Can exercise limits prevent post-exertional malaise in chronic fatigue syndrome? An uncontrolled clinical trial.

<b>Objective</b>: It was hypothesized that the use of exercise limits prevents symptom increases and worsening of their health status following a walking exercise in people with Chronic Fatigue Syndrome (CFS). <b>Design</b>: An uncontrolled clinical trial (semi-experimental design). <b>Setting</b>: Outpatient clinic of a university department. <b>Subjects</b>: 24 patients with CFS. <b>Interventions</b>: Subjects undertook a walking test with the two concurrent exercise limits. Each subject walked at an <i>intensity</i> where the maximum heart rate was determined by heart rate corresponding to the respiratory exchange ratio =1.0 derived from a previous sub-maximal exercise test and for a duration calculated from how long each patient felt they were able to walk. <b>Main outcome measures</b>: The Short Form 36 Health Survey or SF-36, the CFS Symptom List, and the CFS-Activities and Participation Questionnaire were filled in prior to, immediately and 24 hours post-exercise. <b>Results</b>: The fatigue increase observed immediately post-exercise (p=0.006) returned to pre-exercise levels 24 hours post-exercise. The increase in pain observed immediately post-exercise was retained at 24 hours post-exercise (p=0.03). Fourteen of 24 subjects experienced a clinically meaningful change in bodily pain (change of SF-36 bodily pain score ³10). Six of 24 participants indicated that the exercise bout had slightly worsened their health status, and 2 of 24 had a clinically meaningful decrease in vitality (change of SF-36 vitality score ³20). There was no change in activity limitations/participation restrictions. <b>Conclusion</b>: It was shown that the use of exercise limits (limiting both the intensity and duration of exercise) prevents important health status changes following a walking exercise in people with CFS, but was unable to prevent short-term symptom increases

An Innovative Geocentric Decision Support Solution to Comprehensive Planning, Design, Operation, and Management of Urban Drainage Systems

Geographic Information System (GIS) is quickly becoming a critical component to develop and sustain asset management for today’s wastewater utilities as most of their data is geographically referenced. This technology offers sophisticated data management and spatial analysis capabilities that can greatly improve and facilitate urban drainage infrastructure modeling and analysis applications. This paper presents a comprehensive GIS-based decision support system that integrates several technologies for use in the effective management of urban stormwater collection systems. It explicitly integrates ESRI ArcGIS geospatial model with advanced hydrologic, hydraulic, and water quality simulation algorithms, nature-based global optimization techniques including genetic algorithms for design and calibration of stormwater management models, automated dry weather flow generation and allocation, and automated subcatchment delineation and parameter extraction tools to address every facet of urban drainage infrastructure management. The geocentric interface allows seamless communication among the various modules. The resulting decision support system effortlessly reads GIS datasets, extracts necessary modeling information, and automatically constructs, loads, designs, calibrates, analyzes and optimizes a representative urban drainage model considering hydrologic and hydraulic performance requirements. It also makes it easy to run, simulate and compare various modeling scenarios, identify system deficiencies, and determine cost-effective physical and operational improvements to achieve optimum performance and regulatory compliance. These combined capabilities provide favorable geospatial environment to assist wastewater utilities in planning, designing, and operating reliable systems and in optimizing their capital improvement programs

In vivo antimycobacterial studies of toussaintine A-chitosan nanocomposites

Chitosan (CS, molecular weight (MW) 20.2 kDA, stability of 210 °C and degree of deacetylation (DD) 73.31%) was obtained by deacetylation of chitin extracted from shrimp (Litopenaeus vannamei) shell wastes. The encapsulation of the studied bioactive natural product, toussaintine A (TA) isolated from the leaves of Toussaintia orientalis, on a chitosan-tripolyphosphate (CS/TPP) nanoformulation was attained through ionotropic gelation. Characterization of pure CS, CS/TPP and TA-CS/TPP nanocomposites was carried out by FTIR and SEM. The encapsulation efficiency and loading capacity of the TA were 69.33 and 0.46%, respectively. The in vitro release kinetics established an initial release of 27% of TA in the initial six hours followed by a slow and maintained release up to 72 h. The in vivo antimycobacterial acitivities of both TA and TA-CS/TPP nanocomposites against Mycobacterium indicus pranii (MIP) employing Galleria mellonella larvae as an infection model were evaluated. TA-CS/TPP nanocomposite formulations exhibited remarkable effectiveness against MIP than free TA.Keywords: Toussaintine A; chitosan; nanocomposites, antimycobacterial; Galleria mellonell

Biodegradation of the Alkaline Cellulose Degradation Products Generated during Radioactive Waste Disposal.

