Utility of Panoramic Radiographs in the Screening of Individuals with Edentulous Arches: A Need-Analysis Study

Objective: To evaluate the utility of panoramic radiographs in pre-prosthetic screening of edentulous arches. Material and Methods: Panoramic radiographs taken for three years were retrospectively analyzed. Observations from the radiographs shall be categorized and classified into either of the two categories, namely: \u27findings with minimal impact on denture fabrication\u27 and \u27findings which affect denture fabrication and require further evaluation.\u27 Anatomic variations, jaw pathologies, and residual ridge resorption patterns were assessed. Results: This study included the initial screening of 23,020 panoramic radiographs, out of which 505 (showing either one or both edentulous arches) were included for the study purpose. The age range of the subjects was from 21 to 94 years. 52.6% of the radiographs showed positive findings. More than half of the radiographs belonged to the males (52.5%). Hyperpneumatization of the maxillary sinus, crestal position of the mental foramen, and retained root fragments were the most common entities noted in the radiographs. Changes in the mental foramen were significantly higher in males than females (p=0.002). Conclusion: Observations from this study showed that panoramic radiographs have high utility for screening edentulous arches, and they should be used in routine clinical practice before denture fabrication

Transforming wastewater ammonia to carbon free energy: Integrating fuel cell technology with ammonia stripping for direct power production

The transformation of ammonia from pollutant to energy rich carbon free fuel presents an opportunity for the transition of wastewater services to net zero. However, there is only limited knowledge of how the product quality of ammonia recovered from real wastewater might impact on its downstream exploitation in fuel cells. This study therefore exploited vacuum stripping to produce an aqueous ammonia concentrate from real wastewater that was then evaluated within a direct ammonia fuel cell, as a reference technology for energy generation. A 17 g L−1 aqueous ammonia product was created by vacuum stripping centrate from a full-scale anaerobic digester (2 gN L−1). The pH of the product was lower than expected due to the mild-acidification of solution by the co-transport of low MW volatile organic compounds. This reduced power density in the fuel cell, due to the incomplete deprotonation of ammonia (lowering oxidation potential at the fuel cell anode) and a decrease in [OH–] which is required for complete electrochemical conversion. We propose that improved vacuum stripping design can increase the distillate ammonia concentration and produce a more alkaline product, yielding markedly higher fuel cell power density by enhancing ammonia oxidation at the anode (through concentration and deprotonation) and reducing [OH–] mass transfer limitations. As the separation energy for ammonia is dominated by the latent heat demand of water vapour, a synergy exists between creation of a concentrated ammonia product (that improves power density) and reducing the energy demand for separation. The energy balance from this research evidences that despite the high latent heat demand for separation, the low cost of heat coupled with the power produced from ammonia yield a favourable economic return when compared to conventional biological treatment. This study also identifies that revaluing ammonia as a carbon free fuel can help reposition wastewater treatment for a zero-carbon future.Engineering and Physical Sciences Research Council (EPSRC): EP/S036237/

CO2 absorption into aqueous ammonia using membrane contactors: Role of solvent chemistry and pore size on solids formation for low energy solvent regeneration

Solids formation can substanitally reduce the energy penalty for ammonia solvent regeneration in carbon capture and storage (CCS), but has been demonstrated in the literature to be difficult to control. This study examines the use of hollow fibre membrane contactors, as this indirect contact mediated between liquid and gas phases in this geometry could improve the regulation of solids formation. Under conditions comparable to existing literature, NH4HCO3 was evidenced to primarily crystallise in the gas-phase (lumen-side of the membrane) due to the high vapour pressure of ammonia, which promotes gaseous transmission from the solvent. Investigation of solvent reactivity demonstrated how equilibria dependent reactions controlled the onset of NH4HCO3 nucleation in the solvent, and limited ‘slip’ through transfomation of ammonia into its protonated form which occurs prior to the phase change. Crystallisation in the solvent was also dependent upon ammonia concentration, where sufficient supersaturation must develop to overcome the activation energy for nucleation. However, this has to be complemented with a reduction in solvent temperature to offset vapour pressure and limit the risk of gas-phase crystallisation. While changes to the solvent chemistry were sufficient to shift from gas-phase to liquid phase crystallisation, wetting was observed immediately after nucleation in the solvent. This was explained by a local region of supersaturation within the coarse membrane pores that promoted a high nucleation rate, altering the material contact angle of the membrane sufficient for solvent to breakthrough into the gas phase. Adoption of a narrower pore size membrane was shown to dissipate wetting after crystallisation in the solvent, illustrating membrane contactors as a stable platform for the sustained separation of CO2 coupled with its simultaneous transformation into a solid. Through resolving previous challenges experienced with solids formation in multiple reactor configurations, the cost benefit of using ammonia as a solvent can be realised, which is critical to enabling economically viable CCS for the transition to net zero, and can be exploited within hollow fibre membrane contactors, eliciting considerable process intensification over existing reactor designs for CCS

Letrozole-loaded nonionic surfactant vesicles prepared via a slurry-based proniosome technology: Formulation development and characterization

Slurry-based Letrozole (LTZ)-loaded proniosomes were designed using sucrose or sorbitol as carriers and various ratios of cholesterol (CH) and Tween 80 (T80) as lipid composition. Proniosomes were hydrated and probe-sonicated to generate nano-vesicles. The proniosome powders were characterized in terms of morphology using scanning electron microscopy, and drug crystallinity using differential scanning calorimetry (DSC) and X-ray diffraction (XRD). The niosomes generated from proniosomes were characterized and compared to conventional niosomes, in terms of size, zeta potential, drug entrapment, storage stability, and drug release. All formulations had size measurements in the range of 100–194 nm, polydispersity index (PDI) values below 0.3, and zeta potential values below – 23 mV. Drug entrapment was the highest for niosomes generated from sucrose-based proniosomes (CH:T80; 1:1), reaching 74% compared to less than 50% for conventional niosomes. Storage for 3 months at 4 °C resulted in minor drug leakage whilst most drug was leaked from vesicles stored at room temperature. DSC and XRD studies showed that LTZ was converted into its amorphous form upon incorporation into proniosomes. Drug release exhibited a biphasic pattern, being fast at the first 24 h (up to 65% released) followed by a very slow release phase for a duration of one month, releasing at least 95%. The release profile of niosomes fits best with the Higuchi model. Overall, in this study, a facile approach to generating niosomes incorporating LTZ using a slurry-based proniosome technology was demonstrated. The niosomes provided high drug entrapment and controlled biphasic release over one month

Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels.

