Clinical Presentation and Outcomes of Myocarditis Among the COVID-19 Pediatric Population: A Review of 100 Cases.

BACKGROUND: COVID-19 has been associated with myocarditis in the pediatric population, leading to severe cardiac complications. OBJECTIVE: To determine the clinical presentations and outcomes of myocarditis among the COVID-19-positive pediatric population. MATERIALS AND METHODS: This retrospective cross-sectional study included 100 cases from the Saidu Group of Teaching Hospitals, Swat. Inclusion criteria involved children of both genders, confirmed COVID-19 by PCR, and a myocarditis diagnosis. Exclusion criteria were other comorbid conditions, incomplete records, and age over five years. Data included age, gender, weight, clinical features, cardiac enzyme levels, ejection fraction, PCR results, immunoglobulin treatment, outcomes, and hospital stay duration. Statistical analysis was performed in SPSS employing descriptive statistics, chi-square tests, and Fisher's exact tests. RESULTS: The mean age was 24.72±18.67 months, with 67 males and 33 females. Irritability was noted in 18 children, cyanosis in 27, and cough in 74. Tachycardia was observed in 91 children. Elevated cardiac enzymes and positive Troponin-I levels were found in 91 and 84 children, respectively. The mean ejection fraction was 36.29±9.12%. The average hospital stay was 7.11±2.49 days. Among 100 children, 26 died while 74 recovered. Immunoglobulin administration showed no significant difference between the expired and improved groups (p=0.6). Longer hospital stays were associated with mortality (p=0.002). Troponin-I levels were significantly higher in the expired group (p=0.01). CONCLUSION: Key factors associated with poor outcomes include low ejection fraction, elevated cardiac enzymes, positive Troponin-I levels, and shorter hospital stays.

Intercalation of C60 into MXene Multilayers: A Promising Approach for Enhancing the Electrochemical Properties of Electrode Materials for High-Performance Energy Storage Applications.

In this study, we report on the enhancement of the electrochemical properties of MXene by intercalating C60 nanoparticles between its layers. The aim was to increase the interlayer spacing of MXene, which has a direct effect on capacitance by allowing the electrolyte flow in the electrode. To achieve this, various concentrations of Ti3SiC2 (known as MXene) and C60 nanocomposites were prepared through a hydrothermal process under optimal conditions. The resulting composites were characterized by using X-ray diffraction, scanning electron microscopy, energy dispersive spectroscopy, Raman spectroscopy, and cyclic voltammetry. Electrodes were fabricated using different concentrations of MXene and C60 nanocomposites, and current-voltage (I-V) measurements were performed at various scan rates to analyze the capacitance of pseudo supercapacitors. The results showed the highest capacitance of 348 F g1- for the nanocomposite with a composition of 90% MXene and 10% C60. We introduce MXene-C60 composites as promising electrode materials for supercapacitors and highlight their unique properties. Our work provides a new approach to designing high-performance electrode materials for supercapacitors, which can have significant implications for the development of efficient energy storage systems.

Comparative life cycle assessment of sewage sludge treatment in Wuhan, China: Sustainability evaluation and potential implications.

Owing to the relentless growth of sewage sludge production, achieving low-carbon development in sewage sludge treatment and disposal (STD) is becoming increasingly challenging and unpredictable. However, the STD varied spatially, and city-specific analysis is deemed necessary for sustainable evaluation. Therefore, a lifecycle-based greenhouse gas (GHG), energy, and economic analysis were conducted by considering six local STD alternatives in Wuhan City, China, as a case study. The findings indicated anaerobic digestion combined with digestate utilization for urban greening (ADL) and incineration in existing power plants (INCP) exhibited the least GHG emissions at 34.073 kg CO2 eq/FU and 644.128 kg CO2 eq/FU, while INCP generated the most energy at -2594 kW.h/FU. The economic evaluation revealed that ADL and INCP were more beneficial without accounting for land acquisition. Scenario analysis showed that the energy recovery from ADL and INCP is significantly influenced by the hydrolysis yielding rate and sludge organic content. Perturbation sensitivity indicates that regional emission factor of electricity and electricity fee highly influence the overall GHG emission and cost. The results of this study could assist policymakers in identifying viable solutions to the cities experiencing the same sludge treatment burdens.

