Transoceanic pathogen transfer in the age of sail and steam.

In the centuries following Christopher Columbus's 1492 voyage to the Americas, transoceanic travel opened unprecedented pathways in global pathogen circulation. Yet no biological transfer is a single, discrete event. We use mathematical modeling to quantify historical risk of shipborne pathogen introduction, exploring the respective contributions of journey time, ship size, population susceptibility, transmission intensity, density dependence, and pathogen biology. We contextualize our results using port arrivals data from San Francisco, 1850 to 1852, and from a selection of historically significant voyages, 1492 to 1918. We offer numerical estimates of introduction risk across historically realistic ranges of journey time and ship population size, and show that both steam travel and shipping regimes that involved frequent, large-scale movement of people substantially increased risk of transoceanic pathogen circulation.

Efficacy of three EPA-registered antimicrobials and steam against two human norovirus surrogates on nylon carpets with two backing types.

Carpet cleaning guidelines currently do not include the use of an antimicrobial, except after a bodily fluid event. To address this gap, we compared the efficacy of three antimicrobials-two hydrogen peroxide-based (H2O2) products (A and B) and one chlorine-based product (C)-and a steam treatment against two norovirus surrogates, specifically feline calicivirus (FCV) and Tulane virus (TuV). These tests were performed on nylon carpets with either water-permeable or waterproof backing types. The effect of repeated antimicrobial use on carpet properties was also evaluated. For a carpet with water-permeable backing, products A, B, and C achieved a 0.8, 3.1, and 0.9 log10 PFU/coupon reduction of FCV and 0.3, 2.5, and 0.4 log10 TCID50/coupon reduction of TuV, respectively, following a 30 min contact time. For carpet with waterproof backing, only product B achieved a 5.0 log10 PFU/coupon reduction of FCV and >3.0 log10 TCID50/coupon reduction of TuV, whereas products A and C achieved a 2.4 and 1.6 log10 PFU/coupon reduction of FCV and a 1.2 and 1.2 log10 TCID50/coupon reduction of TuV, respectively. Steam treatment achieved a ≥ 5.2 log10 PFU/coupon reduction of FCV and a > 3.2 log10 TCID50/coupon reduction of TuV in 15 seconds on the carpet with both backing types. The repeated use of products A and B decreased the tensile strength of the carpet backing, while use of product B resulted in cracks on carpet fibers. Overall, steam treatment for 15 seconds was efficacious on both carpet types, but only product B achieved efficacy after a 30-minute exposure on the carpet with waterproof backing.IMPORTANCECarpets are common in long-term care facilities, despite its potential as a vehicle for transmission of agents associated with healthcare-associated infections, including human norovirus (NoV). Presently, our understanding of carpet disinfection is limited; hence, there are no commercial antimicrobials against norovirus available for use on carpets. Our findings showed that steam treatment, which minimally affected the properties of carpet fibers and backing, was more efficacious against human norovirus surrogates on carpets compared to the three chemical antimicrobials tested. Additionally, the two surrogates were more sensitive to chemical antimicrobials on the carpet with waterproof backing compared to carpets with water-permeable backing. These findings can inform development of antimicrobials for use on carpets contaminated with human norovirus.

Starch-based films affected by the addition of collagen from Prochilodus magdalenae residues and HPMC: Application in Andean blackberry (Rubus glaucus Benth) coatings.

Starch-based films offer the advantages of biodegradability, edibility, barrier properties, flexibility, and adaptability. This study compared the physicochemical properties of starch-based films by adding raw fish collagen and hydroxypropylmethylcellulose (HPMC). The tensile properties were evaluated, and the interaction with water was analyzed. Barrier properties, such as water vapor and oxygen permeability, were examined, and optical properties, such as gloss and good internal transmittance, were evaluated. The films were evaluated as coatings on Andean blackberries (Rubus glaucus Benth) for 2 weeks at 85% RH and 25°C. The results showed that the inclusion of collagen caused a reduction in the tensile strength and elastic modulus of the films. Also, the formulation with the highest collagen concentration (F7) exhibited the lowest weight loss and water vapor permeability, also it had the highest collagen concentration and showed the highest reduction in Xw and WAC, with values of 0.048 and 0.65 g water/g dry film, respectively. According to analyzing the optical properties, F1 presented the highest bright-ness and transmittance values, with 18GU and 82 nm values, respectively. In general, the films and coatings are alternatives to traditional packaging materials to prolong the shelf life of these fruits.

