Microbial removal of nutrients from anaerobic digestate: assessing product-coupled and non-product-coupled approaches

Although anaerobic digestate contains >90% water, the high nutrient content of digestate makes it economically and technically intractable to treatment by existing wastewater treatment technologies. This study separately assessed the feasibility of nutrient removal from digestate by Rhizopus delemar DSM 905 and a culture of phosphate-accumulating organisms (PAOs). With Rhizopus delemar DSM 905, we investigated concomitant nutrient removal from digestate-supplemented medium and fumaric acid production, as a potentially economical strategy for digestate treatment. Following the cultivation of R. delemar DSM 905 in a fermentation medium containing 25% (v/v) digestate, the concentrations of Al, Cr, Cu, Fe, K, Mg, Mn, Pb, and Zn reduced 40, 12, 74, 96, 12, 26, 23%, ~18, and 28%, respectively. Similarly, the concentrations of total phosphorus, total nitrogen, phosphate (PO4-P), ammonium (NH4-N), nitrate (NO3-N), and sulfur decreased 93, 88, 97, 98, 69, and 13%, respectively. Concomitantly, cultures supplemented with 25 and 15% (v/v) digestate produced comparable titers of fumarate (~11 and ~ 17 g/L, respectively) to the digestate un-supplemented control cultures. With PAOs, we assessed the removal of total phosphorus, total nitrogen, PO4-P, and NH4-N, of which the concentrations reduced 86, 90%, ~99, and 100%, respectively in 60% (v/v) digestate. This study provides additional bases for microbial removal of excess nutrients from anaerobic digestate, with the potential to engender future water recovery from this waste stream that is currently largely recalcitrant to treatment

Comparative evaluation of partial replacement of soybean meal with raw and oven-dried cassia tora seedmeal on the performance of broiler chickens

This study was conducted to comparatively evaluate partial replacement of soybean meal with raw and oven-dried Cassia tora seed meal (CTSM) on the performance of broiler chickens. An eight-week feeding trial involving two hundred and eighty eight (288), day-old chicks purchased from a reputable chick dealer in Uyo Metropolis was used for the study. Four experimental diets each of raw and oven-dried CTSM was formulated such that diets 1, 2, 3, and 4 contained 0%, 5%, 10%, and 15% CTSM respectively. The birds were randomly assigned to the eight dietary treatments of 36 birds each. A treatment was replicated thrice, with 12 birds per replicate in a completely randomized design (CRD). The parameters evaluated were body weight gain, feed intake, feed conversion ratio and blood parameters. Data obtained were subjected to analysis of variance (ANOVA), using SPSS version 20. The results showed that the dietary treatments significantly influenced the growth indices. Weight gain was highest at 10% inclusion of raw CTSM and also at 15% inclusion of oven-dried CTSM. Feed intake response was highest at 10% inclusion of raw CTSM and 15% inclusion of oven-dried CTSM while feed conversion ratio (FCR) was greatly improved at these inclusion levels. The inclusion of raw and oven-dried CTSM at 10% and 15% respectively did not adversely affect carcass qualities and organs. Inclusion of raw CTSM up to 15% adversely affected carcass quality and haematological parameters. Also, haematological parameters of broiler chicken were best at 10% and 15% inclusion of raw and oven-dried CTSM respectively. When all parameters were considered, performance of broiler chickens was best at 10% inclusion of raw CTSM and 15% inclusion of oven-dried CTSM. It is therefore recommended that raw CTSM can only be incorporated into the diets of broiler chickens up to 10% without any detrimental effect. But oven-dried CTSM can be incorporated up to 15% without any detrimental effect. &nbsp

Anti-motility and reductions in the concentrations of gut electrolytes: Mechanisms for the anti-spasmodic use of the seeds of avocado (Persea americana Mill) in folk medicine

