No Impact of Body Mass Index on Outcome in Stroke Patients Treated with IV Thrombolysis BMI and IV Thrombolysis Outcome.

The impact of excess body weight on prognosis after stroke is controversial. Many studies report higher survival rates in obese patients ("obesity paradox"). Recently, obesity has been linked to worse outcomes after intravenous (IV) thrombolysis, but the number and sample size of these studies were small. Here, we aimed to assess the relationship between body weight and stroke outcome after IV thrombolysis in a large cohort study. In a prospective observational multicenter study, we analyzed baseline and outcome data of 896 ischemic stroke patients who underwent IV thrombolysis. Patients were categorized according to body mass index (BMI) as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obese (30-34.9 kg/m2) or severely obese (>35 kg/m2). Using uni- and multivariate modeling, we assessed the relationship of BMI with favorable outcome (defined as modified Rankin Scale 0 or 1) and mortality 3 months after stroke as well as the occurrence of symptomatic intracerebral hemorrhages (sICH). We also measured the incidence of patients that had an early neurological improvement of >40% on the National Institutes of Health Stroke Scale (NIHSS) after 24 hours. Among 896 patients, 321 were normal weight (35.8%), 22 underweight (2.5%), 378 overweight (42.2%), 123 obese (13.7%) and 52 severely obese (5.8%). Three-month mortality was comparable in obese vs. non-obese patients (8.1% vs. 8.3%) and did not differ significantly among different BMI groups. This was also true for favorable clinical outcome, risk of sICH and early neurological improvement on NIHSS at 24 hours. These results remained unchanged after adjusting for potential confounding factors in the multivariate analyses. BMI was not related to clinical outcomes in stroke patients treated with IVT. Our data suggest that the current weight-adapted dosage scheme of IV alteplase is appropriate for different body weight groups, and challenge the existence of the obesity paradox after stroke

Well-being, job satisfaction, stress and burnout in speech-language pathologists: A review.

Purpose: The purpose of this review was to evaluate the factors that influence well-being, job satisfaction, stress, and burnout in speech-language pathologists (SLPs), and to identify the impact of these variables on worker recruitment and retention. Method: A systematic literature search was conducted. Four electronic databases (PsycARTICLES & PsycINFO, PubMed/Medline, CINHAL and ABI/INFORM) were searched. The search was limited to articles published in English between 1998 and June 2018. To be eligible for inclusion, studies needed to investigate or report well-being, job satisfaction, stress or burnout in SLPs. The methodological quality of each paper was assessed using the “Strengthening the Reporting of Observational Studies in Epidemiology” (for quantitative data) and “Consolidated criteria for Reporting Qualitative research” (for qualitative data) checklists. A data-driven thematic analysis of the literature was used to identify key themes. Result: Seventeen of 2050 studies met the inclusion criteria, of which fifteen were cross-sectional surveys yielding quantitative data. Two were qualitative studies. There was consistent evidence for SLPs in the USA and Canada experiencing satisfaction in their jobs. Facet analysis revealed six contributory themes, three of which were clearly associated with well-being: workload/caseload size, professional support, and salary. The contribution of job control (autonomy), length of time in practice and work setting was inconclusive. Evidence for stress and dissatisfaction leading to workforce attrition was found. Conclusion: Job satisfaction, stress, and burnout were found to be associated with various occupational features, including elements of demand, support and reward. No previous studies have investigated the interaction between different elements of a job, which might boost satisfaction or ameliorate stress in SLPs. This is the first review using a systematic approach to focus on well-being, satisfaction, stress and burnout in SLPs and suggests more work needs to be done to help identify and improve the well-being of the workforce

Ground-based and airborne in-situ measurements of the Eyjafjallajökull volcanic aerosol plume in Switzerland in spring 2010

The volcanic aerosol plume resulting from the Eyjafjallajökull eruption in Iceland in April and May 2010 was detected in clear layers above Switzerland during two periods (17–19 April 2010 and 16–19 May 2010). In-situ measurements of the airborne volcanic plume were performed both within ground-based monitoring networks and with a research aircraft up to an altitude of 6000 m a.s.l. The wide range of aerosol and gas phase parameters studied at the high altitude research station Jungfraujoch (3580 m a.s.l.) allowed for an in-depth characterization of the detected volcanic aerosol. Both the data from the Jungfraujoch and the aircraft vertical profiles showed a consistent volcanic ash mode in the aerosol volume size distribution with a mean optical diameter around 3 ± 0.3 μm. These particles were found to have an average chemical composition very similar to the trachyandesite-like composition of rock samples collected near the volcano. Furthermore, chemical processing of volcanic sulfur dioxide into sulfate clearly contributed to the accumulation mode of the aerosol at the Jungfraujoch. The combination of these in-situ data and plume dispersion modeling results showed that a significant portion of the first volcanic aerosol plume reaching Switzerland on 17 April 2010 did not reach the Jungfraujoch directly, but was first dispersed and diluted in the planetary boundary layer. The maximum PM<sub>10</sub> mass concentrations at the Jungfraujoch reached 30 μgm<sup>−3</sup> and 70 μgm<sup>−3</sup> (for 10-min mean values) duri ng the April and May episode, respectively. Even low-altitude monitoring stations registered up to 45 μgm<sup>−3</sup> of volcanic ash related PM<sub>10</sub> (Basel, Northwestern Switzerland, 18/19 April 2010). The flights with the research aircraft on 17 April 2010 showed one order of magnitude higher number concentrations over the northern Swiss plateau compared to the Jungfraujoch, and a mass concentration of 320 (200–520) μgm<sup>−3</sup> on 18 May 2010 over the northwestern Swiss plateau. The presented data significantly contributed to the time-critical assessment of the local ash layer properties during the initial eruption phase. Furthermore, dispersion models benefited from the detailed information on the volcanic aerosol size distribution and its chemical composition

