elements have been expanding in the last few decades due to the abilities of such structures to withstand mechanical loads and operate as sensors or actuators using their electromechanical coupling. The available manufacturing techniques can result in uncertainties in the structure's geometric parameters, which, coupled with uncertainties in material properties, can lead to unexpected failures or unreliable performance. This paper presents a reliability analysis of a smart laminated composite plate made of a graphite/epoxy cross-ply substrate with a piezoelectric fiber-reinforced composite (PFRC) actuator layer under static electrical and mechanical loads. A coupled finite element (FE) model was developed in COMSOL Multiphysics, from which nondimensional stresses and displacements were calculated. To investigate the effects of randomness in the material and geometric properties, an artificial neural network (ANN) model was developed and trained using generated FE data. Monte Carlo Simulation (MCS) and First- and Second-Order Reliability Methods (FORM/SORM) were then used to shed light on the significance of considering randomness in the various material and geometric parameters and the effect of such uncertainty on the resulting nondimensional stresses and displacements. A coefficient of variation (CV) study identified the piezoelectric stress coefficient as the most significant contributing factor to the variation of all nondimensional parameters. Variation in the nondimensional parameters also increases under the application of an electric load. ANN-based FORM, SORM, and MCS all indicate a pattern of low probability of failure until a threshold value of about 3% of input parameter variation is reached, beyond which there is a rapid nonlinear increase in failure probability with increasing input parameter variation.

Liver imaging reporting and data system (LI-RADS) v2018: Reliability and agreement for assessing hepatocellular carcinoma locoregional treatment response.

PURPOSE: The purpose of this study was to determine the reliability and interobserver agreement of the liver imaging reporting and data system (LI-RADS) treatment response algorithm (LR-TR) v2018 using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the added value of diffusion-weighted imaging (DWI). MATERIALS AND METHODS: A total of 54 patients who underwent DCE-MRI and DWI after locoregional treatment of 81 hepatocellular carcinoma (HCC) lesions from September 2020 to July 2021 were included. There were 47 men and 7 women, with a mean age of 63.9 ± 9.2 (SD) years (age range: 23-77 years). Locoregional treatments included transarterial chemoembolization (TACE) (53/81; 65.4%), radiofrequency ablation (RFA) (25/81; 30.9%) and microwave ablation (MWA) (3/81; 3.7%). Two independent radiologists retrospectively evaluated DCE-MRI examinations obtained after locoregional treatment using LR-TR, and then three months later both radiologists reevaluated DCE-MRI examinations with DWI. Interobserver agreement was assessed using intraclass correlation coefficient (ICC) and Kappa test. Diagnostic performances were evaluated in term of sensitivity, specificity, and area under ROC curve (AUC) using a composite standard of reference that included results of histopathological examinations and follow-up findings. RESULTS: Using DCE-MRI alone, observer 1 had 83.9% sensitivity (26/31; 95% confidence interval [CI]: 66-95%), 88% specificity (44/50; 95% CI: 76-95%) and 86.4% accuracy (70/81; 95%CI: 77-93%), and observer 2 had 71% sensitivity (22/31; 95% CI: 52-86%), 92% specificity (46/50; 95% CI: 81-98%) and 83.9% accuracy (68/81; 95% CI: 74-91%). For the diagnosis of viable tumors using DCE-MRI with DWI, observer 1 and observer 2 had 87.1% (27/31; 95% CI: 70-96%) and 74.2% (23/31; 95% CI: 55-88%) sensitivity, respectively. The diagnostic performance of DCE-MRI with DWI yielded an AUC (0.875; 95% CI: 0.789-0.962) not different from that of DCE-MRI without DWI (0.859; 95% CI: 0.768-0.951) (P = 0.317). Interobserver agreement for arterial phase hyperenhancement, washout, enhancement similar to pretreatment and DWI findings in all treated HCCs was almost perfect (kappa = 0.815, 0.837, 0.826 and 0.81 respectively). Agreement between observers for LR-TR category was substantial (kappa = 0.795; 95% CI: 0.665-0.924). Interobserver agreement for size of viable HCC was excellent (ICC = 0.938; 95% CI: 0.904-0.960). CONCLUSION: LR-TR using DCE-MRI alone or DCE-MRI with DWI are both accurate for detecting viable HCC lesions after locoregional treatment, with no differences in diagnostic performance and excellent interobserver agreement.

Interrater reliability and agreement of the liver imaging reporting and data system (LI-RADS) v2018 for the evaluation of hepatic lesions.

