Measuring the economic burden of neuromyelitis optica spectrum disorder in Colombia

OBJECTIVE

To assess the economic burden of neuromyelitis optica spectrum disorder (NMOSD) in the Colombian context.

METHODS

Analyses were conducted from a societal perspective using the prevalence-based approach. Costs were expressed in 2022 US dollars (1 USD = $3,914.46 COP). Direct medical costs were assessed from a bottom-up approach. Indirect costs included loss of productivity of the patient and their caregivers. The economic burden of NMOSD in Colombia was estimated as the sum of direct and indirect costs.

RESULTS

The direct cost of treating a patient with NMOSD was USD$ 8,149.74 per year. When projecting costs nationwide, NMOSD would cost USD$ 7.2 million per year. Of these costs, 53.5% would be attributed to relapses and 34.4% to pharmacological therapy. Indirect costs potentially attributed to NMOSD in Colombia were estimated at USD$ 1.5 million per year per cohort. Of these, 78% are attributable to loss of patient productivity, mainly due to reduced access to the labor market and premature mortality.

CONCLUSIONS

The NMOSD has a representative economic burden at the patient level, with direct costs, particularly related to relapses and medicines, being the main component of total costs. These findings are useful evidence that requires attention from public policymakers in Colombia.

Assessment of late on-set fetal growth restriction using SMI (superb microvascular imaging) Doppler

Background

The identification of late-onset fetal growth restriction (FGR) fetuses remains a challenge, given the difficulty to distinguish them from healthy small for gestational age (SGA) fetuses. Given the limitations of conventional Doppler for the identification of placental insufficiency, the appearance of superb microvascular imaging (SMI) Doppler seems promising. Our main objective was to evaluate the diagnostic capability of SMI Doppler for the detection of placental insufficiency findings.

Methods

A prospective observational study was conducted at a tertiary care center, including 51 patients who had been diagnosed with late on-set SGA or FGR. A placental ultrasonographic evaluation was carried out using SMI Doppler. Patients were sorted into two groups attending to the histologic evaluation of the placentas after delivery: Group 1 (21 cases), Normal group; and Group 2 (30 cases), FGR group.

Results

Placentas in the FGR group had lower peak systolic velocity (PV) values of the chorionic plate. The PV of the other vessels were consistently lower in the FGR group that in the normal group, although without reaching statistical significance.

Conclusions

The PV of the chorionic plate measured with SMI Doppler, have the capacity to identify placental insufficiency findings. Ultrasonographic placental assessment using SMI Doppler appears to be a useful technique for the evaluation of suspected late on-set placental insufficiency.

Cost-utility and budget impact analysis of CPAP therapy compared to no treatment in the management of moderate to severe obstructive sleep apnea in Colombia from a third-party payer perspective

OBJECTIVES

To conduct cost-utility and budget impact analysis of providing Continuous Positive Airway Pressure (CPAP) therapy versus no treatment for moderate to severe obstructive sleep apnea (OSA) in Colombia from a third-party payer perspective.

METHODS

We used a Markov model to assess the cost-utility and budget impact analysis of CPAP in patients over 40 years old with moderate to severe OSA. Data on effectiveness and utility values were obtained from published literature. A discount rate of 5% was applied for outcomes and costs. ICER was calculated and compared against the threshold estimated for Colombia, which is 86% of the GDP per capita.

RESULTS

Over a lifetime horizon, the base case analysis showed the incremental cost per quality-adjusted life-years (QALYs) gained with CPAP therapy was COP$3,503,804 (USD$1,011 in 2020 prices). The budget impact analysis showed that the adoption of CPAP therapy in the target population would lead to a cumulative net budget impact of COP$411,722 million (USD$118,784,412 in, 2020 prices) over five years of time horizon.

CONCLUSIONS

CPAP was cost-effective compared to no-treatment in OSA. According to the budget impact analysis, adopting this technology would require a budget allocation that is partially offset by reduced number of strokes and traffic accident events.

Demineralization Inhibition by Two Calcium-releasing Restorative Materials

OBJECTIVE

To compare the ability of two calcium-releasing restorative materials to inhibit root dentin demineralization in an artificial caries model.

