Travel-related MERS-CoV cases: An assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014

__Background:__ In May 2014, Middle East respiratory syndrome coronavirus (MERS-CoV) infection, with closely related viral genomes, was diagnosed in two Dutch residents, returning from a pilgrimage to Medina and Mecca, Kingdom of Saudi Arabia (KSA). These patients travelled with a group of 29 other Dutch travellers. We conducted an epidemiological assessment of the travel group to identify likely source(s) of infection and presence of potential risk factors. __Methods:__ All travellers, including the two cases, completed a questionnaire focussing on potential human, animal and food exposures to MERS-CoV. The questionnaire was modified from the WHO MERS-CoV questionnaire, taking into account the specific route and activities of the travel group. __Results:__ Twelve non-cases drank unpasteurized camel milk and had contact with camels. Most travellers, including one of the two patients (Case 1), visited local markets, where six of them consumed fruits. Two travellers, including Case 1, were exposed to coughing patients when visiting a hospital in Medina. Four travellers, including Case 1, visited two hospitals in Mecca. All travellers had been in contact with Case 1 while he was sick, with initially non-respiratory complaints. The cases were found to be older than the other travellers and both had co-morbidities. __Conclusions:__ This epidemiological study revealed the complexity of MERS-CoV outbreak investigations with multiple potential exposures to MERS-CoV reported such as healthcare visits, camel exposure, and exposure to untreated food products. Exposure to MERS-CoV during a hospital visit is considered a likely source of infection for Case 1 but not for Case 2. For Case 2, the most likely source could not be determined. Exposure to MERS-CoV via direct contact with animals or dairy products seems unlikely for the two Dutch cases. Furthermore, exposure to a common but still unidentified source cannot be ruled out. More comprehensive research into sources of infection in the Arabian Peninsula is needed to strengthen and specify the prevention of MERS-CoV infections

Travel-related MERS-CoV cases: an assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014

BACKGROUND: In May 2014, Middle East respiratory syndrome coronavirus (MERS-CoV) infection, with closely related viral genomes, was diagnosed in two Dutch residents, returning from a pilgrimage to Medina and Mecca, Kingdom of Saudi Arabia (KSA). These patients travelled with a group of 29 other Dutch travellers. We conducted an epidemiological assessment of the travel group to identify likely source(s) of infection and presence of potential risk factors. METHODS: All travellers, including the two cases, completed a questionnaire focussing on potential human, animal and food exposures to MERS-CoV. The questionnaire was modified from the WHO MERS-CoV questionnaire, taking into account the specific route and activities of the travel group. RESULTS: Twelve non-cases drank unpasteurized camel milk and had contact with camels. Most travellers, including one of the two patients (Case 1), visited local markets, where six of them consumed fruits. Two travellers, including Case 1, were exposed to coughing patients when visiting a hospital in Medina. Four travellers, including Case 1, visited two hospitals in Mecca. All travellers had been in contact with Case 1 while he was sick, with initially non-respiratory complaints. The cases were found to be older than the other travellers and both had co-morbidities. CONCLUSIONS: This epidemiological study revealed the complexity of MERS-CoV outbreak investigations with multiple potential exposures to MERS-CoV reported such as healthcare visits, camel exposure, and exposure to untreated food products. Exposure to MERS-CoV during a hospital visit is considered a likely source of infection for Case 1 but not for Case 2. For Case 2, the most likely source could not be determined. Exposure to MERS-CoV via direct contact with animals or dairy products seems unlikely for the two Dutch cases. Furthermore, exposure to a common but still unidentified source cannot be ruled out. More comprehensive research into sources of infection in the Arabian Peninsula is needed to strengthen and specify the prevention of MERS-CoV infections

Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

Background: Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.Methods/design: Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.Discussion: This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.Trial registration: Netherlands Trial Register (NTR): NTR1907

Exome sequencing identifies rare damaging variants in ATP8B4 and ABCA1 as novel risk factors for Alzheimers Disease

