Morphological response to a North Sea bed depression induced by gas mining

Gas mining leads to saucer-like surface depressions. In the North Sea, gas is currently mined at several offshore locations. The associated bed depression has a similar spatial extent as offshore tidal sandbanks, which are large-scale bed patterns covering a significant part of the North Sea bottom. The morphological time scales of bed depressions and tidal sandbanks are similar, so that significant interaction between these features is expected. In this paper we allow the bed depression to become morphologically active. A simple depression model based on a homogeneous soil is tuned with data of a bed depression near the Dutch barrier island of Ameland. Next, this subsidence model is included in a morphodynamic model. We show that this model is able to explain tidal sandbanks, which represent natural bed behavior. Here we approximate the solution by an expansion up to first order. The zeroth-order solution of the model is a flat bed with a spatially uniform, time-independent current. The first-order solution is investigated using a Fourier transformation. In general, we observe significant interaction between the bed depression and the natural sandbank formation process. The process of induced bed depression triggers and intensifies the natural morphological behavior of the offshore seabed. The model also shows essential differences between modeling a morphodynamically active marine bottom depression and a bottom depression below the threshold for sediment motion. The maximum bed level depression in the active case is significantly larger, and the circular shape of depression contours is affected by stretching toward the preferred orientation of the tidal sandbank formation process

Ketogenic Diet in Refractory Childhood Epilepsy:Starting With a Liquid Formulation in an Outpatient Setting

Background: Ketogenic diet in children with epilepsy has a considerable impact on daily life and is usually adopted for at least 3 months. Our aim was to evaluate whether the introduction of an all-liquid ketogenic diet in an outpatient setting is feasible, and if an earlier assessment of its efficacy can be achieved. Methods: The authors conducted a prospective, observational study in a consecutive group of children with refractory epilepsy aged 2 to 14 years indicated for ketogenic diet. Ketogenic diet was started as an all-liquid formulation of the classical ketogenic diet, KetoCal 4:1 LQ, taken orally or by tube. After 6 weeks, the liquid diet was converted into solid meals. The primary outcome parameter was time-to-response (>50% seizure reduction). Secondary outcome parameters were time to achieve stable ketosis, the number of children showing a positive response, and the retention rate at 26 weeks. Results: Sixteen children were included. Four of them responded well with respect to seizure frequency, the median time-to-response was 14 days (range 7-28 days). The mean time to achieve stable ketosis was 7 days. The retention rate at 26 weeks was 50%. Of the 8 children who started this protocol orally fed, 6 completed it without requiring a nasogastric tube. Conclusions: Introduction of ketogenic diet with a liquid formulation can be accomplished in orally fed children without major complications. It allowed for fast and stable ketosis

Single amino acid supplementation in aminoacidopathies:a systematic review

Aminoacidopathies are a group of rare and diverse disorders, caused by the deficiency of an enzyme or transporter involved in amino acid metabolism. For most aminoacidopathies, dietary management is the mainstay of treatment. Such treatment includes severe natural protein restriction, combined with protein substitution with all amino acids except the amino acids prior to the metabolic block and enriched with the amino acid that has become essential by the enzymatic defect. For some aminoacidopathies, supplementation of one or two amino acids, that have not become essential by the enzymatic defect, has been suggested. This so-called single amino acid supplementation can serve different treatment objectives, but evidence is limited. The aim of the present article is to provide a systematic review on the reasons for applications of single amino acid supplementation in aminoacidopathies treated with natural protein restriction and synthetic amino acid mixtures

Regional variation in the interpretation of contact precautions for multi-drug-resistant Gram-negative bacteria:a cross-sectional survey

Background: Contact precautions are recommended when caring for patients with carbapenemase-producing Enterobacterales (CPE), carbapenemase-producing Pseudomonas aeruginosa (CPPA), and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Aim: Our aim was to determine the interpretation of contact precautions and associated infection prevention and control (IPC) measures in the non-ICU hospital setting for patients with CPE, CPPA or ESBL-E in 11 hospitals in the Southwest of the Netherlands. Methods: A cross-sectional survey was developed to collect information on all implemented IPC measures, including use of personal protective equipment, IPC measures for visitors, cleaning and disinfection, precautions during outpatient care and follow-up strategies. All 11 hospitals were invited to participate between November 2020 and April 2021. Findings: The survey was filled together with each hospital. All hospitals installed isolation precautions for patients with CPE and CPPA during inpatient care and day admissions, whereas 10 hospitals (90.9%) applied isolation precautions for patients with ESBL-E. Gloves and gowns were always used during physical contact with the patient in isolation. Large variations were identified in IPC measures for visitors, cleaning and disinfection products used, and precautions during outpatient care. Four hospitals (36.4%) actively followed up on CPE or CPPA patients with the aim of declaring them CPE- or CPPA-negative as timely as possible, and two hospitals (20.0%) actively followed up on ESBL-E patients. Conclusion: Contact precautions are interpreted differently between hospitals, leading to regional differences in IPC measures applied in clinical settings. Harmonizing infection-control policies between the hospitals could facilitate patient transfers and benefit collective efforts of preventing transmission of multi-drug-resistant Gram-negative bacteria.</p