METHODS AND MATERIALS

Preparations were made at the cementum-enamel junction of extracted human molars (40, n=10/material) and restored with two calcium-releasing materials (Experimental composite, Pulpdent Corporation and Cention N, Ivoclar Vivadent), a resin composite (Filtek Supreme Ultra, 3M Oral Care), and a resin-modified glass ionomer (RMGI) (Fuji II LC, GC). All materials (other than the RMGI) were used with an adhesive (Scotchbond Universal Adhesive, 3M Oral Care) in the self-etch mode, which was light cured for 10 seconds. All restorative materials were light cured in 2-mm increments for 20 seconds and then finished with a polishing disc. Teeth were incubated (37°C) for 24 hours in water. An acid-resistant varnish was painted onto the teeth around the restoration, leaving a 2-mm border of uncovered tooth. A demineralization solution composed of 0.1 M lactic acid, 3 mM Ca3(PO4)2, 0.1% thymol, and NaOH (to adjust pH=4.5), and a remineralization solution composed of 1.5 mM Ca, 0.9 mM P, and 20 mM Tris(hydroxymethyl)-aminomethane (pH=7.0) were prepared. Specimens were placed in the demineralization solution for 4 hours, followed by the remineralization solution for 20 hours and cycled daily for 30 days. The specimens were embedded, sectioned into 100-μm sections, and the interface between the restorative material and root dentin was viewed with polarized light microscopy. A line was drawn parallel with the zone of demineralization for each tooth. The area of "inhibition" (defined as the area external to the line) or "wall lesion" (defined as the area internal to the line) was measured with image evaluation software. Areas of inhibition were measured as positive values, and areas of wall lesions were measured as negative areas.

RESULTS

A one-way analysis of variance (ANOVA) found significant differences between materials for "inhibition/wall lesion" areas in root dentin (p<0.001). Tukey post hoc analysis ranked materials (μm2, mean ±SD): Fuji II LC (5412±2754) > Cention N (2768±1576) and experimental composite (1484±1585) > Filtek Supreme Ultra (-1119±1029).

CONCLUSION

The experimental composite and Cention N materials (used with an adhesive) showed net areas of inhibition greater than a reference resin composite, albeit at a lower level than a reference RMGI material (used with no adhesive).

On-line monitoring of photosynthetic activity based on pH data to assess microalgae cultivation

Microalgae performance of outdoor cultivation systems is influenced by environmental and operating dynamics. Monitoring and control systems are needed to maximise biomass productivity and nutrient recovery. The goal of this work was to corroborate that pH data could be used to monitor microalgae performance by means of data from an outdoor membrane photobioreactor (MPBR) plant. In this system, microalgae photosynthetic activity was favoured over other physical and biological processes, so that the pH data dynamics was theoretically related to the microalgae carbon uptake rate (CUR). Short- and long-term continuous operations were tested to corroborate the relationship between the first derivate of pH data dynamics (pH') and microalgae photosynthetic activity. Short-term operations showed a good correlation between gross pH' values and MPBR performance. An indicator of the maximum daily average microalgae activity was assessed by a combination of on-line pH' measurements obtained in the long-term and a microalgae growth kinetic model. Both indicators contributed to the development of advanced real-time monitoring and control systems to optimise microalgae cultivation technology.

Study of the Development of Placental Microvascularity by Doppler SMI (Superb Microvascular Imaging): A Reality Today

Our objective was to evaluate the development of placental vascularization in normal gestation by using Doppler superb microvascular imaging (SMI). The fetal and maternal parameters of 20 pregnant women without pathology were evaluated at weeks 12, 16, 20-22, 24-26, 28-30, 32-34, 36-38 and 40-42. Doppler SMI was used to evaluate the placental vascularization (pulsatile index and peak systolic velocity) of the primary, secondary and tertiary (third) villi, and qualitative placental descriptions and anatomic-pathologic studies of these placentas were performed. The number of cotyledons identified by Doppler SMI increased from two between weeks 16 and 18 to 24 between weeks 28 and 38. The secondary and tertiary villi began developing at 20 wk of gestation. The pulsatile index of the primary villi remained constant (0.8-0.9 in all pregnancies). The pulsatile index of the secondary and tertiary villi increased from 1.1 to 1.53 and from 1.4 to 1.68, respectively. The peak systolic velocity underwent a significant increase throughout gestation in the secondary and tertiary villi (9.2 to 34.9 cm/s and 7.5 to 52.9 cm/s, respectively). We evaluated the development of placental microvascularization using Doppler SMI in pregnancies without pathology and describe normal placental Doppler SMI findings.

