Identification of the xenometabolome and novel contaminant markers in fish exposed to a wastewater treatment works effluent

Fish can bioconcentrate complex mixtures of xenobiotics arising from exposure to wastewater effluents discharged into surface waters. Wastewaters contain a complex mixture of organic compounds and little is known about their uptake into fish and their health effects. In this study, a chemical profiling approach was used to characterize the profile of xenobiotics and their metabolites (the xenometabolome) in biofluids (bile and plasma) of juvenile rainbow trout (Oncorhynchus mykiss) exposed to a wastewater effluent. Metabolite profiles of effluent-exposed fish were compared with that from control fish exposed to uncontaminated river water. Samples were analysed by ultra performance liquid chromatography-time-of-flight mass spectrometry and data analysed by multivariate statistics. Exposure to effluent resulted in accumulation in trout bile of alkylsulfophenyl and alkylpolyethoxy carboxylates, as well as glucuronide conjugates of nonylphenol ethoxylates, alcohol ethoxylates, naphthols, chlorinated xylenols and phenoxyphenols, chlorophenes, resin acids, mefenamic acid and oxybenzone. Nonconjugated or sulphate conjugates of many of these contaminants were also detected in plasma of effluent-exposed trout. In addition, changes in the concentrations of endogenously derived metabolites were also detected in trout plasma, and these included an increase in blood bile acids, methylbutryolcarnitine and a decrease in sphingosine levels. These observations were verified in a further exposure of sexually mature roach (Rutilus rutilus) to concentrations of the same effluent. Exposure to 50% or 100% effluent resulted in dose dependent increases in blood concentrations of xenobiotics, taurocholic acid, syprinol sulphate and lysophospholipids and decreases in sphingosine levels. This work reveals the complex nature of xenobiotics accumulating in effluent-exposed fish together with the identification of changes in concentrations of lipid metabolites associated with hepatotoxicity. These results reveal, for the first time, that metabolite profiling techniques can be used to screen for uptake of complex mixtures of contaminants into fish and also for the detection of natural metabolite pathways in the organism that are disrupted due to exposure to multiple xenobiotics

The continuous p-centre problem: An investigation into variable neighbourhood search with memory

A VNS-based heuristic using both a facility as well as a customer type neighbourhood structure is proposed to solve the p-centre problem in the continuous space. Simple but effective enhancements to the original Elzinga-Hearn algorithm as well as a powerful ‘locate-allocate’ local search used within VNS are proposed. In addition, efficient implementations in both neighbourhood structures are presented. A learning scheme is also embedded into the search to produce a new variant of VNS that uses memory. The effect of incorporating strong intensification within the local search via a VND type structure is also explored with interesting results. Empirical results, based on several existing data set (TSP-Lib) with various values of p, show that the proposed VNS implementations outperform both a multi-start heuristic and the discrete-based optimal approach that use the same local search

Obesity and kidney stone disease. A systematic review

INTRODUCTION: Currently, abdominal obesity has reached an epidemic stage and obesity represents an important challenge for worldwide health authorities. Epidemiologic studies have demonstrated that the stone risk incidence increases with Body Mass Index, through multiple pathways. Metabolic syndrome and diabetes are associated with an increased renal stones disease incidence. The aim of this systematic review was to investigate the prevalence, morbidity, risk factors involved in the association between obesity and urolithiasis. EVIDENCE ACQUISITION: The search involved finding relevant studies from MEDLINE, EMBASE, Ovid, the Cochrane Central Register of Controlled Trials, CINAHL, Google Scholar, and individual urological journals between January 2001 and May 2017. The inclusion criteria were for studies written in the English language, reporting on the association between obesity and urinary stones. EVIDENCE SYNTHESIS: The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are observed frequently in these patients. Insulin resistance is thought to alter the renal acid-base metabolism, resulting in a lower urine pH, and increasing the risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances and with an increase in urinary tract infection incidence. Recent studies highlighted that renal stone disease increases the risk of myocardial infarction, progression of chronic kidney disease, and diabetes. Contemporary, bariatric surgery has been shown to be associated with hyperoxaluria and oxalate nephropathy. Certainly, the many health risks of obesity, including nephrolithiasis, will add more burden on urologists and nephrologists. CONCLUSIONS: Obesity related nephrolithiasis seems to necessitate weight loss as primary treatment, but the recognition of the associated complications is necessary to prevent induction of new and equally severe medical problems. The optimal approach to obesity control that minimizes stone risk needs to be determined in order to manage obesity-induced renal stones disease

