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The article discusses the restrospective observational study on the misuse of methylphenidate (MPH) by adult patients in Denmark. The study involved data from the Danish Poison Information Centre in Copenhagen, Denmark from January 2006 to July 2012. The results reportedly revealed that increase of MPH exposures is significantly parallel to the increase in therapeutic use and that most MPH exposure were intentional.

The cGAS-STING pathway plays a crucial role in anti-tumoral responses by activating inflammation and reprogramming the tumour microenvironment. Upon activation, STING traffics from the endoplasmic reticulum (ER) to Golgi, allowing signalling complex assembly and induction of interferon and inflammatory cytokines. Here we report that cGAMP stimulation leads to a transient decline in ER cholesterol levels, mediated by Sterol O-Acyltransferase 1-dependent cholesterol esterification. This facilitates ER membrane curvature and STING trafficking to Golgi. Notably, we identify two cholesterol-binding motifs in STING and confirm their contribution to ER-retention of STING. Consequently, depletion of intracellular cholesterol levels enhances STING pathway activation upon cGAMP stimulation. In a preclinical tumour model, intratumorally administered cholesterol depletion therapy potentiated STING-dependent anti-tumoral responses, which, in combination with anti-PD-1 antibodies, promoted tumour remission. Collectively, we demonstrate that ER cholesterol sets a threshold for STING signalling through cholesterol-binding motifs in STING and we propose that this could be exploited for cancer immunotherapy., (© 2024. The Author(s).)

Objective: 10% of all adult Danish citizen has a functional disorder (FD). This study aimed to describe how patients referred to specialized treatment (CFD; Clinic for Functional Disorders) differentiate from those not referred to specialized treatment in terms of sex, comorbidty, different types of hospital contacts and affiliation to labour market 12 and 60 months prior discharged from the hospital with a FD-diagnosis between 2019 and 2021., Methods: The study was a register-based cross-sectional study of patients discharged with a FD in North Denmark Region between 2019 and 2021 (study period). Patients between 18 and 65 years of age with FD were identified in the regional patient administrative system., Results: A total of 6831 patients were discharged from the hospital with a FD, of which 160 were referred to CFD. Patients with FD were more likely to be referred to CFD, if they were female, had reduced or no affiliation to the labour market or most hospital contacts were as outpatient. Moreover, an increase in hospital contacts as outpatient and a reduction in affiliation to labour market over time increased the chance of being treated at CFD., Conclusion: Patients referred to CFD differed from patients not referred to CFD. Patients referred to CFD were to a lesser extent affiliated to the labour market but had more often hospital contacts as outpatient prior to being discharged with FD. In addition, patients referred to CFD increased their contacts to the hospital as outpatient more than those not referred during the preceding 5 years from discharge with FD., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Recycling of phosphorus (P) from waste streams in agriculture is essential to reduce the negative environmental effects of surplus P and the unsustainable mining of geological P resources. Sewage sludge (SS) is an important P source; however, several issues are associated with the handling and application of SS in agriculture. Thus, post-treatments such as pyrolysis of SS into biochar (BC) could address some of these issues. Here we elucidate how patches of SS in soil interact with the living roots of wheat and affect important P-related rhizosphere processes compared to their BC counterparts. Wheat plants were grown in rhizoboxes with sandy loam soil, and 1 cm Ø patches with either SS or BC placed 10 cm below the seed. A negative control (CK) was included. Planar optode pH sensors were used to visualize spatiotemporal pH changes during 40 days of plant growth, diffusive gradients in thin films (DGT) were applied to map labile P, and zymography was used to visualize the spatial distribution of acid (ACP) and alkaline (ALP) phosphatase activity. In addition, bulk soil measurements of available P, pH, and ACP activity were conducted. Finally, the relative abundance of bacterial P-cycling genes (phoD, phoX, phnK) was determined in the patch area rhizosphere. Labile P was only observed in the area of the SS patches, and SS further triggered root proliferation and increased the activity of ACP and ALP in interaction with the roots. In contrast, BC seemed to be inert, had no visible effect on root growth, and even reduced ACP and ALP activity in the patch area. Furthermore, there was a lower relative abundance of phoD and phnK genes in the BC rhizosphere compared to the CK. Hence, optimization of BC properties is needed to increase the short-term efficiency of BC from SS as a P fertilizer., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Klaus Koren and Theresa Merl report that financial support was provided by Grundfos Foundation. Klaus Koren and Theresa Merl report that financial support was provided by Independent Research Fund Denmark (IRFD) (Grant number DFF-8048-00057B). Marie Louise Bornø, Mette H. Nicolaisen, Frederik Bak, Athanasios Zervas, Lars S. Jensen, and Dorette S. Müller-Stöver reports that financial support was provided by Novo Nordic Foundation (Grant number: NNF19SA0059360)., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Life cycle assessment (LCA) was applied to evaluate duckweed ponds and constructed wetlands as polishing steps in pig manure liquid fraction treatment. Using nitrification-denitrification (NDN) of the liquid fraction as the starting point, the LCA compared direct land application of the NDN effluent with different combinations of duckweed ponds, constructed wetlands and discharge into natural waterbodies. Duckweed ponds and constructed wetlands are viewed as a viable tertiary treatment option and potential remedy for nutrient imbalances in areas of intense livestock farming, such as in Belgium. As the effluent stays in the duckweed pond, settling and microbial degradation reduce the remaining phosphorous and nitrogen concentrations. Combined with duckweed and/or wetland plants that take up nutrients in their plant body, this approach can reduce over-fertilisation and prevent excessive nitrogen losses to aquatic environments. In addition, duckweed could serve as an alternative livestock feed and replace imports of protein destined for animal consumption. The environmental performance of the overall treatment systems studied was found to depend greatly on assumptions about the possible avoidance of potassium fertiliser production through the field application of effluents. If it is assumed that the potassium contained in the effluent replaces mineral fertiliser, direct field application of the NDN effluent performed best. If the application of NDN effluent does not lead to mineral fertiliser savings or if the replaced K fertiliser is of low grade, duckweed ponds seem to be a viable additional step in the manure treatment chain. Consequently, whenever background concentrations of N and/or P in fields allow for effluent application and potassium fertiliser substitution, direct application should be favoured over further treatment. If direct land application of the NDN effluent is not an option, the focus should be on long residence times in duckweed ponds to allow for maximum nutrient uptake and feed production., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

A key phenomenon in cancer is the establishment of a highly immunosuppressive tumour microenvironment (TME). Despite advances in immunotherapy, where the purpose is to induce tumour recognition and hence hereof tumour eradication, the majority of patients applicable for such treatment still fail to respond. It has been suggested that high immunological activity in the tumour is essential for achieving effective response to immunotherapy, which therefore have led to exploration of strategies that triggers inflammatory pathways. Here activation of the stimulator of interferon genes (STING) signalling pathway has been considered an attractive target, as it is a potent trigger of pro-inflammatory cytokines and types I and III interferons. However, immunotherapy combined with targeted STING agonists has not yielded sustained clinical remission in humans. This suggests a need for exploring novel adjuvants to improve the innate immunological efficacy. Here, we demonstrate that extracellular vesicles (EVs), derived from activated CD4 + T cells (T-EVs), sensitizes macrophages to elevate STING activation, mediated by IFNγ carried on the T-EVs. Our work support that T-EVs can disrupt the immune suppressive environment in the tumour by reprogramming macrophages to a pro-inflammatory phenotype, and priming them for a robust immune response towards STING activation., (© 2023 The Authors. Journal of Extracellular Vesicles published by Wiley Periodicals, LLC on behalf of the International Society for Extracellular Vesicles.)

