A critical influence of HIF-1 on MMP-9 and Galectin-3 in oral lichen planus.

OBJECTIVE: Oral lichen planus carries a risk for malignancy. The pathogenesis of the disease is mediated by various inflammatory mediators. Several mediators could be responsible for the oncogenic behavior in certain cases. Hypoxia-inducible factor-1a (HIF-1), and its possible correlation to Galactin-3 (Gal-3) and matrix metalloproteinase-9 (MMP-9) over expression represents an important indicator for malignant transformation. The investigation of these factors may present evidence-based information on malignant transformation of the disease. SUBJECTS AND METHODS: The study investigated the expression of HIF-1, Gla-3 and MMP-9 in tissue samples of OLP compared to control subjects of un-inflamed gingival overgrowth. 20 biospecimen were allocated in each group. RESULTS: Immunohistochemical findings of OLP showed immunoreactivity for Galectin 3, HIF1a and MMP-9 by most of the epithelial cells. There was a positive correlation between HIF1α and MMP-9, r = 0.9301 (P-value < 0.00001). A positive correlation was detected between Galectin 3 and MMP-9, r = 0.7292 (P-value = 0.000264) between Galectin 3 and HIF1α, r = 0.5893 (P-value = 0.006252). CONCLUSION: These findings confirm the hypothesis that the adaptive pathways to hypoxia as Gal 3 and MMP-9 expressions and their HIF-1 may play a crucial role in carcinogenesis of OLP.

The efficacy of diode laser and subgingival air polishing with erythritol in treatment of periodontitis (clinical and microbiological study).

BACKGROUND: There is insufficient clinical and microbiological evidence to support the use of diode laser and air-polishing with erythritol as supplements to scaling and root planning(SRP). The aim of the current study is to evaluate the clinical and microbiologic efficacy of erythritol subgingival air polishing and diode laser in treatment of periodontitis. METHODS: The study encompassed twenty-four individuals seeking periodontal therapy and diagnosed with stage I and stage II periodontitis. Eight patients simply underwent SRP. Eight more patients had SRP followed by erythritol subgingival air polishing, and eight patients had SRP followed by diode laser application. At baseline and six weeks, clinical periodontal parameters were measured, including Plaque Index (PI), Gingival Index (GI), periodontal Probing Depth (PPD), and Clinical Attachment Level (CAL). The bacterial count of Aggregatibacter actinomycetemcomitans(A.A), Porphyromonas gingivalis (P.G) was evaluated at different points of time. RESULTS: The microbiological assessment revealed significant differences in the count of A.A. between the laser and erythritol groups immediately after treatment, indicating a potential impact on microbial levels. However, the microbial levels showed fluctuations over the subsequent weeks, without statistically significant differences. Plaque indices significantly decreased post-treatment in all groups, with no significant inter-group differences. Gingival indices decreased, and the laser group showed lower values than erythritol and control groups. PPD and CAL decreased significantly across all groups, with the laser group exhibiting the lowest values. CONCLUSION: The supplementary use of diode laser and erythritol air polishing, alongside SRP, represents an expedited periodontal treatment modality. This approach leads to a reduction in bacteria and improvement in periodontal health. TRIAL REGISTRATION: This clinical trial was registered on Clinical Trials.gov (Registration ID: NCT06209554) and released on 08/01/2024.

Assessing the conversion of electronic medical record data into antibiotic stewardship indicators.

BACKGROUND: Measuring the appropriateness of antibiotic use is crucial for antibiotic stewardship (ABS) programmes to identify targets for interventions. OBJECTIVES: To assess the technical feasibility of converting electronic medical record (EMR) data into ABS indicators. METHODS: In this observational feasibility study covering a period of 2 years, the EMRs of patients hospitalized at a large non-university hospital network and receiving at least one dose of a systemic antibiotic were included. ABS indicators measuring steps in the process of antibiotic prescription proposed by the literature were collected and rephrased or defined more specifically to be calculable if needed. Algorithms were programmed in R to convert EMR data into ABS indicators. The indicators were visualized in an interactive dashboard and the plausibility of each output value was assessed. RESULTS: In total, data from 25 337 hospitalizations from 20 723 individual patients were analysed and visualized in an interactive dashboard. Algorithms could be programmed to compute 89% (25/28) of all pre-selected indicators assessing treatment decisions automatically out of EMR data, with good data quality for 46% (13/28) of these indicators. According to the data quality observed, the most important issues were (i) missing or meaningless information on indication (e.g. 'mild infection') and (ii) data processing issues such as insufficiently categorized metadata. CONCLUSIONS: The calculation of indicators assessing treatment decisions from EMRs was feasible. However, better data structure and processing within EMR systems are crucial for improving the validity of the results.

