Subsequent Maintenance Research Articles

Macroeconomic aspects of maintenance optimization of critical key assets

The main goal of maintenance is prevention, timely detection and elimination of failures and damage. From the point of view of critical infrastructures (CIs), the main purpose of their maintenance is to increase the safety of CIs and / or to ensure life safety. CIs should be optimal in terms of their purpose, cost, as a source of income and profit at all stages of their life cycle, and also acceptable in terms of possible loss of human lives or injuries. The paper considers the assessment of necessary optimal investments in maintenance (time interval between subsequent maintenance) for ensuring life safety, the so-called life saving costs. The problem of limiting the threat to human life is as follows: how much money is society ready and able to spend to reduce the likelihood of a premature death. A quantitative criterion of risk acceptance is used, in which the marginal life saving cost (MLSC) is compared with social willingness to pay. This value is determined using the life quality index.

Solar urticaria: Clinic, diagnostic, course and therapy management in 27 patients.

Solar urticaria is a rare photodermatosis, the diagnosis and therapy of which have not yet been standardized. The aim of this research was to use innovative radiation sources for diagnostics with defined and reproducible emission spectra and doses. Auniform therapy step scheme was to be created. In a longitudinal study, 27 patients with solar urticaria were examined over 13 years. With a characteristic anamnesis, the diagnosis was confirmed with phototesting (photoprovocation) from various radiation sources (UVB, UVB311nm, UVA, UVA-1, green light, red light) and a therapy step scheme was designed consisting of light protection, antihistamines, rush hardening with UVA-1, and administration of omalizumab. Action spectrum: UVB 44%, UVA 70%, UVA-1 89%, green light 37% and red light 22%. Rush hardening with subsequent maintenance therapy was performed on 20 patients, 17 of whom were hereby adequately protected. In three further patients, omalizumab was additionally administered. Phototesting with UVB, UVB311nm, UVA, UVA-1, and visible light with innovative radiation sources is uniformly possible in every major skin clinic. With the help of the therapy step scheme the patients can be adjusted well. Rush hardening with UVA-1 is a safe method to help the patients during the sunny season. Omalizumab as the last therapy option is effective, but currently only possible in off-label use.

Analysis of Fault Diagnosis Methods of High-power Permanent Magnet Synchronous Motor

High-power motor is widely used in actual production and life, and motor failure will seriously affect the efficiency and safety of the equipment, and normal production and life. Therefore, it is necessary to strengthen the fault judgment of the motor, quickly locate the fault and analyze through integrated means, and improve the subsequent maintenance methods. The article will take the permanent magnet synchronous motor of an electric vehicle as an example to discuss the analysis of the fault diagnosis method of the high-power motor.

Green Infrastructure Implementation Programmes at National Level: Case Study “National Project – Support of Biodiversity with Green Infrastructure Elements in Municipalities of Slovakia”

Abstract EU-wide strategy promotes the deployment of green infrastructure across Europe. Integrating green infrastructure in spatial planning, policy and strategy development at regional/national levels is the task of each EU member state. The aim of this article is to give an example and evaluate one of the ongoing projects at national level, namely National project – Support of Biodiversity with Green Infrastructure Elements in Municipalities of Slovakia “Green municipalities of Slovakia“. The aim of the national project is to implement green infrastructure at local level through vegetation elements in order to maintain and restore biodiversity and ecosystems outside of protected areas Natura 2000. The programme supporting tree planting in rural municipalities is an important tool for the creation of basic elements of green infrastructure throughout Slovakia. As part of the national program, an implementation plan for 6 municipalities in Slovakia in 2020 is proposed. Subsequently, the implementation projects in terms of the use of vegetation in different categories of green spaces, types of vegetation, representation of tree species, including costs and benefits, are proposed. Based on the results, the potential and limits of the programme and specific suggestions for its further use are set. In 6 municipalities, a total of 17 suitable localities were selected for the project, which is an average of 2.83 localities per municipality. A total of 467 woody plants individuals were proposed, representing a total of 19 woody plants species. The total cost of planting is an average of €12,601.10 per municipality, €7,312.05 per ha of area, and €161.90 per single tree. The average number of trees per ha is 45.15 individuals and per each municipality it is 77.83 trees. In the conclusions, a potential risk of the programme regarding the subsequent maintenance of trees, which is not funded under the program, is highlighted.

