Removal of contaminants of emerging concern from pig manure in different operation stages of a thin-layer cascade photobioreactor. Relationship with concentrations in microalgae and manure.

The performance of a pilot-scale thin-layer cascade photobioreactor, operated in semicontinuous mode, for the removal of veterinary drug residues and other contaminants of emerging concern (CECs) from pig manure has been assessed in six operation stages. Chlorella sp. (70-90%), Scenedesmus sp. (10-25%) and Diatomea (<5%) comprise the microalgae species present during the stages. The global performance to remove the total CEC content in the photobioreactor effluent varied from 62 to 86% on each stage, while an CEC mean amount close to 8% was accumulated in the photobioreactor biomass. A relation with weather conditions was not observed. Elimination ratio was not related to the concentration in the influent which reached up to 8000 ng L-1 for some CECs. As expected, the concentrations of veterinary drugs were higher than those of non-veterinary CECs. The concentrations accumulated in the grown biomass were relative low, lower than 10 ng per fresh g excepting for a few cases. However, statistical data suggested that the linkage of CECs to microalgae biomass boosted their removal from the influent. Furthermore, it was observed that the manure liquid phase contained higher amounts of CECs than the solid phase.

Best Protocol for Combined Contrast-Enhanced Thoracic and Abdominal CT for Lung Cancer: A Single-Institution Randomized Crossover Clinical Trial.

OBJECTIVE: The purpose of this study was to evaluate the superiority of either of two protocols for combined contrast-enhanced thoracic and abdominal CT of patients with lung cancer by comparing contrast enhancement, contrast-related artifacts, image quality, and radiation dose. SUBJECTS AND METHODS: In this randomized controlled crossover clinical trial, 77 patients who underwent 203 CT examinations were enrolled. All patients underwent at least two examinations performed with both protocols. Protocol A consisted of two acquisitions: one 35-second delayed CT acquisition for the chest followed by a 70-second delayed abdominal acquisition. Protocol B was a single 60-second delayed acquisition covering the chest and the abdomen. Attenuation and noise of the aorta, pulmonary artery, and liver were measured. Contrast-related artifacts, mediastinal lymph node visualization, liver enhancement, and noise were visually scored. Dose-length product was recorded. Statistical analysis was performed by t and chi-square tests and kappa statistics. RESULTS: Contrast-related artifacts were more severe at all evaluated levels, and visualization of lymph node regions was statistically significantly worse with protocol A. There were no differences in enhancement or noise score of the liver. Tumor delineation and pleural findings were better evaluated with delayed phase images. Dose-length product was significantly higher with protocol A (645.0 vs 521.5 mGy · cm; p < 0.0001). CONCLUSION: A single 60-second delayed acquisition for thoracic and abdominal contrast-enhanced CT is associated with less contrast artifact and affords better visualization of lymph nodes at a lower radiation dose while acceptable vascular and hepatic contrast enhancement is maintained.

Early Transthoracic Echocardiography after Cardiac Surgery Predicts Postoperative Atrial Fibrillation.

PURPOSE: Postoperative atrial fibrillation (POAF) is frequent after cardiac surgery. We aimed to establish a predictive model of POAF based on postoperative transthoracic echocardiography (TTE) findings. METHODS: This study included 147 patients (aged 67 ± 11 years; 109 men) undergoing coronary artery bypass grafting and/or aortic valve replacement. TTE and Doppler tissue imaging were performed on intensive care unit arrival after surgery. All patients were continuously monitored during hospitalization. The end point was the appearance of POAF. RESULTS: POAF appeared in 37 patients (25.2%). These patients were older (69 ± 16 vs. 65 ± 12 years; P < 0.001) and had increased long axis of the left atrium (LA) dimension (5.4 ± 1 vs. 4.8 ± 0.9 cm, P = 0.02), lower early diastolic velocity of the mitral annulus (e') (6.9 ± 2.1 vs. 8 ± 1.8 cm/sec; P < 0.01), and higher early diastolic pulsed Doppler mitral ratio (E)/e' (E/e') (17.4 ± 6.8 vs. 13.8 ± 6; P = 0.01). Left ventricle diastolic dysfunction grade (DFG) of 2 or 3 relative to grade 0 was significant: odds ratio (OR) 22.5, 95% confidence interval (CI) 4.52-57.2; P < 0.001, and OR: 23.6, 95% CI: 3.57-60.1; P = 0.001), respectively. On multivariate analysis, the independent predictors of POAF were age (OR: 1.10, 95% CI: 1.01-1.18; P < 0.05), long-axis LA dimension (OR: 6.24, 95% CI: 1.97-8.23; P = 0.0017), DFG-2 (OR: 4.1, 95% CI: 1.57-15.81; P < 0.001), and DFG-3 (OR: 8.3, 95% CI: 4.11-25.37; P < 0.001). CONCLUSIONS: Apart from age, the simple determination by postoperative TTE of long-axis LA dimension and DFG after cardiac surgery proved to be powerful independent predictors of POAF and may be useful for risk stratification of these patients.