Nanoparticles as a novel and promising antiviral platform in veterinary medicine.

Traditional veterinary virus vaccines, such as inactivated and live-attenuated vaccines, have achieved tremendous success in controlling many viral diseases of livestock and chickens worldwide. However, many recent viral outbreaks caused by different emerging and re-emerging viruses continue to be reported annually worldwide. It is therefore necessary to develop new control regimens. Nanoparticle research has received considerable attention in the last two decades as a promising platform with significant success in veterinary medicine, replacing traditional viral vector vaccines. However, the field of nanoparticle applications is still in its initial phase of growth. Here, we discuss various preparation methods, characteristics, physical properties, antiviral effects, and pharmacokinetics of well-developed nanoparticles and the potential of nanoparticles or nano-vaccines as a promising antiviral platform for veterinary medicine.

Assessment of Cyanex 301 impregnated resin for its potential use to remove cobalt from aqueous solutions.

The feasibility of using Cyanex 301 impregnated onto biopolymer resin for removing cobalt from radioactive waste streams is investigated. The emulsion compositions for resin preparation were optimized to ensure compliance with nuclear grade resin specifications on particle size distribution and chemical stabilities using multi-variant analysis. The enhanced chemical stabilities of the resins in different solutions are attributed to the interaction between Cyanex 301 and the emulsifier with alginate via a reaction with the glycosidic bond. The structure and morphology of the three optimized samples were studied using FTIR, SEM, and TGA and their end-of-life cycle treatment was preliminarily investigated. Equilibrium sorption investigations revealed that the sorption is taking place via bi-layers onto two sites on the surface layer independently from the cobalt contamination level and the nature of these sites were characterized by determining the energy barriers and fraction of the weak and strong sites. Cobalt adsorption is chemical spontaneous endothermic reaction and the loaded material spectroscopic analysis and thermodynamics calculations referred to chemical coordination and hydrogen bonding. The enhanced radiological stabilities of the optimum resins at irradiation fields <100 KGy were explained and the relations between the loss of exchange capacity and the doses were quantified. The resins could be regenerated using 0.5 M HCl and the effect of the elution cycles on cobalt uptake was presented.

Validation of a Fluorescence Sensor Microtiterplate for Biogenic Amines in Meat and Cheese.

An optical sensor microtiterplate for quantitative analysis of the total content of biogenic amines (TAC) in meat and cheese was developed and validated for the first time. In the plate, a chameleon dye (Py-1) is embedded in a polymeric cocktail which is deposited on the bottom of the wells in a common microtiterplate. On reaction with biogenic amines (BAs), the fluorescence of Py-1 at 620 nm rapidly delivers a precise TAC. After 10 min incubation at 25 °C the determination of the TAC in various (real) samples is possible in high-throughput with a standard microplate reader. The optimized fluorescence method was validated for linearity, sensitivity, accuracy, precision (intraday and inter day repeatability) and recovery using histamine (HIS) as a representative BA. The sensor microtiterplate was successfully applied to quantitatively analyze the TAC in 10 real samples of cheese and meat obtained from various Egyptian markets. The TAC of these real samples obtained by the sensor microtiterplate was validated against the contents of BAs obtained by GC-MS at various times of storage. The data of the sensor microtiterplate agreed well with those of GC-MS. This demonstrates that the sensor microtiterplate is a reliable screening tool for the degradation status of food samples.

Epidemiology of bloodstream infections caused by extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae in Switzerland, 2015-2022: secular trends and association with the COVID-19 pandemic.

