Background/Aims: The postoperative risk of small bowel obstruction is a recognized complication following appendectomy. Few studies have reconsidered the whole extent of abdominal complaints and problems following appendectomy. This study tries to evaluate the long-term outcome describing abdominal complaints requiring readmission following appendectomy. Methods: A retrospective study of 3,230 patients undergoing open appendectomy at a single center university hospital in Sweden between 1981 and 1996. Late (>30 days) readmissions were noted and the cause for readmission and need for surgical intervention were analyzed. Results: Overall, late readmissions occurred in 2.94% during a median follow-up of 10 years after appendectomy. Females predominated among those readmitted, as did patients with complicated appendicitis or a ‘normal’ appendix. Nonspecific abdominal pain with no sign of small bowel obstruction caused almost half of the readmissions (45%). To a large extent this group consisted of females (76%). Small bowel obstruction was seen in 1.24% and was surgically treated in 0.68% of all appendectomies. Incisional hernias were also seen (0.4% of all appendectomies). Conclusion: The magnitude of readmissions due to abdominal complaints is more pronounced than previously reported with as many patients with signs of small bowel obstruction managed nonoperatively as surgically, and frequent readmissions due to nonspecific abdominal pain.

This paper develops a strategy of where and how to install and implement communication and remote control systems in the distribution network, with respect to lowering customer interruption cost and reliability indices. The aim is to evaluate and update customer restoration time based on the proposed level of automation in the system. Three different automation levels are considered: 1) ordinary secondary substation, that is not connected to the SCADA/DMS system; 2) monitored secondary substation that sends certain information to SCADA/DMS system; 3) monitored secondary substation with the addition of remotely controlled switching device. The developed strategy has been tested on three different models: 1) reference test system; 2) real feeder network; 3) small grid. Based on the results and the developed framework, the best strategy for implementing monitoring and remote control equipment is presented in the paper. It has been shown that the design of the system affects the results and the strategy. Moreover, secondary substations in models are highly dependent on each other's configuration and level of automation.

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BackgroundAlzheimer’s disease (AD) is a chronic progressive neurodegenerative disorder caused by multiple pathogenic factors including Amyloid‐β (Aβ), phospho‐Tau (pTau), alpha‐synuclein, and ApoE4, etc. It is widely accepted that intermediate oligomeric forms, rather than monomers or mature fibrils, are more neurotoxic. Galectin‐3 (Gal‐3) was reported to be involved in Aβ oligomerization. Here, we show that Gal‐3 promotes oligomerization of Aβ and other pathogenic factors, and TB006, a monoclonal antibody targeting Gal‐3, acts as a possible treatment for AD by degrading neurotoxic oligomers.MethodWe used two anti‐Gal‐3 antibodies, our clinical lead TB006 and a mouse cross‐reactive surrogate, mTB001, to establish the benefits of Gal‐3 neutralization in AD in vitro and in vivo. The effects of mTB001 were tested in three AD mouse models (two transgenic mouse models (APPSwe, 5xFAD) and an Aβ42‐injected mouse model). After two‐week treatment, a spatial memory function test was conducted, followed by biochemical and immunohistochemical characterizations.ResultAmyloid aggregation is a hallmark of several neurodegenerative diseases (AD, PD and ALS) affecting the brain or peripheral tissues, whose intermediates (oligomers, protofibrils) and final mature fibrils display different toxicity. In vitro, Gal‐3 intrinsically and selectively promotes, while mTB001 and TB006 degrade, oligomerization of only pathogenic proteins like Aβ42/40, α‐synuclein, pTau and ApoE4, but not of normal proteins like normal Tau and ApoE2/3. Gal‐3 enhanced, while mTB001 blocked, Aβ42‐induced microglia activation. Additionally, Aβ42 and Gal‐3 synergistically induced, while mTB001 reversed, neuronal death. In vivo, in three mouse models of AD, cognitive deficits were strongly attenuated after just two weeks of mTB001 treatment. Mechanistically, Gal‐3 antibody blocked the initiating events in AD (Aβ aggregates), reduced inflammation and rescued neuronal damage. Furthermore, microhemorrhages, a potential safety liability seen in clinical stage drugs, were reduced.ConclusionPre‐clinical studies show that TB006 is an efficacious therapeutic entity through degradation of toxic oligomers and blocking or even reversing AD progression. Clinically, TB006 has shown a superior safety profile without any drug‐related adverse events in a nearly finished healthy volunteer trial. Promising efficacious data are expected in Q2/2022 from the ongoing phase I/II AD trial.

We present an overview of the local environmental development of the valley of Hjaltadalur, situated in Skagafjörður, northern Iceland. The aim of this study is to increase the knowledge about the valley region before and during human settlement in the ninth century. Four mires were investigated after which the Viðvík peat bog was selected as the main site for evaluating changes in climate and landscape. The master core from Viðvík (V-325) was dated and studied further through sediment analysis, loss-on-ignition (LOI), and pollen analysis. According to the agedepth model, based on three radiocarbon dates and analysis of two tephra layers, the 325 cm long Viðvík core comprises approximately 5500 years. In the pollen percentage record, there is a decrease in birch (Betula) and an increase in grass (Poaceae) in the central part of the core, between Hekla 3 horizon at c. 2800 BP and the next dated level at c. 2000 BP. This change corresponds well with previously outlined environmental fluctuations, showing a transition from warm and dry climate to cool and humid climate at this time. Human activity is mainly reflected by a distinct peak in Lactucae pollen in the uppermost part of the core. This change in vegetation corresponds with earlier studies, showing that the vegetation changed dramatically after the colonization of Iceland in the ninth century (during Landnám period, 870-930 AD). The present study shows that a decline in birch started well before human settlement, although the subsequent Viking Age and later settlements continued the deforestation trend.