Fatal Outcome of Multiple Clinical Presentations of Human Herpesvirus 8-related Disease After Solid Organ Transplantation.

Kaposi sarcoma is the most common human herpesvirus 8 (HHV-8)-related disease described after solid organ transplantation. Multicentric Castleman disease and hemophagocytic syndrome are other potential HHV-8-induced entities but are less frequently reported. We describe the case of a liver transplant recipient who presented with an acute febrile illness 1 year after transplantation with a rapidly fatal outcome. Autopsy revealed 3 distinct HHV-8-related entities: Kaposi sarcoma, HHV-8-associated multicentric Castleman disease with microlymphomas and a severe hemophagocytic syndrome. Retrospective serologic tests suggested that HHV-8 was likely transmitted by the seropositive donor at the time of transplantation. To our knowledge, this is the first case of copresentation of 3 clinical presentations of HHV-8-mediated human disease in the post-transplant setting. Considering the absence of systematic screening of organ donors/recipients for HHV-8 infection, HHV-8-related illness should be suspected in transplant recipients who present with acute febrile illness, systemic symptoms, lymphadenopathies, and/or multiorgan failure to rapidly document the diagnosis and provide timely an adequate treatment.

Privatization, cooperation and costs of solid waste services in small towns

This paper analyzes the cost implications of privatization and cooperation in the provision of solid waste services for a sample of small municipalities. In conducting this empirical analysis, a survey is first designed and administered to municipalities in the Spanish region of Aragon, and then an estimation of the determinants of service costs is undertaken, considering the possible endogeneity of delivery choices. Our findings indicate that cooperation is more effective than privatization in saving costs. Both production forms can enable small municipalities to cut costs by exploiting scale economies. However, the fact that inter-municipal cooperation involves lower transaction costs and is less likely to be affected by competition problems would seem to account for the fact that it is a more effective way of reducing costs.

Materials selection for superheater tubes in municipal solid waste incineration plants

Corrosion reduces the lifetime of municipal solid waste incineration (MSWI) superheater tubes more than any other cause. It can be minimized by the careful selection of those materials that are most resistant to corrosion under operating conditions. Since thousands of different materials are already known and many more are developed every year, here the selection methodology developed by Prof. Ashby of the University of Cambridge was used to evaluate the performance of different materials to be used as MSWI superheater tubes. The proposed materials can operate at steam pressures and temperatures over 40 bars and 400ºC, respectively. Two case studies are presented: one makes a balanced selection between mechanical properties and cost per thermal unit; and the other focuses on increasing tube lifetime. The balanced selection showed that AISI 410 martensitic stainless steel (wrought, hard tempered) is the best candidate with a good combination of corrosion resistance, a relatively low price (0.83-0.92 e/kg) and a good thermal conductivity (23-27 W/m K). Meanwhile, Nitronic 50/XM-19 stainless steel is the most promising candidate for longterm selection, as it presents high corrosion resistance with a relatively low price (4.86-5.14 e/kg) compared to Ni-alloys.

Histopathology and prognosis of de novo bladder tumors following solid organ transplantation.

BACKGROUND: Patients following solid organ transplantation have an increased risk of developing de novo bladder tumors, but their biology is poorly characterized. METHODS: We studied 1743 patients who underwent a transurethral resection of a newly diagnosed bladder tumor at a single institution. The histopathology, treatment, recurrence-free survival and overall survival were evaluated and compared between transplant and non-transplant patients. RESULTS: We identified 74 transplant patients who developed a de novo bladder tumor after a median post-transplantation interval of 62 months. The tumor was malignant in 29 patients (39 %). The most common benign lesion was nephrogenic adenoma (84 %), which neither coexisted with nor developed into malignant tumors during follow-up. Compared with non-transplant patients (n = 1669), transplant patients were significantly younger (median 55 vs 69 years, P < 0.001) and had a 9.0-fold higher odds of benign tumors (P < 0.001), while there were no differences in pathology among patients with urothelial carcinoma of the bladder (UCB). In a multivariable analysis for non-muscle-invasive UCB that was adjusted for the risk group, patients with a transplant had a 1.8-fold increased risk of recurrence (P = 0.048). Four of five transplant patients did not respond to Bacillus Calmette-Guérin instillations. There were no differences in overall survival after radical cystectomy (P = 0.87). CONCLUSIONS: The majority of bladder tumors in transplant patients are benign, and they neither coexist with nor develop into malignant tumors. Transplant patients with non-muscle-invasive UCB show an increased risk of disease recurrence, while those treated with radical cystectomy have similar outcomes to patients without a transplant.

The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation.

