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There is a growing demand for biopolymers for packaging, dietary fiber, and as a food additive, where nanocellulose has become an important material for such purposes. In this study, a process utilizing successive steps in the same container was used, avoiding washing and neutralization between stages, showing nanocellulose isolation using a brown alga with a yield of 14.9%. Transparent films of pure 2D nanocellulose were prepared by the cast evaporation method, using Sargassum spp. as a raw material in a one-pot innovative process. Thermogravimetric analysis shows the presence of non-cellulosic components within the Sargassum and also the presence of nanocellulose at the end of the process. The obtained material was characterized by FTIR, NMR, and UV–Vis spectrophotometry, showing that the cellulose was successfully isolated, generating films with a transmittance of 81%. Finally, laser scanning microscope and the scanning electron microscope results corroborated the presence of cellulose nanoplatelets made of cellulose nanofibers with a thickness of ≈100 nm which explains the optical properties, such as the transmittance and constructive interference that facilitates characterization with a simple optical microscope.

In the field of beam physics, two frontier topics have taken center stage due to their potential to enable new approaches to discovery in a wide swath of science. These areas are: advanced, high gradient acceleration techniques, and x-ray free electron lasers (XFELs). Further, there is intense interest in the marriage of these two fields, with the goal of producing a very compact XFEL. In this context, recent advances in high gradient radio-frequency cryogenic copper structure research have opened the door to the use of surface electric fields between 250 and 500 MV m−1. Such an approach is foreseen to enable a new generation of photoinjectors with six-dimensional beam brightness beyond the current state-of-the-art by well over an order of magnitude. This advance is an essential ingredient enabling an ultra-compact XFEL (UC-XFEL). In addition, one may accelerate these bright beams to GeV scale in less than 10 m. Such an injector, when combined with inverse free electron laser-based bunching techniques can produce multi-kA beams with unprecedented beam quality, quantified by 50 nm-rad normalized emittances. The emittance, we note, is the effective area in transverse phase space (x, p x /m e c) or (y, p y /m e c) occupied by the beam distribution, and it is relevant to achievable beam sizes as well as setting a limit on FEL wavelength. These beams, when injected into innovative, short-period (1-10 mm) undulators uniquely enable UC-XFELs having footprints consistent with university-scale laboratories. We describe the architecture and predicted performance of this novel light source, which promises photon production per pulse of a few percent of existing XFEL sources. We review implementation issues including collective beam effects, compact x-ray optics systems, and other relevant technical challenges. To illustrate the potential of such a light source to fundamentally change the current paradigm of XFELs with their limited access, we examine possible applications in biology, chemistry, materials, atomic physics, industry, and medicine-including the imaging of virus particles-which may profit from this new model of performing XFEL science.

