Effect of type of fiber and its physicochemical properties on performance, digestive transit time, and cecal fermentation in broilers from 1 to 23 d of age

The effects of insoluble fiber (IF) sources differing on particle size and hydration capacity (HC) on growth performance, gastrointestinal tract (GIT) development, cecal fermentation, and digestive transit time were investigated from 1 to 23 d of age in 550 Ross-308 broiler males housed in 50 cages. The experimental design was based on the administration of a common corn-soybean meal nonsupplemented with additional IF sources diet in mash form (Control), and 4 dietary treatments consisting in the Control diet diluted with 1.5% of different IF: lignocellulose (LC), fine-ground straw (FS) and coarse-ground straw (CS), all characterized by high HC; and almond shell (AS) having low HC. Cecal fermentation was assessed by in vitro fermentation of the IF sources using the cecal content of 22-day broilers as inoculum. Compared with control birds, the inclusion of IF sources tended to impair the FCR (P = 0.053), with birds fed the HC-IF sources (LC, FS, and CS) showing lower ADFI (P = 0.005) and ADG (P = 0.001) than those fed the AS diet. The relative weight of gizzard and cecum, small intestine length, and digestive transit time decreased in AS group (P ≤ 0.050) compared with the average value of the groups fed the other IF sources. The inclusion of IF reduced (P = 0.006) the excreta moisture content, with no differences among IF sources. Dietary treatments had no effect either on cecal short fatty acids concentration or on intestinal morphology. As indicated by the in vitro gas production results, both LC and AS were less fermented than FS and CS, although all IF sources were low fermentable. None of the IF sources were able to influence the fermentation capacity of cecal microbiota after 22 d of feeding. In summary, animals fed AS presented smaller gizzard and cecum relative size, showed higher ADFI and ADG, and tended to improve fed conversion ratio in comparison to those fed the rest of IF sources.

Stereotactic body radiation therapy (SBRT) for spinal metastases: 12 years of a single center experience

OBJECTIVE

To assess the clinical outcomes of patients with spine metastases treated with SBRT at our institution.

MATERIALS AND METHODS

Patients with spine metastases treated with SBRT (1 fraction/18 Gy or 5 fractions/7 Gy) during the last 12 years have been analyzed. All patients were simulated supine in a vacuum cushion or with a shoulder mask. CT scans and MRI image registration were performed. Contouring was based on International Spine-Radiosurgery-Consortium-Consensus-Guidelines. Highly conformal-techniques (IMRT/VMAT) were used for treatment planning. Intra and interfraction (CBCT or X-Ray-ExacTrac) verification were mandatory.

RESULTS

From February 2010 to January 2022, 129 patients with spinal metastases were treated with SBRT [1 fraction/18 Gy (75%) or 5 fractions/7 Gy] (25%). For patients with painful metastases (74/129:57%), 100% experienced an improvement in pain after SBRT. With a median follow-up of 14.2 months (average 22.9; range 0.5-140) 6 patients (4.6%) experienced local relapse. Local progression-free survival was different, considering metastases's location (p < 0.04). The 1, 2 and 3 years overall survival (OS) were 91.2%, 85.1% and 83.2%, respectively. Overall survival was significantly better for patients with spine metastases of breast and prostate cancers compared to other tumors (p < 0.05) and significantly worse when visceral metastases were present (p < 0.05), when patients were metastatic de novo (p < 0.05), and in those patients receiving single fraction SBRT (p: 0.01).

CONCLUSIONS

According to our experience, SBRT for patients with spinal metastases was effective in terms of local control and useful to reach pain relief. Regarding the intent of the treatment, an adequate selection of patients is essential to propose this ablative approach.

Endoscopic implantation of autologous myoblasts for stress urinary incontinence and evaluation of its efficacy in sphincterotomized rabbits

INTRODUCTION

Stress urinary incontinence (SUI) is one of the health problems with more impact on patients' lives. The aim of the present work was to develop a therapy for SUI using tissue engineering by isolation and culture of autologous myoblasts (CAM) followed by endoscopic implantation. We also evaluated the efficacy of this therapy in a rabbit model of incontinence after sphincterotomy.

MATERIALS AND METHODS

We used healthy male New Zealand rabbits. The animals were first bled to obtain platelet-poor plasma (PPP) and biopsied for myoblast isolation. Post-sphincterotomy, they were divided into two groups: the treatment group (including animals that received CAM resuspended in PPP) and the control group (including animals receiving only PPP). The leak-point pressure (LPP) was used to measure continence in both groups at different time points. The results were evaluated with hierarchical linear regression models. Histological evaluation of the rabbits' sphincters was also performed at the end of follow-up.

RESULTS

No statistically significant differences were observed between the baseline LPP values of each group. The post-sphincterotomy values of both groups were below 50% of the baseline value, which was a mandatory condition for incontinence. The post-implantation values of the treatment group were higher than 50% of the baseline value, which led us to assume continence recovery. A statistically significant difference was observed in the LPP values between the two treatment groups (p=0.003). Histological study revealed interconnected islands formed by muscle fibers in the treatment group, and connective tissue surrounding the urethral lumen and inflammatory infiltrate in the control group.

DISCUSSION AND CONCLUSIONS

The implantation of CAM significantly improved LPP values in the treatment group, and the improvement remained throughout the evaluation period. It may be associated with the consistency of the implant and its stability at the injection site. Longer follow-up studies and human clinical investigations are required to consider CAM implantation as an alternative treatment for stress urinary incontinence.

Real-world effectiveness and safety of stereotactic body radiotherapy for liver metastases with different respiratory motion management techniques

PURPOSE

Stereotactic body radiotherapy (SBRT) has been firmly established as a treatment choice for patients with oligometastases, as it has demonstrated both safety and efficacy by consistently achieving high rates of local control. Moreover, it offers potential survival benefits for carefully selected patients in real-world clinical settings.