Extracellular Control of Radial Glia Proliferation and Scaffolding During Cortical Development and Pathology.

During the development of the cortex, newly generated neurons migrate long-distances in the expanding tissue to reach their final positions. Pyramidal neurons are produced from dorsal progenitors, e.g., radial glia (RGs) in the ventricular zone, and then migrate along RG processes basally toward the cortex. These neurons are hence dependent upon RG extensions to support their migration from apical to basal regions. Several studies have investigated how intracellular determinants are required for RG polarity and subsequent formation and maintenance of their processes. Fewer studies have identified the influence of the extracellular environment on this architecture. This review will focus on extracellular factors which influence RG morphology and pyramidal neuronal migration during normal development and their perturbations in pathology. During cortical development, RGs are present in different strategic positions: apical RGs (aRGs) have their cell bodies located in the ventricular zone with an apical process contacting the ventricle, while they also have a basal process extending radially to reach the pial surface of the cortex. This particular conformation allows aRGs to be exposed to long range and short range signaling cues, whereas basal RGs (bRGs, also known as outer RGs, oRGs) have their cell bodies located throughout the cortical wall, limiting their access to ventricular factors. Long range signals impacting aRGs include secreted molecules present in the embryonic cerebrospinal fluid (e.g., Neuregulin, EGF, FGF, Wnt, BMP). Secreted molecules also contribute to the extracellular matrix (fibronectin, laminin, reelin). Classical short range factors include cell to cell signaling, adhesion molecules and mechano-transduction mechanisms (e.g., TAG1, Notch, cadherins, mechanical tension). Changes in one or several of these components influencing the RG extracellular environment can disrupt the development or maintenance of RG architecture on which neuronal migration relies, leading to a range of cortical malformations. First, we will detail the known long range signaling cues impacting RG. Then, we will review how short range cell contacts are also important to instruct the RG framework. Understanding how RG processes are structured by their environment to maintain and support radial migration is a critical part of the investigation of neurodevelopmental disorders.

Cryopreservation of the parasitic and saprophytic life stage of the blastocladialean pathogen Paraphysoderma sedebokerense infecting the green algae Haematococcus pluvialis and Scenedesmus dimorphus

ABSTRACT Host–pathogen interactions involving microalgae have attracted more and more interest over the past decade. In order to understand interactions between those two partners and as basis of each single experiment, biological material in the form of cultures is crucial. Whereas the establishment of such cultures can by itself be very difficult and time-consuming, their subsequent maintenance often requires as much effort and manpower. The commercially utilised green microalgae Haematococcus pluvialis and Scenedesmus dimorphus are often challenged by the blastocladialean fungus Paraphysoderma sedebokerense, leading to culture crashes and economic loss. Currently, the interaction between alga and pathogen as well as the life cycle of the fungus are only partially understood. This represents a bottleneck and risk for the maintenance via continuous subcultivation. We here report the development of a cryopreservation protocol for Paraphysoderma sedebokerense and show its applicability to two different life stages of the pathogen. This protocol was validated on two different strains of Paraphysoderma.

Earlier and slower or later and faster: Spring migration pace linked to departure time in a Neotropical migrant songbird.