The genetic component of Alzheimer’s disease (AD) has been mainly assessed using Genome Wide Association Studies (GWAS), which do not capture the risk contributed by rare variants. Here, we compared the gene-based burden of rare damaging variants in exome sequencing data from 32,558 individuals —16,036 AD cases and 16,522 controls— in a two-stage analysis. Next to known genes TREM2, SORL1 and ABCA7, we observed a significant association of rare, predicted damaging variants in ATP8B4 and ABCA1 with AD risk, and a suggestive signal in ADAM10. Next to these genes, the rare variant burden in RIN3, CLU, ZCWPW1 and ACE highlighted these genes as potential driver genes in AD-GWAS loci. Rare damaging variants in these genes, and in particular loss-of-function variants, have a large effect on AD-risk, and they are enriched in early onset AD cases. The newly identified AD-associated genes provide additional evidence for a major role for APP-processing, Aβ-aggregation, lipid metabolism and microglial function in AD

Exome sequencing identifies rare damaging variants in ATP8B4 and ABCA1 as risk factors for Alzheimer’s disease

Alzheimer’s disease (AD), the leading cause of dementia, has an estimated heritability of approximately 70%1. The genetic component of AD has been mainly assessed using genome-wide association studies, which do not capture the risk contributed by rare variants2. Here, we compared the gene-based burden of rare damaging variants in exome sequencing data from 32,558 individuals—16,036 AD cases and 16,522 controls. Next to variants in TREM2, SORL1 and ABCA7, we observed a significant association of rare, predicted damaging variants in ATP8B4 and ABCA1 with AD risk, and a suggestive signal in ADAM10. Additionally, the rare-variant burden in RIN3, CLU, ZCWPW1 and ACE highlighted these genes as potential drivers of respective AD-genome-wide association study loci. Variants associated with the strongest effect on AD risk, in particular loss-of-function variants, are enriched in early-onset AD cases. Our results provide additional evidence for a major role for amyloid-β precursor protein processing, amyloid-β aggregation, lipid metabolism and microglial function in AD

HYDROGEN PRODUCTION FROM SELECTED KEROSINE COMPONENTS BY PARTIAL CATALYTIC DEHYDROGENATION

The providing and storage of hydrogen for efficient fuel cell systems is an on-going challenge. The partial catalytic dehydrogenation (PCD) of liquid fuels can provide stationary or mobile fuel cell systems with hydrogen. Through PCD, liquid fuels can be treated as hydrogen storage as well as an energy provider for combustion processes. It is also an alternative to the common reforming processes where the fuel is converted with steam into a hydrogen rich product gas with co- products like carbon monoxide and carbon dioxide that requires CO clean-up before feeding into a proton exchange membrane fuel cell. The direct dehydrogenation on a catalyst can provide a hydrogen product gas of high purity (95 vol-%) without carbon monoxide or carbon dioxide. The hydrogen is partly removed and the fuel is not completely transformed into a gaseous product. Therefore the partial dehydrogenated fuel can be used for further processes. At the Institute of Technical Thermodynamics of the German Aerospace Centre, a test rig was built for the PCD of kerosene, to investigate the product gas quality, the by-products, and hydrogen yield. A big challenge for PCD catalyst is the sulphur content, on average 500 ppmw, of kerosene [1]. To remove sulphur components from kerosene, thermal fractionation by rectification is suitable based on the boiling range of kerosene. The process concept for the PCD with fuel cell system includes the desulphurization of kerosene or the use of desulphurized kerosene (DK) (3ppmw sulphur)

A new process concept for highly efficient conversion of sewage sludge by combined fermentation and gasification and power generation in a hybrid system consisting of a SOFC and a gas turbine

Sewage sludge can be disposed of by fermentation, incineration or gasification. Conversion of the resulting biogas, combustion heat or gasification gas into electricity is often employed. Since sewage sludge cannot be fermented completely and due to the significant heat requirements for drying it in the incineration plant or before the gasifier, the electrical output in all cases is very low. Consequently, this work seeks to investigate a combination of fermentation and gasification in which dried fermentation waste is converted in a gasifier. With the aim of combining these two biomass conversion processes with power generation in an efficient manner, a hybrid system consisting of a SOFC and a gas turbine is investigated. This combination of a biogas plant and a gasifier has the advantage that waste heat can be used as a heat source in drying the fermentation waste. Another advantage is the combined conversion of biogas and gasification gas in the SOFC. As steam from gasification gas is used for internal reforming of methane out of biogas at the anode of the SOFC, the complexity of the plant is reduced and the efficiency is increased. A configuration including a pressurized gasification process was identified as most efficient in terms of electrical output

