Exploring a route to a selective and sensitive portable system for explosive detection- swab spray ionisation coupled to of high-field assisted waveform ion mobility spectrometry (FAIMS)

Paper spray mass spectrometry is a rapid and sensitive tool for explosives detection but has so far only been demonstrated using high resolution mass spectrometry, which bears too high a cost for many practical applications. Here we explore the potential for paper spray to be implemented in field applications with portable mass spectrometry. This involved (a) replacing the paper substrate with a swabbing material (which we call “swab spray”) for compatibility with standard collection materials; (b) collection of explosives from surfaces; (c) an exploration of interferences within a ± 0.5 m/z window; and (d) demonstration of the use of high-field assisted waveform ion mobility spectrometer (FAIMS) for enhanced selectivity. We show that paper and Nomex® are viable collection materials, with Nomex providing cleaner spectra and therefore greater potential for integration with portable mass spectrometers. We show that sensitive detection using swab spray will require a mass spectrometer with a mass resolving power of 4000 or more. We show that by coupling the swab spray ionisation source with FAIMS, it is possible to reduce background interferences, thereby facilitating the use of a low resolving power (e.g. quadrupole) mass spectrometer.

Improving operational management of wastewater systems. A case study

Wastewater treatment facilities collecting wastewater from longstanding sewer networks of five municipalities in the Ave River basin (located in NW Portugal) are especially vulnerable to water inflows since they have considerable extensions of sewers installed in stream and riverbeds. TRATAVE, the company responsible for operating the system, designed and implemented a monitoring network to measure discharges along the entire drainage network and treatment facilities in order to reduce those water inflows. Several flow measurement devices were installed at strategic locations within the sewer network and integrated with a SCADA system responsible for its operation. A decision support system (DSS) is being implemented using the Delft-FEWS platform, integrating monitoring data and models. Based on monitored data and model results, an estimation of infiltration volumes during wet periods is presented. Moreover, the capabilities of the DSS are illustrated in: (i) location of manholes losses along sewer networks during wet periods; (ii) identification and location of unknown connections to the sewer network using wastewater balances; and (iii) design of a PID controller for a pumping station using on-line tank water level measurement. Acquired knowledge resulting from the DSS greatly improved the utility performance both in terms of economic revenue and environmental protection.

Spatial variability in air pollution exposure in relation to socioeconomic indicators in nine European metropolitan areas: A study on environmental inequality

A limited number of studies have addressed environmental inequality, using various study designs and methodologies and often reaching contradictory results. Following a standardized multi-city data collection process within the European project EURO-HEALTHY, we conducted an ecological study to investigate the spatial association between nitrogen dioxide (NO₂), as a surrogate for traffic related air pollution, and ten socioeconomic indicators at local administrative unit level in nine European Metropolitan Areas. We applied mixed models for the associations under investigation with random intercepts per Metropolitan Area, also accounting for the spatial correlation. The stronger associations were observed between NO₂ levels and population density, population born outside the European Union (EU28), total crimes per 100,000 inhabitants and unemployment rate that displayed a highly statistically significant trend of increasing concentrations with increasing levels of the indicators. Specifically, the highest vs the lowest quartile of each indicator above was associated with 48.7% (95% confidence interval (CI): 42.9%, 54.8%), 30.9% (95%CI: 22.1%, 40.2%), 19.8% (95%CI: 13.4%, 26.6%) and 15.8% (95%CI: 9.9%, 22.1%) increase in NO₂ respectively. The association with population density most probably reflects the higher volume in vehicular traffic, which is the main source of NO₂ in urban areas. Higher pollution levels in areas with higher percentages of people born outside EU28, crime or unemployment rates indicate that worse air quality is typically encountered in deprived European urban areas. Policy makers should consider spatial environmental inequalities to better inform actions aiming to lower urban air pollution levels that will subsequently lead to improved quality of life, public health and health equity across the population.

