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The utilization of different industrial waste, by-products or other materials such as ground granulated blast furnace slag, silica fume, fly ash, limestone, and kiln dust, etc. as supplemen- tary cementing materials has received considerable attention in recent years. A study has been conducted to look into the performance of laterite as Supplementary Cementing Materials (SCM). The study focuses on compressive strength performance of blended cement containing different percentage of laterite. The cement is replaced accordingly with percentage of 2 %, 5 %, 7 % and 10 % by weight. In addition, the effect of use of three chemically different laterites have been studied on physical performance of cement as in setting time, Le-Chatlier expansion, loss on ignition, insoluble residue, free lime and specifically compressive strength of cement cubes tested at the age of 3, 7, and 28 days. The results show that the strength of cement blended with laterite as SCM is enhanced. Key words: Portland cement, supplementary cementing materials (SCM), laterite, compressive strength KUI – 6/2013 Received January 4, 2012 Accepted February 11, 2013

Research has been conducted on the Cryptosporidium parvum oocysts. The inactivation of these oocysts after the chemical, physical and environmental stress treatment has been investigated.

Research was conducted to examine the effects of sample turbidity on the recovery of Cryptosporidium parvum oocysts using two immunomagnetic separation (IMS) kits. The objectives of the study was to identify an IMS kit that generated high purified oocyst suspensions, to determine turbidity levels and to use the IMS kit for the evaluation of the effects of age on the recovery of C. parvum oocysts. Results indicate that IMS is a promising alternative to flotation procedures for the recovery of oocysts from turbid water matrices.

Enterohaemorrhagic Escherichia coli (EHEC) O157:H7, the causative agent for haemolytic uraemic syndrome, has become a significant health concern, due to an increasing number of cases. The focus of this project was rapid (<8 h) detection of E. coli O157:H7 from source and finished waters samples, either directly or indirectly, by dovetailing the procedures with existing total coliform procedures. Evaluation of four immunological lateral diffusion assays determined a detection range between 1 x 104 and 1 x 106 CFU, with the Reveal® E. coli O157: H7 Test System (Neogen) being the most sensitive for detecting E. coli O157: H7. Evaluation of the BAX® System for molecular detection determined that as few as 10 CFU could be reproducibly detected. Coupling either of these detection procedures with organism propagation using Tryptic Soy Broth (TSB) enabled sufficient quantities of E. coli O157: H7, such that the Reveal® and BAX® detection methods could be used with the 8 h time frame. Examination of matrix effects on the overall procedure indicated little impact on method performance. [ABSTRACT FROM AUTHOR]

For over a decade, despite continuous efforts, the methods for collection, isolation and detection of Cryptosporidium have remained time-consuming and inefficient. For example, two standard methods for Cryptosporidium are the United Kingdom Standing Committee of Analysts (SCA) method (Anon, 1990) and the U.S. Environmental Protection Agency (USEPA) Information Collection Rule (ICR) method (1996). Both these methods have relied on large volume filtration, elution using large quantities of a weak detergent solution, concentration with various centrifugation steps and then clarification of the target organisms by using specific density flotation, with either sucrose alone or in conjunction with Percoll. Because of the laborious nature of these methodsand their poor recovery efficiencies, the USEPA instigated the development of improved methodologies, with the objective that commercially available products could be incorporated into methods that would eventually lead to the development of reliable methods, with improved oocyst recoveries. This has resulted in the development of a method for surface waters and is based on collection of small sample volumes (10 L) through cartridge or membrane filters, elution of organisms andclarification by immunomagnetic separation followed by their detection by immunofluorescence. This USEPA method has been collectively termed Method 1622 (USEPA, 1998) and has undergone initial validation work and is currently in the round-robin testing phase. [ABSTRACT FROM AUTHOR]

Ubiquitin (Ub) is a post-translational modification that largely controls proteostasis through mechanisms spanning transcription, translation, and notably, protein degradation. Ub conjugation occurs through a hierarchical cascade of three enzyme classes (E1, E2, and E3s) involving >1000 proteins that regulate the ubiquitination of proteins. The E2 Ub-conjugating enzymes are the midpoint, yet their cellular roles remain under-characterized, partly due to a lack of inhibitors. For example, the cellular roles of the promiscuous E2 UBE2D/UBCH5 are not well described. Here, we develop a highly selective, multivalent, engineered protein inhibitor for the UBE2D family that simultaneously targets the RING- and backside-binding sites. In HeLa cells, these inhibitors phenocopy knockdown of UBE2D by reducing the IC 50 to cisplatin and whole-cell proteomics reveal an increased abundance of ~20% of the identified proteins, consistent with reduced Ub degradation and proteotoxic stress. These precision tools will enable new studies probing UBE2D's central role in proteome management.

