Megacity solid waste disposal suitability mapping in Dhaka, Bangladesh: an integrated approach using remote sensing, GIS and statistics.

Selecting suitable Megacity Solid Waste Disposal (MSWD) sites is a challenging task in densely populated deltas of developing countries, exacerbated by limited public awareness about waste management. One of the major environmental concerns in Dhaka City, the world's densest megacity, is the presence of dumps close to surface water bodies resources. This study employed the Geographic Information System (GIS)-Analytic Hierarchy Process (AHP) framework to integrate geomorphological (slope and flow accumulation), geological (lithological and lineament), hydrogeological (depth to groundwater table and surface waterbody), socioeconomic (Land use land cover, distance to settlement, road, and airport), and climatological (wind direction) determinants, coupled by land-use and hydro-environmental analyses, to map optimal dumps (MSWDO) sites. The resulting preliminary (MSWDP) map revealed 15 potential landfill areas, covering approximately 5237 hectares (ha). Combining statistical analysis of restricted areas (settlements, water bodies, land use) with AHP-based ratings, the MSWDO map revealed two optimal locations (2285 ha). Additionally, the hydro-environmental analysis confirmed the unsuitability of northern sites due to shallow groundwater (< 5.43 m) and thin clay, leaving 11 options excluded. Sites 12 (Zone A, 2255 ha) and 15 (Zone B, 30 ha), with deeper groundwater tables and thicker clay layers, emerged as optimal choices for minimizing environmental risks and ensuring effective long-term waste disposal. This study successfully integrates remote sensing, geospatial data, and GIS-AHP modeling to facilitate the development of sustainable landfill strategies in similar South Asian delta megacities. Such an approach provides valuable insights for policymakers to implement cost-effective and sustainable waste management plans, potentially minimizing the environmental risks to achieve Sustainable Development Goals (SDGs) 6, 11, 13, and 15.

Efficacy of intensive cervical traction on depression, insomnia, and quality of life in patients with cervical radiculopathy.

BACKGROUND: Radiculopathy can cause pain and numbness along a pinched nerve. OBJECTIVE: To investigate how people with cervical radiculopathy respond to intense cervical traction in terms of depression, sleeplessness, and quality of life (QoL). METHODS: Two equal groups of forty male patients with unilateral cervical radiculopathy were randomly assigned. In addition to transcutaneous electrical nerve stimulation (TENS) and other treatments, twenty individuals in group I received mechanical cervical traction. Group II consisted of twenty individuals who received only TENS treatment. Before and after treatment, every participant completed the Arabic versions of the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and Short-Form 36 Health Survey (SF-36). RESULTS: While there was no significant difference in group II, there was a significant decline in group I visual analog scale (P = 0.001), depression subscale of the hospital anxiety and depression score (P = 0.001), and ISI (P = 0.001). Eight domains of SF-36 showed a significant increase in group I. These domains included physical functioning (P = 0.001), role limitations due to physical health (P = 0.001), role limitations due to emotional problems (P = 0.001), and energy (P = 0.001). In group II, there was a non-significant increase nevertheless. CONCLUSION: Cervical traction improved individuals' QoL, depression, and insomnia, suggesting the effectiveness of it with TENS for cervical radiculopathy patients.

Getting the Dose Right in Drug Development for Rare Diseases: Barriers and Enablers.

In the relentless pursuit of optimizing drug development, the intricate process of determining the ideal dosage unfolds. This involves "dose-finding" studies, crucial for providing insights into subsequent registration trials. However, the challenges intensify when tackling rare diseases. The complexity arises from poorly understood pathophysiologies, scarcity of appropriate animal models, and limited natural history understanding. The inherent heterogeneity, coupled with challenges in defining clinical end points, poses substantial challenges, hindering the utility of available data. The small affected population, low disease awareness, and restricted healthcare access compound the difficulty in conducting dose-finding studies. This white paper delves into critical dose selection aspects, focusing on key therapeutic areas, such as oncology, neurology, hepatology, metabolic rare diseases. It also explores dose selection challenges posed by pediatric rare diseases as well as novel modalities, including enzyme replacement therapies, cell and gene therapies, and oligonucleotides. Several examples emphasize the pivotal role of clinical pharmacology in navigating the complexities associated with these diseases and emerging treatment modalities.

