Data on ion-exchange membrane fouling by humic acid during electrodialysis.

This data paper aims to provide data on the effect of the process settings on the fouling of an electrodialysis pilot installation treating a sodium chloride solution (0.1 M and 0.2 M) in the presence of humic acid (1 g/L). This data was used by "Colloidal fouling in electrodialysis: a neural differential equations model" [1] to construct a predictive model and provides interpretive insights into this dataset. 22 electrodialysis fouling experiments were performed where the electrical resistance over the electrodialysis stack was monitored while varying the crossflow velocity (2.0 cm/s - 3.5 cm/s) in the compartments, the current applied (1.41 A - 1.91 A) to the stack and the salt concentration in the incoming stream. The active cycle was maintained for a maximum of 1.5 h after which the polarity was reversed to remove the fouling layer. Additional data is gathered such as the temperature, pH, flow rate, conductivity, pressure in the different compartments of the electrodialysis stack. The data is processed to remove the effect of temperature fluctuations and some filtering is performed. To maximise the reuse potential of this dataset, both raw and processed data are provided along with a detailed description of the pilot installation and sensor locations. The data generated can be useful for researchers and industry working on electrodialysis fouling and the modelling thereof. The availability of conductivity and pH in all compartments is useful to investigate secondary effects of humic acid fouling such as the eventual decrease in membrane permselectivity or water splitting effects introduced by the fouling layer.

Obligate anaerobes are abundant in human necrotizing soft tissue infection samples - a metagenomics analysis.

Necrotizing soft tissue infections (NSTIs) are associated with high morbidity and mortality and are increasing in incidence. Proper identification of the microbial causes of NSTIs is a crucial step in diagnosis and treatment, but the majority of data collected are culture based, which is biased against fastidious organisms, including obligate anaerobes. The goal of this study was to address this gap in knowledge by characterizing NSTI microbial communities through molecular diagnostics. We performed 16S rRNA sequencing on human NSTI samples and identified five genera most commonly found in NSTIs (Prevotella, Bacteroides, Peptoniphilus, Porphyromonas, and Enterococcus). We found that a >70% contribution of obligate anaerobes to the bacterial population distribution was associated with NSTI mortality, and that NSTI samples, from both survivors and non-survivors, had an increased relative abundance of gram negative bacteria compared to those of abscess patients. Based on our data, we conclude that obligate anaerobes are abundant in NSTIs and a high relative abundance of anaerobes is associated with a worse outcome. We recommend increasing anaerobe antibiotic coverage during the treatment of NSTIs even when anaerobes are not found by traditional clinical microbiology methods, and especially when there is a clinical suspicion for anaerobe involvement.

Unfavorable Socioeconomic Factors Underlie High Rates of Hospitalization for Complicated Thyrotoxicosis in Some Regions of the United States.

OBJECTIVE: The authors' institution-a safety net, university, and tertiary-care hospital located in West Texas-has a high number of hospital admissions for complicated thyrotoxicosis. It was hypothesized that unfavorable socioeconomic conditions result in increased risk of poor outcomes in hyperthyroid patients, and increased rates of hospitalization for thyrotoxicosis in West Texas. The primary aim of this study was to identify factors associated with admission for complicated thyrotoxicosis in patients living in the Panhandle and Llano Estacado of Texas. METHOD: A retrospective chart review of patients aged ≥18 years with a diagnosis of thyrotoxicosis evaluated at the authors' institution from January 2011 to January 2017. Patients were divided into two groups: a hospitalized group, consisting of patients who required hospitalization for complicated thyrotoxicosis, and an outpatient group. Demographics, clinical, and biochemical data were reviewed to identify factors associated with hospitalization for complicated thyrotoxicosis. RESULTS: The hospitalized group consisted of 80 patients, and the outpatient group consisted of 294 patients. Thyrotoxicosis accounted for 0.05% of all-cause hospital admissions during the study period. Patients with thyrotoxicosis and a lack of health insurance had 12 times higher odds of being hospitalized for complicated thyrotoxicosis compared to patients with commercial insurance. Conversely, the odds of hospitalization for complicated thyrotoxicosis were reduced by 63% in patients with a higher median income, and by 33% in those with college or university studies versus high school studies. Thirty-two percent of patients hospitalized for complicated thyrotoxicosis presented with thyroid storm, and this accounted for 7% of the studied cohort. CONCLUSION: Socioeconomic conditions are the main factors associated with the odds of being admitted to a hospital in West Texas for complicated thyrotoxicosis, including thyroid storm. Patients without healthcare insurance have higher odds of admission, while patients with higher education and living in areas of higher income have lower odds of hospital admission due to thyrotoxicosis.

