Pretreatment of Real Wastewater from the Chocolate Manufacturing Industry through an Integrated Process of Electrocoagulation and Sand Filtration

En este artículo se analizó el efecto de un proceso acoplado de electrocoagulación y filtración, para remover partículas suspendidas en un agua residual procedente de una industria de chocolates.The purpose of this study was to evaluate the efficiency of removal of suspended solids in terms of turbidity, color, and chemical oxygen demand (COD) when integrating the electrocoagulation process using aluminum sacrificial anodes and the sand filtration process as a pretreatment of wastewater from the chocolate manufacturing plant in Toluca, México. Wastewater from the chocolate manufacturing industry used in this study is classified as nontoxic, but is characterized as having a high content of color (5952 ± 76 Pt-Co), turbidity (1648 ± 49 FAU), and COD (3608 ± 250 mg/L). Therefore, enhanced performance could be achieved by combining pretreatment techniques to increase the efficiencies of the physical, chemical, and biological treatments. In the integrated process, there was a turbidity reduction of 96.1 ± 0.2% and an increase in dissolved oxygen from 3.8 ± 0.05 mg/L (inlet sand filtration) to 6.05 ± 0.03 mg/L (outlet sand filtration) after 120 min of treatment. These results indicate good water quality necessary for all forms of elemental life. Color and COD removals were 98.2 ± 0.2% and 39.02 ± 2.2%, respectively, during the electrocoagulation process (0.2915 mA/cm2 current density and 120 min of treatment). The proposed integrated process could be an attractive alternative of pretreatment of real wastewater to increase water quality of conventional treatments

Planeación, gobernanza y sustentabilidad Retos y desafíos desde el enfoque territorial

Frente a la compleja realidad actual, resulta ineludible el desarrollo de la investigación científica de los fenómenos y procesos urbanos, territoriales y ambientales, que contribuya a su comprensión y la construcción de alternativas de solución a los retos y desafíos vigentes. En este contexto, el abordaje de las ciudades y regiones metropolitanas, el ordenamiento del territorio y la ocupación del espacio, así como la relación sociedad-naturaleza y la complejidad ambiental, precisa la generación de metodologías y procesos de investigación multi e inter disciplinarios que contribuyan a la comprensión de los procesos socioterritoriales, el mejoramiento de las condiciones de vida y la conservación ambiental.Programa de Fortalecimiento de la Calidad Educativa PFCE-2016 proyecto K0313101

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Surgical Management of Temporal Lobe Epilepsy Secondary to Epidermoid Cysts: A Case Report With Review of the Literature

Epidermoid cysts represent roughly 1% of all intracranial tumors. They are frequently located in the cerebellopontine angle but rarely extend to the supratentorial brain. Epilepsy is an extremely uncommon manifestation of this neoplasm. We suggest the surgical management of a 35-year-old male who presented with a six-month history of intractable temporal lobe epilepsy. His seizures were characterized by a focal onset in the form of deja vu experiences, followed by a secondarily generalized tonic-clonic seizure. Imaging revealed a heterogeneous cystic mass in the right cerebellopontine angle, extending supratentorially causing a mass effect on the mesial temporal region. Gross total resection was achieved through a combined subtemporal-retrosigmoid approach. Histopathology revealed an epidermoid cyst. The patient was entirely seizure-free at the three-month follow-up. Epidermoid cysts may present with epileptic seizures. Seizure freedom can be achieved with surgical management in most cases. The patient's symptoms, imaging findings, and epileptogenic focus must be considered to select the appropriate surgical strategy

Relationship Between Quantitative Adverse Plaque Features From Coronary Computed Tomography Angiography and Downstream Impaired Myocardial Flow Reserve by 13N-Ammonia Positron Emission Tomography

