Seasonal variation of Mastophorus muris (Nematoda: Spirurida) in the water vole Arvicola amphibius from southern Sweden.

This study focused on the spirurid nematode Mastophorus muris in water voles (Arvicola amphibius) trapped in three regions in southern Sweden during spring and fall 2013. The collection of water voles formed part of a larger project (EMIRO) on the cestode Echinococcus multilocularis in rodents. The voles' stomach contents were examined for the presence of M. muris. Prevalence, mean abundance and mean intensity of infection were calculated. A generalized linear model model was used to examine the effects of sex, functional group, season and region on the number of M. muris individuals in each vole. Forty-seven of 181 (26%) voles were infected with M. muris, with up to 74 worms each. The overall mean intensity (worms per infected vole) was 15 (95% CI 10-21), and abundance (mean number of worms in all voles) was 4 (95% CI 2-6). Model output indicated a significant effect of season and region with respect to abundance of nematode infection, which was independent of sex and functional group of the investigated host.

Epilepsy in patients with primary brain tumors: The impact on mood, cognition, and HRQOL.

BACKGROUND: A primary brain tumor (PBT) is often a fatal disease of the nervous system and has a serious impact on health-related quality of life (HRQOL). Presence of epilepsy and adverse reactions from tumor and epilepsy treatments may cause additional decline in HRQOL. OBJECTIVES: We aimed to study the impact of epileptic seizures on cognition, mood, and HRQOL in patients with brain tumor-related epilepsy. MATERIALS AND METHOD: Patients were grouped on an ordinal scale according to epilepsy burden from none to severe based on the presence of epileptic seizures and seizure frequency: L1, no epilepsy; L2, with epilepsy, seizure-free in the last 6 months with antiepileptic drugs; and L3, with epilepsy, at least one seizure in the last 6 months with AEDs. Health-related quality of life was measured by Functional Assessment of Cancer Therapy-Brain (FACT-Br) and Quality of Life in Epilepsy-31 (QOLIE-31) tools, cognition by the Montreal Cognitive Assessment (MoCA) tool and Frontal Assessment Battery (FAB), mood by the Hospital Anxiety and Depression Scale (HADS), activities of daily living (ADLs) by the Barthel Index (BI), and performance status by the Karnofsky Performance Status (KPS) scale in patients with primary brain tumors at least one month following neurosurgery with or without radiotherapy and chemotherapy. RESULTS: Eighty-one patients with a diagnosis of primary brain tumors were recruited. Sixty-eight percent of patients were diagnosed with primary brain tumor-related epilepsy, 50.61% patients had cognitive impairment, 33% had abnormal scores in the anxiety scale, and 34% had abnormal scores in the depression scale. There were no statistically significant differences in these scores among L1, L2, and L3 groups. There were statistically significant differences in duration of disease and KPS and BI scores between L1 and L3 groups. The L3 group has significantly longer duration of disease and scored low in both the BI and KPS scale when compared to the L1 group. All patients with primary brain tumors scored significantly low in FACT-Br 'physical well-being' (PWB) and 'emotional well-being' (EWB) and high in 'social well-being' (SWB) when compared to healthy controls. When scores of each group were individually compared to healthy controls, the L3 group showed the lowest scores in PWB, EWB, and 'functional well-being'. In SWB, L1 and L2 groups showed statistically significantly high scores when compared to normative data. The QOLIE-31 applied to groups with epilepsy showed statistically significantly lower scores in the L3 group when compared to the L2 group in 'cognitive' and 'social functioning' domains. On multivariate analysis, both poor performance status and frequency of seizures were found to be independent risk factors for poor HRQOL when FACT-Br mean scores were compared. Level of seizures was found to be an independent risk factor for poor HRQOL when QOLIE-31 scores were compared between L2 and L3 groups. DISCUSSION: Presence of brain tumors could be attributed to cognitive impairment irrespective of the presence of epilepsy in our cohort. High seizure burden is an independent risk factor for poor HRQOL in patients with primary brain tumors. The QOLIE-31 is a more sensitive tool than the FACT-Br because of the presence of a seizure-related questionnaire.

