Effects of Live Saccharomyces cerevisiae Yeast Administration in Periparturient Dairy Cows

Dairy cows face several challenges during the transition period, and the administration of live yeast might be useful to mitigate this stressful condition. In the current study, the effects of live yeast administration on milk production, feed intake, and metabolic and inflammatory conditions were evaluated. Multiparous Holstein cows were enrolled in this randomized controlled trial and received either a control diet (CTR, n = 14) or the control diet plus 4 g/d of live Saccharomyces cerevisiae yeast (LSC, n = 14) from -21 to 56 days relative to calving. Dry matter intake, milk yield and composition, and rumination time were monitored daily. Blood samples were collected at -21, -7, 3, 14, 28, 42, and 56 days relative to calving to evaluate the metabolic profile. Fecal samples were collected at 56 days relative to calving to measure volatile fatty acids and feed digestibility. No differences between groups were observed in dry matter intake. Compared with CTR, rumination time was lower in LSC in after calving. Although there were no differences in milk components between groups, LSC had greater milk yield in the last three weeks of the study than CTR. No differences were observed in inflammatory markers or other plasma metabolites, except for β-hydroxybutyrate, which was higher in LSC, and reactive oxygen metabolites (ROMs), which were lower in LSC. Overall, these outcomes suggest that live yeast supplementation had some positive effects on milk yield and oxidative status.

A Deep Learning Approach to Detect Failures in Bridges Based on the Coherence of Signals

Structural health monitoring of civil infrastructure, such as bridges and buildings, has become a trending topic in the last few years. The key factor is the technological push given by new technologies that permit the acquisition, storage, processing and visualisation of data in real time, thus assessing a structure’s health condition. However, data related to anomaly conditions are difficult to retrieve, and, by the time those conditions are met, in general, it is too late. For this reason, the problem becomes unsupervised, since no labelled data are available, and anomaly detection algorithms are usually adopted in this context. This research proposes a novel algorithm that transforms the intrinsically unsupervised problem into a supervised one for condition monitoring purposes. Considering a bridge equipped with N sensors, which measure static structural quantities (rotations of the piers) and environmental parameters, exploiting the relationships between different physical variables and determining how these relationships change over time can indicate the bridge’s health status. In particular, this algorithm involves the training of N models, each of them able to estimate the quantity measured via a sensor by using the others’ N−1 measurements. Hence, the system can be represented by the ensemble of the N models. In this way, for each sensor, it is possible to compare the real measurement with the predicted one and evaluate the residual between the two; this difference can be addressed as a symptom of changes in the structure with respect to the condition regarded as nominal. This approach is applied to a real test case, i.e., Candia Bridge in Italy, and it is compared with a state-of-the-art anomaly detector (namely an autoencoder) in order to validate its robustness.

Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

BACKGROUND AND PURPOSE

The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria.

METHODS

The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed.

RESULTS

In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty-seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%).

CONCLUSIONS

Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non-diagnostic nerve conduction studies.

Integrated ecological modelling for evidence-based determination of water management interventions in urbanized river basins: Case study in the Cuenca River basin (Ecuador)

The growth of urbanization worldwide has contributed to the deterioration of the ecological status of water bodies. Efforts at improving the ecological status have been made either in isolated form or by means of integrated measures by stakeholders, but in many cases, these measures have not been evaluated to determine their benefit. In this study, we implemented a scenario analysis to restore the ecological water quality in the Cuenca River and its tributaries, which are located in the southern Andes of Ecuador. For this analysis, an integrated ecological model (IEM) was developed. The IEM linked an urban wastewater system (IUWS) model, which gave satisfactory results in its calibration and validation processes, with ecological models. The IUWS is a mechanistic model that incorporated the river water quality model, a wastewater treatment plant (WWTP) with activated sludge technology, and discharges from the sewage system. The ecological status of the waterways was evaluated with the Andean Biotic Index (ABI), which was predicted using generalized linear models (GLMs). The GLMs were calculated with physicochemical results from the IUWS model. Four scenarios that would enhance the current ecological water quality were analyzed. In these scenarios, the inclusion of a new WWTP with carbon, and with carbon and nitrogen removal as well as the addition of retention tanks before the discharges of combined sewer overflows (CSOs) were assessed. The new WWTP with carbon and nitrogen removal would bring about a better restoration of the ecological water quality due to better nitrogen removal. The retention tanks would help to enhance the ecological status of the rivers during rainy seasons. The integrated model implemented in this study was shown to be an essential tool to support decisions in the Cuenca River basin management.

Subgroup comparison according to clinical phenotype and serostatus in autoimmune encephalitis: a multicenter retrospective study

BACKGROUND AND PURPOSE

Autoimmune encephalitides (AE) include a spectrum of neurological disorders whose diagnosis revolves around the detection of neuronal antibodies (Abs). Consensus-based diagnostic criteria (AE-DC) allow clinic-serological subgrouping of AE, with unclear prognostic implications. The impact of AE-DC on patients' management was studied, focusing on the subgroup of Ab-negative-AE.