Persistence of two coronaviruses and efficacy of steam vapor disinfection on two types of carpet.

BACKGROUND: Coronaviruses, a group of highly transmissible and potentially pathogenic viruses, can be transmitted indirectly to humans via fomites. To date, no study has investigated their persistence on carpet fibers. Establishing persistence is essential before testing the efficacy of a disinfectant. METHODS: The persistence of BCoV and HCoV OC43 on polyethylene terephthalate (PET) and nylon carpet was first determined using infectivity and RT-qPCR assays. Then, the disinfectant efficacy of steam vapor was evaluated against both coronaviruses on nylon carpet. RESULTS: Immediately after inoculation of carpet coupons, 32.50% of BCoV and 3.87% of HCoV OC43 were recovered from PET carpet, compared to 34.86% of BCoV and 24.37% of HCoV OC43 recovered from nylon carpet. After incubation at room temperature for 1 h, BCoV and HCoV OC43 showed a 3.6 and > 2.8 log10 TCID50 reduction on PET carpet, and a 0.6 and 1.8 log10 TCID50 reduction on nylon carpet. Based on first-order decay kinetics, the whole gRNA of BCoV and HCoV OC43 were stable with k values of 1.19 and 0.67 h- 1 on PET carpet and 0.86 and 0.27 h- 1 on nylon carpet, respectively. A 15-s steam vapor treatment achieved a > 3.0 log10 TCID50 reduction of BCoV and > 3.2 log10 TCID50 reduction of HCoV OC43 on nylon carpet. CONCLUSION: BCoV was more resistant to desiccation on both carpet types than HCoV OC43. Both viruses lost infectivity quicker on PET carpet than on nylon carpet. Steam vapor inactivated both coronaviruses on nylon carpet within 15 s.

Mechanistic Insights into the Adsorption of Monoclonal Antibodies at the Water/Vapor Interface.

Monoclonal antibodies (mAbs) are active components of therapeutic formulations that interact with the water-vapor interface during manufacturing, storage, and administration. Surface adsorption has been demonstrated to mediate antibody aggregation, which leads to a loss of therapeutic efficacy. Controlling mAb adsorption at interfaces requires a deep understanding of the microscopic processes that lead to adsorption and identification of the protein regions that drive mAb surface activity. Here, we report all-atom molecular dynamics (MD) simulations of the adsorption behavior of a full IgG1-type antibody at the water/vapor interface. We demonstrate that small local changes in the protein structure play a crucial role in promoting adsorption. Also, interfacial adsorption triggers structural changes in the antibody, potentially contributing to the further enhancement of surface activity. Moreover, we identify key amino acid sequences that determine the adsorption of antibodies at the water-air interface and outline strategies to control the surface activity of these important therapeutic proteins.

Feasibility assessment of catheter-free water vapor thermal therapy for treatment of benign prostatic hyperplasia.

PURPOSE: To investigate safety and feasibility of performing water vapor thermal therapy (WVTT; Rezum, Boston Scientific, Marlborough, MA, USA) without postoperative catheterization among men with benign prostatic hyperplasia. METHODS: This is a prospective, single arm, unblinded pilot study of 20 consecutive male patients ages 40-80 who underwent WVTT at a single academic institution. All patients underwent 1 injection per lobe at the point of maximal obstruction based on visualization. Primary outcome was evaluation of voiding parameters, symptom scores, and need for catheterization at 3 day, 1, 3, and 6 month follow up compared to baseline visit 30 days prior to surgery. RESULTS: Mean age was 65 years (range 55-75). Mean prostate volume and PVR were 43 cc (range 30-68) and 89 cc, with 30% (n = 6) having median lobes. Patients received 2-3 treatments based on presence of bilobar versus trilobar hyperplasia. One patient (55 cc prostate, no median lobe) required catheterization for acute urinary retention on postoperative day 2. No patients required antibiotics for urinary tract infection or inpatient readmission within 30 days. Qmax significantly increased from 6 mL/s to 8, 13, 12, and 14 at 3 days, 1, 3, and 6 months (p < 0.05). IPSS decreased from 17 preoperatively to 10, 6, 7, and 8 (p < 0.05). No significant differences were noted in PVR, IIEF, MSHQ-EjD, or SF-12. CONCLUSIONS: In well-selected men, catheter-free WVTT is feasible and improved voiding parameters and symptom scores. No changes in sexual function, infectious complications, or readmission were noted. Only 1 patient (5%) required postoperative catheterization within 30 days.

