SMaRT-PCR: sampling using masks and RT-PCR, a non-invasive diagnostic tool for paediatric pulmonary TB.

Key challenges in paediatric TB diagnosis are invasive sampling and poor sensitivity of standard methods. This study demonstrates the diagnostic potential of non-invasive sampling of bioaerosols from children using SMaRT-PCR, comprising mask sampling combined with reverse transcriptase-polymerase chain reaction (RT-PCR) for TB.Exhaled bioaerosols were captured on modified N-95 masks in a 10-min talk-cough-breathe process from 51 children (30 with TB confirmed using standard sampling methods and 21 without TB) aged 2-15 years. All mask samples were tested using in-house RT-PCR for 16s and rpoB RNA transcripts. Additional mask samples from children with TB were tested using Xpert® MTB/RIF (n = 3) and Xpert® MTB/RIF Ultra (n = 27).SMaRT-PCR sensitivity for detecting TB among treatment-naïve children was 96% if 16s or rpoB was present, and 75% if both genes were present, comparable to standard methods (71%) in the same cohort. Specificity was better for both genes, at 95%, than 85% for a single gene detection. Mask sampling with Xpert MTB/RIF or Ultra had a sensitivity of only 13%.This is the first study to provide evidence for testing bioaerosols as a promising alternative for detecting paediatric TB. Sampling is non-invasive and simple, with the potential for point-of-care applications. This pilot study also suggests that RNA transcript-based detection may improve TB diagnostic sensitivity in children; however, further investigation is required to establish its adaptability in clinical settings..

Synergistic effect of KI on the corrosion inhibition of a poly(diallylammonium chloride)-based cyclocopolymer containing bis-cationic motifs for mild steel corrosion in 20% formic acid.

This study entails the syntheses of a homopolymer, poly(diallylammonium chloride) (3), and copolymers (8a-c) containing hydrophilic/hydrophobic pendants and their role in mitigating mild steel in aggressive 20% formic acid, a type of corrosion that is not frequently discussed in the literature. The synthesized homopolymer and copolymers were characterized by FTIR, NMR, viscometry, and TGA. Inhibitor 8b was found to be the most potent, with 81.8% inhibition efficiency (IE) registered via the potentiodynamic polarization method for 100 ppm of inhibitor concentration at 30 °C. Inhibitor 8b, mixed with 2 mmol KI, showed more than 90% IE for a meager 1 ppm inhibitor concentration. For a synergism of 50 ppm inhibitor and 2 mmol KI, the IE reached a high value of 99.1%. The synergism was so good that it helped the inhibitor retain ∼100% of its original IE even after a 24 h weight loss study at 60 °C. The adsorption isotherm study showed that 8b followed the Langmuir adsorption isotherm and adsorbed via chemisorption. A very high value (2.48 × 105 L mol-1) of the equilibrium adsorption constant (Kads) indicated strong adsorption. XPS and SEM surface studies provided evidence of the inhibitor found on the metal surface. Some toxicological parameters, such as LC50, bioaccumulation factor, and developmental toxicity, have been measured computationally. A brief mechanistic insight into how the inhibitors functioned has been offered along with the DFT study.

A Systematic Review of Pediatric Dialysis in Asia: Unveiling Demographic Trends, Clinical Representation, and Outcomes.

