Navigating towards decoupled aquaponic systems : a system dynamics design approach

The classical working principle of aquaponics is to provide nutrient-rich aquacultural water to a hydroponic plant culture unit, which in turn depurates the water that is returned to the aquaculture tanks. A known drawback is that a compromise away from optimal growing conditions for plants and fish must be achieved to produce both crops and fish in the same environmental conditions. The objective of this study was to develop a theoretical concept of a decoupled aquaponic system (DAPS), and predict water, nutrient (N and P), fish, sludge, and plant levels. This has been approached by developing a dynamic aquaponic system model, using inputs from data found in literature covering the fields of aquaculture, hydroponics, and sludge treatment. The outputs from the model showed the dependency of aquacultural water quality on the hydroponic evapotranspiration rate. This result can be explained by the fact that DAPS is based on one-way flows. These one-way flows results in accumulations of remineralized nutrients in the hydroponic component ensuring optimal conditions for the plants. The study also suggests to size the cultivation area based on P availability in the hydroponic component as P is an exhaustible resource and has been identified one of the main limiting factors for plant growth

Immunologic Response to Antiretroviral Therapy in Hepatitis C Virus-Coinfected Adults in a Population-Based HIV/AIDS Treatment Program

BackgroundWe sought to characterize the impact that hepatitis C virus (HCV) infection has on CD4 cells during the first 48 weeks of antiretroviral therapy (ART) in previously ART-naive human immunodeficiency virus (HIV)-infected patients MethodsThe HIV/AIDS Drug Treatment Programme at the British Columbia Centre for Excellence in HIV/AIDS distributes all ART in this Canadian province. Eligible individuals were those whose first-ever ART included 2 nucleoside reverse transcriptase inhibitors and either a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor and who had a documented positive result for HCV antibody testing. Outcomes were binary events (time to an increase of ⩾75 CD4 cells/mm3 or an increase of ⩾10% in the percentage of CD4 cells in the total T cell population [CD4 cell fraction]) and continuous repeated measures. Statistical analyses used parametric and nonparametric methods, including multivariate mixed-effects linear regression analysis and Cox proportional hazards analysis ResultsOf 1186 eligible patients, 606 (51%) were positive and 580 (49%) were negative for HCV antibodies. HCV antibody-positive patients were slower to have an absolute (P<.001) and a fraction (P=.02) CD4 cell event. In adjusted Cox proportional hazards analysis (controlling for age, sex, baseline absolute CD4 cell count, baseline pVL, type of ART initiated, AIDS diagnosis at baseline, adherence to ART regimen, and number of CD4 cell measurements), HCV antibody-positive patients were less likely to have an absolute CD4 cell event (adjusted hazard ratio [AHR], 0.84 [95% confidence interval {CI}, 0.72-0.98]) and somewhat less likely to have a CD4 cell fraction event (AHR, 0.89 [95% CI, 0.70-1.14]) than HCV antibody-negative patients. In multivariate mixed-effects linear regression analysis, HCV antibody-negative patients had increases of an average of 75 cells in the absolute CD4 cell count and 4.4% in the CD4 cell fraction, compared with 20 cells and 1.1% in HCV antibody-positive patients, during the first 48 weeks of ART, after adjustment for time-updated pVL, number of CD4 cell measurements, and other factors ConclusionHCV antibody-positive HIV-infected patients may have an altered immunologic response to AR

Nitrogen transformations across compartments of an aquaponic system

The presence and transformations of nitrogen (N) in the environment depend on a variety of environmental factors but are also strongly influenced by anthropogenic activities such as modern agriculture. Understanding N transformations within the context of agricultural systems is crucial for efficient use thereof. The aim of this study was to investigate the changes in concentration of N forms (ammonium, nitrite, nitrate and organic N) within an aquaponic system, a modern agricultural system, in order to obtain insights into environmental pressures influencing N transformation processes. By measuring the concentrations of the individual N compounds, complemented by the determination of abiotic parameters and other relevant nutrients within the system water at 13 sampling points, significant differences between compartments that build up an aquaponic system could be demonstrated. These differences were attributed to individual microenvironments specific to the aerobic loop, anaerobic loop and radial flow settler as a connection between the two, shaping the microbial processes within the aquaponic system