Elevated serum urate levels cause gout and correlate with cardiometabolic diseases via poorly understood mechanisms. We performed a trans-ancestry genome-wide association study of serum urate in 457,690 individuals, identifying 183 loci (147 previously unknown) that improve the prediction of gout in an independent cohort of 334,880 individuals. Serum urate showed significant genetic correlations with many cardiometabolic traits, with genetic causality analyses supporting a substantial role for pleiotropy. Enrichment analysis, fine-mapping of urate-associated loci and colocalization with gene expression in 47 tissues implicated the kidney and liver as the main target organs and prioritized potentially causal genes and variants, including the transcriptional master regulators in the liver and kidney, HNF1A and HNF4A. Experimental validation showed that HNF4A transactivated the promoter of ABCG2, encoding a major urate transporter, in kidney cells, and that HNF4A p.Thr139Ile is a functional variant. Transcriptional coregulation within and across organs may be a general mechanism underlying the observed pleiotropy between urate and cardiometabolic traits.The Genotype-Tissue Expression (GTEx) Project was supported by the Common Fund of the Office of the Director of the National Institutes of Health, and by NCI, NHGRI, NHLBI, NIDA, NIMH, and NINDS. Variant annotation was supported by software resources provided via the Caché Campus program of the InterSystems GmbH to Alexander Teumer

Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria

Abstract: Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria

Genetic loci and prioritization of genes for kidney function decline derived from a meta-analysis of 62 longitudinal genome-wide association studies

Estimated glomerular filtration rate (eGFR) reflects kidney function. Progressive eGFR-decline can lead to kidney failure, necessitating dialysis or transplantation. Hundreds of loci from genome-wide association studies (GWAS) for eGFR help explain population cross section variability. Since the contribution of these or other loci to eGFR-decline remains largely unknown, we derived GWAS for annual eGFR-decline and meta-analyzed 62 longitudinal studies with eGFR assessed twice over time in all 343,339 individuals and in high-risk groups. We also explored different covariate adjustment. Twelve genome-wide significant independent variants for eGFR-decline unadjusted or adjusted for eGFR-baseline (11 novel, one known for this phenotype), including nine variants robustly associated across models were identified. All loci for eGFR-decline were known for cross-sectional eGFR and thus distinguished a subgroup of eGFR loci. Seven of the nine variants showed variant-by-age interaction on eGFR cross section (further about 350,000 individuals), which linked genetic associations for eGFR-decline with age-dependency of genetic cross-section associations. Clinically important were two to four-fold greater genetic effects on eGFR-decline in high-risk subgroups. Five variants associated also with chronic kidney disease progression mapped to genes with functional in-silico evidence (UMOD, SPATA7, GALNTL5, TPPP). An unfavorable versus favorable nine-variant genetic profile showed increased risk odds ratios of 1.35 for kidney failure (95% confidence intervals 1.03-1.77) and 1.27 for acute kidney injury (95% confidence intervals 1.08-1.50) in over 2000 cases each, with matched controls). Thus, we provide a large data resource, genetic loci, and prioritized genes for kidney function decline, which help inform drug development pipelines revealing important insights into the age-dependency of kidney function genetics

Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria

Publisher Copyright: © 2019, The Author(s).Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria.Peer reviewe

Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria

Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria

Downscaling reverse osmosis for single-household wastewater reuse: towards low-cost decentralised sanitation through a batch open-loop configuration

There is a significant demand for water recycling in low-income countries. However, wastewater infrastructure is primarily decentralised, necessitating the development of affordable household-scale reclamation technology. In this study, a batch open-loop reverse osmosis (RO) system is therefore investigated as a low-cost clean water reclamation route from highly saline concentrated blackwater. In a single-stage configuration, increasing feed pressure from 10 to 30 bars improved selective separation at water recovery exceeding 85%, whereas lower cross-flow velocity improved product recovery, reducing specific permeate energy demand from 21 to 4.8 kWh m−3. Rejection achieved for total phosphorous (99%), chemical oxygen demand (COD, 96%), and final pH (8.7) of the RO permeate was compliant with the ISO30500 reuse standard for discharge. However, the rejection of total nitrogen in the RO permeate was non-compliant with the reuse standard due to the transmission of low-molecular weight (MW) uncharged organic compounds. It is suggested that rejection may be improved by increasing feed pressure to rebalance selectivity but may also be controlled by reducing fluid residence time (storage) to constrain the hydrolysis of urea. The economic analysis identified that a high-pressure 1812 element cost of ∼US$30 meets the sanitation affordability index of US$0.05 capita−1 day−1. However, the unit cost of a high-pressure feed pump must be reduced to ∼US$500 to obtain an affordable system cost. These unit costs can be achieved by manufacturing 1812 elements at economies of scale, and by adopting pumping solutions that have been developed for other applications requiring high pressures and low flows. Overall, our findings suggest that RO in the batch open-loop configuration has the potential to deliver affordable and safe water production from blackwater in a decentralised (single-household) context