Dialysis in pediatric groups is complicated by a wide range of factors that can affect long-term prognosis. The purpose of this meta-analysis and systematic review is to better understand the demographic and clinical factors that affect dialysis success in children. We searched a variety of databases for relevant articles and included 14 reports that dealt with the case studies of pediatric patients undergoing dialysis for a wide range of renal diseases. Patients' demographics, clinical presentations, laboratory findings, and treatment outcomes were the primary areas of data collection. To get a better sense of the overall prevalence of certain outcomes and to spot noteworthy trends or patterns in the disease process, we conducted a meta-analysis. Variations in dialysis efficacy and outcomes are highlighted throughout a wide range of ages in the pediatric dialysis cohort, from neonates to teenagers. Acute kidney injuries (AKI) tended to impact more boys, but chronic kidney diseases (CKD), such as lupus nephritis, disproportionately afflicted girls. Many different ethnic groups were represented, and there was evidence that some diseases having a hereditary component were more common in some areas than others. However, the potential for long-term consequences remained a concern. Hemodialysis was found to be effective in controlling end-stage renal disease (ESRD) and AKI, with some patients going on to have a kidney transplant. At the same time, peritoneal dialysis was associated with an increased risk of infection. This comprehensive analysis highlights the importance of demographic and clinical parameters in determining pediatric dialysis outcomes. A 14.47% mortality rate and gender disparities are revealed by this meta-analysis of pediatric renal diseases, which included a cohort of 235 patients with conditions like lupus nephritis and hepatitis C infection. The findings stress the necessity for individualized treatment techniques and suggest that demographic characteristics should be addressed in prognostic models. For better patient outcomes, the study also suggests standardized reporting in pediatric dialysis studies.

Healthcare seeking behavior and delays in case of Drug-Resistant Tuberculosis patients in Bangladesh: Findings from a cross-sectional survey.

The emergence of Drug-Resistant Tuberculosis (DR-TB) has become a major threat globally and Bangladesh is no exception. Delays in healthcare seeking, proper diagnosis and initiation of treatment cause continuous transmission of the resistant tubercule bacilli through the communities. This study aimed to assess the different health care-seeking behaviors and delays among DR-TB patients in Bangladesh. A prospective cross-sectional study was conducted from November to December 2018, among 92 culture positive and registered DR-TB patients in four selected hospitals in Bangladesh. Data were collected through face-to-face interviews with survey questionnaire as well as record reviews. Among the 92 study participants, the median patient delay was 7 (IQR 3, 15) days, the median diagnostic delay was 88 (IQR 36.5, 210), the median treatment delay was 7 (IQR 4,12) days, and the median total delay among DR-TB patients was 108.5 (IQR 57.5, 238) days. 81.32% sought initial care from informal healthcare providers. The majority (68.48%) of the informal healthcare providers were drug sellers while 60.87% of patients sought care from more than four healthcare points before being diagnosed with DR-TB. The initial care seeking from multiple providers was associated with diagnostic and total delays. In Bangladesh, DR-TB cases usually seek care from multiple providers, particularly from informal providers, and among them, alarmingly higher healthcare-seeking related delays were noted. Immediate measures should be taken both at the health system levels and, in the community, to curb transmission and reduce the burden of the disease.

Ellipro scores of donor epitope specific HLA antibodies are not associated with kidney graft survival.

In kidney transplantation, donor HLA antibodies are a risk factor for graft loss. Accessibility of donor eplets for HLA antibodies is predicted by the ElliPro score. The clinical usefulness of those scores in relation to transplant outcome is unknown. In a large Dutch kidney transplant cohort, Ellipro scores of pretransplant donor antibodies that can be assigned to known eplets (donor epitope specific HLA antibodies [DESAs]) were compared between early graft failure and long surviving deceased donor transplants. We did not observe a significant Ellipro score difference between the two cohorts, nor significant differences in graft survival between transplants with DESAs having high versus low total Ellipro scores. We conclude that Ellipro scores cannot be used to identify DESAs associated with early versus late kidney graft loss in deceased donor transplants.

Determination of the clinical relevance of donor epitope-specific HLA-antibodies in kidney transplantation.