Predictors of symptomatic relief in water vapor thermal therapy for prostatic hyperplasia: 36-month prospective study.

PURPOSE: Existing literature lacks an analysis of factors predicting the achievement of minimum clinically important differences (MCID) after water vapor thermal therapy (WVTT) for prostatic hyperplasia. This study aims to identify these predictors over a 36-month post-WVTT period. METHODS: This prospective single surgeon case series assessed male patients receiving WVTT. Eligibility criteria included being at least 45 years old, having an estimated prostate volume (EPV) of 30-80 cc, an International Prostate Symptom Score (IPSS) of 12 points or more, and a maximum urinary flow rate (Qmax) under 16 mL/sec. MCID, representing the smallest symptomatic improvement perceived by patients, was calculated using the distribution-based method, considering half a standard deviation of baseline IPSS scores. Correlation and linear regression analyses assessed MCID attainment. Multivariable logistic regression evaluated MCID achievement, considering multicollinearity, heteroskedasticity, and normality. RESULTS: Of 206 men with a median 29.1-month follow-up (Range: 24-36), 13.6% didn't achieve MCID for IPSS, and 7.2% for QoL scores. Significant hindrances to MCID attainment for IPSS were a large median lobe (> 10 mm protrusion) (OR = 3.01, 95% CI: 2.3-3.72), increased median lobe treatments (OR = 1.73, 95% CI: 1.23-2.35), and high preoperative irritative IPSS scores (OR = 1.25, 95% CI: 1.13-1.38). Factors for QoL MCID non-achievement included age over 75 (OR = 1.25, 95% CI: 1.13-1.38), a large median lobe (OR = 1.87, 95% CI: 1.62-2.01), and EPV over 60 cc (OR = 1.55, 95% CI: 1.16-1.97). A 6.3% surgical re-intervention rate was noted. CONCLUSIONS: The characteristics of the median lobe as well as the severity of lower urinary tract symptoms are crucial for treatment success. These should be integral to preoperative assessments and patient discussions on treatment options.

Is water vapor thermal therapy safe and feasible in elderly and frail men? The Italian experience.

PURPOSE: In recent years, water vapor thermal therapy (WVTT) has spread as minimally invasive technique in lower urinary tract symptoms due to benign prostatic hyperplasia treatment. Even if its safety and feasibility have been largely proved in young men, nobody has proved the same feasibility and safety in the elderly (men older than 75 years old). Our aim is to compare WVTT safety outcomes in men older than 75 with younger men. METHODS: We prospectively collected data on men who underwent water vapor thermal therapy from 2019. We compared data on operative time, number of injections, intra-operative and post-operative complications, reinterventions rate. RESULTS: We enrolled 426 patients; among these, 60 were older than 75 years old, 366 were younger. Our cohorts of patients had similar results in terms of intra-operative and post-operative complications. Operative time accounts about 11 min for both groups (p = 0.535), total number of injections was seven for young men and eight for elderly (p = 0.314). We found no intra-operative complications in elderly men group and only one in the younger group (p = 0.678), while five younger men underwent clot retention, and two elderly men experienced this complication (p = 0.239). Only one transfusion occurred in the elderly group. No differences between groups occurred in terms of length of stay, post-operative urinary retention and reintervention rate, while catheterization time was longer in the elderly men. CONCLUSION: WVTT is a safe procedure in elderly patients with comparable intra-operative and post-operative complication rate in comparison with younger patients.

Safety of ventricular arrhythmia radiofrequency ablation with half-normal saline irrigation.