METHODS

Between January 2008 and May 2020, a total of 149 patients (with 414 liver metastases) received treatment. The Active Breathing Coordinator device was used for 68 patients, while respiratory gating was used for 65 and abdominal compression was used for 16 patients. The most common histological finding was colorectal adenocarcinoma, with 37.6% of patients having three or more metastases, and 18% having two metastases. The prescribed dose ranged from 36 to 60 Gy, delivered in 3-5 fractions.

RESULTS

Local control rates at 2 and 3 years were 76.1% and 61.2%, respectively, with no instances of local recurrence after 3 years. Factors negatively impacting local control included colorectal histology, lower prescribed dose, and the occurrence of new liver metastases. The median overall survival from SBRT was 32 months, with the presence of metastases outside the liver and the development of new liver metastases after SBRT affecting survival. The median disease-free survival was 10 months. No substantial differences in both local control and survival were observed between the respiratory motion control techniques employed. Treatment tolerance was excellent, with only one patient experiencing acute grade IV thrombocytopenia and two patients suffering from ≥ grade II chronic toxicity.

CONCLUSION

For radical management of single or multiple liver metastases, SBRT is an effective and well-tolerated treatment option. Regardless of the technology employed, experienced physicians can achieve similarly positive outcomes. However, additional studies are required to elucidate prognostic factors that can facilitate improved patient selection.

Real-world efficacy of postoperative radiotherapy with a moderate dose-escalation for phyllodes tumors of the breast

Background

Phyllodes tumors are rare breast tumors comprising less than 1% of cases, categorized as benign, borderline, or malignant. Treatment typically involves complete surgical excision with wide margins. Adjuvant radiotherapy may be recommended for borderline or malignant tumors, or when clear margins cannot be achieved through surgery alone.

Methods

We conducted a retrospective review of 14 women diagnosed with phyllodes tumors between 2015 and 2023. Among them, 36% had benign tumors and 64% had borderline/malignant tumors. The majority (86%) underwent breast-conserving surgery. Postoperative radiation therapy was delivered to the whole breast/chest wall, with a median biologically effective dose (BED) of 92.7 Gy (90.0-102.6 Gy), representing a moderate dose-escalation over conventional breast cancer schedules.

Results

After a median follow-up of 48.5 months, no local or distant recurrence were observed. Mild to moderate skin toxicity occurred in all patients: 36% reported grade 1, 43% grade 2, and 21% grade 3 toxicity. One patient developed grade 2 fibrosis during follow-up. No significant correlations were found between the severity of acute/late toxicity and tumor size, surgical approach, or the radiation field's planning target volume (PTV).

Conclusions

Adjuvant radiation therapy appears to be well tolerated and feasible for high-risk phyllodes tumors. However, the decision to utilize radiotherapy should be personalized, considering tumor characteristics and the risks and benefits associated with treatment.

Sustainable recovery of phenolic antioxidants from real olive vegetation water with natural hydrophobic eutectic solvents and terpenoids

Olive oil production leads to the generation of olive mill wastewater (OMWW). Due to the presence of phenolic compounds, they are difficult to process, but they represent a source of high-added value chemicals since they have antioxidant and therapeutic properties. This work has studied the extraction of phenolic compounds from a type of OMWW, olive vegetation water, which presents these compounds in a more diluted dosage than in other studied to date, to revalue this waste stream. A real olive vegetation water from a Spanish olive oil producer was used, and liquid-liquid extraction was applied. Terpenoids and terpene-based hydrophobic eutectic solvents were systematically used to extract phenolic compounds following the concentrations of tyrosol, catechol, caffeic acid, and total phenolic content. By molecular simulation with the COSMO-RS method, 4 terpenoids, and 2 eutectic solvents were selected and compared with 2 conventional solvents. The Solvent/Feed ratio in the extraction of phenolic compounds was studied, showing that the solvents with the highest extraction results were geraniol, eucalyptol, and eutectic solvent menthol + camphor, which outperformed conventional solvents methyl isobutyl ketone and diisopropyl ether. Menthol + camphor gave total phenol extraction yields of 88.73% at a Solvent/Feed ratio in volume of 0.50, surpassing all solvents tested. A solvent reuse and regeneration process was applied by back-extraction of the 4 solvents: FTIR results showed the stability of the solvents while maintaining yields in the solvent reuse process. The phenolic compounds could be concentrated in the alkaline phase to factors up to 49.3 to the initial concentration in olive vegetation water. The alkaline phases were neutralized to obtain a precipitate with a caffeic acid content of up to 26 % wt%, and a tyrosol-rich supernatant with a concentration of up to 6.54 g/L. This work proposes a process using natural solvents to extract phenolic compounds from olive vegetation water.

Influence of the calcium and nutrient content of the prelay diet on egg production, egg quality, and tibiae mineralization of brown egg-laying hens from 16 to 63 wk of age

The influence of the Ca and nutrient content of the diet fed from 16 to 19 wk of age, on egg production, egg quality, and tibiae mineralization, was studied in brown egg-laying hens from 16 to 63 wk of age. The experimental design was completely randomized with 4 prelay diets organized as a 2 × 2 factorial with 2 levels of Ca (2.5 vs. 3.8%) and 2 standardized ileal digestible Lys (g/kg) to AMEn (Mcal/kg) ratios (DLys:ME; 2.84 vs. 3.13) as main effects. From 20 to 63 wk of age, all hens received a common diet with 2.75 Mcal AMEn/kg, 0.75% DLys, and 3.8% Ca. Each treatment was replicated 18 times and the experimental unit was a cage with 10 hens. Hen production and egg quality traits were measured by period (4 wk), feeding phase (prelay and lay), and cumulatively (16-63 wk of age) and tibiae mineralization was measured at 63 wk of age. During the prelay phase, an increase in Ca delayed egg production (P = 0.065), reduced feed intake (P < 0.05), and increased BW gain (P < 0.01) and percentage of shell of the egg (P < 0.05). An increase in the DLys:ME ratio increased feed intake (P < 0.01) and reduced egg size (P < 0.01). Nutrient content of the prelay diets did not affect hen production during the lay phase, except egg weight that increased (P < 0.05) in hens previously fed the low DLys:ME ratio. Eggshell quality (weight, percentage, strength, and thickness) in this phase was better (P < 0.05) in hens previously fed 3.8% Ca. Cumulatively (16-63 wk of age), hens fed the high Ca prelay diets had better shell quality but tibiae mineralization was not affected. In conclusion, an increase in Ca content of the prelay diet from 2.5 to 3.8% improved shell quality for the entire egg cycle without showing any negative effect on hen production.