Net zero greenhouse emissions and energy recovery from food waste: manifestation from modelling a city-wide food waste management plan.

Food waste (FW) being a major solid waste component and of degradable nature is the most challenging to manage and mitigate greenhouse gas emissions (GHEs). Policymakers seek innovative approaches to achieve net zero objectives and recover resources from the FW which requires a comparative and holistic investigation of contemporary treatment methods. This study assessed the lifecycle of six alternative scenarios for reducing net GHEs and energy use potential from FW management in a metropolis, taking Hong Kong as a reference. In both impact categories, the business-as-usual (landfilling) was the worst-case scenario. The combined anaerobic digestion and composting (ADC) technique was ranked best in the global warming impact but was more energy intensive than anaerobic digestion with sludge landfilling (ADL). Incineration ranked second in net GHEs but less favourable for energy recovery from FW alone. The proposed integration of FW and biological wastewater treatment represented an enticing alternative. Integration by co-disposal and treatment with wastewater (CoDT-WW) performed above average in both categories, while anaerobic co-digestion with sewage sludge (AnCoD-SS) ranked fourth. The sensitivity analysis further identified critical parameters inherent to individual scenarios along with biogenic carbon emission and sequestration, revealing their significance on the magnitude of GHEs and scenarios' ranking. Capacity assessment of the studied treatment facilities showed a FW diversion potential of ∼60% while reducing the net GHEs by ∼70% compared to the base-case, indicating potential of net zero carbon emissions and energy footprint by increasing treatment capacity. From this study, policymakers can gain insights and guidelines for low-carbon urban infrastructure development worldwide.

Hyponatremia As A Marker Of Complicated Appendicitis.

Background: The most frequent cause of paediatric acute abdomen is acute appendicitis. If acute appendicitis is not treated promptly, one third of cases progress to complicated appendicitis. Complicated appendicitis is associated with significant morbidity and its management protocol differs significantly from that of uncomplicated appendicitis. In this study, we assessed the relationship between serum sodium levels and complicated appendicitis. Methods: We conducted a prospective observational study from July to December 2020 at the Department of Neonatal and Paediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, on a sample size of 140 patients who met inclusion and exclusion criteria. For this study, we divided the patients into two groups. Group 1 had uncomplicated appendicitis and Group 2 had complicated appendicitis. These findings were then compared to preoperative serum sodium (Na) levels. Results: The median serum sodium level in group 1 (uncomplicated appendicitis) was 137.81 mg/dl, while in group 2 it was 131.35 mg/dl (Complicated Appendicitis). The sensitivity and specificity of serum sodium levels at a cut-off point of less than 135 mg/dl were 84.80% and 89.40%, respectively. Conclusion: Hyponatremia is currently thought to be a new marker for differentiating between complicated and uncomplicated appendicitis. It is a low-cost, high efficiency predictive marker for diagnosing and differentiating complicated appendicitis in children.

Formation and crystallization of TiO2 nanostructures on various surfaces.

A comparative study of the synthesis of TiO2 nanorods on fluorine-doped tin oxide (FTO) glass, Si, SiO2, Si/Ta, Si/TiN, Si/TiN/Ti and Si/HFO2 substrates by hydrothermal reaction is presented. Detailed analysis on the growth of TiO2 on pre-annealed Si/TiN/Ti and HfO2 (HFO) surfaces is also given. For Si/TiN/Ti, a pre-annealing procedure led to the transformation of Ti to a TiO2 layer which acts as a seed for aligned growth of TiO2 nanorods. In contrast, Si/HFO does not provide a nucleation site for the formation of aligned nanorods. Various samples were prepared by varying the synthesis conditions, i.e. pre- and post-annealing temperatures and hydrothermal reaction time to figure out the optimum conditions which lead to unidirectional and highly aligned nanorods. X-ray diffraction, scanning electron microscopy, ultraviolet-visible spectroscopy and Raman spectroscopy were used to study structural, morphological and optical properties of synthesized samples. It is found that TiO2 nanorods exhibit a rutile phase on the Si/Ti/TiN and Si/HFO substrates, but highly oriented vertical growth of nanorods has been observed only on pre-annealed Si/TiN/Ti substrates. On the other hand, TiO2 nanorods form dandelion-like structures on Si/HFO substrates. Growth of vertically oriented TiO2 nanorods on Si/TiN/Ti is attributed to the TiO2 seed layer which forms after the process of pre-annealing of substrates at a suitable temperature. Variation in hydrothermal reaction time and post-annealing temperature brings further improvement in crystallinity and morphology of nanorods. This work shows that the pre-annealed Si/TiN/Ti substrate is the optimal choice to achieve vertically oriented, highly aligned TiO2 nanorods.