AIMS: Failure of radiofrequency (RF) ablation of ventricular arrhythmias is often due to inadequate lesion size. Irrigated RF ablation with half-normal saline (HNS) has the potential to increase lesion size and reduce sodium delivery to the patient if the same volume of RF irrigant were used for normal saline (NS) and HNS but could increase risks related to steam pops and lesion size. This study aims to assess periprocedural complications and acute ablation outcome of ventricular arrhythmias ablation with HNS. METHODS AND RESULTS: Prospective assessment of outcomes was performed in 1024 endocardial and/or epicardial RF ablation procedures in 935 consecutive patients (median age 64 years, 71.2% men, 73.4% cardiomyopathy, 47.2% sustained ventricular tachycardia). Half-normal saline was selected at the discretion of the treating physician. Radiofrequency ablation power was generally titrated to a ≤15â€…Ω impedance fall with intracardiac echocardiography monitoring. Half-normal saline was used in 900 (87.9%) and NS in 124 (12.1%) procedures. Any adverse event within 30 days occurred in 13.0% of patients treated with HNS RF ablation including 4 (0.4%) strokes/transient ischaemic attacks and 34 (3.8%) pericardial effusions requiring treatment (mostly related to epicardial access). Two steam pops with perforation required surgical repair (0.2%). Patients who received NS irrigation had less severe disease and arrhythmias. In multivariable models, adverse events and acute success of the procedure were not related to the type of irrigation. CONCLUSION: Half-normal saline irrigation RF ablation with power guided by impedance fall and intracardiac echocardiography has an acceptable rate of complications and acute ablation success while administering half of the saline load expected for NS irrigation.

Efficient Catalytic Elimination of Chlorobenzene Based on the Water Vapor-Promoting Effect within Mn-Based Catalysts: Activity Enhancement and Polychlorinated Byproduct Inhibition.

Achieving no or low polychlorinated byproduct selectivity is essential for the chlorinated volatile organic compounds (CVOCs) degradation, and the positive roles of water vapor may contribute to this goal. Herein, the oxidation behaviors of chlorobenzene over typical Mn-based catalysts (MnO2 and acid-modified MnO2) under dry and humid conditions were fully explored. The results showed that the presence of water vapor significantly facilitates the deep mineralization of chlorobenzene and restrains the formation of Cl2 and dichlorobenzene. This remarkable water vapor-promoting effect was conferred by the MnO2 substrate, which could suitably synergize with the postconstructed acidic sites, leading to good activity, stability, and desirable product distribution of acid-modified MnO2 catalysts under humid conditions. A series of experiments including isotope-traced (D2O and H218O) CB-TPO provided complete insights into the direct involvement of water molecules in chlorobenzene oxidation reaction and attributed the root cause of the water vapor-promoting effect to the proton-rich environment and highly reactive water-source oxygen species rather than to the commonly assumed cleaning effect or hydrogen proton transfer processes (generation of active OOH). This work demonstrates the application potential of Mn-based catalysts in CVOCs elimination under practical application conditions (containing water vapor) and provides the guidance for the development of superior industrial catalysts.

Water Vapor Condensation Triggers Simultaneous Oxidation and Hydrolysis of Organic Pollutants on Iron Mineral Surfaces.

Increasing worldwide contamination with organic chemical compounds is a paramount environmental challenge facing humanity. Once they enter nature, pollutants undergo transformative processes that critically shape their environmental impacts and associated risks. This research unveils previously overlooked yet widespread pathways for the transformations of organic pollutants triggered by water vapor condensation, leading to spontaneous oxidation and hydrolysis of organic pollutants. These transformations exhibit variability through either sequential or parallel hydrolysis and oxidation, contingent upon the functional groups within the organic pollutants. For instance, acetylsalicylic acid on the goethite surface underwent sequential hydrolysis and oxidation that first hydrolyzed to salicylic acid followed by hydroxylation oxidation of the benzene moiety driven by the hydroxyl radical (•OH). In contrast, chloramphenicol underwent parallel oxidation and hydrolysis, forming hydroxylated chloramphenicol and 2-amino-1-(4-nitrophenyl)-1,3-propanediol, respectively. The spontaneous oxidation and hydrolysis occurred consistently on three naturally abundant iron minerals with the key factors being •OH production capacity and surface binding strength. Given the widespread presence of iron minerals on Earth's surface, these spontaneous transformation paths could play a role in the fate and risks of organic pollutants of health concerns.

Prefeasibility analysis of biomass gasification and electrolysis for hydrogen production.

Hydrogen is a key energy vector to accomplishing energy transition and decarbonization goals proposed in the transport and industrial sectors worldwide. In recent years, research has focused on analyzing, designing, and optimizing hydrogen production, searching to improve economic prefeasibility with minimal emissions of polluting gases. Therefore, the techno-economic analysis of hydrogen production by electrolytic and gasification processes becomes relevant since these processes could compete commercially with industrial technologies such as SMR - Steam methane reforming. This work aims to analyze hydrogen production in stand-alone processes and energy-driven biorefineries. The gasification and electrolysis technologies were evaluated experimentally, and the yields obtained were input data for scaling up the processes through simulation tools. Biomass gasification is more cost-effective than electrolytic schemes since the hydrogen production costs were 4.57 USD/kg and 8.30 USD/kg at an annual production rate of 491.6 tons and 38.96 tons, respectively. Instead, the electrolysis process feasibility is strongly influenced by the recycled water rate and the electricity cost. A sensitivity analysis was performed to evaluate the temperature, pressure, and current density variability on the hydrogen production rate. The increase in pressure and current density induces parasitic currents while the temperature increases hydrogen production. Although higher hydrogen production rates from gasification, the syngas composition decreases the possibility of being implemented in applications where purity is critical.