Instrumentation, control and automation in wastewater--from London 1973 to Narbonne 2013.

Key developments of instrumentation, control and automation (ICA) applications in wastewater systems during the past 40 years are highlighted in this paper. From the first ICA conference in 1973 through to today there has been a tremendous increase in the understanding of the processes, instrumentation, computer systems and control theory. However, many developments have not been addressed here, such as sewer control, drinking water treatment and water distribution control. It is hoped that this review can stimulate new attempts to more effectively apply control and automation in water systems in the coming years.

Aeration control - a review.

This review covers automatic control of continuous aeration systems in municipal wastewater treatment plants. The review focuses on published research in the 21st century and describes research into various methods to decide and control the dissolved oxygen (DO) concentration and to control the aerobic volume with special focus on plants with nitrogen removal. Important aspects of control system implementation and success are discussed, together with a critical review of published research on the topic. With respect to DO control and determination, the strategies used for control span from modifications and developments of conventional control methods which have been explored since the 1970s, to advanced control such as model-based predictive and optimal controllers. The review is supplemented with a summary of comparisons between control strategies evaluated in full-scale, pilot-scale and in simulations.

Opportunities and challenges of tackling Scope 3 "Indirect" emissions from residential hot water.

The water sector could play a major role towards a Net Zero greenhouse gas (GHG) future if Scope 3 emissions were embraced and operationalised. Significant opportunities and challenges exist in tackling Scope 3 emissions including those associated with customer hot water use. Present GHG emission reduction practices predominantly focus on Scope 1 "within utility" and Scope 2 "purchased energy" emissions. In the urban water cycle, Scope 3 "indirect" emissions dominate, and water use is only one example of Scope 3 emissions. Over 90% of all water cycle GHG emissions can be attributed to water use in residential, industrial and commercial premises, collectively some 7% of global GHG emissions. One possibility is for water utilities to actively support efficient hot water use such as new ultra-low flow shower heads. Scope 3 opportunities also offer a range of cost-effective emissions-reduction opportunities, particularly when the wider perspective of "community value" is considered and not just a "business financial perspective". Hot water efficiency is additionally essential to Net Zero carbon futures, even with decarbonised grids, because most major Net Zero roadmaps require energy efficiency gains. Scientific and management advance needed includes: accounting methodologies, clear roles, collaboration, new business models, and clear definitions. The water sector has the opportunity to play a significant role in achieving Net Zero cities. The decision how much is yet to be made.

Investigations and actions taken during 2011 due to the first finding of Echinococcus multilocularis in Sweden.

Echinococcus multilocularis is a parasite that can cause alveolar echinococcosis disease. After the first positive finding of E. multilocularis in Sweden in 2011, a consulting group with representatives from relevant authorities was summoned. In this group, all relevant information was shared, strategies for information dissemination and any actions to be taken due to the finding of E. multilocularis were discussed and decided. The present paper describes the actions taken during 2011 and the results thereof, including surveillance in animals, risk assessment for humans to become infected and recommendations given to the public. Further discussion about whether the parasite was introduced, and if so, how, as well as possible future development of the infection in animals and humans in Sweden and future actions are included.

Strength characteristics of aerobic granular sludge.

Aerobic granular sludge has a number of advantages over conventional activated sludge flocs, such as cohesive and strong matrix, fast settling characteristic, high biomass retention and ability to withstand high organic loadings, all aspects leading towards a compact reactor system. Still there are very few studies on the strength of aerobic granules. A procedure that has been used previously for anaerobic granular sludge strength analysis was adapted and used in this study. A new coefficient was introduced, called a stability coefficient (S), to quantify the strength of the aerobic granules. Indicators were also developed based on the strength analysis results, in order to categorize aerobic granules into three levels of strength, i.e. very strong (very stable), strong (stable) and not strong (not stable). The results indicated that aerobic granules grown on acetate were stronger (high density: >150 g T SSL(-1) and low S value: 5%) than granules developed on sewage as influent. A lower value of S indicates a higher stability of the granules.

Intimate relationships and childbearing after adolescent depression: a population-based 15 year follow-up study.

