Process design and techno-economic analysis of activated carbon derived from anthracite coal.

Activated carbon (AC), renowned for its versatile applications in water treatment, air purification, and industrial processes, is a critical component in environmental remediation and resource recovery strategies. This study encompasses the process modeling of AC production using anthracite coal as a precursor, involving multiple activation stages at different operating conditions, coupled with a detailed techno-economic analysis aimed at assessing the operational feasibility and financial viability of the plant. The economic analysis explores the investigation of economic feasibility by performing a detailed cashflow and sensitivity analysis to identify key parameters influencing the plant's economic performance, including raw material and energy prices, operational and process parameters. Capital and operational costs are meticulously evaluated, encompassing raw material acquisition, labor, energy consumption, and equipment investment. Financial metrics like Net Present Value (NPV), Internal Rate of Return (IRR), and payout period (POP) are employed, and the results show that AC selling price, raw material cost and plant capacity are the most influential parameters determining the plant's feasibility. The minimum AC production cost of 1.28 $/kg is obtained, corresponding to coal flow rate of 14,550 kg/h. These findings provide valuable insights for stakeholders, policymakers, and investors seeking to engage in activated carbon production from anthracite.

Design of a Parabolic Trough Collector Solar Field for a Pilot CO2 Capture Plant from Natural Gas Combined Cycle Power Plant Flue Gas.

A parabolic trough collector solar field was designed to supply the heat needed to regenerate the CO2-rich monoethanolamine in a solar-assisted carbon capture system. Process design modeling was performed for 90% of the CO2 removal from 1% of the flue gas produced by a 255 MWe natural gas combined cycle power plant. Calculations with and without 24 h of thermal energy storage by increasing the solar collector size needed and providing a buffer vessel to store hot heat transfer fluid were performed. A dynamic analysis of the solar field using the hourly solar forecast was performed to investigate how heat transfer fluid mass flow changes during January and June to maintain the desired parabolic solar field outlet temperature needed for CO2 reboiler operation. The calculations provided here present an explicit method to calculate relevant solar field design parameters that can be scaled up and used in solar energy-assisted gas capture processes.

Obinutuzumab plus bendamustine for relapsed/refractory chronic lymphocytic leukemia and predictive and prognostic impact of genetic alterations: the phase II GABRIELL study.

GABRIELL was a phase II single-arm study to evaluate the efficacy and safety of obinutuzumab plus bendamustine for relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). Seventy-two patients with active disease received treatment for up to six 28-day cycles. Overall response rate was 78.6% with a median progression-free survival (PFS) of 26 months, and overall survival (OS) not reached at the end of follow-up (36 months). Undetectable measurable residual disease (≤0.01%; 36.4% in bone marrow and 53.4% in peripheral blood) correlated with a significantly longer PFS and OS (vs. >0.01). Common grade ≥3 adverse events (76.4%) were neutropenia (58.3%), thrombocytopenia (26.4%) and febrile neutropenia (11.1%). TP53 disruption was the only independent predictive factor for response (Hazard ratio; HR: 0.228). Unmutated immunoglobulin heavy chain variable region (HR: 16.061) was a negative prognostic factor for PFS. In conclusion, the combination of obinutuzumab plus bendamustine is an active and generally adequately-tolerated treatment for R/R CLL.

Guía de práctica clínica para el diagnóstico y tratamiento de la distrofia muscular de Duchenne. Sociedad Peruana de Neurología. Versión Corta / Clinical Practice Guidelines for diagnosis and treatment of Duchenne muscular dystrophy. Peruvian Neurology Society. Short Version

RESUMEN Objetivo : Elaborar una guía de práctica clínica peruana para el diagnóstico y tratamiento de la Distrofia Muscular de Duchenne y Becker (DMD). Materiales y métodos : Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas en neurología, neuropediatría, genética y metodología. El GEG formuló ocho preguntas para desarrollar las recomendaciones de la Guía de Práctica Clínica (GPC). Se realizó una búsqueda sistemática en Medline, Scopus y CCRT durante el periodo enero-abril 2021 para responder a las preguntas PICO. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Resultados : Las preguntas PICO, se orientaron para explorar el tamizaje, diagnóstico y tratamiento de la DMD. Se formularon 15 recomendaciones (10 fuertes, 5 condicionales) y 11 puntos de buena práctica clínica Conclusión : Se presenta la guía para el diagnóstico y tratamiento de la DMD, elaborada bajo una metodología basada en las evidencias actuales.

ABSTRACT Objective : to provide evidence-based clinical recommendations for the diagnosis and treatment of Duchenne Muscular Dystrophy. Methods : a guideline development group (GEG) was formed that included specialized physicians in the fields of neurology, neuropediatrics, genetics, and methodology. The GEG asked eight clinical questions to be answered by recommendations in this clinical practice guidelines (CPG). We conducted a systematic search and - when deemed relevant - primary studies in Medline, Scopus, and the Cochrane Controlled Register of Trials during 2021 were reviewed. Evidence was selected to answer each of the clinical questions posed. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice, and a diagnosis and treatment flowchart. Results : this CPG addressed eight clinical questions, divided into three topics: screening, diagnosis, and treatment. Based on these questions, fifteen recommendations were formulated (10 strong, 5 conditional) and 11 points for good clinical practice. Conclusion : this paper summarizes the methodology and evidence- based conclusions of the CPG for the diagnosis and treatment of Duchenne muscular dystrophy.

