Notes

Efficient super-bandwidth within lazer pulses.
The reverse osmosis (RO) process has been increasingly applied to landfill leachate treatment. The published literature reports several studies that investigated the technical feasibility of RO. However, information about process costs is scarce. Also, companies that run leachate treatment plants do not provide actual costs. To fill this gap, this study aimed to evaluate the treatment costs of a full-scale RO for the treatment of landfill leachate located in Rio de Janeiro State, Brazil. A procedure was proposed to estimate the capital expenses (CAPEX), operational expenses (OPEX), and specific total treatment cost, the total cost per m3 of treated leachate, of the leachate treatment by membrane process, and the results obtained are discussed. The CAPEX for this full-scale RO was estimated at MUS$ 1.413, and OPEX ranged from US$ 0.132 to US$ 0.265 m-3 per year. The cost of leachate treatment has been estimated at US$ 8.58 m-3 considering the operation of the RO-unit for 20 years after landfill closure.Coumarins have been shown to possess antimicrobial, anti-quorum sensing and anti-biofilm properties against a wide range of pathogenic bacteria. This study aimed to shed light on the effects of non-substituted coumarin on biofilm formation by the foodborne pathogen Salmonella Typhimurium. Additionally, its efficacy was tested in combination with another potent anti-biofilm agent, resveratrol. Coumarin inhibited biofilm formation for prolonged periods in millimolar concentrations with marginal effects on planktonic growth. It attenuated curli and cellulose production, likely by downregulating the transcript levels of major biofilm formation genes csgD, csgA and adrA. Coumarin further restricted motility in a dose-dependent manner. In addition, coumarin with resveratrol exhibited improved anti-biofilm properties compared with the individual compounds alone. Thus, coumarin alone or with resveratrol can be employed for inhibiting biofilms in food storage and processing units.Purpose To report cases of uveitis induced by biological therapy given for cancer. Methods Retrospective review of medical charts of patients. Results Included were six patients aged 14-81 years. Three were treated with vemurafenib and one each with nivolumab, ipilimumab, and osimertinib. The oncological diagnoses were metastatic thyroid carcinoma, pleomorphic xanthoastrocytoma, metastatic melanoma, adenocarcinoma of the lung, and metastatic breast cancer. Ocular manifestations appeared 4-82 weeks after the biological treatment was initiated. The most common ocular presentation was anterior uveitis. Onset was sudden in all cases. The median duration of uveitis was 70 weeks. Treatment included topical or systemic corticosteroids; one patient received a single intravitreal steroid injection in one eye. Conclusions Uveitis may rarely be induced by treatment with biological agents for cancer. Both oncologists and ophthalmologists should be aware of this potential side effect. Early detection and management can prevent permanent complications and save the patient's vision.Insufficient automatization of the alphabet may falsely impair performance on the Trail Making Test among persons with dyslexia or persons not accustomed to the Latin alphabet. We analyze whether writing the alphabet on top of the test sheet changes performance in these risk groups, and whether alphabet support reduces the complexity of the set-shifting task.One-hundred and seventy patients referred to neuropsychological assessment participated and were given both a TMT-version offering alphabet support and the D-KEFS TMT. The discrepancy between the D-KEFS subtask where lines are drawn successively between numbers only, and the task where lines are drawn between letters only, was operationalized as measuring insufficient alphabet automatization.Both the possible dyslexia group, and persons taught to read with another alphabet, had a larger discrepancy score than the remaining sample. Regression analyses showed that the discrepancy scores explained 3.4% of the variance beyond age and speed when giving alphabet support. The corresponding percentage for the D-KEFS Switching task was 17.5%. The findings indicate that alphabet support alleviated effects of non-automatization. The TMT-B-NR TMT-A ratio score was equivalent to what is found when not applying alphabet support, showing that alphabet support did not contaminate the test as a EF-measure.The phase 2 portion of this open-label phase 2/3 study assessed the efficacy and safety of blinatumomab as second salvage for aggressive relapsed or refractory (r/r) aggressive B-cell non-Hodgkin lymphoma (B-NHL) following platinum-based first salvage chemotherapy. Forty-one patients with aggressive disease (32% relapsed; 68% refractory) enrolled and received stepwise blinatumomab (9-28-112 μg/day) in a 70-day cycle 1 and an optional 28-day cycle 2; 19 (46%) completed cycle 1 and 3 (7%) completed cycle 2. The overall response rate after 12 weeks was 37%, including 9 (22%) complete metabolic responses. Eight (20%) patients (all responders) subsequently received stem cell transplants. Grade ≥3 adverse events were reported in 29 (71%) patients. check details Grade 3 cytokine release syndrome occurred in one patient. Grade 3 neurologic events occurred in 10 (24%) patients; all resolved. Blinatumomab monotherapy appears effective as second salvage therapy in patients with r/r aggressive B-NHL. Trial registration NCT02910063.Unmet need for postpartum contraception in rural Nepal remains high and expanding access to sexual and reproductive healthcare is essential to achieving universal healthcare. We evaluated the impact of an integrated intervention that employed