Aim: In this study, we assessed the use of advanced pharmacological behavior management techniques (BMTs) among pediatric dentists in Saudi Arabia and the barriers to their clinical application., Materials and Methods: This cross-sectional study used a self-administered electronic survey that targeted members of the Saudi Society of Pediatric Dentistry. The questionnaire included questions on five techniques of advanced and pharmacological behavior management recommended by the American Academy of Pediatric Dentistry. Descriptive statistics, frequency, Chi-square test, and Fisher's exact test were used to present the outcomes and independent variables., Results: A total of 57 pediatric dentists completed the survey. Nitrous oxide (N 2 O) sedation, general anesthesia (GA), and protective stabilization were used regularly by pediatric dentists in 70.2%, 68.4%, and 56.1% of the participants, respectively. A few participants reported using oral (14.0%) or intravenous (IV) sedation (10.5%) regularly. The most common barriers to using these techniques were either dentists' discomfort or the non-availability of the equipment/drugs., Conclusions: The most common method used by pediatric dentists was N 2 O inhalation sedation, followed by GA and protective stabilization. The participants' use of pharmacological BMTs, including IV and oral sedation, was relatively low., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of International Society of Preventive and Community Dentistry.)

Purpose: A comprehensive operative report for cancer surgery is crucial for accurate disease staging, risk stratification, and therapy escalation/de-escalation, which affects the outcome. Narrative operative reports may fail to include some critical findings. Furthermore, standardized operative reports can form the basis of a local registry, which is often lacking in limited-resource settings (LRSs). In adult literature, synoptic operative reports (SOR) contain more key findings than narrative operative reports. In the LRSs, where the capacity of diagnostic pathology services is typically suboptimal, the value of a thorough operative report is even greater. The aim of this study was to develop a SOR template to help standardize childhood cancer surgery reporting in LRSs., Methods: Twenty-three experts in pediatric cancer with extensive experience practicing in LRSs were invited to participate in a modified Delphi procedure. SOR domains for pediatric oncology surgery were drafted based on a literature search and then modified based on experts' opinions. The experts anonymously answered multiple rounds of online questionnaires until all domains and subdomains reached a consensus, which was predefined as 70% agreement., Results: Sixteen experts participated in the study, and two rounds of the survey were completed. Twenty-one domains were considered relevant, including demographics, diagnosis, primary site, preoperative disease stage, previous tumor biopsy or surgery, preoperative tumor rupture, neoadjuvant therapy, surgical access, type of resection, completeness of resection, tumor margin assessment, locoregional tumor extension, organ resection, intraoperative tumor spillage, vascular involvement, lymph node sampling, estimated blood loss, intraoperative complications and interventions to address them, specimen names, and specimen orientation., Conclusion: We developed a SOR template for pediatric oncology surgery in LRSs. Consensus for all 21 domains and associated subdomains was achieved using a modified Delphi procedure., (© 2023 Wiley Periodicals LLC.)

The present study explores the concept of reenactment of known and unknown war trauma that may be unfamiliar to the readers while also opening up new discourses of understanding and empathy through the lens of Cathy Caruth's trauma theory by focusing on the novel A Land of Permanent Goodbyes by Atia Abawi. War fiction, such as Abawi's novel, highlights the concept of psychological trauma as a double wound (known as "outsiders" and unknown as "insiders") through the textual analysis and characterization of characters by presenting their haunting pasts, present lives, and losses concerning traumatic events. The present study also recounts what the trauma of the unknown means to war-torn survivors by focusing on "trauma as double wounds" from three aspects: cause, effects, and recuperation. Finally, the study concludes with a new paradigm in which trauma is portrayed as a healer rather than a wound., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ahmad, Bukhari, Khan, Ashraf and Kanwal.)