PURPOSE: Adolescent depression is associated with a range of interpersonal adversities. We hypothesized that depressed adolescents are at subsequent increased risk of problems related to intimate relationships and childbearing in adulthood, and used longitudinal data to examine this. METHOD: A population-based investigation of depression in 16 to 17 year olds was followed up after 15 years, at around the age of 30 years. Comparisons were made between adolescents with depression (n = 361, 78% females) and non-depressed peers (n = 248, 77% females). Data from both national registers and personal interviews were used. RESULTS: At follow-up, the former depressed and non-depressed adolescents had become parents to a similar extent. The former depressed females were more likely than the non-depressed females to report abortion, miscarriage, intimate partner violence and sexually transmitted disease. They also reported a higher number of intimate relationships and were more likely to have divorced and to be registered as single mothers. Depressed females with a comorbid disruptive disorder had a particularly poor outcome. In the depressed females without a disruptive disorder, only those who subsequently had recurrent depressions in adulthood were at increased risk of poor outcome. There was no indication that the formerly depressed males were at increased risk of subsequent problems related to intimate relationships. CONCLUSION: Females with adolescent depression subsequently have problems related to intimate relationships and childbearing. Disruptive disorders and recurrence of depression appear to be instrumental in this association. Attention should be given to intimate relationship problems and sexual and reproductive health issues in young women with depression.

The effect of mixed liquor suspended solids (MLSS) on biofouling in a hybrid membrane bioreactor for the treatment of high concentration organic wastewater.

Biofouling is a crucial factor in membrane bioreactor (MBR) applications, particularly for high organic loading operations. This paper reports a study on biofouling in an MBR to establish a relationship between critical flux, Jc, mixed liquor suspended solids (MLSS) (ranging from 5 to 20 g L-1) and volumetric loading rate (6.3 kg COD m-3 h-1) of palm oil mill effluent (POME). A lab-scale 100 L hybrid MBR consisting of anaerobic, anoxic, and aerobic reactors was used with flat sheet microfiltration (MF) submerged in the aerobic compartment. The food-to-microorganism (F/M) ratio was maintained at 0.18 kg COD kg-1 MLSSd-1. The biofouling tendency of the membrane was obtained based on the flux against the transmembrane pressure (TMP) behaviour. The critical flux is sensitive to the MLSS. At the MLSS 20 g L-1 the critical flux is about four times lower than that for the MLSS concentration of 5 g L-1. The results showed high removal efficiency of denitrification and nitrification up to 97% at the MLSS concentration 20 g L-1. The results show that the operation has to compromise between a high and a low MLSS concentration. The former will favour a higher removal rate, while the latter will favour a higher critical flux.

Exposure to Low to Moderate Doses of Ionizing Radiation Induces A Reduction of Pro-Inflammatory Ly6chigh Monocytes and a U-Curved Response of T Cells in APOE -/- Mice.

Low dose ionizing radiation (LDIR) is known to have a protective effect on atherosclerosis in rodent studies, but how it impacts different cells types involved in lesion formation remains incompletely understood. We investigated the immunomodulatory response of different doses and dose-rates of irradiation in ApoE-/- mice. Mice were exposed to external γ rays at very low (1.4 mGy.h-1) or low (50 mGy.h-1) dose-rates, with cumulative doses spanning 50 to 1000 mGy. Flow cytometry of circulating cells revealed a significant decrease in pro-inflammatory Ly6CHi monocytes at all cumulative doses at low dose-rate, but more disparate effects at very low dose-rate with reductions in Ly6CHi cells at doses of 50, 100 and 750 mGy only. In contrast, Ly6CLo monocytes were not affected by LDIR. Similarly, proportions of CD4+ T cell subsets in the spleen did not differ between irradiated mice and non-irradiated controls, whether assessing CD25+FoxP3+ regulatory or CD69+ activated lymphocytes. In the aorta, gene expression of cytokines such as IL-1 and TGF-ß and adhesion molecules such as E-Selectin, ICAM-1, and VCAM-1 were reduced at the intermediate dose of 200 mGy. These results suggest that LDIR may reduce atherosclerotic plaque formation by selectively reducing blood pro-inflammatory monocytes and by impairing adhesion molecule expression and inflammatory processes in the vessel wall. In contrast, splenic T lymphocytes were not affected by LDIR. Furthermore, some responses to irradiation were nonlinear; reductions in aortic gene expression were significant at intermediate doses, but not at either highest or lowest doses. This work furthers our understanding of the impact of LDIR with different dose-rates on immune system response in the context of atherosclerosis.