The seeds of avocado (Persea americana Mill) are used in traditional medicine to treat, allay or prevent some spasm-related disorders, for instance, diarrhoea. The chloroform and methanol fractions of the chloroform-methanol extract of the seeds of P. americana were investigated for their qualitative and quantitative phytochemical constituents as well as effects on gastro-intestinal motility (transit) and castor oil-induced intestinal fluid sodium ion (Na+) and potassium ion (K+) concentrations in Wistar rats. The qualitative and quantitative phytochemical studies of the chloroform and methanol fractions showed the presence and amounts of alkaloids (2.92 ± 0.14 g/100 g and 2.81 ± 0.08 g/100 g respectively), flavonoids (3.43 ± 0.19 g/100 g and 3.11 ± 0.16 g/100 g, respectively), tannins (2.64 ± 0.13 g/100 g and 2.85 ± 0.14 g/100 g, respectively), steroids (1.51 ± 0.07 g/100 g and 1.27 ± 0.04 g/100 g, respectively), saponins (2.35 ± 0.08 % and 2.47 ± 0.09%, respectively), terpenoids, proteins and carbohydrates in both fractions. Fats and oil were present only in the chloroform fraction. At the two doses (100 and 200 mg/kg body weight), the chloroform and methanol fractions produced significant (p<0.05) and dose-related decreases in the gastro-intestinal motility and concentration of the intestinal fluid potassium ions but only the chloroform fraction at the dose of 200 mg/kg body weight significantly (p<0.05) decreased the concentration of the intestinal fluid sodium ions. Results of the fractions were comparable with those of the standard anti-diarrhoeal drug, hyoscine butylbromide (3 mg/kg body weight). The results indicate that the chloroform-methanol extract of the seeds of P. americana contains compounds with anti-spasmodic effect.Keywords: Persea americana, spasm-related, castor oil, gastro-intestinal motility and electrolytesAfrican Journal of Biotechnology Vol. 12(37), pp. 5610-561

Postcoital Haemoptysis: A Case Report and a Review of the Literature

Haemoptysis is rarely reported following coitus, and cardiac decompensation has been mostly implicated in the aetiology. We present a 53-year-old Nigerian, known hypertensive diabetic woman with background ischaemic heart disease who presented with postcoital haemoptysis of one-year duration. Echocardiography revealed combined ischaemic and mitral valvular heart disease, probably of rheumatic aetiology. There has been no previous report in an African population. This case illustrates the need to rule out coitus as a rare but potential cause of haemoptysis in middle aged patients with underlying cardiac pathologies and the need for an extensive cardiac workup in a population with predominantly pulmonary causes of haemoptysis

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

There are a number of potential physical advantages to performing orotracheal intubation in an upright position. The objective of this study was to measure the success of intubation of a simulated patient in an upright versus supine position by novice intubators after brief training. This was a cross-over design study in which learners (medical students, physician assistant students, and paramedic students) intubated mannequins in both a supine (head of the bed at 0°) and upright (head of bed elevated at 45°) position. The primary outcome of interest was successful intubation of the trachea. Secondary outcomes included log time to intubation, Cormack–Lehane view obtained, Percent of Glottic Opening score, provider assessment of difficulty, and overall provider satisfaction with the position. There were a total of 126 participants: 34 medical students, 84 physician assistant students, and 8 paramedic students. Successful tracheal intubation was achieved in 114 supine attempts (90.5 %) and 123 upright attempts (97.6 %; P = 0.283). Upright positioning was associated with significantly faster log time to intubation, higher likelihood of achieving Grade I Cormack–Lehane view, higher Percent of Glottic Opening score, lower perceived difficulty, and higher provider satisfaction. A subset of 74 participants had no previous intubation training or experience. For these providers, there was a non-significant trend toward improved intubation success with upright positioning vs supine positioning (98.6 % vs. 87.8 %, P = 0.283). For all secondary outcomes in this group, upright positioning significantly outperformed supine positioning

Feasibility of upright patient positioning and intubation success rates at two academic emergency departments