BACKGROUND: The association between the COVID-19 pandemic and the incidence of invasive infections caused by multidrug-resistant organisms remains a topic of debate. AIM: To analyse the national incidence rates of bloodstream infections (BSI) caused by Escherichia coli (EC) and Klebsiella pneumoniae (KP) with extended-spectrum cephalosporin resistance (ESCR) in two distinct regions in Switzerland, each exhibiting varying antimicrobial resistance patterns and that were impacted differently by the pandemic. METHODS: Data was analysed from positive blood cultures prospectively collected by the nationwide surveillance system (ANRESIS) from January 1st, 2015, to August 31st, 2022. To explore the potential relationship between COVID-19 patient occupancy and ESCR incidence rates, an in-depth analysis was conducted over the two-year pandemic period from April 1st, 2020, to March 30th, 2022, using Quasi-Poisson and logistic regression analyses. FINDINGS: During the study period, 40,997 EC-BSI and 8537 KP-BSI episodes were collected and reported to ANRESIS by the participating hospitals. ESCR was observed in 11% (N = 4313) of E. coli and 8% (N = 664) of K. pneumoniae, respectively. A significant reduction in ESCR-EC BSI incidence occurred during the pandemic in the region with the highest COVID-19 incidence. Conversely, ESCR-KP BSI incidence initially fell considerably and then increased during the pandemic in both regions, though this effect was not statistically significant. No association between hospital occupancy from COVID-19 patients and these trends was observed. CONCLUSION: In the early phase of the COVID-19 pandemic, a decrease in ESCR rates was observed, particularly in ESCR-EC BSI within the most heavily impacted region.

Luminescent and time-resolved determination of gemifloxacin mesylate in pharmaceutical formulations and spiked blood plasma samples using a lanthanide complex as a probe.

A novel luminescence-based analytical methodology was established employing a europium(III) complex with 3-allyl-2-hydroxybenzohydrazide (HAZ) as the coordinating ligand for the quantification of gemifloxacin mesylate (GMF) in pharmaceutical preparations and human plasma samples spiked with the compound. The stoichiometry of the europium complex with HAZ was determined via the Job plot and exhibited a metal-to-ligand ratio of 1 : 2. The analytical procedure relies on a rapid and significant enhancement of luminescence by the Eu(AZ)2 complex when it interacts with gemifloxacin mesylate, which allowed for the rapid detection of 96 samples within approximately 2 minutes. The thermodynamic parameters of the complexation of GMF with Eu(AZ)2 were evaluated and showed that the complexation of GMF was spontaneous with a negative ΔG. The binding constant K was 4.27 × 105 L mol-1 and DFT calculations supported GMF binding and the formation of Eu(AZ)2-GMF without further ligand exchange. The calibration graph for the luminescence quantitation of GMF was linear over a wide concentration range of 0.11-16 µg mL-1 (2.26 × 10-7 to 3.30 × 10-5 mol L-1), with a limit of quantification (LOQ) of 110 ng mL-1 (230 nmol L-1) and a detection limit (LOD) of 40 ng mL-1 (82 nmol L-1). The proposed method showed good accuracy with an average recovery of 99% with relative standard deviations of less than 5% in spiking experiments, even in complex pharmaceutical dosage forms such as tablets and in human blood plasma. Herein, the ability of the suppression of the luminescence background by using the long lag times of the lanthanide probe in a time-resolved detection scheme provided reliable and precise results, which suggests its potential for use in further real or patient samples.

Uncovering an effecient binary system as a chemosensor for visual and fluorescence detection of chromium (VI) in water samples.