In kidney transplantation, survival rates are still partly impaired due to the deleterious effects of donor specific HLA antibodies (DSA). However, not all luminex-defined DSA appear to be clinically relevant. Further analysis of DSA recognizing polymorphic amino acid configurations, called eplets or functional epitopes, might improve the discrimination between clinically relevant vs. irrelevant HLA antibodies. To evaluate which donor epitope-specific HLA antibodies (DESAs) are clinically important in kidney graft survival, relevant and irrelevant DESAs were discerned in a Dutch cohort of 4690 patients using Kaplan-Meier analysis and tested in a cox proportional hazard (CPH) model including nonimmunological variables. Pre-transplant DESAs were detected in 439 patients (9.4%). The presence of certain clinically relevant DESAs was significantly associated with increased risk on graft loss in deceased donor transplantations (p < 0.0001). The antibodies recognized six epitopes of HLA Class I, 3 of HLA-DR, and 1 of HLA-DQ, and most antibodies were directed to HLA-B (47%). Fifty-three patients (69.7%) had DESA against one donor epitope (range 1-5). Long-term graft survival rate in patients with clinically relevant DESA was 32%, rendering DESA a superior parameter to classical DSA (60%). In the CPH model, the hazard ratio (95% CI) of clinically relevant DESAs was 2.45 (1.84-3.25) in deceased donation, and 2.22 (1.25-3.95) in living donation. In conclusion, the developed model shows the deleterious effect of clinically relevant DESAs on graft outcome which outperformed traditional DSA-based risk analysis on antigen level.

Fabrication of a New Rationally Designed Mussel-Inspired Cationic Amphiphilic Terpolymer to Enhance the Separation and Anti-Fouling Performance of Membranes.

Polyvinylidene fluoride (PVDF) membrane-based systems for treating oily wastewater are prone to fouling. Herein, we introduced a novel mussel-inspired cationic amphiphilic terpolymer consisting of monomers N,N-diallyldimethylammonium chloride (DADMAC), N,N-diallyltetradecan-1-ammonium chloride (DTDAC), and mussel-inspired N,N-diallyldopamine hydrochloride (DADAHC) to improve the performance and characteristics of the PVDF membranes for oil-in-water emulsion separations. The cationic terpolymer, poly(DADMAC-co-DTDAC-co-DADAHC), shortened as PDDD, was synthesized in excellent yields via free radical polymerization and has good compatibility with the PVDF owing to the presence of hydrophobic long alkyl chains in DTDAC. The presence of dopamine motifs helps stabilize the PDDD-PVDF membrane by chelating with Fe3+ ions. The water contact angle on the PDDD-incorporated PVDF membranes was reduced from 87.6 to 54.6°, demonstrating improved hydrophilicity than pristine PVDF (M-0). The incorporation of PDDD into the PVDF improved the separation efficiencies of the membrane, which reached up to 99% while treating the oil-in-water emulsions. Incorporating PDDD into PVDF has significantly enhanced the anti-fouling characteristics of the membranes, which are indicated by their remarkable flux recovery ratio (FRR) (up to 92%). The hydrophobic and hydrophilic groups worked synergetically to enhance the performance of the fabricated membrane.

THE STUDY OF VDR FOKI RS2228570 SNP IN AUTOIMMUNE THYROIDITIS.

Autoimmune thyroid disease (AITD) is a common organ-specific autoimmune disease. A strong influence of genetic and epigenetic modifications has been demonstrated to take part in the development and progression of autoimmune thyroid diseases. The linkage between the Vitamin D receptor (VDR) polymorphism and several autoimmune disorders, including the AITD. In this article, we aim to investigate the Frequency of VDR Fokl (rs2228570) genotypes (CC, CT, TT) and alleles (C,T) in autoimmune thyroiditis. The investigation of VDR Fokl (rs2228570) was conducted on 150 samples (control (75 healthy women) and diseased women (75 diseased with autoimmune thyroiditis)) patients from the Adjara (Georgia) Population. It also examined some clinical and laboratory characteristics of the study population. Autoimmune thyroiditis's disease was diagnosed by measuring blood antibodies, determining the level of thyroperoxidase, and conducting an ultrasound examination. Anti-TPO and TSH were studied using the ELISA method. The genomic DNA was extracted from the peripheral blood. The polymerase chain reaction was evaluated to examine the VDR Fokl rs2228570 SNP polymorphism. According to VDR Fokl (rs2228570) genotypes (CC; CT, TT) frequency, in the control group, the Frequency of CC-genotype is 48%, CT-heterozygous genotype is 29.33%, and TT-genotype is 22.67%; in the diseased population, the Frequency of CC-genotype is 57.33%, CT-genotype is 34.67%, and TT-genotype is 8%. According to VDR Fokl (rs2228570) alleles (C, T), the Frequency of the C-allele is high, and the Frequency of the T-allele is low in both populations. The Frequency of the CC and CT genotypes of VDR Fokl (rs2228570) is high in the population with autoimmune thyroiditis compared to the control group; the TT genotype is relatively low in the population suffering from autoimmune thyroiditis; According to VDR Fokl (rs2228570) alleles (C, T), the Frequency of C-allele is high both population.

