Continuous-mode acclimation and operation of lignocellulosic sulfate-reducing bioreactors for enhanced metal immobilization from acidic mining-influenced water.

Lignocellulosic sulfate-reducing bioreactors are an inexpensive passive approach for treatment of mining-influenced water (MIW). Typically, microbial community acclimation to MIW involves bioreactor batch-mode operation to initiate lignocellulose hydrolysis and fermentation and provide electron donors for sulfate-reducing bacteria. However, batch-mode operation could significantly prolong bioreactor start-up times (up to several months) and select for slow-growing microorganisms. In this study we assessed the feasibility of bioreactor continuous-mode acclimation to MIW (pH 2.5, 6.5 mM SO42-, 18 metal(loid)s) as an alternate start-up method. Results showed that bioreactors with spent brewing grains and sugarcane bagasse achieved acclimation in continuous mode at hydraulic retention times (HRTs) of 7-12-d within 16-22 days. During continuous-mode acclimation, extensive SO42- reduction (80 ± 20% -91 ± 3%) and > 98% metal(loid) removal was observed. Operation at a 3-d HRT further yielded a metal(loid) removal of 97.5 ± 1.3 -98.8 ± 0.9% until the end of operation. Sulfate-reducing microorganisms were detected closer to the influent in the spent brewing grains bioreactors, and closer to the effluent in the sugarcane bagasse bioreactors, giving insight as to where SO42- reduction was occurring. Results strongly support that a careful selection of lignocellulose and bioreactor operating parameters can bypass typical batch-mode acclimation, shortening bioreactor start-up times and promoting effective MIW metal(loid) immobilization and treatment.

EHR-based cohort assessment for multicenter RCTs: a fast and flexible model for identifying potential study sites.

OBJECTIVE: The Recruitment Innovation Center (RIC), partnering with the Trial Innovation Network and institutions in the National Institutes of Health-sponsored Clinical and Translational Science Awards (CTSA) Program, aimed to develop a service line to retrieve study population estimates from electronic health record (EHR) systems for use in selecting enrollment sites for multicenter clinical trials. Our goal was to create and field-test a low burden, low tech, and high-yield method. MATERIALS AND METHODS: In building this service line, the RIC strove to complement, rather than replace, CTSA hubs' existing cohort assessment tools. For each new EHR cohort request, we work with the investigator to develop a computable phenotype algorithm that targets the desired population. CTSA hubs run the phenotype query and return results using a standardized survey. We provide a comprehensive report to the investigator to assist in study site selection. RESULTS: From 2017 to 2020, the RIC developed and socialized 36 phenotype-dependent cohort requests on behalf of investigators. The average response rate to these requests was 73%. DISCUSSION: Achieving enrollment goals in a multicenter clinical trial requires that researchers identify study sites that will provide sufficient enrollment. The fast and flexible method the RIC has developed, with CTSA feedback, allows hubs to query their EHR using a generalizable, vetted phenotype algorithm to produce reliable counts of potentially eligible study participants. CONCLUSION: The RIC's EHR cohort assessment process for evaluating sites for multicenter trials has been shown to be efficient and helpful. The model may be replicated for use by other programs.

The Impact of Hysteroscopic Tissue Removal Systems on Histopathologic Analysis for Benign and Cancerous Endometrial Pathology: An Ex Vivo Study.

