Mesocosm- and Field-Scale Evaluation of Lignocellulose- Amended Soil Treatment Areas for Removal of Nitrogen from Wastewater

Non-proprietary N-removal onsite wastewater treatment systems are less costly than proprietary systems, increasing the likelihood of adoption to lower N inputs to receiving waters. We assessed the capacity of non-proprietary lignocellulose-amended soil treatment areas (LCSTAs)—a 45-cm-deep layer of sand above a 45-cm-deep layer of sand and sawdust—to lower the concentration of total N (TN) in septic tank effluent (STE) at mesocosm and field scales. The mesocosm received wastewater for two years and had a median effluent TN concentration of 3.1 mg/L and TN removal of 60–100%, meeting regulatory standards of 19 mg/L or 50% removal. Removal varied inversely with temperature, and was lower below 10 °C. Removal was higher in the mesocosm than in five field sites monitored for 12–42 months. Median effluent TN concentration and removal met the standard in three continuously-occupied homes but not for two seasonally-occupied homes. Sites differed in temporal pattern of TN removal, and in four of five sites TN removal was greater—and effluent TN concentration lower—in the LCSTA than in a control STA containing only sand. The performance of non-proprietary LCSTAs was comparable to that for proprietary systems, suggesting that these may be a viable, more affordable alternative for lowering N inputs to receiving waters

Increased percentage of L-selectin+ and ICAM-1+ peripheral blood CD4+/CD8+ T cells in active Graves' ophthalmopathy.

The purpose of the study was to evaluate the percentage of CD4+/CD8+ peripheral T cells expressing CD62L+ and CD54+ in patients with Graves' disease and to assess if these estimations could be helpful as markers of active ophthalmopathy. The study was carried out in 25 patients with Graves' disease (GD) divided into 3 groups: 1/ 8 patients with active Graves' ophthalmopathy (GO) (CAS 3-6, GO complaints pound 1 year), 2/ 9 patients with hyperthyroid GD without symptoms of ophthalmopathy (GDtox) and 3/ 8 patients with euthyroid GD with no GO symptoms (GDeu). The control group consisted of 15 healthy volunteers age and sex matched to groups 1-3. The expression of lymphocyte adhesion molecules was evaluated by using three-color flow cytometry. In GO group the percentage of CD8+CD54+, CD8+CD62L+, CD4+CD54+ and CD4+CD62L+ T cells was significantly higher as compared to controls (p<0.001, p<0.05, p<0.01, p<0.001 respectively). The percentage of CD8+CD54+ T lymphocytes was also elevated in GO group in comparison to hyperthyroid GD patients (p< 0.05). CD4+CD62L+ and CD8+CD54+ percentages were also increased in GDtox and GDeu as compared to controls. We found a positive correlation between the TSHRab concentration and the percentage of CD8+CD62L+ T cells in all studied groups (r= 0.39, p<0.05) and between the TSHRab level and CAS (r= 0.77, p<0.05). The increased percentage of CD8+CD54+ and CD8+CD62L+ T cells in patients with Graves' ophthalmopathy may be used as a marker of immune inflammation activity

