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BackgroundWilson disease (WD) is a rare and potentially fatal genetic disorder caused by accumulation of toxic levels of copper. Current treatments include chelating agents and/or zinc. We characterized real-world US treatment patterns in patients with WD.MethodsThis retrospective, observational medical chart review utilized deidentified clinical data, including treatment patterns, abstracted from patient medical charts between 01/2012 and 06/2017. Line of therapy was assessed based on disease presentation and aggregated. Index treatment was defined as the first line of therapy, followed by second line of therapy and third line of therapy. Results were summarized using descriptive statistics.ResultsA total of 225 patients were included (mean [SD] age at diagnosis: 24.7 [9.8] years). Initial disease presentation was both neurologic/psychiatric and hepatic in 52.9%, followed by neurologic/psychiatric (20.0%), hepatic (16.9%), and asymptomatic (10.2%). Median (first and third quartiles) duration of follow-up from diagnosis was 39.5 (33.8–60.4) months. The most common first line of therapy was penicillamine monotherapy in 45.5%, followed by trientine monotherapy (26.1%) and chelator/zinc combination therapy (21.2%). A total of 167/222 (75.2%) patients remained on first line of therapy during the follow-up period. Of the 13.5% who switched to second line of therapy, most changed to trientine monotherapy (53.3%). All those who switched to third line of therapy transitioned to zinc monotherapy (100.0%). Unexpectedly, 11.3% discontinued first line of therapy without transitioning to a subsequent therapy. The primary rationale for index monotherapy selection was improved efficacy (61.6%). Most discontinuations were due to side effects/tolerability (40.8%). Treatment patterns varied by initial disease presentation, practice setting, physician specialty, and geographic location.ConclusionThese results demonstrate a lack of consensus in the US regarding first-line treatment for patients with WD. Evidence-based treatment pathways informed by high-quality clinical trials for improved health outcomes are needed.

La leche de cabra suplementada con aceites de girasol y pescado presenta un aumento en el porcentaje de ácidos grasos poliinsaturados (LAGPI) respecto a la leche de cabra no suplementada (LC), una disminución en el porcentaje de ácidos grasos saturados y la consecuente baja del índice aterogénico que le otorga mayor valor nutracéutico. El objetivo del trabajo fue caracterizar y comparar las propiedades físico-químicas que determinan la calidad tecnológica para la elaboración de quesos de LAGPI y LC, con énfasis en las proteínas. Ambas leches se obtuvieron en una granja comercial de cabras raza Saanen ubicada en el Sudeste Bonaerense. Una vez confirmados los perfiles de ácidos grasos se analizaron: 1) componentes principales: grasa butirosa (GB), proteína bruta, lactosa, sólidos no grasos y sólidos totales (ST), 2) composición porcentual de la caseína y tamaño de las micelas, 3) tamaño de los glóbulos grasos, 4) composición físico-química: contenido de humedad, densidad, pH y acidez y 5) calidad higiénica (bacterias aeróbicas mesófilas totales). Los contenidos de GB, lactosa y ST fueron significativamente mayores en LAGPI (P