Infectious diseases after solid organ transplantation (SOT) are a significant cause of morbidity and reduced allograft and patient survival; however, the influence of infection on the development of chronic allograft dysfunction has not been completely delineated. Some viral infections appear to affect allograft function by both inducing direct tissue damage and immunologically related injury, including acute rejection. In particular, this has been observed for cytomegalovirus (CMV) infection in all SOT recipients and for BK virus infection in kidney transplant recipients, for community-acquired respiratory viruses in lung transplant recipients, and for hepatitis C virus in liver transplant recipients. The impact of bacterial and fungal infections is less clear, but bacterial urinary tract infections and respiratory tract colonization by Pseudomonas aeruginosa and Aspergillus spp appear to be correlated with higher rates of chronic allograft dysfunction in kidney and lung transplant recipients, respectively. Evidence supports the beneficial effects of the use of antiviral prophylaxis for CMV in improving allograft function and survival in SOT recipients. Nevertheless, there is still a need for prospective interventional trials assessing the potential effects of preventive and therapeutic strategies against bacterial and fungal infection for reducing or delaying the development of chronic allograft dysfunction.

CRTC2 polymorphism as a risk factor for the incidence of metabolic syndrome in patients with solid organ transplantation.

NlmCategory="UNASSIGNED">Metabolic syndrome after transplantation is a major concern following solid organ transplantation (SOT). The CREB-regulated transcription co-activator 2 (CRTC2) regulates glucose metabolism. The effect of CRTC2 polymorphisms on new-onset diabetes after transplantation (NODAT) was investigated in a discovery sample of SOT recipients (n1=197). Positive results were tested for replication in two samples from the Swiss Transplant Cohort Study (STCS, n2=1294 and n3=759). Obesity and other metabolic traits were also tested. Associations with metabolic traits in population-based samples (n4=46'186, n5=123'865, n6>100,000) were finally analyzed. In the discovery sample, CRTC2 rs8450-AA genotype was associated with NODAT, fasting blood glucose and body mass index (Pcorrected<0.05). CRTC2 rs8450-AA genotype was associated with NODAT in the second STCS replication sample (odd ratio (OR)=2.01, P=0.04). In the combined STCS replication samples, the effect of rs8450-AA genotype on NODAT was observed in patients having received SOT from a deceased donor and treated with tacrolimus (n=395, OR=2.08, P=0.02) and in non-kidney transplant recipients (OR=2.09, P=0.02). Moreover, rs8450-AA genotype was associated with overweight or obesity (n=1215, OR=1.56, P=0.02), new-onset hyperlipidemia (n=1007, OR=1.76, P=0.007), and lower high-density lipoprotein-cholesterol (n=1214, β=-0.08, P=0.001). In the population-based samples, a proxy of rs8450G>A was significantly associated with several metabolic abnormalities. CRTC2 rs8450G>A appears to have an important role in the high prevalence of metabolic traits observed in patients with SOT. A weak association with metabolic traits was also observed in the population-based samples.The Pharmacogenomics Journal advance online publication, 8 December 2015; doi:10.1038/tpj.2015.82.

p-Nitrobenzyloxycarbonyl (pNZ) as Temporary Na-Protecting Group for Mild Solid-Phase Peptide Synthesis. Avoiding Diketopiperazine and Aspartimide Formation

p-Nitrobenzyloxycarbonyl was used as temporary protecting group for the -amino function in solid-phase peptide synthesis. The corresponding derivatives are solids, easy to be synthesized, and perform well in the solid-phase mode. pNZ is removed in practical neutral conditions in the presence of catalytic amounts of acid. They are orthogonal with the most common protecting groups used in peptide chemistry. They are specially useful in combination with Fmoc chemistry to overcome those side reactions associated with the used of the piperidine such DKP and aspartiimide formation. The flexibility of pNZ can be very useful for the preparation of libraries of small organic molecules.

Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study

Objective:To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality.Materials and Methods:Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration.Results:As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions.Conclusion:Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography.

X-ray fluorescence determination of adsorbed copper on activated charcoal after glycerin complexation

X-This work shows an alternative method to copper determination by X-Ray Fluorescence (XRF). Since copper concentration in natural waters is not enough to reach XRF detection limit, a liquid-solid preconcentration procedure was proposed. Glycerin was used to complex the metal increasing its adsorption on activated charcoal. The solid phase was used to XRF determination. Several parameters were evaluated, such as, the complexation pH, the charcoal adsorption limit and the glycerin concentration. The interferences are lead and bismuth and the sensitivities decreased in the order Cu2+, Bi3+ and Pb2+. The advantages of the method are its simplicity, low cost and low spectral interference.

Intercontinental fligths from European Airports: Towards hub concentration or not?

This paper empirically analyzes changes in the supply of non-stop intercontinental flights from European airports. We take advantage of OAG data for air services from a rich sample of European airports to intercontinental destinations in the period 2004-2008. Results of the empirical analysis indicate a tendency towards a more balanced distribution of intercontinental flights across European airports. We also find that the demographic size of a region, its sector specialization, the political role of its central city and the proportion of connecting traffic explain the amount of and changes in long-haul air services supplied from European airports.