Georeferenced rural distribution network model considering scalable growth of users in rural areas

This paper presents a georeferenced optimal planning model of a rural distribution network for deploying an underground network considering a real scenario for increasing electrification in this area. A model is presented based on a heuristic process that minimizes the resources required to route the grid for a defined time horizon. Then, the model is scalable according to the population density, the established and georeferenced zone, and the specified period; that is, it adjusts to any of these variables. Additionally, the modeling is presented in CYME software, considering a series of technical criteria to provide the actual scenario with a verifiable planning model of an underground network. Therefore, the voltage drop and level of overload in transformers and feeders are considered to deliver an optimum power quality to the end-user. These results will be tabulated and presented as an alternative to different planning and design models that an electric distribution company may have to minimize the resources used in an underground deployment.

Critical review of technologies for the on-site treatment of hospital wastewater: From conventional to combined advanced processes

This review aims to assess different technologies for the on-site treatment of hospital wastewater (HWW) to remove pharmaceutical compounds (PhCs) as sustances of emerging concern at a bench, pilot, and full scales from 2014 to 2020. Moreover, a rough characterisation of hospital effluents is presented. The main detected PhCs are antibiotics and psychiatric drugs, with concentrations up to 1.1 mg/L. On the one hand, regarding the presented technologies, membrane bioreactors (MBRs) are a good alternative for treating HWW with PhCs removal values higher than 80% in removing analgesics, anti-inflammatories, cardiovascular drugs, and some antibiotics. Moreover, this system has been scaled up to the pilot plant scale. However, some target compounds are still present in the treated effluent, such as psychiatric and contrast media drugs and recalcitrant antibiotics (erythromycin and sulfamethoxazole). On the other hand, ozonation effectively removes antibiotics found in the HWW (>93%), and some studies are carried out at the pilot plant scale. Even though, some families, such as the X-ray contrast media, are recalcitrant to ozone. Other advanced oxidation processes (AOPs), such as Fenton-like or UV treatments, seem very effective for removing pharmaceuticals, Antibiotic Resistance Bacteria (ARBs) and Antibiotic Resistance Genes (ARGs). However, they are not implanted at pilot plant or full scale as they usually consider extra reactants such as ozone, iron, or UV-light, making the scale-up of the processes a challenging task to treat high-loading wastewater. Thus, several examples of biological wastewater treatment methods combined with AOPs have been proposed as the better strategy to treat HWW with high removal of PhCs (generally over 98%) and ARGs/ARBs (below the detection limit) and lower spending on reactants. However, it still requires further development and optimisation of the integrated processes.

Enhanced removal of neonicotinoid pesticides present in the Decision 2018/840/EU by new sewage sludge-based carbon materials

Due to the increasingly strict legislation about the disposal of sewage sludge, it is necessary to find sustainable solutions to manage this waste at low-cost conditions. In addition, priority contaminants are now attracting much attention since they are usually detected in WWTP effluents. In this work, five sludge have been used as precursors for the synthesis of activated carbons subsequently tested in the removal by adsorption of three neonicotinoid pesticides listed in the EU Watch List: acetamiprid (ACT), thiamethoxam (THM), and imidacloprid (IMD). Generally, the activated carbons were prepared by chemical activation using ZnCl₂ as an activating agent and then the resulting materials were pyrolyzed at 800 °C for 2 h. The synthesized activated carbons showed different textural properties; thus, the best adsorption results were found for AC-Industrial activated carbon, obtained from an industrial origin sewage sludge, with high equilibrium adsorption capacities (q_e = 104.2, 137.0, and 119.9 mg g^-1), for ACT, THM, and IMD, respectively. Furthermore, it was elucidated that the use of CO₂ in the synthesis generated an opening, followed by widening, of the narrowest microporosity, increasing the specific surface area of the carbon materials. The kinetic and isotherm adsorption experimental data were obtained for each of the pesticide-activated carbon systems; thus, the kinetic curves were well-fitted to the pseudo-second-order kinetic model, as well as, Freundlich and Guggenheim-Anderson-de Boer (GAB) empirical models were used for the fitting of the equilibrium adsorption isotherms, finding that GAB model best fitted the experimental data. Additionally, the regeneration of the activated carbons using methanol as a regenerating agent and the single and simultaneous adsorption of a hospital wastewater effluent, fortified with the three studied pesticides have been explored.

Intrafraction target shift comparison using two breath-hold systems in lung stereotactic body radiotherapy

Background and purpose

In lung Stereotactic Body Radiotherapy (SBRT) respiratory management is used to reduce target motion due to respiration. This study aimed (1) to estimate intrafraction shifts through a Cone Beam Computed Tomography (CBCT) acquired during the first treatment arc when deep inspiration breath-hold (DIBH) was performed using spirometry-based (SB) or surface-guidance (SG) systems and (2) to analyze the obtained results depending on lesion localization.

Material and methods

A sample of 157 patients with 243 lesions was analyzed. A total of 860 and 410 fractions were treated using SB and SG. Averaged intrafraction shifts were estimated by the offsets obtained when registering a CBCT acquired during the first treatment arc with the planning CT. Offsets were recorded in superior-inferior (SI), left-right (LR) and anterior-posterior (AP). Significance tests were applied to account for differences in average offsets and variances between DIBH systems. Systematic and random errors were computed.