BackgroundThyroid stimulating immunoglobulins (TSI) play a central role in the pathogenesis of Graves’ orbitopathy (GO), while soluble interleukin-2 receptor (sIL-2R) is a marker for T-cell activity. We investigated TSI and sIL-2R levels in relation to thyroid function, disease activity and severity and response to treatment with intravenous methylprednisolone (IVMP) in patients with GO.MethodsTSI (bridge-based TSI binding assay), sIL-2R, TSH and fT4 levels were measured in biobank serum samples from 111 GO patients (37 male, 74 female; mean age 49.2 years old) and 25 healthy controls (5 male, 20 female; mean age 39.8 years old). Clinical characteristics and response to treatment were retrospectively retrieved from patient files.ResultsHigher sIL-2R levels were observed in GO patients compared to controls (p < 0.001). sIL-2R correlated with fT4 (r = 0.26), TSH (r = -0.40) and TSI (r = 0.21). TSI and sIL-2R concentrations were higher in patients with active compared to inactive GO (p < 0.001 and p < 0.05, respectively). Both TSI and sIL-2R correlated with total clinical activity score (CAS; r = 0.33 and r = 0.28, respectively) and with several individual CAS items. Cut-off levels for predicting active GO were 2.62 IU/L for TSI (AUC = 0.71, sensitivity 69%, specificity 69%) and 428 IU/mL for sIL-2R (AUC = 0.64, sensitivity 62%, specificity 62%). In multivariate testing higher TSI (p < 0.01), higher age (p < 0.001) and longer disease duration (p < 0.01) were associated with disease activity. TSI levels were higher in patients with a poor IVMP response (p = 0.048), while sIL-2R levels did not differ between responders and non-responders. TSI cut-off for predicting IVMP response was 19.4 IU/L (AUC = 0.69, sensitivity 50%, specificity 91%). In multivariate analysis TSI was the only independent predictor of response to IVMP (p < 0.05).ConclusionsHigh TSI levels are associated with active disease (cut-off 2.62 IU/L) and predict poor response to IVMP treatment (cut-off 19.4 IU/L) in GO. While sIL-2R correlates with disease activity, it is also related to thyroid function, making it less useful as an additional biomarker in GO.

ABSTRACT OBJECTIVE To evaluate the association between gestational age and green areas, urban built areas, and the concentration of particulate matter 2.5 (PM2.5) in the city of São Paulo, analyzing the irregular distribution of these areas and pollution levels above the recommended level. METHODS The study population consisted of a cohort of live births from 2012, and data from the Live Birth Information System (Sinasc) of the city of São Paulo were used. Using satellite images and supervised classification, the distribution and quantity of green areas and built areas in the city of São Paulo was obtained, as well as the concentrations of PM2.5. Logistic regressions were used to obtain possible associations. RESULTS The results of the study show that a lower percentage of green areas is significantly associated with a higher chance of preterm births. A higher building density was positively associated with the odds ratio for preterm birth. We did not find any significant associations between air pollution (PM2.5) and preterm births. CONCLUSIONS The results of this study show that greener areas are less associated with preterm births when compared with less green areas.

In the last twenty years, electrochemistry and photochemistry have attracted a renewed and still uprising interest in organic synthesis. Two of the most simple and abundant reagents, electrons and photons, became the key players in synthetic chemistry as cornerstones of developing greener and sustainable chemical processes. An interesting strategy that recently emerged is the possibility of merging the two worlds in what is called ElectroPhotoChemistry (EPC). In particular, this review will focus on the most recent contributions in the field. The basic principles of EPC will be presented along with a discussion of the published works of the last few years. Electrophotochemical oxidation/reduction reactions will be discussed, including in this section the transformations of a C–H bond to a C-X (X: heteroatom). In the C–H activation chapter the formation of C–C bond, starting from a C–H bond, will be considered. Finally, the miscellaneous chapter includes examples which do not clearly belong to the previous categories.

Copper is an essential redox-active metal that plays integral roles in biology ranging from enzymatic catalysis to mitochondrial respiration. However, if not adequately regulated, this redox activity has the potential to cause oxidative stress through the production of reactive oxygen species. Indeed, the dysregulation of copper has been associated with a variety of disease states including diabetes, neurodegenerative disorders, and multiple cancers. While increasing tools are being developed for illuminating labile intracellular copper pools and the trafficking pathways in which they are involved, significantly less attention has been given to the analogous extracellular labile pool. To address this gap, we have developed a bioluminescence-based imaging probe, picolinic ester caged-diphenylterazine (pic-DTZ) for monitoring labile, extracellular copper using a coelenterazine-like imidazopyrazinone and the genetically-engineered, marine-based luciferase, nanoluciferase. Unlike the more commonly-used firefly luciferase, nanoluciferase does not require ATP, allowing its application to the extracellular milieu. pic-DTZ demonstrates high metal and oxidation state selectivity for Cu(ii) in aqueous buffer as well as selectivity for labile pools over coordinatively inaccessible protein-bound Cu(ii). We demonstrate the potential of pic-DTZ as a diagnostic tool in human serum and plasma for copper-associated diseases. Additionally, we apply pic-DTZ to lend insight into the extracellular copper dynamic in anticancer treatments.