community health workers aided by mobile technology to deliver patient-centred, home-based antenatal and postnatal counselling on postpartum modern contraceptive use. This was a pre-post-intervention study in seven village wards in a single municipality in rural Nepal. The primary outcome was modern contraceptive use among recently postpartum women. We performed a multivariable logistic regression to examine contraceptive use among postpartum women pre- and one-year post-intervention. We conducted qualitative interviews to explore the implementation process. There were 445 postpartum women in the pre-intervention group and 508 in the post-intervention group. Modern contraceptive use increased from 29% pre-intervention to 46% post-intervention (p less then 0.0001). Adjusting for age, caste, and household expenditure, time since delivery and sex of child in the index pregnancy, postpartum women one-year post-intervention had twice the odds (OR 2.3; CI 1.7, 3.1; p less then 0.0001) of using a modern contraceptive method as compared to pre-intervention. Factors at the individual, family, and systems level influenced women's contraceptive decisions. The intervention contributed to increasing contraceptive use through knowledge transfer, demand generation, referrals to healthcare facilities, and follow-up. A community-based, patient-centred contraceptive counselling intervention supported by mobile technology and integrated into longitudinal care delivered by community health workers appears to be an effective strategy for improving uptake of modern contraception among postpartum women in rural Nepal.Background Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant disorder caused by mutations in the M918T.We examined whether the association between psychological distress (depression, anxiety and stress) and diabetes-related quality of life (DRQoL) among type 2 diabetes Mellitus (T2DM) patients in Nigeria was moderated by enacted support (ES). Participants were 279 T2DMpatients (Mage = 59.65, SD 11.57) conveniently sampled from three tertiary health-care institutions in Enugu State, Nigeria. Participants completed measures of diabetes-related Quality of Life, depression, anxiety, and stress. Results showed that ES moderated the relationship between anxiety and DRQoL. Moderation graph revealed that for participants with low and moderate ES, anxiety was positively associated with DRQoL. ES also moderated the association between stress and DRQoL. The moderation graph showed that for participants with low and moderate ES, stress was negatively associated with DRQoL. ES did not, however, moderate the association between depression and DRQoL. Our findings suggest the levels of supports for diabetes management behaviours that may be helpful toT2DM patients. This could guide health managers in developing strategies that might prevent or ameliorate the impact of psychological distress.Mitragyna speciosa (Kratom) is a psychotropic tropical tree that is indigenous to Southeast Asia, Africa and New Guinea. Kratom has gained popularity in the United States in more recent years as an opioid agonist. Although Kratom is considered an opioid agonist with abuse potential, its use is not federally regulated. We report on a 47 year-old male presenting to our clinic for treatment of an opioid use disorder. This began with the use of prescription opioids from a doctor, and when this was no longer available this patient started using Kratom. He had used Kratom for one year to treat opioid withdrawal symptoms and chronic pain, resulting in worsening depression, anxiety and pain. He experienced tolerance and withdrawal symptoms related to Kratom. He was initiated on buprenorphine-naloxone at home with improved pain management. Four months after initiation, the patient's depression and anxiety symptoms resolved, and he was able to discontinue his antidepressant and anxiolytic medications. Kratom dependence and withdrawal appear similar to that of opioids, and may also lead to worsening depression and anxiety. Buprenorphine-naloxone may be a viable option to consider for treating opioid use disorder complicated by Kratom use, chronic pain, and depression.Breast cancer ranks first among cancers affecting women's health. Our work aims to realize the intelligence of the medical ultrasound equipment with limited computational capability, which is used for the assistant detection of breast lesions. We embed the high-computational deep learning algorithm into the medical ultrasound equipment with limited computational capability by two techniques (1) lightweight neural network considering the limited computational capability of ultrasound equipment, a lightweight neural network is designed, which greatly reduces the amount of calculation. And we use the technique of knowledge distillation to train the low-precision network helped with the high-precision network; (2) asynchronous calculations consider four frames of ultrasound images as a group; the image of the first frame of each group is used as the input of the network, and the result is respectively fused with the images of the fourth to seventh frames. An amount of computation of 30 GFLO/frame is required for algorithms.Objective To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG). Design A two-group randomized controlled trail. Setting Ambulatory prehabilitation. Subjects Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115). Intervention IG two-week EBPrehab including supervised aerobic exercise. CG usual care. Main measures At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire). Results A total of 171 patients (IG, n = 81; CG, n = 90) completed the study. During EBPrehab no complications occurred.
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