No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 298 trophectoderm biopsies

STUDY QUESTION

Does ovarian stimulation affect embryo euploidy rates or live birth rates (LBRs) after transfer of euploid embryos?

SUMMARY ANSWER

Euploidy rates and LBRs after transfer of euploid embryos are not significantly influenced by gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger or number of oocytes retrieved, regardless of a woman’s age.

WHAT IS KNOWN ALREADY

Aneuploidy rates increase steadily with age, reaching &gt;80% in women &gt;42 years old. The goal of ovarian stimulation is to overcome this high aneuploidy rate through the recruitment of several follicles, which increases the likelihood of obtaining a euploid embryo that results in a healthy conceptus. However, several studies have suggested that a high response to stimulation might be embryotoxic and/or increase aneuploidy rates by enhancing abnormal segregation of chromosomes during meiosis. Furthermore, a recent study demonstrated a remarkable difference in euploidy rates, ranging from 39.5 to 82.5%, among young oocyte donors in 42 fertility centres, potentially suggesting an iatrogenic etiology resulting from different stimulation methods.

STUDY DESIGN, SIZE, DURATION

This is a retrospective cohort study that included 2230 in vitro fertilisation (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) cycles and 930 frozen-thawed single euploid embryo transfer (FET) cycles, performed in our centre between 2013 and 2017.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A total of 12 298 embryos were analysed for ploidy status. Women were divided into five age groups (&lt;35, 35–37, 38–40, 41–42 and &gt;42 years old). Outcomes were compared between different durations of stimulation (&lt;10, 10–12 and ≥13 days), total gonadotropin dosages (&lt;4000, 4000–6000 and &gt;6000 IU), numbers of oocytes retrieved (&lt;10, 10–19 and ≥20 oocytes), peak estradiol levels (&lt;2000, 2000–3000 and &gt;3000 pg/mL), and sizes of the largest follicle on the day of trigger (&lt;20 and ≥20 mm).

MAIN RESULTS AND THE ROLE OF CHANCE

Within the same age group, both euploidy rates and LBRs were comparable between cycles regardless of their differences in total gonadotropin dosage, duration of stimulation, number of oocytes harvested, size of the largest follicles or peak estradiol levels. In the youngest group, (&lt;35 years, n = 3469 embryos), euploidy rates were comparable between cycles with various total gonadotropin dosages (55.6% for &lt;4000 IU, 52.9% for 4000–6000 IU and 62.3% for &gt;6000 IU; P = 0.3), durations of stimulation (54.4% for &lt;10 days, 55.2% for 10–12 days and 60.9% for &gt;12 days; P = 0.2), number of oocytes harvested (59.4% for &lt;10 oocytes, 55.2% for 10–19 oocytes and 53.4% for ≥20 oocytes; P = 0.2), peak estradiol levels (55.7% for E2 &lt; 2000 pg/mL, 55.4% for E2 2000–3000 pg/mL and 54.8% for E2 &gt; 3000 pg/mL; P = 0.9) and sizes of the largest follicle (55.6% for follicles &lt;20 mm and 55.1% for follicles ≥20 mm; P = 0.8). Similarly, in the oldest group (&gt;42 years, n = 1157 embryos), euploidy rates ranged from 8.7% for gonadotropins &lt;4000 IU to 5.1% for gonadotropins &gt;6000 IU (P = 0.3), from 10.8% for &lt;10 days of stimulation to 8.5% for &gt;12 days of stimulation (P = 0.3), from 7.3% for &lt;10 oocytes to 7.4% for ≥20 oocytes (P = 0.4), from 8.8% for E2 &lt; 2000 pg/mL to 7.5% for E2 &gt; 3000 pg/mL (P = 0.8) and from 8.2% for the largest follicle &lt;20 mm to 8.9% for ≥20 mm (P = 0.7). LBRs after single FET were also comparable between these groups.