Olfaction Preservation and Long-Term Outcomes in Patients with Unilateral Endoscopic Resection of Olfactory Neuroblastoma: A Systematic Review and Institutional Experience.

BACKGROUND: Endoscopic endonasal surgical resection is an effective therapeutic approach for olfactory neuroblastoma (ONB). Unilateral excision of ONBs with limited extension has been reported with the purpose of preserving olfactory function. We aimed to review implications of surgical management, olfactory preservation feasibility, and survival outcomes in patients who underwent endoscopic unilateral resection of ONB. METHODS: A systematic literature review was conducted using the search terms [("Olfactory neuroblastoma") OR ("Esthesioneuroblastoma")] AND [("Unilateral resection") OR ("Olfaction preservation")]. Studies reporting cases of unilateral ONB endoscopic resection with postoperative olfaction assessment were included. Concurrently, records of patients who met inclusion criteria at our institution were reviewed retrospectively. The survival and olfactory outcomes were analyzed in both cohorts. RESULTS: Thirty-three patients were identified in the published literature. Twenty-three (69.7%) reported postoperative olfaction preservation. Olfactory function after surgery did not show an association with Kadish stage (P = 0.128). No evidence of disease was observed at the latest follow-up in this group of patients. Nine patients who met inclusion criteria were identified at our institution. The extent of resection influenced the level of olfaction preservation when cribriform plate and nasal septum resection coexisted (P = 0.05). A single patient at our institution developed recurrence after being lost to follow-up for 22 months. CONCLUSIONS: Olfaction preservation can be achieved in patients who undergo endoscopic unilateral resection and adjuvant radiotherapy. The extent of resection should aim for negative margins, particularly in the midline. Larger studies are required to assess the risk of contralateral microscopic disease, and, hence, close follow-up is advised.

Optimizing Tissue Harvesting Techniques for Establishing Patient-Derived Glioblastoma Organoids.

OBJECTIVE: Brain tumors display remarkable cellular and molecular diversity, significantly impacting the progression and outcomes of the disease. The utilization of tumor tissue acquired through surgical handheld devices for tumor characterization raises important questions regarding translational research. This study seeks to evaluate the integrity of tissue resected using a microdebrider (MD) in the context of establishing tumor organoids from glioblastomas (GBM). METHODS: Tumor samples were collected from patients with GBM using both tumor forceps (en bloc) and a MD. The time required to protocol completion and cell viability of paired samples was measured. H&E staining was performed to examine histologic morphology. RESULTS: Ten paired samples were obtained from GBM patients using tumor forceps and the MD. Samples collected with the MD demonstrated significantly shorter processing times compared to those obtained through en bloc resection, with overall means of 31.7 ± 2.4 mins and 38.8±3 mins, respectively (P < 0.001). Cell viability measured at the end of protocol completion was comparable between tissues obtained using both the MD and en bloc, with mean viabilities of 80.2 ± 12.4% and 79.1 ± 12.5%, respectively (P = 0.848). H&E examination of tissues revealed no significant differences in the cellular and histologic characteristics of paired samples obtained using both methods across GBM tumors, nor in the corresponding established organoids. CONCLUSIONS: Tumor tissues obtained using the MD and en bloc methods demonstrate a high success rate in establishing GBM organoids, with the MD offering the advantage of significantly reduced processing time. Both methods display comparable cell viability and maintain consistent histologic characteristics in the resected tissue and the corresponding organoids.

IL-10 induces activated phenotypes of monocytes observed in virally-suppressed HIV-1-infected individuals.