There is an urgent requirement for the development of sensitive and quick sensors to monitor chromium (VI) due to its substantial carcinogenic and mutagenic properties. A coexisting system of coumarin 334 and diphenylcarbazide (C334/DPC) was used in this study as a fluorescent chemosensor to detect Cr(VI) ions. Upon the addition of Cr(VI), a purple chelate complex (Cr(III)-diphenylcarbazone) was produced, which resulted from the quantitative reaction between Cr(VI) ions and diphenylcarbazide (DPC), whereas no interaction between Cr(VI) and coumarin 334 took place. More interestingly, the absorption spectra of purple (Cr(III)-diphenylcarbazone) complex (λmax = 540 nm) were overlapped with emission and excitation spectra of coumarin 334 (λex/em = 453/492), resulting in the efficient quenching of coumarin 334 (C334) via the inner filter effect. Furthermore, the semi-quantitative estimation of Cr(VI) ion concentration may be achieved by visually watching the progressive color transformation of the probe from yellow to red after the addition different concentration of Cr(VI). The calibration plot for determination of Cr(VI) by this method is ranging from 0.048 to 268 µM. DFT calculations were conducted to enrich our understanding about the mechanism of action. This approach demonstrates an excellent selectivity and sensitivity for Cr(VI) including a detection limit of 48 nM. The new sensor was successfully applied to water samples (tap, mineral, and waste waters). The accuracy was confirmed by the atomic absorption spectroscopy.

Impact of peritoneal carcinomatosis in the disease history of colorectal cancer management: a longitudinal experience of 2406 patients over two decades.

BACKGROUND: Recent therapeutic developments demand for an update of information on natural history, risk factors and prognosis of peritoneal carcinomatosis (PC) of colorectal origin. Therefore, prospective registry data should provide information about incidence, predictors and outcome. METHODS: From a prospectively expanded single-institutional database with 2406 consecutive patients with colorectal cancer (CRC), clinical, histological and survival data were analysed for independent risk factors and prognosis. Findings were then stratified to the era of treatment without chemotherapy, 5-Fluorouracil-only and contemporary systemic chemotherapy, respectively. RESULTS: Overall, 256 (10.6%) patients were diagnosed with PC thereof 141 (5.85%) with metachronous PC. Independent risk factors for the development of metachronous PC were age <62 years, N2-status, T4-status, location of the primary in the left colon or appendix. In the era of contemporary systemic chemotherapy, prognosis for PC improved only not-significantly (median survival of 17.9 months vs 7.03 months, P=0.054). CONCLUSION: Despite improvement in the overall outcome with prolonged median survival for the complete patient cohort with CRC, those patients with PC have not experienced the same benefit. In the era of contemporary systemic chemotherapy, progress in treatment resulted in only limited survival benefit. Thus, continuous efforts for further therapeutic advancements should be undertaken in these patients diagnosed with PC.

Development of an optical sensor for the determination of phenolic compounds in environmental samples.

A new optical sensor was developed for the rapid sensing of total phenolic content, which is simple, cheap, and sensitive, using the Eu(III)-(NTA)2-(Phen) complex [NTA = 1-(2-naphthoyl)-3,3,3-trifluoroacetone and Phen = 1,10 phenanthroline] as a luminescent probe at pH 7.5 using PIPES buffer. This method was based on luminescence quenching. The type of quenching during the reaction between the Eu(III)-(NTA)2-(Phen) complex and the phenolic compounds is dynamic quenching; the binding site is close to 1, and the reaction is endothermic, spontaneous, and involves hydrophobic attraction forces. The calibration curves were plotted using a sigmoidal fit giving an LOD of 0.01 µg mL-1, and the correlation coefficients are more than 0.99. For the first time, the time-resolved fluorescence technique was utilized in microtiter plates to enable the determination of 96 samples within two minutes with high sensitivity and selectivity. The proposed method was applied to three industrial wastewater samples and compared with the standard method for phenolic content determination, yielding high recoveries. This is the first luminescence method based on lanthanide complexes as probes for determining the total phenolic content in water samples.

Sensitive ratiometric sensor for Al(III) detection in water samples using luminescence or eye-vision.