Current political focus on promoting circular economy in the European Union drives great interest in developing and using more biobased fertilizers (BBFs, most often waste or residue-derived). Many studies have been published on environmental emissions, including ammonia (NH 3 ) volatilization from manures, but there have only been a few such studies on BBFs. Ammonia volatilization from agriculture poses a risk to the environment and human health, causing pollution in natural ecosystems when deposited and formation of fine particulate matter (PM x ). Furthermore, NH 3 volatilization results in removal of plant-available N from agricultural systems, constituting an economic loss for farmers. The aim of this laboratory study was to determine the potential NH 3 volatilization from 39 different BBFs commercially available on the European market. In addition, this study aimed to investigate the effect of incorporation, application rate, soil type, and soil moisture content on potential NH 3 volatilization in order to derive suggestions for the optimal field application conditions. Results showed a great variation between BBFs in potential NH 3 volatilization, both in terms of their temporal pattern of volatilization and amount of NH 3 volatilized. The potential NH 3 volatilization varied from 0% of applied total N (olive oil compost) to 64% of applied total N (manure and crop digestate) during a 27- or 44-day incubation period. Characteristics of BBFs (pH, NH 4 + -N, NO 3 - -N, DM, C:N) and their interaction with time could explain 89% of the variation in accumulated potential NH 3 volatilization. Incorporation of BBFs into an acidic sandy soil effectively reduced potential NH 3 volatilization by 37%-96% compared to surface application of BBFs. Potential NH 3 volatilization was not significantly affected by differences in application rate or soil moisture content, but varied between five different soils (with different clay and organic matter content), with the highest NH 3 volatilization potential from the acidic sandy soil., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Nitrogen fertilisation contributes significantly to the atmospheric increase of nitrous oxide (N 2 O). Application of nitrification inhibitors (NIs) is a promising strategy to mitigate N 2 O emissions and improve N-use efficiency in agricultural systems. This study investigated the effect of NI, 3,4-dimethylpyrazol phosphate (DMPP) on N 2 O mitigation from spring barley and spring oilseed rape. Manual and automatic chamber methodologies were used to capture spatial and temporal variability in N 2 O emissions. In a second experiment, we study the effect of N fertiliser levels without NI (0 %, 50 %, 100 %, 150 % and 200 % of recommended amount of N fertiliser), as well as 100 % of N with NI on N 2 O emissions in spring barley. The automated chamber measurements showed dynamics of N 2 O changes throughout the season, including positive and negative peaks that were unobservable with manual chambers due to low temporal resolution. Although not significant, application of NI tended to reduce N 2 O emissions. The reduction was on average 16 % in spring barley and 58 % in spring oilseed rape in manual chamber measurements. However, N 2 O reduction was 108 % in continuous automatic chamber measurements in spring barley. The N 2 O EFs for the growing season were very low (0.025 % to 0.148 %), with a greater reduction in EF in spring oilseed rape (76 %) than in spring barley (32 %) with NI application. A positive correlation (R = 80 %) was observed between N fertiliser levels and N 2 O emissions. Crop yield and crop N uptake were not significantly affected by the use of NI. This study highlighted that NI can reduce N 2 O emissions, but the reduction effects are plot, crop and microclimate specific. Long-term experiments with continuous plot-scale measurements are needed to capture and optimise N 2 O mitigation effect of NIs across wide variability in soils and microclimates in agroecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

The EU nitrogen expert panel (EUNEP) has proposed nitrogen-based indicators for farm productivity (N output), efficiency (NUE) and environmental emissions (N surplus). This model-based study (using the Daisy model) was carried out, i) to study the effects of soil type, soil organic matter (SOM), cropping pre-histories varying in C input, 3-to-4 manure-to-mineral N proportions and ten crop rotations on the N-based indicators, and ii) to evaluate the adequacy of these indicators by establishing quantitative relationships between N surplus, N loss and soil organic N (SON) stock change. The results, averaged over 24-year simulation period, indicated that grass-clover dominant rotations had highest N output and showed a tendency to increase SON stocks when compared with spring-cereal monocultures. For most rotations, the NUE ranged between 70 and 75 %. The SON stocks were mainly influenced by initial SOM and cropping prehistory, and stocks increased only under low initial SOM and low C input cropping pre-history (spring barley). Overall, SON stocks tended to increase under low C input pre-history, coarse sand, low initial SOM and high manure N, however, this combination did not result in highest productivity, NUE, and lowest N losses. The relations between N surplus, N loss and SON stock change were strongly affected by crop rotations, emphasizing that using N surplus as an indicator for N leaching/losses while ignoring changes in SON stocks may result in biased conclusions, e.g. estimated average error for N losses ranged from -45 % (underestimation) for maize monoculture to +50 % (overestimation) for continuous grass-clover ley. The results also imply that the environmental assessment of cropping systems must be improved by combining above indicators with estimation of N loss and SON stock changes. This study provides a detailed account of N balance components/N indicators for diverse crop rotations and their use according to the recommendations of the EUNEP., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Nitrate (N) leaching from intensively managed cropping systems is of environmental concern and it varies at local scale. To evaluate the performance of agricultural practices at this scale, there is a need to develop comprehensive assessments of N leaching and the N leaching reduction potential of mitigation measures. A model-based analysis was performed to (i) estimate N leaching from Danish cropping systems, representing 20 crop rotations, 3 soil types, 2 climates and 3-4 levels of manure (slurry)-to-fertilizer ratios, but with same available N (according to regulatory N fertilization norms), and (ii) appraise mitigation potential of on-farm measures (i.e. catch crops, early sowing of winter cereals) to reduce N leaching. The analysis was performed using a process-based agro-environmental model (Daisy). Simulated average N leaching over 24 years ranged from 16 to 85 kg N/ha/y for different crop rotations. Rotations with a higher proportion of spring crops were more prone to leaching than rotations having a higher proportion of winter cereals and semi-perennial grass-clover leys. N leaching decreased with increasing soil clay content under all conditions. The effect of two climates (different regions, mainly differing in precipitation) on N leaching was generally similar, with slight variation across rotations. Supplying a part of the available N as manure-N resulted in similar N leaching as mineral fertilizer N alone during the simulation period. Among the mitigation measures, both undersown and autumn sown catch crops were effective. Effectiveness of measures also depended on their place and frequency of occurrence in a rotation. Adopting catch crops during the most leaching-prone years and with higher frequency were effective choices. This analysis provided essential data-driven knowledge on N leaching risk, and potential of leaching reduction options. These results can serve as a supplementary guiding-tool for farmers to plan management practices, and for legislators to design farm-specific regulatory measures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

During germination, the seed releases nutrient-rich exudates into the spermosphere, thereby fostering competition between resident microorganisms. However, insight into the composition and temporal dynamics of seed-associated bacterial communities under field conditions is currently lacking. This field study determined the temporal changes from 11 to 31 days after sowing in the composition of seed-associated bacterial communities of winter wheat as affected by long-term soil fertilization history, and by introduction of the plant growth-promoting microbial inoculants Penicillium bilaiae and Bacillus simplex. The temporal dynamics were the most important factor affecting the composition of the seed-associated communities. An increase in the relative abundance of genes involved in organic nitrogen metabolism (ureC and gdhA), and in ammonium oxidation (amoA), suggested increased mineralization of plant-derived nitrogen compounds over time. Dynamics of the phosphorus cycling genes ppt, ppx and cphy indicated inorganic phosphorus and polyphosphate cycling, as well as phytate hydrolysis by the seed-associated bacteria early after germination. Later, an increase in genes for utilization of organic phosphorus sources (phoD, phoX and phnK) indicated phosphorus limitation. The results indicate that community temporal dynamics are partly driven by changed availability of major nutrients, and reveal no functional consequences of the added inoculants during seed germination., (© The Author(s) 2022. Published by Oxford University Press on behalf of FEMS.)