Migratory birds travel vast distances and the timing of migratory flights can affect survival and the ability to reproduce. For Neotropical migrant songbirds, early spring departure from wintering sites, early arrival to the breeding grounds and higher reproductive success have been related to the use of suitable habitats and environmental conditions during the non-breeding season. However, how migratory strategies are shaped by winter habitat choice is largely unknown due to the general inability to track birds from specific wintering habitats to stopovers or breeding destinations. We assessed how winter habitat (native forest vs. shade-grown coffee plantations) relates to spring departure date and migration pace in Swainson's Thrush Catharus ustulatus. We also determined the effect of departure date and total migration duration on the arrival date of birds detected near or within their breeding range. We used a novel application of Motus radiotelemetry arrays to track individuals from their wintering grounds in the Andes of South America along their migratory journey to North America. We found variation in migratory strategies between habitats, with birds wintering in native forest departing later than birds in coffee. We present isotopic evidence for native forest being of higher quality than shade-coffee for Swainson's Thrush and hypothesize that moister conditions in forest, as shown by stable isotope (δ13 C) analysis of thrush whole blood, provides favourable pre-migratory conditions allowing birds to delay departure from wintering grounds. Habitat, between-site and -year variation in departure date, suggests that birds made facultative adjustments to winter habitat quality and environmental conditions. Independent of habitat, birds that departed later migrated faster and this pattern was maintained along the migration route (n=44). Migrating earlier and slower or later and faster was unlikely to result in significant differences in arrival time to breeding destinations. Our findings reveal underappreciated complexity in migratory decisions by long-distance migrants that contrast with the current paradigm of earlier departures and arrival from optimal habitats. The next step is to understand the relative fitness benefits of early versus late schedules or whether each strategy is an equally good response to experienced conditions.

The Pathways between Cortisol-Related Regulation Genes and PTSD Psychotherapy

Post-traumatic stress disorder (PTSD) only develops after exposure to a traumatic event in some individuals. PTSD can be chronic and debilitating, and is associated with co-morbidities such as depression, substance use, and cardiometabolic disorders. One of the most important pathophysiological mechanisms underlying the development of PTSD and its subsequent maintenance is a dysfunctional hypothalamic–pituitary–adrenal (HPA) axis. The corticotrophin-releasing hormone, cortisol, glucocorticoid receptor (GR), and their respective genes are some of the mediators of PTSD’s pathophysiology. Several treatments are available, including medication and psychotherapies, although their success rate is limited. Some pharmacological therapies based on the HPA axis are currently being tested in clinical trials and changes in HPA axis biomarkers have been found to occur in response not only to pharmacological treatments, but also to psychotherapy—including the epigenetic modification of the GR gene. Psychotherapies are considered to be the first line treatments for PTSD in some guidelines, even though they are effective for some, but not for all patients with PTSD. This review aims to address how knowledge of the HPA axis-related genetic makeup can inform and predict the outcomes of psychotherapeutic treatments.

Evaluation of Temperature-Based Empirical Models and Machine Learning Techniques to Estimate Daily Global Solar Radiation at Biratnagar Airport, Nepal

Global solar radiation (GSR) is a critical variable for designing photovoltaic cells, solar furnaces, solar collectors, and other passive solar applications. In Nepal, the high initial cost and subsequent maintenance cost required for the instrument to measure GSR have restricted its applicability all over the country. The current study compares six different temperature-based empirical models, artificial neural network (ANN), and other five different machine learning (ML) models for estimating daily GSR utilizing readily available meteorological data at Biratnagar Airport. Amongst the temperature-based models, the model developed by Fan et al. performs better than the rest with anR2of 0.7498 and RMSE of2.0162 MJm−2d−1. Feed-forward multilayer perceptron (MLP) is utilized to model daily GSR utilizing extraterrestrial solar radiation, sunshine duration, maximum and minimum ambient temperature, precipitation, and relative humidity as inputs. ANN3 performs better than other ANN models with anR2of 0.8446 and RMSE of1.4595 MJm−2d−1. Likewise, stepwise linear regression performs better than other ML models with anR2of 0.8870 and RMSE of1.5143 MJm−2d−1. Thus, the model developed by Fan et al. is recommended to estimate daily GSR in the region where only ambient temperature data are available. Similarly, a more robust ANN3 and stepwise linear regression models are recommended to estimate daily GSR in the region where data about sunshine duration, maximum and minimum ambient temperature, precipitation, and relative humidity are available.