Purpose: The liver imaging reporting and data system (LI-RADS) is a structured reporting system that categorizes hepatic observations according to major imaging features and lesion size, with an optional ancillary features contribution. This study aimed to evaluate inter-reader agreement of dynamic magnetic resonance imaging (MRI) using LI-RADS v2018 lexicon. Material and methods: Forty-nine patients with 69 hepatic observations were included in our study. The major and ancillary features of each hepatic observation were evaluated by 2 radiologists using LI-RADS v2018, and the interreader agreement was allocated. Results: The inter-reader agreement of major LI-RADS features was substantial; κ of non-rim arterial hyperenhancement, non-peripheral washout appearance, and enhancing capsule was 0.796, 0.799, and 0.772 (p < 0.001), respectively. The agreement of the final LI-RADS category was substantial with κ = 0.651 (p < 0.001), and weighted κ = 0.786 (p < 0.001). The inter-reader agreement of the ancillary features was substantial to almost perfect (k range from 0.718 to 1; p < 0.001). An almost perfect correlation was noted for the hepatic lesion size measurement with ICC = 0.977 (p < 0.001). Conclusions: The major and ancillary features of the LI-RADS v2018, as well as the final category and lesions size, have substantial to almost perfect inter-reader agreement.

An integral approach to sludge handling in a WWTP operated for EBPR aiming phosphorus recovery: Simulation of alternatives, LCA and LCC analyses.

As phosphorus is a non-renewable resource mainly used to produce fertilizers and helps to provide food all over the world, the proper management of its reserves is a global concern since it is expected to become scarcer in the near future. In this work we assessed two different sludge line configurations aiming for P extraction and recovery before anaerobic digestion and compared them with the classical configuration. This study has been performed by simulation with the model BNRM2 integrated in the software package DESASS 7.1. Configuration 1 was based on the production of a PO4-enriched stream from sludge via elutriation in the primary thickeners, while Configuration 2 was based on the WASSTRIP® process and its PO4-enriched stream was mechanically obtained with dynamic thickeners. In both alternatives recovery was enhanced by promoting poly-phosphate (poly-P) extraction under anaerobic conditions, for which both configurations were fully evaluated in a full-scale WWTP. Both were also optimized to maximize phosphorus extraction. Their costs and life cycles were also analysed. The novelty of this research lies in the lack of literature about the integral evaluation of pre-anaerobic digestion P recovery from wastewaters. This study included a holistic approach and an optimization study of both alternatives plus their economic and environmental aspects. In Configuration 1, the PO4-P load in the recovery stream reached 43.1% of the total influent P load and reduced uncontrolled P-precipitation in the sludge line up to 52.9%. In Configuration 2, extraction was 48.2% of the influent P load and it reduced precipitation by up to 60.0%. Despite Configuration 1's lower phosphorus recovery efficiency, it had a 23.0% lower life cycle cost and a 14.2% lower global warming impact per hm3 of treated influent than Configuration 2. Configuration 1 also reduced the TAEC by 17.6% and global warming impact by 2.0% less than Configuration 0.

First-in-human phase 0 study of 111In-CHX-A"-DTPA trastuzumab for HER2 tumor imaging.

INTRODUCTION: Tumors over-expressing the human epithelial receptor 2 (HER2) or exhibiting amplification or mutation of its proto-oncogene have a poorer prognosis. Using trastuzumab and/or other HER2 targeted therapies can increase overall survival in patients with HER2(+) tumors making it critical to accurately identify patients who may benefit. We report on a Phase 0 study of the imaging agent, 111In-CHX-A"-DTPA trastuzumab, in patients with known HER2 status to evaluate its safety and biodistribution and to obtain preliminary data regarding its ability to provide an accurate, whole-body, non-invasive means to determine HER2 status. METHODS: 111In-CHX-A"-DTPA trastuzumab was radiolabeled on-site and slowly infused into 11 patients who underwent single (n=5) or multiple (n=6) ɣ-camera (n=6) and/or SPECT (n=8) imaging sessions. RESULTS: No safety issues were identified. Visual and semi-quantitative imaging data were concordant with tissue HER2 expression profiling in all but 1 patient. The biodistribution showed intense peak liver activity at the initial imaging timepoint (3.3h) and a single-phase clearance fit of the average time-activity curve (TAC) estimated t1/2=46.9h (R2=0.97; 95%CI 41.8 to 53h). This was followed by high gastrointestinal (GI) tract activity peaking by 52h. Linear regression predicted GI clearance by 201.2h (R2 =0.96; 95%CI 188.5 to 216.9h). Blood pool had lower activity with its maximum on the initial images. Non-linear regression fit projected a t1/2=34.2h (R2 =0.96; 95%CI 25.3 to 46.3h). Assuming linear whole-body clearance, linear regression projected complete elimination (x-intercept) at 256.5hr (R2=0.96; 95%CI 186.1 to 489.2h). CONCLUSION: 111In-CHX-A"-DTPA trastuzumab can be safely imaged in humans. The biodistribution allowed for visual and semiquantitative analysis with results concordant with tissue expression profiling in 10 of 11 patients. Advances in Knowledge and Implications for Patient Care Using readily available components and on-site radiolabeling 111In-CHX-A"-DTPA trastuzumab SPECT imaging may provide an economical, non-invasive means to detect HER2 over-expression.