Results

Average offset moduli were 2.4 ± 2.2 mm and 3.5 ± 2.6 mm for SB and SG treatments (p < 0.001). When comparing SB and SG offset distributions in each direction no differences were found in average values (p > 0.3). However, variances were statistically smaller for SB than for SG (p < 0.001). The number of vector moduli offsets greater than 5 mm was 2.1 times higher for SG. Compared to other locations, lower lobe lesions moduli were at least 2.3 times higher.

Conclusions

Both systems were accuracy-equivalent but not precision-equivalent systems. Furthermore, the SB system was more precise than the SG one. Despite DIBH, patients with lower lobe lesions had larger offsets than superior lobe ones, mainly in SI.

Strigolactones: New players in the nitrogen-phosphorus signalling interplay

Nitrogen (N) and phosphorus (P) are among the most important macronutrients for plant growth and development, and the most widely used as fertilizers. Understanding how plants sense and respond to N and P deficiency is essential to optimize and reduce the use of chemical fertilizers. Strigolactones (SLs) are phytohormones acting as modulators and sensors of plant responses to P deficiency. In the present work, we assess the potential role of SLs in N starvation and in the N-P signalling interplay. Physiological, transcriptional and metabolic responses were analysed in wild-type and SL-deficient tomato plants grown under different P and N regimes, and in plants treated with a short-term pulse of the synthetic SL analogue 2'-epi-GR24. The results evidence that plants prioritize N over P status by affecting SL biosynthesis. We also show that SLs modulate the expression of key regulatory genes of phosphate and nitrate signalling pathways, including the N-P integrators PHO2 and NIGT1/HHO. The results support a key role for SLs as sensors during early plant responses to both N and phosphate starvation and mediating the N-P signalling interplay, indicating that SLs are involved in more physiological processes than so far proposed.

COVID-19 and chronic diabetes: the perfect storm for reactivation tuberculosis?: a case series

Background

The coronavirus disease 2019 pandemic is predicted to have a net negative effect on tuberculosis control, with an estimated excess of 6.3 million tuberculosis cases and 1.4 million deaths by 2025. Programmatic issues such as the lockdown of tuberculosis services affect all patients, while biosocial factors have a differential impact on an individual’s risk for tuberculosis or adverse tuberculosis outcomes.

Case presentation

We report three Hispanic cases of incident tuberculosis (two males, 43 and 44 years old; one female, 49 years old) after resolution of coronavirus disease episodes. Coincidentally, all cases shared a common risk factor: a chronic history poorly controlled diabetes.

Conclusions

Our findings alert to the threat posed by the synergy between coronavirus disease and diabetes, on tuberculosis reactivation. In medium- to high-risk settings for tuberculosis, we recommend implementation of routine screening for latent tuberculosis infection in these cases, and preventive tuberculosis treatment in those who are positive.

A comparative study among catalytic wet air oxidation, Fenton, and Photo-Fenton technologies for the on-site treatment of hospital wastewater

The feasibility of catalytic wet air oxidation, intensified homogeneous Fenton and heterogeneous Photo-Fenton systems for the treatment of real hospital wastewater has been investigated. Wastewater samples were collected from a hospital sewer, during a weekly monitoring program, and fully characterized. Up to seventy-nine pharmaceuticals, including mostly parent compounds and some of their transformation products, were analyzed. Catalytic wet air oxidation allowed the complete removal of several pharmaceutical groups, but it did not allow to eliminate analgesics/anti-inflammatories and antibiotics, whose average removal was around 85%. Intensified Fenton oxidation was the most efficient process for all the drugs removal with an almost complete reduction of the initial pharmaceutical load (99.8%). The heterogeneous Photo-Fenton system reached a 94.5% reduction of the initial pharmaceutical load. The environmental risk of the treated samples by the hazard quotient (HQ) method was also evaluated. Fenton oxidation was the most effective system with a final ∑HQ of 5.4. Catalytic wet air oxidation and Photo-Fenton systems achieved total ∑HQ values of 895 and 88, respectively. This fact was related to the presence of refractory antibiotics in the treated catalytic wet air oxidation samples. On the opposite, the Photo-Fenton system provided the elimination of most pharmaceutical pollutants that pose a high environmental risk such as antibiotics. Simplified cost estimation was finally performed as a preliminary approach of the economy of the three oxidation processes for the hospital wastewater treatment.

Influence of the energy and digestible lysine contents of the diet on performance and egg quality traits of brown-egg laying hens from 19 to 59 weeks of age

The influence of nutrient density and standardized ileal digestible lys (DLys) content of the diet on egg production and egg quality traits, was studied in brown-egg laying hens from 19 to 59 wk of age. The experimental design was completely randomized with eight treatments arranged as a 2×4 factorial with two AMEn concentrations (2,680 and 2,780 kcal/kg) and four levels of DLys (0.68, 0.72, 0.76, and 0.80%). Each treatment was replicated nine times and the experimental unit was a cage with nine hens. Hen production, egg components (proportion of albumen, yolk, and shell), egg quality traits (Haugh units, egg shell strength, and incidence of broken, dirty, and shell-less eggs) were measured by period (28 d) and cumulatively. Data were analyzed as a completely randomized design with energy concentration, level of DLys, and their interactions as main effects. In addition, the effects of the level of DLys on the variables studied, were partitioned into its linear and quadratic components. No interactions between AMEn and DLys content of the diet were detected for any of the traits studied and therefore, only main effects are presented. An increase in the AMEn concentration of the diet from 2,680 to 2,780 kcal/kg increased energy intake (P < 0.05) and egg weight (P < 0.001) and improved feed conversion ratio (P < 0.05). An Increase in DLys from 0.68 to 0.80% did not affect the number of eggs produced but increased linearly egg weight (P < 0.01) and egg mass production (P < 0.05). Diet did not affect egg quality. In conclusion, an increase in the AMEn content of the diet from 2,680 to 2,780 kcal/kg increased egg weight and improved feed efficiency. Laying hens require no more than 744 mg DLys/d (corresponding to 0.68% DLys) to optimize egg production. However, when the objective is to maximize egg weight, hens should consume at least 843 mg DLys/d (corresponding to 0.76% D Lys).