Holistic biorefinery approach for biogas and hydrogen production: Integration of anaerobic digestion with hydrothermal carbonization and steam gasification.

Recently, the integration of biochemical and thermochemical processes is recognized as a promising strategy for the valorization of lignocellulosic biomass into renewable energy production. In this study, different routes for the valorization of hemp hurd for biohydrogen and biomethane production were proposed, including anaerobic digestion (AD), hydrothermal carbonization, and steam gasification. AD results revealed that NaOH pre-treatment of hemp hurd improved biomethane production yield by 164%. Comparing hydrochars from raw hemp, digestate derived hydrochars had higher mass yield due to changes in composition during AD as well as high ash content of digestates. It was found that high ash content of digestates originated from inorganic compounds in inoculum that accumulated over hemp hurd during anaerobic digestion process. Among feedstocks (hydrochars and raw hemp hurd), hemp hurd derived hydrochar at 200 °C showed the best performance in terms of H2 yield (1278 mL/g) whereas carbon efficiency reached % 92 in case of digestate derived hydrochar at 200 °C. HTC improved the steam gasification performance of hemp hurd whereas hydrochars from NaOH pretreated digestate yielded lowest hydrogen production due to the high content of inorganics, particularly phosphorus (P) and aluminum (Al). According to BMP test, spent liquor obtained at the lowest HTC temperature (200 °C) exhibited the highest BMP, reaching 213 mL CH4/g COD. Considering the overall gas products of four different routes, it is concluded that HTC as a post-treatment exhibits slightly better performance than HTC as pre-treatment. Although alkali pretreatment enhanced the anaerobic digestion performance, the resulting hydrochars exhibited low gasification activity.

Upcycling crab shell waste into biochar for treatment of palm oil mill effluent via microwave pyrolysis and activation.

The escalating consumer demand for crabs results in a growing amount of waste, including shells, claws, and other non-edible parts. The resulting crab shell waste (CSW) is disposed of via incineration or landfills which causes environmental pollution. CSW represents a potential biological resource that can be transformed into valuable resources via pyrolysis technique. In this study, microwave pyrolysis of CSW using self-purging, vacuum, and steam activation techniques was examined to determine the biochar production yield and its performance in treating palm oil mill effluent (POME). The biochar produced through microwave pyrolysis exhibits yields ranging from 50 to 61 wt%, showing a hard texture, low volatile matter content (≤34.1 wt%), and high fixed carbon content (≥58.3 wt%). The KOH-activated biochar demonstrated a surface area of up to 177 m2/g that is predominantly composed of mesopores, providing a good amount of adsorption sites for use as adsorbent. The biochar activated with steam removed 8.3 mg/g of BOD and 42 mg/g of COD from POME. The results demonstrate that microwave pyrolysis of CSW is a promising technology to produce high-quality biochar as an adsorbent for POME treatment.

Analysis of Wet Pack Incidence in Steam Sterilization: A Study in a Chinese Medical Center.

BACKGROUND Central sterile supply departments (CSSDs) play a vital role in hospital infection control. We investigate the factors associated with wet pack occurrence after steam sterilization. MATERIAL AND METHODS We designed a log sheet to record information concerning sterilized packs. The data included the type of sterilized pack; outside weather (sunny, overcast, or rainy); the item in the sterilized pack; packaging material; whether the item had been packaged in compliance with guidelines; whether the pack had been laid flat, upright, or leaning at an acute angle; which sterilizer was used for sterilization of the pack; whether the pack had been placed on the top or bottom shelf inside the sterilizer chamber; whether the pack had been loaded in compliance with guidelines; the drying time following sterilization; and cooling time after sterilization. The sterilized packs in our study were selected from all of the packs that were sterilized in the CSSD of the authors' institution during June to December 2021. RESULTS Factors associated with wet pack occurrence after steam sterilization include: outside weather on the day of sterilization; the item in the sterilized pack; packaging material; whether the item had been packaged in compliance with guidelines; whether the pack had been placed on the top or bottom shelf; and cooling time after sterilization. Statistically significant differences (P<0.05) in wet pack incidence were identified for all of these factors. CONCLUSIONS Various factors are associated with wet pack occurrence after steam sterilization. Recommendations for reducing the risk of wet packs include regular maintenance of the steam pipeline, regular replacement of thermal insulation materials for the steam pipeline, and extension of the drying time.