An Empirical Study of Neural Network-Based Audience Response Technology in a Human Anatomy Course for Pharmacy Students.

This paper presents an empirical study of a formative neural network-based assessment approach by using mobile technology to provide pharmacy students with intelligent diagnostic feedback. An unsupervised learning algorithm was integrated with an audience response system called SIDRA in order to generate states that collect some commonality in responses to questions and add diagnostic feedback for guided learning. A total of 89 pharmacy students enrolled on a Human Anatomy course were taught using two different teaching methods. Forty-four students employed intelligent SIDRA (i-SIDRA), whereas 45 students received the same training but without using i-SIDRA. A statistically significant difference was found between the experimental group (i-SIDRA) and the control group (traditional learning methodology), with T (87) = 6.598, p < 0.001. In four MCQs tests, the difference between the number of correct answers in the first attempt and in the last attempt was also studied. A global effect size of 0.644 was achieved in the meta-analysis carried out. The students expressed satisfaction with the content provided by i-SIDRA and the methodology used during the process of learning anatomy (M = 4.59). The new empirical contribution presented in this paper allows instructors to perform post hoc analyses of each particular student's progress to ensure appropriate training.

Transsphenoidal Approach in Endoscopic Endonasal Surgery for Skull Base Lesions: What Radiologists and Surgeons Need to Know.

In the last 2 decades, endoscopic endonasal transsphenoidal surgery has become the most popular choice of neurosurgeons and otolaryngologists to treat lesions of the skull base, with minimal invasiveness, lower incidence of complications, and lower morbidity and mortality rates compared with traditional approaches. The transsphenoidal route is the surgical approach of choice for most sellar tumors because of the relationship of the sphenoid bone to the nasal cavity below and the pituitary gland above. More recently, extended approaches have expanded the indications for transsphenoidal surgery by using different corridors leading to specific target areas, from the crista galli to the spinomedullary junction. Computer-assisted surgery is an evolving technology that allows real-time anatomic navigation during endoscopic surgery by linking preoperative triplanar radiologic images and intraoperative endoscopic views, thus helping the surgeon avoid damage to vital structures. Preoperative computed tomography is the preferred modality to show bone landmarks and vascular structures. Radiologists play an important role in surgical planning by reporting extension of sphenoid pneumatization, recesses and septations of the sinus, and other relevant anatomic variants. Radiologists should understand the relationships of the sphenoid bone and skull base structures, anatomic variants, and image-guided neuronavigation techniques to prevent surgical complications and allow effective treatment of skull base lesions with the endoscopic endonasal transsphenoidal approach.

Examining the benefits of learning based on an audience response system when confronting emergency situations.

This article presents an empirical study on the effectiveness of the use of an audience response system called SIstema De Respuesta inmediata de la Audiencia on a nursing course. A total of 130 students of mixed gender, age, and computer experience and educational background on a third-year course in nursing administration and management participated in the study. The benefits of an audience response system as regards learning how to confront emergency situations were studied. The innovative aspect of the proposal is twofold: (1) the use of a smartphone to respond to the questions and (2) the analysis of the students' response time when confronting critical situations while managing nursing resources. A positive impact on the students' performance was revealed in their final assessments. Our findings show that SIstema De Respuesta inmediata de la Audiencia increases student participation and aids in identifying and correcting misconceptions. The students found SIstema De Respuesta inmediata de la Audiencia to be very motivating and wanted it to be used in additional lectures. Further research is required to study the effectiveness of SIstema De Respuesta inmediata de la Audiencia for it to be widely used in other disciplines.