Do local antibiotics reduce periprosthetic joint infections? A retrospective review of 744 cases.

Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties. We performed a retrospective chart review of patients two years prior to this date and two years after to compare occurrence of PJI. The groups were broken down into patients who received local antibiotics versus those who did not. The groups were further broken down by type of surgery performed; primary or revision total hip or knee arthroplasty. Administration of local antibiotics was preventative for PJI only in the primary total knee arthroplasty group (aOR = 0.28, 0.09-0.89). Administration of local antibiotics trended towards a preventative effect for PJI in the other groups but was not statistically significant. Patients receiving local antibiotics had similar blood urea nitrogen and creatinine levels postoperatively compared to the no antibiotics group indicating minimal systemic effects of local vancomycin powder. While the use of local antibiotics may prevent PJI, more data is required especially in the revision arthroplasty groups.

Effect of maternal high-fat diet on key components of the placental and hepatic endocannabinoid system.

Maternal obesity in pregnancy has been linked to a spectrum of adverse developmental changes. Involvement of eCBs in obesity is well characterized. However, information regarding eCB physiology in obesity associated with pregnancy is sparse. This study evaluated fetomaternal hepatic, systemic, and placental eCB molecular changes in response to maternal consumption of a HFD. From ≥9 mo before conception, nonpregnant baboons ( Papio spp.) were fed a diet of either 45 (HFD; n = 11) or 12% fat or a control diet (CTR; n = 11), and dietary intervention continued through pregnancy. Maternal and fetal venous plasma samples were evaluated using liquid chromatography-mass spectrometry to quantify AEA and 2-AG. Placental, maternal and fetal hepatic tissues were analyzed using RT-PCR, Western blot, and immunohistochemistry. mRNA and protein expression of endocannabinoid receptors (CB1R and CB2R), FAAH, DAGL, MAGL, and COX-2 were determined. Statistical analyses were performed with the nonparametric Scheirer-Ray-Hare extension of the Kruskal-Wallis test to analyze the effects of diet (HFD vs. CTR), fetal sex (male vs. female), and the diet × sex interaction. Fetal weight was influenced by fetal sex but not by maternal diet. The increase in maternal weight in animals fed the HFD vs. the CTR diet approached significance ( P = 0.055). Maternal circulating 2-AG concentrations increased, and fetal circulating concentrations decreased in the HFD group, independently of fetal sex. CB1R receptor expression was detected in syncytiotrophoblasts (HFD) and the fetal endothelium (CTR and HFD). Placental CB2R protein expression was higher in males and lower in female fetuses in the HFD group. Fetal hepatic CB2R, FAAH, COX-2 (for both fetal sexes), and DAGLα (in male fetuses) protein expression decreased in the HFD group compared with the CTR group. We conclude that consumption of a HFD during pregnancy results in fetal systemic 2-AG and hepatic eCB deficiency.

Socioeconomic status, gender, and burn injury: A retrospective review.

Burn injury rates appear to be influenced by socioeconomic status (SES) and gender globally, but the impact of poverty and gender on burn injury has not been studied in a developed country. This study was a retrospective chart review conducted at a regional burn center in the Southwest US that included 340 patients with TBSA burns >15%. SES was determined using zip code and US census data. The distribution of mechanism of injury was significantly different by gender (χ2(6) = 36.14, p < 0001), but not significantly different by SES (χ2(12) = 19.68, p = 0.073). Burn rates in women was found to have a significant and linear increase (χ2 = 13.8513, p = 0.001) with increasing poverty. Women had higher frequencies of being burned at home, and men had higher frequencies of being burned at work. While poverty did not appear to increase the risk of burn injury overall in a mixed population, it was associated with a significant increase in the risk of burn injury in women. Thus, strategies for decreasing risk factors should be targeted toward low SES females and the working male.

Venous thromboembolism treatment outcomes in cancer patients and effect of third-party payers on anticoagulant choice.