Commissioning and validation of a novel commercial TPS for ocular proton therapy

Abstract Background Until today, the majority of ocular proton treatments worldwide were planned with the EYEPLAN treatment planning system TPS . Recently, the commercial, computed tomography CT based TPS for ocular proton therapy RayOcular was released, which follows the general concepts of model based treatment planning approach in conjunction with a pencil beam type dose algorithm PBA . Purpose To validate RayOcular with respect to two main features accurate geometrical representation of the eye model and accuracy of its dose calculation algorithm in combination with an Ion Beam Applications IBA eye treatment delivery system. Methods Different 3D printed eye ball phantoms were fabricated to test the geometrical representation of the corresponding CT based model, both in orthogonal 2D images for X ray image overlay and in fundus view overlaid with a funduscopy. For the latter, the phantom was equipped with a lens matching refraction of the human eye. Funduscopy was acquired in a Zeiss Claus 500 camera. Tantalum clips and fiducials attached to the phantoms were localized in the TPS model, and residual deviations to the actual position in X ray images for various orientations of the phantom were determined, after the nominal eye orientation was corrected in RayOcular to obtain a best overall fit. In the fundus view, deviations between known and displayed distances were measured. Dose calculation accuracy of the PBA on a 0.2 mm grid was investigated by comparing between measured lateral and depth dose profiles in water for various combinations of range, modulation, and field size. Ultimately, the modeling of dose distributions behind wedges was tested. A 1D gamma test was applied, and the lateral and distal penumbra were further compared. Results Average residuals between model clips and visible clips fiducials in orthogonal X ray images were within 0.3 mm, including different orientations of the phantom. The differences between measured distances on the registered funduscopy image in the RayOcular fundus view and the known ground truth were within 1 mm up to 10.5 mm distance from the posterior pole. No clear benefit projection of either polar mode or camera mode could be identified, the latter mimicking camera properties. Measured dose distributions were reproduced with gamma test pass rates of gt;95 with 2 0.3 mm for depth and lateral profiles in the middle of spread out Bragg peaks. Distal falloff and lateral penumbra were within 0.2 mm for fields without a wedge. For shallow depths, the agreement was worse, reaching pass rates down to 80 with 5 0.3 mm when comparing lateral profiles in air. This is caused by low energy protons from a scatter source in the IBA system not modeled by RayOcular. Dose distributions modified by wedges were reproduced, matching the wedge induced broadening of the lateral penumbra to within 0.4 mm for the investigated cases and showing the excess dose within the field due to wedge scatter. Conclusion RayOcular was validated for its use with an IBA single scattering delivery nozzle. Geometric modeling of the eye and representation of 2D projections fulfill clinical requirements. The PBA dose calculation reproduces measured distributions and allows explicit handling of wedges, overcoming approximations of simpler dose calculation algorithms used in other systems. Keywords RayOcular; proton therapy; uveal melanom

Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS)

<p>Abstract</p> <p>Background</p> <p>Recent evidence suggests that there may be a bidirectional, physiological link between hypogonadism and metabolic syndrome (MetS), and testosterone replacement therapy (TRT) has been shown to improve some symptoms of MetS in small patient populations. We examined the effect of 12 months of TRT on MetS components in a large cohort of hypogonadal men.</p> <p>Methods</p> <p>Data were obtained from TRiUS (Testim^®Registry in the United States), a 12-month, multicenter, prospective observational registry (N = 849) of hypogonadal men prescribed Testim 1% testosterone gel (5-10 g/day). Data analyzed included age, total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), and MetS components: waist circumference, blood pressure, fasting blood glucose, plasma triglycerides, and HDL cholesterol.</p> <p>Results</p> <p>Of evaluable patients (581/849) at baseline, 37% were MetS+ (n = 213) and 63% were MetS- (n = 368). MetS+ patients had significantly lower TT (p < 0.0001) and SHBG (p = 0.01) levels. Patients with the lowest quartile TT levels (<206 ng/dL [<7.1 nmol/L]) had a significantly increased risk of MetS+ classification vs those with highest quartile TT levels (≥331 ng/dL [≥11.5 nmol/L]) (odds ratio 2.66; 95% CI, 1.60 to 4.43). After 12 months of TRT, TT levels significantly increased in all patients (p < 0.005). Despite having similar TT levels after TRT, only MetS+ patients demonstrated significant decreases in waist circumference, fasting blood glucose levels, and blood pressure; lowest TT quartile patients demonstrated significant decreases in waist circumference and fasting blood glucose. Neither HDL cholesterol nor triglyceride levels changed significantly in either patient population.</p> <p>Conclusion</p> <p>Hypogonadal MetS+ patients were more likely than their MetS- counterparts to have lower baseline TT levels and present with more comorbid conditions. MetS+ patients and those in the lowest TT quartile showed improvement in some metabolic syndrome components after 12 months of TRT. While it is currently unclear if further cardiometabolic benefit can be seen with longer TRT use in this population, testing for low testosterone may be warranted in MetS+ men with hypogonadal symptoms.</p