Status distónico, a propósito de dos casos / Status dystonicus, apropos of two cases

El status distónico (SD) es una emergencia médica infrecuente y sub-diagnosticada, común en distonías secundarias; las infecciones son el factor gatillante más frecuente. Puede ser distonía tónica o fásica. El fenotipo tónico es usual en varones, distonías secundarias y tiene peor pronóstico. Se acompaña de hiperpirexia y rabdomiólisis que puede complicarse con falla renal aguda, insuficiencia respiratoria o la muerte. No hay ensayos clínicos disponibles sobre el tratamiento, aunque las benzodiacepinas, trihexifenidilo, levodopa, tetrabenazina, baclofeno, gabapentina han mostrado diversos grados de control sintomático. Se reporta el caso de dos niños, con parálisis cerebral infantil y antecedente de kernícterus que desarrollaron SD después de un cuadro infeccioso, ambos respondieron favorablemente a benzodiacepinas, Levodopa, baclofeno, bromocriptina y gabapentina. En el Perú correspondería a los primeros casos publicados a la fecha

Status dystonicus (SD) is a rare and underdiagnosed medical emergency, which is usually triggered by infectious conditions. SD may have tonic or phasic dystony. The tonic phenotype is common in men, and those with secondary dystony may have a worse prognosis. The condition is accompanied by hyperpyrexia and rhabdomyolysis that may complicate with acute renal failure, respiratory insufficiency or even death. There are no clinical trials available with respect to its therapy; but drugs such as benzodiazepines, trihexyphenidyl, levodopa, tetrabenazine, baclofen, and gabapentin have shown different degrees of symptomatic control. This article reports two cases of SD in children with cerebral palsy and a past medical history of kernicterus who developed SD after an infectious condition. Both children responded satisfactorily to benzodiazepines, levodopa, baclofen, bromocriptine, and gabapentin. These are the very first cases of SD reported in Peru

Meningoencefalitis tuberculosa en niños: Experiencia en el Instituto Nacional de Salud del Niño de Lima, 2009 - 2013 / Meningial Tuberculosis in children: Experience in the Instituto Nacional de Salud del Niño from Lima, 2009-2013

Objetivos: Describir las características epidemiológicas, clínicas, de laboratorio y neuroimagen en los niños diagnosticados de meningoencefalitis tuberculosa (MEC TBC) en el Instituto Nacional de Salud del Niño de Lima - Perú. Material y métodos: Estudio retrospectivo y descriptivo de una serie de casos entre enero del 2009 a setiembre del 2013. Resultados: Se seleccionaron 31 casos con diagnóstico de MEC TBC, con una frecuencia de 7,4 casos por año, edad promedio de 7,3 años, la relación varón/ mujer fue 1,2. Los características más frecuentes fueron la desnutrición, el contacto TBC y la TBC pulmonar. Los síntomas más frecuentes fueron la fiebre, vómitos, y somnolencia. El trastorno de la conciencia y el síndrome meníngeo fueron los síndromes neurológicos más comunes. La mayoría ingresaron en estadio II (83,9 %) y egresaron con secuelas mayores (51,6%). Los hallazgos en el líquido cefalorraquídeo (LCR) fueron pleocitosis promedio de 275,6 células /mm3 y mediana de 184 células/mm3 (rango entre 15-1364 células/mm3), el Bacilo de Koch fue aislado por cultivo en el 19,5% de los casos. Los hallazgos más frecuentes de neuroimagen fueron la hidrocefalia (58%), infarto ygranuloma. Seis pacientes con hidrocefaliarequirieron derivación ventricular. Cinco de los pacientes desarrollaron reacción paradójica. La letalidad fue 12,9%.Conclusiones: La incidencia hospitalaria de MEC TBC fue 7,4 casos por año, la mayoría ingresó en estadio IIy egresó con secuelas mayores, en la neuro imagen la hidrocefalia fue el hallazgo más observado, la letalidad fue 12,9%.

Objectives: To describe clinical, epidemiological, laboratory and neuro imaging characteristics of children with Meningeal Tuberculosis (MEC TBC) at the Instituto Nacional de Salud del Niño, in Lima, Peru. Methods: Retrospective, descriptive case series from January 2009 to September 2013. Results: 31 cases with MEC TBC were included, with a frequency of 7.4 cases per year. The average age was7.3 years and boy/girl rate was 1.2. The more frequent characteristics were the malnutrition, a positive TBC contact and pulmonary TBC. The most common clinical findings were fever, vomits, altered consciousness and meningeal signs. Most cases were in the II clinical state of the disease (83.9%) and the majority evolved with severe complications (51.6%). The cerebrospinal fluid (CSF) findings showed an average 275.6 cells/mm3 cells and median of 184 cells/mm3 (15-1364 cells/mm3). The Koch bacillus was identified in 19.5 % of the CSF culture. The more frequent imaging findings were hydrocephalus (58%), cerebral infarct and granuloma. Six children with hydrocephalus needed a cerebral peritoneal shunt and five children evolved with a paradoxical reaction. The mortality was 12.9%. Conclusions: The hospital incidence was 7.4 cases per year, most of them came in stage II of the disease and left with major sequela, the hydrocephalus was the most frequent imaging finding and the mortality was 12.9%.