METHODS

This was a retrospective multicenter study on patients fulfilling AE-DC. All patients underwent Ab testing with commercial cell-based assays (CBAs) and, when available, in-house assays (immunohistochemistry, live/fixed CBAs, neuronal cultures) that contributed to defining final categories. Patients were classified as Ab-positive-AE [N-methyl-d-aspartate-receptor encephalitis (NMDAR-E), Ab-positive limbic encephalitis (LE), definite-AE] or Ab-negative-AE (Ab-negative-LE, probable-AE, possible-AE).

RESULTS

Commercial CBAs detected neuronal Abs in 70/118 (59.3%) patients. Testing 37/48 Ab-negative cases, in-house assays identified Abs in 11 patients (29.7%). A hundred and eighteen patients fulfilled the AE-DC, 81 (68.6%) with Ab-positive-AE (Ab-positive-LE, 40; NMDAR-E, 32; definite-AE, nine) and 37 (31.4%) with Ab-negative-AE (Ab-negative-LE, 17; probable/possible-AE, 20). Clinical phenotypes were similar in Ab-positive-LE versus Ab-negative-LE. Twenty-four/118 (20.3%) patients had tumors, and 19/118 (16.1%) relapsed, regardless of being Ab-positive or Ab-negative. Ab-positive-AE patients were treated earlier than Ab-negative-AE patients (P = 0.045), responded more frequently to treatments (92.3% vs. 65.6%, P < 0.001) and received second-line therapies more often (33.3% vs. 10.8%, P = 0.01). Delays in first-line therapy initiation were associated with poor response (P = 0.022; odds ratio 1.02; confidence interval 1.00-1.04).

CONCLUSIONS

In-house diagnostics improved Ab detection allowing better patient management but was available in a patient subgroup only, implying possible Ab-positive-AE underestimation. Notwithstanding this limitation, our findings suggest that Ab-negative-AE and Ab-positive-AE patients share similar oncological profiles, warranting appropriate tumor screening. Ab-negative-AE patients risk worse responses due to delayed and less aggressive treatments.

"Limbic encephalitis with acute onset and Hu antibodies treated with rituximab: Paraneoplastic or non-paraneoplastic disorder?"

Paraneoplastic limbic encephalitis (PLE) associated with Hu antibodies is a rare autoimmune disorder usually characterized by subacute onset of slowly progressive neurocognitive symptoms. Small cell lung carcinoma is the most frequent PLE-associated cancer, which negatively affects the prognosis of the disease. We report on a patient with acute onset of confusional state and disorganized speech. Cerebrospinal fluid analysis and brain MRI temporal lesions corroborated the diagnostic suspects toward infectious or autoimmune encephalitis but testing for onconeural antibodies suggested the alternative diagnosis of PLE, in the absence of cancer (total-body CT and PET were negative). The patient's serum was positive for Hu antibodies, thus leading to a diagnosis of PLE. First-line immunotherapies were ineffective on the neurocognitive symptoms, which improved after rituximab. Six months later, a retropharyngeal peri-jugular mass was histopathologically diagnosed as a metastasis of lung neuroendocrine tumor. Still clinically improved, the patient died from the oncological disease-related complications. Testing for onconeural antibodies should be considered in patients with clinico-radiological features of acute infectious or autoimmune encephalitis.

Recent insights on uncertainties present in integrated catchment water quality modelling

This paper aims to stimulate discussion based on the experiences derived from the QUICS project (Quantifying Uncertainty in Integrated Catchment Studies). First it briefly discusses the current state of knowledge on uncertainties in sub-models of integrated catchment models and the existing frameworks for analysing uncertainty. Furthermore, it compares the relative approaches of both building and calibrating fully integrated models or linking separate sub-models. It also discusses the implications of model linkage on overall uncertainty and how to define an acceptable level of model complexity. This discussion includes, whether we should shift our attention from uncertainties due to linkage, when using linked models, to uncertainties in model structure by necessary simplification or by using more parameters. This discussion attempts to address the question as to whether there is an increase in uncertainty by linking these models or if a compensation effect could take place and that overall uncertainty in key water quality parameters actually decreases. Finally, challenges in the application of uncertainty analysis in integrated catchment water quality modelling, as encountered in this project, are discussed and recommendations for future research areas are highlighted.

Recruit Fitness as a Predictor of Police Academy Graduation

Background

Suboptimal recruit fitness may be a risk factor for poor performance, injury, illness, and lost time during police academy training.

Aims

To assess the probability of successful completion and graduation from a police academy as a function of recruits’ baseline fitness levels at the time of academy entry.

Methods

Retrospective study where all available records from recruit training courses held (2006–2012) at all Massachusetts municipal police academies were reviewed and analysed. Entry fitness levels were quantified from the following measures, as recorded at the start of each training class: body composition, push-ups, sit-ups, sit-and-reach, and 1.5-mile run-time. The primary outcome of interest was the odds of not successfully graduating from an academy. We used generalized linear mixed models in order to fit logistic regression models with random intercepts for assessing the probability of not graduating, based on entry-level fitness. The primary analyses were restricted to recruits with complete entry-level fitness data.