A facile, quick, and sensitive ratiometric luminescence sensor is designed for detection aluminum ions in water samples using luminescence or eye-vision. This approach relies on the emission change of the europium(III) complex with 3-(2-naphthoyl)-1,1,1,-trifluoro acetone (3-NTA) after interaction with various concentration of aluminum ions. The addition of aluminum ions suppressed the Eu(III) emission at 615 nm under 333 nm excitation, while simultaneously enhancing the ligand emission at 480 nm. Optimum detection was obtained in methanol. The quantification of aluminum ions using ratiometric method was determined by plotting the luminescence ratio (F480nm/F615nm) versus aluminum ions concentration. The calibration plot was obtained within the range 0.1-100 µM with LOD = 0.27 µM. Additionally, the concentration of aluminum ions can be estimated semi-quantitatively by visually observing the luminescence colour change of the probe from red to light green and then to dark green after being excited by a UV lamp with 365 nm. As far as we are aware, this is the first luminescent lanthanide complex-based ratiometric probe for the detection of aluminum ions. The probe showed remarkable aluminum ions selectivity relative to that of other metal ions. The suggested sensor was used effectively to identify aluminum ions in water samples with good results.

Investigation of thymine as a potential cancer biomarker employing tryptophan with nanomaterials as a biosensor.

Tryptophan and tryptophan-based nanomaterials sensors in a solution have been developed to directly evaluate thymine. The determination of thymine has been done via quenching of the fluorescence of tryptophan and tryptophan-based nanomaterials such as graphene (Gr), graphene oxide (GO), gold nanoparticles (AuNPs), gold-silver nanocomposite (Au-Ag NC) in a physiological buffer. As the concentration of thymine rises, the fluorescence of tryptophan and tryptophan/nanomaterials becomes less intense. Trp, Trp/Gr, and tryptophan/(Au-Ag) NC systems' quenching mechanisms were dynamic, but tryptophan /GO and tryptophan/AuNPs' quenching mechanisms were static. The linear dynamic range for the determination of thy by tryptophan and tryptophan /nanomaterials is 10 to 200 µM. The detection limits for tryptophan, tryptophan /Gr, tryptophan /GO, tryptophan /AuNPs, and tryptophan/Au-Ag NC were 3.21, 14.20, 6.35, 4.67and 7.79 Μm, respectively. Thermodynamic parameters for the interaction of the Probes with Thy include the enthalpy (H°) and entropy (S°) change values, were assessed, as well as the binding constant (Ka) of Thy with Trp and Trp-based nanomaterials. A recovery study was conducted utilizing a human serum sample after the addition of the required quantity of the investigational thymine.

The Influence of Low-Level Laser Therapy on CBCT Radiographic and Biochemical Profiles of Type II Controlled Diabetic Patients After Dental Implant Insertion: A Randomized Case-Control Study.

Background Low-level laser treatment (LLLT) was thought to increase bone quality during osseointegration when combined with dental implants. However, there is no sufficient information on its impact on dental implants in diabetics. Osteoprotegerin (OPG) has been described as a marker for bone turnover to determine implant prognosis. The current research aims to evaluate the effect of low-level laser therapy (LLLT) on bone density (BD) and osteoprotegerin levels in peri-implant crevicular fluid (PICF) in type II diabetic patients. Methods This study comprised 40 individuals with type II diabetes mellitus (T2DM). Implants were randomly placed in 20 non-lasered T2DM patients (control) and 20 lasered T2DM patients (LLLT group). At the follow-up stages, BD and OPG levels in the PICF were evaluated in both groups. Results Significant variations were shown among control and LLLT groups concerning OPG level and BD (p≤0.001). OPG was significantly decreasing with follow-up points (p≤0.001). There was a significant decrease in OPG with time in both groups with a higher decrease in the control group. Conclusion LLLT is promising in controlled T2DM patients due to its outstanding influence on BD and estimated crevicular levels of OPG. Regarding its clinical significance, LLLT significantly improved bone quality during osseointegration on dental implants in T2DM. LLLT is considered potentially important for T2DM patients during implant placement. Trial registration The study was registered on ClinicalTrial.gov under registration number NCT05279911 (registration date: March 15, 2022) (https://clinicaltrials.gov/ct2/show/NCT05279911).

Use of Melatonin/Decorticotomy and Autogenous Bone Graft in Induced 1-Wall Defect.

