Optimization of Pyrolysis Process Parameters for Fuel Oil Production from the Thermal Recycling of Waste Polypropylene Grocery Bags Using the Box–Behnken Design

The impact of dumping plastic waste is realized in different ecosystems of the planet. Several methods have been adopted to dispose of these wastes for energy recovery. This study, for the first time, proposed the Box–Behnken design technique to optimize the pyrolysis process parameters for fuel oil production from waste polypropylene (PP) grocery bags using a semibatch-type pyrolytic reactor. The semibatch-type pyrolytic reactor was developed and employed to produce fuel oil from waste PP grocery bags. The effect of different process parameters on fuel oil production was comprehensively analyzed using the response surface methodology (RSM) with the conjunction of the Box–Behnken design (BBD). The BBD facilitates the prediction of the response variables with respect to changes in the input variables by developing a response model. The BBD was used to optimize the process parameters, such as the reaction temperature (400–550 °C), nitrogen flow rate (5–20 mL min−1), and substrate feed rate (0.25–1.5 kg h−1), and their effect on the responses were observed. The optimum response yields of the fuel oil (89.34 %), solid residue (2.74%), and gas yield (7.92%) were obtained with an optimized temperature (481 °C), a nitrogen flow rate (13 mL min−1), and a feed rate (0.61 kg h−1). The quadratic model obtained for the fuel oil response denotes the greater R2 value (0.99). The specific gravity and calorific value of the fuel oil were found to be 0.787 and 45.42 MJ kg−1, respectively. The fuel oil had higher research octane number (RON) (100.0 min) and motor octane number (MON) (85.1 min) values. These characteristics of the fuel oil were matched with conventional petroleum fuels. Further, Fourier transform infrared spectroscopy (FT-IR) and gas chromatography–mass spectroscopy (GC-MS) were used to analyze the fuel oil, and the results revealed that the fuel oil was enriched with different hydrocarbons, namely, alkane (paraffins) and alkene (olefins), in the carbon range of C4–C20. These results, and also the fractional distillation of the fuel oil, show the presence of petroleum-range hydrocarbons in the waste PP fuel oil

Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV

Limited data are available on the relationship between nutritional status and pulmonary tuberculosis (PTB). Zinc plays a vital role in the immune status of the individual. The present study was carried out to estimate serum zinc and albumin levels in newly detected adult active PTB patients with ( n = 20) and without ( n = 20) HIV, and to compare them with the levels in controls (healthy family members; n = 20) who satisfied rigid selection criteria. Standard methods were adopted to collect an early morning fasting blood sample for zinc (by Atomic Absorption Spectrometer) and albumin (estimated by the bromocresol green method). The mean + SD for BMI, zinc and albumin among the controls, HIV positive and HIV negative paitents were 19.6 + 0.6, 18 + 0.4 and 18.5 + 0.6 kg/m 2 ; 117.13 + 4.2, 53.9 + 8 and 65.5 + 9.8 m g/dL; and 4.1 + 0.6, 2.9 + 0.4 and 3.6 + 0.7 g/dL, respectively. All three parameters were signficiantly low in active PTB patients irrespective of HIV status, but more so in HIV-positive individuals. These changes may be attributable to nutritional factors, enteropathy and acute phase reactant proteins. Hence, the National AIDS Control Organization (NACO) in India is providing nutritional supplements to those HIV-infected cases inducted for antiretroviral therapy and nutritional counseling for others as a part of a nutritional policy

Gestational diabetes mellitus in southeast Asia:A scoping review

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease

Atrioventricular septal defect with anomalous systemic venous and pulmonary venous connection

An anomalous pulmonary venous and systemic connection associated with a partial atrioventricular septal defect (AVSD) is rare. A 23-year-old patient, who presented with dyspnea and cyanosis on exertion, was found to have an anomalous pulmonary and systemic venous drainage with separate drainage of the left superior caval vein and hepatic veins into the left atrium and a partial AVSD. A patch diversion was successfully performed using two patches of glutaraldehyde-treated pericardium to create a nonobstructive pulmonary and systemic venous drainage

The Modulation of Gut Microbiota Composition in the Pathophysiology of Gestational Diabetes Mellitus: A Systematic Review

