Exploring Treated Wastewater Issues Related to Agriculture in Europe, Employing a Quantitative SWOT Analysis

AbstractSuWaNu is a research project funded within the EU Commission FP7 framework where one of the objectives is to identify impediments and factors of success for sustainable water treatment and nutrient reuse options. For this purpose several European regional clusters have been framed (in Bulgaria, Germany, Greece, Malta and Spain) while, through a quantitative SWOT analysis, have been identified and quantified the strengths, weaknesses, opportunities and threats of the treated wastewater sector focusing on the economical regional aspects, on research innovation potential and on market exploitation and penetration. The analysis of the contributions of the different clusters included in the SuWaNu project has provided a detailed description of the reclaimed water sector in the European agriculture. After the analysis of more than 200 strengths, opportunities, weaknesses and threats provided by the partners of the project, this study includes a complete description of the use of reclaimed water in the European agriculture. These findings have been used as the fundamental cognition for the development of a joint action plan and several other business plans in the selected regions. A brief discussion on empirical modelling and results, especially regarding the Greek case study, is shown in this paper. A more detailed discussion can be found in the SuWaNu project report, available through the website (http://www.suwanu.eu)

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

SPARTAN: Speculative Avoidance of Register Allocation to Transient Values for Performance and Energy Efficiency

High-performance microprocessors use large, heavily-ported physical register files (RFs) to increase the instruction throughput. The high complexity and power dissipation of such RFs mainly stem from the need to maintain each and every result for a large number of cycles after the result generation. We observed that a significant fraction (about 45%) of the result values are never read from the register file and are not required to recover from branch mispredictions. In this paper, we propose SPARTAN – a set of micro-architectural extensions that predicts such transient values and in many cases completely avoids physical register allocations to them. We show that the transient values can be predicted as such with more than 97 % accuracy on the average across simulated SPEC 2000 benchmarks. We evaluate the performance of SPARTAN on a variety of configurations and show that significant improvements in performance and energy-efficiency can be realized. Furthermore, we directly compare SPARTAN against a number of previously proposed schemes for register optimizations and show that our technique significantly outperforms all those schemes

Selective Writeback: Exploiting Transient Values for Energy-Efficiency and Performance

Today’s superscalar microprocessors use large, heavily-ported physical register files (RFs) to increase the instruction throughput. The high complexity and power dissipation of such RFs mainly stem from the need to maintain each and every result for a large number of cycles after the result generation. We observed that a significant fraction (about 45%) of the result values are delivered to their consumers via the bypass network (consumed “on-the-fly”) and are never read out from the destination registers. In this paper, we first formulate conditions for identifying such transient values and describe their micro-architectural implementation; then we propose a technique to avoid the writeback of such transient values into the RF. With 64-entry integer and floating point register files, our technique achieves an 11 % performance improvement and 29% reduction in the RF energy consumption compared to the baseline machine with the same number of registers. Furthermore, for the same performance target, the Selective Writeback scheme results in a 38 % reduction in the energy consumption of the RF compared to the baseline machine

Increased Potency of Cardiac Stem Cells Compared with Bone Marrow Mesenchymal Stem Cells in Cardiac Repair

Whereas cardiac-derived c-kit + stem cells (CSCs) and bone marrow-derived mesenchymal stem cells (MSCs) are undergoing clinical trials testing safety and efficacy as a cell-based therapy, the relative therapeutic and biologic efficacy of these two cell types is unknown. We hypothesized that human CSCs have greater ability than MSCs to engraft, differentiate, and improve cardiac function. We compared intramyocardial injection of human fetal CSCs (36,000) with two doses of adult MSCs (36,000 and 1,000,000) or control (phosphate buffered saline) in nonobese diabetic/severe combined immune deficiency mice after coronary artery ligation. The myocardial infarction-induced enlargement in left ventricular chamber dimensions was ameliorated by CSCs ( p < .05 for diastolic and systolic volumes), as was the decline in ejection fraction (EF; p < .05). Whereas 1 × 10 6 MSCs partially ameliorated ventricular remodeling and improved EF to a similar degree as CSCs, 36,000 MSCs did not influence chamber architecture or function. All cell therapies improved myocardial contractility, but CSCs preferentially reduced scar size and reduced vascular afterload. Engraftment and trilineage differentiation was substantially greater with CSCs than with MSCs. Adult-cultured c-kit + CSCs were less effective than fetal, but were still more potent than high-dose MSCs. These data demonstrate enhanced CSC engraftment, differentiation, and improved cardiac remodeling and function in ischemic heart failure. MSCs required a 30-fold greater dose than CSCs to improve cardiac function and anatomy. Together, these findings demonstrate a greater potency of CSCs than bone marrow MSCs in cardiac repair