OBJECTIVE: To assess the impact of hysteroscopic tissue removal systems (TRS) on histopathology tissue diagnosis. MEASUREMENTS AND METHODS: This is a paired-comparison ex vivo study in which 23 endometrial sections from hysterectomized uteri (13 benign and 10 hyperplasia/cancer) were analyzed in a simulation laboratory center at a university teaching hospital. After routine tissue processing, a section of endometrium was provided for ex vivo TRS with suture mounting to a uterine model (Polly, Remedy). Morcellated specimens using the Hologic® MyoSure hysteroscopic device were processed for histopathologic analysis by two blinded pathologists (Pa and Pb) and compared to the original specimens' tissue diagnoses. RESULTS: Sufficient tissue for evaluation was found in 100% (23/23) of TRS specimens by Pa and 91.3% by Pb. TRS specimen diagnoses were concordant with routine histologic diagnosis 86.9% (20/23, k = 0.76) for Pa and 80.9% (17/21, k = 0.68) for Pb. Sensitivity and specificity were 70%/100% for Pa and 80%/91% for Pb, respectively. The false-positive (overdiagnosed) and false-negative rates (underdiagnosed) were 0%/30% and 9%/20% for Pa and Pb. Both Pa and Pb underdiagnosed most specimens confirmed by routine tissue diagnosis. TRS specimen diagnoses between Pa and Pb were concordant in 76.2% (16/21, k = 0.60). CONCLUSION: TRS may adversely impact the ability to provide a histologic tissue analysis. Up to 30% of samples were overdiagnosed and 20% underdiagnosed. If confirmed, pathologists may need to reassess workflows to better offset potential underdiagnosis of malignant specimens as findings may be obscured through TRS. Additionally, surgeons may need to reconsider specimen handling, so highest yield specimens are provided to pathology.

Thrice weekly azacitidine does not improve hematological responses in lower-risk myelodysplastic syndromes: a study of the Hoosier Oncology Group.

Prolonged administration of methyl transferase inhibitors may increase response rates in myelodysplastic syndromes (MDS). Fourteen MDS patients with anemia and less than 10% marrow blasts received azacitidine 50 mg/m(2) thrice weekly for 2 weeks every 4 weeks; 7 also received weekly erythropoietin. The response rate of 43% did not improve the rates reported with other azacitidine administration schedules, so the study was closed. A decreased apoptosis of primitive erythroid progenitors and increased expression of BclX(L) was observed with treatment in responding patients compared to non-responders. Azacitidine may modulate BclX(L) and improve erythropoiesis through reduction of apoptosis in primitive erythroid progenitor population in MDS.

On the optimum sampling time for the measurement of pollutants in ambient air.

No measurement result of any kind is complete without an associated statement of uncertainty. In general, the aim is to minimise this measurement uncertainty to the extent that the measurement made is fit for purpose, or the uncertainty meets an acceptable level such as a "data quality objective". This paper demonstrates how the sampling time used to measure a pollutant in ambient air over a given time period, particularly with automatic instruments, can affect the uncertainty of the measurement result. It is shown that the uncertainty of the overall result depends critically on how the precision characteristics of the measuring instrumentation vary with analyte abundance. An example of the determination of these characteristics for mercury vapour measurement and the conclusions that may be drawn about optimum sampling times to minimise uncertainty are presented. For situations where uncertainty is minimised by the use of long sampling periods, the implications of this strategy on the "information richness" of the data and on the detection of short-term episodes, as well as peak concentrations, are discussed.

Cervical carcinoma metastatic to the orbit.

PURPOSE: To describe a case of orbital metastasis from an undifferentiated pelvic tumor with probable cervical origination. METHODS: Case report. Detailed ophthalmologic examination, orbital CT and MRI, and orbital biopsy with histologic and immunohistochemical analysis. RESULTS: A 29-year-old woman with a history of untreated cervical dysplasia was hospitalized with flank pain, hematuria, and abnormal vaginal bleeding. Biopsy of a large mass, protruding from the cervix as a grape-like cluster, had cellular morphology and immunohistochemical staining patterns consistent with cervical cancer. Diplopia in downgaze developed shortly after hospitalization. Ophthalmic examination was notable for mild right lower eyelid fullness, 1.5 mm right relative proptosis, and a deficit in supraduction and infraduction of the right eye. Orbital MRI and CT revealed a 1.2 x 1.6-cm mass immediately inferior and posterior to the right globe without bone involvement. On biopsy, the mass had histology similar to that of the pelvic tumor. On metastatic workup, lesions were found involving the left femoral head, liver, and spinal column, with adjacent lymphadenopathy. Despite treatment with radiation and chemotherapy, the patient died several months later of causes related to the systemic disease. CONCLUSIONS: Orbital metastasis of cancer originating in the cervix, despite its rarity, should be considered when an orbital mass of unknown cause is present.