Sustainability analysis of implementing sludge reduction in overall sludge management process: Where do we stand?

Sustainable sludge management has significance due to the great potential of recovering energy and resources, potentially achieving carbon neutrality and energy positivity in the process. However, whether the sludge reduction strategy really benefits the aim of a sustainable sludge management process requires a holistic analysis. In this study, nine scenarios involving different sludge management strategies with or without sludge reduction methods were environmentally and economically assessed to clarify the necessity of adopting a sludge reduction or not. Results reveal that direct sludge incineration without prior in-plant sludge reduction generates the least environmental impacts (less than 25-120 %), but it increases operation costs by 103-110 % compared to landfilling with prior in-plant sludge reduction. Chemical Oxygen Demand flows indicate that direct sludge incineration is superior in converting organic matter into energy compared to employing sludge reduction followed by landfilling or land application. This converted energy offsets environmental impacts from electricity consumption, but these electricity benefits are insignificant in the overall cost. Case studies suggest that direct sludge incineration could facilitate potential nutrient and energy recovery, especially for metropolis. While sludge reduction strategies are more suited for developing regions relying on landfills or land application, to lower the economic burdens. The findings of this study tend to shed light on the decision-making of adopting sludge reduction strategies and sustainable sludge management.

Integrated treatment of food waste with wastewater and sewage sludge: Energy and carbon footprint analysis with economic implications.

Food waste (FW) is a primary constituent of solid waste and its adequate management is a global challenge. Instead of disposal in landfills, integrated treatment of FW with wastewater (WW) can diminish both environmental and economic burdens. Utilizing steady-state modelling and life cycle assessment techniques, this study investigated the prospects of FW integration with biological WW treatment in terms of WW treatment performance, net energy and carbon footprint and economics of the process. The explored scenarios include co-disposal and treatment with WW by using FW disposers and anaerobic co-digestion with sewage sludge in Hong Kong. Compared to the existing WW and FW treatment, the integrated scenarios significantly improved the energy balance (~83-126%), net greenhouse gas emissions (~90%), and economics of operation, with permissible impact on WW treatment performance. Therefore, utilizing the surplus capacity of the existing WW treatment facilities, these integrated scenarios are a promising solution for sustainable development.

"Food waste-wastewater-energy/resource" nexus: Integrating food waste management with wastewater treatment towards urban sustainability.

Sustainable food waste management is a global issue with high priority for improving food security and conserving natural resources and ecosystems. Diverting food waste from the solid waste stream to the wastewater stream is a promising way for food waste source separation, collection, treatment, and disposal. Given the advances in wastewater treatment, this integrated system has great potential for the concurrent recovery of water, resource, and energy. To this end, many efforts from lab-scale to full-scale studies have been devoted to evaluating the feasibility and associated impacts on both solid waste and wastewater systems. This paper summarizes the current status of food waste diversion from the aspects of principle and application. The impacts of food waste diversion on solid waste treatment, sewer system, wastewater treatment, and environmental benefits have been comprehensively reviewed and analysed. In the context of the critical review, this paper further identified the challenges of food waste diversion in unified definitions of the field, sewer network assessment, emerging wastewater treatment technologies, scale-up studies, and policy drivers. Perspectives on the contribution of food waste diversion to a food waste management hierarchy were discussed for initiating the nexus of "food waste-wastewater-energy/resource". We conclude that food waste diversion could facilitate sustainable urban development, but the area-specific factors (e.g., household practices, water resource, sewerage system condition, and treatment techniques) require adequate evaluations to determine the implementation. The outcomes of this study could contribute to the practice and policy-making of food waste management towards urban sustainability.