Prospective study to compare antibiosis versus the association of N-acetylcysteine, D-mannose and morinda citrifolia fruit extract in preventing urinary tract infections in patients submitted to urodynamic investigation

BACKGROUND: The abuse of antimicrobical drugs has increased the resistance of microorganisms to treatments, thus to make urinary tract infections (UTIs) more difficult to eradicate. Among natural substances used to prevent UTI, literature has provided preliminary data of the beneficial effects of D-mannose, N-acetylcysteine, and Morinda citrifolia fruit extract, due to their complementary mechanism of action which contributes respectively to limit bacteria adhesion to the urothelium, to destroy bacterial pathogenic biofilm, and to the anti-inflammatory and analgesic activity. The purpose of this study was to compare the administration of an association of D-mannose, N-acetylcysteine (NAC) and Morinda citrifolia extract versus antibiotic therapy in the prophylaxis of UTIs potentially associated with urological mini-invasive diagnostics procedures, in clinical model of the urodynamic investigation. METHODS: 80 patients eligible for urodynamic examination, 42 men and 38 women, have been prospectively enrolled in the study and randomised in two groups (A and B) of 40 individuals. Patients of group A followed antibiotic therapy with Prulifloxacine, by mouth 400 mg/day for 5 days, while patients of the group B followed the association of mannose and NAC therapy, two vials/day for 7 days. Ten days after the urodynamic study, the patients were submitted to urine examination and urine culture. RESULTS: The follow up assessment didn't show statistical significant difference between the two groups regarding the incidence of UTI. CONCLUSIONS: The association of mannose and NAC therapy resulted similar to the antibiotic therapy in preventing UTIs in patients submitted to urodynamic examination. This result leads to consider the possible use of these nutraceutical agents as a good alternative in the prophylaxis of the UTI afterwards urological procedures in urodynamics.BACKGROUND: The abuse of antimicrobical drugs has increased the resistance of microorganisms to treatments, thus to make urinary tract infections (UTIs) more difficult to eradicate. Among natural substances used to prevent UTI, literature has provided preliminary data of the beneficial effects of D-mannose, N-acetylcysteine, and Morinda citrifolia fruit extract, due to their complementary mechanism of action which contributes respectively to limit bacteria adhesion to the urothelium, to destroy bacterial pathogenic biofilm, and to the anti-inflammatory and analgesic activity. The purpose of this study was to compare the administration of an association of D-mannose, N-acetylcysteine (NAC) and Morinda citrifolia extract versus antibiotic therapy in the prophylaxis of UTIs potentially associated with urological mini-invasive diagnostics procedures, in clinical model of the urodynamic investigation. METHODS: 80 patients eligible for urodynamic examination, 42 men and 38 women, have been prospectively enrolled in the study and randomised in two groups (A and B) of 40 individuals. Patients of group A followed antibiotic therapy with Prulifloxacine, by mouth 400 mg/day for 5 days, while patients of the group B followed the association of mannose and NAC therapy, two vials/day for 7 days. Ten days after the urodynamic study, the patients were submitted to urine examination and urine culture. RESULTS: The follow up assessment didn't show statistical significant difference between the two groups regarding the incidence of UTI. CONCLUSIONS: The association of mannose and NAC therapy resulted similar to the antibiotic therapy in preventing UTIs in patients submitted to urodynamic examination. This result leads to consider the possible use of these nutraceutical agents as a good alternative in the prophylaxis of the UTI afterwards urological procedures in urodynamics

Dermatofibrosarcoma Protuberans Mimicking Primary Breast Neoplasm: A case report and literature review

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing mesenchymal neoplasm of the dermis and subcutaneous tissues that has a low- to intermediate-grade malignancy. DFSP commonly involves the trunk and extremities, and very rarely the breast skin, mimicking a primary breast neoplasm with few reported cases in the literature. We report a 35-year old female patient who was referred to the Royal Hospital, Muscat, Oman in 2017, with a two-year history of a slow growing left breast lump. Assessment of the breasts with mammography revealed a lobulated lesion in the left-upper-inner quadrant with neither microcalcification nor architectural distortion, mimicking a benign lesion. However, on ultrasound, the lesion had suspicious features with increased vascularity and hence, it was categorised as breast imaging reporting and data system (BIRAD) IV. The patient underwent left breast wide local excision and the histopathological diagnosis was dermatofibrosarcoma protuberans.Keywords: Breast; Dermatofibrosarcoma Protuberans; Ultrasonography; Oman

Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi. Long-term follow-up results from a case series