Treatment-related changes in glioblastoma: a review on the controversies in response assessment criteria and the concepts of true progression, pseudoprogression, pseudoresponse and radionecrosis

The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials. However, assessment criteria have certain limitations that emerging image techniques have tried to overcome. Differentiating true progression from treatment-related changes (like pseudoprogression or pseudoresponse) is crucial in order not to prematurely discontinue adjuvant chemotherapy or redirect the patient to second-line options. This fact underscores the need for advanced radiologic techniques, like specific diffusion and perfusion MRI sequences, MR spectroscopy and PET, which seem to play a role in distinguishing these phenomena

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Treatment-related changes in glioblastoma: a review on the controversies in response assessment criteria and the concepts of true progression, pseudoprogression, pseudoresponse and radionecrosis.

The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials. However, assessment criteria have certain limitations that emerging image techniques have tried to overcome. Differentiating true progression from treatment-related changes (like pseudoprogression or pseudoresponse) is crucial in order not to prematurely discontinue adjuvant chemotherapy or redirect the patient to second-line options. This fact underscores the need for advanced radiologic techniques, like specific diffusion and perfusion MRI sequences, MR spectroscopy and PET, which seem to play a role in distinguishing these phenomena.

Maximizing fluid delivered by bubble-free electroosmotic pump with optimum pulse voltage waveform.

In generating high electroosmotic (EO) flows for use in microfluidic pumps, a limiting factor is faradaic reactions that are more pronounced at high electric fields. These reactions lead to bubble generation at the electrodes and pump efficiency reduction. The onset of gas generation for high current density EO pumping depends on many parameters including applied voltage, working fluid, and pulse duration. The onset of gas generation can be delayed and optimized for maximum volume pumped in the minimum time possible. This has been achieved through the use of a novel numerical model that predicts the onset of gas generation during EO pumping using an optimized pulse voltage waveform. This method allows applying current densities higher than previously reported. Optimal pulse voltage waveforms are calculated based on the previous theories for different current densities and electrolyte molarity. The electroosmotic pump performance is investigated by experimentally measuring the fluid volume displaced and flow rate.

Presentación atípica del síndrome de Wernicke con afectación cerebelosa en resonancia magnética sin afectación en localizaciones típicas / Atypical presentation of Wernicke syndrome with magnetic resonance imaging showing cerebellar involvement and no changes in typical regions

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Effect of electric field on the performance of soil electro-bioremediation with a periodic polarity reversal strategy.

In this work, it is studied the effect of the electric fields (within the range 0.0-1.5 V cm(-1)) on the performance of electrobioremediation with polarity reversal, using a bench scale plant with diesel-spiked kaolinite with 14-d long tests. Results obtained show that the periodic changes in the polarity of the electric field results in a more efficient treatment as compared with the single electro-bioremediation process, and it does not require the addition of a buffer to keep the pH within a suitable range. The soil heating was not very important and it did not cause a change in the temperature of the soil up to values incompatible with the life of microorganisms. Low values of water transported by the electro-osmosis process were attained with this strategy. After only 14 d of treatment, by using the highest electric field studied in this work (1.5 V cm(-1)), up to 35.40% of the diesel added at the beginning of the test was removed, value much higher than the 10.5% obtained by the single bioremediation technology in the same period.