Results

The fitness measures most strongly associated with academy failure were lesser number of push-ups completed (odds ratio [OR] = 5.2, 95% confidence interval [CI] 2.3–11.7, for 20 versus 41–60 push-ups) and slower run times (OR = 3.8, 95% CI 1.8–7.8, [1.5 mile run time of ≥15′20″] versus [12′33″ to 10′37″]).

Conclusions

Baseline pushups and 1.5-mile run-time showed the best ability to predict successful academy graduation, especially when considered together. Future research should include prospective validation of entry-level fitness as a predictor of subsequent police academy success.

Performance evaluation of a smart buffer control at a wastewater treatment plant

Real time control (RTC) is increasingly seen as a viable method to optimise the functioning of wastewater systems. Model exercises and case studies reported in literature claim a positive impact of RTC based on results without uncertainty analysis and flawed evaluation periods. This paper describes two integrated RTC strategies at the wastewater treatment plant (WWTP) Eindhoven, the Netherlands, that aim to improve the use of the available tanks at the WWTP and storage in the contributing catchments to reduce the impact on the receiving water. For the first time it is demonstrated that a significant improvement can be achieved through the application of RTC in practice. The Storm Tank Control is evaluated based on measurements and reduces the number of storm water settling tank discharges by 44% and the discharged volume by an estimated 33%, decreasing dissolved oxygen depletion in the river. The Primary Clarifier Control is evaluated based on model simulations. The maximum event NH4 concentration in the effluent reduced on average 19% for large events, while the load reduced 20%. For all 31 events the reductions are 11 and 4% respectively. Reductions are significant taking uncertainties into account, while using representative evaluation periods.

Assessing Urban Wastewater System Upgrades Using Integrated Modeling, Life Cycle Analysis, and Shadow Pricing

This study assesses the environmental impacts of four measures proposed for upgrading of the urban wastewater system of Eindhoven and the Dommel River in The Netherlands, against the base case, "do-nothing" option. The measures aim to reduce the overall environmental impact of the Eindhoven urban wastewater system (UWS) by targeting river dissolved oxygen depletion and ammonia peaks, reducing combined sewer overflows, and enhancing nutrient removal. The measures are evaluated using a life cycle analysis with the boundaries including the receiving river section by means of an integrated model of the UWS. An uncertainty analysis of the estimated impacts has been performed to support the outcomes. The study also uses the economic concept of shadow prices to assign relative weights of socio-economic importance to the estimated life cycle impacts. This novel integration of tools complements the assessments of this UWS with the inclusion of long-term global environmental impacts and the investigation of trade-offs between different environmental impacts through a single monetary unit. The results support the selection of deeper clarifiers as the most environmentally beneficial measure for upgrade.

Guillain-Barré syndrome following chickenpox: a case series

Guillain-Barré syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy, usually triggered by an infectious episode, mostly of viral origin. Varicella zoster virus (VZV) is a rare cause of GBS, mainly in the case of latent infection reactivation. We report on three adult patients who developed GBS following chickenpox, after a short period of latency. They were promptly treated with intravenous immunoglobulin, and the first one with plasma exchange additionally. All the patients experienced almost complete clinical recovery. Our experience suggests that primary VZV infection constitutes a GBS triggering event.

Five-year follow-up of immune response after one or two doses of inactivated hepatitis A vaccine given at 1 year of age in the Mendoza Province of Argentina

Our study was conducted to further investigate the single-dose approach of hepatitis A vaccination, while providing supportive data on the flexibility of booster administration. Participants received at least one dose of Avaxim 80U Pediatric at 11-23 months of age, and they will be followed for 10 years. We report here the fourth and fifth years after the first vaccination. Group assignment was based on whether the children received 1 dose and no booster during the study (Group 1) or 2 doses and no further booster (Group 2). Anti-HAV antibody concentrations were assessed at each annual visit. Of the 546 initial participants, 441 (80.8%) and 412 (75.5%) were followed up 4 and 5 years after vaccination, respectively. Of the 411 subjects evaluable at Year 5, 318 had received one vaccine dose and 85 had received two. Seroprotection rates were still high in Group 1 (99.7%) and in Group 2 (100%) 5 years after one or two doses of Avaxim 80U Pediatric, correspondingly. Anti-HAV geometric mean concentrations decreased in both groups compared to what they were 3 years after vaccination, while remaining well above the 10 mIU/mL threshold 5 years after vaccination. The highest concentrations were found in the children who received 2 vaccine doses. Hepatitis A humoral immunity induced by a single dose of inactivated hepatitis A vaccine can persist for at least 5 years in a paediatric population. The study results also support recommendations in favour of a flexible time window for booster vaccination.