The premise of this study is to look at the intergenerational transferal of language and racial trauma of Asian immigrants in general and Korean-American immigrants in particular to a western country, the United States of America. This study investigates trauma from a psychological standpoint, based on Chang-Rae Lee's novel Native Speaker. In describing a marker of citizenship, the novel's title also points to who is the native language speaker and who is a native of a country, and why one who is not may be excluded. The Korean immigrants' vulnerability to the English language and racial differences highlights their status as minority "others," and they suffer from transgenerational trauma. As a result of transgenerational traumatic effects, Henry (the protagonist) has various traumatic side effects such as dysphasia, aphasia, and parasomnia and finally leaves no stone unturned to recuperate from trauma. The Trauma of the Unspeakable theory by Michelle Balaev is used in this article to show how trauma affects people's minds., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ahmad, Nawaz, Bukhari, Nadeem and Hussain.)

Objective: Eosinophilic esophagitis (EoE) is a Th2 disease that presently is diagnosed and followed by clinical symptoms in the presence of endoscopic biopsies documenting elevated esophageal eosinophilia. To simplify clinical care, multiple studies have attempted to identify a disease specific serologic marker. None have been successful. The goal of this study was to employ custom designed Luminex multiplex bead assays to identify a reliable serologic marker for EoE., Methods: Luminex assays were employed to measure serum levels of 11 analytes associated with EoE (IL-5, lL13, periostin, eotaxin-3, thymic stromal lymphopoietin, and immunoglobulins) in a cohort of pediatric patients consisting of active EoE (n=30), EoE in remission (n=13), and controls (n=34)., Results: No analyte was found to be elevated or depressed in active EoE compared to the other groups. Additionally, among the cohort with active EoE, none of the 11 analytes correlated with peak esophageal eosinophilia, endoscopic features of EoE quantitatively defined by an EoE validated endoscopic reference score (EREFS), or esophageal thickness as determined by endosonography., Conclusion: This is the largest prospective survey of heterogeneous markers studied in a consecutive cohort to determine whether they could diagnose or follow EoE. Although none were identified in this cohort, Luminex provides a rapid, economical tool to simultaneously screen multiple sera for proteins that are increased or decreased in disease states., (© 2022 by the Association of Clinical Scientists, Inc.)

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a significant global health emergency with new variants in some cases evading current therapies and approved vaccines. COVID-19 presents with a broad spectrum of acute and long-term manifestations. Severe COVID-19 is characterized by dysregulated cytokine release profile, dysfunctional immune responses, and hypercoagulation with a high risk of progression to multi-organ failure and death. Unraveling the fundamental immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and design of more effective therapeutic interventions for individuals at the highest risk of severe outcomes. Caspases are expressed in both immune and non-immune cells and mediate inflammation and cell death, including apoptosis and pyroptosis. Here we review accumulating evidence defining the importance of the expression and activity of caspase family members following SARS-CoV-2 infection and disease. Research suggests SARS-CoV-2 infection is linked to the function of multiple caspases, both mechanistically in vitro as well as in observational studies of individuals with severe COVID-19, which may further the impact on disease severity. We also highlight immunological mechanisms that occur in severe COVID-19 pathology upstream and downstream of activated caspase pathways, including innate recognition receptor signaling, inflammasomes, and other multiprotein complex assembly, inflammatory mediators IL-1β and IL-18, and apoptotic and pyroptotic cell death. Finally, we illuminate discriminate and indiscriminate caspase inhibitors that have been identified for clinical use that could emerge as potential therapeutic interventions that may benefit clinical efforts to prevent or ameliorate severe COVID-19., Competing Interests: Author OA was employed by company Amerimmune. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Premeaux, Yeung, Bukhari, Bowler, Alpan, Gupta and Ndhlovu.)