Wasserstofferzeugung durch partielle katalytische Dehydrierung (PkD) ausgewählter Komponenten von Kerosin

Wasserstofferzeugung aus flüssigen Brennstoffen für die Versorgung von Brennstoffzellensystemen hat das Potenzial, sowohl in der stationären dezentralen Energieversorgung als auch im mobilen Bereich Anwendung zu finden. Im Flugzeug kann für die Bordstromversorgung mittels Brennstoffzelle on-board aus Kerosin erzeugter Wasserstoff eingesetzt werden. Damit wird ein wesentlicher Beitrag zur Reduzierung der Emissionen als auch der Lärmbeeinträchtigung durch Flugzeuge am Boden geleistet. Neben den bereits intensiv untersuchten Reformierungsverfahren zur Wasserstofferzeugung wird am DLR ein neuartiges Verfahrenskonzept aus Fraktionierung und nachfolgender partieller katalytischer Dehydrierung (PDh) verfolgt. Die Abtrennung einer signifikant schwefelreduzierten Kerosinfraktion mittels Rektifikation konnte bereits erfolgreich experimentell nachgewiesen werden. Mit der partiellen katalytischen Dehydrierung kann bei einer gegenüber der Reformierung deutlich reduzierten Umwandlungstemperatur unterhalb 500°C reiner Wasserstoff erzeugt werden. Dadurch können aufwendige Aufbereitungsschritte zur Reinigung des Produktgases für den Einsatz in der Brennstoffzelle entfallen. Die Herausforderung bei der Dehydrierung des Flugtreibstoffs Jet A1 liegt in dessen komplexer chemischer Zusammensetzung. Durch GCMS und GCFID können vier Hauptstoffgruppen, Paraffine, Iso-Paraffine, Naphthene und Aromaten in Jet A1 identifiziert werden. Die Wasserstoffausbeute aus Kerosin ist in hohem Maße von der Art und dem Anteil dieser Stoffgruppen abhängig. Während Naphthene sich gut zu Wasserstoff und Aromaten umsetzen lassen, werden Aromaten bei der PDh nicht umgesetzt und Paraffine und Iso-Paraffine führen zu teilweise gasförmigen Nebenprodukten wie Methan und Verkokungen am Katalysator. Da in dem vorgeschalteten Fraktionierungsschritt durch thermische Trennung auch die Zusammensetzung der Stoffgruppen des Kerosins verändert wird, ist es von besonderem Interesse, das Verhalten der Stoffgruppen in der PDh durch experimentelle Untersuchungen beurteilen zu können. Beim DLR wurde daher ein PDh-Laborteststand zur Untersuchung der erzielbaren Wasserstoffausbeuten und zur Identifizierung geeigneter Betriebsparameter aufgebaut. Qualifiziert werden neben reinem Kerosin und einzelnen Kohlenwasserstoffgruppen auch unterschiedliche, schwefelreduzierte Fraktionen für die katalytische partielle Dehydrierung. Basierend auf den experimentellen Ergebnissen erfolgt anschließend eine energetische Bewertung des Verfahrenskonzepts für die Bordstromversorgung anhand eines Prozessmodells in Aspen Plus. Für diesen Zweck wurden zwei wärmeintegrierte Prozesskonzepte entwickelt. Zum einen wird die PDh mit vorgeschalteter Fraktionierung abgebildet und zum anderen ein vereinfachtes System bei dem bereits schwefelarmes Kerosin für die PDh bereitgestellt wird aufgrund dessen ein höherer Wirkungsgrad erzielt werden kann. Im Rahmen des Vortrags werden ausgewählte experimentelle Ergebnisse zur partiellen katalytischen Dehydrierung sowie die energetische Bewertung der beiden Prozesskonzepte mittels Pinch- Methode vorgestellt

Wasserstofferzeugung an Tankstellen aus (Bio-)Diesel

Übersicht von Ergebnisse zum Reformierung von Diesel und Biodiesel für eine Tankstellenanwendun