PURPOSE: This study was designed to investigate the effect of intramarrow penetration (IMP) and 1% melatonin (MLN) gel on the remodelling process of autogenous bone graft (ABG) in an induced 1-osseous wall defect model. METHODS: Sixty-four intrabony induced mandibular defects were created on the distal side of premolars-P1, P2, P3, and P4 (on each side)-in 8 beagle dogs. A ligature-induced periodontitis was initiated in each defect. Defects were then divided into 4 equal groups. Group I was treated with open-flap debridement (OFD) alone, group II was treated with OFD/ABG, group III was treated with OFD/IMP/ABG, and group IV was treated with OFD/ABG/IMP/1% MLN gel. The study parameters were bone fill, histologic analysis, and immunohistochemical evaluation of endothelial nitric oxide synthase (eNOS) expression at 2-week (2W) and 8-week (8W) time intervals. RESULTS: At 8W, significant differences were revealed amongst all groups regarding the amount of bone fill and eNOS expressions (P < .001). Bone fill percentages were 55.5%, 22.3%, 16.8%, and 0% in groups IV, III, II, and I, respectively. eNOS expressions were 1.68 ± 0.06, 8.43 ± 0.04, 16.80 ± 0.17, and 1.97 ± 0.07 in groups IV, III, II, and I, respectively. The favourable results were in line with group IV. CONCLUSIONS: According to these preliminary results, defects treated by ABG augmented with IMP and 1% MLN gel revealed a greater amount of bone fill and reduced eNOS expression. This combination is therefore highly suggested as an adjunct to ABG.

Resistance to the mTOR-inhibitor RAD001 elevates integrin α2- and ß1-triggered motility, migration and invasion of prostate cancer cells.

BACKGROUND: Inhibitors of the mammalian target of rapamycin (mTOR) might become a novel tool to treat advanced prostate cancer. However, chronic drug exposure may trigger resistance, limiting the utility of mTOR inhibitors. METHODS: Metastatic potential of PC3 prostate cancer cells, susceptible (PC3(par)) or resistant (PC3(res)) to the mTOR-inhibitor RAD001 was investigated. Adhesion to vascular endothelium or immobilised collagen, fibronectin and laminin was quantified. Motility, migration and invasion were explored by modified Boyden chamber assay. Integrin α and ß subtypes were analysed by flow cytometry, western blotting and real-time PCR. Integrin-related signalling, EGFr, Akt, p70S6kinase and ERK1/2 activation were determined. RESULTS: Adhesion was reduced, whereas motility, migration and invasion were enhanced in PC3(res). The α2 and ß1 integrin subtypes were dramatically elevated, integrins α1 and α6 were lowered, whereas α5 was nearly lost in PC3(res). Activation of the Akt signalling pathway was strongly upregulated in these cells. Treating PC3(par) cells with RAD001 reduced motility, migration and invasion and deactivated Akt signalling. Blocking studies revealed that α2 and ß1 integrins significantly trigger the motile behaviour of the tumour cells. CONCLUSION: Chronic RAD001 treatment caused resistance development characterised by distinct modification of the integrin-expression profile, driving prostate cancer cells towards high motility.

Plant-available and water-soluble phosphorus in soils amended with separated manure solids.

Physical, chemical, or biological treatment of animal liquid manure generally produces a dry-matter rich fraction (DMF) that contains most of the initial phosphorus (P). Our objective was to assess the solubility and plant availability of P from various DMFs as a function of soil P status. Eight different DMFs were obtained from liquid swine (LSM) and dairy cattle (LDC) manures treated by natural decantation, anaerobic digestion, chemical flocculation, composting, or mechanical separation. The DMFs were compared with mineral P fertilizer in a pot experiment with oat ( L.) grown in four soils with varied P-fixing capacities and P saturation levels. The DMFs were added at a rate of 50 mg P kg soil and incubated 14 d before seeding. Soil water-extractable P (P) at all water:soil extraction ratios (2:1, 20:1, and 200:1) was slightly higher when DMFs were derived from LDC rather than LSM. Soil P at the 2:1 ratio was lower with anaerobically digested LSM. At the 2:1 extraction ratio, DMF P was less soluble than mineral P as P saturation in soils increased. In soils with a lower P-fixing capacity, DMF P appeared less water soluble than mineral P under 20:1 and 200:1 extraction ratios. After 72 d of plant growth, DMFs produced yields comparable to mineral P fertilizer. Although the plant availability of P from DMFs was comparable to mineral P fertilizer, P from DMFs could be less vulnerable to leaching or runoff losses in soils with a high P saturation level or low P-fixing capacity.