LIMITATIONS, REASONS FOR CAUTION

Although this large study (2230 IVF/PGT-A cycles, 12 298 embryos and 930 single FET cycles) demonstrates the safety of ovarian stimulation in terms of aneuploidy and implantation potential of euploid embryos, a multi-centre study may help to prove the generalisability of our single-centre data.

WIDER IMPLICATIONS OF THE FINDINGS

These findings reassure providers and patients that gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger and number of oocytes retrieved, within certain ranges, do not appear to significantly influence euploidy rates or LBRs, regardless of the woman’s age.

STUDY FUNDING/COMPETING INTEREST(S)

No external funding was received and there are no competing interests to declare.

TRIAL REGISTRATION NUMBER

N/A

Plant-wide modelling in wastewater treatment: showcasing experiences using the Biological Nutrient Removal Model

Plant-wide modelling can be considered an appropriate approach to represent the current complexity in water resource recovery facilities, reproducing all known phenomena in the different process units. Nonetheless, novel processes and new treatment schemes are still being developed and need to be fully incorporated in these models. This work presents a short chronological overview of some of the most relevant plant-wide models for wastewater treatment, as well as the authors' experience in plant-wide modelling using the general model BNRM (Biological Nutrient Removal Model), illustrating the key role of general models (also known as supermodels) in the field of wastewater treatment, both for engineering and research.

Preliminary data set to assess the performance of an outdoor membrane photobioreactor

This data in brief (DIB) article is related to a Research article entitled 'Optimising an outdoor membrane photobioreactor for tertiary sewage treatment' [1]. Data related to the effect of substrate turbidity, the ammonium concentration at which the culture reaches nitrogen-deplete conditions and the microalgae growth rate under outdoor conditions is provided. Microalgae growth rates under different substrate turbidity were obtained to assess the reduction of the culture's light availability. Lab-scale experiments showed growth rates reductions of 22-44%. Respirometric tests were carried to know the limiting ammonium concentration in this microalgae-based wastewater treatment system. Growth rates (μ) of green microalgae Scenedesmus and Chlorella obtained under outdoor conditions; i.e. 0.40 d^-1 (R² = 0.993) and 0.43 d^-1 (R² = 0.995), respectively, can be useful to obtain optimum operating conditions of membrane photobioreactor (MPBR).

Optimising an outdoor membrane photobioreactor for tertiary sewage treatment

The operation of an outdoor membrane photobioreactor plant which treated the effluent of an anaerobic membrane bioreactor was optimised. Biomass retention times of 4.5, 6, and 9 days were tested. At a biomass retention time of 4.5 days, maximum nitrogen recovery rate:light irradiance ratios, photosynthetic efficiencies and carbon biofixations of 51.7 ± 14.3 mg N·mol^-1, 4.4 ± 1.6% and 0.50 ± 0.05 kg CO₂·m³_influent, respectively, were attained. Minimum membrane fouling rates were achieved when operating at the shortest biomass retention time because of the lower solid concentration and the negligible amount of cyanobacteria and protozoa. Hydraulic retention times of 3.5, 2, and 1.5 days were tested at the optimum biomass retention times of 4.5 days under non-nutrient limited conditions, showing no significant differences in the nutrient recovery rates, photosynthetic efficiencies and membrane fouling rates. However, nitrogen recovery rate:light irradiance ratios and photosynthetic efficiency significantly decreased when hydraulic retention time was further shortened to 1 day, probably due to a rise in the substrate turbidity which reduced the light availability in the culture. Optimal carbon biofixations and theoretical energy recoveries from the biomass were obtained at hydraulic retention time of 3.5 days, which accounted for 0.55 ± 0.05 kg CO₂·m^-3_influent and 0.443 ± 0.103 kWh·m^-3_influent, respectively.

Resource recovery from sulphate-rich sewage through an innovative anaerobic-based water resource recovery facility (WRRF)

This research work proposes an innovative water resource recovery facility (WRRF) for the recovery of energy, nutrients and reclaimed water from sewage, which represents a promising approach towards enhanced circular economy scenarios. To this aim, anaerobic technology, microalgae cultivation, and membrane technology were combined in a dedicated platform. The proposed platform produces a high-quality solid- and coliform-free effluent that can be directly discharged to receiving water bodies identified as sensitive areas. Specifically, the content of organic matter, nitrogen and phosphorus in the effluent was 45 mg COD·L^-1, 14.9 mg N·L^-1 and 0.5 mg P·L^-1, respectively. Harvested solar energy and carbon dioxide biofixation in the form of microalgae biomass allowed remarkable methane yields (399 STP L CH₄·kg^-1 COD_inf) to be achieved, equivalent to theoretical electricity productions of around 0.52 kWh per m³ of wastewater entering the WRRF. Furthermore, 26.6% of total nitrogen influent load was recovered as ammonium sulphate, while nitrogen and phosphorus were recovered in the biosolids produced (650 ± 77 mg N·L^-1 and 121.0 ± 7.2 mg P·L^-1).

