Reliable Sea Water Ro Operation with High Water Recovery and No-Chlorine/No-Sbs Dosing in Arabian Gulf, Saudi Arabia

For providing advanced desalination the combination of the improvement of water recovery ratio in the reverse osmosis (RO) process and the No-Chlorine/No-Sodium Bisulfite (SBS) Dosing process was studied. In order to prevent membrane fouling even in high recovery water operations, an advanced two-stage design was implemented to (1) control the permeate flux through the RO membrane module, (2) optimize the system to reduce contaminant build-up and (3) eliminate the use of chlorine and SBS, which can accelerate membrane fouling. The system was evaluated by monitoring the biofouling and the microorganisms proliferation on the membrane surface based on membrane biofilm formation rate (mBFR). The pilot plant was operated in the condition of a water recovery rate of 55%. As a result, the system was operated for longer than four months without membrane cleaning (clean in place; CIP) and the possibility of operation for seven months without CIP was confirmed by the extrapolation of the pressure values. In addition, the mBFR is a reliable tool for water quality assessment, based on a comparison between the fouling tendency estimated from the mBFR and the actual membrane surface condition from autopsy study and the effectiveness No-Chlorine/No-SBS Dosing process was verified from mBFR of pretreated seawater

Low TSH requirement and goiter in transgenic mice overexpressing IGF-I and IGF-Ir receptor in the thyroid gland.

Through the cAMP signaling pathway, TSH stimulates thyroid follicular cell proliferation, differentiation, and function. Although the autocrine production of IGF-I in the thyroid gland suggests an important physiological function for this factor in these processes, the exact role of the IGF-I/IGF-I receptor system in vivo remains unclear. Although the mitogenic action of TSH requires the presence of IGF-I or insulin in primary culture of dog and human thyroid cells, IGF-I has an effect equal to and independent of the effect of TSH on cell proliferation in rat thyroid cell lines and may even be the main growth regulator in this case. To investigate the in vivo function of the IGF-I/IGF-I receptor system, transgenic mice overexpressing human IGF-I, IGF-I receptor, or both in the thyroid were generated. Adult transgenic mice did not present external signs of thyroid dysfunction, but mice overexpressing both transgenes had significantly increased gland weight and follicular lumen area. A decreased TSH level together with a slightly increased serum T(4) concentration and increased thyroidal iodine uptake were also observed, suggesting that IGF-I and IGF-I receptor stimulate thyroid function to some extent in vivo.Journal ArticleResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.info:eu-repo/semantics/publishe

Switching Tenofovir/Emtricitabine plus Lopinavir/r to Raltegravir plus Darunavir/r in Patients with Suppressed Viral Load Did Not Result in Improvement of Renal Function but Could Sustain Viral Suppression: A Randomized Multicenter Trial

<div><p>Background</p><p>Whether tenofovir nephrotoxicity is reversible after its withdrawal is unknown. Furthermore, there are no data on the viral efficacy of raltegravir (RAL) plus ritonavir-boosted Darunavir (DRV/r) in patients with suppressed viral load.</p> <p>Methods</p><p>This multicenter, randomized trial compared renal function and viral efficacy in patients with suppressed viral load treated with RAL+DRV/r and ritonavir-boosted lopinavir (LPV/r) plus tenofovir/emtricitabine (TVD), who had been previously on LPV/r+TVD. The primary endpoint was the proportion of patients with >10% improvement in estimated glomerular filtration rate (eGFR) at 48 weeks calculated with Cockcroft-Gault equation.</p> <p>Results</p><p>58 randomized and treatment-exposed patients were analyzed (28 on RAL+DRV/r and 30 on LPV/r+TVD). Greater than 10% improvement in eGFR was noted in 6 (25%) out of 24 with RAL+DRV/r and 3 (11%) of 28 with LPV/r+TVD, and the difference was not statistically significant (p=0.272, 95% CI -0.067 to 0.354). Sensitivity analyses using three other equations for eGFR showed the same results. Urinary β2 microglobulin, a sensitive marker of tenofovir tubulopathy, significantly improved with RAL+DRV/r than with LPV/r+TVD (-271 versus -64 µg/gCr, p=0.026). Per protocol analysis showed that the HIV-RNA was <50 copies/mL at week 48 in all patients of both arms (24 in RAL+DRV and 29 in LPV/r+TVD).</p> <p>Conclusions</p><p>Switching LPV/r+TVD to RAL+DRV/r did not significantly increase the proportion of patients who showed >10% improvement in renal function among those with relatively preserved eGFR. However, the switch improved urinary β2 microglobulin, suggesting that discontinuation of TDF might be beneficial in the long-term. RAL+DRV/r showed favorable viral efficacy in patients with suppressed viral load.</p> <p>Trial Registration</p><p><a href="http://clinicaltrials.gov" target="_blank">ClinicalTrials.gov</a> NCT01294761 <a href="http://clinicaltrials.gov/ct2/show/nct01294761?term=spare&rank=2" target="_blank"><u>http://clinicaltrials.gov/ct2/show/NCT01294761?term=SPARE&rank=2</u></a>, Umin Clinical Trials Registry UMIN000005116 <a href="http://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=r000006083&language=j" target="_blank"><u>http://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000006083&language=J</u></a>)</p> </div

Median changes in markers of renal tubular function between baseline and 48 weeks.

<p>(A) Urinary β2 microglobulin, (B) Urinary albumin, (C) Percent tubular resorption of phosphate, (D) Urinary N-acetyl-β-D-glucosaminidase. RAL, raltegravir; DRV/r, ritonavir-boosted darunavir; LPV/r, ritonavir-boosted lopinavir; TVD, fixed dose of tenofovir/emtricitabine.</p

Proportion of patients with HIV RNA <50 copies/ml at 24 and 48 weeks.

<p>(A) Per protocol analysis. (B) Intention-to-treat analysis. VL, viral load; RAL, raltegravir; DRV/r, ritonavir-boosted darunavir; LPV/r, ritonavir-boosted lopinavir; TVD, fixed dose of tenofovir/emtricitabine.</p