Background: COVID-19 can present with lymphopenia and extraordinary complex multiorgan pathologies that can trigger long-term sequela., Aims: Given that inflammasome products, like caspase-1, play a role in the pathophysiology of a number of co-morbid conditions, we investigated caspases across the spectrum of COVID-19 disease., Materials & Methods: We assessed transcriptional states of multiple caspases and using flow cytometry, the expression of active caspase-1 in blood cells from COVID-19 patients in acute and convalescent stages of disease. Non-COVID-19 subject presenting with various comorbid conditions served as controls., Results: Single-cell RNA-seq data of immune cells from COVID-19 patients showed a distinct caspase expression pattern in T cells, neutrophils, dendritic cells, and eosinophils compared with controls. Caspase-1 was upregulated in CD4+ T-cells from hospitalized COVID-19 patients compared with unexposed controls. Post-COVID-19 patients with lingering symptoms (long-haulers) also showed upregulated caspase-1activity in CD4+ T-cells that ex vivo was attenuated with a select pan-caspase inhibitor. We observed elevated caspase-3/7levels in red blood cells from COVID-19 patients compared with controls that was reduced following caspase inhibition., Discussion: Our preliminary results suggest an exuberant caspase response in COVID-19 that may facilitate immune-related pathological processes leading to severe outcomes. Further clinical correlations of caspase expression in different stages of COVID-19 will be needed., Conclusion: Pan-caspase inhibition could emerge as a therapeutic strategy to ameliorate or prevent severe COVID-19., (© 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

We studied the incidence of HPV genotypes in mostly Black women with cervical carcinoma and correlated histopathologic tumor characteristics, immune markers and clinical data with survival. Disease-free survival (DFS) and overall survival (OS) were recorded for 60 months post-diagnosis. Fifty four of the 60 (90%) patients were Black and 36 (60%) were < 55 years of age. Of the 40 patients with typeable HPV genotypes, 10 (25%) had 16/18 HPV genotypes, 30 (75%) had one of the non-16/18 HPV genotypes, and 20 (50%) had one of the 7 genotypes (35, 39, 51, 53, 56, 59 and 68) that are not included in the nonavalent vaccine. Mixed HPV infections (≥ 2 types) were found in 11/40 (27.5%) patients. Patients infected with non-16/18 genotypes, including the most common genotype, HPV 35, had significantly shorter DFS and OS. PD-L1 (p = 0.003), MMR expression (p = 0.01), clinical stage (p = 0.048), histologic grade (p = 0.015) and mixed HPV infection (p = 0.026) were independent predictors of DFS. A remarkably high proportion of cervical cancer cells in our patients expressed PD-L1 which opens the possibility of the use of immune checkpoint inhibitors to treat these cancers. Exclusion of the common HPV genotypes from the vaccine exacerbates mortality from cervical cancer in underserved Black patients.

The use of experimental relations to approximate the efficient thermophysical properties of a nanofluid (NF) with Cu nanoparticles (NPs) and hybrid nanofluid (HNF) with Cu-SWCNT NPs and subsequently model the two-dimensional pulsatile Casson fluid flow under the impact of the magnetic field and thermal radiation is a novelty of the current study. Heat and mass transfer analysis of the pulsatile flow of non-Newtonian Casson HNF via a Darcy-Forchheimer porous channel with compliant walls is presented. Such a problem offers a prospective model to study the blood flow via stenosed arteries. A finite-difference flow solver is used to numerically solve the system obtained using the vorticity stream function formulation on the time-dependent governing equations. The behavior of Cu-based NF and Cu-SWCNT-based HNF on the wall shear stress (WSS), velocity, temperature, and concentration profiles are analyzed graphically. The influence of the Casson parameter, radiation parameter, Hartmann number, Darcy number, Soret number, Reynolds number, Strouhal number, and Peclet number on the flow profiles are analyzed. Furthermore, the influence of the flow parameters on the non-dimensional numbers such as the skin friction coefficient, Nusselt number, and Sherwood number is also discussed. These quantities escalate as the Reynolds number is enhanced and reduce by escalating the porosity parameter. The Peclet number shows a high impact on the microorganism's density in a blood NF. The HNF has been shown to have superior thermal properties to the traditional one. These results could help in devising hydraulic treatments for blood flow in highly stenosed arteries, biomechanical system design, and industrial plants in which flow pulsation is essential.