Temporal and structural patterns of extended-spectrum cephalosporin-resistant Klebsiella pneumoniae incidence in Swiss hospitals.

BACKGROUND: Routine surveillance data revealed increasing rates of invasive extended-spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCR-KP) in Switzerland, from 1.3% in 2004 to 8.5% in 2019. AIM: The main aim of this study was to understand the causes of this recent trend, specifically to identify predictors affecting the incidence of invasive ESCR-KP infections in Switzerland. METHODS: A retrospective observational multi-centre study was conducted in 21 Swiss hospitals over a period of 11 years (2009-2019). Potential predictor variables for the incidence of invasive ESCR-KP infections were studied with a multiple linear regression model. In an additional analysis, the overall ESCR-KP incidence (all sample sites) was investigated. FINDINGS: An increasing incidence of invasive ESCR-KP infections from 0.01 to 0.04 patients per 1000 bed-days was observed between 2009 and 2019 and confirmed by multiple linear regression analysis (P < 0.01). ESCR-KP incidence was higher in university hospitals (P < 0.01) and in the French-speaking region than in the German-speaking region (P < 0.01). There was no association with antibiotic consumption. Analysing the overall ESCR-KP incidence (all sample sites) revealed high variability between university hospitals, mainly due to a high proportion of patients with screening isolates at Geneva University Hospital (50% of patients with ESCR-KP). CONCLUSION: The incidence of invasive ESCR-KP infections increased in Switzerland between 2009 and 2019 and was not associated with antibiotic consumption. Our findings indicate that, in this low-incidence setting, structural factors such as the hospital type and the linguistic region play a more important role in relation to ESCR-KP incidence than the hospital's antibiotic consumption.

Alkali treatment-acid leaching of rare earth elements from phosphogypsum fertilizer: insight for additional resource of valuable components.

Phosphogypsum (PG) is the main by-product of phosphoric acid, which is produced by the sulfuric acid attack of phosphate rocks, wet process. This by-product, which contains around 2.0% phosphoric acid, is used as a low-cost soil fertilizer, PGF. PGF consists mainly of gypsum (CaSO4·2H2O), P2O5, SiO2, and other impurities, including a minor amount of rare earth elements, REEs. In general, phosphate rocks contain from about 0.04 to 1.0% REE, which are precipitated with PG. Now, REEs are considered as strategic elements. Therefore, PG is now regarded as a secondary source of REE. This paper address a process for the separation of REEs and sodium sulphate as a product from PGF. This paper is based on the metathesis of the bulk of PGF with sodium carbonate to obtain calcium carbonate precipitated contain REEs. Furthermore, sodium sulphate was obtained as a product. Calcium carbonate containing REEs was leached out by citric acid as a green acid or nitric acid. At optimum conditions, maximum leaching of REEs from CaCO3 after one cycle of leaching by 3.0 mol/L nitric acid at L/S = 3/1, agitation time of 180.0 min., and at a temperature of 25 °C is 75.1%, 361.10 mg/kg from the total REEs present in PGF. While, the maximum leaching of 87.4%, 420.2 mg/kg of REEs from CaCO3 after one cycle of leaching by 1.0 mol/L citric acid, L/S = 5/1, agitation time of 15.0 min., and 85 °C. The REEs that were obtained in the leaching citrate solutions were purified by solvent extraction using 10% of di-2-ethyl hexyl phosphoric acid, HDEHP, in kerosene. The extracted REEs were stripped by 0.5 mol/L H2SO4. The stripped solutions were further treated with 10.0% oxalic acid to precipitate the REEs. The developed procedure can recover REEs from PGF with an efficiency of 85.2% and a purity of 97.7%.