Spatial variability in air pollution exposure in relation to socioeconomic indicators in nine European metropolitan areas: A study on environmental inequality

A limited number of studies have addressed environmental inequality, using various study designs and methodologies and often reaching contradictory results. Following a standardized multi-city data collection process within the European project EURO-HEALTHY, we conducted an ecological study to investigate the spatial association between nitrogen dioxide (NO₂), as a surrogate for traffic related air pollution, and ten socioeconomic indicators at local administrative unit level in nine European Metropolitan Areas. We applied mixed models for the associations under investigation with random intercepts per Metropolitan Area, also accounting for the spatial correlation. The stronger associations were observed between NO₂ levels and population density, population born outside the European Union (EU28), total crimes per 100,000 inhabitants and unemployment rate that displayed a highly statistically significant trend of increasing concentrations with increasing levels of the indicators. Specifically, the highest vs the lowest quartile of each indicator above was associated with 48.7% (95% confidence interval (CI): 42.9%, 54.8%), 30.9% (95%CI: 22.1%, 40.2%), 19.8% (95%CI: 13.4%, 26.6%) and 15.8% (95%CI: 9.9%, 22.1%) increase in NO₂ respectively. The association with population density most probably reflects the higher volume in vehicular traffic, which is the main source of NO₂ in urban areas. Higher pollution levels in areas with higher percentages of people born outside EU28, crime or unemployment rates indicate that worse air quality is typically encountered in deprived European urban areas. Policy makers should consider spatial environmental inequalities to better inform actions aiming to lower urban air pollution levels that will subsequently lead to improved quality of life, public health and health equity across the population.

V348I mutation in UL23 gene of human herpesvirus 1 in a case of herpetic hepatitis and haemophagocytic lymphohistiocytosis

We herein report the case of a young immunocompetent adult patient with a rapidly fatal haemophagocytic lymphohistiocytosis syndrome related to human herpesvirus 1 (HHV-1) infection, with herpetic hepatitis and persistent high-level viraemia despite treatment with acyclovir. Haemophagocytic lymphohistiocytosis was confirmed in the patient's spleen and bone marrow. HHV-1 DNA was extracted from whole blood and liver biopsy and the UL23 gene was sequenced. A V348I natural polymorphism of the TK protein was found in blood and liver specimens. Further studies are needed to investigate the role of this polymorphism in the development of systemic immune dysregulation.

Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study

Background

Global chronic urticaria (CU) disease experience and management is not well documented. This study descriptively compares these aspects among CU patients residing in Europe (EU) and Central and South America (C/SA).

Methods

AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is a global prospective, non-interventional study of CU in the real-world setting. Patients were ≥ 18 years with a diagnosis of H1-antihistamine-refractory CU for > 2 months. Differences between the EU and C/SA regions in demographic and clinical characteristics, quality of life (QoL), work and activity impairment, pharmacological treatment, and healthcare resource use were examined.

Results

In total, 4224 patients were included in the analysis (C/SA 492; EU 3732). Rates of untreated patients were greater in the C/SA region (45.1% vs. 31.9%; P < 0.005) and escalation to third-line therapy was rare in both regions. Differences in disease experience emerged, with C/SA patients more commonly experiencing angioedema (C/SA 50.8% vs. EU 46.1%; P = 0.03) or comorbid chronic inducible urticaria (C/SA 30% vs. EU 22%; P < 0.001). Correspondingly, rates of uncontrolled urticaria were higher among C/SA patients (82.8% vs. 77.5%; P = 0.017) and patients in the C/SA region showed significantly greater work and activity impairment (absenteeism: 10.4 ± 19.7 vs. 6.7 ± 19.0, P = 0.004; presenteeism: 30.3 ± 31.9 vs. 24.4 ± 25.8, P = 0.001; work productivity loss: 33.9 ± 33.9 vs. 26.5 ± 27.5, P < 0.001; activity impairment: 37.7 ± 34.7 vs. 32.7 ± 30.1, P = 0.001). However, QoL impairment was greater in the EU region (Dermatology Life Quality Index: C/SA 6.5 ± 5.9 vs. EU 8.3 ± 7.0; P < 0.001). There was a significant difference in use of healthcare resources, including emergency services (39.6% vs. 29.3%; P < 0.001), hospitalization (7.7% vs 21.9%; P < 0.001) general practitioners (31.7% vs 57.3%; P < 0.001), and additional allergists or dermatologists (50.6% vs. 47.3%, P < 0.001), among patients in the C/SA and EU region, respectively. In both regions, patients with a primary diagnosis of CU with angioedema had significantly greater impairment in work and non-work activities and healthcare resource utilization compared to those without angioedema.