The Impact of Repeated Steam Sterilization Cycles on the Efficacy of Chairside Adjustment Kits for Polishing Monolithic Multi-Layered Zirconia Dental Restoration Material.

BACKGROUND Before insertion, chairside adjustment kits are heat sterilized for positioning and polishing dental restorations. This study aimed to evaluate the effects of 2 steam sterilization cycles on the efficacy of polishing highly translucent monolithic zirconia (HTMLZ) dental restoration material. MATERIAL AND METHODS 100 HTMLZ disc-shaped specimens were adjusted (grinding, finishing, polishing) with EVE Diacera kit. Two steam sterilization techniques [standard (Gp S), immediate/flash (Gp (F)] of CAK were further subgrouped based on number of sterilization cycles [cycle 1 (control), cycle 5, 10, 15, and 20 (experimental)] (n=10 each). Each subgroup accordingly was evaluated for average surface roughness (Ra) and root mean square roughness (Rq) using a profilometer. Mean and standard deviation of 5 subgroups were statistically analyzed using one-way ANOVA/post hoc Tukey's test. Scanning electron microscopy complemented Ra, Rq measurements. Statistical differences of P≤0.05 were considered significant. RESULTS HTMLZ specimens in both groups showed increased (Ra/Rq) values after repeated sterilization of EVE Diacera kit, with Gp F showing lesser increase than Gp S (20 cycles). Gp F at 10 cycles and Gp S at 15 cycles showed clinically unacceptable roughness threshold (0.25 µm). Differences between subgroups for Ra and Rq values were significant (P≤0.05) with less differences within groups observed in early cycles (1, 10). Results validate the manufacturer's recommendations of using flash sterilization/10 cycles for EVE Diacera kit. CONCLUSIONS Repeated sterilization reduces efficacy of chairside adjustment kit to produce smooth surfaces on HTMLZ. This study recommends flash sterilization to a maximum of 10 times to get the clinically acceptable results of Ra and Rq.

Safety and performance of the Clearum™ high flux hemodialyzer.

BACKGROUND: Clearum™ is a high flux steam sterilized dialyzer for patients with hemodialysis or hemodiafiltration. This study evaluated the safety and performance of the Clearum high flux steam sterilized hemodialyzer in the removal of small and middle-sized toxins. METHODS: A prospective, interventional, nonrandomized study enrolled twenty end-stage renal disease patients undergoing hemodialysis. The Clearum high flux steam sterilized dialyzer was compared to Fresenius FX dialyzers for baseline comparison. The duration of the trial was 2 weeks for the FX dialyzer and 6 weeks with the Clearum high flux steam sterilized dialyzer. In vitro studies with dextrans of varying sizes were performed to compare the membrane characteristics and sieving coefficient curves for the two dialyzers. RESULTS: The primary objective of a mean urea reduction ratio >65% was met, with no significant difference in mean urea reduction ratio between the Clearum high flux steam sterilized and Fresenius FX-series of dialyzers (p = 0.86). No dialyzer-related adverse events were reported in the study. ß-2-microglobulin reduction with the Clearum high flux steam sterilized dialyzer was statistically higher than the FX-series dialyzer (66.5% vs. 53.6%; p < 0.0001). Predialysis interleukin-6 and C-reactive protein concentrations, blood-rest scores (residual blood after blood restitution), and thrombin-anti-thrombin values were comparable. Albumin remained stable during the 6 weeks of Clearum high flux steam sterilized dialyzer use, with no appreciable differences compared to the Fresenius FX-series. CONCLUSION: The Clearum high flux steam sterilized dialyzer showed good mid-term effectivity for small and middle molecule removal with no reported dialyzer-related adverse events.

Network pharmacology analysis of the renal protective effects of bracken (Pteridium aquilinum) using experimental data obtained in an avian (quail) hyperuricemia model.

