Multi-objective optimization for the economic production of d-psicose using simulated moving bed chromatography

The biocatalytic production of rare carbohydrates from available sugar sources rapidly gains interest as a route to acquire industrial amounts of rare sugars for food and fine chemical applications. Here we present a multi-objective optimization procedure for a simulated moving bed (SMB) process for the production of the rare sugar d-psicose from enzymatically produced mixtures with its epimer d-fructose. First, model parameters were determined using the inverse method and experimentally validated on a 2-2-2-2 lab-scale SMB plant. The obtained experimental purities (PUs) were in excellent agreement with the simulated data derived from a transport-dispersive true-moving bed model demonstrating the feasibility of the proposed design. In the second part the performance of the separation was investigated in a multi-objective optimization study addressing the cost-contributing performance parameters productivity (PR) and desorbent requirement (DR) as a function of temperature. While rare sugar SMB operation under conditions of low desorbent consumption was found to be widely unaffected by temperature, SMB operation focusing on increased PR significantly benefited from high temperatures, with possible productivities increasing from 3.4kg(Lday)(-1) at 20°C to 5kg(Lday)(-1) at 70°C, indicating that decreased selectivity at higher temperatures could be fully compensated for by the higher mass transfer rates, as they translate into reduced switch times and hence higher PR. A DR/PR Pareto optimization suggested a similar but even more pronounced trend also under relaxed PU requirements, with the PR increasing from 4.3kg(Lday)(-1) to a maximum of 7.8kg(Lday)(-1) for SMB operation at 50°C when the PU of the non-product stream was reduced from 99.5% to 90%. Based on the in silico optimization results experimental SMB runs were performed yielding considerable PRs of 1.9 (30°C), 2.4 (50°C) and 2.6kg(Lday)(-1) (70°C) with rather low DR (27L per kg of rare sugar produced) on a lab-scale SMB installation.

Dolutegravir-based antiretroviral therapy in a severely overweight child with a multidrug-resistant human immunodeficiency virus infection. A case report and review

The management of multidrug-resistant human immunodeficiency virus (MDR HIV) infections in children is particularly challenging due to the lack of experience with new drugs. Dolutegravir, combined with an optimized antiretroviral background therapy, is promising for the treatment of MDR HIV and has been approved recently for adults and adolescents. Data for children are extremely limited. We describe the efficacy, safety and plasmatic levels of a dolutegravir-based, complex active antiretroviral treatment regimen in a severely overweight 11-year-old child infected with an MDR HIV strain.

Child health, its dynamic interaction with nutrition and health memory--evidence from Senegal

Child malnutrition is pervasive in developing countries and anthropometric measures such as weight-for-height and height-for-age have proven reliable indicators of short term malnutrition and stunting. Rather than studying these indicators separately, we look at their interaction and carve out child health dynamics. Considering height-for-age a child's health stock and weight-for-lagged height a proxy for nutritional inputs, we develop a child health production function that features self-productivity of past health stocks and contemporaneous nutritional inputs. We test the model on a Senegalese panel of 271 children between 0 and 5 years employing dynamic panel methods to control for endogeneity in the production function. In line with previous evidence, we find that children can partially catch-up from malnutrition spells. Yet, child health stocks also deplete quickly and need constant updating in the form of nutrition. This demonstrates the importance of health memory and that malnutrition cannot be fought with snapshot interventions. Consequently, sustainable nutrition interventions have to be long term and yield higher returns the earlier they reach children.

Comparative pharmacokinetics and bioavailability of brimonidine following ocular and dermal administration of brimonidine tartrate ophthalmic solution and gel in patients with moderate-to-severe facial erythema associated with rosacea

BACKGROUND

Persistent facial erythema is the most common primary pathological feature of rosacea, the only treatment for which is brimonidine tartrate (BT) gel.

OBJECTIVES

To assess the relative bioavailability of topical BT gel in comparison with the ophthalmic BT solution.

METHODS

A pharmacokinetic study was conducted to compare intraindividual systemic exposures after dermal application of BT gel (0·07%, 0·18% and 0·5%) under maximal use conditions in patients with moderate-to-severe facial erythema associated with rosacea, and administration of BT ophthalmic solution 0·2%.

RESULTS

Patients who received BT ophthalmic solution 0·2% three times a day for 1 day had a mean Cmax of 54 ± 28 pg mL(-1) and a mean 0-24-h area under the curve (AUC0-24 h ) of 568 ± 277 pg h mL(-1) . Topical application of BT gel for 29 days resulted in quantifiable systemic exposure in 22%, 48%, 71% and 79% of patients who received BT gel 0·07% twice daily, 0·18% once daily, 0·18% twice daily and 0·5% once daily, respectively. The mean Cmax values for the BT gels ranged between 13 and 25 pg mL(-1) , and mean AUC0-24 h values ranged between 42 and 290 pg h mL(-1) . Systemic exposure increased with applied dose, with no drug accumulation for the duration of treatment. The systemic exposure observed with the highest dose of BT gel (0·5% once daily) was significantly lower than the systemic levels observed for the ophthalmic solution. 0·2% apply for all the concentrations.

CONCLUSIONS

The systemic safety profile of BT gel may be considered better than that of the ophthalmic solution.

[Emerging parasitic diseases]

Travels, migration and circulation of goods facilitate the emergence of new infectious diseases often unrecognized outside endemic areas. Most of emerging infections are of viral origin. Muscular Sarcocystis infection, an acute illness acquired during short trips to Malaysia, and Chagas disease, a chronic illness with long incubation period found among Latin American migrants, are two very different examples of emerging parasitic diseases. The former requires a preventive approach for travelers going to Malaysia and must be brought forth when they return with fever, myalgia and eosinophilia, while the latter requires a proactive attitude to screen Latin American migrant populations that may face difficulties in accessing care.