This dataset presents the chemical characteristics of plant biomass and crop residues from agrosystems in European areas (carbon and nitrogen contents and biochemical composition). These data have been collected from the scientific literature. The specific data and their origins are presented. The mean values from these data are also provided by major production type (main crops, forage and pasture crops, green manure and cover crops, vegetable crops and energy crops), species and litter type. These data were collected as part of the framework of the European project ResidueGas (ERA-GAS, 2017-2021), which aims to improve the estimation of greenhouse gas emissions associated with crop residues., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article., (© 2021 The Authors. Published by Elsevier Inc.)

Aims: To determine inactivation of Cryptosporidium parvum oocysts and reduction of Escherichia coli and enterococci in cattle slurry added aqueous ammonia., Methods and Results: Escherichia coli, enterococci and nonviable C. parvum oocysts (DAPI+PI+) were enumerated every second day for 2 weeks in cattle slurry amended with 60 mmol l -1 aq. ammonia and compared with untreated slurry at three temperatures. Regardless of temperature, the proportion of nonviable C. parvum oocysts increased significantly faster over time in slurry with added ammonia than raw slurry (P = 0·021) corresponding to 62·0% higher inactivation (P = 0·001) at day 14. Additionally, 91·8% fewer E. coli and 27·3% fewer enterococci were observed in slurry added ammonia at day 14 compared to raw slurry., Conclusion: The addition of aqueous ammonia to raw slurry significantly reduced the viability of C. parvum oocysts and numbers of bacterial indicators. Hence, ammonia is usable at lower pathogen concentrations in slurry before application to agricultural land., Significance and Impact of the Study: Livestock waste is a valuable source of plant nutrients and organic matter, but may contain high concentrations of pathogens like E. coli and Cryptosporidium sp. that can be spread in the environment, and cause disease outbreaks. However, die-off rates of pathogens in organic waste can increase following increasing ammonia concentrations., (© 2020 The Society for Applied Microbiology.)

Phosphate-solubilising microorganisms (PSM) are often reported to have positive effects on crop productivity through enhanced phosphorus (P) nutrition. Our aim was to evaluate the validity of this concept. Most studies that report 'positive effects' of PSM on plant growth have been conducted under controlled conditions, whereas field experiments more frequently fail to demonstrate a positive response. Many studies have indicated that the mechanisms seen in vitro do not translate into improved crop P nutrition in complex soil-plant systems. Furthermore, associated mechanisms are often not rigorously assessed. We suggest that PSM do not mobilise sufficient P to change the crops' nutritional environment under field conditions. The current concept, in which PSM solubilise P 'for the plant' should thus be revised. Although PSM have the capacity to solubilise P to meet their own needs, it is the turnover of the microbial biomass that subsequently provides P to plants over a longer time. Therefore, the existing concept of PSM function is unlikely to deliver a reliable strategy for increasing crop P nutrition. A further mechanistic understanding is needed to determine how P mobilisation by PSM as a component of the whole soil community can be manipulated to become more effective for plant P nutrition., (© 2020 The Authors New Phytologist © 2020 New Phytologist Trust.)

Objective: Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe., Summary Background Data: The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries., Methods: Using a secure online platform (www.gastrodata.org), referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period., Results: A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications' incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and Comprehensive Complications Index were IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively., Conclusions: The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications.

Rice production systems are the largest anthropogenic wetlands on earth and feed more than half of the world's population. However, they are also a major source of global anthropogenic greenhouse gas (GHG) emissions. Several agronomic strategies have been proposed to improve water-use efficiency and reduce GHG emissions. The aim of this study was to evaluate the impact of water-saving irrigation (alternate wetting and drying (AWD) vs. soil water potential (SWP)), contrasting land establishment (puddling vs. reduced tillage) and fertiliser application methods (broadcast vs. liquid fertilisation) on water-use efficiency, GHG emissions and rice yield. The experiment was laid out in a randomised complete block design with eight treatments (all combinations of the three factors) and four replicates. AWD combined with broadcasting fertilisation was superior to SWP in terms of maintaining yield. However, seasonal nitrous oxide (N 2 O) emissions were significantly reduced by 64% and 66% in the Broadcast-SWP and Liquid fertiliser-SWP treatments, respectively, compared to corresponding treatments in AWD. The SWP also significantly reduced seasonal methane (CH 4 ) emissions by 34 and 30% in the broadcast and liquid fertilisation treatments, respectively. Area-scaled GWPs were reduced by 48% and 54% in Broadcast-SWP and Liquid fertiliser-SWP treatments respectively compared to the corresponding treatments in AWD. Compared to AWD, the broadcast and liquid fertilisation in SWP irrigation treatments reduced yield-scaled GWPs by 46% and 37%, respectively. In terms of suitability, based on yield-scaled GWPs, the treatments can be ordered as follows: Broadcast-SWP < Broadcast-AWD = Liquid fertiliser-SWP < Liquid fertiliser-AWD. Growing-season water use was 15% lower in the SWP treatments compared with the water-saving AWD. Reduced tillage reduced additional water use during land preparation. The conclusions of this study are that improved water management and timely coordination of N fertiliser with crop demand can reduce water use, N loss via N 2 O emissions, and CH 4 emissions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

In recent years, there has been a surge in the number of applications of Fourier-transform mid-infrared (FTIR) spectroscopy for the characterization of environmental samples and prediction of some of their properties whose measurement has traditionally involved time-consuming and costly methods. However, there are several different mid-infrared techniques available, and there is a gap in knowledge regarding the best-suited technique for recording informative spectra of different types of environmental samples. This study compared the three most widespread FTIR techniques using solid and liquid samples. A total of 11 environmental samples belonging to four categories were analyzed with attenuated total reflectance (ATR), photoacoustic (PAS), and diffuse reflectance (DR) FTIR spectroscopy. Overall, PAS-FTIR was the best technique, providing a greater amount of information, especially for opaque samples (i.e., organic waste, biochar, and soil), than ATR-FTIR and DR-FTIR spectroscopy. Attenuated total reflectance FTIR provided the best spectra for soft samples, such as plant materials, probably due to their ability to achieve good optical contact with the ATR crystal. Finally, DR-FTIR performed relatively well for most samples but was found to be more sensitive to moisture in the samples, resulting in noise in specific areas, and was less sensitive in bond vibrations related to Si., (© 2020 The Authors. Journal of Environmental Quality © 2020 American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.)

