Correction: Hassanabadi et al. Hydraulic Characterization of Ceramic Foam Filters Used in Aluminum Filtration. Materials 2023, 16, 2805.

In the original publication [...].

Hydraulic Characterization of Ceramic Foam Filters Used in Aluminum Filtration.

Ceramic Foam Filters (CFF) are frequently used during the filtration of aluminum (Al) melts to produce high-quality products. In the present study, the physical and hydraulic characteristics of alumina (Al2O3)-based CFF from three different suppliers (A, B and C) have been thoroughly investigated. The filters' porosity and pore diameter, i.e., Window and Cell Feret diameters, were measured and the permeability of the different filters calculated based on pressure drop experiments. The comparison of the classification systems of CFF, i.e., Grade and PPI (Pore Per Inch) numbers, using statistical analysis of permeability and Window Feret diameter showed significant variations between the morphological and hydraulic properties of some CFFs of identical Grade and PPI numbers. Moreover, the Fanning friction factor was plotted as a function of interstitial Reynolds numbers (Rei), and laminar, transient, and turbulent flow regimes were identified. The relationship between the Fanning friction factor and the interstitial Reynolds numbers of all the filter samples investigated was processed using regression analysis, and a model equation developed to calculate the pressure drop over the CFF using the Window Feret diameter. The correlation between the experimental pressure drop values and the derived model equation indicates that empirical expressions for calculating the pressure drop over CFFs should be derived based on experimental measurements carried out at the velocity range of the application of the CFF, which is about 10 mm·s-1 for aluminum filtration.

Study and Modelling of Fluid Flow in Ceramic Foam Filters.

To investigate the fluid flow characteristics of conventional Ceramic Foam Filters (CFFs) of grades 30 and 50, a 2D macro-scale geometry was generated by converting pixel grid images of the filters into vector format images. The flow behaviour through the filter channels was then numerically modelled using the Stocks equation within the Creeping Flow interface of COMSOL Multiphysics®. Through modelling, the average interstitial velocity was estimated and found to be higher than the corresponding value obtained from the Dupuit-Forchheimer equation. The discrepancy obtained suggested that the flow behaviour within the filter channels differed from that based on the simplified assumptions of the equation. The porosity and permeability of the CFFs were evaluated during the post-processing stage using surface integration and user-defined equations. The experimentally determined porosity closely matched the values obtained from the simulation model, demonstrating the reliability of the numerical approach. However, the permeability values from the simulation of CFFs of grades 30 and 50 were higher than those obtained experimentally. This discrepancy can be attributed to the larger channels in the generated geometrical pattern compared to the original CFF structure. The present findings highlight the effectiveness of the proposed methodology in developing a representative macro-scale geometry for CFFs and in simulating fluid flow behaviour.

Postprandial Glucose Excursions in Asian Versus Non-Asian Patients with Type 2 Diabetes: A Post Hoc Analysis of Baseline Data from Phase 3 Randomised Controlled Trials of IDegAsp.

INTRODUCTION: Increased postprandial glucose (PPG) is associated with high glycated haemoglobin levels and is an independent risk factor for cardiovascular diseases. The aim of this study was to compare PPG increments in Asian versus non-Asian adults with type 2 diabetes (T2D), who were insulin-naïve or insulin-experienced, from the phase 3 insulin degludec/insulin aspart (IDegAsp) clinical trials. METHODS: This was a post hoc analysis of data from 13 phase 3, randomised, parallel-group, open-label IDegAsp trials in patients with T2D. The pooled baseline clinical data were analysed for insulin-naïve and insulin-experienced groups; and each group was split into subgroups of Asian and non-Asian patients, respectively, and analysed accordingly. Baseline self-monitored blood glucose (SMBG) values at breakfast, lunch and the evening meal (before and 90 min after each meal) were used to assess PPG increments. The estimated differences in baseline SMBG increment between the Asian and non-Asian subgroups were analysed. RESULTS: Clinical data from 4750 participants (insulin-naïve, n = 1495; insulin-experienced, n = 3255) were evaluated. In the insulin-naïve group, the postprandial SMBG increment was significantly greater in the Asian versus the non-Asian subgroup at breakfast (estimated difference 28.67 mg/dL, 95% confidence interval [CI] 18.35, 38.99; p < 0.0001), lunch (17.34 mg/dL, 95% CI 6.47, 28.21; p = 0.0018) and the evening meal (16.19 mg/dL, 95% CI 5.04, 27.34; p = 0.0045). In the insulin-experienced group, the postprandial SMBG increment was significantly greater in the Asian versus non-Asian subgroup at breakfast (estimated difference 13.81 mg/dL, 95% CI 9.19, 18.44; p < 0.0001) and lunch (29.18 mg/dL, 95% CI 24.22, 34.14; p < 0.0001), but not significantly different at the evening meal. CONCLUSION: In this post hoc analysis, baseline PPG increments were significantly greater in Asian participants with T2D than in their non-Asian counterparts at all mealtimes, with the exception of the evening meal in insulin-experienced participants. Asian adults with T2D may benefit from the use of regimens that control PPG excursions. CLINICAL TRIAL NUMBERS: NCT02762578, NCT01814137, NCT01513590, NCT01009580, NCT01713530, NCT02648217, NCT01045447, NCT01365507, NCT01045707, NCT01272193, NCT01059812, NCT01680341, NCT02906917.