PURPOSE: The purpose of this study is to compare the rates of recurrent VTE among cancer patients treated with parenteral agents to the oral anticoagulants. METHODS: This single-center study was a retrospective chart review of cancer patients with recurrent VTE between January 1, 2009 and December 31, 2014. The primary outcome of the study is the rate of recurrent VTE in patients who received a parenteral anticoagulant (enoxaparin, dalteparin, fondaparinux) versus those who received oral anticoagulants (warfarin and rivaroxaban). Other outcomes investigated include risk factors associated with recurrent VTE events and influence of third-party payer on anticoagulant selection. RESULTS: Four hundred fifty-seven patients met inclusion criteria (178 in the oral anticoagulant group and 279 in the parenteral anticoagulant group). Patients with Medicare were more likely to have received an oral anticoagulant (P = 0.003) and patients with private insurance were more likely to have received a parenteral anticoagulant (P = 0.004). There were 23 recurrent VTE events, 12 events (6.7 %) in the oral anticoagulant group and 11 events (3.94 %) in the parenteral group (P = 0.182). The only significant risk factor noted to increase risk of recurrent VTE was the presence of an IVC filter (adjusted OR 4.38, 95 % CI 1.67-11.53, P = 0.003). CONCLUSIONS: While there is no statistical difference in VTE events between groups, the oral anticoagulant group numerically had a higher rate. Important associations were found to have an influence on anticoagulant selection and risk of recurrent VTE. These factors must be incorporated into decision making when treating cancer patients with VTE.

Fetal Syndrome of Endocannabinoid Deficiency (FSECD) In Maternal Obesity.

The theory of a fetal origin of adult diseases links many pathological conditions to very early life events and is known as a "developmental programming" phenomenon. The mechanisms of this phenomenon are not quite understood and have been explained by inflammation, stress, etc. In particular the epidemic of obesity, with more than 64% of women being overweight or obese, has been associated with conditions in later life such as mental disorders, diabetes, asthma, and irritable bowel syndrome. Interestingly, these diseases were classified a decade ago as Clinical Syndrome of Endocannabinoid Deficiency (CECD), which was first described by Russo in 2004. Cannabinoids have been used for the treatment of chronic pain for millenniums and act through the mechanism of "kick-starting" the components of the endogenous cannabinoid system (ECS). ECS is a pharmacological target for the treatment of obesity, inflammation, cardiovascular and neuronal damage, and pain. We hypothesize that the deteriorating effect of maternal obesity on offspring health is explained by the mechanism of Fetal Syndrome of Endocannabinoid Deficiency (FSECD), which accompanies maternal obesity. Here we provide support for this hypothesis.

Acute effectiveness of a "fat-loss" product on substrate utilization, perception of hunger, mood state and rate of perceived exertion at rest and during exercise.

BACKGROUND: Achieving fat-loss outcomes by ingesting multi-ingredient mixtures may be further enhanced during exercise. This study tested the acute thermogenic effectiveness of a commercially available multi-ingredient product (Shred-Matrix®), containing Green Tea Extract, Yerba Maté, Guarana Seed Extract, Anhydrous caffeine, Saw palmetto, Fo-Ti, Eleuthero root, Cayenne Pepper, and Yohimbine HCI, on fatty acid oxidation (FAO), perception of hunger, mood state and rate of perceived exertion (RPE) at rest and during 30 min of submaximal exercise. METHODS: Following institutional ethical approval, twelve healthy recreationally active participants, five females and seven males, were randomized to perform two separate experimental ergometry cycling trials, and to ingest 1.5 g (3 × capsules) of either a multi-ingredient supplement (SHRED) or placebo (PL). Participants rested for 3 h, before performing a 30-min cycling exercise corresponding to their individually-determined intensity based on their maximal fat oxidation (Fatmax). Fatty acid oxidation (FAO) was determined at rest, 3 h before exercise (Pre1), immediately before exercise (Pre2) and during exercise (Post), using expired gasses and indirect calorimetry. Rate of perceived exertion (RPE) was measured every 3 min during the 30-min exercise. Additionally both mood state and perception of hunger were assessed at Pre1, Pre2 and Post exercise. A repeated measures ANOVA design and Cohen's d effect sizes were used to analyze potential differences between times and treatment conditions. RESULTS: FAO increased in SHRED from Pre1 to Pre2 [0.56 ± 0.26 to 0.96 ± 0.37, (p = 0.003, d =1.34)] but not in PL [0.67 ± 0.25 to 0.74 ± 0.19, (p = 0.334) d = 0.49], with no differences were found between conditions (p = 0.12, d = 0.49). However, Cohen's d = 0.77 revealed moderate effect size in favor of SHRED from Pre to Post exercise. RPE values were lower in SHRED compared to Pl (p< 0.001). Mood state and perception of hunger were not different between conditions, with no interaction effects. However, a trend was shown towards improved satiety in SHRED compared with PL, [F(1,11) = 3.58, p = 0.085]. CONCLUSIONS: The multi-ingredient product's potential enhancement of FAO during exercise, satiety, and RPE reduction suggests an acute effectiveness of SHRED in improving the exercise-related fat loss benefits.