5-year results of accelerated partial breast irradiation (APBI) with SBRT (stereotactic body radiation therapy) and exactrac adaptive gating (Novalis®) for very early breast cancer patients: was it all worth it?

PURPOSE

To explore the feasibility of image-guided and respiratory-gated Stereotactic Body Radiation Therapy (SBRT) for Accelerated Partial Breast Irradiation (APBI) in patients with very early breast cancer.

MATERIAL AND METHODS

Selected patients with early breast carcinoma after breast-conserving surgery were enrolled in this phase II trial. A fiducial marker was percutaneously placed close to surgical bed and five external fiducials were set on the skin. A CT scan for planning was acquired at free breathing. The treatment was planned and DVH were assessed according to international recommendations. Prescription dose was 30 Gy in five consecutive fractions of 6 Gy. A 6MV monoenergetic LINAC (linear accelerator) that combines stereoscopic X-ray imaging system and ExacTrac Adaptive Gating technique was used. PTV (planning target volume) intrafraction motion was controlled and PTV was irradiated in a selected gated area of the respiratory cycle. Shifts for a correct, gated set-up were calculated and automatically applied.

RESULTS

Between April 2013 and October 2015, a total of 23 patients were included. The median tumor size was 12 mm. The mean PTV volume was 114 cc. The mean ipsilateral lung V9 Gy was 2.2% and for left-sided breast cancers, the volume of the heart receiving 1.5 Gy was 11.5%. Maximum skin dose was 30.8 Gy. Acute toxicity was grade1 in all the patients and 100% experienced excellent/good breast cosmesis outcomes. With a median follow-up of 66 months (range 8-99 months) local-relapse-free-survival reaches 100%. One patient developed a second breast cancer outside the treated quadrant after 25.1 months.

CONCLUSION

APBI with SBRT and ExacTrac Adaptive Gating System was feasible. The acute and late toxicities were almost null and cosmesis was excellent. We also found that the margins of 5 mm applied from CTV to PTV were sufficient to compensate for geometric uncertainties.

New insights on the removal of diclofenac and ibuprofen by CWPO using a magnetite-based catalyst in an up-flow fixed-bed reactor

This research has been focused on the removal of two anti-inflammatory drugs, diclofenac (DCF) and ibuprofen (IBU), by a continuous catalytic wet peroxide oxidation (CWPO) process using a lab-synthesized nanomagnetic catalyst (Fe₃O₄/MWCNTs). The central composite rotatable design (CCRD) method was used to study the effect of DCF and IBU concentration (expressed as theoretical oxygen demand (ThOD) between 0 and 52.5 mg L^-1) and of the feed stream pH (from 3 to 7) on the removal of total organic carbon (TOC) and the concentration of aromatic compounds (Arm) and total phenolic compounds (TP) by CWPO. It could be observed that DCF was preferably removed from the DCF-IBU aqueous mixture at pH values ranging from 3 to 5. In addition, feed stream pH had a significant effect on the pollutants removal, as well as on TOC, TP and aromatic compounds removal, observing an increasing in the pollutants degradation when feed stream pH decreased from 7 to 3. Quadratic models predicted for response variable, such as TOC, TP and aromatic compounds removal, and their maximum model-predicted removal values were of 90.0, 80.2 and 90.0%, respectively. Finally, as a proof of concept, three environmentally-relevant aqueous matrices, spiked with DCF-IBU mixture, were treated. In this case, relatively high TOC degradation values were found after 20 h reaction time (ca. 57.7, 73.9 and 54.5% in surface water, WWTP effluent and hospital wastewater, respectively). This work deals the first study about DCF-IBU removal in aqueous solution by CWPO, as well as a continuous study using real wastewater that allow to extend the experimental results to a real scenario.

Manufacturing parameter analysis for alumina coating on steel substrate by automated image processing of isolated splats samples

Thermal spray technology, which involves the Atmospheric Plasma Spraying (APS), encompasses a category of coating processes that supply surface properties to protect or improve the performance of a substrate or component. The coating produced by this technology is built by overlapped splats, whose morphology determines the coating properties. In the same way, the splats obtained in a separated distribution by interposing a perforated mask but using the same thermal spray parameters, has a relationship with the overlapped splats inside the coating. The samples with isolated splats have the advantage of being faster and cheaper to generate and analyse. This article analyses alumina plasma-sprayed splats on steel substrates by image processing techniques, which recognize individual splats and their corresponding morphology (doughnut and pancake) parameters. These parameters allow the user to efficiently classify the splats. After that classification, a quality control can be implemented by comparison between the original and checked sample of isolated splats and a new sample obtained during a small interruption in the normal operation. Additionally, these parameters obtained in an automated way can be used to evaluate the effect of different selections of spraying process parameters.

Enhanced removal of the endocrine disruptor compound Bisphenol A by adsorption onto green-carbon materials. Effect of real effluents on the adsorption process

The high exposure to the endocrine disrupting compounds (EDC) in water represents a relevant issue for the health of living beings. The xenoestrogen Bisphenol A (BPA), a suspected EDC, is an industrial additive broadly used for manufacturing polycarbonate and epoxy resins. Due to its harmful effect in humans and the aquatic environment, an efficient method to remove BPA from wastewater is urgently required. The present work aims to study the adsorption of BPA from aqueous solutions onto carbonaceous materials, e.g., a synthesized carbon xerogel (RFX), a chemical-activated carbon from Kraft lignin (KLP) and a commercial activated carbon (F400) for comparative purposes. Batch kinetic and adsorption tests of BPA in ultrapure water were accomplished, finding higher adsorption capacities of BPA onto both F400 activated carbon (q_sat = 407 mg g^-1) and the biochar KLP (q_sat = 220 mg g^-1), versus to that obtained for the xerogel (q_sat = 78 mg g^-1). Furthermore, kinetic experiments revealed faster kinetic adsorption for RFX and KLP materials, achieving the equilibrium time within 24 h, attributed to their more-opened porous structure. Pseudo-first order, pseudo-second order, Elovich, intra-particle diffusion and film diffusion models were used to fit the experimental data. Thus, the BPA adsorption isotherms were analysed by Langmuir, Freundlich, Sips, Redlich-Peterson and Dual-site Langmuir (DLS) isotherm models.In addition, the influence of different aqueous matrices, such as a hospital wastewater, a wastewater treatment plant (WWTP) effluent and a river water, on BPA removal efficiency has been explored. These adsorption tests revealed a clear competitive effect between the target compound (BPA) and the natural organic matter content (NOM) present in the matrices for the active sites, resulting in a high decreasing of BPA adsorption removal.