Photocrosslinking of polymers for industrial applications show undoubted advantages related to the mild conditions needed and the economical equipment. However, some issues include: the use of (i) mercury lamps as light sources, which poses concerns about safety and energy consumption, (ii) typical additives, such as halogen-free flame-retardant fillers (HFFR) are powdered materials, which can scatter UV photons and avoid a deep penetration of the light. In this study, we explore the UV-curing of an innovative EVA-POE blend containing hydrotalcite and aluminum hydroxide as HFFR in the presence of a 370-nm UV LED, namely Ekopren[R] XI1321, a plastic used as coverage for electric cables. Two commercially available photoinitiators (benzophenone and ethyl Michler's ketone) were analyzed as well as two crosslinking coagents widely used in industry, that is, triallyl cyanurate and trimethylolpropane trimethacrylate. A comparison with pure EVA and LDPE was performed to show a higher cross-linked content of the proposed blend, even in the presence of light scattering mineral fillers at high concentration. KEYWORDS crosslinking, curing of polymers, flame retardance, initiators, irradiation, 1 | INTRODUCTION Polymers are probably the most versatile materials available nowadays. By engineering both the nature of the monomers and the structure in which the monomers are linked together, [...]

Objective: Some studies suggest that hypothyroidism is associated with increased oxidative stress. Urinary excretion of 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) represents whole-body RNA and DNA oxidation, respectively. These biomarkers have only been explored sparsely in patients with thyroid disorders. Methods: In 45 Danish women with newly diagnosed hypothyroidism, we compared 8-oxoGuo and 8-oxodG before or shortly after initiating levothyroxine with the excretion rates at euthyroidism. We also compared the excretion of 8-oxoGuo and 8-oxodG in the patients after restored euthyroidism with 18 healthy control subjects. Results: Compared with baseline, none of the biomarkers changed significantly in the patients after becoming euthyroid. The geometric mean of 8-oxoGuo was 1.63 (95% CI: 1.49–1.78) nmol/mmol creatinine at baseline and 1.67 nmol/mmol at euthyroidism (95% CI: 1.53–1.83) (P = 0.39), while that of 8-oxodG was 1.28 nmol/mmol creatinine at baseline (95% CI: 1.14–1.44) and 1.32 nmol/mmol at euthyroidism (95% CI: 1.18–1.48), respectively (P = 0.47). The relative mean differences were 0.97 (95% CI: 0.91–1.04) for 8-oxoGuo and 0.97 (95% CI: 0.88–1.06) for 8-oxodG. At baseline, multiple linear regression revealed a positive association between free thyroxine and both biomarkers (8-oxoGuo, P < 0.001; 8-oxodG, P = 0.04). Furthermore, 8-oxoGuo was positively associated with age (P = 0.04) and negatively associated with thyrotropin (P = 0.02). In the control group, the geometric mean of 8-oxoGuo was 1.23 nmol/mmol creatinine (95% CI: 1.07–1.42), while that of 8-oxodG was 1.04 nmol/mmol creatinine (95% CI: 0.88–1.23). Thus, compared with control subjects, euthyroid patients showed a significantly higher level of both 8-oxoGuo (P < 0.001) and 8-oxodG (P = 0.03). Conclusion: In hypothyroid women, no significant effect of levothyroxine treatment on the oxidative stress biomarkers 8-oxoGuo and 8-oxodG could be demonstrated. However, the excretion of these biomarkers was significantly higher than in healthy controls.