Predicting Space Radiation Single Ion Exposure in Rodents: A Machine Learning Approach.

This study presents a data-driven machine learning approach to predict individual Galactic Cosmic Radiation (GCR) ion exposure for 4He, 16O, 28Si, 48Ti, or 56Fe up to 150 mGy, based on Attentional Set-shifting (ATSET) experimental tests. The ATSET assay consists of a series of cognitive performance tasks on irradiated male Wistar rats. The GCR ion doses represent the expected cumulative radiation astronauts may receive during a Mars mission on an individual ion basis. The primary objective is to synthesize and assess predictive models on a per-subject level through Machine Learning (ML) classifiers. The raw cognitive performance data from individual rodent subjects are used as features to train the models and to explore the capabilities of three different ML techniques for elucidating a range of correlations between received radiation on rodents and their performance outcomes. The analysis employs scores of selected input features and different normalization approaches which yield varying degrees of model performance. The current study shows that support vector machine, Gaussian naive Bayes, and random forest models are capable of predicting individual ion exposure using ATSET scores where corresponding Matthews correlation coefficients and F1 scores reflect model performance exceeding random chance. The study suggests a decremental effect on cognitive performance in rodents due to ≤150 mGy of single ion exposure, inasmuch as the models can discriminate between 0 mGy and any exposure level in the performance score feature space. A number of observations about the utility and limitations in specific normalization routines and evaluation scores are examined as well as best practices for ML with imbalanced datasets observed.

Machine Learning Models to Predict Cognitive Impairment of Rodents Subjected to Space Radiation.

This research uses machine-learned computational analyses to predict the cognitive performance impairment of rats induced by irradiation. The experimental data in the analyses is from a rodent model exposed to ≤15 cGy of individual galactic cosmic radiation (GCR) ions: 4He, 16O, 28Si, 48Ti, or 56Fe, expected for a Lunar or Mars mission. This work investigates rats at a subject-based level and uses performance scores taken before irradiation to predict impairment in attentional set-shifting (ATSET) data post-irradiation. Here, the worst performing rats of the control group define the impairment thresholds based on population analyses via cumulative distribution functions, leading to the labeling of impairment for each subject. A significant finding is the exhibition of a dose-dependent increasing probability of impairment for 1 to 10 cGy of 28Si or 56Fe in the simple discrimination (SD) stage of the ATSET, and for 1 to 10 cGy of 56Fe in the compound discrimination (CD) stage. On a subject-based level, implementing machine learning (ML) classifiers such as the Gaussian naïve Bayes, support vector machine, and artificial neural networks identifies rats that have a higher tendency for impairment after GCR exposure. The algorithms employ the experimental prescreen performance scores as multidimensional input features to predict each rodent's susceptibility to cognitive impairment due to space radiation exposure. The receiver operating characteristic and the precision-recall curves of the ML models show a better prediction of impairment when 56Fe is the ion in question in both SD and CD stages. They, however, do not depict impairment due to 4He in SD and 28Si in CD, suggesting no dose-dependent impairment response in these cases. One key finding of our study is that prescreen performance scores can be used to predict the ATSET performance impairments. This result is significant to crewed space missions as it supports the potential of predicting an astronaut's impairment in a specific task before spaceflight through the implementation of appropriately trained ML tools. Future research can focus on constructing ML ensemble methods to integrate the findings from the methodologies implemented in this study for more robust predictions of cognitive decrements due to space radiation exposure.

Life cycle assessment of deploying sludge minimization with (sulfidogenic-)oxic-settling-anaerobic configurations in sewage-sludge management systems.