Background: Low-resource rural communities face significant challenges regarding availability and adequacy of evidence-based services., Purposes: With respect to accessing evidence-based services for Autism Spectrum Disorder (ASD), this brief report summarizes needs of rural citizens in the South-Central Appalachian region, an area notable for persistent health disparities., Methods: A mixed-methods approach was used to collect quantitative and qualitative data during focus groups with 33 service providers and 15 caregivers of children with ASD in rural southwest Virginia., Results: Results supported the barriers of availability and affordability of ASD services in this region, especially relating to the need for more ASD-trained providers, better coordination and navigation of services, and addition of programs to assist with family financial and emotional stressors. Results also suggested cultural attitudes related to autonomy and trust towards outside professionals that may prevent families from engaging in treatment., Implications: Relevant policy recommendations are discussed related to provider incentives, insurance coverage, and telehealth. Integration of autism services into already existing systems and multicultural sensitivity of providers are also implicated., (Copyright © 2020 Angela Scarpa, Laura S. Jensen, Denis Gracanin, Sharon L. Ramey, Angela V. Dahiya, L. Maria Ingram, Jordan Albright, Alyssa J. Gatto, Jen P. Scott, and Lisa Ruble.)

Thermal drying is an increasingly common post-treatment for digestate-solids, but prone to N losses via ammonia (NH 3 ) volatilization. Acidification with strong acids prior to drying may retain ammonium (NH 4 + ) in the solids. Natural zeolites can provide adsorption sites for exchangeable cations as ammonium and porosity for free ammonia, which has the potential to contribute to higher N retention in the dried solids. The present study investigated whether the zeolite addition increases NH 4 + -N retention during thermal drying of two digestate solids (manure based, MDS; sewage sludge based, SDS), and whether any synergistic effects of combining acidification with sulfuric acid and the addition of zeolite exist. Operating conditions included four pH levels (non-acidified control, adjusted to 8.0, 7.5, 6.5 with concentrated sulfuric acid), four zeolite addition rates (0%, 1%, 5% and 10%), fixed drying temperature (130 °C) and fixed air ventilation rate (headspace exchange rate of 286 times hour -1 ). Zeolite addition significantly increased NH 4 + -N retention from 18.0% of initial NH 4 + -N in the non-acidified control up to a maximum of 57.4% for MDS, and from 76.6% to 94.5% for SDS. No positive synergistic effect between acidification and zeolite addition was observed, with acidification being the dominant. Nevertheless, zeolite has the potential to be a safe and easy-to-handle alternative to concentrated sulfuric acid., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose: Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2-4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy. Methods: 16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. 'Return to work' was defined as being self-supporting one year after diagnosis of breast cancer. Results: 16% of our cohort had used psychiatric medical treatment 2-4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87-0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity. Conclusions: Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer. Implications for cancer survivors: Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.

A life cycle assessment (LCA) was performed on five garden waste treatment practices: the production of mature compost including the woody fraction (MCIW), the production of mature compost without the woody fraction (MCWW), the production of immature compost without the woody fraction (ICWW), fresh garden waste including the woody fraction (GWIW) and fresh garden waste without the woody fraction (GWWW). The assessment included carbon sequestration after land application of the garden waste and composts, and associated emissions. The removed woody fraction was incinerated and energy recovery included as heat and electricity. The functional unit of the assessment was treatment of 1000 kg of garden waste generated in Denmark. Overall, the results showed that composting of garden waste resulted in comparable or higher environmental impact potentials (depletion of abiotic resources, marine eutrophication, and terrestrial eutrophication and acidification) than no treatment before land application. The toxicity potentials showed the highest normalised impact potentials for all the scenarios, but were unaffected by the different garden waste treatments. The choice of energy source for substituted heat and electricity production affected the performance of the different treatment scenarios with respect to climate change. The scenarios with removal of the woody fraction performed better than the scenarios without removal of the woody fraction when fossil energy sources were substituted, but performed worse when renewable energy sources were substituted. Furthermore, the study showed the importance of including long-term emission factors after land application of fresh and composted garden waste products since the greatest proportion of carbon and nitrogen emissions occurred after land application in three out of the five scenarios for carbon and in all scenarios for nitrogen., (Copyright © 2019. Published by Elsevier Ltd.)

Persisting post-concussive symptoms are challenging to treat and may delay return-to-work (RTW). The aims of this study were to describe a multidisciplinary and holistic vocational rehabilitation (VR) program for individuals with mild traumatic brain injury (mTBI) and to explore course and predictors of employment outcome during VR. The VR program was described using the Standard Operating Procedures (SOPs) framework. Further, a retrospective, cohort study on individuals with mTBI receiving VR was conducted based on clinical records ( n = 32; 22% males; mean age 43.2 years; 1.2 years since injury on average). The primary outcome was difference in hours at work per week from pre- to post-VR, and the secondary outcome was change in a three-level RTW-status. Time since injury, age, sex, and loss of consciousness were investigated as predictors of the outcomes. The VR intervention is individually tailored and targets patients' individual needs. Thus, it may combine a variety of methods based on a biopsychosocial theoretical model. During VR, hours at work, 17.0 ± 2.2, p < 0.001, and RTW-status, OR = 14.0, p < 0.001, improved significantly with 97% having returned to work after VR. Shorter length of time since injury and male sex were identified as predictors of a greater gain of working hours. Time since injury was the strongest predictor; double the time was associated with a reduction in effect by 4.2 ± 1.4 h after adjusting for working hours at start of VR. In sum, these results suggest that individuals facing persistent problems following mTBI may still improve employment outcomes and RTW after receiving this multidisciplinary and holistic VR intervention, even years after injury. While results are preliminary and subject to bias due to the lack of a control group, this study warrants further research into employment outcomes and VR following mTBI, including who may benefit the most from treatment.

The drive to a more circular economy has created increasing interest in recycling organic wastes as bio-based fertilizers. This study screened 15 different manures, digestates, sludges, composts, industry by-products, and struvites. Nitrogen (N) and phosphorous (P) release was compared following addition to soil. Three waste materials were then 'upgraded' using heating and pressure (105°C at 220 kPa), alkalinization (pH 10), or sonification to modify N and P release properties, and compared in a second soil incubation. Generally, maximum N release was negatively correlated with the CN ratio of the material (r = -0.6). Composted, dried, or raw organic waste materials released less N (mean of 10.8 ± 0.5%, 45.3 ± 7.2%, and 47.4 ± 3.2% of total N added respectively) than digestates, industry-derived organic fertilizer products, and struvites (mean of 58.2 ± 2.8%, 77.7 ± 6.0%, and 100.0 ± 13.1% of total N added respectively). No analyzed chemical property or processing type could explain differences in P release. No single upgrading treatment consistently increased N or P release. However, for one raw biosolid, heating at a low temperature (105°C) with pressure did increase N release as a percentage of total N added to soil from 30% to 43%.

Background: Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus., Methods: The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications., Results: A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet., Conclusion: The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.

Background: As older gastric cancer patients are often excluded from randomized clinical trials, the most appropriate treatment strategy for these patients remains unclear. The current study aimed to gain more insight in treatment strategies and relative survival of older patients with resectable gastric cancer across Europe., Methods: Population-based cohorts from Belgium, Denmark, The Netherlands, Norway, and Sweden were combined. Patients ≥70 years with resectable gastric cancer (cT1-4a, cN0-2, cM0), diagnosed between 2004 and 2014 were included. Resection rates, administration of chemotherapy (irrespective of surgery), and relative survival within a country according to stage were determined., Results: Overall, 6698 patients were included. The percentage of operated patients was highest in Belgium and lowest in Sweden for both stage II (74% versus 56%) and stage III disease (57% versus 25%). For stage III, chemotherapy administration was highest in Belgium (44%) and lowest in Sweden (2%). Three year relative survival for stage I, II, and III disease in Belgium was 67.8% (95% CI:62.8-72.6), 41.2% (95% CI:37.3-45.2), 17.8% (95% CI:12.5-24.0), compared with 56.7% (95% CI:51.5-61.7), 31.3% (95% CI:27.6-35.2), 8.2% (95% CI:4.4-13.4) in Sweden. There were no significant differences in treatment strategies of patients with stage I disease., Conclusion: Substantial treatment differences are observed across North European countries for patients with stages II and III resectable gastric cancer aged 70 years or older. In the present comparison, treatment strategies with a higher proportion of patients undergoing surgery seemed to be associated with higher survival rates for patients with stages II or III disease., (Copyright © 2018. Published by Elsevier Ltd.)