Giant cell arteritis (GCA) is the most common primary systemic vasculitis in adults over 50 years of age. Its incidence increases with age, with a peak between 70-80 years and predominates in women, 3:1. It is a medical emergency that, if not diagnosed, can lead to irreversible complications. The delay in time from diagnosis to start of treatment is crucial to avoid possible serious outcomes on short, medium and long term. Survival in GCA is estimated between 60-90% at 5 years and 48-81% at 10 years. Efforts have been made to implement rapid diagnostic circuits to assess patients and initiate treatment without delay with good results both in reducing permanent vision loss and in reducing the costs of these patients due to emergency visits and admissions. The morbidity and mortality of this disease is high, but the use of efficient diagnostic strategies, such as ultrasound of superficial temporal arteries, has proven to be a useful, practical, cost-effective and, above all, quick tool to make the diagnostic approach. Analyze the impact of early temporal artery ultrasound on survival for patients with GCA. Survival study of 48 patients with GCA, in two different “stages” in terms of diagnostic approach: Group A (n = 27), patients diagnosed between 2002 - 2011 using only ACR 1990 criteria and Group E (n = 21) diagnosed between 2010-2015 using ACR criteria and TAUS. TAUS was performed by Rheumatologists with extensive experience in ultrasound and within a period of no more than 7 days for these patients. The definitive diagnosis of GCA was based on the clinical criteria of the Rheumatologist within the clinical and analytical context and with the specific complementary examinations for each case (Ultrasound, PET-CT, biopsy). Demographic data, comorbidities, signs and symptoms at debut, analytical data, complementary examinations, treatment and evolution were obtained retrospectively through the electronic medical record of the patient, based on the database of our GCA cohort. A survival analysis was performed considering death as the main outcome. The statistic used was the Kaplan-Meier test. In addition, other complications related to treatment or pathology are collected. The mean age at diagnosis of our patients was 79 + - 6 years, with a female: male ratio of 3: 1. The follow-up was between 2 and 16 years with a mean of 5.8 + - 3 years, until the last visit collected or until the outcome of death. Group A had a survival at 5 and 10 years of 53.4% and 36.7% respectively, while group E of 79.5% at both cut-off points. (Figure 1). There is a significant difference between the survival of both groups, p <0.01, this being better in the group in which TAUS was implemented for rapid diagnosis (group E). The main causes of death were cardiovascular events, 30%, predominantly in group E (75%), and infection, 30%, predominantly in group A. The median from diagnosis to death was 3 years (range 1 - 13). The implementation of temporal artery ultrasound (TAUS) is associated with a significant improvement in the survival rate of patients with GCA and a reduction in treatment-related complications in patients who were diagnosed with ultrasound in less than 7 days compared to those diagnosed by the conventional healthcare attention routes. [1]Gonzalez-Gay MA, et al. Giant cell arteritis: epidemiology, diagnosis, and management. DOI: 10.1007/s11926-010-0135-9 [2]Patil P, et al. Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study. PMID: 26016758 [3]Breuer GS, et al. Survival of patients with giant cell arteritis: a controversial issue. PMID: 31969222 [4]Diamantopoulos AP, et al. The fast-track ultrasound clinic for early diagnosis of giant cell arteritis significantly reduces permanent visual impairment: towards a more effective strategy to improve clinical outcome in giant cell arteritis? 10.1093/rheumatology/kev289 None declared [Display omitted]

The production of high spectral brilliance radiation from electron beam sources depends critically on the electron beam qualities. One must obtain very high electron beam brightness, implying simultaneous high peak current and low emittance. These attributes are enabled through the use of very high field acceleration in a radio-frequency (rf) photoinjector source. Despite the high fields currently utilized, there is a limit on the achievable peak current in high brightness operation, in the range of tens of Ampere. This limitation can be overcome by the use of a hybrid standing wave/traveling wave structure; the standing wave portion provides acceleration at a high field from the photocathode, while the traveling wave part yields strong velocity bunching. This approach is explored here in a C-band scenario, at field strengths (>100MV/m) at the current state-of-the-art. It is found that one may arrive at an electron beam with many hundreds of Amperes with well-sub-micron normalized emittance. This extremely compact injector system also possesses attractive simplification of the rf distribution system by eliminating the need for an rf circulator. We explore the use of this device in a compact 400 MeV-class source, driving both inverse Compton scattering and free-electron laser radiation sources with unique, attractive properties.

Late-onset hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT) has been associated with BK virus (BKV). Antiviral drugs are of limited efficacy and the optimal treatment for HC has not yet been established. Hyperbaric oxygen (HBO) may benefit these patients. We, therefore, retrospectively evaluated the effectiveness of HBO therapy in 16 patients with HC after allogeneic HSCT. All 16 patients had macroscopic hematuria and BKV infection. Patients received 100% oxygen in a hyperbaric chamber at 2.1 atmospheres for 90 min, 5 days per week, with a median 13 treatments (range, 4–84). Fifteen patients (94%) showed complete resolution of hematuria. Median urinary DNA BKV titers declined after HBO ( P <0.05). Patients started on HBO earlier after diagnosis of HC responded sooner ( P <0.05). HBO was generally well tolerated and proved to be a reliable option for this difficult to manage condition.