Objectives Endotracheal intubation is most commonly taught and performed in the supine position. Recent literature suggests that elevating the patient's head to a more upright position may decrease peri-intubation complications. However, there is little data on the feasibility of upright intubation in the emergency department. The goal of this study was to measure the success rate of emergency medicine residents performing intubation in supine and non-supine, including upright positions. Methods This was a prospective observational study. Residents performing intubation recorded the angle of the head of the bed. The number of attempts required for successful intubation was recorded by faculty and espiratory therapists. The primary outcome of first past success was calculated with respect to three groups: 0–10° (supine), 11–44° (inclined), and ≥ 45° (upright); first past success was also analyzed in 5 degree angle increments. Results A total of 231 intubations performed by 58 residents were analyzed. First pass success was 65.8% for the supine group, 77.9% for the inclined group, and 85.6% for the upright group (p = 0.024). For every 5 degree increase in angle, there was increased likelihood of first pass success (AOR = 1.11; 95% CI = 1.01–1.22, p = 0.043). Conclusions In our study emergency medicine residents had a high rate of success intubating in the upright position. While this does not demonstrate causation, it correlates with recent literature challenging the traditional supine approach to intubation and indicates that further investigation into optimal positioning during emergency department intubations is warranted

HYPOGLYCAEMIC AND HAEMATINIC PROPERTIES OF ETHANOL LEAF EXTRACT OF ARTOCARPUS HETEROPHYLLUS IN ALLOXAN INDUCED DIABETIC RATS.

Background: Anaemia is known to be associated with diabetes; moreover, with the increasing cases of diabetes there is need for the use of more affordable alternative herbal medicines for the treatment of diabetes and anaemia. The aim of this work was to evaluate the hypoglycaemic and haematinic properties of Artocarpus heteropyllus on diabetic rats. Materials and Methods: Ethanol leaf extract of Artocarpus heteropyllus was screened for phytochemicals and its acute toxicity was tested on mice. Induction of diabetes was done at a dose of 150 mg/kg body weight (b.w) (with exception of the control group). The extract was administered to rats for a period of 7 days at 100, 300 and 500 mg/kg b.w, respectively, following induction. Blood samples of rats were tested for fasting blood sugar (FBS), packed cell volume (PCV), white blood cell (WBC), red blood cell (RBC), haemoglobin, neutrophil lymphocyte and eosinophil counts. Results: The ethanol leaf extract of A. heterophyllus showed no mortality up to a dose of 5000 mg/kg b.w. Administration of the extract to diabetic rats resulted in a decrease in the FBS of diabetic rat, and significant increases (p< 0.05) in RBC, PCV, WBC and haemoglobin levels. Conclusion: The ethanol leaf extract of A. heterophyllus increased the haematological indices of diabetic rats. Our findings support the use of this plant as an herbal alternative in the treatment of diabetes and anaemia associated diabetes

A Protocol for the Inclusion of Minoritized Persons in Alzheimer Disease Research From the ADNI3 Diversity Taskforce

Importance: Black or African American (hereinafter, Black) and Hispanic or Latino/a/x (hereinafter, Latinx) adults are disproportionally affected by Alzheimer disease, but most research studies do not enroll adequate numbers of both of these populations. The Alzheimer’s Disease Neuroimaging Initiative-3 (ADNI3) launched a diversity taskforce to pilot a multipronged effort to increase the study inclusion of Black and Latinx older adults. Objective: To describe and evaluate the culturally informed and community-engaged inclusion efforts to increase the screening and enrollment of Black and Latinx older adults in ADNI3. Design, Setting, and Participants: This cross-sectional study used baseline data from a longitudinal, multisite, observational study conducted from January 15, 2021, to July 12, 2022, with no follow-up. The study was conducted at 13 ADNI3 sites in the US. Participants included individuals aged 55 to 90 years without cognitive impairment and those with mild cognitive impairment or Alzheimer disease. Exposures: Efforts included (1) launch of an external advisory board, (2) changes to the study protocol, (3) updates to the digital prescreener, (4) selection and deployment of 13 community-engaged research study sites, (5) development and deployment of local and centralized outreach efforts, and (6) development of a community-science partnership board. Main Outcomes and Measures: Screening and enrollment numbers from centralized and local outreach efforts, digital advertisement metrics, and digital prescreener completion. Results: A total of 91 participants enrolled in the trial via centralized and local outreach efforts, of which 22 (24.2%) identified as Latinx and 55 (60.4%) identified as Black (median [IQR] age, 65.6 [IQR, 61.5-72.5] years; 62 women [68.1%]). This represented a 267.6% increase in the monthly rate of enrollment (before: 1.11 per month; during: 4.08 per month) of underrepresented populations. For the centralized effort, social media advertisements were run between June 1, 2021, and July 31, 2022, which resulted in 2079 completed digital prescreeners, of which 1289 met criteria for subsequent site-level screening. Local efforts were run between June 1, 2021, to July 31, 2022. A total of 151 participants underwent site-level screening (100 from local efforts, 41 from centralized efforts, 10 from other sources). Conclusions and Relevance: In this cross-sectional study of pilot inclusion efforts, a culturally informed, community-engaged approach increased the inclusion of Black and Latinx participants in an Alzheimer disease cohort study.</p