Real-time optimization of the key filtration parameters in an AnMBR: Urban wastewater mono-digestion vs. co-digestion with domestic food waste

This study describes a model-based method for real-time optimization of the key filtration parameters in a submerged anaerobic membrane bioreactor (AnMBR) treating urban wastewater (UWW) and UWW mixed with domestic food waste (FW). The method consists of an initial screening to find out adequate filtration conditions and a real-time optimizer applied to a periodically calibrated filtration model for minimizing the operating costs. The initial screening consists of two statistical analyses: (1) Morris screening method to identify the key filtration parameters; (2) Monte Carlo method to establish suitable initial control inputs values. The operating filtration cost after implementing the control methodology was €0.047 per m³ (59.6% corresponding to energy costs) when treating UWW and €0.067 per m³ when adding FW due to higher fouling rates. However, FW increased the biogas productivities, reducing the total costs to €0.035 per m³. Average downtimes for reversible fouling removal of 0.4% and 1.6% were obtained, respectively. The results confirm the capability of the proposed control system for optimizing the AnMBR performance when treating both substrates.

Short and long-term experiments on the effect of sulphide on microalgae cultivation in tertiary sewage treatment

Microalgae cultivation appears to be a promising technology for treating nutrient-rich effluents from anaerobic membrane bioreactors, as microalgae are able to consume nutrients from sewage without an organic carbon source, although the sulphide formed during the anaerobic treatment does have negative effects on microalgae growth. Short and long-term experiments were carried out on the effects of sulphide on a mixed microalgae culture. The short-term experiments showed that the oxygen production rate (OPR) dropped as sulphide concentration increased: a concentration of 5mgSL^-1 reduced OPR by 43%, while a concentration of 50mgSL^-1 came close to completely inhibiting microalgae growth. The long-term experiments revealed that the presence of sulphide in the influent had inhibitory effects at sulphide concentrations above 20mgSL^-1 in the culture, but not at concentrations below 5mgSL^-1. These conditions favoured Chlorella growth over that of Scenedesmus.

Metals as chemical tracers to discriminate ecological populations of threatened Franciscana dolphins (Pontoporia blainvillei) from Argentina

Franciscana dolphins are the most impacted small cetacean in the Southwestern Atlantic Ocean, classified as Vulnerable A3d by IUCN. Essential (Fe, Mo, Mn, Cr, Ni, Co) and non-essential (Ag, Pb, Sn) trace elements (TEs) were measured in liver, kidney, and brain samples of by-catch Franciscana dolphins that were living in estuarine (n = 21) and marine (n = 21) habitats (1) to assess whether TEs posed a threat and (2) to evaluate the suitability of TEs for discriminating ecological populations of this species in Argentinean waters. Essential TEs showed little variation in tissues from both groups in agreement with levels reported for other cetaceans and suggesting that these concentrations correspond to normal physiological levels. Non-essential TEs were higher in estuarine juveniles and adults dolphins than in marine specimens. These results suggest anthropogenic sources associated with estuarine area and that Franciscana dolphins are good sentinels of the impact of the environment. The difference in the concentrations of TEs beetwen ecological populations appeared to be related to distinct exposures in both geographical areas, and it is suggested that Ag and Sn concentrations in adults are good chemical tracers of anthropogenic input of TEs. These results provide additional information for improved management and regulatory policy.

