关键词： carob kibble   kvass   S   boulardii   L   plantarum   gallic acid   HMF  

摘要： BACKGROUND Non-diary beverages with probiotic properties are of great interest nowadays. In this research, we evaluated the suitability of carob kibbles in the manufacture of kvass. Kvass is a low-alcohol drink popular in Central and Eastern Europe and indicated as a potential non-diary beverage with probiotic properties. Therefore, the viability of probiotic strains of Lactobacillus plantarum and Saccharomyces boulardii during 4 weeks' storage in manufactured beverages was tested. RESULTS Carob kibbles introduced significant amounts of phenolic compounds into kvasses, especially gallic acid (up to 117.45 +/- 10.56 mg L-1), and improved antiradical activity up to 78% after fermentation. Moreover, fermentation efficiently reduced furfural and hydroxymethylfurfural content in samples up to 12.9% and 29.9%, respectively. Kvasses with rye malt extract possessed coffee-like, chocolate-like, roasted and caramel-like odours and a more bitter taste. Whereas kvass with carob kibbles was characterized by fruit-like odour and sweeter taste. Fermentation contributed to a creation as well as degradation of volatiles. L. plantarum exhibited higher general mortality during storage, whereas, in the case of S. boulardii, the viability was significantly higher regardless of the sample composition. CONCLUSION This is the first study reporting the use of carob kibbles for kvass production. The obtained results showed that carob kibbles can replace rye malt extract, at least partially, in the production of kvass, giving to the product added health benefits. Moreover, S. boulardii is a better choice for production of kvass with probiotic properties. (c) 2021 Society of Chemical Industry.

关键词： liver transplant   cardiac surgery   end-stage liver disease  

摘要： Background: The results of cardiac surgery in patients with end-stage-liver-disease (ESLD) are poor. Concomitant cardiac surgery and orthotopic liver transplantation (OLT) may be an alternative treatment strategy in these patients. Methods: Between 2001 and 2018, eight patients underwent concomitant cardiac surgery and OLT (Conc_OLT) in our institution. We analyzed their preoperative, intraoperative and postoperative data and compared them to seven high risk patients with ESLD who underwent isolated cardiac surgery (Iso_Surg). Results: The two groups were not significantly different in terms of gender and age (Conc_OLT: 5 males, 55 +/- 15 years, Iso_Surg: 4 males, 60 +/- 10 years). Causes for ESLD were primary biliary cirrhosis (Conc_OLT = 1, Iso_Surg = 1), alcoholism (Conc_OLT = 2, Iso_Surg = 2), viral hepatitis (Conc_OLT = 2, Iso_Surg = 2), cryptogenic (Conc_OLT = 2, Iso_Surg = 1), ischemic (Conc_OLT = 1) and hepatocellular carcinoma (Iso_Surg = 1). Model for End-stage-Liver-Disease (MELD) Score (Conc_OLT = 14, Iso_Surg = 13) and Child-Pugh Score (Conc_OLT = 9.5, Iso_Surg = 8) were not significantly different between the two groups. Median logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 9.5% (Conc_OLT) and 7.1% (Iso_Surg). Cardiac procedures undertaken were aortic valve replacement (Conc_OLT = 6, Iso_Surg = 3), coronary bypass grafting (Conc_OLT = 1,Iso_Surg = 2), tricuspid valve repair (Conc_OLT = 1), combined aortic and mitral valve replacement (Iso_Surg = 1) and excision of atrial myxoma (Iso_Surg = 1). Median length of in-hospital-stay was longer in the Conc_OLT group (73 vs. 42 days;p = 0.11). At 3 months, in-hospital mortality was 25% in the Conc_OLT group (n = 2) and lower compared to 71% observed in the Iso_Surg group (n = 5, p = 0.13). Conclusion: Concomitant cardiac surgery and OLT is a promising alternative compared to isolated cardiac surgery in high risk patients with ESLD. Given the high operative mortality of cardiac s

关键词： prostatic neoplasms   androgen deprivation therapy   antineoplastic agents   hormonal  