Pharmacokinetics after an intravenous single dose of the opioid ketobemidone in children.

BACKGROUND: Ketobemidone is often used as an alternative to morphine in children in the Scandinavian countries. The aim of this clinical trial was to explore the pharmacokinetics of ketobemidone in children because these properties have not been reported previously. METHODS: Thirty children, newborn to 10 years, scheduled for elective surgery were included in the trial. Ketobemidone hydrochloride was administered as a single intravenous bolus dose and ketobemidone and norketobemidone concentrations were measured by LC-MS over 8 h. Pharmacokinetic parameters were determined using compartmental methods. RESULTS: Six children were excluded from pharmacokinetic analysis because of incomplete blood sampling. The values of ketobemidone clearance (l/h/kg) given as median (range) were 0.84 (0.29-3.0) in Group A (0-90 days), 0.89 (0.55-1.35) in Group B (1-2.5 years) and 0.74 (0.50-0.99) in Group C (7-10 years). The corresponding values for apparent volume of distribution (l/kg) were 4.4 (3.7-6.9) (Group A), 2.6 (2.0-5.6) (Group B) and 3.9 (2.7-5.0 (Group C), and for elimination half-life (h) 3.0 (1.4-8.9) (Group A), 2.0 (1.2-4.7) (Group B) and 3.7 (2.4-6.9) (Group C), respectively. In the two neonates the elimination half-life was almost 9 h. The metabolite norketobemidone did not reach levels above the limit of quantification (0.07 ng/ml) in any of the patients. CONCLUSION: The pharmacokinetic parameters of ketobemidone in children older than 1 month appear to be similar to those in adults. Because of the large interindividual variability of the pharmacokinetics in neonates, further studies especially in this age group are warranted.

Intellectual profile and level of IQ among a clinical group of obese children and adolescents.

This study explored intellectual profile of children attending a clinic for obesity and to what extent their characteristics predicted full scale IQ. Totally, 60 patients aged 8-16 years were recruited consecutively from the National Childhood Obesity Centre at Karolinska University Hospital in Sweden. These patients were tested using the Wechsler Intelligence Scale for Children (WISC). Of these 60 patients, 51 (85%) parents gave informed consent for their children's results to be included in this study (mean age 12.94, standard deviation, SD 2.42). The children's mean full scale IQ was 85.39. Parental education was strongly associated with child IQ. After adjustment for parental education, female gender and a higher level of obesity were associated with lower IQ. Obese children are at increased risk of having below average IQ and strategies to tackle associated problems should be developed in paediatric obesity clinics.

Controlled compression and liposuction treatment for lower extremity lymphedema.

In 1987 we noticed excess adipose tissue in a patient with arm lymphedema and later, objective studies confirmed this clinical finding in patients with non-pitting arm lymphedema following breast cancer. A prospective study was begun in 1993, and its long-term results (15 years) shows overall complete reduction of the excess volume in patients with non-pitting arm lymphedema and that adipose tissue dominates the excess volume. Encouraged by these results we operated on a patient with primary and secondary elephantiasis of the leg. The edema was first transferred from a pitting to a non-pitting state by controlled compression therapy. Then liposuction was performed to remove the remaining excess adipose tissue, and complete reduction was finally achieved. The patient wears compression garments continuously and during the 11 years of followup, no recurrence has occurred. This paper explains our philosophical approach: a pitting lymphedema first should be treated conservatively to remove excess fluid, then liposuction can be performed to remove remaining excess volume bothersome to the patient.

Family conditions and dietary control in phenylketonuria.