Despite viral suppression by effective combined antiretroviral therapy, HIV-1-infected individuals have an increased risk of non-AIDS-related overall morbidity, which is due to the persistent chronic inflammation exemplified by the activation of monocytes, such as increased CD16high subset, and elevated plasma level of soluble CD163 (sCD163) and soluble CD14 (sCD14). Here, we show that IL-10, which has been recognized as anti-inflammatory, induces these activated phenotypes of monocytes in vitro. IL-10 increased CD16high monocytes, which was due to the upregulation of CD16 mRNA expression and completely canceled by an inhibitor of Stat3. Moreover, IL-10 increased the production of sCD163 and sCD14 by monocytes, which was consistent with the upregulation of cell surface expression of CD163 and CD14, and mRNA expression of CD163. However, unlike the IL-10-indeuced upregulation of CD16, that of CD14 was minimally affected by the Stat3 inhibitor. Furthermore, the IL-10-induced upregulation of CD163 protein and mRNA was partially inhibited by the Stat3 inhibitor, but completely canceled by an inhibitor of AMPK, an upstream kinase of Stat3 and PI3K/Akt/mTORC1 pathways. In this study, we also found that HIV-1 pathogenic protein Nef, which is known to persist in plasma of virally-suppressed individuals, induced IL-10 production in monocyte-derived macrophages. Our results may suggest that IL-10, which is inducible by Nef-activated macrophages, is one of drivers for activated phenotypes of monocytes in virally-suppressed individuals, and that IL-10 induces the increased CD16high monocytes and elevated level of sCD163 and sCD14 through the activation of different signaling pathways.

Biportal Endoscopic TransOrbital and transMaxillary Approach to the Cranio-Orbital Region and Middle Cranial Fossa: A Preliminary Analysis of Maneuverability.

BACKGROUND AND OBJECTIVES: Traditional and well-established transcranial approaches to the spheno-orbital region and middle cranial fossa guarantee optimal intracranial exposure, and additional orbital and zygomatic osteotomies provide further control over extracranial components to be resected; however, these techniques come at the cost of additional morbidity. The introduction of minimally invasive endoscopic approaches and the conceptualization of the so-called "multiportal" paradigm might provide an alternative route. This preliminary study investigates the feasibility of the combined Biportal Endoscopic TransOrbital and transMaxillary Approach (bETOMA) approach to the spheno-orbital and middle cranial fossa regions. METHODS: Using 4 silicon-injected adult cadaver heads (8 sides; 16 approaches), we systematically dissected through superior eyelid ETOA and endoscopic TMA approaches. The analysis focused on pterygopalatine, infratemporal, anterior and middle cranial fossae, Meckel cave, and cavernous sinus access. We evaluated the feasibility of bETOMA using linear distances, angles of attack, and exposure areas. We also introduced volume of operative maneuverability, its standardized derivative (sVOM), target distance, visuo-operative angle, and working zone volume as novel metrics. RESULTS: The analysis revealed comparable angles of attack between approaches. ETOA and TMA exposure areas were 918.38 ± 223.93 mm2 and 257.07 ± 86.07 mm2, respectively. TMA showed a larger VOM in the greater sphenoid wing, but ETOA offered superior distal maneuverability (sVOM: 5.39 ± 1.94 vs 2.54 ± 0.79 cm3) and closer intracranial space access (27.45 vs 50.83 mm). The combined approaches yielded a mean working zone volume of 13.75 ± 3.73 cm3 in the spheno-orbital interface. CONCLUSION: The bETOMA approach provides adequate neurovascular exposure and maneuverability to the spheno-orbital region, infratemporal, and anterior and middle cranial fossae, addressing significant limitations of previously investigated monoportal techniques (ie, optic nerve decompression, hyperostotic bone resection, and infratemporal exposure). This combined minimally invasive approach might help manage lesions harbored within the cranio-orbital interface region invading the extracranial space.

Clinical trial designs of emerging therapies for diabetic kidney disease (DKD).