This study conducted life-cycle evaluation (on the greenhouse gas (GHG) emissions, energy consumption and economic performance) and sensitivity analysis in nine scenarios considering the deployment of conventional anoxic/oxic (AO) and/or sludge-minimizing (OSA, SOSA) bioprocess for sewage treatment linking with subsequent sludge handling. The analysis results demonstrated that compared with conventional AO-based scenarios, OSA- and SOSA-based scenarios reduced 23-28% GHG emissions (GHGs) and 18-24% cost, despite no significant electricity consumption reduction. The scenario analysis indicates renewable energy and improving energy consumption efficiency benefit the application of OSA and SOSA. The perturbation analysis revealed that the influential factors related to energy consumption were sensitive to GHGs, energy consumption and economic effects.

Anaerobic self-forming dynamic membrane bioreactors (AnSFDMBRs) for wastewater treatment - Recent advances, process optimization and perspectives.

Recently, anaerobic self-forming dynamic membrane bioreactors (AnSFDMBRs) have attracted increasing attention, and are considered as an alternative to conventional anaerobic membrane bioreactors (AnMBRs). The key advantages of AnSFDMBRs include high flux, low propensity towards fouling, and low capital and operational costs. Although there have been several reviews on AnMBRs, very few reviews on AnSFDMBR system. Previous AnSFDMBR studies have focused on lab-scale to investigate the long-term flux, methods to improve performance and the associated mechanisms. Microbial analysis showed that the phyla namely Proteobacteria, Bacteroidetes and Firmicutes are dominant in both bulk sludge and cake biofilm, but their abundance is low in biocake. This review critically examines the fundamentals of AnSFDMBRs, operational conditions, process optimization and applications. Moreover, the current knowledge gaps (e.g., dynamic membrane module optimization, membrane surface modification and functional microbes enrichment) that should be studied in future to design an efficient AnSFDMBR system for treatment of diverse wastewaters.

Integrated food waste management with wastewater treatment in Hong Kong: Transformation, energy balance and economic analysis.

Diversion of food waste (FW) away from the solid waste stream into the wastewater stream is proved viable through the use of food waste disposers (FWDs). However, this may cause unwanted influences on the wastewater treatment system. In this context, this study has comprehensively evaluated integrated food waste and wastewater management on a city scale for the first time. A plant-wide COD-based transformation model was first established to assess the impacts of the use of FWDs on the networks of biological wastewater treatment plants (WWTPs) in Hong Kong. The biological WWTPs can remove about 78% of solids and 58% of chemical oxygen demand (COD) in FW. Moreover, the diversion of FW poses limited impacts on treatment capacity and effluent quality in WWTPs with the FWDs penetration rate up to 30%. The increases in energy consumption and operational cost are highly dependent on the treatment processes and the FWDs penetration rates, while municipal solid waste treatment can benefit from the diversion of FW. This study suggests that upgrading treatment processes (e.g., with less aeration) and optimizing the operation of WWTPs (e.g., reduce sludge retention time) may be required with the use of FWDs to achieve an energy-efficient and cost-effective goal. More importantly, this study not only provides a methodology for effectively evaluating the impacts of diverting FW into wastewater treatment in Hong Kong but also facilitates FW management in similar metropolises.

Potential for co-disposal and treatment of food waste with sewage: A plant-wide steady-state model evaluation.

The water, food and energy nexus is a vital subject to achieve sustainable development goals worldwide. Wastewater (WW) and food waste (FW) from municipal sources are the primary contributors of organic waste from cities. Along with the loss of these valuable natural resources, their treatment systems also consume a considerable amount of abiotic energy and resource input and make a perceptible contribution to global warming. Hence, the global paradigm has evolved from simple pollution mitigation to resource recovery systems. In this study, the prospects of FW co-disposal into the sewer system and treatment with municipal sewage were quantitatively investigated for Hong Kong's largest biological WW treatment plant (WWTP) by integrated plant-wide steady-state modelling (PWSSM) and lifecycle assessment (LCA) approaches. The investigation assessed the impacts on the design and operational capacity of the WWTP, effluent quality, sludge output, and its net energy and carbon footprint. The results revealed that even at a higher than normal FW to sewage ratio, the WWTP's organic load capacity and performance in terms of organics and nitrogen removal was not significantly degraded, in fact the denitrification efficiency was improved by the FW organics with low N/C ratio. The net energy balance was improved by 80-400%, the net carbon footprint was lowered by 37-63% (without biogenic emissions), while the sludge production was increased by ∼33%. The results are very sensitive and improved with greater influent FW concentration and solids capture in the primary settling unit of the WWTP. The differences in the results have to be seen in relation to uncontrolled methane emission and a faster filling rate if the FW were disposed to landfill. The study provides valuable insights and policy guidelines for the decision makers locally and a generic methodological template.