A fuzzy-logic-based controller for methane production in anaerobic fixed-film reactors

The main objective of this work was to develop a controller for biogas production in continuous anaerobic fixed-bed reactors, which used effluent total volatile fatty acids (VFA) concentration as control input in order to prevent process acidification at closed loop. To this aim, a fuzzy-logic-based control system was developed, tuned and validated in an anaerobic fixed-bed reactor at pilot scale that treated industrial winery wastewater. The proposed controller varied the flow rate of wastewater entering the system as a function of the gaseous outflow rate of methane and VFA concentration. Simulation results show that the proposed controller is capable to achieve great process stability even when operating at high VFA concentrations. Pilot results showed the potential of this control approach to maintain the process working properly under similar conditions to the ones expected at full-scale plants.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Economic and environmental sustainability of an AnMBR treating urban wastewater and organic fraction of municipal solid waste

The objective of this study was to evaluate the economic and environmental sustainability of a submerged anaerobic membrane bioreactor (AnMBR) treating urban wastewater (UWW) and organic fraction of municipal solid waste (OFMSW) at ambient temperature in mild/hot climates. To this aim, power requirements, energy recovery from methane (biogas methane and methane dissolved in the effluent), consumption of reagents for membrane cleaning, and sludge handling (polyelectrolyte and energy consumption) and disposal (farmland, landfilling and incineration) were evaluated within different operating scenarios. Results showed that, for the operating conditions considered in this study, AnMBR technology is likely to be a net energy producer, resulting in considerable cost savings (up to €0.023 per m(3) of treated water) when treating low-sulphate influent. Life cycle analysis (LCA) results revealed that operating at high sludge retention times (70 days) and treating UWW jointly with OFMSW enhances the overall environmental performance of AnMBR technology.

A plant-wide energy model for wastewater treatment plants: application to anaerobic membrane bioreactor technology

The aim of this study is to propose a detailed and comprehensive plant-wide model for assessing the energy demand of different wastewater treatment systems (beyond the traditional activated sludge) in both steady- and unsteady-state conditions. The proposed model makes it possible to calculate power and heat requirements (W and Q, respectively), and to recover both power and heat from methane and hydrogen capture. In order to account for the effect of biological processes on heat requirements, the model has been coupled to the extended version of the BNRM2 plant-wide mathematical model, which is implemented in DESSAS simulation software. Two case studies have been evaluated to assess the model's performance: (1) modelling the energy demand of two urban wastewater treatment plants based on conventional activated sludge and submerged anaerobic membrane bioreactor (AnMBR) technologies in steady-state conditions and (2) modelling the dynamics of reactor temperature and heat requirements in an AnMBR plant in unsteady-state conditions. The results indicate that the proposed model can be used to assess the energy performance of different wastewater treatment processes and would thus be useful, for example, WWTP design or upgrading or the development of new control strategies for energy savings.

Economic and environmental sustainability of submerged anaerobic MBR-based (AnMBR-based) technology as compared to aerobic-based technologies for moderate-/high-loaded urban wastewater treatment

The objective of this study was to assess the economic and environmental sustainability of submerged anaerobic membrane bioreactors (AnMBRs) in comparison with aerobic-based technologies for moderate-/high-loaded urban wastewater (UWW) treatment. To this aim, a combined approach of steady-state performance modelling, life cycle analysis (LCA) and life cycle costing (LCC) was used, in which AnMBR (coupled with an aerobic-based post-treatment) was compared to aerobic membrane bioreactor (AeMBR) and conventional activated sludge (CAS). AnMBR with CAS-based post-treatment for nutrient removal was identified as a sustainable option for moderate-/high-loaded UWW treatment: low energy consumption and reduced sludge production could be obtained at given operating conditions. In addition, significant reductions can be achieved in different aspects of environmental impact (global warming potential (GWP), abiotic depletion, acidification, etc.) and LCC over existing UWW treatment technologies.

Electrical conductivity as a state indicator for the start-up period of anaerobic fixed-bed reactors

The aim of this work was to analyse the applicability of electrical conductivity sensors for on-line monitoring the start-up period of an anaerobic fixed-bed reactor. The evolution of bicarbonate concentration and methane production rate was analysed. Strong linear relationships between electrical conductivity and both bicarbonate concentration and methane production rate were observed. On-line estimations of the studied parameters were carried out in a new start-up period by applying simple linear regression models, which resulted in a good concordance between both observed and predicted values. Electrical conductivity sensors were therefore identified as an interesting method for monitoring the start-up period of anaerobic fixed-bed reactors due to its reliability, robustness, easy operation, low cost, and minimum maintenance compared with the currently used sensors.