Robot assisted radical prostatectomy in fit older patients compared to a standard population: Clinical characteristics, surgical, oncological and functional outcomes.

INTRODUCTION: To compare robotic assisted radical prostatectomy (RARP) in well-selected older patients with clinically localized prostate cancer, compared to a younger population. Primary endpoint was perioperative outcomes comparison and secondary endpoint were oncological and functional outcomes comparison to a younger population. METHODS: Single tertiary center cohort of consecutive patients treated with RARP (2017-2020) with retrospective analysis. Patients were classified by age in two groups: <75: control group (CG) and ≥75: study group (SG). Patients aged ≥75 had a comprehensive geriatric assessment (CGA) and only patients classified Balducci ≤2 were admitted to surgery. RESULTS: Two hundred and sixty-nine patients were included, 56 in SG and 213 in CG. Median follow-up was 9.8 months. Univariate analysis showed no statistically significant (SS) difference between the groups for patients' characteristics (PSA, digital rectal examination -DRE- and biopsy Gleason Score), perioperative data (operative time, hospitalization length, transfusions rate, immediate complications, Clavien-Dindo complications, 30-days re-interventions and 30-days re-hospitalisation), oncological (TNM, margins, extraprostatic extension, postoperative PSA, BCR, metastases, overall survival -OS- and cancer specific survival -CSS-) and functional outcomes. Median perioperative blood loss was lower in the SG: 200.00 cc IQR [100.00, 300.00] vs 200.00cc IQR [100.00, 400.00] in the CG (P<0.05). A multivariate regression considering age>75, DRE, GS, PSA, cardiovascular history and diabetes showed none of variables associated with early BCR. Limitations are retrospective design, small number of patients and short follow-up. CONCLUSIONS: RARP shows similar perioperative, oncologic and functional outcomes for older patients selected by a CGA when compared to younger patients. The SG shows a minor perioperative bleeding. LEVEL OF EVIDENCE: IV.

Novel ways to modulate the vestibular system: Magnetic vestibular stimulation, deep brain stimulation and transcranial magnetic stimulation / transcranial direct current stimulation.

BACKGROUND: Advances in neurotechnologies are revolutionizing our understanding of complex neural circuits and enabling new treatments for disorders of the human brain. In the vestibular system, electromagnetic stimuli can now modulate vestibular reflexes and sensations of self-motion by artificially stimulating the labyrinth, cerebellum, cerebral cortex, and their connections. OBJECTIVE: In this narrative review, we describe evolving neuromodulatory techniques including magnetic vestibular stimulation (MVS), deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), and transcranial direct-current stimulation (tDCS) and discuss current and potential future application in the field of neuro-otology. RESULTS: MVS triggers both vestibular nystagmic (persistent) and perceptual (lasting ∼1 min) responses that may serve as a model to study central adaptational mechanisms and pathomechanisms of hemispatial neglect. By systematically mapping DBS electrodes, targeted stimulation of central vestibular pathways allowed modulating eye movements, vestibular heading perception, spatial attention and graviception, resulting in reduced anti-saccade error rates and hypometria, improved heading discrimination, shifts in verticality perception and transiently decreased spatial attention. For TMS/tDCS treatment trials have demonstrated amelioration of vestibular symptoms in various neuro-otological conditions, including chronic vestibular insufficiency, Mal-de-Debarquement and cerebellar ataxia. CONCLUSION: Neuromodulation has a bright future as a potential treatment of vestibular dysfunction. MVS, DBS and TMS may provide new and sophisticated, customizable, and specific treatment options of vestibular symptoms in humans. While promising treatment responses have been reported for TMS/tDCS, treatment trials for vestibular disorders using MVS or DBS have yet to be defined and performed.