The anoxic, alkaline hydrolysis of cellulosic materials generates a range of cellulose degradation products (CDP) including α and β forms of isosaccharinic acid (ISA) and is expected to occur in radioactive waste disposal sites receiving intermediate level radioactive wastes. The generation of ISA's is of particular relevance to the disposal of these wastes since they are able to form complexes with radioelements such as Pu enhancing their migration. This study demonstrates that microbial communities present in near-surface anoxic sediments are able to degrade CDP including both forms of ISA via iron reduction, sulphate reduction and methanogenesis, without any prior exposure to these substrates. No significant difference (n = 6, p = 0.118) in α and β ISA degradation rates were seen under either iron reducing, sulphate reducing or methanogenic conditions, giving an overall mean degradation rate of 4.7×10−2 hr−1 (SE±2.9×10−3). These results suggest that a radioactive waste disposal site is likely to be colonised by organisms able to degrade CDP and associated ISA's during the construction and operational phase of the facility

26-hour Storage of a Declined Liver Before Successful Transplantation Using Ex Vivo Normothermic Perfusion.

This is the author accepted manuscript. The final version is available at http://dx.doi.org/10.1097/SLA.000000000000183

Silicon-Based Solid-State Batteries: Electrochemistry and Mechanics to Guide Design and Operation

Solid-state batteries (SSBs) are promising alternatives to the incumbent lithium-ion technology; however, they face a unique set of challenges that must be overcome to enable their widespread adoption. These challenges include solid-solid interfaces that are highly resistive, with slow kinetics, and a tendency to form interfacial voids causing diminished cycle life due to fracture and delamination. This modeling study probes the evolution of stresses at the solid electrolyte (SE) solid-solid interfaces, by linking the chemical and mechanical material properties to their electrochemical response, which can be used as a guide to optimize the design and manufacture of silicon (Si) based SSBs. A thin-film solid-state battery consisting of an amorphous Si negative electrode (NE) is studied, which exerts compressive stress on the SE, caused by the lithiation-induced expansion of the Si. By using a 2D chemo-mechanical model, continuum scale simulations are used to probe the effect of applied pressure and C-rate on the stress-strain response of the cell and their impacts on the overall cell capacity. A complex concentration gradient is generated within the Si electrode due to slow diffusion of Li through Si, which leads to localized strains. To reduce the interfacial stress and strain at 100% SOC, operation at moderate C-rates with low applied pressure is desirable. Alternatively, the mechanical properties of the SE could be tailored to optimize cell performance. To reduce Si stress, a SE with a moderate Young's modulus similar to that of lithium phosphorous oxynitride (∼77 GPa) with a low yield strength comparable to sulfides (∼0.67 GPa) should be selected. However, if the reduction in SE stress is of greater concern, then a compliant Young's modulus (∼29 GPa) with a moderate yield strength (1-3 GPa) should be targeted. This study emphasizes the need for SE material selection and the consideration of other cell components in order to optimize the performance of thin film solid-state batteries

Conversion From Calcineurin to Mammalian Target of Rapamycin Inhibitors in Liver Transplantation: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Conversion to mammalian target of rapamycin inhibitors (mTORi) is often used in liver transplantation to overcome calcineurin inhibitor (CNI) nephrotoxicity but the evidence base for this approach is not well defined. To summarize the evidence, from randomized clinical trials (RCTs), for conversion from CNI to mTORi-based immunosuppression after liver transplantation. METHODS: Databases and conference abstracts were searched up to August 2015. The RCTs evaluating conversion from CNI to mTORi-based maintenance immunosuppression after adult liver transplantation. Descriptive and quantitative information was extracted; summary mean difference and risk ratio (RR) estimates were synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and I. RESULTS: Ten RCTs, with a total of 1927 patients, met the final inclusion criteria. Patients converted to mTORi had significantly better renal function at 1 year after randomization compared with patients remaining on CNI (mean difference, 7.48 mL/min per 1.73 m; 95% confidence interval [95% CI], 3.18-11.8). The risks of graft loss (RR, 0.77; 95% CI, 0.29-2.09; I, 31%) and patient death (RR, 1.05; 95% CI, 0.63-1.73; I, 0%) were similar for patients converted to mTORi and patients remaining on CNI. However, conversion to mTORi was associated with a higher risk of acute rejection (RR, 1.76; 95% CI, 1.33-2.34; I, 0%) and study discontinuation due to adverse events (RR, 2.17; 95% CI, 1.38-3.44; I, 63%) up to 1 year after randomization. CONCLUSIONS: Conversion from CNI to mTORi after liver transplantation is associated with improved renal function after 1 year but increases the risk of acute rejection and may be poorly tolerated.The study was funded in part by the NIHR Cambridge Biomedical Research Centre.This is the author accepted manuscript. The final version is available from Lippincott Williams & Wilkins via http://dx.doi.org/10.1097/TP.000000000000100