The roles of RgpB and Kgp in late onset gingipain activity in the vimA-defective mutant of Porphyromonas gingivalis W83

Previous studies have shown that VimA, an acetyltransferase, can modulate gingipain biogenesis in Porphyromonas gingivalis. Inactivation of the vimA gene resulted in isogenic mutants that showed a late onset of gingipain activity that only occurred during the stationary growth phase. To further elucidate the role and contribution of the gingipains in this VimA-dependent process, isogenic mutants defective in the gingipain genes in the vimA-deficient genetic background were evaluated. In contrast with the wild-type strain, RgpB and Kgp gingipain activities were absent in exponential phase in the ∆rgpA::tetQ-vimA::ermF mutant. However, these activities increased to 31 and 53%, respectively, of that of the wild-type during stationary phase. In the ∆rgpA::cat-∆kgp::tetQ-vimA::ermF mutant, the RgpB protein was observed in the extracellular fraction but no activity was present even at the stationary growth phase. There was no gingipain activity observed in the ∆rgpB::cat-∆kgp::tetQ-vimA::ermF mutant whereas Kgp activity in ∆rgpA::cat-∆rgpB::tetQ-vimA::ermF mutant was 24% of the wild-type at late stationary phase. In contrast to RgpA, the glycosylation profile of the RgpB catalytic domain from both W83 and P. gingivalis FLL92 (vimA::ermF) showed similarity. Taken together, the results suggest multiple gingipain activation pathways in P. gingivalis. Whereas the maturation pathways for RgpA and RgpB are different, the late-onset gingipain activity in the vimA-defective mutant was due to activation/maturation of RgpB and Kgp. Moreover, unlike RgpA, which is VimA-dependent, the maturation/activation pathways for RgpB and Kgp are interdependent in the absence VimA.

Histopathological and biochemical evidence of hepatopancreatic toxicity caused by cadmium in white shrimp, Palaemonetes argentinus

Cadmium (Cd) is one of the most common pollutants in the environment and induces a range of tissue changes or damages and organ dysfunction. The histopathological effects of Cd and lipid peroxidation (LPO) on hepatopancreas of the freshwater shrimp, Palaemonetes argentinus, were studied. Shrimp were obtained from two lagoons with contrasting environmental quality, De los Padres (LP, impacted site) and Nahuel Rucá (NR, reference site), and were exposed to 3.06 and 12.24µgCdL(-1) for 3, 7, 10 and 15 days. The health status of both populations was also evaluated by histological analysis of control individuals. After exposure, shrimp were transferred to clean water for 28 days to evaluate the recuperation capacity of hepatopancreas. Control shrimp from NR exhibited a normal hepatopancreas structure; unlike control shrimp from LP which showed several alterations. These results were attributed to the different environmental quality of lagoons. The exposure to Cd resulted in several alterations in the histological structure of the hepatopancreas of both populations. The observed alterations included haemocytic and connective infiltrations in the intertubular space, erosioned microvilli, ripple of basal lamina, atrophied epithelium and necrosis, however, the latter was only observed in shrimp from LP. The exposure also caused an increase of LPO levels in both populations. P. argentinus was able to repair the hepatopancreas structure from the damage caused by Cd, evidenced by the histopathological results and LPO levels. Obtained results are indicating that the histological analysis of the hepatopancreas proved to be a highly sensitive method for evaluating water quality, in both environmental and laboratory conditions.

Diagnostic validity of the Alzheimer's disease functional assessment and change scale in mild cognitive impairment and mild to moderate Alzheimer's disease

BACKGROUND

The Alzheimer's Disease Functional Assessment and Change Scale (ADFACS) is a functional assessment instrument widely used in clinical research.

AIMS

To test the diagnostic and concurrent validity of the Spanish version of this scale and to describe the functional deficit pattern for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia.

METHODS

The ADFACS, the Interview for Deterioration in Daily Living Activities in Dementia (IDDD), and the Mini Mental State Examination (MMSE) were administered to 146 control subjects (CS) and 165 patients (67 MCI and 98 AD). Nonparametric tests were used to compare the diagnostic groups. Cronbach's α and correlations with the MMSE and the IDDD were calculated. Sensitivity, specificity and predictive values were studied.

