3,138 research outputs found

    An assessment of road-verge grass as a feedstock for farm-fed anaerobic digestion plants

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    Cuttings from road-verge grass could provide biomass for energy generation, but currently this potential is not exploited. This research assessed the technical, practical and financial feasibility of using grass harvested from road verges as a feedstock in farm-fed anaerobic digestion (AD) plants. The methane potential (191 mL CH4 gDM−1) and digestion characteristics of verge grass were similar to those of current farm feedstocks; indicating suitability for AD. Ensiling had no significant impact on the biomethane generated. Testing co-digestions of verge grass with current farm feedstocks showed enhanced methane yields, suggesting that verge grass could be a valuable addition to AD feedstock mixes. In a case study of the UK county of Lincolnshire, potential volumes and locations of verge grass biomass were estimated, with capacities and locations of existing AD plants, to assess the potential to supply practical grass volumes. Grass harvesting costs were modelled and compared with other feedstock costs. Finally, the attitudes of AD operators to using verge grass were investigated to understand whether a market for verge grass exists. In a small survey all operators were willing to use it as a feedstock and most were prepared to pay over the estimated harvesting cost. If verge grass was legally recognised as a waste product it could be attractive to AD operators especially where financial incentives to use waste feedstocks are in place. In rural areas, verge grass could be harvested and co-digested by existing farm-fed AD plants, potentially reducing the cost of road verge maintenance and increasing biodiversity

    Diagnosis and Complications of Cushing's Syndrome: A Consensus Statement

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    In October 2002, a workshop was held in Ancona, Italy, to reach a Consensus on the management of Cushing's syndrome. The workshop was organized by the University of Ancona and sponsored by the Pituitary Society, the European Neuroendocrine Association, and the Italian Society of Endocrinology. Invited international participants included almost 50 leading endocrinologists with specific expertise in the management of Cushing's syndrome. The consensus statement on diagnostic criteria and the diagnosis and treatment of complications of this syndrome reached at the workshop is hereby summarized

    Impact of inhaled corticosteroids on growth in children with asthma: systematic review and meta-analysis

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    Background: Long-term inhaled corticosteroids (ICS) may reduce growth velocity and final height of children with asthma. We aimed to evaluate the association between ICS use of >12 months and growth. Methods: We initially searched MEDLINE and EMBASE in July 2013, followed by a PubMed search updated to December 2014. We selected RCTs and controlled observational studies of ICS use in patients with asthma. We conducted random effects meta-analysis of mean differences in growth velocity (cm/year) or final height (cm) between groups. Heterogeneity was assessed using the I2 statistic. Results: We found 23 relevant studies (twenty RCTs and three observational studies) after screening 1882 hits. Meta-analysis of 16 RCTs showed that ICS use significantly reduced growth velocity at one year follow-up (mean difference -0.48 cm/year (95% CI -0.66 to -0.29)). There was evidence of a dose-response effect in three RCTs. Final adult height showed a mean reduction of -1.20 cm (95% CI -1.90 cm to -0.50 cm) with budesonide versus placebo in a high quality RCT. Meta-analysis of two lower quality observational studies revealed uncertainty in the association between ICS use and final adult height, pooled mean difference -0.85 cm (95% CI -3.35 to 1.65). Conclusion: Use of ICS for >12 months in children with asthma has a limited impact on annual growth velocity. In ICS users, there is a slight reduction of about a centimeter in final adult height, which when interpreted in the context of average adult height in England (175 cm for men and 161 cm for women), represents a 0.7% reduction compared to non-ICS users

    Unicompartmental knee arthroplasty in patients aged less than 65: Combined data from the Australian and Swedish Knee Registries

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    Introduction and purpose: In recent years, there has been renewed interest in using unicompartmental knee arthroplasty (UKA). Several studies have reported increasing numbers of UKAs for osteoarthritis in patients who are less than 65 years of age, with low revision rates. To describe and compare the use and outcome of UKA in this age group, we have combined data from the Australian and Swedish knee registries. Patients and methods: More than 34,000 UKA procedures carried out between 1998 and 2007 were analyzed, and we focused on over 16,000 patients younger than 65 years to determine usage and to determine differences in the revision rate. Survival analysis was used to determine outcomes of revision related to age and sex, using any reason for revision as the endpoint. Results: Both countries showed a decreasing use of UKA in recent years in terms of the proportion of knee replacements and absolute numbers undertaken per year. The 7-year cumulative risk of revision of UKA in patients younger than 65 years was similar in the two countries. Patients younger than 55 years had a statistically significantly higher cumulative risk of revision than patients aged 55 to 64 years (19% and 12%, respectively at 7 years). The risk of revision in patients less than 65 years of age was similar in both sexes. Interpretation: The results of the combined UKA data from the Australian and Swedish registries show a uniformity of outcome between countries with patients aged less than 65 having a higher rate of revision than patients who were 65 or older. Surgeons and patients should be aware of the higher risk of revision in this age group.Annette W-Dahl, Otto Robertsson, Lars Lidgren, Lisa Miller, David Davidson, Stephen Graves