Nintedanib in chronic fibrosing interstitial lung diseases. A case series.

Progressive pulmonary fibrosis (PPF) can be fatal in non-idiopathic interstitial lung diseases. We report a descriptive series of 13 patients with PPF who received treatment with nintedanib, a multitargeted tyrosine kinase inhibitor with antifibrotic effect. Although the reduced number of patients and the observational nature of a case series prevent us from providing strong evidence, our results suggest that nintedanib could be effective in PPF of various etiologies. Nintedanib could also be useful in specific populations such as patients awaiting lung transplant and elderly patients.

Combination of different noninvasive brain stimulation treatments for upper limb recovery in stroke patients: A systematic review.

We report a review of Pubmed (Medline), CENTRAL, Web of Science, and Scopus to test the effectiveness of the combined application of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in the improvement of different functional variables of the upper limb in people with stroke. Two independent reviewers assessed eligibility and evaluated the quality of the studies. Five articles were included in the final review according to the inclusion criteria: Most show statistically significant differences in motor function improvement in favor of the experimental group, but not in activity. Due to the heterogeneity of the observed studies, the results should be interpreted with caution-more high-quality studies are needed to investigate the effectiveness of these interventions in different stages of stroke patients.

A Prospective Observational Study of Frailty in Geriatric Revitalization Aimed at Community-Dwelling Elderly.

(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45-50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed "Up & Go" at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods.

Geographic Analysis of the Safety and Efficacy of Filgotinib in Rheumatoid Arthritis.

INTRODUCTION: Global clinical trials in rheumatoid arthritis (RA) often do not recruit enough patients from diverse racial and ethnic backgrounds to identify any potential differences in treatment outcome across such groups. To overcome this limitation, using data from five previous clinical trials and two ongoing trial extensions, this study aimed to assess the efficacy and safety of filgotinib in patients with RA across geographic regions. METHODS: This was a post hoc, exploratory analysis of data from male and female patients with RA meeting the 2010 RA criteria as defined by the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology. Data were analyzed from phase 2 (DARWIN 1-2) and phase 3 (FINCH 1-3) clinical trials, as well as two long-term extension studies (DARWIN 3, FINCH 4), of filgotinib. Efficacy endpoints included ACR 20%/50%/70% improvement (ACR20/50/70) responses, disease activity score in 28 joints using C-reactive protein [DAS28(CRP)], Clinical Disease Activity Index scores, Boolean remission, and change from baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI). Safety data were presented as exposure-adjusted incidence rates per 100 patient-years of exposure of treatment-emergent adverse events. RESULTS: Compared with placebo, at week 12 a greater proportion of patients receiving filgotinib 200 mg (FIL200) or 100 mg (FIL100) achieved ACR20 (p < 0.01), with similar outcomes in most regions. Overall, the reduction in HAQ-DI with FIL200 or FIL100 was greater than with placebo (p < 0.05) at week 12. Compared with placebo, at week 24 the proportions of patients achieving DAS28(CRP) ≤ 3.2 were greater for both doses of FIL, as seen in most regions (p < 0.01). Safety outcomes did not indicate regional or ethnic differences in the safety profile of filgotinib. CONCLUSION: Filgotinib efficacy and safety in patients with RA were generally consistent across geographic regions. GOV TRIAL REGISTRATION NUMBERS: NCT02889796; NCT02873936; NCT02886728; NCT03025308; NCT01888874; NCT01894516; NCT02065700.

Clinical trials in rheumatoid arthritis recruit too few patients from diverse ethnic backgrounds to be able to identify differences in treatment outcomes. In adults with moderate-to-severe active rheumatoid arthritis who do not tolerate or have responded poorly to other advanced treatments, the Janus kinase inhibitor filgotinib can be used alone or in combination with the immunosuppressant methotrexate. Using data from 4695 patients with rheumatoid arthritis from five previous clinical trials and two ongoing trial extensions, this paper examined the efficacy and safety of filgotinib in patients with rheumatoid arthritis across geographic locations worldwide.Patients were grouped by region: North America, South and Central America, Western Europe, Eastern Europe, East Asia, South and Southeast Asia, and Other (South Africa, New Zealand, Australia, and Israel). The efficacy of filgotinib in treating the symptoms of rheumatoid arthritis was assessed using several measures of disease activity, with changes in patient quality of life determined using a health assessment questionnaire. Safety data were reported as the rates of side effects experienced by patients.Across different geographic regions, no major differences in filgotinib treatment response were observed. Rheumatoid arthritis disease activity levels were consistently lower in patients receiving filgotinib than in patients receiving placebo. Across the regions examined, quality-of-life scores also improved to a greater degree in patients receiving filgotinib compared with placebo. The rates of side effects, including infections, were similar irrespective of region. The number of deaths was low, mostly resulting from cardiovascular events, infections, and malignancies.This study demonstrates that the efficacy and safety of filgotinib are consistent in patients with rheumatoid arthritis from a broad range of geographic regions and ethnic backgrounds.