Microplastics are emerging pollutants, formed through weathering, with sizes equal to or smaller than 5 mm. They can reach surface and groundwater sources, as well as oceans and seas through natural pathways or from the discharge of liquid effluents, causing immeasurable effects on human beings. This study aimed to evaluate the optimal conditions for the removal of polyethylene (PE) and expanded polystyrene (EPS) microplastics through coagulation and flocculation processes using aluminum sulfate. To achieve this goal, two 2² full factorial designs were employed, including two replicates at the central points. The sizes of the microplastics were fixed at 0.6 mm and 0.9 mm for PE and EPS, respectively. The selected independent variables were Al2(SO4)3 and pH. The experiments were conducted considering rapid mixing parameters (400 rpm for 1 min), slow mixing (100 rpm for 15 min), and sedimentation (30 min), with a velocity of 0.1 cm min⁻¹ in the Jar Test. Turbidity determination was applied to quantify the remaining microplastics. Consequently, it was observed that the highest efficiency occurred for PE microplastics at 4.25 mg L⁻¹ of Al2(SO4)3 and pH 5, and for EPS microplastics at 6.00 mg L⁻¹ of Al2(SO4)3 and pH 4, resulting in removal rates of 96.81% and 96.30% and turbidity levels of 0.38 and 0.50 NTU, respectively. The removal efficiencies of microplastics were similar, with a decrease at pH 6 for both, as low ionic strength prevents the release of H+ ions.

Abstract In this article, we address the question of electric bus planning and operation under stochastic travel time and energy consumption. Uncertainties in the environment may cause disruptions to the planning and operation of electric buses, and a transportation planner must anticipate such conditions and be able to respond appropriately. One of the preconditions for planning robust strategies is understanding the existence and impact of multiple trade-off scenarios, which is the basis for this study. We model the travel time delays and trip energy consumption using estimated probability density functions and use a stochastic, mixed-integer formulation with chance constraints to evaluate several trade-off scenarios for electric bus fleets under uncertainty. The results show the existence of trade-off scenarios that lead to varying degrees of impacts related to network and environment. Careful fleet planning, dispatch, and charge control enable us to make the balance between these trade-offs and achieve better operational performances under uncertainty.

Abstract Deploying real-time control on large-scale fleets of electric vehicles (EVs) is becoming pivotal as the share of EVs over internal combustion engine vehicles increases. In this paper, we present a Vehicle-to-Grid (V2G) algorithm to simultaneously schedule thousands of EVs charging and discharging operations, that can be used to provide ancillary services. To achieve scalability, the monolithic problem is decomposed using the alternating direction method of multipliers (ADMM). Furthermore, we propose a method to handle bilinear constraints of the original problem inside the ADMM iterations, which changes the problem class from Mixed-Integer Quadratic Program (MIQP) to Quadratic Program (QP), allowing for a substantial computational speed up. We test the algorithm using real data from the largest carsharing company in Switzerland and show how our formulation can be used to retrieve flexibility boundaries for the EV fleet. Our work thus enables fleet operators to make informed bids on ancillary services provision, thereby facilitating the integration of electric vehicles.

Context: In individuals with hypothyroidism and overweight, levothyroxine substitution therapy is often expected to cause weight loss due to its effect on resting energy expenditure. However, despite levothyroxine-induced enhancement of resting energy expenditure, fat mass loss is rarely seen after levothyroxine substitution therapy. The mechanism behind this conundrum is unknown. Aim: The aim of the study was to assess the effect of levothyroxine t herapy on hunger sensations and ad libitum food intake in individuals with hypothyroidism. Design and setting: Prospective cohort study of 18 newly diagnosed hypothyroid women (thyroid-stimulating hormone (TSH) >10 mU/L). Participants were investigated at diagnosis, after normalization of TSH (