Pathologic and Environmental Studies Provide New Pathogenetic Insights Into Ringtail of Laboratory Mice

Ringtail is a pathologic condition of laboratory rodents characterized by annular constrictions of the tail. Traditionally, it is classified as an environmental disorder caused by low relative humidity, but other factors (temperature, dietary deficiencies, genetic susceptibility, and caging type) have also been proposed. Twenty litters of mice with ringtail lesions occurred from September 2010 to August 2013 in a facility located in the northern Italy. Mice were maintained under controlled environmental conditions and fed a standard diet. Retrospective analysis of environmental data (relative humidity, temperature) was carried out. Gross, histopathologic, scanning, and transmission electron microscopy examination of tails and limbs was performed. The incidence of ringtail was 0.075% (20/26 800) of all weaned litters over the 3-year period of examination. Temperature and relative humidity remained within accepted limits in all cases except one. We observed annular constrictions in tail, digits of pes, crus, and antebrachium in 116 (100.0%), 47 (40.5%), 11 (9.5%), and 2 (1.7%) of 116 affected mice, respectively. Histologic and ultrastructural examination revealed abnormal keratin desquamation and presence of a keratin ring encircling the tail, causing progressive strangulation of the growing tail with subsequent compression and ulceration of underlying soft tissues, resulting in circulatory changes (edema, hyperemia, thrombosis, hemorrhages), ischemic necrosis, and eventually auto-amputation distal to the constriction. On the basis of our findings, we suggest a disorder of cornification as the primary lesion of ringtail in mice. The cause of these cases, however, remained undetermined, even though traditional etiologic factors (relative humidity, temperature, diet, caging type) were reasonably excluded.

Development and assessment of an integrated ecological modelling framework to assess the effect of investments in wastewater treatment on water quality

Worldwide, large investments in wastewater treatment are made to improve water quality. However, the impacts of these investments on river water quality are often not quantified. To assess water quality, the European Water Framework Directive (WFD) requires an integrated approach. The aim of this study was to develop an integrated ecological modelling framework for the River Drava (Croatia) that includes physical-chemical and hydromorphological characteristics as well as the ecological river water quality status. The developed submodels and the integrated model showed accurate predictions when comparing the modelled results to the observations. Dissolved oxygen and nitrogen concentrations (ammonium and organic nitrogen) were the most important variables in determining the ecological water quality (EWQ). The result of three potential investment scenarios of the wastewater treatment infrastructure in the city of Varaždin on the EWQ of the River Drava was assessed. From this scenario-based analysis, it was concluded that upgrading the existing wastewater treatment plant with nitrogen and phosphorus removal will be insufficient to reach a good EWQ. Therefore, other point and diffuse pollution sources in the area should also be monitored and remediated to meet the European WFD standards.

On data requirements for calibration of integrated models for urban water systems

Modeling of integrated urban water systems (IUWS) has seen a rapid development in recent years. Models and software are available that describe the process dynamics in sewers, wastewater treatment plants (WWTPs), receiving water systems as well as at the interfaces between the submodels. Successful applications of integrated modeling are, however, relatively scarce. One of the reasons for this is the lack of high-quality monitoring data with the required spatial and temporal resolution and accuracy to calibrate and validate the integrated models, even though the state of the art of monitoring itself is no longer the limiting factor. This paper discusses the efforts to be able to meet the data requirements associated with integrated modeling and describes the methods applied to validate the monitoring data and to use submodels as software sensor to provide the necessary input for other submodels. The main conclusion of the paper is that state of the art monitoring is in principle sufficient to provide the data necessary to calibrate integrated models, but practical limitations resulting in incomplete data-sets hamper widespread application. In order to overcome these difficulties, redundancy of future monitoring networks should be increased and, at the same time, data handling (including data validation, mining and assimilation) should receive much more attention.

The incorporation of variability and uncertainty evaluations in WWTP design by means of stochastic dynamic modeling: the case of the Eindhoven WWTP upgrade

This paper illustrates how a dynamic model can be used to evaluate a plant upgrade on the basis of post-upgrade performance data. The case study is that of the Eindhoven wastewater treatment plant upgrade completed in 2006. As a first step, the design process based on a static model was thoroughly analyzed and the choices regarding variability and uncertainty (i.e. safety factors) were made explicit. This involved the interpretation of the design guidelines and other assumptions made by the engineers. As a second step, a (calibrated) dynamic model of the plant was set up, able to reproduce the anticipated variability (duration and frequency). The third step was to define probability density functions for the parameters assumed to be uncertain, and propagate that uncertainty with the dynamic model by means of Monte Carlo simulations. The last step was the statistical evaluation and interpretation of the simulation results. This work should be regarded as a 'learning exercise' increasing the understanding of how and to what extent variability and uncertainty are currently incorporated in design guidelines used in practice and how model-based post-project appraisals could be performed.

Modelling and monitoring of integrated urban wastewater systems: review on status and perspectives

While the general principles and modelling approaches for integrated management/modelling of urban water systems already present a decade ago still hold, in recent years aspects like model interfacing and wastewater treatment plant (WWTP) influent generation as complements to sewer modelling have been investigated and several new or improved systems analysis methods have become available. New/improved software tools coupled with the current high computational capacity have enabled the application of integrated modelling to several practical cases, and advancements in monitoring water quantity and quality have been substantial and now allow the collecting of data in sufficient quality and quantity to permit using integrated models for real-time applications too. Further developments are warranted in the field of data quality assurance and efficient maintenance.

Benchmark simulation models, quo vadis?