Ácido acetilsalicílico y clonidina en el perioperatorio de pacientes intervenidos de cirugía no cardíaca (estudio POISE-2) / Perioperative acetylsalicylic acid and clonidine in noncardiac surgery patients (POISE-2 trial)

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La expresión clínica y epidemiológica actual por tos ferina en un hospital terciario / The clinical expression and current epidemiology of whooping cough in a tertiary hospital

Objetivo: Describir el patrón clínico y epidemiológico de la expresión de tos ferina. Material y métodos: Estudio retrospectivo observacional de pacientes entre 0 y 15 años de edad diagnosticados de infección por Bordetella pertussis entre enero de 2009 y diciembre de 2011 en un hospital terciario de Madrid. Resultados: Se confirmaron microbiológicamente 65 casos, un 46,1% de ellos en menores de 1 año; un 20% de los niños no había recibido ninguna vacuna de B. pertussis, un 77% de ellos debido a que eran menores de 2 meses. El síntoma principal fue la tos paroxística (61,5%), con una media de 11 días de evolución. La radiografía de tórax y el hemograma no ayudaron a esclarecer el diagnóstico. Conclusión: La tos ferina es una enfermedad que cabe considerar en lactantes y adolescentes. Es necesario adoptar determinadas medidas preventivas para disminuir la incidencia de esta patología (AU)

Title: The clinical expression and current epidemiology of whooping cough in a tertiary hospital Objective: To describe the clinical and epidemiological pattern of expression of pertussis. Methods: Retrospective observational study of patients between 0 and 15 years of age diagnosed with infection by Bordetella pertussis between January 2009 and December 2011 in a tertiary hospital in Madrid. Results: 65 cases were confirmed microbiologically, 46.1% of them in children under 1 year; 20% of children had received no vaccine for B. pertussis, 77% of them were under 2 months old. The main symptom was ther paroxistical cough (61.5%), with 11 days of average evolution. Chest X ray and blood test didn’t help to find out the diagnosis. Conclusion: Pertussis is a disease to be considered in infants and adolescents. It is necessary to perform certain preventive attitudes to reduce the incidence of this disease (AU)

Functional and molecular imaging: applications for diagnosis and staging of localised prostate cancer.

Prostate cancer is currently the most common solid organ cancer type among men in the Western world. Currently, all decision-making algorithms and nomograms rely on demographics, clinicopathological data and symptoms. Such an approach can easily miss significant cancers while detecting many insignificant cancers. In this review, novel functional and molecular imaging techniques used in the diagnosis and staging of localised prostate cancer and their effect on treatment decisions are discussed.

Simplificación del problema inverso electroencefalográfico a una sola región homogénea con condición de Neumann nula / Simplification of the Inverse Electroencephalographic Problem to One Homogeneous Region with Null Neumann Condition

Objetivo: Presentar una simplificación del Problema Inverso Electroencefalográfico (PIE) del caso de varias capas conductoras a una región homogénea con condición de Neumann Nula. Metodología: Se divide el PIE en tres problemas, dos de los cuales se resuelven usando el potencial medido en el cuero cabelludo y con estas soluciones y el tercer problema se lleva a cabo la simplificación. Para validar la simplificación se genera un ejemplo sintético usando el modelo de esferas concéntricas. Resultados: Por medio de la simplificación la fuente se determina a partir de la ecuación de Poisson con una condición de Neumann nula y un dato adicional sobre la frontera de la región homogénea, el cual se obtiene de la medición. Esto es válido para regiones generales con fronteras suficientemente suaves. Adicionalmente, para el caso de esferas concéntricas, se plantea el PIE para el caso de una fuente dipolar (que representa a focos epilépticos) usando esta simplificación y la técnica de la función de Green. Conclusión: La simplificación presentada aquí permite analizar el PIE en una región lo cual simplifica su estudio teórico y numérico. En particular, puede ser útil para el análisis del problema de identificación de los parámetros de una fuente dipolar.

Objective: To give a simplification of the Inverse Electroencephalographic Problem (IEP) from the case of multilayer conductive medium to the case of a homogeneous region with null Neumann condition. Methodology: IEP is divided in three problems, two of which are resolved using the measurements of potential on the scalp and with these solutions and the third problem the simplification is carried out. In order to validate the simplification a synthetic example is generated using the model of concentric spheres. Results: Through of simplification, the source is determined from the Poisson equation with null Neumann condition and an additional data on the boundary of the homogeneous region, which is obtained from the measurement. This is valid for regions with smooth boundary. Additionally, in the case of concentric spheres, it is statement the identification problem for dipolar sources (representing epileptic focus) using this simplification and Green function. Conclusion: The simplification presented here allows us to analyze the inverse problem in one region, which simplifies the theoretical and numerical study. In particular it may be useful to analyze the problem of parameter identification of a dipolar source.