Compatibility between Leptolegnia chapmanii and diflubenzuron and neem oil for the control of Aedes aegypti

Leptolegnia chapmanii is pathogenic to mosquito larvae. The compatibility between L. chapmanii and two insect growth regulators (IGR), diflubenzuron and neem oil, was evaluated. L. chapmanii was grown on culture media containing different concentrations of each IGR. The mycelial growth was significantly reduced with the highest concentrations of IGR (F_6,98=268, p<0.05). However, the production of zoospores (F_6,56=0.93, p>0.05) and the larval mortality of Aedes aegypti (F_6,56=0.95, p>0.05) were not significantly different among treatments. Furthermore, the percentage of adult emergence in the presence of different concentrations of diflubenzuron or a neem formulation was determined, and the pathogenic activity of zoospores was evaluated at the concentrations that inhibit the emergence at 30, 50 and 90%. The pathogenicity of zoospores was not significantly different among treatments (F_6,14=0.54, p>0.05), and the larval mortalities were above 90% in all cases.

AB0726 CHOROIDAL THICKNESS IS A BIOMARKER AND CAN PREDICT THE RESPONSE TO TREATMENT IN ANKYLOSING SPONDYLITIS

Background:

Choroidal thickness (CT) has been proposed and evaluated as a potential marker of systemic inflammation associated with inflammatory diseases as Ankylosing spondylitis (AS). Patients with active AS have a thicker choroid than healthy subjects, regardless of eye inflammation. The evolution of choroid after treatment is poorly known.

Objectives:

This study evaluates the CT of patients with severe AS disease activity before and after six months of biological therapy.

Methods:

This prospective multicenter study evaluates the CT in 44 patients with high AS disease activity, naïve for biological treatment, and no history of eye inflammation before and after six months of biological therapy, aged from 18 to 65 years. The correlations between the CT and C-reactive protein (CRP) with the disease activity indices and scales as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), night pain and Patient Global Assessment (PGA) were calculated at baseline and after six months of biological therapy. The concordance between the CT and CRP was determined. Finally, we assessed potential predictors of response to treatment. Clinically important improvement was defined as a decrease in ASDAS score ≥ 1.1 points.

Results:

Globally, 44 eyes of 44 patients aged between 18-65 years were included in the study, 12 (27%) women. The biological treatments prescribed were: Adalimumab 13 (29.5%), Certolizumab 9 (20.5%), Secukinumab 10 (20%), Etanercept 8 (18%), Infliximab 3 (6.8%), and Golimumab 1 (2.2%).

Mean CT values were significantly higher at baseline than after six months of treatment (baseline 355.28±80.46 µm; 6 months, 341.26±81.06 µm) (p<0.001).

CT decreased both in patients on biological treatment without effect in eye (Secukinumab and Etanecept; p=0.024) and in patients on treatment with effect in eye (other; p=0.005). Also, CRP, BASDAI, night pain and PGA decreased after six months of treatment ((p<0.001, p<0.001, p<0.001, p<0.001). We found a 95% concordance between CT and CRP at baseline and 6 months.

Multivariable analysis showed that clinically important improvement was associated with higher CT and age as independent factors (OR 0.97, CI95% 0.91-0.93; p=0.009, and OR 0.81, CI95% 0.7-0.95; p=0.005). Clinically important improvement was associated with basal CT >374 µm (sensitivity 78 %, [CI 95% 60-90], specificity 78% [CI 95% 52-92], area under the curve of ROC, 0.70, likelihood ratio 3.6).

Conclusion:

CT decreased significantly after six months of biological treatment. CT and CPR had a 95% concordance. A high CT is associated with risk of failure to biological treatment. CT can be considered as a useful biomarker of inflammation and predictor of response to treatment in AS.

References:

[1]Karkucak M, Kalkisim A, Kola M, et al. SAT0408 anti Tnf-α therapy provides beneficial effects on choroidal thickness increase in patients with active ankylosing spondylitis: a possible mechanism of infliximab effectiveness in suppressing uveitis attacks.Ann Rheum Dis. 2016;75:817.

Disclosure of Interests:

None declared

Prognostic impact of diagnostic and treatment delays in children with osteosarcoma

BACKGROUND

The aim of this study is to evaluate the relationship between the latency to diagnosis (LD) and the time to completion of chemotherapy (TCC) with clinical outcomes in children with osteosarcoma.

METHODS

We performed a retrospective analysis of all patients who received treatment for osteosarcoma in two tertiary centers in Peru from 2008 to 2015. All causes of delayed LD or TCC were evaluated. Overall survival (OS) and event-free-survival (EFS) were estimated and compared according to LD, TCC, and established clinical prognostic factors.

RESULTS

One hundred and thirteen patients were included in the study. The median LD was 13.5 weeks (interquartile range, 10-18.5 weeks). No association was observed among clinical stage, tumor size, and LD. Delayed LD was not associated with a worse clinical outcome. Multivariate analysis confirmed that OS and EFS were significantly worse in cases of a delayed TCC (≥4 weeks), with hazard ratios of 2.70 (1.11-6.76, P = 0.003) and 1.13 (1.00-1.26, P = 0.016), respectively. Most delays in TCC (85%) were due to extramedical reasons (e.g., lack of available hospital beds).