High brightness electron beams enable a wide spectrum of applications ranging from short wavelength radiation sources to high gradient wakefield acceleration. The rich dynamics that are intrinsic in charged particles accelerated in complex systems require a careful description in the analysis and design of a given machine, particularly regarding its stability. Numerous computer codes are in use by the accelerator community for such purposes. In particular, MILES is a simple tracking code we have developed that allows fast evaluations of collective effects in RF linacs. In this paper we extend the simple models previously developed to describe specific, diverse applications that can benefit from the fast simulation tools developed in MILES. Examples of this kind include particle driven acceleration schemes in a plasma where driver and witness beams propagate in the “comb” pulse-train configuration. Specifically, we investigate the self-induced fields excited within the X-band rf-linac stage of EuPRAXIA@SPARC_LAB. Further, we discuss additional advanced topics such as resistive wall wakefield effects in planar FEL undulators and their impact on the radiation emitted.

The luminosity requirements of TeV-class linear colliders demand use of intense charged beams at high repetition rates. Such features imply multi-bunch operation with long current trains accelerated over the km length scale. Consequently, particle beams are exposed to the mutual parasitic interaction due to the long-range wakefields excited by the leading bunches in the accelerating structures. Such perturbations to the motion induce transverse oscillations of the bunches, potentially leading to instabilities such as transverse beam break-up. Here we present a dedicated tracking code that studies the effects of long-range transverse wakefield interaction among different bunches in linear accelerators. Being described by means of an efficient matrix formalism, such effects can be included while preserving short computational times. As a reference case, we use our code to investigate the performance of a state-of-the-art linear collider currently under design and, in addition, we discuss possible mitigation techniques based on frequency detuning and damping.

The aim of this study was to develop and to assess a specific Multi-Criteria Decision Analysis (MCDA) framework to evaluate new drugs in an hospital pharmacy and therapeutics committee (P&TC) setting. A pilot criteria framework was developed based on the EVIDEM (Evidence and Value: Impact on DEcisionMaking) framework, together with other relevant criteria, and assessed by a group of P&TC's members. The weighting of included criteria was done using a 5-point weighting technique. Two drugs were chosen by evaluation: an orphan-drug for Gaucher disease, and a nonorphan drug for the treatment of inflammatory bowel disease. Evidence matrices were developed, and value contribution of each drug was evaluated by P&TC's members. An agreed final framework was obtained through a discussion between the P&TC's members. After criteria assessment, the pilot framework included eight quantitative criteria: \"disease severity,\" \"unmet needs,\" \"comparative efficacy/effectiveness,\" \"comparative safety/tolerability,\" \"comparative patient-reported outcomes,\" \"comparative cost consequences-cost of treatment,\" \"comparative cost consequences-other medical costs,\" and \"quality of evidence\"; and one contextual criterion: \"opportunity costs and affordability.\" The most valued criteria were: \"comparative safety/tolerability,\" \"disease severity,\" and \"comparative efficacy/effectiveness.\" When assessing the drugs most valued characteristics of the MCDA were the possibility that all team may contribute to drug assessment by means of scoring the matrices and the discussion to reach a consensus in drug positioning and value decision making. The reflective MCDA would integrate quantitative and qualitative criteria relevant for a P&TC setting, allowing reflective discussions based on the criteria weighting score.