OBJECTIVE: To investigate the nephroprotective potential of orally administered bracken Pteridium aquilinum extract against renal damage in quails, induced by a high-purine diet, to form a foundation for subsequent clinical studies and applications. MATERIALS AND METHODS: A mass spectrometry analysis was conducted on the pteridophyte subjected to steam explosion. Network pharmacological methods were then utilized to pinpoint shared targets and pathways, which suggested that Pteridium aquilinum has a capability to counteract renal injury. A total of 48 specific-pathogen-free (SPF) "Difaku" quails were selected and segregated into six distinct groups. The control group received a standard diet, whereas the other groups were fed a high-purine diet. Beginning on day 14, each group was subjected to designated therapeutic measures. The study continued for 40 days, after which relevant biological markers were assessed. RESULTS: Active compound peaks from the steam-exploded Pteridium aquilinum were isolated. Subsequently, 101 targets and several pathways associated with renoprotective effects were discerned, indicating that the Pteridium aquilinum achieves its nephroprotective function through comprehensive regulatory mechanisms. The high-purine diet successfully induced hyperuricemia in the quails, resulting in renal impairment. Following intervention with varied Pteridium aquilinum dosages, renal protective outcomes were evident, though xanthine oxidase activity remained unaffected. Histological analyses demonstrated a notable decrease in renal lesion dimensions post-intervention. CONCLUSION: The steam-exploded bracken Pteridium aquilinum may provide nephroprotective benefits against hyperuricemia-induced renal damage in quails through comprehensive regulatory processes. This highlights the Pteridium aquilinum's potential as an innovative nephroprotective therapeutic and dietary solution, presenting a promising avenue for hyperuricemia and renal damage treatment and prevention.

A Potential Therapeutic Approach According to Traditional Thai Medicine Theory for Post-COVID-19 Syndrome Treatment: An Observational Retrospective Clinical Study.

Background: Most post-COVID-19 patients had physiological health problems, which differed for each patient. The potential treatment for post-COVID-19 syndrome must require multi-disciplinary approaches that focus on individualized treatment. Therefore, traditional Thai Medicine (TTM) clinical practice guidelines for post-COVID-19 treatment are developed by the Traditional Thai Medicine Hospital, Prince of Songkla University, to care for post-COVID-19 patients. Objective: This current study aimed to investigate the effect of the guidelines on post-COVID-19 patient's physical health. Methods: This research was a retrospective clinical study, carried out from June 2022 to July 2022. Setting: The study was conducted at the Traditional Thai Medicine Hospital, Prince of Songkla University, and La Flora Khao Lak TTM clinic, Thailand. Participants: Data (n=17) were collected from the medical record. They were included if they met the following criteria: patients were more than 18 years old, had a medical history of COVID-19 disease, had fully recovered from the disease (ATK for COVID-19 is negative) at least a week before starting the guideline, and had complete medical information such as post-COVID-19 symptoms, vital signs, pain score, cough severity score, and quality of life examination. Intervention: Approaches for post-COVID-19 treatment included herbal Thai medicine recipes, Thai massage, herbal steam inhalation, herbal hot steam, herbal hot water immersion, acupressure massage for breathing stimulation, and a breathing exercise. All procedures were applied for 7 days continually or until they have recovered. Primary Outcome Measures: The effects of TTM approaches on the symptoms of post-COVID-19 patients on pain score, quality of life, cough severity were measured using a visual analog score (VAS), SF-36 questionnaire, and cough severity index (CSI), respectively. Results: The average duration time of post-COVID-19 syndrome was 25.76 days, and the most common symptom was muscle pain/stress (10; 71.43%). Yahom-Navakot (6; 42.86%) is the most common recipe used for the treatment. Interestingly, the pain score was significantly reduced by 3 days of the treatment (4.88±2.03 vs 2.29±2.08 ). Moreover, the cough severity index (12.86±11.55 vs 3.31±6.38) was significantly lessened by 7 days of the treatment. Remarkably, most symptoms vanished entirely after 7 days of the intervention, leading to a better quality of life for the patients (53.24±22.15 vs 65.59±23.64). Conclusions: The TTM clinical practice guideline for treating post-COVID-19 syndrome effectively improved the overall physical health capacity and symptoms associated with post-COVID-19 syndrome. Therefore, the implementation of this guideline, together with other approaches, could strengthen the treatment for post-COVID-19 to be more effective.