BackgroundWe investigated the relationship of quantitative plaque features from coronary computed tomography (CT) angiography and coronary vascular dysfunction by impaired myocardial flow reserve (MFR) by (13)N-Ammonia positron emission tomography (PET).Methods and resultsFifty-one patients (32 men, 62.4±9.5 years) underwent combined rest-stress (13)N-ammonia PET and CT angiography scans by hybrid PET/CT. Regional MFR was measured from PET. From CT angiography, 153 arteries were evaluated by semiautomated software, computing arterial noncalcified plaque (NCP), low-density NCP (NCP&lt;30 HU), calcified and total plaque volumes, and corresponding plaque burden (plaque volumex100%/vessel volume), stenosis, remodeling index, contrast density difference (maximum difference in luminal attenuation per unit area in the lesion), and plaque length. Quantitative stenosis, plaque burden, and myocardial mass were combined by boosted ensemble machine-learning algorithm into a composite risk score to predict impaired MFR (MFR≤2.0) by PET in each artery. Nineteen patients had impaired regional MFR in at least 1 territory (41/153 vessels). Patients with impaired regional MFR had higher arterial NCP (32.4% versus 17.2%), low-density NCP (7% versus 4%), and total plaque burden (37% versus 19.3%, P&lt;0.02). In multivariable analysis with 10-fold cross-validation, NCP burden was the most significant predictor of impaired MFR (odds ratio, 1.35; P=0.021 for all). For prediction of impaired MFR with 10-fold cross-validation, receiver operating characteristics area under the curve for the composite score was 0.83 (95% confidence interval, 0.79-0.91) greater than for quantitative stenosis (0.66, 95% confidence interval, 0.57-0.76, P=0.005).ConclusionsCompared with stenosis, arterial NCP burden and a composite score combining quantitative stenosis and plaque burden from CT angiography significantly improves identification of downstream regional vascular dysfunction

Macroscopic appearance of spaces created by small surgical approach to debridement (SSAD).

<p>Representative images of cross sections at epicenter of control (A, B) and SSAD (C-F) specimens. Rats were subjected to both moderate (A, C, and E) and severe (B, D, and F) injuries, and cords were harvested at 1 h (A-D) and 24 h (E, F) after SSAD or control handling. In treated rats (C-F), the spaces created by SSAD appear filled with hydrogel. +, abundance of intramedullary hemorrhagic necrosis (IHN); *, petechial hemorrhaging and scarce IHN.</p

Relationship Between Quantitative Adverse Plaque Features From Coronary Computed Tomography Angiography and Downstream Impaired Myocardial Flow Reserve by 13

BACKGROUND: We investigated the relationship of quantitative plaque features from coronary CT Angiography (CTA) and coronary vascular dysfunction by impaired myocardial flow reserve (MFR) by (13)N-Ammonia Positron Emission Tomography (PET). METHODS AND RESULTS: Fifty-one patients (32 men, 62.4±9.5 years) underwent combined rest-stress (13)N-ammonia PET and CTA scans by hybrid PET/CT. Regional MFR was measured from PET. From CTA, 153 arteries were evaluated by semi-automated software, computing arterial non-calcified plaque (NCP), low-density NCP (NCP<30 HU), calcified and total plaque volumes, and corresponding plaque burden (plaque volumex100%/vessel volume), stenosis, remodeling index, contrast density difference (maximum difference in luminal attenuation per unit area in the lesion), and plaque length. Quantitative stenosis, plaque burden and myocardial mass were combined by boosted ensemble machine-learning algorithm into a composite risk score to predict impaired MFR (MFR≤2.0) by PET, in each artery. Nineteen patients (37%) had impaired regional MFR in at least one territory, (41/153 vessels). Patients with impaired regional MFR had higher arterial NCP (32.4 vs.17.2 %), low-density NCP (7 vs 4 %) and total plaque burden (37 vs 19.3 %, p<0.02). In multivariable analysis with 10-fold cross-validation, NCP burden was the most significant predictor of impaired MFR (Odds Ratio 1.35, p=0.021). For prediction of impaired MFR with 10-fold cross-validation, receiver-operating-characteristics-area-under-the-curve for the composite score was 0.83 (95%CI:0.79–0.91), greater than for quantitative stenosis (0.66, 95%CI:0.57–0.76, p = 0.005). CONCLUSIONS: Compared to stenosis, arterial NCP burden and a composite score combining quantitative stenosis and plaque burden from CTA significantly improves identification of downstream regional vascular dysfunction