Current evidence for medical therapies for diabetic kidney disease (DKD) is largely based on large-scale clinical trials. These trials, however, often exhibit heterogeneity in participant characteristics and baseline kidney function. These differences may lead to misinterpretation in clinical practice, such that treatment effects from different trials are directly compared and generalized to broader populations beyond the population in which each trial was conducted. This is particularly relevant if comparisons on efficacy and safety are made when the underlying study populations are distinctly different. Indeed, key clinical trials evaluating sodium-glucose transport protein-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonist (nsMRA), and glucagon-like peptide-1 receptor agonist (GLP-1RA) differed in recruitment requirements (inclusion/exclusion criteria), resulting in differences in the severity of the underlying kidney disease as well as risk factor profiles. Moreover, these trials defined their primary and secondary outcomes differently. Collectively, these factors lead to distinct study populations with different baseline risks for DKD progression in the placebo arm in each clinical trial. Consequently, a direct head-to-head comparison of the treatment effect between treatments using relative risk measures from placebo-controlled clinical trials alone is not recommended. In addition, healthcare professionals should be equipped to understand the specific target population of clinical trials to avoid over-generalization when drawing conclusions from these trials.

The medicines approved to help people with compromised kidney function were developed based on clinical trials that differed in many ways. There is a risk that clinical trials may be incorrectly compared and generalized by healthcare providers. In this review, the authors highlight the importance of interpreting clinical trial results cautiously while being mindful of the study population features. Key clinical trials for the treatment of diabetic kidney disease had different recruitment requirements for participants, a wide range of kidney disease severity, and different risks of disease progression in the comparison arm that did not receive the treatment during the trial. The conclusion of this review is to highlight the inappropriateness of comparing these medicines with each other using the results of clinical trials alone. It is important for the medical community to understand the specific types of patients that were involved in the clinical trials, to avoid unjustified conclusions.

Impact of Latency Variations on the Predictive Value of Facial Nerve Proximal-to-Distal Amplitude Ratio during Vestibular Schwannoma Surgery.

Introduction This study highlights the relation between compound muscle action potential (CMAP) latency variations and the predictive value of facial nerve (FN) proximal-to-distal (P/D) amplitude ratio measured at the end of vestibular schwannoma resection. Methods Forty-eight patients underwent FN stimulation at the brainstem (proximal) and internal acoustic meatus (distal) using a current intensity of 2 mA. The proximal latency and the P/D amplitude ratio were assessed. House-Brackmann grades I & II indicated good FN function, and grades III to VI were considered fair/poor function. A P/D amplitude ratio > 0.6 was used as a cutoff to indicate a good FN function, while a ratio of ≤ 0.6 indicated a fair/poor FN function. Results The P/D amplitude ratio was measured for all patients, and the calculated sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were 85.2, 85.7, 88.5, and 81.8%, respectively. The CMAPs from the mentalis muscle were then classified based on their proximal latency into group I (< 6 ms), group II (6-8 ms), and group III (> 8 ms). The SE, SP, PPV, and NPV became 90.5, 90.9, 95, and 83.3%, respectively, in group II. In group I, SE and NPV increased, whereas SP and PPV decreased. While in group III, SP and PPV increased, whereas SE and NPV decreased. Conclusion At a latency between 6 and 8 ms, the P/D amplitude ratio was predictive of outcomes with high SE and SP. When latency was < 6 ms or > 8 ms, the same predictive ability was not observed. Knowing the strengths and limitations is important for understanding the predictive value of the P/D amplitude ratio.

Predictive Value of Clinical, CSF and Vessel Wall MRI Variables in Diagnosing Primary Angiitis of the CNS.