Non-alcoholic fatty liver disease (NAFLD) is a common liver pathology that includes steatosis, or non-alcoholic fatty liver (NAFL), and non-alcoholic steatohepatitis (NASH). Without a clear pathophysiological mechanism, it affects Hispanics disproportionately compared to other ethnicities. Polyunsaturated fatty acids (PUFAs) and inflammatory lipid mediators including oxylipin (OXL) and endocannabinoid (eCB) are altered in NAFLD and thought to contribute to its pathogenesis. However, the existence of ethnicity-related differences is not clear. We employed targeted lipidomic profiling for plasma PUFAs, non-esterified OXLs and eCBs in White Hispanics (HIS, n = 10) and Caucasians (CAU, n = 8) with biopsy-confirmed NAFL, compared with healthy control subjects (HC; n = 14 HIS; n = 8 CAU). NAFLD was associated with diminished long chain PUFA in HIS, independent of histological severity. Differences in plasma OXLs and eCBs characterized ethnicities in NASH, with lower arachidonic acid derived OXLs observed in HIS. The secondary analysis comparing ethnicities within NASH (n = 12 HIS; n = 17 CAU), confirms these ethnicity-related differences and suggests lower lipoxygenase(s) and higher soluble epoxide hydrolase(s) activities in HIS compared to CAU. While causes are not clear, these lipidomic differences might be with implications for NAFLD severity and are worth further investigation. We provide preliminary data indicating ethnicity-specific lipidomic signature characterizes NASH which requires further validation.

To decipher the mediator role of the grape Abscisic acid, Stress, Ripening (ASR) protein, VvMSA, in the pathways of glucose signaling through the regulation of its target, the promoter of hexose transporter VvHT1, we overexpressed and repressed VvMSA in embryogenic and non-embryogenic grapevine cells. The embryogenic cells with organized cell proliferation were chosen as an appropriate model for high sensitivity to the glucose signal, due to their very low intracellular glucose content and low glycolysis flux. In contrast, the non-embryogenic cells displaying anarchic cell proliferation, supported by high glycolysis flux and a partial switch to fermentation, appeared particularly sensitive to inhibitors of glucose metabolism. By using different glucose analogs to discriminate between distinct pathways of glucose signal transduction, we revealed VvMSA positioning as a transcriptional regulator of the glucose transporter gene VvHT1 in glycolysis-dependent glucose signaling. The effects of both the overexpression and repression of VvMSA on glucose transport and metabolism via glycolysis were analyzed, and the results demonstrated its role as a mediator in the interplay of glucose metabolism, transport and signaling. The overexpression of VvMSA in the Arabidopsis mutant abi8 provided evidence for its partial functional complementation by improving glucose absorption activity.

Increased hepatic lipid content and decreased insulin sensitivity have critical roles in the development of cardiometabolic diseases. Therefore, our objective was to investigate the dose-response effects of consuming high fructose corn syrup (HFCS)-sweetened beverages for two weeks on hepatic lipid content and insulin sensitivity in young (18-40 years) adults (BMI 18-35 kg/m2). In a parallel, double-blinded study, participants consumed three beverages/day providing 0% (aspartame: n = 23), 10% (n = 18), 17.5% (n = 16), or 25% (n = 28) daily energy requirements from HFCS. Magnetic resonance imaging for hepatic lipid content and oral glucose tolerance tests (OGTT) were conducted during 3.5-day inpatient visits at baseline and again at the end of a 15-day intervention. During the 12 intervening outpatient days participants consumed their usual diets with their assigned beverages. Significant linear dose-response effects were observed for increases of hepatic lipid content (p = 0.015) and glucose and insulin AUCs during OGTT (both p = 0.0004), and for decreases in the Matsuda (p = 0.0087) and Predicted M (p = 0.0027) indices of insulin sensitivity. These dose-response effects strengthen the mechanistic evidence implicating consumption of HFCS-sweetened beverages as a contributor to the metabolic dysregulation that increases risk for nonalcoholic fatty liver disease and type 2 diabetes.