CONCLUSION

The LD did not seem to influence the EFS and OS in pediatric patients with osteosarcoma. However, a delay in TCC from any cause is independently associated with poor outcome in pediatric patients with osteosarcoma. Based on these results, further efforts may be needed to avoid treatment delays in patients with osteosarcoma in middle-income countries.

A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer

PURPOSE/OBJECTIVE(S)

To improve the curative resection rates and prognoses, a variety of neoadjuvant (NA) strategies have been explored in PDAC. In our institution, non-metastatic PDACs have been treated with a NA intent with induction multiagent chemotherapy and SBRT. The primary endpoint was to increase R0 resection rate. The secondary endpoints were the analysis of the clinical tolerance, the pathological response, the local control (LC) and the OS.

MATERIALS/METHODS

All consecutive patients with non-metastatic PDAC underwent SBRT as part of the NA strategy were included. A total dose of 40-62 Gy were delivered in 5-10 fractions. Surgery was performed after SBRT and restaging.

RESULTS

Since February 2014 to December 2018, 45 patients were enrolled. Thirty-two patients underwent surgery (71.1%), 10 out of 15 were initially unresectable disease patients (66.75%). R0 resection rate was 93% (30 patients) and pN0 status was achieved in 20 patients (60.6%). Tumour regression grade (TRG): 12 patients with complete response or marked response (TRG 0-1: 37.5%), 16 patients with moderate response (TRG 2: 50%) and four patients with poor response (TRG 3: 12.5%). The median follow-up was 16.2 m (range 6.6-59.6 m) since diagnosis. The LC rate achieved was very high (95.5%). Actuarial 12 and 24 m OS was 67.4% and 35.9% respectively. No grade 3 or higher toxicity related to SBRT was observed.

CONCLUSION

The results are encouraging, suggesting that SBRT has a significant role in the management of these patients and further studies will be necessary to prove these findings.

Influence of egg weight and inclusion of oat hulls in the diet on digestive tract traits and growth performance of brown pullets reared under stress conditions

We studied the influence of pre-hatch egg weight (EW) and the inclusion of oat hulls (OH) in the diet on gastrointestinal tract (GIT) traits and growth performance of pullets reared under stress conditions early in life. There were 14 treatments organized as a 7 × 2 factorial with 7 EW groups (47.0 to 54.0 g differing in 1 g between groups) and 2 inclusion levels of OH in the diet (0 vs. 3%). The pullets were reared under a series of stresses early in life (no access to feed for extended time post-hatching, reduced accessibility to feed and water at arrival to the farm, reduced ambient temperature at night, low light intensity, and hot-blade beak trimming at 18 D of age). Feed intake, BW gain, and FCR were measured by period (0 to 5, 5 to 10, and 10 to 16 wk of age) and cumulatively. Data were analyzed as a completely randomized design with EW and OH inclusion as main effects. In addition, EW effect was partitioned into linear and quadratic components. The stress conditions applied affected similarly the growth and GIT development of the pullets, independent of EW. An increase in EW increased BW at hatch and at 5 wk of age linearly (P < 0.05), but no effects were detected thereafter. Oat hulls inclusion increased ADFI and impaired FCR (P < 0.05) from 0 to 5 wk of age but did not affect energy efficiency at any age. At 5 wk of age, the relative weight (% BW) of the GIT decreased linearly (P < 0.05) with increases in EW and increased with OH inclusion (P < 0.05). Oat hulls inclusion increased the relative weight of the gizzard at all ages (P < 0.01). In conclusion, egg weight did not affect pullet growth from hatch to 16 wk of age. Independent of the initial BW of the pullets, OH inclusion improved gizzard development at all ages without affecting growth performance.

New insights from modelling and estimation of mass transfer parameters in fixed-bed adsorption of Bisphenol A onto carbon materials

The removal of Bisphenol A, 2,2-bis (4-hydroxyphenyl) propane (BPA) in fixed-bed columns was investigated by breakthrough adsorption tests at different operation conditions and further prediction by a mathematical model to describe the adsorption-diffusion process onto two synthesized carbon porous materials. In this study, a xerogel (RFX) prepared by an optimized conventional sol-gel method and a lignin-based activated carbon (KLP) obtained via chemical activation were used in batch and fixed-bed adsorption experiments. The materials were fully characterized and their adsorptive properties were compared to those obtained with a commercial activated carbon (F400). RFX and KLP materials reached the equilibrium adsorption in only 24 h, whereas F400 activated carbon required 48 h. In addition, F400 and KLP adsorbents showed higher equilibrium adsorption capacity values (q_e = 0.40 and 0.22 kg/kg, for F400 and KLP, respectively) than that obtained for the xerogel (q_e = 0.08 kg/kg). Both synthesized carbon-adsorbents were studied in fixed-bed adsorption tests, exploring the effect of the operation conditions, e.g., initial BPA concentration (0.005-0.04 kg/m³), weight of adsorbent (0.01-0.05 g) and volumetric flow rate (0.2 to 1.0 mL/min), on the adsorption performance of the column. All the tested adsorption columns reached the equilibrium in a very short time, due to the efficient dimensionless of the bed. Additionally, the regeneration of the exhausted adsorbent was studied, achieving the total reuse of the solids after three consecutive cycles using methanol as regeneration agent. Finally, a mathematical model based on mass conservation equations was proposed, allowing to efficiently fit the experimental BPA breakthrough curves and estimate the external and adsorbed-phase mass transfer coefficients with a high accuracy.

Micafungin as antifungal prophylaxis in non-transplanted haemotological patients

OBJECTIVE

Fungal infections are a major cause of morbidity and mortality in the haematological patients. These infections are mainly due to Candida spp. and Aspergillus spp. Mortality by these infections is high, but rates have descended in the latest series due to better antifungal agents. Echinocan-dins are, in vitro, very active against Candida and Aspergillus spp. The objective of the study is to analyse the efficacy and safety of micafungin in the antifungal prophylaxis of haema-tological patients on chemotherapy.