Abstract: Cytopenias in systemic lupus erythematosus (SLE) require clinical and laboratory workup and bone marrow (BM) examination to determine the cause and for appropriate patient management. Common causes include an increase in SLE activity, immune-mediated hemolysis, iron deficiency, antiphospholipid antibody syndrome, infection, or the effect of medications. We retrospectively evaluated the clinical and laboratory findings of patients with SLE and cytopenias who had undergone BM studies to determine the indicators of malignancy.We retrospectively reviewed medical records of patients with SLE who presented with cytopenias for their disease course, medications, laboratory parameters and documented the spectrum of morphological changes in BM including CD34 expression.Twenty patients with SLE had undergone BM biopsy for evaluation of cytopenias. 14/20 (70%) of the patients had reactive BM, and the rest had hematologic malignancies involving the BM. Of these 14 patients, 8 had hypocellular marrow with loss of precursor cells (low CD34), 4 had left shift in myeloid lineage, 3 had serous atrophy, and 1had multilineage dysplasia. The 6 patients with hematologic malignancies included 2 with diffuse large B cell lymphoma, and one each of natural killer/T cell lymphoma, post-transplant lymphoproliferative disorder, Hodgkin lymphoma, and myelodysplastic syndrome evolving to acute myelogenous leukemia. The presence of autoantibodies, SLE activity, and lupus nephritis were comparable in patients with and without neoplasia. However, the duration of the use of multiple immunosuppressants, years since renal transplant (22 vs 10), multiple transplants, and the presence of other autoimmune diseases were greater in those with neoplasia. Two of the 14 patients with non-neoplastic BM and 1 with the neoplastic BM had nonhematological malignancy.Clinical and laboratory findings, the number of transplants, and the use of immunosuppressive agents can guide physicians to identify patients with a higher risk of developing hematologic malignancy. BM findings of cytopenia in SLE are often due to increased disease activity causing global cell death and dysmaturation. SLE patients presenting with cytopenias, with a history of long-term exposure to immunosuppressive drugs, should be regularly screened for hematologic and nonhematologic malignancies., Competing Interests: The authors have no funding and conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Development of antibody protection during SARS-CoV-2 infection is a pressing question for public health and for vaccine development. We developed highly sensitive SARS-CoV-2-specific antibody and neutralization assays. SARS-CoV-2 Spike protein or Nucleocapsid protein specific IgG antibodies at titers more than 1:100,000 were detectable in all PCR+ subjects (n = 115) and were absent in the negative controls. Other isotype antibodies (IgA, IgG1-4) were also detected. SARS-CoV-2 neutralization was determined in COVID-19 and convalescent plasma at up to 10,000-fold dilution, using Spike protein pseudotyped lentiviruses, which were also blocked by neutralizing antibodies (NAbs). Hospitalized patients had up to 3000-fold higher antibody and neutralization titers compared to outpatients or convalescent plasma donors. Interestingly, some COVID-19 patients also possessed NAbs against SARS-CoV Spike protein pseudovirus. Together these results demonstrate the high specificity and sensitivity of our assays, which may impact understanding the quality or duration of the antibody response during COVID-19 and in determining the effectiveness of potential vaccines.