Prognostic value of echocardiographic-derived calcium index in coronary artery disease diagnosed by 64-multidetector computed tomography.

PURPOSE: To determine whether echocardiographic calcium index (ECI) calculated using transthoracic echocardiography (TTE) predicts coronary ischemic events. We also wished to determine coronary artery calcium score (CACS), the presence of obstructive coronary artery disease (CAD) and plaque composition, all of which were assessed by multidetector computed tomography (MDCT). METHODS: We carried out a prospective cohort study of 82 consecutive outpatients with chest pain and low-moderate risk of CAD, referred for noninvasive coronariography by MDCT. ECI was blindly assessed by TTE and correlated with subsequent cardiovascular events during a follow up period of 36 months. RESULTS: ECI values of ≥7 had a sensitivity of 77.3%, a specificity of 90%, positive predictive value of 73.9%, and negative predictive value of 91.5% with respect to future coronary ischemic events. In addition, patients with ECI ≥ 7 showed a greater presence of severe calcified and obstructive CAD and a linear increase of obstructed vessels and mixed and calcified plaques, with a linear trend according to ECI values. CONCLUSION: ECI values of ≥7 determine poor CAD prognosis in relation to ischemic events. Furthermore, ECI ≥ 7 may serve as a marker of content of coronary artery calcium, intraluminal obstruction, and plaque composition. Therefore, ECI seems to provide prognostic information as well as information about the characteristics of the plaque of atheroma.

Determination of contaminants of emerging concern in raw pig manure as a whole: difference with the analysis of solid and liquid phases separately.

The content of veterinary drugs in manure is usually estimated by the amount of residues determined in its solid or liquid phase, individually, which previously required a separation step. As an alternative, a multiresidue method for the analysis of 48 veterinary drugs and other contaminants of emerging concern (CECs) in swine raw manure as a whole has been developed and in-house validated in this work. The impact of several experimental factors during ultrasound assisted extraction was assessed. Hence, the use of alumina seemed to especially decrease the matrix effect and improve the overall recovery of drugs, mainly those with a high octanol-water partition coefficient. CECs in the extracts were analyzed by ultra-high performance liquid chromatography coupled to mass spectrometry in tandem. A standard addition-matrix matched calibration was used for quantification. Application of the method to two related samples (raw manure and farm centrifuged raw manure) from a facility revealed that the concentrations of CECs determined in the raw manure by the comprehensive methodology were higher than those calculated by adding the concentrations measured in the solid and liquid phases, separately. This was attributed to the loss of CECs adsorbed on fine particles in the suspension during the sample preparation procedure of the liquid-phase. Furthermore, the decrease of residues in the raw manure when this is centrifuged in the farm to yield compost is shown.

Lung Volume Calculation in Preclinical MicroCT: A Fast Geometrical Approach.

In this study, we present a time-efficient protocol for thoracic volume calculation as a proxy for total lung volume. We hypothesize that lung volume can be calculated indirectly from this thoracic volume. We compared the measured thoracic volume with manually segmented and automatically thresholded lung volumes, with manual segmentation as the gold standard. A linear regression formula was obtained and used for calculating the theoretical lung volume. This volume was compared with the gold standard volumes. In healthy animals, thoracic volume was 887.45 mm3, manually delineated lung volume 554.33 mm3 and thresholded aerated lung volume 495.38 mm3 on average. Theoretical lung volume was 554.30 mm3. Finally, the protocol was applied to three animal models of lung pathology (lung metastasis and transgenic primary lung tumor and fungal infection). In confirmed pathologic animals, thoracic volumes were: 893.20 mm3, 860.12 and 1027.28 mm3. Manually delineated volumes were 640.58, 503.91 and 882.42 mm3, respectively. Thresholded lung volumes were 315.92 mm3, 408.72 and 236 mm3, respectively. Theoretical lung volume resulted in 635.28, 524.30 and 863.10.42 mm3. No significant differences were observed between volumes. This confirmed the potential use of this protocol for lung volume calculation in pathologic models.