RESULTS

The ADFACS had a high internal consistency (α = 0.95). Three cutoff points of 1, 4, and 17 were provided to separate CS and MCI patients, MCI and mild AD patients, and mild AD and moderate AD patients, respectively. The ADFACS strongly correlated with functional (IDDD, 0.927) and cognitive (MMSE, 0.747) measures. A similar pattern of dysfunction, but in different grades, was found for the MCI and AD groups.

CONCLUSION

The ADFACS is a reliable, valid, and sensitive instrument to assess functional abilities; it is useful in dementia assessment for elderly populations.

Metabolome variations in the Porphyromonas gingivalis vimA mutant during hydrogen peroxide-induced oxidative stress

The adaptability and survival of Porphyromonas gingivalis in the oxidative microenvironment of the periodontal pocket are indispensable for survival and virulence, and are modulated by multiple systems. Among the various genes involved in P. gingivalis oxidative stress resistance, vimA gene is a part of the 6.15-kb locus. To elucidate the role of a P. gingivalis vimA-defective mutant in oxidative stress resistance, we used a global approach to assess the transcriptional profile, to study the unique metabolome variations affecting survival and virulence in an environment typical of the periodontal pocket. A multilayered protection strategy against oxidative stress was noted in P. gingivalis FLL92 with upregulation of detoxifying genes. The duration of oxidative stress was shown to differentially modulate transcription with 94 (87%) genes upregulated twofold during 10 min and 55 (83.3%) in 15 min. Most of the upregulated genes (55%), fell in the hypothetical/unknown/unassigned functional class. Metabolome variation showed reduction in fumarate and formaldehyde, hence resorting to alternative energy generation and maintenance of a reduced metabolic state. There was upregulation of transposases, genes encoding for the metal ion binding protein transport and secretion system.

Global sensitivity analysis of a filtration model for submerged anaerobic membrane bioreactors (AnMBR)

The results of a global sensitivity analysis of a filtration model for submerged anaerobic MBRs (AnMBRs) are assessed in this paper. This study aimed to (1) identify the less- (or non-) influential factors of the model in order to facilitate model calibration and (2) validate the modelling approach (i.e. to determine the need for each of the proposed factors to be included in the model). The sensitivity analysis was conducted using a revised version of the Morris screening method. The dynamic simulations were conducted using long-term data obtained from an AnMBR plant fitted with industrial-scale hollow-fibre membranes. Of the 14 factors in the model, six were identified as influential, i.e. those calibrated using off-line protocols. A dynamic calibration (based on optimisation algorithms) of these influential factors was conducted. The resulting estimated model factors accurately predicted membrane performance.

Anaerobic treatment of urban wastewater in membrane bioreactors: evaluation of seasonal temperature variations

The objective of this study was to evaluate the effect of seasonal temperature variations on the anaerobic treatment of urban wastewater in membrane bioreactors (MBRs). To this aim, sludge production, energy recovery potential, chemical oxygen demand (COD) removal and membrane permeability were evaluated in a submerged anaerobic MBR fitted with industrial-scale membrane units. The plant was operated for 172 days, between summer and winter seasons. Sludge production increased and energy recovery potential decreased when temperature decreased. COD removal and membrane permeability remained nearby stable throughout the whole experimental period.

Environmental impact of submerged anaerobic MBR (SAnMBR) technology used to treat urban wastewater at different temperatures

The objective of this study was to assess the environmental impact of a submerged anaerobic MBR (SAnMBR) system in the treatment of urban wastewater at different temperatures: ambient temperature (20 and 33°C), and a controlled temperature (33°C). To this end, an overall energy balance (OEB) and life cycle assessment (LCA), both based on real process data, were carried out. Four factors were considered in this study: (1) energy consumption during wastewater treatment; (2) energy recovered from biogas capture; (3) potential recovery of nutrients from the final effluent; and (4) sludge disposal. The OEB and LCA showed SAnMBR to be a promising technology for treating urban wastewater at ambient temperature (OEB=0.19 kW h m(-3)). LCA results reinforce the importance of maximising the recovery of nutrients (environmental impact in eutrophication can be reduced up to 45%) and dissolved methane (positive environmental impact can be obtained) from SAnMBR effluent.