Background: African-Americans/Blacks have suffered higher morbidity and mortality from COVID-19 than all other racial groups. This study aims to identify the causes of this health disparity, determine prognostic indicators, and assess efficacy of treatment interventions., Methods: We performed a retrospective cohort study of clinical features and laboratory data of COVID-19 patients admitted over a 52-day period at the height of the pandemic in the United States. This study was performed at an urban academic medical center in New York City, declared a COVID-only facility, serving a majority Black population., Results: Of the 1103 consecutive patients who tested positive for COVID-19, 529 required hospitalization and were included in the study. 88% of patients were Black; and a majority (52%) were 61-80 years old with a mean body mass index in the "obese" range. 98% had one or more comorbidities. Hypertension was the most common (79%) pre-existing condition followed by diabetes mellitus (56%) and chronic kidney disease (17%). Patients with chronic kidney disease who received hemodialysis were found to have lower mortality, than those who did not receive it, suggesting benefit from hemodialysis Age > 60 years and coronary artery disease were independent predictors of mortality in multivariate analysis. Cox proportional hazards modeling for time to death demonstrated a significantly high ratio for COPD/Asthma, and favorable effects on outcomes for pre-admission ACE inhibitors and ARBs. CRP (180, 283 mg/L), LDH (551, 638 U/L), glucose (182, 163 mg/dL), procalcitonin (1.03, 1.68 ng/mL), and neutrophil:lymphocyte ratio (8.3:10.0) were predictive of mortality on admission and at 48-96 h. Of the 529 inpatients 48% died, and one third of them died within the first 3 days of admission. 159/529patients received invasive mechanical ventilation, of which 86% died and of the remaining 370 patients, 30% died., Conclusions: COVID-19 patients in our predominantly Black neighborhood had higher in-hospital mortality, likely due to higher prevalence of comorbidities. Early dialysis and pre-admission intake of ACE inhibitors/ARBs improved patient outcomes. Early escalation of care based on comorbidities and key laboratory indicators is critical for improving outcomes in African-American patients.

The present paper examines the flow behavior and separation region of a non-Newtonian electrically conducting Casson fluid through a two-dimensional porous channel by using Darcy's law for the steady and pulsatile flows. The vorticity-stream function approach is employed for the numerical solution of the flow equations. The effects of various emerging parameters on wall shear stress and stream-wise velocity are displayed through graphs and discussed in detail. It is noticed the increasing values of the magnetic field parameter (Hartman number) cause vanishing of the flow separation region and flattening of the stream-wise velocity component. The study also reveals that the non-Newtonian character of Casson fluid bears the potential of controlling the flow separation region in both steady and pulsating flow conditions.

Recovering and reusing treated wastewater effluent is a sustainable and cost-effective practice for addressing global water sustainability. To date, most potable reuse advanced water treatment (AWT) solutions are based on reverse osmosis (RO), which generates a continuous reject stream of concentrated brine waste. Ozone-biofiltration based solutions have been investigated as a potential alternative for RO. However, implementation of ozone-biofiltration for potable reuse projects around the world has been limited. The goal of this study was to conduct an extended field investigation of ozone-biofiltration treatment to address regulatory, design, and operational hurdles that may hinder implementation in water-short areas. For 16 months, two parallel biological activated carbon (BAC) filters were operated at empty bed contact times (EBCTs) of 10 min and 20 min treating up to 60,000 and 30,000 bed volumes (BVs), respectively, of sand filtered effluent from a municipal wastewater treatment process. BAC 1 (EBCT = 10 min) and BAC 2 (EBCT = 20 min) used Calgon Filtrasorb 400 granular activated carbon (GAC) as filter media, with equal bed depths of 0.8 m. Increasing the specific ozone dose from 0.9 to 2.0 provided a muted response with respect to oxidation of contaminants of emerging concern (CECs) that are resistive to ozonation. N-Nitrosodimethylamine (NDMA) was generated during ozonation, with the average concentration of NDMA in ozonated effluent being 40.4 ng/L. In BAC 1 (EBCT = 10 min), NDMA was fully removed during the first month of study (<2000 BVs), partially removed between 2000 and 20,000 BVs, and completely removed when monitored between 57,000 and 62,000 BVs. These trends clearly reveal time-dependent interactions between carbon-based (e.g., adsorption) and non-carbon-based (e.g., biodegradation) removal mechanisms. In BAC 2 (EBCT = 20 min), almost all CECs, excluding NDMA, were removed consistently throughout the study (through ∼30,000 BVs). This indicates a somewhat different interaction between carbon-based and non-carbon-based removal in the more lightly loaded BAC 2, compared to BAC 1. After 482 days of operation, BAC 1 (EBCT = 10 min) produced effluent with lower NDMA concentration (<2 ng/L) than BAC 2 (10 ng/L), confirming prior evidence of cometabolic NDMA biodegradation pathways operable in more heavily loaded BACs. These findings emphasize the need for extended field testing (50,000 BVs or greater). BAC 1 removed TOC in effluent until it plateaued at around 6 mg/L after 60,000 BVs, whereas BAC 2 effluent plateaued at around 4 mg/L. Under plateau conditions, BAC 1 and BAC 2 with sand filter pretreatment and ozonation appear to have a gross TOC removal potential of around 0.2-0.3 kg of TOC removed per day per cubic meter of carbon media (kg/d/m 3 ). A comparative analysis of findings from this study and results from a past ozone-BAC study in the Reno area (termed BAC 3 operated downstream of membrane filter with an EBCT of 30 min) shows that higher TOC removal was observed in BAC with shorter EBCT and upstream sand filter compared to BAC with longer EBCT and upstream membrane filter. The present study addresses the regulatory and financial concerns associated with ozone-BAC performance in potable reuse applications. Improved comprehension of ozone-BAC performance, coupled with its reduced capital and operations and maintenance (O&M) costs compared to RO, may accelerate the full-scale implementation of ozone-BAC treatment as a sustainable solution for the rapidly emerging potable reuse market., 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 Elsevier Ltd. All rights reserved.)