Thiopurines and their optimization during infliximab induction and maintenance: A retrospective study in Crohn's disease.

Combining therapy with a thiopurine is favored when commencing infliximab in Crohn's disease; however, the optimal 6-thioguanine nucleotide (TGN) level and how long to continue thiopurines after induction are uncertain. We aimed to compare outcomes after induction and during maintenance in combination therapy versus infliximab monotherapy in Crohn's and to examine whether TGN levels were associated with outcomes. Crohn's patients induced with infliximab with or without concomitant thiopurines were retrospectively identified. Response to induction and clinical outcomes in subsequent 6-month maintenance semesters were analyzed. A TGN level ≥235pmol/8×108 red blood cells was considered therapeutic. In 89 patients, response to induction was higher in combination therapy than monotherapy (74 vs 47%, P=0.04). This benefit was only seen in patients with a therapeutic TGN (odds ratio 3.72, confidence interval 1.07-13.0, P=0.04). Combination therapy during induction yielded a three times longer time to subsequent need for treatment escalation or treatment failure compared with monotherapy (29 vs 9months, P=0.01), with both therapeutic and subtherapeutic TGNs independent predictors on multivariate analysis. Among 370 semesters, there was no difference in outcomes between combination therapy and monotherapy (P=0.42), nor when combination semesters were stratified by therapeutic versus subtherapeutic TGN (P=0.56). In semester 1 only, a significantly higher remission rate was observed with therapeutic compared with subtherapeutic TGN (76% vs 33%, P=0.02). Combination therapy dosed with an optimized thiopurine was superior to infliximab monotherapy for induction of response, durability of response, and clinical outcomes in the first 6months following induction. Thereafter, combination therapy yielded no clinical advantage, supporting consideration of thiopurine withdrawal on a case-by-case basis.

Drug Vulnerabilities and Disease Prognosis Linked to the Stem Cell-Like Gene Expression Program Triggered by the RHO GTPase Activator VAV2 in Hyperplastic Keratinocytes and Head and Neck Cancer

We have recently shown that VAV2, a guanosine nucleotide exchange factor that catalyzes the stimulation step of RHO GTPases, is involved in a stem cell-like (SCL) regenerative proliferation program that is important for the development and subsequent maintenance of the tumorigenesis of both cutaneous (cSCC) and head and neck squamous cell carcinomas (hnSCC). In line with this, we have observed that the levels of the VAV2 mRNA and VAV2-regulated gene signatures are associated with poor prognosis in the case of human papillomavirus-negative hnSCC patients. These results suggest that the SCL program elicited by VAV2 in those cells can harbor therapeutically actionable downstream targets. We have addressed this issue using a combination of both in silico and wet-lab approaches. Here, we show that the VAV2-regulated SCL program does harbor a number of cell cycle- and signaling-related kinases that are essential for the viability of undifferentiated keratinocytes and hnSCC patient-derived cells endowed with high levels of VAV2 activity. Our results also show that the VAV2-regulated SCL gene signature is associated with poor hnSCC patient prognosis. Collectively, these data underscore the critical role of this VAV2-regulated SCL program for the viability of both preneoplastic and fully transformed keratinocytes.

HL-307: A Retrospective Analysis of Brentuximab Vedotin and Pembrolizumab Combination as Salvage Treatment for Patients with Relapsed or Refractory Hodgkin Lymphoma