SARS-CoV-2 Exposure from Health Care Workers to Infants: Effects and Outcomes.

OBJECTIVE: This study aimed to evaluate the risk and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission from positive health care workers (HCW) to infants in the neonatal intensive care unit (NICU) and the postnatal ward. STUDY DESIGN: We conducted a retrospective analysis of infants in NICU and the postnatal ward postexposure to a COVID-19 positive HCW between May 1 and July 31, 2020. HCW had the detection of SARS-CoV-2 after being symptomatic. Infants exposed to these HCW were tested for SARS-CoV-2 and were classified as confirmed positive when test was positive 24 hours after exposure; confirmed negative when test was negative with no escalation of respiratory support provided; and probable if test was negative. However, infant required escalation of respiratory support. Infants were followed at 14 days postexposure then at the end of the study period for admitted infants. RESULTS: A total of 31 infants were exposed to SARS-CoV-2 positive HCWs (42 exposure incidences). The median age at exposure was 21 days. None of the infants was confirmed positive. Nine infants were classified as probable cases of whom five infants with underlying chronic illnesses died, two were discharged home, and two were still admitted. Of the 22 confirmed negative cases, 15 were discharged and were well on follow-up, and 7 were still admitted. CONCLUSION: No active transmission of infection from infected HCW to admitted infants was identified. Although some infants had respiratory escalation postexposure none were confirmed positive. Adhering to personal protective equipment by HCW or low susceptibility of infants to SARS-CoV-2 infection may explain the lack of transmission. KEY POINTS: · There are no reported cases of transmission of SARS-CoV-2 infection from infected HCW to infants admitted to the NICU in our study.. · Adherence to personnel protective equipment is important to prevent transmission of SARS-CoV-2. · When an infant is exposed to a HCW who is positive for SARS-CoV-2 and has escalation of respiratory support, SARS-CoV-2 as a cause should be investigated.

Stimuli-Responsive Macromolecular Architecture by Butler Cyclopolymerizations: Synthesis and Applications.

This article reviews the synthesis of polyzwitterions (PZs) (poly-carboxybetaines, -phosphonobetaines, and -sulfobetaines) having multiple pH-responsive centers. The synthesis follows the Butler cyclopolymerization protocol involving a multitude of diallylammonium salts and their copolymerization with SO2 and maleic acid. The PZs have been transformed into cationic-, anionic-polyelectrolytes, and polyampholytes under the influence of pH. Particular attention is given to the application of these polymers as antiscalants, mild steel corrosion inhibitors, components in constructing Aqueous Two-Phase Systems (ATPSs), and membrane modifiers. The ATPSs could be used to separate various biomolecules, including proteins. Many amphiphilic polymers incorporating a few mol % hydrophobic monomers have shown enhanced viscosities and could be suitable for applications in oil fields. The progress of applying Butler cyclopolymerization in reversible addition-fragmentation chain transfer (RAFT) chemistry has been discussed. Future works are expected to focus on RAFT cyclopolymerization to construct block copolymers.