As the work of the IWA Task Group on Benchmarking of Control Strategies for wastewater treatment plants (WWTPs) is coming to an end, it is essential to disseminate the knowledge gained. For this reason, all authors of the IWA Scientific and Technical Report on benchmarking have come together to provide their insights, highlighting areas where knowledge may still be deficient and where new opportunities are emerging, and to propose potential avenues for future development and application of the general benchmarking framework and its associated tools. The paper focuses on the topics of temporal and spatial extension, process modifications within the WWTP, the realism of models, control strategy extensions and the potential for new evaluation tools within the existing benchmark system. We find that there are major opportunities for application within all of these areas, either from existing work already being done within the context of the benchmarking simulation models (BSMs) or applicable work in the wider literature. Of key importance is increasing capability, usability and transparency of the BSM package while avoiding unnecessary complexity.

Cost-effective solutions for water quality improvement in the Dommel River supported by sewer-WWTP-river integrated modelling

This project aims at finding cost-efficient sets of measures to meet the Water Framework Directive (WFD) derived goals for the Dommel River (The Netherlands). Within the project, both acute and long-term impacts of the urban wastewater system on the chemical and ecological quality of the river are studied with a monitoring campaign in the urban wastewater system (wastewater treatment plant and sewers) and in the receiving surface water system. An integrated model, which proved to be a powerful tool to analyse the interactions within the integrated urban wastewater system, was first used to evaluate measures in the urban wastewater system using the existing infrastructure and new real-time control strategies. As the latter resulted to be beneficial but not sufficient, this paper investigated the use of additional infrastructural measures to improve the system cost-effectively and have it meet the Directive's goals. Finally, an uncertainty analysis was conducted to investigate the impact of uncertainty in the main model assumptions and model parameters on the performance robustness of the selected set of measures. Apart from some extreme worst-case scenarios, the proposed set of measures turned out to be sufficiently robust. Due to the substantial savings obtained with the results of this project, the pay-back time of the whole monitoring and modelling work proved to be less than 5 months. This illustrates the power of mathematical modelling for decision support in the context of complex urban water systems.

Modelling micro-pollutant fate in wastewater collection and treatment systems: status and challenges

This paper provides a comprehensive summary on modelling of micro-pollutants' (MPs) fate and transport in wastewater. It indicates the motivations of MP modelling and summarises and illustrates the current status. Finally, some recommendations are provided to improve and diffuse the use of such models. In brief, we conclude that, in order to predict the contaminant removal in centralised treatment works, considering the dramatic improvement in monitoring and detecting MPs in wastewater, more mechanistic approaches should be used to complement conventional, heuristic and other fate models. This is crucial, as regional risk assessments and model-based evaluations of pollution discharge from urban areas can potentially be used by decision makers to evaluate effluent quality regulation, and assess upgrading requirements, in the future.

Hippocampal SPARC regulates depression-related behavior

SPARC (secreted protein acidic and rich in cysteine) is a matricellular protein highly expressed during development, reorganization and tissue repair. In the central nervous system, glial cells express SPARC during development and in neurogenic regions of the adult brain. Astrocytes control the glutamate receptor levels in the developing hippocampus through SPARC secretion. To further characterize the role of SPARC in the brain, we analyzed the hippocampal-dependent adult behavior of SPARC KO mice. We found that SPARC KO mice show increased levels of anxiety-related behaviors and reduced levels of depression-related behaviors. The antidepressant-like phenotype could be rescued by adenoviral vector-mediated expression of SPARC in the adult hippocampus, but anxiety-related behavior persisted in these mice. To identify the cellular mechanisms underlying these behavioral alterations, we analyzed neuronal activity and neurogenesis in the dentate gyrus (DG). SPARC KO mice have increased levels of neuronal activity, evidenced as more neurons that express c-Fos after a footshock. SPARC also affects cell proliferation in the subgranular zone of the DG, although it does not affect maturation and survival of new neurons. SPARC expression in the adult DG does not revert the proliferation phenotype in KO mice, but our results suggest a role of SPARC in limiting the survival of new neurons in the DG. This work suggests that SPARC could affect anxiety-related behavior by modulating neuronal activity, and that depression-related behavior is dependent upon the adult expression of SPARC, which affects adult brain function by mechanisms that need to be elucidated.

The role of PKCε-dependent signaling for cardiac differentiation

Protein kinase Cepsilon (PKCε) exerts a well-known cardio-protective activity in ischemia-reperfusion injury and plays a pivotal role in stem cell proliferation and differentiation. Although many studies have been performed on physiological and morphological effects of PKCε mis-expression in cardiomyocytes, molecular information on the role of PKCε on early cardiac gene expression are still lacking. We addressed the molecular role of PKCε in cardiac cells using mouse cardiomyocytes and rat bone marrow mesenchymal stem cells. We show that PKCε is modulated in cardiac differentiation producing an opposite regulation of the cardiac genes NK2 transcription factor related, locus 5 (nkx2.5) and GATA binding protein 4 (gata4) both in vivo and in vitro. Phospho-extracellular regulated mitogen-activated protein kinase 1/2 (p-ERK1/2) levels increase in PKCε over-expressing cells, while pkcε siRNAs produce a decrease in p-ERK1/2. Indeed, pharmacological inhibition of ERK1/2 rescues the expression levels of both nkx2.5 and gata4, suggesting that a reinforced (mitogen-activated protein kinase) MAPK signaling is at the basis of the observed inhibition of cardiac gene expression in the PKCε over-expressing hearts. We demonstrate that PKCε is critical for cardiac cell early gene expression evidencing that this protein is a regulator that has to be fine tuned in precursor cardiac cells.