Objective: Pancreatic ductal carcinoma has a 5-year survival rate of 9%. This makes it the 4th leading cause of cancer-related death in the United States. Advanced-stage diagnosis and limited treatment options contribute to poor prognosis. Thus, there is an urgent need for new approaches to treatment. Enhancer of Zeste 2 (EZH2), a catalytic subunit of the multi-protein histone methyltransferase, known as the polycomb repressive complex, has been implicated in carcinogenesis. E2H2's downregulation has been shown to have a therapeutic effect in B cell lymphomas., Materials and Methods: We examined the effect of EZH2 downregulation in combination with irradiation on the proliferation and apoptosis of pancreatic cancer cells (PANC-1 and MIA PaCa-2) in vitro . EZH2 downregulation was accomplished by treatment of cells with small interfering RNA (siRNA) or EPZ. To do this, cell survival was assessed over a 96 hr (short-term) by ATP measurement and immunohistochemical assessment of Phosphohistone 3 (PHH3), Ki-67 and CC3 over two weeks (long-term) by clonogenic assay., Results: EZH2 downregulation resulted in the decreased proliferation of PANC-1 and MIA PaCa-2 cells within short-term assays with maximal reduction at 72 hr. Irradiation reduced cell proliferation beginning at 96 hr and continued over the long-term. Irradiation with EZH2 downregulation reduced cell proliferation between 48 and 72 hr. This combined treatment reduced cell proliferation by 3 to 14% as compared to those treated with irradiation alone at two weeks. PANC-1 and MIA PaCa-2 cells exhibited similar responses to EZH2 downregulation and irradiation, but to different degrees. siRNA or EPZ were equally effective in EZH2 downregulation., Conclusions: EZH2 downregulation in combination with irradiation reduces PANC-1 and MIA PaCa-2 cell proliferation more than irradiation alone. This study affirms the role of EZH2 downregulation for radiosensitization in pancreatic cancer treatment., (© 2020 by the Association of Clinical Scientists, Inc.)

Legionella spp. is a key contributor to the United States waterborne disease burden. Despite potentially widespread exposure, human disease is relatively uncommon, except under circumstances where pathogen concentrations are high, host immunity is low, or exposure to small-diameter aerosols occurs. Water quality guidance values for Legionella are available for building managers but are generally not based on technical criteria. To address this gap, a quantitative microbial risk assessment (QMRA) was conducted using target risk values in order to calculate corresponding critical concentrations on a per-fixture and aggregate (multiple fixture exposure) basis. Showers were the driving indoor exposure risk compared to sinks and toilets. Critical concentrations depended on the dose response model (infection vs clinical severity infection, CSI), risk target used (infection risk vs disability adjusted life years [DALY] on a per-exposure or annual basis), and fixture type (conventional vs water efficient or "green"). Median critical concentrations based on exposure to a combination of toilet, faucet, and shower aerosols ranged from ∼10 -2 to ∼10 0 CFU per L and ∼10 1 to ∼10 3 CFU per L for infection and CSI dose response models, respectively. As infection model results for critical L. pneumophila concentrations were often below a feasible detection limit for culture-based assays, the use of CSI model results for nonhealthcare water systems with a 10 -6 DALY pppy target (the more conservative target) would result in an estimate of 12.3 CFU per L (arithmetic mean of samples across multiple fixtures and/or over time). Single sample critical concentrations with a per-exposure-corrected DALY target at each conventional fixture would be 1.06 × 10 3 CFU per L (faucets), 8.84 × 10 3 CFU per L (toilets), and 14.4 CFU per L (showers). Using a 10 -4 annual infection risk target would give a 1.20 × 10 3 CFU per L mean for multiple fixtures and single sample critical concentrations of 1.02 × 10 5 , 8.59 × 10 5 , and 1.40 × 10 3 CFU per L for faucets, toilets, and showers, respectively. Annual infection risk-based target estimates are in line with most current guidance documents of less than 1000 CFU per L, while DALY-based guidance suggests lower critical concentrations might be warranted in some cases. Furthermore, approximately <10 CFU per mL L. pneumophila may be appropriate for healthcare or susceptible population settings. This analysis underscores the importance of the choice of risk target as well as sampling program considerations when choosing the most appropriate critical concentration for use in public health guidance.