A sorbent containing pH-responsive chelating residues of aspartic and maleic acids for mitigation of toxic metal ions, cationic, and anionic dyes.

t-Butyl hydroperoxide-initiated cycloterpolymerization of diallylaminoaspartic acid hydrochloride [(CH2[double bond, length as m-dash]CHCH2)2NH+CH(CO2H)CH2CO2H Cl-] (I), maleic acid (HO2CH[double bond, length as m-dash]CHCO2H) (II) and cross-linker tetraallylhexane-1,6-diamine dihydrochloride [(CH2[double bond, length as m-dash]CHCH2)2NH+(CH2)6NH+ (CH2CH[double bond, length as m-dash]CH2)2 2Cl-] (III) afforded a new pH-responsive resin (IV), loaded with four CO2H and a chelating motif of NH+⋯CO2 - in each repeating unit. The removal of cationic methylene blue (MB) (3000 ppm) at pH 7.25 and Pb(ii) (200 ppm) at pH 6 by IV at 298, 313, and 328 K followed second-order kinetics with E a of 33.4 and 40.7 kJ mol-1, respectively. Both MB and Pb(ii) were removed fast, accounting for 97.7% removal of MB within 15 min at 313 K and 94% of Pb(ii) removal within 1 min. The super-adsorbent resin gave respective q max values of 2609 mg g-1 and 873 mg g-1 for MB and Pb(ii). IV was also found to trap anionic dyes; it removed 91% Eriochrome Black T (EBT) from its 50 ppm solutions at pH 2. The resin was found to be effective in reducing priority metal contaminants (like Cr, Hg, Pb) in industrial wastewater to sub-ppb levels. The synthesis of the recyclable resin can be easily scaled up from inexpensive starting materials. The resin has been found to be better than many recently reported sorbents.

Synthesis of a biomimetic zwitterionic pentapolymer to fabricate high-performance PVDF membranes for efficient separation of oil-in-water nano-emulsions.

Oily wastewater from industries has an adverse impact on the environment, human and aquatic life. Poly(vinylidene fluoride) (PVDF) membrane modified with a zwitterionic/hydrophobic pentapolymer (PP) with controlled pore size has been utilized to separate oil from water from their nano-emulsions. The PP has been synthesized in 91% yield via pentapolymerization of four different diallylamine salts [(CH2=CHCH2)2NH+(CH2)x A-], bearing CO2-, PO3H-, SO3-, (CH2)12NH2 pendants, and SO2 in a respective mol ratio of 25:36:25:14:100. Incorporating PP into PVDF has shown a substantially reduced membrane hydrophobicity; the contact angle decreased from 92.5° to 47.4°. The PP-PVDF membranes have demonstrated an excellent capability to deal with the high concentrations of nano-emulsions with a separation efficiency of greater than 97.5%. The flux recovery ratio (FRR) of PP-5 incorporated PVDF membrane was about 82%, which was substantially higher than the pristine PVDF.

[Medico-economic evaluation of the impact of measures to adapt to the switch to surgery robot-assisted in urology]. / Évaluation médico-economique de l'impact de mesures d'adaptation au virage de la chirurgie robot-assistée en urologie.

INTRODUCTION: The development of robot-assisted urological surgery is held back by the lack of robust medico-economic analyses and their heterogeneity. We conducted a medico-economic study to evaluate the implementation of measures to optimize the transition to robotic surgery. METHOD: We carried out a single-center, controlled study from the point of view of the public healthcare establishment for 4 years. Economic data collection was based on a micro-costing method and revenues from stay-related groups. Clinical data corresponded to mean lengths of stay, operating duration, complications and stays in intensive care. The measures to optimize the transition to robotic, implemented mid-study period, enabled before/after comparison. RESULTS: Altogether, 668 patients undergoing robotic surgery were included. Robotic activity increased significantly from periods 1 to 2 to 256% (P=<0.001) as did the overall proportion of robotic by 45% to 85% (P=<0.001). The mean lengths of stay fell significantly, 6.8 d vs. 5.1 d (P<0.001). Costs and revenues increased significantly, resulting in a persistent deficit for the activity €226K vs. €382K (P=<0.001). With increased volume of activity, the deficit per operation and the cost per minute of robotic operating room fell significantly, €3,284 vs. €1,474/procedure (P=<0.001) and €27 vs €24/min (P=<0.029), tending towards a break-even point (=zero deficit) at 430 operations per year. CONCLUSIONS: Robotic-assisted surgery can be significantly optimized by implementing measures for the robotic turn to reach a break-even point at 430 operations per year. A better multidisciplinary case mix could lower the break-even volume of activity in short term. LEVEL OF EVIDENCE: 3.