Towards a benchmarking tool for minimizing wastewater utility greenhouse gas footprints

A benchmark simulation model, which includes a wastewater treatment plant (WWTP)-wide model and a rising main sewer model, is proposed for testing mitigation strategies to reduce the system's greenhouse gas (GHG) emissions. The sewer model was run to predict methane emissions, and its output was used as the WWTP model input. An activated sludge model for GHG (ASMG) was used to describe nitrous oxide (N(2)O) generation and release in activated sludge process. N(2)O production through both heterotrophic and autotrophic pathways was included. Other GHG emissions were estimated using empirical relationships. Different scenarios were evaluated comparing GHG emissions, effluent quality and energy consumption. Aeration control played a clear role in N(2)O emissions, through concentrations and distributions of dissolved oxygen (DO) along the length of the bioreactor. The average value of N(2)O emission under dynamic influent cannot be simulated by a steady-state model subjected to a similar influent quality, stressing the importance of dynamic simulation and control. As the GHG models have yet to be validated, these results carry a degree of uncertainty; however, they fulfilled the objective of this study, i.e. to demonstrate the potential of a dynamic system-wide modelling and benchmarking approach for balancing water quality, operational costs and GHG emissions.

Impact of influent data frequency and model structure on the quality of WWTP model calibration and uncertainty

Application of activated sludge models (ASMs) to full-scale wastewater treatment plants (WWTPs) is still hampered by the problem of model calibration of these over-parameterised models. This either requires expert knowledge or global methods that explore a large parameter space. However, a better balance in structure between the submodels (ASM, hydraulic, aeration, etc.) and improved quality of influent data result in much smaller calibration efforts. In this contribution, a methodology is proposed that links data frequency and model structure to calibration quality and output uncertainty. It is composed of defining the model structure, the input data, an automated calibration, confidence interval computation and uncertainty propagation to the model output. Apart from the last step, the methodology is applied to an existing WWTP using three models differing only in the aeration submodel. A sensitivity analysis was performed on all models, allowing the ranking of the most important parameters to select in the subsequent calibration step. The aeration submodel proved very important to get good NH(4) predictions. Finally, the impact of data frequency was explored. Lowering the frequency resulted in larger deviations of parameter estimates from their default values and larger confidence intervals. Autocorrelation due to high frequency calibration data has an opposite effect on the confidence intervals. The proposed methodology opens doors to facilitate and improve calibration efforts and to design measurement campaigns.

Model-based knowledge acquisition in environmental decision support system for wastewater integrated management

The main goal of the Water Framework Directive is to achieve good chemical and ecological status of water bodies by 2015. The implementation of integrated river basin management, including sewer systems, wastewater treatment plants and receiving water bodies, is essential to accomplishing this objective. Integrated management is complex and therefore the implementation of control systems and the development of decision support systems are needed to facilitate the work of urban wastewater system (UWS) managers. Within this context, the objective of this paper is to apply integrated modelling of an UWS to simulate and analyse the behaviour of the 'Congost' UWS in Spain, and to optimize its performance against different types of perturbations. This analysis results in optimal operating set-points for each perturbation, improves river water quality, minimizes combined sewer overflows and optimizes flow lamination from storm water tanks. This is achieved by running Monte Carlo simulations and applying global sensitivity analysis. The set-points will become part of the knowledge base composed of a set of IF-THEN rules of the environmental decision support system being developed for this case study.

Immunosuppressive treatment in refractory chronic inflammatory demyelinating polyradiculoneuropathy. A nationwide retrospective analysis

BACKGROUND AND PURPOSE

There are other options open to patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) who are non-responders to conventional treatment, including immunosuppressive and immunomodulatory agents (IA). The aim of this study was to assess whether the use of IA is able to increase the number of responders.

METHODS

Clinical and electrophysiological data of patients with refractory CIDP, followed at 10 Italian centres, were collected, and the clinical outcome (Rankin Scale) and drug side effects (SE) for the different therapies were analysed.

RESULTS

A total of 110 patients were included. These patients underwent 158 different therapeutic procedures with IA. Seventy-seven patients were treated with azathioprine, 18 rituximab, 13 cyclophosphamide, 12 mycophenolate mofetil, 12 cyclosporine, 12 methotrexate, 11 interferon-alpha and three interferon beta-1a. The percentage of patients who responded to azathioprine (27%) was comparable to the percentage of responders to other therapies, after the exclusion of interferon beta-1a that was not effective in any of the three patients treated. The percentage of SE ranges from 8% (methotrexate) to 50% (cyclosporine).