Determination of Stromal Signatures in Breast Carcinoma

Many soft tissue tumors recapitulate features of normal connective tissue. We hypothesize that different types of fibroblastic tumors are representative of different populations of fibroblastic cells or different activation states of these cells. We examined two tumors with fibroblastic features, solitary fibrous tumor (SFT) and desmoid-type fibromatosis (DTF), by DNA microarray analysis and found that they have very different expression profiles, including significant differences in their patterns of expression of extracellular matrix genes and growth factors. Using immunohistochemistry and in situ hybridization on a tissue microarray, we found that genes specific for these two tumors have mutually specific expression in the stroma of nonneoplastic tissues. We defined a set of 786 gene spots whose pattern of expression distinguishes SFT from DTF. In an analysis of DNA microarray gene expression data from 295 previously published breast carcinomas, we found that expression of this gene set defined two groups of breast carcinomas with significant differences in overall survival. One of the groups had a favorable outcome and was defined by the expression of DTF genes. The other group of tumors had a poor prognosis and showed variable expression of genes enriched for SFT type. Our findings suggest that the host stromal response varies significantly among carcinomas and that gene expression patterns characteristic of soft tissue tumors can be used to discover new markers for normal connective tissue cells

Discovery of molecular subtypes in leiomyosarcoma through integrative molecular profiling.

Leiomyosarcoma (LMS) is a soft tissue tumor with a significant degree of morphologic and molecular heterogeneity. We used integrative molecular profiling to discover and characterize molecular subtypes of LMS. Gene expression profiling was performed on 51 LMS samples. Unsupervised clustering showed three reproducible LMS clusters. Array comparative genomic hybridization (aCGH) was performed on 20 LMS samples and showed that the molecular subtypes defined by gene expression showed distinct genomic changes. Tumors from the muscle-enriched cluster showed significantly increased copy number changes (P=0.04). A majority of the muscle-enriched cases showed loss at 16q24, which contains Fanconi anemia, complementation group A, known to have an important role in DNA repair, and loss at 1p36, which contains PRDM16, of which loss promotes muscle differentiation. Immunohistochemistry (IHC) was performed on LMS tissue microarrays (n=377) for five markers with high levels of messenger RNA in the muscle-enriched cluster (ACTG2, CASQ2, SLMAP, CFL2 and MYLK) and showed significantly correlated expression of the five proteins (all pairwise P&lt;0.005). Expression of the five markers was associated with improved disease-specific survival in a multivariate Cox regression analysis (P&lt;0.04). In this analysis that combined gene expression profiling, aCGH and IHC, we characterized distinct molecular LMS subtypes, provided insight into their pathogenesis, and identified prognostic biomarkers

Effect of lubricants and sliding conditions on the tribo-performance of SiO2/epoxy composites

The influence of solid lubricants, normal load, sliding speed and water environment on the tribo-performance of solid lubricant-containing SiO2-epoxy composites is investigated. 10 to 15 wt% PTFE concentration yields a low coefficient of friction (CoF) and low wear rate under 60 N load. With increasing PTFE concentration in the composites, the load capacity decreases. Graphite exhibits worse friction and wear performance than PTFE under dry sliding condition, i.e. the CoF increases with a decreasing load in ball-on-disc. A higher concentration of PTFE-containing tribolayer on the worn composite surface is found under a higher load. The CoF and ball wear rate increase with increasing sliding speed under dry sliding, which is accompanied with an increase of the surface temperature of the composite. A high relative humidity is advantageous for a low friction due to adsorbed water molecules that lubricate the sliding couple. Water lubrication leads to a lower wear rate of the PTFE and graphite filled composites, whereas it gives rise to a higher wear rate of the Al2O3 ball due to the lack of protection of the transfer films