The aim of this review was to determine the most common peri-implant mucositis and peri-implantitis case definitions used worldwide in the implant dentistry literature. A systematic assessment of peri-implant disease classification was conducted using all publications in MEDLINE, EMBASE, SCOPUS, and Google Scholar between 1994 and November 2017. Screening of eligible studies and data extraction were conducted in duplicate and independently by 2 reviewers. The search protocol identified 3049 unique articles, of which 2784 were excluded based on title and abstract. In total, 265 full texts were screened, 106 of which met the eligibility criteria. Of these, 41 defined peri-implant mucositis. Eight (19.6%) used bleeding on probing (BOP) only; 8 (19.6.7%) used a combination of probing depth (PD), BOP, and radiograph; and 5 (12.3%) used PD and BOP. Cases with crestal bone loss of ≤2 mm in the first year and ≤0.2 mm in each subsequent year were considered as peri-implant mucositis. Ninety-three articles defined peri-implantitis; 28 (30.1%) used a combination of PD with suppuration, BOP, and radiograph, followed by 25 (26.9%) using a combination of PD, BOP, and radiograph. The main criteria in most of the studies were considered to be BOP, PD, and radiograph. Cases of crestal bone loss of ≥2 mm and PD ≥3 mm are considered peri-implantitis. Different peri-implant disease case definitions may affect disease prevalence and treatment strategies. We need to standardize case definitions to avoid discrepancies in case diagnosis and prognosis.

The use of reclaimed water brings new challenges for the water industry in terms of maintaining water quality while increasing sustainability. Increased attention has been devoted to opportunistic pathogens, especially Legionella pneumophila, due to its growing importance as a portion of the waterborne disease burden in the United States. Infection occurs when a person inhales a mist containing Legionella bacteria. The top three uses for reclaimed water (cooling towers, spray irrigation, and toilet flushing) that generate aerosols were evaluated for Legionella health risks in reclaimed water using quantitative microbial risk assessment (QMRA). Risks are compared using data from nineteen United States reclaimed water utilities measured with culture-based methods, quantitative PCR (qPCR), and ethidium-monoazide-qPCR. Median toilet flushing annual infection risks exceeded 10 -4 considering multiple toilet types, while median clinical severity infection risks did not exceed this value. Sprinkler and cooling tower risks varied depending on meteorological conditions and operational characteristics such as drift eliminator performance. However, the greatest differences between risk scenarios were due to 1) the dose response model used (infection or clinical severity infection) 2) population at risk considered (residential or occupational) and 3) differences in laboratory analytical method. Theoretical setback distances necessary to achieve a median annual infection risk level of 10 -4 are proposed for spray irrigation and cooling towers. In both cooling tower and sprinkler cases, Legionella infection risks were non-trivial at potentially large setback distances, and indicate other simultaneous management practices could be needed to manage risks. The sensitivity analysis indicated that the most influential factors for variability in risks were the concentration of Legionella and aerosol partitioning and/or efficiency across all models, highlighting the importance of strategies to manage Legionella occurrence in reclaimed water., (Copyright © 2018 Elsevier Ltd. All rights reserved.)