Global distribution of soil fauna functional groups and their estimated litter consumption across biomes.

Soil invertebrates (i.e., soil fauna) are important drivers of many key processes in soils including soil aggregate formation, water retention, and soil organic matter transformation. Many soil fauna groups directly or indirectly participate in litter consumption. However, the quantity of litter consumed by major faunal groups across biomes remains unknown. To estimate this quantity, we reviewed > 1000 observations from 70 studies that determined the biomass of soil fauna across various biomes and 200 observations from 44 studies on litter consumption by soil fauna. To compare litter consumption with annual litterfall, we analyzed 692 observations from 24 litterfall studies and 183 observations from 28 litter stock studies. The biomass of faunal groups was highest in temperate grasslands and then decreased in the following order: boreal forest > temperate forest > tropical grassland > tundra > tropical forest > Mediterranean ecosystems > desert and semidesert. Tropical grasslands, desert biomes, and Mediterranean ecosystems were dominated by termites. Temperate grasslands were dominated by omnivores, while temperate forests were dominated by earthworms. On average, estimated litter consumption (relative to total litter input) ranged from a low of 14.9% in deserts to a high of 100.4% in temperate grassland. Litter consumption by soil fauna was greater in grasslands than in forests. This is the first study to estimate the effect of different soil fauna groups on litter consumption and related processes at global scale.

COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study.

Introduction: COVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease. Methods: A prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis. Results: Between 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10-1.61); p < 0.001]. Conclusion: The COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality.

Determination of antibiotics and other veterinary drugs in the solid phase of pig manure.

The presence of residues of veterinary pharmaceuticals in farm wastewaters such as pig slurry represents a problem that needs to be tackled to avoid further contamination of environmental waters and the development of resistant bacteria. For their monitoring and control, it is necessary the existence of reliable analytical tools. The present paper describes for the first time the development and optimization by statistical experimental design of a specifically designed analytical method for the analysis of 21 veterinary drugs, including 18 antibiotics of several families (ß-lactams, tetracyclines, fluoroquinolones, sulfonamides, macrolides, among others), 1 antiparasitic, 1 analgesic and 1 hormone, in a complex environmental matrix such as the fresh solid phase of pig slurry. The resulting method, consisted of an ultrasound assisted extraction (UAE) combined with in-situ dispersive solid phase extraction (d-SPE) from a 0.3 g of freeze-dried sample aliquot followed by a preconcentration step by compact solid phase extraction (c-SPE) and subsequent instrumental analysis by ultra-high-performance-liquid-chromatography (UHPLC) coupled to mass spectrometry in tandem (MS/MS) by a triple quadrupole, was successfully validated as a very sensitive (method limit of quantification in the low ng g-1) and reliable method (relative recoveries around 100% and method repeatability featured by a general relative standard deviation below 20%). Provided raw data was intended to be processed by matrix-matched quantification approach. The resulting methodology was applied to the characterization of several pig manures from different Spanish farms sampled across breeding season between 2018 and 2019. Sample precedence showed to have a high impact in the positives, its frequency and concentration.

The role of unenhanced phase of the liver in the scanning protocol of metastatic breast cancer: implications for sensitivity, response evaluation and size measurement.