General gut microbial dysbiosis in diabetes mellitus, including gestational diabetes mellitus (GDM), has been reported in a large body of literature. However, evidence investigating the association between specific taxonomic classes and GDM is lacking. Thus, we performed a systematic review of peer-reviewed observational studies and trials conducted among women with GDM within the last ten years using standard methodology. The National Institutes of Health (NIH) quality assessment tools were used to assess the quality of the included studies. Fourteen studies investigating microbial interactions with GDM were found to be relevant and included in this review. The synthesis of literature findings demonstrates that Bacteroidetes, Proteobacteria, Firmicutes, and Actinobacteria phyla, such as Desulfovibrio, Ruminococcaceae, P. distasonis, Enterobacteriaceae, Collinsella, and Prevotella, were positively associated with GDM. In contrast, Bifidobacterium and Faecalibacterium, which produce butyrate, are negatively associated with GDM. These bacteria were associated with inflammation, adiposity, and glucose intolerance in women with GDM. Lack of good diet management demonstrated the alteration of gut microbiota and its impact on GDM glucose homeostasis. The majority of the studies were of good quality. Therefore, there is great potential to incorporate personalized medicine targeting microbiome modulation through dietary intervention in the management of GDM

Diet, lifestyle and gut microbiota composition among Malaysian women with gestational diabetes mellitus: a prospective cohort study

Abstract The study addressed a significant gap in the profiling and understanding of the gut microbiota’s influence on Malaysian Malay women with gestational diabetes mellitus (GDM). This prospective cohort study aimed to explore the intricate relationship between gut microbiota, dietary choices, and lifestyle factors among Malay women, both with and without GDM. The research specifically focused on participants during the second (T0) and third (T1) trimesters of pregnancy in Johor Bahru, Malaysia. In Part 1 of the study, a diverse pool of pregnant women at T0 was categorized into two groups: those diagnosed with GDM and those without GDM, with a total sample size of 105 individuals. The assessments encompassed demographic, clinical, lifestyle, and dietary factors at the T0 and T1 trimesters. Part 2 of the study delved into microbiome analysis, targeting a better understanding of the gut microbiota among the participants. Stool samples were randomly collected from 50% of the individuals in each group (GDM and non-GDM) at T0 and T1. The collected samples underwent processing, and 16s rRNA metagenomic analysis was employed to study the microbial composition. The results suggested an association between elevated body weight and glucose levels, poor sleep quality, lack of physical activity, greater intake of iron and meat, and reduced fruit consumption among women with GDM compared to non-GDM groups. The microbiome analysis revealed changes in microbial composition over time, with reduced diversity observed in the GDM group during the third trimester. The genera Lactiplantibacillus, Parvibacter, Prevotellaceae UCG001, and Vagococcus positively correlated with physical activity levels in GDM women in the second trimester. Similarly, the genus Victivallis exhibited a strong positive correlation with gravida and parity. On the contrary, the genus Bacteroides and Roseburia showed a negative correlation with omega-3 polyunsaturated fatty acids (PUFAs) in women without GDM in the third trimester. The study highlighted the multifaceted nature of GDM, involving a combination of lifestyle factors, dietary choices, and changes in gut microbiota composition. The findings emphasized the importance of considering these interconnected elements in understanding and managing gestational diabetes among Malaysian Malay women. Further exploration is essential to comprehend the mechanisms underlying this relationship and develop targeted interventions for effective GDM management

Comparative study of hypolipidemic profile of resinoids of Commiphora mukul/Commiphora wightii from different geographical locations

The antihyperlipidemic activity of resinoids of guggul (Commiphora mukul/Commiphora wightii), belonging to family Burseraceae (Genus: Commiphora), collected from different parts of India (Gujarat, Madhya Pradesh and Rajasthan), was studied on cholesterol-rich high fat diet-induced model of hyperlipidemia in rats. The resinoids of these exudates were prepared in ethyl acetate and ethyl alcohol. The physicochemical characterization of these resinoids was carried out to determine their appearance, %yield, %moisture, %ash, acid value (mg/KOH/g), saponification value (mg/KOH/g), ester value and iodine value (g/g). Antihyperlipidemic study was carried out on all resinoids in high fat diet induced model of hyperlipidemia in Wistar albino rats. The result demonstrated that the resinoids of exudates of Commiphora wightii and Commiphora mukul, collected from Gujarat and extracted in ethyl acetate, and the resinoids of exudates of Commiphora mukul, collected from Madhya Pradesh and extracted in ethyl acetate, possessed significantly higher antihyperlipidemic activity compared with other resinoids, which may be due to regional/geographical variations

Plasma Vascular Endothelial Growth Factor Concentrations after Intravitreous Anti–Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema

© 2018 American Academy of Ophthalmology Purpose: To assess systemic vascular endothelial growth factor (VEGF)-A levels after treatment with intravitreous aflibercept, bevacizumab, or ranibizumab. Design: Comparative-effectiveness trial with participants randomly assigned to 2 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab after a re-treatment algorithm. Participants: Participants with available plasma samples (N = 436). Methods: Plasma samples were collected before injections at baseline and 4-week, 52-week, and 104-week visits. In a preplanned secondary analysis, systemic-free VEGF levels from an enzyme-linked immunosorbent assay were compared across anti-VEGF agents and correlated with systemic side effects. Main Outcome Measures: Changes in the natural log (ln) of plasma VEGF levels. Results: Baseline free VEGF levels were similar across all 3 groups. At 4 weeks, mean ln(VEGF) changes were −0.30±0.61 pg/ml, −0.31±0.54 pg/ml, and −0.02±0.44 pg/ml for the aflibercept, bevacizumab, and ranibizumab groups, respectively. The adjusted differences between treatment groups (adjusted confidence interval [CI]; P value) were −0.01 (−0.12 to +0.10; P = 0.89), −0.31 (−0.44 to −0.18; P \u3c 0.001), and −0.30 (−0.43 to −0.18; P \u3c 0.001) for aflibercept-bevacizumab, aflibercept-ranibizumab, and bevacizumab-ranibizumab, respectively. At 52 weeks, a difference in mean VEGF changes between bevacizumab and ranibizumab persisted (−0.23 [−0.38 to −0.09]; P \u3c 0.001); the difference between aflibercept and ranibizumab was −0.12 (P = 0.07) and between aflibercept and bevacizumab was +0.11 (P = 0.07). Treatment group differences at 2 years were similar to 1 year. No apparent treatment differences were detected at 52 or 104 weeks in the cohort of participants not receiving injections within 1 or 2 months before plasma collection. Participants with (N = 9) and without (N = 251) a heart attack or stroke had VEGF levels that appeared similar. Conclusions: These data suggest that decreases in plasma free-VEGF levels are greater after treatment with aflibercept or bevacizumab compared with ranibizumab at 4 weeks. At 52 and 104 weeks, a greater decrease was observed in bevacizumab versus ranibizumab. Results from 2 subgroups of participants who did not receive injections within at least 1 month and 2 months before collection suggest similar changes in VEGF levels after stopping injections. It is unknown whether VEGF levels return to normal as the drug is cleared from the system or whether the presence of the drug affects the assay\u27s ability to accurately measure free VEGF. No significant associations between VEGF concentration and systemic factors were noted

Effect of adding dexamethasone to continued ranibizumab treatment in patients with persistent diabetic macular edema: A DRCR network phase 2 randomized clinical trial

© 2017 American Medical Association. All rights reserved. IMPORTANCE Some eyes have persistent diabetic macular edema (DME) following anti-vascular endothelial growth factor (anti-VEGF) therapy for DME. Subsequently adding intravitreous corticosteroids to the treatment regimen might result in better outcomes than continued anti-VEGF therapy alone. OBJECTIVE To compare continued intravitreous ranibizumab alone with ranibizumab plus intravitreous dexamethasone implant in eyes with persistent DME. DESIGN, SETTING, AND PARTICIPANTS Phase 2 multicenter randomized clinical trial conducted at 40 US sites in 129 eyes from 116 adults with diabetes between February 2014 and December 2016. Eyes had persistent DME, with visual acuity of 20/32 to 20/320 after at least 3 anti-VEGF injections before a run-in phase, which included an additional 3 monthly 0.3-mg ranibizumab injections. Data analysis was according to intent to treat. INTERVENTIONS Following the run-in phase, study eyes that had persistent DME and were otherwise eligible were randomly assigned to receive 700 μg of dexamethasone (combination group, 65 eyes) or sham treatment (ranibizumab group, 64 eyes) in addition to continued 0.3-mg ranibizumab in both treatment arms as often as every 4 weeks based on a structured re-treatment protocol. MAIN OUTCOMES AND MEASURES The primary outcomewas change in mean visual acuity letter score at 24 weeks as measured by the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS). The principal secondary outcome was change in mean central subfield thickness as measured with the use of optical coherence tomography. RESULTS Of the 116 randomized patients, median age was 65 years (interquartile range [IQR], 58-71 years); 50.9%were female and 60.3%were white. Mean (SD) improvement in visual acuity from randomization was 2.7 (9.8) letters in the combination group and 3.0 (7.1) letters in the ranibizumab group, with the adjusted treatment group difference (combination minus ranibizumab) of -0.5 letters (95%CI, -3.6 to 2.5; 2-sided P = .73). Mean (SD) change in central subfield thickness in the combination group was -110 (86) μm compared with -62 (97) μm for the ranibizumab group (adjusted difference, -52; 95%CI, -82 to -22; 2-sided P \u3c .001). Nineteen eyes (29%) in the combination group experienced increased intraocular pressure or initiated treatment with antihypertensive eyedrops compared with 0 in the ranibizumab group (2-sided P \u3c .001). CONCLUSIONS AND RELEVANCE Although its use is more likely to reduce retinal thickness and increase intraocular pressure, the addition of intravitreous dexamethasone to continued ranibizumab therapy does not improve visual acuity at 24 weeks more than continued ranibizumab therapy alone among eyes with persistent DME following anti-VEGF therapy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT0194586