Context The standard treatment for Hodgkin lymphoma (HL) patients presenting a relapsed/refractory disease is salvage chemotherapy followed by autologous stem cell transplantation (ASCT). However, with commonly used chemotherapy combinations (such as DHAP, ICE, BEGEV), 25–30% of these patients fail to achieve a complete metabolic response (CMR) and to proceed to ASCT, with consequently poor outcomes. Single agents brentuximab vedotin (BV) and pembrolizumab have shown efficacy in heavily pretreated HL patients, as reported in previous studies. Objective To describe the outcome of a series of refractory HL patients with a combination of brentuximab vedotin and pembrolizumab. Patients We retrospectively collected data of seven HL patients presenting with a high-risk multi-refractory disease (at least two prior treatments received) followed at Jules Bordet Institute between May 2019 and May 2020 and treated with a combination of BV and pembrolizumab. Patients were treated according to special insurance conditions permitting treatment reimbursement. Interventions We planned to treat patients with 3-week cycles of a combination of BV and pembrolizumab, performing an early PET-CT evaluation followed by high-dose chemotherapy and ASCT consolidation for those achieving a CMR (Deauville score ≤3). After ASCT, patients received BV as maintenance for a total of 16 administration (also including pre-ASCT cycles). Main outcome measures The rate of CMR and the percentage of patients achieving ASCT. Results We included 7 patients, 6 male and 1 female, with a mean age of 27.4 years. All patients presented with an advanced-stage disease, with a mean number of received treatments of 2.56 (range 2–3). The mean follow-up time was 7.1 months, the average received cycles of treatment were 4.2 (range 2–7). A CMR was achieved in five patients (72%), with a median time to response of two cycles. One partial response and one disease progression were also observed. Five patients proceeded to ASCT (72%) and subsequent BV maintenance, with no reported disease progressions in this group. One patient achieving a CMR after two cycles subsequently lost the response and failed to proceed to ASCT. Conclusions The BV and pembrolizumab combination seems to be effective as bridge to ASCT for high-risk multi-refractory HL patients.

Mixed Weibull distribution model of DC protection system based on entropy weight method

By analyzing the blocking event of DC converter station of the State Grid Corporation in recently ten years, it can be concluded that the sampling system failure, secondary circuit fault, board fault, host fault, etc. of the protection system caused more than 10% of the DC system blockings, which have seriously threatened the normal operation of DC system. Towards this end, this paper makes a statistical analysis of the operation defects of high-voltage direct current (HVDC) transmission protection in Hubei Company in the past five years. A mixed Weibull distribution model method based on entropy weight method is proposed. By using this method, the reliability curve and average defect interval time (MTBF) of the DC protection system are obtained. Combined with the actual situation of the converter station, the DC protection system of the converter station is evaluated, which provides an important guiding basis for the subsequent maintenance, system transformation, and replacement of the converter station.

Pre-radiotherapy dental status of oropharyngeal cancer patients based on HPV status in a novel radiation era.

Objectives Among common head and neck cancers (HNCs), oropharyngeal cancer (OPC) patients have been identified as having a better dentition than many other tumour subsites. OPC consists of human papillomavirus (HPV)-positive and negative groups with different prognosis. The purpose of this study is to explore the presenting dental status of OPC patients based on HPV status at the pre-radiotherapy phase.Materials and methods The study reviewed the dental panoramic radiographs of OPC patients seen at a dedicated pre-radiotherapy dental assessment clinic from 2011-2017. Only patients planned for intensity-modulated radiotherapy treatment were included within this study. Relevant dental and oncological data were collected.Results A total of 316 patients with known HPV status (215 positive; 101 negative) were included for analysis. HPV-positive patients had significantly more teeth on attendance than HPV-negative patients (22.3 vs 19.0, p = 0.0000) and horizontal bone loss was less severe compared to HPV-negative patients (p = 0.0000). HPV-positive males and patients in the 55-64 decade presented with the best and most complex dentition.Conclusion The rise of OPC with the prospect of long survival, particularly in HPV-positive patients, requires a dentition with adequate function and subsequent maintenance. The current study demonstrated that these patients have a complex dentition presenting new challenges to the dentist. This may explain in part the elevated osteoradionecrosis rate seen in this tumour group.

