Comparative study on electro-regeneration of antibiotic-laden activated carbons in reverse osmosis concentrate.

Electro-regeneration is emerging as a new technique to regenerate spent carbon adsorbents through an electrochemical process. In this study, sequential adsorption and electro-regeneration of ciprofloxacin (CIP)-laden carbon were investigated using both pristine and iron (Fe)-doped F400 activated carbon in distilled, deionized (DI) water and reverse osmosis (RO) concentrate water. The impact of reactor flow rate and sequential adsorption/electro-regeneration cycles on the regeneration efficiency were also evaluated. The results indicate that the breakthrough points for both adsorbents in DI water, where 100 % of the CIP molecules were adsorbed, occurred at around 7,800 bed volumes (BVs). Conversely, electro-regeneration for both adsorbents, where 94 % of the CIP molecules were desorbed, took place at 380 BVs. The main distinction between the two activated carbons lies in the initial range of BVs (<400 BVs).Fe doping on F400 appears to enhance its surface selectivity for CIP uptake, which can easily diffuse into the meso/macropore regions of Fe-doped F400. In contrast, pristine F400, being highly microporous, necessitated more contact time to fill its high-energy sites, resulting in a higher affinity for CIP adsorption. Over the four sequential adsorption/electro-regeneration cycles in DI water, a similar regeneration efficiency was observed at 190 BVs. As the flow rate increased from 2 to 6 mL/min, the CIP uptake on pristine F400 decreased in DI water, calculating 138, 74 and 57 mg/g for flow rates of 2, 4, and 6 mL/min, respectively. When the RO concentrate water was compared with DI water, the pristine F400 quickly reached saturation due to pore blockage caused by organic matter in RO concentrate. During electro-regeneration, up to 100 % of adsorbed CIP molecules were desorbed at around 120 BVs in RO concentrate, which is 3X faster than DI water. The effectiveness of this technology can be enhanced by implementing continuous flow systems, thereby improving the overall efficiency of CIP removal in RO concentrate.

Correction to: Risk stratification of pediatric high-grade glioma: a newly proposed prognostic score.

The original version of this article unfortunately contained an error. The author apologizes for having provided an incorrect name: "Mohamed S. Zaghluol" should be "Mohamed S. Zaghloul". Given in this article is the correct author name.

Risk stratification of pediatric high-grade glioma: a newly proposed prognostic score.

OBJECTIVES: High-grade glioma (HGG) is a clinical challenge. Radiation Therapy Oncology Group Recursive Partitioning Analysis (RTOG-RPA) for HGG remains the standard for assessing the prognosis of adult HGG. This study assesses the validity of the RTOG-RPA to be applied to pediatric HGG. METHODS: A retrospective study was conducted on 59 pediatric HGG treated in the Children's Cancer Hospital, Egypt (CCHE) between 2007 and 2016. Several factors were studied as predictors for the disease survival, including age, gender, increased intracranial hypertension, tumor characteristics and pathology, CSF seeding, performance status, post-surgical residual, and radiation dose. The statistically significant results were integrated into a Cox-regression model to develop a prognostic risk score. RESULTS: Kaplan-Meier statistics identified 13 factors that impacted the overall survival. However, Cox model showed that the histological grade IV [HR 14.2, 95%CI; (3.5-57), P < 0.0001], thalamic infiltration [HR 8.7; 95%CI; (2.9-25.9), P < 0.0001], PS ≥ 60 [HR 0.317; 95%CI; (0.13-0.776); P = 0.012], and maximum tumor dimension > 3.3 cm [HR 10.2; 95%CI; (1.58-65.89); P = 0.015] were the independent variables that predicted the overall survival. A risk score was proposed based on the presence of one or more of these factors. The median OS for the low risk (score 0-1), the intermediate-low risk (score 2), the intermediate-high risk (score 3), and the high risk (score 4) were 40, 18.5, 9.5, and 2.5 months, respectively, (P < 0.0001). CONCLUSION: The proposed model and risk score could stratify pediatric patients as the RTOG-RPA do for the adults.

External beam radiation therapy with or without low-dose-rate brachytherapy: Analysis of favorable and unfavorable intermediate-risk prostate cancer patients.

PURPOSE: To compare the tumor control and toxicity in men with intermediate-risk prostate cancer treated with either external beam radiation therapy (EBRT) or EBRT plus low-dose-rate brachytherapy (combo-RT). METHODS AND MATERIALS: Between 1995 and 2012, 579 men with intermediate-risk prostate cancer were treated with either EBRT (n = 388) or combo-RT (n = 191). Outcomes assessed included biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and cumulative incidence of genitourinary (GU) and gastrointestinal toxicity. Favorable and unfavorable intermediate-risk subgroups were analyzed. RESULTS: Median followup was 7.5 years. Combo-RT group had improved 10-year bRFS compared with EBRT (91.7% vs. 75.4%, p = 0.014). On multivariable analysis, combo-RT (hazard ratio, 0.48; 95% confidence interval: 0.25, 0.92; p = 0.03) was associated with improved bRFS. Combo-RT had significantly improved bRFS compared with EBRT in the unfavorable subgroup (p = 0.02) but not in the favorable subgroup (p = 0.37). DMFS was similar within the entire cohort and by risk group. Combo-RT was associated with an increased rate in the 6-year cumulative incidence of Grade 3 GU toxicity (hazard ratio, 3.48; 95% confidence interval: 1.1, 11.1; p = 0.026); however, 57% of Grade 3 GU toxicity was resolved, 29% had partial improvement, and only 1 patient had persistent Grade 3 GU toxicity. CONCLUSIONS: In intermediate-risk prostate cancer, combo-RT improved bRFS but not DMFS and increased Grade 3 GU toxicity. The bRFS benefit was limited to unfavorable intermediate-risk patients.