BACKGROUND: To analyse if performing unenhanced CT of the liver aids in the evaluation of metastatic lesions, response assessment or alter the size of the lesions, compared with portal phase alone, in patients with hepatic metastases from breast carcinoma. PATIENTS AND METHODS: One-hundred and fifty-three CT scans of 36 women were included. Scans consisted of unenhanced, arterial and portal delayed phases of the liver. Two readers sorted which phase was best for visualization of metastases, evaluated the number of lesions detected in each phase, selected the best phase for assessment of response in two consecutive scans, and measured one target lesion in all the phases. Χ2 was used to compare differences among phases and paired t test for measurement differences. RESULTS: Unenhanced, arterial and portal phases were considered better phases by readers 1/2 in 68/67%, 27/28% and 69/70%, and some lesions were missed in 2%, 11% and 7%, respectively. Sensitivity was significantly better for unenhanced and portal phases compared to arterial phase. Comparison between consecutive scans was considered better in unenhanced (80/79%), followed by portal (70/69%) and arterial phases (31/31%). Maximum diameter of target lesions was 15% greater in unenhanced phase (p < 0.001). CONCLUSIONS: Portal and unenhanced phases of the liver allow better detection and delineation of metastatic hepatic lesions from breast carcinoma. In most cases, unenhanced CT is the best phase to assess response and provides the largest diameter. Therefore, we recommend the use of unenhanced CT in the evaluation of patients with breast carcinoma and suspected or known hepatic metastatic disease.

Regenerated cartilage produced by autogenous periosteal grafts: a histologic and mechanical study in rabbits under the influence of continuous passive motion.

PURPOSE: To evaluate the repaired tissues formed in full-thickness cartilage defects in a rabbit model implanted with autogenous periosteal grafts under the influence of continuous passive motion (CPM) establishing a correlation between histology, histomorphometry, and mechanical behavior. METHODS: Autogenous periosteal grafts were used to resurface full-thickness defects produced in the trochlear groove in the right knees of 60 New Zealand rabbits. Four groups were formed according to the time to death and postoperative mobilization: group A--active intermittent motion, euthanized at 8 weeks; group B--CPM, euthanized at 8 weeks; group C--active intermittent motion, euthanized at 36 weeks; and group D, CPM, euthanized at 36 weeks. Repaired tissues were evaluated grossly, histologically, and mechanically, as well as by histomorphometry. RESULTS: The repair tissue was hyaline-like cartilage in 68.1% of the specimens in group A, 71.4% in group B, 0% in group C, and 20% in group D. The mean thickness of the regenerated tissue was 1.20 mm in group A, 1.23 mm in group B, 0.20 mm in group C, and 0.25 in group D. Elastic stiffness at 8 weeks was lower than that of the control cartilage and increased significantly at 36 weeks because of degenerative changes. Postoperative motion showed no influence on the results. Repaired tissue developed severe degenerative changes in time, and deterioration of the mechanical properties was observed without any protective effect of the CPM. CONCLUSIONS: Full-thickness cartilage defects treated with autologous periosteal grafts were repaired with hyaline-like cartilage tissue. Regenerated tissue showed viscoelastic behavior similar to normal cartilage 8 weeks after surgery. CPM did not improve histologic or mechanical results. Repaired tissue did not last over time. CLINICAL RELEVANCE: Free periosteal grafts should not be used clinically in the treatment of full-thickness cartilage defects because even though regenerated tissue seems initially to be hyaline-like cartilage, it is not capable of maintaining its histologic and mechanical properties over a long period of time.

Surface water quality assessment in a semiarid Mediterranean region (Medjerda, Northern Tunisia) using partial triadic analysis.

A range of methods have been developed specifically to analyze several tables of data simultaneously (variable × space × time) in the field of ecological research, although they have been less widely used to examine water quality. In this study, we assessed the spatiotemporal variability of water quality in the Medjerda River basin (Northern Tunisia). Partial triadic analysis (PTA) provides an effective framework for the assessment of spatiotemporal variability of water quality in the Medjerda River basin (Northern Tunisia). Fourteen physicochemical variables were monitored from 12 sampling sites monthly during 2013. PTA allowed correlations among different physicochemical parameters to be identified and to assess overall water quality in the Medjerda River. Salinity (S), Cl-, SO42-, Ca2+, and Mg2+ ions were associated with intensive agricultural activities (agricultural pollution sources) leading to salinization. However, NH4+, PO43-, chemical oxygen demand (COD), and biochemical oxygen demand (BOD5) we more strongly associated with polluted urban sites. PTA helped illustrate that strong links exist between land uses and adjacent water quality. The advantages of this multi-table method approach for water quality monitoring include as follows: (1) identifying common multivariate spatial structures and problems associated with maintaining water quality, (2) allowing identification of consistent patterns in water chemistry, and (3) allowing analysis on the temporal variability of water chemistry.