Empirical analysis of solid management waste costs: Some evidence from Galicia, Spain

This paper analyses the factors that determine solid waste service costs. The empirical analysis is based on information derived from a survey conducted in a sample of Galician municipalities. The results reveal economies of scale in municipalities of fewer than 50,000 inhabitants, such that cooperation between these municipalities could lead to cost savings. It also appears that private delivery is not cheaper than public delivery. Finally, designating a larger proportion of the total waste volume to recycling does not imply greater costs.

Aplicação de SPME (Solid Phase Micro-Extraction) na análise de águas potáveis de três localidades do estado de São Paulo

The technique of solid phase microextraction (SPME) was used for the extraction of halogenated contaminants of water samples from three cities of the State of São Paulo and the extracts were submitted to gas chromatographic analysis with electron capture detection (GC-ECD). In the samples of water collected at the city of São Paulo the detected level of trihalomethanes (THM) expressed as the sum of chloroform, dibromochloromethane and dichlorobromomethane, were higher than the permissible limit established by the Brazilian regulation. In the samples collected at the two other cities the level of any of the three THM remained below the sensitivity of the ECD.

Utilização de eletrodos potenciométricos de amálgama em estudos de complexação de substâncias húmicas

Potentiometric amalgam electrodes of lead, cadmium, and zinc are proposed to study the complexation properties of commercial and river sediment humic acids. The copper complexation properties of both humic acids were studied in parallel using the solid membrane copper ion-selective electrode (Cu-ISE). The complexing capacity and the averaged conditional stability constants were determined at pH 6.00 ± 0.05 in medium of 2x10-2 mol L-1 sodium nitrate, using the Scatchard method. The lead and cadmium amalgam electrodes presented a Nernstian behavior from 1x10-5 to 1x10-3 moles L-1 of total metal concentration, permitting to perform the complexation studies using humic acid concentrations around of 20 to 30 mg L-1, that avoids colloidal aggregation. The zinc amalgam electrode showed a subnernstian linear response in the same range of metal concentrations. The Scatchard graphs for both humic acids suggested two classes of binding sites for lead and copper and one class of binding site for zinc and cadmium.

Sinkkirikasteen liukenemisnopeuteen vaikuttavat tekijät ja sinkkirikasteen suoraliuotuksen mallintaminen

Työn kirjallisuusosassa selvitettiin eri tekijöiden (lämpötila, paine, mineralogia, partikkelikoko, sekoitus, kiintoainepitoisuus, liuoksen happo-, rauta- ja happipitoisuus) vaikutusta sinkkirikasteen suoraliuotusprosessin tärkeimpiin ilmiöihin (diffuusio, aineensiirto, reaktiokinetiikka). Kirjallisuusosassa kartoitettiin myös tämän hetkistä tietämystä niistä tekijöistä, jotka ovat oleellisia, kun sinkkirikasteen suoraliuotusprosessia mallinnetaan. Näitä tekijöitä ovat: sinkkirikasteiden liuotuksen kemia, sinkkirikasteiden liuotuksen kinetiikka ja mekanismit, kaasuneste aineensiirto ja kiinteäneste aineensiirto. Lisäksi selvitettiin millä tavoin aikaisemmissa tutkimuksissa sinkkirikasteiden suoraliuotusta on mallinnettu. Mallinnusosassa käsiteltiin atmosfääristä sinkkirikasteen suoraliuotusta, jossa hapettimena toimi ferri(III)rauta. Mallintamisessa käytettiin kirjallisuudessa esitettyjä mittaustuloksia ja mallintaminen tehtiin Modest tietokoneohjelmistolla. Työssä tehty atmosfäärisen suoraliuotuksen mallintaminen labo-ratoriomittakaavassa (laimeat liuokset ja pienet kiintoainepitoisuudet) antoi lupaavia tuloksia. Ongelmia mallin ennustuksen kanssa esiintyi pienissä happopitoisuuksissa, alhaisissa lämpötiloissa sekä pienillä ja suurilla partikkeleilla. Työn kirjallisuusosassa tunnistettiin ne ongelmakohdat, jotka vaativat lisätutkimuksia, jotta sinkkirikasteen atmosfääriselle suoraliuotukselle pystytään kehittämään simulointimalli. Näitä ovat: 1. Hapen liukoisuus ja aineensiirto teollisuuden käyttämissä sinkkirikastelietteissä, 2. Sopivien mittaustulosten puuttuminen, jotta atmosfääristä suoraliuotusta, jossa O2 ja Fe3+ toimivat hapettimena voitaisiin mallintaa, 3. Kiinteäneste aineensiirron merkitys sinkkirikasteen suoraliuotuksessa. Mallinnusosassa osoitettiin, että mekanistisella mallintamisella voidaan simuloida sinkkirikasteen atmosfääristä suoraliuotusta ainakin laboratoriomittakaavassa. Työn perusteella voidaan todeta, että sinkkirikasteen atmosfääriselle suoraliuotukselle voidaan työssä ehdotettujen jatkotutkimusten avulla kehittää numeerinen mekanistinen malli, jolla atmosfääristä sinkkirikasteiden suoraliuotusprosessia voidaan simuloida eri olosuhteissa.