Early detection of maternal risk for preeclampsia

Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortality. New molecular insights offer new possibilities of early diagnosis of elevated maternal risk. Maternal risk factors, biophysical parameters like Doppler examination of the uterine arteries and biochemical parameters allow early risk calculation. Preventive and effective therapeutic agents like acetylsalicylacid can be started in the early second trimester. This article reviews the diagnostic possibilities of early risk calculation to detect women having high risk for preeclampsia and the potential benefits for them, the offspring and health care systems. We provide risk calculation for preeclampsia as an important and sensible part of first trimester screening.

[Pulmonary diseases among returning travelers]

Respiratory tract infections are a frequent cause of travelers' health problems. Tropical diseases are relatively rare compared to common respiratory infections. Nevertheless, due to their potential gravity, they must be systematically considered. The differential diagnosis of tropical pathogens is wide. A targeted travel history taking into account specific epidemiological, geographical and behavioral risk factors helps focusing biological exams to identify the causative diagnosis. The chest radiography remains very helpful in this context; however, more specific exams, such as serologies are often necessary to reach a final diagnosis.

[Management of childhood malaria in Switzerland]

Imported malaria is a rare condition in current paediatric practice in Switzerland but should be suspected in all febrile children returning from a malaria-endemic region. Immediate treatment is essential to decrease the risk of complications and mortality. Severity criteria must always be searched for. We suggest a diagnostic strategy based on the use of microscopy and rapid antigen-detection tests. Treatment depends on the Plasmodium species and the severity of illness. For uncomplicated malaria, a drug combination that includes an artemisinin derivative should be used in priority. Atovaquone/proguanil represents an alternative. Chloroquine can be used in most cases of malaria caused by another Plasmodium species. Severe malaria must be treated intravenously with quinine and soon with artesunate.

Development of microsatellite markers in Fosterella rusbyi (Bromeliaceae) using 454 pyrosequencing

PREMISE OF THE STUDY

Polymorphic microsatellite markers were developed for Fosterella rusbyi (Bromeliaceae) to evaluate the population genetic structure and genetic diversity of natural populations of F. rusbyi and other Fosterella species in Bolivia.

METHODS AND RESULTS

454 pyrosequencing technology was used to generate 73027 sequence reads from F. rusbyi DNA, which together contained 2796 perfect simple sequence repeats (SSRs). Primer pairs were designed for 30 loci, of which 15 were used to genotype 30 F. rusbyi plants from two geographical areas in Bolivia. All markers were polymorphic, with two to nine alleles in the overall sample. Cross-species amplification was tested in 10 additional Fosterella species. Seven loci showed consistent amplification in six or more species.

CONCLUSIONS

The 15 SSR markers developed for F. rusbyi are promising candidates for population genetic analyses within F. rusbyi and other species of Fosterella.

Tunneling and Percolation Behavior in Granular Metals

The nature of the percolation process in granular metals is examined for the first time by a computer simulation of a system of metallic grains embedded in an insulating matrix. Assuming that the intergrain conduction is due to quantum mechanical tunneling it is found that a percolation-like critical behavior of the conductivity is obtained, but that a percolation universal behavior will be found only in a very special case. In contrast, the behavior of the electrical noise does not deviate substantially from the universal one. Comparison of these results with recent experimental observations suggests that in the metallic range, both transport properties are controlled by the continuous metallic network rather than by intergrain tunnelin.. We propose that the metallic network resembles the previously studied system of ‘inverted random voids’.

Effect of deviation from the mid-sagittal plane on the measurement of fetal nuchal translucency

OBJECTIVE

Screening for trisomy 21 by fetal nuchal translucency (NT) thickness at 11 to 13 + 6 weeks' gestation requires an appropriate examination of the NT. Errors in the assessment of NT may lead to an under- or overestimation of the NT and to incorrect patient-specific risks. In this study we aimed to examine the importance of the mid-sagittal section and whether the acquired plane of the head and face influences the measurement of the fetal NT thickness.

METHODS

Sixty three-dimensional volumes of the fetal head and face in a mid-sagittal plane were acquired. NT thickness was firstly measured in the mid-sagittal plane according to the guidelines of The Fetal Medicine Foundation. The head was then rotated by steps of 5 degrees up to 25 degrees around the mid-point of the biparietal diameter and occipitofrontal diameter and NT was measured again. All six NT measurements were taken by the same operator, Operator A, who on completion of the assessment of the 60 volumes repeated all the measurements. The whole process was then repeated by Operator B. Both operators were blinded to each others' measurements.

RESULTS

In the true mid-sagittal plane, the mean NT was 1.9 mm and it was above the expected median in 72.5% of the measurements. At a deviation of 15 degrees , mean NT was 1.5 mm, and 36.3% of the measurements were above the expected median. At a deviation of 25 degrees , mean NT was reduced to 1.3 mm and 17.9% of the measurements were above the expected median.

CONCLUSION

Fetal NT thickness is greatest in the mid-sagittal plane. Increasing deviation away from the mid-sagittal plane results in progressive underestimation of the fetal NT thickness and so to a corresponding underestimation of the patient-specific risk.

Prenatal diagnosis and management of a fetal intra-abdominal teratoma: a case report and review of the literature

We report on a case of a large intra-abdominal teratoma diagnosed antenatally and managed successfully after birth. Intra-abdominal teratomas are rare in prenatal life. Ultrasound examination shows a heterogenic tumor with cystic and solid components. After postpartum surgical removal, the prognosis is generally good.