Background and Objectives: Without brain biopsy, there are limited diagnostic predictors to differentiate primary angiitis of the CNS (PACNS) from intracranial atherosclerotic disease (ICAD). We examined the utility of clinical, CSF, and quantitative vessel wall magnetic resonance imaging (VWMRI) variables in predicting PACNS from ICAD. Methods: In this cross-sectional design, observational study, we reviewed electronic medical records to identify patients (18 years and older) who presented to our medical center between January 2015 and December 2021 for ischemic stroke due to intracranial vasculopathy. Patients with biopsy-proven PACNS, probable PACNS, or ICAD were included. Patients with secondary CNS vasculitis or no VWMRI data were excluded. On VWMRI, for each patient, a total of 20 vessel wall segments were analyzed for percent concentricity, percent irregularity, and concentricity to eccentricity (C/E) ratios. We also collected several clinical and CSF variables. Using logistic regression models, we assessed the diagnostic value of VWMRI, CSF, and clinical variables in predicting PACNS in patients with biopsy-proven disease. We then performed a sensitivity analysis to assess predictors of biopsy-proven and probable PACNS. Results: Thirty-two patients with ICAD (54.2%) and 27 patients with PACNS (45.8%) were included. Of the patients with PACNS, 21 (77.8%) were not biopsied and considered probable PACNS. Twenty-four patients with ICAD (75%) and 6 biopsy-proven patients with PACNS (22.2%) showed large vessel involvement and were included in the primary analysis. Encephalopathy (odds ratio [OR], 7.60; 95% CI 1.07-54.09) and seizure (OR 23.00; 95% CI 1.77-298.45) were significantly associated with PACNS. All patients were included in the sensitivity analysis, in which headache significantly predicted PACNS (OR 7.60; 95% CI 1.07-54.09). In the primary analysis, for every 1 white blood cell/µL increase in CSF, there was a 47% higher odds of PACNS (OR 1.47; 95% CI 1.04-2.07). On VWMRI, a C/E ratio >1 (OR 115.00; 95% CI 6.11-2165.95), percent concentricity ≥50% (OR 55.00; 95% CI 4.13-732.71), and percent irregularity <50% (OR 55.00; 95% CI 4.13-732.71) indicated significantly higher odds of PACNS compared with ICAD. Discussion: Our results suggest that quantitative VWMRI metrics, CSF pleocytosis, and clinical features of encephalopathy, seizure, and headache significantly predict a diagnosis of probable PACNS when compared with ICAD.

Environmental impact assessement and determination of radiogenic heat production in the North Jabal Maghrabiyah area, Central Eastern Desert, Egypt.

The present study deals essentially with the establishment of the environmental natural radiation levels in the surveyed area. These will provide base-line information that can be used as a reference to detect and determine the amount and extent of any possible future variation or contamination in the natural radioactivity levels that might occur in the study area due to any potential incidents involving release of nuclear radiation or fallout of nuclear fission products that could affect both terrestrial and atmospheric radioactivity. A map of radiogenic heat production (RHP) was built from the airborne spectral gamma-ray data of North Jabal Maghrabiyah area, central Eastern Desert, Egypt. The area of study reflects radiogenic heat production varying from 0.03 to 6.44 µWm-3, averaging a value of 0.99 µWm-3, while their standard deviation reaches 0.61 µWm-3. The maximum values are associated with the acidic rocks in the northeastern, central, southeastern, northeastern and eastern parts of the area of study. Results showed several levels of radiation as follows: (less than 0.39 mSv/y), (from 0.39 to 0.59 mSv/y), (higher than 0.59 and reached to 2.01 mSv/y). The dose rate more than 1 mSv/y is considered the radioactivity hazard level which represented mainly with late to post tectonic Potassic calc-alkaline granitoids, calc-alkaline granitoids, Muꞌtiq group, Dukhan volcanic/subvolcanic group, Atallah felsite, Parts of Quaternary deposits, Hammamat sediments, parts of Tarif, Dakhlah and Duwwi Formations. Thus, the North Jabal Maghrabiyah area can be considered as high RHP, because of the relatively high radioactive concentrations. There are good relationships between the derived RHP and the three radioactive elements, equivalent Uranium (eU), equivalent Thorium (eTh) and Potassium (K), as represented by the binary relationship between any of two elements. The importance of radiogenic heat production is the source of ground thermal energy.

Association of interleukin-17F (rs763780) single nucleotide polymorphism with multiple sclerosis and optic neuritis.