Purpose: Staghorn renal stones are a challenging field in urology. Due to their high recurrence rates, particularly those associated with an infective process, a complete removal is the ultimate goal in their management. We report our experience with a combined approach of laparoscopic pyelolithotomy and endoscopic pyelolithotripsy, the stone clearance rate, and long-term, follow-up outcomes. Methods: From June 2012 to October 2014, nine adult patients with large staghorn renal calculi (mean size, 7.2 cm; range, 6.2–9.0 cm) underwent a combined laparoscopic and endoscopic approach. The technique comprised laparoscopic pyelolithotomy and holmium-YAG laser stone fragmentation with the use of a flexible cystoscope introduced through a 12 mm trocar. Results: The average operative time was 140 min (range, 90–190 min). The mean estimated hemoglobin loss was 0.6 mmol/l (range 0.5–0.7 mmol/l). None of the patients required an open- surgery conversion. The mean hospital stay was 4 days (range, 2–6 days). A computed tomography urogram control at 6 months of follow up did not show any stone recurrence. Conclusions: Laparoscopic pyelolithotomy combined with endoscopic pyelolithotripsy could be a therapeutic option in cases where mini-invasive procedures, that is, extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, and percutaneous nephrolithotomy (PCNL) have failed. This technique has a high stone-clearance rate (75–100%) comparable with open surgery and PCNL. However, it could be technically demanding and should be performed by skilled laparoscopy surgeons

Can daily intake of aspirin and/or statins influence the behavior of non-muscle invasive bladder cancer? A retrospective study on a cohort of patients undergoing transurethral bladder resection

Background: This study aimed to evaluate the behavior of non-muscle-invasive bladder cancer (NMIBC) in patients submitted to transurethral bladder resection (TURB) comparing subjects in chronic therapy with aspirin, statins, or both drugs to untreated ones. Methods: This retrospective study was conducted on 574 patients diagnosed with NMIBC who underwent TURB between March 2008 and April 2013. The study population was divided into two main groups: treated (aspirin and/or statins) and untreated. The treated group was further divided into three therapeutic subgroups: Group A (100 mg of aspirin, daily for at least two years); Group B (20 mg or more of statins, daily for at least two years); and Group C (100 mg of aspirin and 20 mg of statins together). The mean follow-up of patients was 45.06 months. Results: No significant differences were observed among the different groups at baseline. On multivariate analysis, statin treatment, smokers and high stage disease (T1) achieved the level of independent risk factor for the occurrence of a recurrence. When patients were stratified according to the different treatment; patients treated with statins (Group B) presented an higher rate of failure (56/91 patients; 61.5%) when compared to Group A (42/98 patients; 42.9%), Group C (56/98; 57.1%) and (133/287 patients; 46.3%). This difference corresponds to a significant difference in recurrence failure free survival (p = 0.01). Conclusions: Our results suggest that long-term treatment with aspirin in patients with NMIBC might play a role on reducing the risk of tumor recurrence. In contrast, in our investigation data from statins and combination treatment groups showed increased recurrence rates. A long-term randomized prospective study could definitively assess the possible role of this widely used drugs in NMIBC

Distance Learning in Emergencies: Social and Pedagogical Relations in the Context of the COVID-19 Pandemic

The current study aims to investigate social and pedagogical relations during the experience of distance learning in emergencies, in the context of the spread of the Covid-19 pandemic. The study identifies the impact of the transition towards this new system in rebuilding social and pedagogical links between professors and students through a case study at Ajman University, as one of the institutions of higher education in the United Arab Emirates. The study relied on the quantitative approach and the sample of the study consisted of (730) students selected in a simple random manner. The study found that most of the sample members had advanced infrastructure that would enable them to keep up with the transition to the distance learning system, and that the level of access to electronic tools and distance learning platforms and the ability to deal with them were high. The study also found that the distance learning system increases the level of interaction, discussion and communication between students and between students and teachers, which extends beyond the lesson period, as an attempt to replace direct interaction

Displacement in Architecture An analytical study in contemporary mosques design

Previous architectural studies have presented new concems for contemporary design of mosques. These concems were raised on both academic and professional levels. what is significant is to elaborate on special aspects of these concems, instead of limited understanding without it being comprehensive enough to utilizc the mental and intellectual content in the local meliue. Displacement represents a major concern specially its relationship to concepts and forms; and what the design process aims at to achieve uniqueness in expression. It is possible to enterprite unique qualities in ideas expressed architecturally as a displacement of current types, which is founded on a deep design problem. This paper discusses displacement with the abore rtat"d context, aiming to achieve. a contemporary frame work theory a discussion of current theories Ind application to achieve a distinguish mosque aichitecture