Intravenous Bevacizumab in Hereditary Hemorrhagic Telangiectasia–Related Bleeding and High-Output Cardiac Failure: Significant Inter-Individual Variability in the Need for Maintenance Therapy

ObjectiveTo present our center’s experience with a maintenance treatment algorithm for intravenous bevacizumab that allows for personalized therapy decisions. Patients and MethodsWe reviewed all patients treated with intravenous bevacizumab for hereditary hemorrhagic telangiectasia–related bleeding and/or high-output cardiac failure (HOCF) from January 1, 2013, to July 1, 2019, at the Mayo Clinic, Rochester, Minnesota. Data regarding subsequent bevacizumab dosing were abstracted. ResultsA total of 57 patients (n=40, 70.2% females) were identified with a median age of 65 (55 to 74; range, 37 to 89) years. High-cardiac output state was present in 21 patients (36.8%) and 10 (17.5%) were treated with intravenous bevacizumab primarily for HOCF. The median duration of follow-up after completion of the initial intravenous bevacizumab treatment was 25 (12.3 to 40.8; range, 0.1 to 65.4) months. A total of 20 (35.1%) patients with a median follow-up of 13.5 (range, 0 to 48.4) months required no maintenance dosing throughout the duration of follow-up. Among those who required subsequent maintenance doses, only a small fraction (8 patients; 14.0%) required regular maintenance doses every 4 to 8 weeks during follow-up whereas the majority of patients required intermittent “as-needed” doses at varying intervals. ConclusionThere is significant inter-individual variability in the need for maintenance intravenous bevacizumab when patients are followed using a predefined bevacizumab maintenance dosing treatment algorithm. The use of “as-needed” maintenance bevacizumab appears to be an effective strategy for management of hereditary hemorrhagic telangiectasia–related bleeding and HOCF.

Biological and Chemo-Physical Features of Denture Resins.

In the dental field, the study of materials has always been the basis of the clinical practice. Over the years, with the evolution of materials, it has been possible to produce safe and predictable prosthetic devices, with ever better aesthetic features, biocompatibility and patient satisfaction. This review briefly analyzes the features of dental resin materials to underline the biological, microbiological and chemo-physical characteristics. The main aim of prosthodontics is to rehabilitate patients and therefore improve their quality of life. Dental resins are the main materials used for the production of dentures. Once solidified, these polymers have different mechanical or surface characteristics. The results of the literature on these characteristics were analyzed and some new brand dental resins, known as modern resin, were subsequently evaluated. The new materials are undoubtedly a step forward in the creation of dental prostheses, and also in all subsequent maintenance phases. This review shows how changing the chemical structure of the resins could have microbiological influences on the growth and management of the biofilm, and also physical influences in terms of its mechanical characteristics. The development of new materials is a constant goal in dentistry in order to obtain increasingly predictable rehabilitations.

Trips4health: Protocol of a single-blinded randomised controlled trial incentivising adults to use public transport for physical activity gain

BackgroundPublic transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting. Methodstrips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined. Discussiontrips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies. Trial registrationACTRN12619001136190. Universal trial numberU1111-1233-8050.

Induction of Sustained Clinical Remission in Early Axial Spondyloarthritis Following Certolizumab Pegol Treatment: 48-Week Outcomes from C-OPTIMISE.

IntroductionAchievement of remission is a key treatment goal for patients with axial spondyloarthritis (axSpA). C-OPTIMISE assessed achievement of sustained clinical remission in patients with axSpA, including radiographic (r) and non-radiographic (nr) axSpA, during certolizumab pegol (CZP) treatment, and subsequent maintenance of remission following CZP dose continuation, dose reduction or withdrawal. Here, we report outcomes from the first 48 weeks (induction period) of C-OPTIMISE, during which patients received open-label CZP.MethodsC-OPTIMISE (NCT02505542) was a two-part, multicenter, phase 3b study in adult patients with early axSpA (r-/nr-axSpA), including a 48-week open-label induction period followed by a 48-week maintenance period. Patients with active adult-onset axSpA, < 5 years’ symptom duration, and fulfilling Assessment of SpondyloArthritis international Society classification criteria, were included. During the induction period, patients received a loading dose of CZP 400 mg at weeks 0, 2, and 4, followed by CZP 200 mg every 2 weeks (Q2W) up to week 48. The main outcome of the 48-week induction period was the achievement of sustained clinical remission (defined as an Ankylosing Spondylitis Disease Activity Score [ASDAS] < 1.3 at week 32 and < 2.1 at week 36 [or vice versa], and < 1.3 at week 48).ResultsIn total, 736 patients (407 with r-axSpA, 329 with nr-axSpA) were enrolled into the study. At week 48, 43.9% (323/736) of patients achieved sustained remission, including 42.8% (174/407) of patients with r-axSpA and 45.3% (149/329) with nr-axSpA. Patients also demonstrated substantial improvements in axSpA symptoms, MRI outcomes and quality of life measures. Adverse events occurred in 67.9% (500/736) of patients, of which 6.0% (44/736) were serious.ConclusionsOver 40% of patients with early axSpA achieved sustained remission during 48 weeks of open-label CZP treatment. Additionally, patients across the axSpA spectrum demonstrated substantial improvements in imaging outcomes and quality of life following treatment. No new safety signals were identified.Trial RegistrationNCT02505542.Electronic Supplementary MaterialThe online version of this article (10.1007/s40744-020-00214-7) contains supplementary material, which is available to authorized users.