IL-17F single nucleotide polymorphism (SNP) can affect IL-17F expression and activity and this can lead to the increased susceptibility to several autoimmune diseases. The aim was to investigate the association of IL-17F (rs763780) SNP with the development of multiple sclerosis (MS) in a cohort of Egyptian patients and to evaluate the effect of this polymorphism on the disease course. IL-17F (rs763780) gene polymorphisms was typed by TaqMan genotyping assay for 231 Egyptians divided into 102 MS patients and 129 healthy controls with matched age and sex. The IL-17F rs763780 C containing genotypes (CT+CC) and C allele have statistically significant increased frequency in MS patients when compared with controls (p = 0.005 and 0.004 respectively) especially in females' patients (p = 0.005 and 0.006 respectively). The heterozygous CT genotype was associated with the presence of optic neuritis (p = 0.038). The multivariable regression analysis revealed significant associations between smoking, the higher frequency of attacks and the prediction of higher EDSS score (p = 0.032, 0.049 respectively). It can be concluded that the IL-17F rs763780 C containing genotypes (CT and CC) and C allele may be risk factors for the development of MS in the studied Egyptian cohort by a gender-dependent mechanism that contributes to tendency for predisposition in females and optic neuritis is more common in patients carrying the CT heterozygous genotype.

Comprehensive Chemical Profiling and Mechanistic Insight into Anticancer Activity of Annona muricata Leaves Extract.

The aqueous extract of Annona muricata L. leaves was thoroughly analyzed using the UPLC-MS/MS, in addition to a new approach of examination of the extract's impact on cancer of EAC(Ehrlich ascites carcinoma) in albino male mice. The aim was to investigate the diversity of the phytochemical constituents of the aqueous leaf capsule extract and their impacts on EAC as anticancer agents. The UPLC-ESI-MS/MS screening resulted in 410 tentatively identified metabolites. Among them, 384 compounds were tentatively identified in a previous study, besides a number of 26 compounds belonging to acetogenins, phenolics, flavonoids, alkaloids, and other miscellaneous compounds, which were exclusively identified in the aqueous extract of the leaf capsule. Interestingly, a new compound was tentatively characterized as galloyl-quinic acid-rutinoside. This study also demonstrated that treating EAC mice with an extract from A. muricata leaves significantly improved the abnormalities in the expression of pro-apoptotic (Bax and caspase-3) and anti-apoptotic (Bcl-2) genes. Furthermore, the extract showed good protection against induced Ehrlich hepatocarcinoma, according to the microscopical, histological, and immune-histochemical analyses of the liver tissues and tumor mass.

A Systemic Review of Primary Malignant Long Bone Tumors in Children and Adolescents.

PURPOSE OF THE STUDY: Managing bone tumours is complex, relying on limited evidence, expert opinions, and retrospective reviews. Multidisciplinary approaches and early diagnosis are crucial for better outcomes, especially in young patients with growing skeletons. The aim of this systemic review and meta-analysis is to give a comprehensive review of common malignant tumors affecting long bones in children and adolescents. MATERIAL AND METHODS: A PubMed/Medline search for "primary malignant long bone tumours in children" initially retrieved 1120 papers, which were subsequently narrowed down to 110 articles based on inclusion and exclusion criteria. These articles were reviewed, focusing on clinical presentation, diagnostic workup, treatment options, surgical planning, and variations in presentation, including rare tumours. The two most commonly reported tumours were osteosarcoma and Ewing sarcoma, leading to the division of studies into five groups. The inclusion criteria encompassed malignancies in patients aged 2-25 years, work-up, imaging, surgical treatment, rare tumour case reports, and surgical management principles, resulting in a heterogeneous group of articles. To enhance categorisation, it was clarified that studies with 10 or more cases were considered retrospective reviews. RESULTS: Reviewing of results thus demonstrate that the two likely tumours in children under consideration were osteosarcoma and Ewing sarcoma. Their presentation findings and clinical features were discussed in detail in the review. It is worth noting here that in case of differential diagnosis this should be the first on the list. DISCUSSION AND CONCLUSIONS: Although focus of literature is more on the two most common tumours. However, rare tumours should be considered as they can mimic these common tumors. KEY WORDS: primary, malignant, bone tumors, children, adolescent.

Adsorption and antibacterial studies of a novel hydrogel adsorbent based on ternary eco-polymers doped with sulfonated graphene oxide developed from upcycled plastic waste.