Microbial diversity across compartments in an aquaponic system and its connection to the nitrogen cycle

Aquaponics combines hydroponic crop production with recirculating aquaculture. These systems comprise various compartments (fish tank, biofilter, sump, hydroponic table, radial flow settler and anaerobic digester), each with their own specific environmental pressures, which trigger the formation of unique microbial communities. Triplicated aquaponic systems were used to investigate the microbial community composition during three lettuce growing cycles. The sampling of individual compartments allowed community patterns to be generated using amplicon sequencing of bacterial and archaeal 16S rRNA genes. Nitrifying bacteria were identified in the hydroponic compartments, indicating that these compartments may play a larger role than previously thought in the system's nitrogen cycle. In addition to the observed temporal changes in community compositions within the anaerobic compartment, more archaeal reads were obtained from sludge samples than from the aerobic part of the system. Lower bacterial diversity was observed in fresh fish feces, where a highly discrete gut flora composition was seen. Finally, the most pronounced differences in microbial community compositions were observed between the aerobic and anaerobic loops of the system, with unique bacterial compositions in each individual compartment

A Canadian Critical Care Trials Group project in collaboration with the international forum for acute care trialists - Collaborative H1N1 Adjuvant Treatment pilot trial (CHAT): study protocol and design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Swine origin influenza A/H1N1 infection (H1N1) emerged in early 2009 and rapidly spread to humans. For most infected individuals, symptoms were mild and self-limited; however, a small number developed a more severe clinical syndrome characterized by profound respiratory failure with hospital mortality ranging from 10 to 30%. While supportive care and neuraminidase inhibitors are the main treatment for influenza, data from observational and interventional studies suggest that the course of influenza can be favorably influenced by agents not classically considered as influenza treatments. Multiple observational studies have suggested that HMGCoA reductase inhibitors (statins) can exert a class effect in attenuating inflammation. The Collaborative H1N1 Adjuvant Treatment (CHAT) Pilot Trial sought to investigate the feasibility of conducting a trial during a global pandemic in critically ill patients with H1N1 with the goal of informing the design of a larger trial powered to determine impact of statins on important outcomes.</p> <p>Methods/Design</p> <p>A multi-national, pilot randomized controlled trial (RCT) of once daily enteral rosuvastatin versus matched placebo administered for 14 days for the treatment of critically ill patients with suspected, probable or confirmed H1N1 infection. We propose to randomize 80 critically ill adults with a moderate to high index of suspicion for H1N1 infection who require mechanical ventilation and have received antiviral therapy for ≤ 72 hours. Site investigators, research coordinators and clinical pharmacists will be blinded to treatment assignment. Only research pharmacy staff will be aware of treatment assignment. We propose several approaches to informed consent including a priori consent from the substitute decision maker (SDM), waived and deferred consent. The primary outcome of the CHAT trial is the proportion of eligible patients enrolled in the study. Secondary outcomes will evaluate adherence to medication administration regimens, the proportion of primary and secondary endpoints collected, the number of patients receiving open-label statins, consent withdrawals and the effect of approved consent models on recruitment rates.</p> <p>Discussion</p> <p>Several aspects of study design including the need to include central randomization, preserve allocation concealment, ensure study blinding compare to a matched placebo and the use novel consent models pose challenges to investigators conducting pandemic research. Moreover, study implementation requires that trial design be pragmatic and initiated in a short time period amidst uncertainty regarding the scope and duration of the pandemic.</p> <p>Trial Registration Number</p> <p><a href="http://www.controlled-trials.com/ISRCTN45190901">ISRCTN45190901</a></p

Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996-2007

<p>Abstract</p> <p>Background</p> <p>International cohort studies have shown that antiretroviral treatment (ART) has improved survival of HIV-infected individuals. National population based studies of HIV mortality exist in industrialized settings but few have been presented from developing countries. Our objective was to investigate on a population basis, the regional situation regarding HIV mortality and trends in Latin America (LA) in the context of adoption of public ART policies and gender differences.</p> <p>Methods</p> <p>Cause of death data from vital statistics registries from 1996 to 2007 with "good" or "average" quality of mortality data were examined. Standardized mortality rates and Poisson regression models by country were developed and differences among countries assessed to identify patterns of HIV mortality over time occurring in Latin America.</p> <p>Results</p> <p>Standardized HIV mortality following the adoption of public ART policies was highest in Panama and El Salvador and lowest in Chile. During the study period, three overall patterns were identified in HIV mortality trends- following the adoption of the free ART public policies; a remarkable decrement, a remarkable increment and a slight increment. HIV mortality was consistently higher in males compared to females. Mean age of death attributable to HIV increased in the majority of countries over the study period.</p> <p>Conclusions</p> <p>Vital statistics registries provide valuable information on HIV mortality in LA. While the introduction of national policies for free ART provision has coincided with declines in population-level HIV mortality and increasing age of death in some countries, in others HIV mortality has increased. Barriers to effective ART implementation and uptake in the context of free ART public provision policies should be further investigated.</p

The Spectrum of Pulmonary Disease in Patients with HIV Infection

Pneumocystis carinii pneumonia (PCP) and Kaposi’s sarcoma were the harbingers of the HIV epidemic more than 10 years ago. Since then. the spectrum of pulmonary disease associated with HIV infection has become better understood. Although most of these conditions are infectious in nature. neoplastic and inflammatory processes also occur with increased frequency. The most common infectious pulmonary diseases include PCP. Mycobacterium tuberculosis infection and pyogenic bacterial pneumonia secondary to Streptococcus pneumoniae. Haemophilus influenzae or Staphylococcus aureus. Among the noninfectious causes of pulmonary disease. the most common are Kaposi's sarcoma. airways hyper-reactive disease (asthma) and emphysema. Respiratory involvement in HIV-infected individuals is not always related to the HIV infection. These patients often present with pulmonary disorders that are common in the genernal population. Differential diagnosis of respiratory conditions is significantly facilitated by the prior knowledge of the degree of immunodeficiency present as measured by the CD4 count. In particular, most episodes of PCP occur in patients with absolute CD4 counts below 200 cells/mm3. On the other hand. bacterial pneumonias and tuberculosis tend to occur at any time during the natural history of HIV disease. History and physical examination can help in the differential diagnosis; however. they are rclatively nonspecific in this setting. The same can be said of radiographic findings as well as laboratory and physiological abnormalities. Of note, the lactate dehydrogenase (LDH) serum level has proved to be extremely useful in ruling out PCP. Even mild PCP is usually accompanied by a significant elevation of LDH. Furthermore, the degree of LDH elevalion generally correlates wilh the severity of the PCP episode. Also, changes in LDH parallel the clinical course of the underlying PCP. Often LDH level has been useful in discriminating worsening PCP following the initiation of therapy from worsening respiratory symptoms due to superimposed disease. It must be emphasized, however. thal LDH level. although a very sensitive marker for PCP. is also nonspecific. Of note, hemolysis, lymphomas, pulmonary embolism, liver disease and dapsone therapy can be associated with elevated LDH in the context of HIV disease. Given the high frequency of respiratory involvement in this patient populalion. it is generally recommended thal preventive therapies be used whenever possible. Current recommendations stress the need for pneumococcal vaccine, yearly flu vaccination and routine screening with tuberculin skin test (PPD). HIV-infected individuals with a PPD skin test reaction of 5 mm of induration or greater using 5 tuberculin units will be considered candidates for one year of isoniazid prophylaxis. PCP prophylaxis has been shown to be extremely useful in this selling either as primary or secondary prophylaxis. Recently. rifabutin at doses of 300 mg daily has been shown to decrease significantly the frequency of Mycobacterium avium complex infection in patients with CD4 counts below 100/mm3 . (Pour résumé. voir page 35E