摘要： Purpose: Phase-III randomized control trial evidence suggests intermittent androgen deprivation therapy (IADT) is not significantly inferior to continuous androgen deprivation therapy (ADT) for patients with prostate cancer (PC). However, clinical practice and guidelines differ in their recommendations. We evaluate real-world utilization and practice patterns of IADT. Materials and Methods: Ontario men >= 65 years of age with PC who initiated ADT for >= 3 months were identified (1997-2017). Lapses in ADT >= 6 months (initial gap) and >= 3 months (subsequent gaps) were used to classify IADT. Neoadjuvant/adjuvant therapy was excluded. Disease stage adjustment was completed for patients with likely metastatic disease based on de novo presentation with ADT. Patient and physician predictors of IADT were analyzed using multivariable logistic regression. Results: We identified 8,544 patients with 1,715 having previously received local therapy. Among all patients, 16.4% received IADT. This ranged from 11.4%-24.8% across health-planning regions and increased to 26.6% in those with previous local therapy. Mean followup was 8.3 years. Patients with prior local therapy (OR 1.85, 95% CI 1.59-2.17, p<0.001) and those in the highest income quintile (OR 1.32, 95% CI 1.08-1.60, p=0.005) had increased odds of receiving IADT. Radiation oncologists were more likely to use IADT than urologists (OR 1.99, 95% CI 1.59-2.50, p<0.001), as were physicians with more experience (>= 10 years in practice: OR 1.44, 95% CI 1.11-1.88, p=0.007). In specialty-stratified analyses, case volume was significantly associated with IADT for radiation oncologists (highest quartile: OR 1.73, 95% CI 1.14-2.62, p=0.009). Conclusions: IADT remains underutilized for patients with PC who >= 65 years of age with only 1 in 4 to 1 in 6 eligible patients receiving this form of care. Clinical, sociodemographic and physician characteristics play an important role in treatment selection.

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关键词： solvent extraction   third phase   uranium   thorium   tributylphosphate (TBP)  

摘要： A more sustainable management of natural resources and the establishment of processes allowing a joint management of nuclear materials to avoid their diversion from their civilian use are two issues for the nuclear industry. Short alternatives to existing processes have therefore been proposed based on known systems available, tributylphosphate (TBP), for the separation of actinides by liquid/liquid extraction. Proof of concept of such alternative has been established on the uranium(VI)/thorium(IV) system. From an organic phase consisting of a mixture of TBP/n-dodecane loaded with uranium and thorium, two fluxes have been obtained: the first contains almost all of the thorium in the presence of uranium in a controlled ratio, the second contains surplus uranium. Two levers were selected to control the spontaneous separation of the organic phase: the addition of concentrated nitric acid, or the temperature variation. Best results have been obtained using a temperature drop in the liquid/liquid extraction process, and variations in process conditions have been studied. Final metal recovery and solvent recycling have also been demonstrated, opening the door for further process development.

关键词： Light-duty vehicles   Transport   Electrification   Climate change mitigation  

摘要： There is a wide consensus that a fundamental technology shift within the light duty vehicles (LDVs) sector is necessary to achieve the emissions reductions required for the Paris Agreement's targets, but substantial controversy prevails about the most suitable strategy. While some decision makers favor a transition to battery electric vehicles, others advocate for fuel cell vehicles and efuels. These strategies differ markedly in terms of consumer acceptance and implications for the energy system. We explore a range of electrification pathways in Europe until 2050. Direct electrification leads to a strong reduction in direct CO2 emissions of LDVs, with electric vehicles reaching 90% of sales in 2050. Indirect electrification places substantially higher pressure on the supply sector, with almost double the primary energy demand relative to direct electricity use. In addition, the implementation of complementary policies addressing perceived inconvenience markups for alternative mobility is crucial to initiate the mobility transformation.

关键词： Capacity   M- and AM-moduli  

摘要： A new condenser capacity CapPM(EG) is introduced as an alternative to the classical Dirichlet capacity in a metric measure space X. For p > 1, it coincides with the M_p-modulus of the curve family Γ(E, G) joining G to an arbitrary set E ⊂ G and, for p = 1, it lies between AM₁(Γ(E, G)) and M₁(Γ(E, G)). Moreover, the CapPM(EG)-capacity has good measure theoretic regularity properties with respect to the set E. The CapPM(EG)-capacity uses Lipschitz functions and their upper gradients. The doubling property of the measure μ and Poincaré inequalities in X are not needed. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.