In recent years, the environmental impact of pharmaceutical residues has emerged as a pressing global concern, catalyzed by their widespread usage and persistence in aquatic ecosystems. Among these pharmaceuticals, acyclovir (ACV) stands out due to its extensive prescription during medical treatments for herpes simplex virus, chickenpox, and shingles, as well as its heightened usage amidst the COVID-19 pandemic. ACV is excreted largely unchanged by the human body, leading to significant environmental release through wastewater effluents. The urgency of addressing ACV’s environmental impact lies in its potential to persist in water bodies and affect aquatic life. This persistence underscores the critical need for effective degradation strategies that can mitigate its presence in aquatic systems. This study focuses on employing sodium hypochlorite as an oxidative agent for the degradation of ACV, leveraging its common use in wastewater treatment plants. Our research aims to explore the kinetics of ACV degradation, identify and characterize its degradation byproducts, and optimize the conditions under which complete degradation can be achieved. By assessing the efficiency of sodium hypochlorite in real wastewater samples, this study seeks to provide practical insights into mitigating ACV contamination in aquatic environments. The novelty of this research lies in its comprehensive approach to understanding the degradation pathways of ACV and evaluating the feasibility of using sodium hypochlorite as a sustainable solution in wastewater treatment. By addressing the environmental concerns associated with ACV and offering practical solutions, this study contributes to the broader goal of sustainable pharmaceutical waste management and environmental stewardship.

5′-Phosphorylation of nucleosides is a reaction as important in nature and in industry as it is cumbersome to be performed. Whilst chemical phosphorylation relies on the use of harsh reagents, solvents, and conditions, as well as on the need for protection–deprotection steps, biocatalysis can be a tool to achieve one-step phosphorylation reactions, which are selective, protecting group-free, and occurring under mild and sustainable conditions. In this work, the wild-type non-specific acid phosphatase from Morganella morganii (PhoC-Mm) was expressed, purified, and used for the synthesis of inosine 5′-monophosphate (IMP), an important food additive, by using pyrophosphate (PPi) as an inexpensive phosphate donor in a fully aqueous medium at 30 °C. Via the fine-tuning of the reaction set-up taking into account the type of buffer, amount of PPi, mode/time of PPi addition, and enzyme and substrate concentration, PhoC-Mm could be used for catalyzing the phosphorylation of inosine (I) to IMP in a good yield and high purity (62% yield). The catalysis of the hydrolytic reaction direction, which is the primary function of phosphatases in nature, was here reversed to a certain extent by a reaction engineering approach, without the need for protein engineering strategies.

Autism spectrum disorders (ASDs) are complex neurodevelopmental conditions characterized by deficits in social interaction and communication, as well as repetitive behaviors. Although the etiology of ASD is multifactorial, with both genetic and environmental factors contributing to its development, a strong genetic basis is widely recognized. Recent research has identified numerous genetic mutations and genomic rearrangements associated with ASD-characterizing genes involved in brain development. Alterations in developmental programs are particularly harmful during critical periods of brain development. Notably, studies have indicated that genetic disruptions occurring during the second trimester of pregnancy affect cortical development, while disturbances in the perinatal and early postnatal period affect cerebellar development. The developmental defects must be viewed in the context of the role of the cerebellum in cognitive processes, which is now well established. The present review emphasizes the genetic complexity and neuropathological mechanisms underlying ASD and aims to provide insights into the cerebellar involvement in the disorder, focusing on recent advances in the molecular landscape governing its development in humans. Furthermore, we highlight when and in which cerebellar neurons the ASD-associated genes may play a role in the development of cortico–cerebellar circuits. Finally, we discuss improvements in protocols for generating cerebellar organoids to recapitulate the long period of development and maturation of this organ. These models, if generated from patient-induced pluripotent stem cells (iPSC), could provide a valuable approach to elucidate the contribution of defective genes to ASD pathology and inform diagnostic and therapeutic strategies.