Water drainage is an important mitigation option for reducing CH 4 (methane) emissions from residue-amended paddy soils. Several studies have indicated a long-term reduction in CH 4 emissions, even after re-flooding, suggesting that the mechanism goes beyond creating temporary oxidized conditions in the soil. In this pot trial, the effects of different drainage patterns on straw-derived CH 4 and CO 2 (carbon dioxide) emissions were compared to identify the balance between straw-carbon CH 4 and CO 2 emissions influenced by soil aeration over different periods, including effects of drainage on emissions during re-flooding. The water treatments included were: continuous flooding [C] as the control and five drainage patterns (pre-planting drainage [P], early-season drainage [E], midseason drainage [M], pre-planting plus midseason drainage [PM], early-season-plus-midseason drainage [EM]). An equal amount of 13 C-enriched rice straw was applied to all treatments to identify straw-derived 13 C-gas emissions from soil carbon derived emissions. The highest fluxes of CH 4 and δ 13 C-CH 4 were recorded from the control treatment in the first week after straw application. The CH 4 flux and δ 13 C-CH 4 were reduced the most (0.1-0.8 μg CH 4 g -1 soil day -1 and -13 to -34‰) in the pre-planting and pre-planting plus midseason drainage treatments at day one after transplanting. Total and straw-derived CH 4 emissions were reduced by 69% and 78% in pre-planting drainage and 77% and 87% in pre-planting plus midseason drainage respectively, compared to control. The early-season, midseason, pre-planting plus midseason and early-season-plus-midseason drainage treatments resulted in higher total and straw-derived CO 2 emissions compared to the control and pre-planting drainage treatments. The pre-planting and pre-planting plus midseason drainage treatments lowered the global warming potential by 47-53%, and early-season and early-season-plus-midseason drainage treatments reduced it by 24-31% compared to control. By using labelled crop residues, this experiment demonstrates a direct link between early drainage and reduced CH 4 emissions from incorporated crop residues, eventually leading to a reduction in total global warming potential. It is suggested that accelerated decomposition of the residues during early season drainage prolonged the reduction in CH 4 emissions. Therefore, it is important to introduce the early drainage as an effective measure to mitigate CH 4 emissions from crop residues., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: In the randomized Asian REGATTA trial, no survival benefit was shown for additional gastrectomy over chemotherapy alone in patients with advanced gastric cancer with a single incurable factor, thereby discouraging surgery for these patients. The purpose of this study was to evaluate treatment strategies for patients with metastatic gastric cancer in daily practice in five European countries, along with relative survival in each country., Methods: Nationwide population-based data from Belgium, Denmark, the Netherlands, Norway and Sweden were combined. Patients with primary metastatic gastric cancer diagnosed between 2006 and 2014 were included. The proportion of gastric resections performed and the administration of chemotherapy (irrespective of surgery) within each country were determined. Relative survival according to country was calculated., Results: Overall, 15 057 patients with gastric cancer were included. The proportion of gastric resections varied from 8·1 per cent in the Netherlands and Denmark to 18·3 per cent in Belgium. Administration of chemotherapy was 39·2 per cent in the Netherlands, compared with 63·2 per cent in Belgium. The 6-month relative survival rate was between 39·0 (95 per cent c.i. 37·8 to 40·2) per cent in the Netherlands and 54·1 (52·1 to 56·9) per cent in Belgium., Conclusion: There is variation in the use of gastrectomy and chemotherapy in patients with metastatic gastric cancer, and subsequent differences in survival.

The impact of formulation and desiccation on the shelf life of phosphate (P)-solubilising microorganisms is often under-studied, particularly relating to their ability to recover P-solubilisation activity. Here, Penicilllium bilaiae and Aspergillus niger were formulated on vermiculite (V) alone, or with the addition of protectants (skimmed milk (V + SM) and trehalose (V + T)), and on sewage sludge ash with (A + N) and without nutrients (A), and dried in a convective air dryer. After drying, the spore viability of P. bilaiae was greater than that of A. niger. V formulations achieved the highest survival rates without being improved by the addition of protectants. P. bilaiae formulated on V was selected for desiccation in a fluidised bed dryer, in which several temperatures and final water activities (aw) were tested. The highest spore viability was achieved when the formulation was dried at 25 °C to a final aw >0.3. During three months' storage, convective air dried formulations were stable for both strains, except in the presence of skimmed milk for P. bilaiae which saw a decrease in spore viability. In the fluidised bed-dried formulations, when aw >0.3, the loss in viability was higher, especially when stored at 20 °C, than at aw <0.1. P-solubilisation activity performed on ash was preserved in most of the formulations after desiccation and storage. Overall, a low drying temperature and high final aw positively affected P. bilaiae viability, however a trade-off between higher viability after desiccation and shelf life should be considered. Further research is needed to optimise viability over time and on more sustainable carriers., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Mesenteric vasculitis is the most common abdominal manifestation of vasculitis and can present as acute abdominal pain. Mesenteric vasculitis is most frequent in systemic lupus erythematosus and polyarteritis nodosa in adulthood and immunoglobulin A-vasculitis in childhood. Involvement of other organs is also seen. The diagnosis can be challenging, but detailed clinical assessment in combination with diagnostic tests often identifies the underlying cause. Medical treatment is used, when the abdominal manifestation is considered reversible, while surgery is used in unstable patients or patients with non-reversible conditions.

Global rice production systems face two opposing challenges: the need to increase production to accommodate the world's growing population while simultaneously reducing greenhouse gas (GHG) emissions. Adaptations to drainage regimes are one of the most promising options for methane mitigation in rice production. Whereas several studies have focused on mid-season drainage (MD) to mitigate GHG emissions, early-season drainage (ED) varying in timing and duration has not been extensively studied. However, such ED periods could potentially be very effective since initial available C levels (and thereby the potential for methanogenesis) can be very high in paddy systems with rice straw incorporation. This study tested the effectiveness of seven drainage regimes varying in their timing and duration (combinations of ED and MD) to mitigate CH 4 and N 2 O emissions in a 101-day growth chamber experiment. Emissions were considerably reduced by early-season drainage compared to both conventional continuous flooding (CF) and the MD drainage regime. The results suggest that ED+MD drainage may have the potential to reduce CH 4 emissions and yield-scaled GWP by 85-90% compared to CF and by 75-77% compared to MD only. A combination of (short or long) ED drainage and one MD drainage episode was found to be the most effective in mitigating CH 4 emissions without negatively affecting yield. In particular, compared with CF, the long early-season drainage treatments LE+SM and LE+LM significantly (p<0.01) decreased yield-scaled GWP by 85% and 87% respectively. This was associated with carbon being stabilised early in the season, thereby reducing available C for methanogenesis. Overall N 2 O emissions were small and not significantly affected by ED. It is concluded that ED+MD drainage might be an effective low-tech option for small-scale farmers to reduce GHG emissions and save water while maintaining yield., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