A novel ternary blended polymer composed of cost-effective and readily available polymers was synthesized using poly (vinyl alcohol) (PVA), iota carrageenan (IC), and poly (vinyl pyrrolidone) (PVP). Sulfonated graphene oxide (SGO), prepared from recycled drinking water bottles, was utilized as a doping agent. Varying amounts (1-3 wt%) were combined into the polymer matrix. The produced hydrogel film was examined as a potential adsorbent hydrogel film for the removal of methylene blue (MB) and Gentamicin sulfate (GMS) antibiotic from an aqueous solution. The experimental results demonstrate that the presence of SGO significantly increased the adsorption efficiency of PVA/IC/PVP hydrogel film. The antimicrobial tests revealed that the PVA/IC/PVP-3% SGO hydrogel film exhibited the most potent activity against all the tested pathogenic bacteria. However, the adsorption results for MB and GMS showed that the addition of 3 wt% SGO resulted in a removal percentage that was a two fold increase in the removal percentage compared with the undoped PVA/IC/PVP hydrogel film. Furthermore, the response surface methodology (RSM) model was utilized to examine and optimize several operating parameters, including time, pH of the solution, and initial pollutant concentration. The adsorption kinetics were better characterized by the pseudo-second-order kinetics model. The composite film containing 3 wt% SGO had a maximum adsorption capacity of 606 mg g-1 for MB and 654 mg g-1 for GMS, respectively. The generated nanocomposite hydrogel film demonstrated promising potential for application in water purification systems.

Transforming patterned defects into dynamic poly-regional topographies in liquid crystal oligomers.

We create high-aspect-ratio dynamic poly-regional surface topographies in a coating of a main-chain liquid crystal oligomer network (LCON). The topographies form at the topological defects in the director pattern organized in an array which are controlled by photopatterning of the alignment layer. The defect regions are activated by heat and/or light irradiation to form reversible topographic structures. Intrinsically, the LCON is rubbery and sensitive to temperature changes, resulting in shape transformations. We further advanced such system to make it light-responsive by incorporating azobenzene moieties. Actuation reduces the molecular order of the LCON coating that remains firmly adhered to the substrate which gives directional shear stresses around the topological defects. The stresses relax by deforming the surfaces by forming elevations or indents, depending on the type of defects. The formed topographies exhibit various features, including two types of protrusions, ridges and valleys. These poly-regional structures exhibit a large modulation amplitude of close to 60%, which is 6 times larger than the ones formed in liquid crystal networks (LCNs). After cooling or by blue light irradiation, the topographies are erased to the initial flat surface. A finite element method (FEM) model is adopted to simulate structures of surface topographies. These dynamic surface topographies with multilevel textures and large amplitude expand the application range, from haptics, controlled cell growth, to intelligent surfaces with adjustable adhesion and tribology.

Validation of the Klinrisk chronic kidney disease progression model in the FIDELITY population.

Background: Chronic kidney disease (CKD) affects >800 million individuals worldwide and is often underrecognized. Early detection, identification and treatment can delay disease progression. Klinrisk is a proprietary CKD progression risk prediction model based on common laboratory data to predict CKD progression. We aimed to externally validate the Klinrisk model for prediction of CKD progression in FIDELITY (a prespecified pooled analysis of two finerenone phase III trials in patients with CKD and type 2 diabetes). In addition, we sought to identify evidence of an interaction between treatment and risk. Methods: The validation cohort included all participants in FIDELITY up to 4 years. The primary and secondary composite outcomes included a ≥40% decrease in estimated glomerular filtration rate (eGFR) or kidney failure, and a ≥57% decrease in eGFR or kidney failure. Prediction discrimination was calculated using area under the receiver operating characteristic curve (AUC). Calibration plots were calculated by decile comparing observed with predicted risk. Results: At time horizons of 2 and 4 years, 993 and 1795 patients experienced a primary outcome event, respectively. The model predicted the primary outcome accurately with an AUC of 0.81 for 2 years and 0.86 for 4 years. Calibration was appropriate at both 2 and 4 years, with Brier scores of 0.067 and 0.115, respectively. No evidence of interaction between treatment and risk was identified for the primary composite outcome (P = .31). Conclusions: Our findings demonstrate the accuracy and utility of a laboratory-based prediction model for early identification of patients at the highest risk of CKD progression.