METHODS

A multicentre, observational retrospective study was performed in 7 Haematology Depart-ments in Spain. Patients admitted to these departments with chemotherapy or immunosuppressive treatment, and who had received antifungal prophylaxis with micafungin between 1 January 2009 and 31 December 2014 were included.

RESULTS

There were 5 cases of probable or proven fun-gal infection (4.8%) according to the 2008 EORTC criteria: 2 proven, 3 probable. The types of fungal infection were 3 as-pergillosis and 2 candidiasis. There were no drop-outs from the prophylaxis with micafungin due to toxicity.

CONCLUSIONS

Micafungin is an antifungal agent which, used in prophylaxis, has demonstrated good efficacy and an excellent toxicity profile, making it an apparently interesting option in patients requiring antifungal prophylaxis during their hospitalisation episode.

Influence of beak trimming and inclusion of sodium butyrate in the diet on growth performance and digestive tract traits of brown-egg pullets differing in initial body weight

We studied the effects of beak trimming and sodium-butyrate inclusion in the diet on growth performance and gastrointestinal tract (GIT) traits of brown-egg pullets differing in initial BW. In experiment 1, a total of 6 treatments were organized as a 2 × 3 factorial with 2 BW at hatch (light, 33.9 g and heavy, 37.6 g) and 3 beak trimming protocols [mild (MI-0) or aggressive (AG-0) infrared power setting at hatch and traditional hot blade at 8 D of age (HB-8)] as main effects. Initial BW did not affect growth performance or GIT traits at any age. From hatch to 5 wk of age, HB-8 pullets had lower ADFI (P < 0.01) and ADG (P < 0.05) than MI-0 and AG-0 pullets but no differences were detected after this age. Beak trimming did not affect FCR, BW uniformity, GIT traits, or bacteria count in the excreta at any age. In experiment 2, a total of 12 treatments were organized as a 2 × 3 × 2 factorial, with 2 BW at hatch, 3 beak trimming protocol (as per in experiment 1), and 2 levels of a sodium-butyrate additive (0 vs. 0.3%) as main effects. At 7 D of life, beak treatment reduced pullet growth and AG-0 procedure impaired pullet uniformity (P < 0.001) but the birds recovered completely by day 14 (P < 0.001 for the interaction with time). Cumulatively (0 to 6 wk of age), pullets beak treated at hatch (MI-0 and AG-0) had greater ADFI than HB-8 pullets (P < 0.01). Sodium butyrate tended to improve ADG (P = 0.073) and FCR (P = 0.069) with most of the benefits observed for the first 2 wk of life. In summary, initial BW and beak trimming procedure did not affect final pullet growth in any of the 2 experiments, or GIT traits in experiment 1. Sodium butyrate tended to improve growth and FCR from 0 to 6 wk of age but did not affect BW uniformity.

Magnetic Fe3O4/multi-walled carbon nanotubes materials for a highly efficient depletion of diclofenac by catalytic wet peroxideoxidation

The aim of this work is to synthesize a magnetic magnetite/multi-walled carbon nanotube (Fe₃O₄/MWCNT) catalyst by a method combining co-precipitation and hydrothermal treatments for the efficient removal of diclofenac (DCF) by catalytic wet peroxide oxidation (CWPO). The support (MWCNTs) shows a moderate-large surface area and good adsorption capacity, leading to the improvement of the magnetite (Fe₃O₄) dispersion on its surface. The response surface methodology (RSM) was applied in order to find out the effect of the reaction parameters on DCF removal, allowing to establish the optimum operating conditions (T = 60 °C, [H₂O₂]₀ = 2.7 mM, [catalyst] = 1.0 g L^-1). The optimum CWPO experiment showed an outstanding catalytic activity at non-modified pH solution (6.7), obtaining a 95% of DCF removal after 3 h reaction time; this high efficiency can be attributed to the synergistic effect of the iron-based catalyst with the high quantity of ^•OH radicals generated on the surface of the catalyst. In addition, the Fe₃O₄/MWCNT material exhibited good reusability along three consecutive reaction cycles, finding a pollutant removal close to 95% in each cycle of 3 h reaction time. Additionally, a degradation mechanism pathway was proposed for the removal of DCF by CWPO. The versatility of the material was finally demonstrated in the treatment of different environmentally relevant aqueous matrices (a wastewater treatment plant effluent, surface water, and hospital wastewater), obtaining an effective reduction in the ecotoxicity values.

Equine pythiosis in the eastern wetlands of Uruguay

ABSTRACT: Equine pythiosis is an ulcerative and granulomatous disease of the skin, caused by the oomycete Pythium insidiosum (Pythiaceae). The objective of this study was to describe seven cases of equine pythiosis that occurred from 2012 to 2017 in the eastern region of Uruguay. Six of the seven cases occurred in the eastern wetland ecosystems of the Merin basin, and the remaining case occurred in the wetland fluvial plains of the Tacuarembó River. Lesions consisted of a large, rapidly growing ulcerated tumor with abundant granulation tissue, serosanguineous secretion, and fistulous tracts containing large concretions or kunkers. The animals presented intense pruritus, claudication and loss of body condition, with death or euthanasia in extremis in six cases. The main histological lesions consisted of an eosinophilic and pyogranulomatous inflammatory process, with numerous foci of eosinophilic necrosis (kunkers), collagenolysis, and a Splendore-Hoeppli reaction. In all cases, silver coloration (Grocott) showed intralesional hyphae compatible with P. insidiosum, which was confirmed by immunohistochemistry in three cases. A horse in the terminal phase of the disease was treated with triamcinolone acetonide (50mg IM every 15 days), and fully recovered after 1 year. It is concluded that equine pythiosis is prevalent in the wetland ecosystems of eastern Uruguay and that treatment with triamcinolone is auspicious.