CONCLUSIONS

One-fourth of patients, refractory to conventional treatment, showed an improvement in their disability with IA. Methotrexate had the lowest SE; cyclosporine was associated with severe SE and often led to drug discontinuation.

[The role of the ASL of Brescia in the health and safety of immigrant workers]

According to available studies, migrant workers represent a vulnerable workers' category. For this reason, the Italian law on safety and health at work (art. 11, D.Lgs 81/08) points out the need for Public Administration initiatives devoted to migrant workers' health and safety at work. Local Public Health Department of Brescia for years now had a significant commitment in migrants' health. Thanks to the collaboration of occupational physicians and expert physicians on migration health, it was developed a multidimensional method to assess working risks taking into account also the fragile conditions of migrant workers, considering both personal and social characteristics and professional experience, in order to support companies in the planning of necessary actions to improve health and safety at work. The method was shared by both local industrial association and trade unions and then tested in some manufactures.

Rituximab in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a report of 13 cases and review of the literature

BACKGROUND

A few case reports have shown controversial results of rituximab efficacy in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

OBJECTIVE

To analyse the efficacy of rituximab in a large CIDP cohort.

METHODS

A retrospective, observational and multicentre study on the use of rituximab in CIDP. 13 Italian CIDP patients were treated with rituximab after the partial or complete lack of efficacy of conventional therapies. Eight patients had co-occurring haematological diseases. Patients who improved by at least two points in standard clinical scales, or who reduced or discontinued the pre-rituximab therapies, were considered as responders.

RESULTS

Nine patients (seven with haematological diseases) responded to rituximab: six of them, who were non-responders to conventional therapies, improved clinically, and the other three maintained the improvement that they usually achieved with intravenous immunoglobulin or plasma exchange. Significantly associated with shorter disease duration, rituximab responses started after a median period of 2.0&emsp14;months (range, 1-6) and lasted for a median period of 1&emsp14;year (range, 1-5).

CONCLUSIONS

Rituximab seems to be a promising therapeutic choice when it targets both CIDP and co-occurring haematological diseases. Timely post-onset administration of rituximab seems to be associated with better responses.

Shall we upgrade one-dimensional secondary settler models used in WWTP simulators? - An assessment of model structure uncertainty and its propagation

In WWTP models, the accurate assessment of solids inventory in bioreactors equipped with solid-liquid separators, mostly described using one-dimensional (1-D) secondary settling tank (SST) models, is the most fundamental requirement of any calibration procedure. Scientific knowledge on characterising particulate organics in wastewater and on bacteria growth is well-established, whereas 1-D SST models and their impact on biomass concentration predictions are still poorly understood. A rigorous assessment of two 1-DSST models is thus presented: one based on hyperbolic (the widely used Takács-model) and one based on parabolic (the more recently presented Plósz-model) partial differential equations. The former model, using numerical approximation to yield realistic behaviour, is currently the most widely used by wastewater treatment process modellers. The latter is a convection-dispersion model that is solved in a numerically sound way. First, the explicit dispersion in the convection-dispersion model and the numerical dispersion for both SST models are calculated. Second, simulation results of effluent suspended solids concentration (XTSS,Eff), sludge recirculation stream (XTSS,RAS) and sludge blanket height (SBH) are used to demonstrate the distinct behaviour of the models. A thorough scenario analysis is carried out using SST feed flow rate, solids concentration, and overflow rate as degrees of freedom, spanning a broad loading spectrum. A comparison between the measurements and the simulation results demonstrates a considerably improved 1-D model realism using the convection-dispersion model in terms of SBH, XTSS,RAS and XTSS,Eff. Third, to assess the propagation of uncertainty derived from settler model structure to the biokinetic model, the impact of the SST model as sub-model in a plant-wide model on the general model performance is evaluated. A long-term simulation of a bulking event is conducted that spans temperature evolution throughout a summer/winter sequence. The model prediction in terms of nitrogen removal, solids inventory in the bioreactors and solids retention time as a function of the solids settling behaviour is investigated. It is found that the settler behaviour, simulated by the hyperbolic model, can introduce significant errors into the approximation of the solids retention time and thus solids inventory of the system. We demonstrate that these impacts can potentially cause deterioration of the predictive power of the biokinetic model, evidenced by an evaluation of the system's nitrogen removal efficiency. The convection-dispersion model exhibits superior behaviour, and the use of this type of model thus is highly recommended, especially bearing in mind future challenges, e.g., the explicit representation of uncertainty in WWTP models.

Assessing the convergence of LHS Monte Carlo simulations of wastewater treatment models

Monte Carlo (MC) simulation appears to be the only currently adopted tool to estimate global sensitivities and uncertainties in wastewater treatment modelling. Such models are highly complex, dynamic and non-linear, requiring long computation times, especially in the scope of MC simulation, due to the large number of simulations usually required. However, no stopping rule to decide on the number of simulations required to achieve a given confidence in the MC simulation results has been adopted so far in the field. In this work, a pragmatic method is proposed to minimize the computation time by using a combination of several criteria. It makes no use of prior knowledge about the model, is very simple, intuitive and can be automated: all convenient features in engineering applications. A case study is used to show an application of the method, and the results indicate that the required number of simulations strongly depends on the model output(s) selected, and on the type and desired accuracy of the analysis conducted. Hence, no prior indication is available regarding the necessary number of MC simulations, but the proposed method is capable of dealing with these variations and stopping the calculations after convergence is reached.