A sludge treatment reed bed system (STRB) is a technology used for dewatering and stabilising sewage sludge via assisted biological mineralisation, which creates a sludge residue suitable for use as fertiliser on agricultural land. We evaluated the effect of sludge residue storage time (stabilisation time) for three STRBs on soil N mineralisation and CO 2 and N 2 O emissions in soil. The experiment revealed that the N mineralisation rate and emissions of CO 2 and N 2 O decreased as a function of treatment time in the STRBs. Mixed sludge residue (sludge residue subjected to different treatment times) for the three STRBs resulted in N mineralisation rates similar to the sludge residue subjected to a shorter treatment time but lower N 2 O emissions similar to the values of the older sludge residue. This finding reveals that combining fresh and more stabilised sludge residue ensures high N availability and reduces N 2 O emissions when applied to land., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: A breast cancer diagnosis affects an individual's affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that participated in the work force. We also examined the roles of sociodemographic factors and prior psychiatric medical treatment., Methods: This registry-based cohort study was based on information retrieved from linked Danish nationwide registries. We compared the incomes of 13,101 women (aged 30-59 years) diagnosed with breast cancer (exposed) to those of 60,819 women without breast cancer (unexposed). Changes in income were examined during a 10-year follow-up; for each follow-up year, we calculated the mean annual income and the relative change compared to the income earned one year prior to diagnosis. Expected changes in Danish female income, according to calendar year and age, were estimated based on information from Statistics Denmark. For exposed and unexposed groups, the observed income changes were dichotomized to those above and those below the expected change in income in the Danish female population. We examined the impact of breast cancer on income each year of follow-up with logistic regression models. Analyses were stratified according to educational level, marital status, and prior psychiatric medical treatment., Results: Breast cancer had a temporary negative effect on income. The effect was largest during the first three years after diagnosis; thereafter, the gap narrowed between exposed and unexposed cohorts. The odds ratio for an increase in income in the cancer cohort compared to the cancer-free cohort was 0.81 (95% CI 0.77-0.84) after three years. After seven years, no significant difference was observed between cohorts. Stratified analyses demonstrated that the negative effect of breast cancer on income lasted longest among women with high educational levels. Being single or having received psychiatric medical treatment increased the chance to experience an increase in income among women with breast cancer., Conclusion: A breast cancer diagnosis led to negative effects on income, which ameliorated over the following seven years. Sociodemographic factors and prior psychiatric medical treatment might influence long-term consequences of breast cancer on income.

Knowledge about environmental impacts associated with the application of anaerobic digestion residue to agricultural land is of interest owing to the rapid proliferation of biogas plants worldwide. However, virtually no information exists concerning how soil-emitted NO is affected by the feedstock hydraulic retention time (HRT) in the biogas digester. Here, the O planar optode technique was used to visualize soil O dynamics following the surface application of digestates of the codigestion of pig slurry and agro-industrial waste. We also used NO isotopomer analysis of soil-emitted NO to determine the NO production pathways, i.e., nitrification or denitrification. Two-dimensional images of soil O indicated that anoxic and hypoxic conditions developed at 2.0- and 1.5-cm soil depth for soil amended with the digestate produced with 15-d (PO15) and 30-d (PO30) retention time, respectively. Total NO emissions were significantly lower for PO15 than PO30 due to the greater expansion of the anoxic zone, which enhanced NO reduction via complete denitrification. However, cumulative CO emissions were not significantly different between PO15 and PO30 for the entire incubation period. During incubation, NO emissions came from both nitrification and denitrification in amended soils. Increasing the HRT of the biogas digester appears to induce significant NO emissions, but it is unlikely to affect the NO production pathways after application to soil., (Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.)

Background: Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database., Methods: All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included. Quality-of-care indicators, including number of lymph nodes removed, anastomotic leak rate, 30- and 90-day mortality, and 2- and 5-year overall survival, were assessed. To compare quality-of-care indicators over time, the relative risk (RR) was calculated using a multivariable log binomial regression model., Results: Some 6178 patients were included, of whom 1728 underwent oesophagectomy. The overall number of patients with 15 or more lymph nodes in the resection specimen increased from 38·1 per cent in 2004 to 88·7 per cent in 2013. The anastomotic leak rate decreased from 14·8 to 7·6 per cent (RR 0·66, 95 per cent c.i. 0·43 to 1·01). The 30-day mortality rate decreased from 4·5 to 1·7 per cent (RR 0·51, 0·22 to 1·15) and the 90-day mortality rate from 11·0 to 2·9 per cent (RR 0·46, 0·26 to 0·82). There were no statistically significant changes in 2- or 5-year survival rates over time., Conclusion: Indicators of quality of care have improved since the centralization of oesophageal cancer treatment in Denmark., (© 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.)

Concentrating nutrients on biochar and clinoptilolite and subsequently using the nutrient-enriched sorbents as a fertiliser could be an alternative way to manage nutrients in digestate. In this study, we investigated the use of biochar and clinoptilolite columns in removing ammonium, potassium, orthophosphate and dissolved organic carbon (DOC) from the liquid fraction of digestate. Our objectives were to investigate the effect of the initial loading ratio between liquid and biochar on nutrient removal, and to investigate the effect of combining biochar with clinoptilolite on nutrient and DOC removal efficiency. Increasing the initial loading ratios increased nutrient concentrations on biochar to 8.61 mg NH 4 -N g -1 , 1.95 mg PO 4 -P g -1 and 13.01 mg DOC g -1 , but resulted in decreasing removal efficiencies. The combination of biochar and clinoptilolite resulted in improved ammonium, potassium and DOC removal efficiencies compared to biochar alone, but did not significantly change PO 4 -P removal efficiencies. Removal efficiencies with combined sorbents were up to 67% for ammonium, 58% for DOC and 58% for potassium. Clinoptilolite showed higher removal efficiencies compared to biochar alone, and combining clinoptilolite with biochar improved only total P removal efficiency. Concentrating nutrients with clinoptilolite and biochar may be an option when both sorbents are available at low cost.

Cell therapy repair strategies using adult mesenchymal stromal cells have shown promising evidence to prevent cardiac deterioration in rodents even in the absence of robust differentiation of the cells into cardiomyocytes. We tested whether increasing doses of porcine adipose-tissue derived mesenchymal stem cells (pASCs) increase cardiac tissue perfusion in pigs post-myocardial infarction (MI) receiving angiotensin-converting-enzyme inhibitor (ACE inhibitors) and Beta-blockers similarly to patients. Female pigs were subjected to MI induction by sponge permanent occlusion of left circumflex coronary artery (LCx) generating approximately 10% of injured LV area with minimum hemodynamic impact. We assessed tissue perfusion by real time myocardial perfusion echocardiography (RTMPE) using commercial microbubbles before and following pASCs treatment. Four weeks after the occlusion of the left circumflex artery, we transplanted placebo or pASCs (1, 2 and 4x106 cells/Kg BW) into the myocardium. The highest dose of pASCs increased myocardial vessel number and blood flow in the border (56% and 3.7-fold, respectively) and in the remote area (54% and 3.9-fold, respectively) while the non-perfused scar area decreased (up to 38%). We also found an increase of immature collagen fibers, although the increase in total tissue collagen and types I and III was similar in all groups. Our results provide evidence that pASCs-induced stimulation of tissue perfusion and accumulation of immature collagen fibers attenuates adverse remodeling post-MI beyond the normal beneficial effects associated with ACE inhibition and beta-blockade.