Daratumumab plus lenalidomide and dexamethasone in relapsed/ refractory multiple myeloma: extended follow-up of POLLUX, a randomized, open-label, phase 3 study

In POLLUX, daratumumab (D) plus lenalidomide/dexamethasone (Rd) reduced the risk of disease progression or death by 63% and increased the overall response rate (ORR) versus Rd in relapsed/refractory multiple myeloma (RRMM). Updated efficacy and safety after >3 years of follow-up are presented. Patients (N = 569) with ≥1 prior line received Rd (lenalidomide, 25 mg, on Days 1–21 of each 28-day cycle; dexamethasone, 40 mg, weekly) ± daratumumab at the approved dosing schedule. Minimal residual disease (MRD) was assessed by next-generation sequencing. After 44.3 months median follow-up, D-Rd prolonged progression-free survival (PFS) in the intent-to-treat population (median 44.5 vs 17.5 months; HR, 0.44; 95% CI, 0.35–0.55; P < 0.0001) and in patient subgroups. D-Rd demonstrated higher ORR (92.9 vs 76.4%; P < 0.0001) and deeper responses, including complete response or better (56.6 vs 23.2%; P < 0.0001) and MRD negativity (10–5; 30.4 vs 5.3%; P < 0.0001). Median time to next therapy was prolonged with D-Rd (50.6 vs 23.1 months; HR, 0.39; 95% CI, 0.31–0.50; P < 0.0001). Median PFS on subsequent line of therapy (PFS2) was not reached with D-Rd versus 31.7 months with Rd (HR, 0.53; 95% CI, 0.42–0.68; P < 0.0001). No new safety concerns were reported. These data support using D-Rd in patients with RRMM after first relapse

Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions -- a user perspective

BACKGROUND\ud \ud The ACCESS programme aims at understanding and improving access to prompt and effective malaria treatment. Between 2004 and 2008 the programme implemented a social marketing campaign for improved treatment-seeking. To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania in 2006. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007 and subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on understanding and treatment of malaria was studied in rural Tanzania. The data also enabled an investigation of the determinants of access to treatment.\ud \ud METHODS\ud \ud Three treatment-seeking surveys were conducted in 2004, 2006 and 2008 in the rural areas of the Ifakara demographic surveillance system (DSS) and in Ifakara town. Each survey included approximately 150 people who had suffered a fever case in the previous 14 days.\ud \ud RESULTS\ud \ud Treatment-seeking and awareness of malaria was already high at baseline, but various improvements were seen between 2004 and 2008, namely: better understanding causes of malaria (from 62% to 84%); an increase in health facility attendance as first treatment option for patients older than five years (27% to 52%); higher treatment coverage with anti-malarials (86% to 96%) and more timely use of anti-malarials (80% to 93-97% treatments taken within 24 hrs). Unfortunately, the change of treatment policy led to a low availability of ALu in the private sector and, therefore, to a drop in the proportion of patients taking a recommended malaria treatment (85% to 53%). The availability of outlets (health facilities or drug shops) is the most important determinant of whether patients receive prompt and effective treatment, whereas affordability and accessibility contribute to a lesser extent.\ud \ud CONCLUSIONS\ud \ud An integrated approach aimed at improving understanding and treatment of malaria has led to tangible improvements in terms of people's actions for the treatment of malaria. However, progress was hindered by the low availability of the first-line treatment after the switch to ACT