OBJECTIVE: This investigation is an attempt to describe coping with phenylketonuria (PKU) in order to understand some aspects underlying good compliance. METHODS: The coping concept was applied to PKU in two questionnaires. Self- and parental ratings were combined with assessments of phenylalanine levels and the severity of the disease. All Swedish patients with PKU born in 1980-91, a total of 53 children and youths with their parents, were invited to participate in the study and 41 (77%) of them did so. RESULTS: The patients turned out to have good compliance with the diet. The main result was that patients with separated or divorced parents were more likely to have higher phenylalanine levels and this association was not diminished by adjustment for the potential confounding factors. CONCLUSION: Patients' need for support must be judged individually according to different family conditions.

Quality of life following liposuction and conservative treatment of arm lymphedema.

Arm lymphedema can produce an additional burden from a psychosocial point of view. Although edema reduction through treatment can be an advantage in terms of reduced weight of the arm and simplified clothing needs, the purpose of the present study was to register changes in psychosocial parameters during one year after treatment. Thirty-five patients underwent liposuction combined with postoperative CCT (Controlled Compression Therapy), while 14 received CCT alone. Edema volume and range of motion in the shoulder joint were measured and effects on quality of life were assessed with various questionnaires. Liposuction+CCT removed the arm lymphedema completely, whereas CCT alone reduced it by half. The treatments improved range of motion in the shoulder joint and patients' quality of life in relationship to the volume reduction. Liposuction+CCT improves patients' quality of life, particularly qualities related to the volume reduction and hence qualities associated with everyday activities. CCT is beneficial too, but the effect is less obvious than when combined with surgery, probably because the edema reduction is less. The consequences of arm lymphedema for more psychologically oriented qualities and social life in general seem to be less serious and we found few notable effects of treatment in these domains.

Instrumentation, control and automation in the water industry--state-of-the-art and new challenges.

Instrumentation, control and automation (ICA) are key technologies in modern water and wastewater systems. Ever present disturbances make it necessary to automatically attenuate their consequences. A wastewater treatment system is load driven, while a water distribution system is demand driven. Despite the variability the system outputs have to be satisfactory. Economic realities encourages the application of ICA to make a maximum use of plant capacities. An increasing complexity of competing processes in a modern nutrient removal plant makes more elaborate control necessary. The final goal of protecting the environmental resources necessitates an integrated view of several interdependent systems, the collection, transport and treatment processes. In this integrating development ICA will be a decisive technology.

Plant-wide control: dream, necessity or reality?

Instrumentation, control and automation (ICA) are key technologies in modern water and wastewater systems. Despite the variability of the influents the system outputs have to be satisfactory. Economic realities and new water directives encourage the application of ICA to make a maximum use of plant and other storage capacities. The final goal of protecting the environmental resources necessitates an integrated view of several interdependent systems, including the collection, transport and treatment processes. In this integrating development ICA will be a decisive technology.

Extremum-seeking with variable gain control for intensifying biogas production in anaerobic fermentation.

A state-dependent variable-gain control system is implemented to follow the characteristics of a laboratory-scale up-flow anaerobic fixed-bed reactor dynamically. The transition from one state to another is determined on an hourly basis, depending on difference between the setpoint of the reactor pH and its true value. Considerable improvement of the process stability--reduction of oscillation in both the reactor pH and biogas production rate during high-rate operation, has been achieved, although the control structure is simple and intuitive.

Failure monitoring in water distribution networks.

An algorithm for the burst detection and location in water distribution networks based on the continuous monitoring of the flow rate at the entry point of the network and the pressure at a number of points within the network is presented. The approach is designed for medium to large bursts with opening times in the order of a few minutes and is suitable for networks of relatively small size, such as district metered areas (DMAs). The burst-induced increase in the inlet flow rate is detected using the modified cumulative sum (CUSUM) change detection test. Based on parameters obtained from the CUSUM test, the burst is simulated at a number of burst candidate locations. The calculated changes in pressure at the pressure monitoring points are then compared to the measured values and the location resulting in the best fit is selected as the burst location. The EPANET steady-state hydraulic solver is utilised to simulate the flows and pressures in the network. A sensitivity-based sampling design procedure is introduced to find the optimal positions for pressure monitoring points. The proposed algorithm is tested on a case study example network and shows potential for burst detection and location in real water distribution systems.