Biochar application to agricultural land has been proposed as a means for improving phosphorus (P) availability in soil. The purpose of the current study was to understand how pyrolysis temperature affects P speciation in biochar and how this affects availability of P in the amended soil. Biochar was produced at different temperatures from digestate solids. The primary species of P in digestate solids were simple calcium phosphates. However, a high co-occurrence of magnesium (Mg) and P, indicated that struvite or other magnesium phosphates may also be important species. At low temperatures, pyrolysis had little effect on P speciation; however, as the temperature increased above 600 °C, the P gradually became more thermodynamically stable in species such as apatite. At very high temperatures above 1000 °C, there were indications of reduced forms of P. Biochar production decreased the immediate availability of P in comparison with the original digestate solids. However, for biochar produced at low temperatures, availability quickly increased to the same levels as in the digestate solids. For biochar produced at higher temperatures, availability remained depressed for much longer. The low availability of P in the biochar produced at high temperatures can probably be explained by the formation of less soluble P species in the biochar. In contrast, the transient decrease of availability of the P in the biochar produced at low temperatures can be explained by mechanisms, such as sorption on biochar, which gradually decreases because of oxidation of the biochar surfaces or changes in pH around the biochar particles., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0-resection performed for esophageal and GEJ cancer between January 2003 and December 2010 were identified from a prospectively maintained database. Data on stenting, postoperative mortality, morbidity, recurrence-free survival, complications, and length of hospital stay were collected. Kaplan-Meier plots for survival and recurrence-free survival curves were constructed for R0 resected patients. Data were compared between the stent and no-stent group by nonparametric tests. Two hundred seventy three consecutive R0 resected patients with esophageal or GEJ cancer were identified. Of these patients, 63 had a stent as a bridge to surgery. The male/female ratio was 2.64 (198/75) with a median age in the stent group (SG) of 65.1 versus 64.3 in the no stent group (NSG). Patients were comparable with respect to gender, age, smoking, TNM-classification, oncological treatment, hospital stay, tumor location, and histology. The median survival in the SG was 11.6 months compared with 21.3 months for patients treated without a bridging stent (P < 0.001). There were no statistically significant differences in 30-day mortality between the two groups, but NSG patients exhibited a significantly better two-year survival (P = 0.017). The median recurrence-free survival was 9.1 months for the SG compared with 15.2 months for the NSG. The use of a stent as a bridging procedure to surgery in patients treated without neaoadjuvant therapy for an esophageal or GEJ cancer that later underwent R0 resection decreased the two year survival and the recurrence-free survival., (© 2016 International Society for Diseases of the Esophagus.)

Thermal gasification of straw is a highly efficient technology that produces bioenergy and gasification biochar that can be used as a soil amendment, thereby returning non-renewable nutrients and stable carbon, and securing soil quality and crop productivity. A Danish on-farm field study investigated the impact of traditional straw incorporation vs. straw removal for thermal gasification bioenergy production and the application of straw gasification biochar (GB) on soil quality and crop production. Two rates of GB were applied over three successive years in which the field was cropped with winter wheat (Triticum aestivum L.), winter oilseed rape (Brassica napus L.) and winter wheat, respectively, to assess the potential effects on the soil carbon pool, soil microorganisms, earthworms, soil chemical properties and crop yields. The application of GB did not increase the soil organic carbon content significantly and had no effect on crop yields. The application of straw and GB had a positive effect on the populations of bacteria and protists, but no effect on earthworms. The high rate of GB increased soil exchangeable potassium content and soil pH indicating its potassium bioavailability and liming properties. These results suggest, that recycling GB into agricultural soils has the potential to be developed into a system combining bioenergy generation from agricultural residues and crop production, while maintaining soil quality. However, future studies should be undertaken to assess its long-term effects and to identify the optimum balance between straw removal and biochar application rate., (Copyright © 2016. Published by Elsevier Ltd.)

In the last decade, numerous studies have evaluated the benefits of biochar for improving soil quality. The purposes of the current study were to use Fourier transform infrared-photoacoustic spectroscopy (FTIR-PAS) to analyse P species in biochar and to determine the effect of pyrolysis temperature on P speciation. The photoacoustic detector has a range of advantages for the very dark biochar samples in comparison to more traditional reflectance or transmission FTIR detectors. The spectra turned out to be more informative in the regions with P vibrations for biochar produced at temperatures above 400°C, where most of the remaining organic compounds were aromatic and therefore not overlapping with the P vibrations. For biochars produced from the solid fraction of digestate from biogas production, an increase in the pyrolysis temperature led to the formation of a large variety of P species. Hydroxylapatite and tricalcium phosphate were the most dominant P species in the mid to high temperature range (600-900°C), while at 1050°C apatite, iron phosphates, variscite and calcium phosphates were identified. However, the changes in P speciation in biochars produced from bone meal at different temperatures were smaller than in the biochars from digestate. Hydroxylapatite and calcium phosphates were identified in biochar produced at all temperatures, while there was some indication of struvite formation., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Global livestock production is increasing rapidly, leading to larger amounts of manure and environmental impacts. Technologies that can be applied to treat manure in order to decrease certain environmental impacts include separation and acidification. In this study, a life cycle assessment was used to investigate the environmental effects of slurry acidification and separation, and whether there were synergetic environmental benefits to combining these technologies. Furthermore, an analysis was undertaken into the effect of implementing regulations restricting the P application rate to soils on the environmental impacts of the technologies. The impact categories analysed were climate change, terrestrial, marine and freshwater eutrophication, fossil resource depletion and toxicity potential. In-house slurry acidification appeared to be the most beneficial scenario under both N and P regulations. Slurry separation led to a lower freshwater eutrophication potential than the other scenarios in which N regulations alone were in force, while these environmental benefits disappeared after implementation of stricter P regulations. With N regulations alone, there was a synergetic positive effect of combining in-house acidification and separation on marine eutrophication potential compared to these technologies individually. The model was sensitive to the chosen ammonia emission coefficients and to the choice of inclusion of indirect nitrous oxide emissions, since scenarios changed ranking for certain impact categories., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aims: Outcomes for patients with oesophago-gastric cancer are variable across Europe. The reasons for this variability are not clear. The aim of this study was to describe and analyse clinical pathways to understand differences in service provision for oesophageal and gastric cancer in the countries participating in the EURECCA Upper GI group., Methods: A questionnaire was devised to assess clinical presentation, diagnosis, staging, treatment, pathology, follow-up and service frameworks across Europe for patients with oesophageal and gastric cancer. The questionnaire was issued to experts from 14 countries. The responses were analysed quantitatively and qualitatively and compared., Results: The response rate was (10/14) 71.4%. The approach to diagnosis was similar. Most countries established a diagnosis within 3 weeks of presentation. However, there were different approaches to staging with variable use of endoscopic ultrasound reflecting availability. There has been centralisation of treatments in most countries for oesophageal surgery. The most consistent area was the approach to pathology. There were variations in access to specialist nurse and dietitian support. Although most countries have multidisciplinary teams, their composition and frequency of meetings varied. The two main areas of significant difference were research and audit and overall service provision. Observations on service framework indicated that limited resources restricted many of the services., Conclusion: The principle approaches to diagnosis, treatment and pathology were similar. Factors affecting the quality of patient experience were variable. This may reflect availability of resources. Standard pathways of care may enhance both the quality of treatment and patient experience., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Purpose: This study explores the applicability of registry data as a proxy for perceived stress by examining the association between perceived stress measured in health surveys and registry data., Methods: Of 35,700 randomly invited participants from the 2010 Health Survey in the North Denmark Region (age 16-99 years), 21,842 answered 10 items from Cohen's Perceived Stress Scale. Respondents were divided into quartiles based on their stress score. Survey information was individually linked to national registries containing information on prescribed psychiatric medication and consultations with psychologists or psychiatrists from 2009 to 2011., Results: The percentage of persons with prescriptions or consultations was higher (37.6%) in the highest stress score group, compared with the lowest stress score group (7.7%). Odds ratio (95% confidence interval) for the highest score compared with the lowest score was 7.3 (6.5-8.1). Different combinations of treatment showed low sensitivity (8.7%-37.6%), positive predictive value (49.4%-56.8%), and positive agreement (16.2%-42.7%) were found, whereas specificity (88.5%-98.0%) and negative agreement (85.5%-87.2%) were higher. Kappa measure showed slight to fair agreement (0.104-0.285)., Conclusions: Participants reporting high perceived stress were more often prescribed medications and referred for consultations with psychologists or psychiatrists. However, due to low predictive values, registry data may not be suitable as a proxy for perceived stress., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Previous studies found that thermally dried biosolids contained more mineralisable organic nitrogen (N) than the raw or anaerobically digested (AD) biosolids they were derived from. However, the effect of thermal drying temperature on biosolid N availability is not well understood. This will be of importance for the value of the biosolids when used to fertilise crops. We sourced AD biosolids from a Danish waste water treatment plant (WWTP) and dried it in the laboratory at 70, 130, 190 or 250 °C to >95 % dry matter content. Also, we sourced biosolids from the WWTP dried using its in-house thermal drying process (input temperature 95 °C, thermal fluid circuit temperature 200 °C, 95 % dry matter content). The drying process reduced the ammonium content of the biosolids and reduced it further at higher drying temperatures. These findings were attributed to ammonia volatilisation. The percentage of mineralisable organic N fraction (min-N) in the biosolids, and nitrous oxide (N2O) and carbon dioxide (CO2) production were analysed 120 days after addition to soil. When incubated at soil field capacity (pF 2), none of the dried biosolids had a greater min-N than the AD biosolids (46.4 %). Min-N was lowest in biosolids dried at higher temperatures (e.g. 19.3 % at 250 °C vs 35.4 % at 70 °C). Considering only the dried biosolids, min-N was greater in WWTP-dried biosolids (50.5 %) than all of the laboratory-dried biosolids with the exception of the 70 °C-dried biosolids. Biosolid carbon mineralisation (CO2 release) and N2O production was also the lowest in treatments of the highest drying temperature, suggesting that this material was more recalcitrant. Overall, thermal drying temperature had a significant influence on N availability from the AD biosolids, but drying did not improve the N availability of these biosolids in any case.