关键词： adrenal gland neoplasms   survival analysis   quality of health care   guideline adherence  

摘要： Purpose: Adrenocortical carcinoma is a rare but aggressive malignancy. While centralization of care to referral centers improves outcomes across common urological malignancies, there exists a paucity of data for low-incidence cancers. We sought to evaluate differences in practice patterns and overall survival in patients with adrenocortical carcinoma across types of treating facilities. Materials and Methods: We identified all patients diagnosed with adrenocortical carcinoma from 2004-2016 in the National Cancer Database. The Kaplan-Meier method was used to evaluate overall survival and multivariable Cox regression analysis was used to investigate independent predictors of overall survival. The chi-square test was used to analyze differences in practice patterns. Results: We identified 2,886 patients with adrenocortical carcinoma. Median overall survival was 21.8 months (95% CI 19.8-23.8). Academic centers had improved overall survival versus community centers on unadjusted Kaplan-Meier analysis (p < 0.05) and had higher rates of adrenalectomy or radical en bloc resection (p < 0.001), performed more open surgery (p < 0.001), administered more systemic therapy (p < 0.001) and had lower rates of positive surgical margins (p=0.03). On multivariable analysis, controlling for treatment modality, academic centers were associated with significantly decreased risk of death (HR 0.779, 95% CI 0.631-0.963, p=0.021). Conclusions: Treatment of adrenocortical carcinoma at an academic center is associated with improved overall survival compared to community programs. There are significant differences in practice patterns, including more aggressive surgical treatment at academic facilities, but the survival benefit persists on multivariable analysis controlling for treatment modality. Further studies are needed to identify the most important predictors of survival in this at-risk population.

关键词： Cross‐   fertilization   floral trait function   male fitness   pollen loss   pollen reward   stamen dimorphism  

摘要： Heteranthery, the presence of distinct stamen types within a flower, is commonly explained as functional adaptation to alleviate the "pollen dilemma," defined as the dual and conflicting function of pollen as pollinator food resource and male reproductive agent. A single primary hypothesis, "division of labor," has been central in studies on heteranthery. This hypothesis postulates that one stamen type functions in rewarding pollen-collecting pollinators and the other in reproduction, thereby minimizing pollen loss. Only recently, alternative functions (i.e., staggered pollen release), were proposed, but comparative and experimental investigations are lagging behind. Here, we used 63 species of the tribe Merianieae (Melastomataceae) to demonstrate that, against theory, heteranthery occurs in flowers offering rewards other than pollen, such as staminal food bodies or nectar. Although shifts in reward type released species from the "pollen dilemma," heteranthery has evolved repeatedly de novo in food-body-rewarding, passerine-pollinated flowers. We used field investigations to show that foraging passerines discriminated between stamen types and removed large stamens more quickly than small stamens. Passerines removed small stamens on separate visits towards the end of flower anthesis. We propose that the staggered increase in nutritive content of small stamens functions to increase chances for outcross-pollen transfer.

关键词： HBS model   MIMO-NOMA systems   Alternative grey wolf with beetle swarm optimization   Beam power   Spectral efficiency   Energy efficiency  

摘要： Beam selection is a major conflict in wireless communications. In the existing methods, the energy efficiency maximization problem is handled by the non-convex fractional programming algorithm. Yet, various traditional works have used the Single Beam Selection (SBS) scheme having the mmWave beamspace Multi-Input Multi-Output (MIMO) channel for minimizing the MIMO dimension. Still, multiple Radio-Frequency (RF) chain groups cannot be properly selected by users. Generally, the conventional (SBS) concept cannot work with a multiple beam group selection opportunities for all the types of supported users. So, the user suffers from a severe computational burden for measuring the decoded message and it also leads to a beam optimization problem. This paper plans to integrate the two meta-heuristic algorithms like Beetle swarm optimization (BSO) and Grey Wolf Optimization called the Alternative Grey Wolf with Beetle Swarm Optimization (AGW-BSO) for developing the Hybrid Beam Selection (HBS) scheme in MIMO-NOMA and the new HBS scheme could support the multiple SBS scheme in beamspace MIMO-NOMA systems. Here, the optimization of RF chain group by the proposed AGW-BSO is considered as the main contribution, in such a way to attain the multi-objective function concerning the maximization of beam power, energy efficiency, and spectral efficiency. Finally, the attained objective of the proposed model is analyzed by comparing the proposed model over the conventional models through computer simulations.