Assessment of radiographic morphology of mandibular condyles: a radiographic study.

BACKGROUND: Panoramic radiographs are the most common radiographic tool used by the dental clinicians to evaluate teeth, mandible and other related structures of the jaws. Mandibular condyle is an important anatomical landmark for facial growth, expressed in an upward and backward direction. The presentation of mandibular condyle differs widely among different group of ages and individuals. MATERIALS AND METHODS: The retrospective cross-sectional study was conducted from November 2018 to March 2019 at Dow International Dental College Karachi that includes radiographic evaluation of 500 mandibular condyles. All retrievable orthopantomograms were obtained and data were extracted regarding age, gender and condylar morphology. RESULTS: The morphological appearances of mandibular condyle have great variation among different age groups and subjects. Normally, we recognise five basic shapes i.e. oval, bird beak, crooked finger, diamond and mixed. Out of 250 pair of condylar heads that were evaluated, 50% were oval, 40% bird beak, 4.8% crooked finger and diamond 4.8%. CONCLUSIONS: All four morphological types of mandibular condyles were observed and the oval shape condyles were most prevalent among both genders and all age groups. In future studies, the inclusion of other parameters and large sample size may provide unique information.

Hybrid support vector regression and crow search algorithm for modeling and multiobjective optimization of microalgae-based wastewater treatment.

Microalgae-based wastewater treatment (and biomass production) is an environmentally benign and energetically efficient technique as compared to traditional practices. The present study is focused on optimization of the major treatment variables such as temperature, light-dark cycle (LD), and nitrogen (N)-to-phosphate (P) ratio (N/P) for the elimination of N and P from tertiary municipal wastewater utilizing Chlorella kessleri microalgae species. In this regard, a hybrid support vector regression (SVR) technique integrated with the crow search algorithm has been applied as a novel modeling/optimization tool. The SVR models were formulated using the experimental data, which were furnished according to the response surface methodology with Box-Behnken Design. Various statistical indicators, including mean absolute percentage error, Taylor diagram, and fractional bias, confirmed the superior performance of SVR models as compared to the response surface methodology (RSM) and generalized linear model (GLM). Finally, the best SVR model was hybridized with the crow search algorithm for single/multi-objective optimizations to acquire the global optimal treatment conditions for maximum N and P removal efficiencies. The best-operating conditions were found to be 29.3°C, 24/0 h/h of LD, and 6:1 of N/P, with N and P elimination efficiencies of 99.97 and 93.48%, respectively. The optimized values were further confirmed by new experimental data.

A resin containing motifs of maleic acid and glycine: a super-adsorbent for adsorptive removal of basic dye pararosaniline hydrochloride and Cd(II) from water.

The cyclocopolymerization of N,N-diallylglycine hydrochloride, maleic acid and 1,1,4,4-tetraallylpiperazinium dichloride afforded a cross-linked polyzwitterionic acid, which, upon treatment with NaOH, gave the corresponding cross-linked anionic polyelectrolyte (CAPE) in quantitative yield. The pH-responsive resins contained a high density of CO2 - motifs as well as the chelating motifs of glycine residues. The resin CAPE was found to be a super-adsorbent for the removal of pararosaniline hydrochloride (PRH); having a q max of 1534 mg/g. The adsorption process followed pseudo-second-order kinetics and was found to be a nearly irreversible process as suggested by the parameters obtained from Elovich kinetic model. The resin demonstrated excellent adsorption/desorption efficiencies, thereby ensuring its recycling and reuse in potent applications like remediation of industrial dye-waste water. The resin's chelating motifs were also efficient in the adsorptive removal of Cd(II) ions with a q max of 248 mg/g. It was also employed for the simultaneous and effective trapping of Cd(II) and the dye from industrial wastewater. The resin's impressive performance accords it a prestigious place among many sorbents in recent works.