Does polarized training improve performance in recreational runners?

PURPOSE: To quantify the impact of training-intensity distribution on 10K performance in recreational athletes. METHODS: 30 endurance runners were randomly assigned to a training program emphasizing low-intensity, sub-ventilatory-threshold (VT), polarized endurance-training distribution (PET) or a moderately high-intensity (between-thresholds) endurance-training program (BThET). Before the study, the subjects performed a maximal exercise test to determine VT and respiratory-compensation threshold (RCT), which allowed training to be controlled based on heart rate during each training session over the 10-wk intervention period. Subjects performed a 10-km race on the same course before and after the intervention period. Training was quantified based on the cumulative time spent in 3 intensity zones: zone 1 (low intensity, RCT). The contribution of total training time in each zone was controlled to have more low-intensity training in PET (±77/3/20), whereas for BThET the distribution was higher in zone 2 and lower in zone 1 (±46/35/19). RESULTS: Both groups significantly improved their 10K time (39min18s ± 4min54s vs 37min19s ± 4min42s, P < .0001 for PET; 39min24s ± 3min54s vs 38min0s ± 4min24s, P < .001 for BThET). Improvements were 5.0% vs 3.6%, ~41 s difference at post-training-intervention. This difference was not significant. However, a subset analysis comparing the 12 runners who actually performed the most PET (n = 6) and BThET (n = 16) distributions showed greater improvement in PET by 1.29 standardized Cohen effect-size units (90% CI 0.31-2.27, P = .038). CONCLUSIONS: Polarized training can stimulate greater training effects than between-thresholds training in recreational runners.

Training-intensity distribution during an ironman season: relationship with competition performance.

PURPOSE: To describe training loads during an Ironman training program based on intensity zones and observe Training-performance relationships. METHODS: Nine triathletes completed a program with the same periodization model aiming at participation in the same Ironman event. Before and during the study, subjects performed ramp-protocol tests, running, and cycling to determine aerobic (AeT) and anaerobic thresholds (AnT) through gas-exchange analysis. For swimming, subjects performed a graded lactate test to determine AeT and AnT. Training was subsequently controlled by heart rate (HR) during each training session over 18 wk. Training and the competition were both quantified based on the cumulative time spent in 3 intensity zones: zone 1 (low intensity; AnT). RESULTS: Most of training time was spent in zone 1 (68% ± 14%), whereas the Ironman competition was primarily performed in zone 2 (59% ± 22%). Significant inverse correlations were found between both total training time and training time in zone 1 vs performance time in competition (r = -.69 and -.92, respectively). In contrast, there was a moderate positive correlation between total training time in zone 2 and performance time in competition (r = .53) and a strong positive correlation between percentage of total training time in zone 2 and performance time in competition (r = .94). CONCLUSIONS: While athletes perform with HR mainly in zone 2, better performances are associated with more training time spent in zone 1. A high amount of cycling training in zone 2 may contribute to poorer overall performance.

Effects of a low volume injury prevention program on the hamstring torque angle relationship.

The effects of a 4-week lower body injury prevention program on knee muscle torque-angle relationship were examined in soccer players. Twenty men were randomly allocated to either a control (n = 10) or training group (n = 10). The training group underwent three training sessions per week, comprising 3 sets of 8 repetitions of one open-chain exercise (Nordic curl) and two closed-chain exercises-forward lunges on a Bosu balance trainer and eccentric single leg dead lifts. Maximal peak knee flexion torque was measured at 35°, 45°, 60°, 80°, 90°, and 100° pre- and post-intervention. Significant improvements were observed only at 80° (p = .001; d = .94) along with a nonsignificant trend at 35° (p = .081; d = .43). As these modifications might protect athletes against muscle and joint injuries, the use of both stable-open and unstable-closed kinetic chain exercises emphasizing eccentric hamstring and knee stabilization actions should be integrated into injury prevention programs in team sports athletes.