Aerobic granular sludge formation in a sequencing batch reactor treating agro-industrial digestate

ABSTRACT Most of nitrogen emissions can be ascribed to agro-industrial activities. Since digestate produced by fermentation of agro-industrial residues can be difficult to dispose of due to its high ammonium content, advanced technical- and cost-effective technologies must be developed and applied in order to significantly reduce its impact on the environment. In this study, aerobic granules were successfully cultivated in a granular sludge sequencing batch reactor (GSBR) fed with the ammonium-rich (approx. 2500 mg L−1) effluent of a 3-stage anaerobic digester treating agro-industrial residues. The peculiar characteristics of such wastewater required a 2-step operating strategy aimed at the selection of nitrifying biomass (Step 1) and the formation of aerobic granular sludge (Step 2). During Step 1, nitrifying biomass selection was achieved by properly regulating the cycle length: removal rates progressively increased from 42 to 109 mgN L−1d−1, and a corresponding increase in specific removal rates from 8 to 24 mgN gVSS −1d−1 was also observed. During Step 2, the increase in selective pressures (i.e. minimum settling velocity and volumetric organic loading rate) led to the formation of compact (average diameter, 1.02 ± 0.43 mm) and well-settling granules (SVI5, 28.6 ± 3.8 mL gTSS −1), which were able to remove up to 89 ± 2% of organic matter (as COD), 79 ± 3% of and 59 ± 4% of nitrogen (as a sum of , and ). The 2-step operating strategy played a key role in biomass selection and subsequent granule formation and maintenance in the GSBR, and may be successfully adopted for the treatment of different ammonium-rich wastewaters.

Centralization of gas supply systems based on butane-air mixture

The expansion of the construction of cottage villages, isolated settlements in ecologically clean areas, away from large cities, as well as the provision of gas to the settlements of the eastern part of the Russian Federation, sets the task of developing autonomous gas supply systems. A significant deterrent to the development of autonomous gas supply systems based on butane mixtures with air is their high cost and the absence of scientifically sound recommendations for choosing system parameters. To develop scientifically sound recommendations for the design of systems, considering all the factors of influence that ensure the optimal cost of gasification and subsequent maintenance by the consumer, additional studies are necessary. The article considers the choice of optimal centralization of gas supply systems based on a mixture of butane with air to determine the minimum cost of construction and operation for consumers. the systems analysis, mathematic model methods with calculation of optimal values in the presence of corresponding limits and the methods of material correlation processing are used. The data have been obtained for effective centralization of gas supply systems based on butane-air mixture. The criteria are set which influence the optimum number of houses connected to a tank installation, such as population density in a gas supplied area, climatic features of an area, a type of consumer’s gas-using equipment and a form of settlement development. As a result of the research, the optimum number of apartments has been determined for gas supply to a settlement connected to a tank installation. These recommendations will make it possible to increase efficiency of gas supply source selection and consumer connecting to a gas sup-ply network at minimum cost for consumers