Model-based energy optimisation of a small-scale decentralised membrane bioreactor for urban reuse

The energy consumption of a small-scale membrane bioreactor, treating high strength domestic wastewater for community level wastewater recycling, has been optimised using a dynamic model of the plant. ASM2d was chosen as biological process model to account for the presence of phosphate accumulating organisms. A tracer test was carried out to determine the hydraulic behaviour of the plant. To realistically simulate the aeration demand, a dedicated aeration model was used incorporating the dependency of the oxygen transfer on the mixed liquor concentration and allowing differentiation between coarse and fine bubble aeration, both typically present in MBRs. A steady state and dynamic calibration was performed, and the calibrated model was able to predict effluent nutrient concentrations and MLSS concentrations accurately. A scenario analysis (SCA) was carried out using the calibrated model to simulate the effect of varying SRT, recirculation ratio and DO set point on effluent quality, MLSS concentrations and aeration demand. Linking the model output with empirically derived correlations for energy consumption allowed an accurate prediction of the energy consumption. The SCA results showed that decreasing membrane aeration and SRT were most beneficial towards total energy consumption, while increasing the recirculation flow led to improved TN removal but at the same time also deterioration in TP removal. A validation of the model was performed by effectively applying better operational parameters to the plant. This resulted in a reduction in energy consumption by 23% without compromising effluent quality, as was accurately predicted by the model. This modelling approach thus allows the operating envelope to be reliably identified for meeting criteria based on energy demand and specific water quality determinants.

Combining multimedia models with integrated urban water system models for micropollutants

Integrated urban water system (IUWS) modeling aims at assessing the quality of the surface water receiving the urban emissions through sewage treatment plants, combined sewer overflows (CSOs) and stormwater drainage systems. However, some micropollutants tend to appear in more than one environmental medium (air, water, sediment, soil, groundwater, etc.). In this work, a multimedia fate and transport model (MFTM) is "wrapped around" a dynamic IUWS model for organic micropollutants to enable integrated environmental assessment. The combined model was tested on a hypothetical catchment using two scenarios: on the one hand a reference scenario with a combined sewerage system and on the other hand a stormwater infiltration pond scenario, as an example of a sustainable urban drainage system (SUDS). A case for Bis(2-ethylhexyl) phthalate (DEHP) was simulated and resulted in reduced surface water concentrations for the latter scenario. However, the model also showed that this was at the expense of increased fluxes to air, groundwater and infiltration pond soil. The latter effects are generally not included in IUWS models, whereas MTFMs usually do not consider dynamic surface water concentrations,; hence the combined model approach provides a better basis for integrated environmental assessment of micropollutants' fate in urban environments.

Benchmark Simulation Model No 2: finalisation of plant layout and default control strategy

The COST/IWA Benchmark Simulation Model No 1 (BSM1) has been available for almost a decade. Its primary purpose has been to create a platform for control strategy benchmarking of activated sludge processes. The fact that the research work related to the benchmark simulation models has resulted in more than 300 publications worldwide demonstrates the interest in and need of such tools within the research community. Recent efforts within the IWA Task Group on "Benchmarking of control strategies for WWTPs" have focused on an extension of the benchmark simulation model. This extension aims at facilitating control strategy development and performance evaluation at a plant-wide level and, consequently, includes both pretreatment of wastewater as well as the processes describing sludge treatment. The motivation for the extension is the increasing interest and need to operate and control wastewater treatment systems not only at an individual process level but also on a plant-wide basis. To facilitate the changes, the evaluation period has been extended to one year. A prolonged evaluation period allows for long-term control strategies to be assessed and enables the use of control handles that cannot be evaluated in a realistic fashion in the one week BSM1 evaluation period. In this paper, the finalised plant layout is summarised and, as was done for BSM1, a default control strategy is proposed. A demonstration of how BSM2 can be used to evaluate control strategies is also given.

Evaluating the usefulness of dynamic pollutant fate models for implementing the EU Water Framework Directive

The European Water Framework Directive (WFD) aims at achieving a good ecological and chemical status of surface waters in river basins by 2015. The chemical status is considered good if the Environmental Quality Standards (EQSs) are met for all substances listed on the priority list and eight additional specific emerging substances. To check compliance with these standards, the WFD requires the establishment of monitoring programmes. The minimum measuring frequency for priority substances is currently set at once per month. This can result in non-representative sampling and increased probability of misinterpretation of the surface water quality status. To assist in the classification of the water body, the combined use of monitoring data and pollutant fate models is recommended. More specifically, dynamic models are suggested, as possible exceedance of the quality standards can be predicted by such models. In the presented work, four realistic scenarios are designed and discussed to illustrate the usefulness of dynamic pollutant fate models for implementing the WFD. They comprise a combination of two priority substances and two rivers, representative for Western Europe.