Background Chlamydia trachomatis is the causative agent of the most common bacterial sexually transmitted infection worldwide. The aim of this study was to investigate the frequency and genotypes of C. trachomati s in patients attending an obstetrics and gynecology clinic in Jalisco, Mexico and correlates them with sociodemographic, behavioral, and biological factors. Methods C. trachomatis detection was performed in endocervical samples from 662 patients by direct fluorescence assay (DFA) and two PCR assays that amplified the phospholipase D endonuclease superfamily protein (PLDESP) and OmpA genes. Positive samples were genotyped using PCR–restriction fragment length polymorphism assays. Sociodemographic, behavioral, and biological data were collected. Results The mean age of the study population was 31 (range, 14–78) years. C. trachomatis positivity was detected by DFA in 16.7% ( n  = 111), PLDESP gene amplification in 14.2% ( n  = 94), and OmpA gene amplification in 14.5% ( n  = 96) of the population. Eight C. trachomatis genotypes were detected: E (39.6%), F (29.2%), D (15.6%), K (6.3%), L2 (3.1%), G, J, and I (2.1% each). C. trachomatis infection was associated with age, marital status, pregnancy, and hormonal contraceptive use (all p  = 0.01); intrauterine device use and previous premature birth (both p  = 0.03); and infection during pregnancy, previous ectopic pregnancy, pelvic inflammatory disease ( PID), and green vaginal discharge (all p  = 0.04) . C. trachomatis genotype K was more likely to be detected in women histories of ≥2 sexual partners, genotype F was more likely in pregnant women, genotype L2 was more likely in women with PID, genotype D was more likely in women who had had infection during previous pregnancies, and genotype E was more likely in those with previous ectopic pregnancies and green vaginal discharge (all p  = 0.01). Conclusions The frequency of C. trachomatis in our population was higher than previously reported worldwide, but within the range reported for Mexico. Genotype E was detected most frequently in the study population. Infection by C. trachomatis and C. trachomatis genotypes K, F, D, and E was strongly associated with multiple sociodemographic, behavioral, and biological factors. C. trachomatis genotype L2 was detected in women with PID.

BackgroundThe standard dose of rituximab (RTX) in rheumatoid arthritis (RA) is two intravenous (iv) 1 g infusions, separated by two weeks. Recently, the efficacy of a low-dose of RTX for retreatment in RA patients has been reported.1 ObjectivesOur aim was to assess the long-term sustained effectiveness of a low-dose of RTX in daily clinical practice.MethodsObservational retrospective study including all RA patients treated on a tertiary hospital who had received at least one cycle of RTX, at the standard dose, between June 2006 and May 2017. We selected those patients who achieved a good or moderate EULAR response and thereafter were down-titrated to a low-dose regimen (1 g). Variables analysed: age, sex, disease duration, presence of ACPA (antiCCP2) and rheumatoid factor (RF), glucocorticoid (GC) and conventional synthetic DMARD (csDMARD) use and dosage before and after RTX treatment, number of biologic DMARD (bDMARD) used prior to initiating RTX. Disease activity was measured using DAS28 index (prior to first RTX infusion, at low-dose regimen initiation and at last follow-up visit).Results53 patients received, at least, one cycle of 2 g RTX, 70% achieved a good or moderate EULAR response and were stepped-down to a low dose re-treatment regimen. Baseline characteristics of patients receiving low-dose RTX were: mean age 56.4±10.9 years; 13.5% male, mean disease duration 12.7±9.8 years, 91.9% RF +and 97.3% ACPA +; mean DAS28 prior to RTX initiation 5,79±1,17.73% of patients had received other bDMARD before RTX, 48% 2 or more. 92% were on cs-DMARDs, 51.4% methotrexate (MTX) and 37.8% leflunomide (LEF) and 86.5% were receiving concomitant GC (median dose 10 mg, P25–75 5–10 mg). 73% of subjects received only one standard cycle before RTX dose reduction.Mean DAS28 decreased significantly between the first visit on 1 g RTX vs the last follow-up visit (4.08 vs 3.04; p<0.0001). Additionally, 11 patients (8 MTX, 3 LEF) were able to reduce csDMARD dosage, 56.3% of patients receiving GC at the initiation of low-dose retreatment were able to reduce the dose (median 10 mg vs 5 mg; p<0.0001), and 28% discontinued GC therapy.After a mean follow-up of 3±1.8 years, RTX was withdrawn in 10 patients: 8 due to adverse events (recurrent infections in 4) and 2 cases due to loss of efficacy.ConclusionsA sustained clinical response was observed with the 1 gr retreatment of RTX after a long-term follow-up period.Reference[1] Mariette X, et al. Ann Rheum Dis2014;73:1508–14.Disclosure of InterestNone declared