Metabolic effects of brown fat in transitioning from hyperthyroidism to euthyroidism.

OBJECTIVE: Brown adipose tissue (BAT) controls metabolic rate through thermogenesis. As its regulatory factors during the transition from hyperthyroidism to euthyroidism are not well established, our study investigated the relationships between supraclavicular brown adipose tissue (sBAT) activity and physiological/metabolic changes with changes in thyroid status. DESIGN: Participants with newly diagnosed Graves' disease were recruited. A thionamide antithyroid drug (ATD) such as carbimazole (CMZ) or thiamazole (TMZ) was prescribed in every case. All underwent energy expenditure (EE) measurement and supraclavicular infrared thermography (IRT) within a chamber calorimeter, as well as 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/magnetic resonance (PET/MR) imaging scanning, with clinical and biochemical parameters measured during hyperthyroidism and repeated in early euthyroidism. PET sBAT mean/maximum standardized uptake value (SUV mean/max), MR supraclavicular fat fraction (sFF) and mean temperature (Tscv) quantified sBAT activity. RESULTS: Twenty-one (16 female/5 male) participants aged 39.5 ± 2.5 years completed the study. The average duration to attain euthyroidism was 28.6 ± 2.3 weeks. Eight participants were BAT-positive while 13 were BAT-negative. sFF increased with euthyroidism (72.3 ± 1.4% to 76.8 ± 1.4%; P < 0.01), but no changes were observed in PET SUV mean and Tscv. Significant changes in serum-free triiodothyronine (FT3) levels were related to BAT status (interaction P value = 0.04). FT3 concentration at hyperthyroid state was positively associated with sBAT PET SUV mean (r = 0.58, P = 0.01) and resting metabolic rate (RMR) (P < 0.01). CONCLUSION: Hyperthyroidism does not consistently lead to a detectable increase in BAT activity. FT3 reduction during the transition to euthyroidism correlated with BAT activity.

[Outcomes following the triage of patients for urological cancer and non-cancer surgery during Covid-19 pandemic peak]. / Évaluation des mesures de triages de la première vague pandémique Covid-19 pour sélectionner les patients à opérer pour cancers et urgences urologiques.

INTRODUCTION: Faced with the first wave of Covid-19 pandemic, guidelines for surgical triage were developed to free up healthcare resources. The aim of our study was to assess clinical characteristics and surgical outcomes of triaged patients during the first Covid-19 crisis. METHOD: We conducted a cohort-controlled, non-randomized, study in a University Hospital of south-eastern France. Data were collected prospectively from consecutive patients after triage during the period from March 15th to May 1st and compared with control data from outside pandemic period. Primary endpoint was intensive care unit (ICU) admissions for surgery-related complications. Rates of surgery-specific death, postponed operations, positive PCR testing and Clavien-Dindo complications and data from cancer and non- cancer subgroups were assessed. RESULTS: After triage, 96 of 142 elective surgeries were postponed. Altogether, 71 patients, median age 68 y.o (IQR: 56-75 y.o), sex ratio M/F of 4/1, had surgery, among whom, 48 (68%) had uro-oncological surgery. No patients developed Covid-19 pneumonia in the post-surgery period. Three (4%) were admitted to the ICU, one of whom died from multi-organ failure due to septic shock caused by klebsiella pneumonia following a delay in treatment. Three Covid-19 RT-PCR were done and all were negative. There was no difference in mortality rates or ICU admission rates between control and Covid- era patients. CONCLUSIONS: Surgery after triage during the first Covid-19 pandemic was not associated with worse short-term outcomes. Urological cancers could be operated on safely in our context but delays in care for aggressive genitourinary diseases could be life threatening. LEVEL OF EVIDENCE: 3.