    Correlation between echocardiographic and hemodynamic variables in cardiothoracic intensive care unit

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    Objectives the echocardiographic indices have not been validated in critically ill population. We investigated the correlation between some echocardiographic and hemodynamics parameters. Design Prospective Spontaneous non-interventional observational study. Setting Adult cardiothoracic intensive care unit, single center (Royal Brompton Hospital, London UK). Participants Consecutive adult patients admitted to cardiothoracic intensive care unit for severe respiratory failure, primary cardio-circulatory failure and post-aortic surgery. Interventions Clinical, hemodynamic parameters (stroke volume – SV, cardiac output – CO, mean arterial pressure – MAP, and cardiac power index – CPI) and echocardiographic indices of ventricular function (left ventricular total isovolumic time – t-IVT, mitral annular plane systolic excursion – MAPSE, and left ventricular fraction – LVEF) were evaluated offline. Measurements and main results 117 patients were studied (age 57.2 ± 19; 60.6% male). t-IVT showed an inverse correlation with SV, CO, MAP and CPI (respectively r: -67%; -38%; -45%; -51%). MAPSE exhibited a positive correlation with SV, CO, MAP and CPI (respectively r: 43%; 44%; 34%; 31%). LVEF did not show any correlation. In the multivariate analysis the association of t-IVT and hemodynamics was confirmed for SV, CO, MAP and CPI with the highest partial correlation between t-IVT and MAP (R = -58%). Conclusions MAPSE and t-IVT are two reproducible and reliable echocardiographic indices of systolic function and ventricular efficacy associated with hemodynamic variables in cardiothoracic critically ill patients, while LVEF did not show any correlation

    Antimalarial Exposure Delays Plasmodium falciparum Intra-Erythrocytic Cycle and Drives Drug Transporter Genes Expression

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    BACKGROUND: Multi-drug resistant Plasmodium falciparum is a major obstacle to malaria control and is emerging as a complex phenomenon. Mechanisms of drug evasion based on the intracellular extrusion of the drug and/or modification of target proteins have been described. However, cellular mechanisms related with metabolic activity have also been seen in eukaryotic systems, e.g. cancer cells. Recent observations suggest that such mechanism may occur in P. falciparum. METHODOLOGY/PRINCIPAL FINDINGS: We therefore investigated the effect of mefloquine exposure on the cell cycle of three P. falciparum clones (3D7, FCB, W2) with different drug susceptibilities, while investigating in parallel the expression of four genes coding for confirmed and putative drug transporters (pfcrt, pfmdr1, pfmrp1 and pfmrp2). Mefloquine induced a previously not described dose and clone dependent delay in the intra-erythrocytic cycle of the parasite. Drug impact on cell cycle progression and gene expression was then merged using a non-linear regression model to determine specific drug driven expression. This revealed a mild, but significant, mefloquine driven gene induction up to 1.5 fold. CONCLUSIONS/SIGNIFICANCE: Both cell cycle delay and induced gene expression represent potentially important mechanisms for parasites to escape the effect of the antimalarial drug

    The Impact of Fuelwood Moisture Content on the Emission of Gaseous and Particulate Pollutants from a Wood Stove

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    The amount of moisture in wood fuel has a significant influence on the emissions of particulate matter (PM) and gaseous pollutants when burned in small-scale domestic appliances. Previous studies have shown that higher moisture content generally produces higher particulate emissions factors. As well as quantity of material emitted, it is also important to understand the effects of moisture on particle qualities including size, composition and morphology – since these can influence the human-toxicity and environmental impacts of the particles. In this study, emissions were quantified and the particulate qualities were also examined using chemical, optical and thermogravimetric analysis as well as size-graded sampling. By comparing the results from the use of batches of beech wood fuel with differing moisture content, it was shown that there are consistent and significant differences in both the quantity and qualities of the resulting emissions when burned under the same conditions. This has important consequences for emission inventories which currently only assume an emission factor from a proscribed combustion situatio
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