Conclusions

This study revealed that CU is a heterogeneous condition with differences in healthcare utilization and outcomes between EU and C/SA. However, overall there is a high unmet need of H1-antihistamine-refractory CU patients, which is associated with high use of healthcare resources, and has a large negative effect on QoL and work productivity.

Rapid assessment of As and other elements in naturally-contaminated calcareous soil through hyperspectral VIS-NIR analysis

Although arsenic (As) toxicity in soil vary depending on its chemical forms and oxidation states, regulatory limits for this compartment rely on total As content. Conventional methods of total As determination are expensive and time-consuming. The development of predictive techniques might enable a speditive assessment of As contamination in those scenarios, such as thermal spring sites, where exposure to the metalloid poses a threat to human health. The objective of this study was to assess the suitability of Visible Near Infrared spectrophotometry for predicting the total As content in highly calcareous thermal spring soils and the same aim was pursued for those elements (i.e. Al, Fe and Mn) the chemistry of which is tightly connected with that of As. A Partial Least Square approach, including cross-validation and external independent test, was used to relate the concentrations of the target elements to spectral data. The most accurate prediction was found for As with Pearson's coefficient, RMSE, RPD and SEP being equal to 0.94, 69.65, 2.9 and 66.99, respectively. Less accurate predictions were found for Al (r = 0.88; RMSE = 11014; RPD = 1.96; SEP = 11014), Fe (r = 0.93; RMSE = 6921.1; RPD = 2.45; SEP = 6462.4), and Mn (r = 0.92; RMSE = 542.01; RPD = 2.43; SEP = 529.79).

Faunal activity rhythms influencing early community succession of an implanted whale carcass offshore Sagami Bay, Japan

Benthic community succession patterns at whale falls have been previously established by means of punctual submersible and ROV observations. The contribution of faunal activity rhythms in response to internal tides and photoperiod cues to that community succession dynamism has never been evaluated. Here, we present results from a high-frequency monitoring experiment of an implanted sperm whale carcass in the continental slope (500 m depth) offshore Sagami Bay, Japan. The benthic community succession was monitored at a high frequency in a prolonged fashion (i.e. 2-h intervals for 2.5 months) with a seafloor lander equipped with a time-lapse video camera and an acoustic Doppler profiler to concomitantly study current flow dynamics. We reported here for the first time, to the best of our knowledge, the occurrence of strong 24-h day-night driven behavioral rhythms of the most abundant species (Simenchelys parasitica; Macrocheira kaempferi, and Pterothrissus gissu). Those rhythms were detected in detriment of tidally-controlled ones. Evidence of a diel temporal niche portioning between scavengers and predators avoiding co-occurrence at the carcass, is also provided. The high-frequency photographic and oceanographic data acquisition also helped to precisely discriminate the transition timing between the successional stages previously described for whale falls’ attendant communities.

Seemingly Harmless Differentiated Thyroid Carcinoma Presenting as Bone Metastasis

Thyroid carcinoma is the most common endocrine neoplasia. Differentiated thyroid carcinomas (DTCs) represent the majority of cases, which usually follow an indolent clinical course with low mortality rates. The authors describe two cases of well DTC without classic histological poor prognosis features, presenting as extensive and unresectable osteolytic bone metastases. DTCs are considered harmless tumours, due to their benign and silent behaviour. The authors want to underline the importance of clinical awareness during follow-up in cases of DTC, which can be aggressive in presentation and behaviour. Timely identification and diagnosis of these tumours are essential for prompt treatment initiation and improvement of overall survival.

Epidural catheter anchored in the posterior lateral epidural space: How to manage it

We describe a case of an epidural catheter entrapment without knotting, kinking, shearing or breakage confirmed by CT scan and how to manage it. A patient was admitted for tibial fracture repair under general anesthesia with an epidural. At discharge day, multiple attempts to retrieve the catheter were made. Contrast CT scan showed the catheter anchored in the left posterior-lateral epidural space. Despite the absence of guidelines regarding epidural catheter entrapment, all the methods described in the literature were used. This is a rare complication and it may be associated with neurological and infectious complications. Radiologic imaging should be obtained to better characterize the catheters' position and plan removal. In this case, tension in the paraspinal muscles or in the supraspinous and intraspinous ligaments could explain the entrapment. General anesthesia with the non-depolarising muscle relaxant allowed muscles and ligaments to relax and we were able to retrieve the catheter intact.