Transformation of PVP coated silver nanoparticles in a simulated wastewater treatment process and the effect on microbial communities

Extent: 18p.Background: Manufactured silver nanoparticles (AgNPs) are one of the most commonly used nanomaterials in consumer goods and consequently their concentrations in wastewater and hence wastewater treatment plants are predicted to increase. We investigated the fate of AgNPs in sludge that was subjected to aerobic and anaerobic treatment and the impact of AgNPs on microbial processes and communities. The initial identification of AgNPs in sludge was carried out using transmission electron microscopy (TEM) with energy dispersive X-ray (EDX) analysis. The solid phase speciation of silver in sludge and wastewater influent was then examined using X-ray absorption spectroscopy (XAS). The effects of transformed AgNPs (mainly Ag-S phases) on nitrification, wastewater microbial populations and, for the first time, methanogenesis was investigated. Results: Sequencing batch reactor experiments and anaerobic batch tests, both demonstrated that nitrification rate and methane production were not affected by the addition of AgNPs [at 2.5 mg Ag L-1 (4.9 g L-1 total suspended solids, TSS) and 183.6 mg Ag kg -1 (2.9 g kg-1 total solids, TS), respectively]. The low toxicity is most likely due to AgNP sulfidation. XAS analysis showed that sulfur bonded Ag was the dominant Ag species in both aerobic (activated sludge) and anaerobic sludge. In AgNP and AgNO3 spiked aerobic sludge, metallic Ag was detected (~15%). However, after anaerobic digestion, Ag(0) was not detected by XAS analysis. Dominant wastewater microbial populations were not affected by AgNPs as determined by DNA extraction and pyrotag sequencing. However, there was a shift in niche populations in both aerobic and anaerobic sludge, with a shift in AgNP treated sludge compared with controls. This is the first time that the impact of transformed AgNPs (mainly Ag-S phases) on anaerobic digestion has been reported. Conclusions: Silver NPs were transformed to Ag-S phases during activated sludge treatment (prior to anaerobic digestion). Transformed AgNPs, at predicted future Ag wastewater concentrations, did not affect nitrification or methanogenesis. Consequently, AgNPs are very unlikely to affect the efficient functioning of wastewater treatment plants. However, AgNPs may negatively affect sub-dominant wastewater microbial communities.Casey L Doolette, Mike J McLaughlin, Jason K Kirby, Damien J Batstone, Hugh H Harris, Huoqing Ge and Geert Corneli

Viscum album Exerts Anti-Inflammatory Effect by Selectively Inhibiting Cytokine-Induced Expression of Cyclooxygenase-2

Viscum album (VA) preparations are extensively used as complementary therapy in cancer and are shown to exert anti-tumor activities which involve the cytotoxic properties, induction of apoptosis, inhibition of angiogenesis and several other immunomodulatory mechanisms. In addition to their application in cancer therapy, VA preparations have also been successfully utilized in the treatment of several inflammatory pathologies. Owing to the intricate association of inflammation and cancer and in view of the fact that several anti-tumor phytotherapeutics also exert a potent anti-inflammatory effect, we hypothesized that VA exerts an anti-inflammatory effect that is responsible for its therapeutic benefit. Since, inflammatory cytokine-induced cyclo-oxygenase-2 (COX-2) and prostaglandin E2 (PGE2) play a critical role in the pathogenesis of inflammatory diseases, we investigated the anti-inflammatory effect of VA on regulation of cyclo-oxygenase expression and PGE2 biosynthesis by using human lung adenocarcinoma cells (A549 cells) as a model. A549 cells were stimulated with IL-1β and treated with VA preparation (VA Qu Spez) for 18 hours. PGE2 was analysed in the culture supernatants by enzyme immunoassay. Expression of COX-2 and COX-1 proteins was analyzed by immunoblotting and the expression of COX-2 mRNA was assessed by semi-quantitative RT-PCR. We found that VA Qu Spez inhibit the secretion of IL-1β-induced PGE2 in a dose-dependent manner. Further, we also show that this inhibitory action was associated with a reduced expression of COX-2 without modulating the COX-1 expression. Together these results demonstrate a novel anti-inflammatory mechanism of action of VA preparations wherein VA exerts an anti-inflammatory effect by inhibiting cytokine-induced PGE2 via selective inhibition of COX-2

Release of engineered nanomaterials from personal care products throughout their life cycle

The impetus for this study was to provide release estimates that can serve to improve predictions of engineered nanomaterial (ENM) exposure for risk assessment. We determined the likely release of ENMs from personal care products (PCPs) through a consumer survey on use and disposal habits, and research on the types and quantities of ENMs in PCPs. Our estimates show that in the US zinc oxide (ZnO), with 1,800-2,100 mt yr-1, and titanium dioxide (TiO2), with 870-1,000 mt yr-1, represent 94 % of ENMs released into the environment or landfills from the use of PCPs. Around 36-43 % of ENMs from PCPs were estimated to end up in landfills, 24-36 % released to soils, 0.7-0.8 % to air, and 28-32 % to water bodies. ENMs in sunscreen represent around 81-82 % of total release, from ZnO and TiO2 as UV blockers, followed by facial moisturizer (7.5 %), foundation (5.7 %), and hair coloring products (3.1 %). Daily care products such as body wash, shampoo, and conditioner had by far the highest per capita and total use, but contributed little to the ENM release estimates as these products generally contain little or no ENMs. However, if ENMs are incorporated into these daily care products, this may substantially increase ENM release. © 2014 Springer Science+Business Media