Municipal solid waste: Review of best practices in application of life cycle assessment and sustainable management techniques.

Municipal solid waste (MSW) management is a globally recognized environmental issue. The concepts of sustainability and the circular economy have progressed MSW management system from basic disposal to recycling and resource recovery. Life cycle assessment (LCA) is the technique that has been widely used to analyse MSW management system. However, the reliability of results is deeply influenced by the methodology, quality of data, and robustness of the analyses. This raises two questions: how to improve the quality of LCA work, and how to select the appropriate MSW management strategy for practice? To answer these questions, we have conducted a critical review of 79 scientific studies from 36 low-to-high income countries. The review examines the scientific community's application of LCA to MSW management and identifies the best practices to follow for a good-quality study. Then after categorically assessing the results of the studies, a ranking of appropriate MSW management scenarios is made. Results reveal that the objective of an LCA study is subjective but a decisive factor that defines the procedure of subsequent steps. Differences are found among the practitioners, especially in study boundaries, selection of impact categories, choice of input data and analysis methods. Sensitivity analysis is critical for producing reliable results but was not performed in around 38% of the studies. Our analysis also reveals that the integration of recycling, treatment and disposal technologies is the most appropriate strategy. The choice of technologies and their performance, however, depends on the technological and socio-economic background of the studied region.

Relaxation dynamics and polydispersivity associated with defects and ferroelectric correlations in Ba-doped EuTiO3.

We present the frequency- and temperature-dependent dielectric response of Eu1-x Ba x TiO3 (0 ⩽ x ⩽ 0.5) in detail. Excluding grain boundary effects, four relaxation mechanisms were observed. Relaxation dynamics were observed to arise due to hopping conduction associated with defects, namely oxygen vacancies as well as Eu3+ and Ti3+ ions. Dielectric relaxation analysis led to the identification of Ti ions in two different environments with different relaxation rates in the overall EuTiO3 perovskite structure. The emergence of another relaxation mechanism associated with ferroelectric order as a consequence of the formation of polar regions was also observed for higher Ba concentrations. The addition of Ba led to the identification of relaxation dynamics associated with hopping conduction between Eu ions, Ti ions (in the regions with and without oxygen vacancies) and with the formation of ferroelectric polar regions. Furthermore, the polydispersivity and relaxation times were extracted within the framework of the modified Debye model. Relaxation times have been observed to increase with a decrease in temperature while larger values of polydispersivity reveal a wide distribution of relaxation times due to the presence of lattice parameter and energy barrier distributions.

Barcoding of fresh water fishes from Pakistan.

DNA bar-coding is a taxonomic method that uses small genetic markers in organisms' mitochondrial DNA (mt DNA) for identification of particular species. It uses sequence diversity in a 658-base pair fragment near the 5' end of the mitochondrial cytochrome c oxidase subunit 1 (CO1) gene as a tool for species identification. DNA barcoding is more accurate and reliable method as compared with the morphological identification. It is equally useful in juveniles as well as adult stages of fishes. The present study was conducted to identify three farm fish species of Pakistan (Cyprinus carpio, Cirrhinus mrigala, and Ctenopharyngodon idella) genetically. All of them belonged to family cyprinidae. CO1 gene was amplified. PCR products were sequenced and analyzed by bioinformatic software. Conspecific, congenric, and confamilial k2P nucleotide divergence was estimated. From these findings, it was concluded that the gene sequence, CO1, may serve as milestone for the identification of related species at molecular level.