A number of root and root hair traits have been proposed as important for nutrient acquisition. However, there is still a need for knowledge on which traits are most important in determining macro- and micronutrient uptake at low soil fertility. This study investigated the variations in root growth vigor and root hair length (RHL) and density (RHD) among spring wheat genotypes and their relationship to nutrient concentrations and uptake during early growth. Six spring wheat genotypes were grown in a soil with low nutrient availability. The root and root hair traits as well as the concentration and content of macro- and micronutrients were identified. A significant genetic variability in root and root hair traits as well as nutrient uptake was found. Fast and early root proliferation and long and dense root hairs enhanced uptake of macro- and micronutrients under low soil nutrient availability. Vigorous root growth, however, was a better indicator of early nutrient acquisition than RHL and RHD. Vigorous root growth and long and dense root hairs ensured efficient acquisition of macro- and micronutrients during early growth and a high root length to shoot dry matter ratio favored high macronutrient concentrations in the shoots, which is assumed to be important for later plant development.

Organic fertilisation inevitably leads to heterogeneous distribution of organic matter and nutrients in soil, i.e. due to uneven surface spreading or inhomogeneous incorporation. The resulting localised hotspots of nutrient application will induce various biotic and abiotic nutrient turnover processes and fixation in the residue sphere, giving rise to distinct differences in nutrient availability, soil oxygen content and greenhouse gas (GHG) production. In this study we investigated the spatiotemporal dynamics of the reaction of manure solids and manure solids char with soil, focusing on their phosphorus (P) availability, as current emphasis on improving societal P efficiency through recycling waste or bio-based fertilisers necessitates a sound understanding of their behaviour. Soil layers amended at a constant P application rate with either pig manure solids or char made from pig manure solids were incubated for three weeks between layers of non-amended, P-depleted soil. Spatial and temporal changes in and around the amendment layers were simultaneously investigated in this study using a sandwich sensor consisting of a planar oxygen optode and multi-element diffusive gradients in thin films (DGT) gels, combined with GHG emission measurements. After three weeks of incubation, the soil containing a layer amended with manure solids had a lower overall O2 content and had emitted significantly more CO2 than the non-amended control or the char-amended soil. The P availability from manure solids was initially higher than that from the char, but decreased over time, whereas from the char-amended layer P availability increased in the same period. In both treatments, increases in P availability were confined to the amended soil layer and did not greatly affect P availability in the directly adjacent soil layers during the three-week incubation. These results highlight the importance of placing organic P fertilisers close to where the plant roots will grow in order to facilitate optimal fertiliser use efficiency., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

The combined effects of pig slurry acidification, subsequent separation techniques and biochar production from the solid fraction on N mineralisation and N2O and CO2 emissions in soil were investigated in an incubation experiment. Acidification of pig slurry increased N availability from the separated solid fractions in soil, but did not affect N2O and CO2 emissions. However acidification reduced soil N and C turnover from the liquid fraction. The use of more advanced separation techniques (flocculation and drainage > decanting centrifuge > screw press) increased N mineralisation from acidified solid fractions, but also increased N2O and CO2 emissions in soil amended with the liquid fraction. Finally, the biochar production from the solid fraction of pig slurry resulted in a very recalcitrant material, which reduced N and C mineralisation in soil compared to the raw solid fractions., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background and Aim: Gastroesophageal junction cancer is one of the leading causes to cancer-related death and the prognosis is poor. However, progress has been made over the last couple of decades with the introduction of multimodality treatment and optimized surgery. Three-year survival rates have improved to 50% in patients receiving neoadjuvant therapy. Only a few studies have focused on the difference of postoperative complications in patients receiving neoadjuvant therapy in relation to a comparative surgery-only group. The aim of this study was to compare the prevalence of postoperative complications of patients with cancer at the gastroesophageal junction treated with either neoadjuvant chemotherapy or surgery alone in patients from "The Danish Clinical Registry of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach.", Materials and Methods: A historical follow-up study, comparing postoperative complications between two cohorts before and after implementation of chemotherapy was completed., Results: In all, 180 consecutive patients treated with perioperative chemotherapy and a comparative surgery-only group of patients were identified from The Danish Clinical Registry of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach. No difference was found in demographics between the two groups, except for alcohol consumption and a lower T and N stage in the surgery-only group, and no difference in complication rates was found. Furthermore, no variable in the multivariate analysis was significantly associated with anastomotic leakage which was considered the most severe complication., Conclusion: Since perioperative chemotherapy does not appear to increase surgical complications, the future challenges include defining the optimal combination of chemo- and/or radiotherapy, but more importantly also to select the patients who will benefit the most from the different neoadjuvant strategies., (© The Finnish Surgical Society 2015.)