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes: A Real-World, Prospective, Non-interventional Study Across Six Countries.

INTRODUCTION: Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec (a basal insulin) and insulin aspart (a prandial insulin). The aim of this study was to investigate clinical outcomes in people with type 2 diabetes (T2D) after initiating IDegAsp treatment in a real-world setting. METHODS: This 26-week, open-label, non-interventional study was conducted in Australia, India, Malaysia, Philippines, Saudi Arabia, and South Africa. Data were obtained from 1102 adults with T2D initiating or switching to IDegAsp from antidiabetic treatments (including oral antidiabetic drugs, basal insulin, basal-bolus insulin, premix insulin, and glucagon-like peptide 1 receptor agonist) per local clinical practice. RESULTS: Compared with baseline, there was significant improvement in HbA1c at end of study (EOS, first visit within weeks 26-36; estimated change - 1.4% [95% CI - 1.51; - 1.29]; P < 0.0001 [primary outcome]). From baseline to EOS, there were significant reductions in fasting plasma glucose (- 2.7 mmol/L [95% CI - 2.98; - 2.46]; P < 0.0001), body weight (- 1.0 kg [95% CI - 1.51; - 0.52]; P < 0.0001), and basal insulin dose in insulin-experienced participants (- 2.3 units [95% CI - 3.51; - 1.01]; P < 0.001). The incidence rates of non-severe (overall and nocturnal) and severe hypoglycaemia decreased significantly (P < 0.001) between the period before baseline and before EOS. CONCLUSION: In adults with T2D, initiating or switching to IDegAsp from previous antidiabetic treatment was associated with improved glycaemic control, lower basal insulin dose (in insulin-experienced participants), and lower rates of hypoglycaemia. TRIAL REGISTRATION: Clinical trial registration NCT04042441.

Aluminothermic Reduction of Manganese Oxide from Selected MnO-Containing Slags.

The aluminothermic reduction process of manganese oxide from different slags by aluminum was investigated using pure Al and two types of industrial Al dross. Two types of MnO-containing slags were used: a synthetic highly pure CaO-MnO slag and an industrial high carbon ferromanganese slag. Mixtures of Al and slag with more Al than the stoichiometry were heated and interacted in an induction furnace up to 1873 K, yielding molten metal and slag products. The characterization of the produced metal and slag phases indicated that the complete reduction of MnO occurs via the aluminothermic process. Moreover, as the Al content in the charge was high, it also completely reduced SiO2 in the industrial ferromanganese slag. A small mass transport of Ca and Mg into the metal phase was also observed, which was shown to be affected by the slag chemistry. The obtained results indicated that the valorization of both Al dross and FeMn slag in a single process for the production of Mn, Mn-Al, and Mn-Al-Si alloys is possible. Moreover, the energy balance for the process indicated that the energy consumption of the process to produce Mn-Al alloys via the proposed process is insignificant due to the highly exothermic reactions at high temperatures.

Valorization of Aluminum Dross with Copper via High Temperature Melting to Produce Al-Cu Alloys.

The valorization of aluminum dross for Al recovery was performed via its mixing with metallic copper to produce Al-Cu alloys. This approach was with the intention of establishing a new smelting process to treat the dross with Cu scrap use. To evaluate the high temperature interaction of the materials, the wettability of a Cu-containing aluminum alloy with the non-metallic components of the dross was studied by the sessile drop method. It was found that the wetting was weak via temperature changes at 973-1373 K, and consequently no proper metal separation occurred. To better separate the metallic and non-metallic phases with larger density differences, a higher Cu portion was considered to obtain a significantly denser metallic phase, and it was found that partial separation of the Al in an Al-Cu alloy is possible. The complete separation of the metallic components of the dross was, however, experienced by the dross and copper melting with the addition of pre-melted calcium aluminate slags at elevated temperatures. It was found that Al-Cu alloys were produced and separated from the adjacent slags, and the aluminum oxide of the dross ended up in the slag phase. Moreover, the characteristics of the produced slags depend on the process charge.

Hallux varus following scarf osteotomy.

Hallux varus is an uncommon condition and majority of the cases are iatrogenic. It can occur as a result of any type of hallux valgus correction surgery and in our cases scarf osteotomy is not an exception. Treatment of this complication can be challenging and it is important to understand the factors that cause this deformity before embarking on surgical correction. Four cases of hallux varus following Scarf osteotomy (1% of our total Scarf osteotomy cases) and discuss the salient features of these patients. The authors ascertained the factors that caused iatrogenic hallux varus and formulated a classification of the nature of the deformity. The management of iatrogenic hallux varus based on our experience and proposed classification system has also been outlined and discussed.

Liraglutide effect and action in diabetes-In (LEAD-In): A prospective observational study assessing safety and effectiveness of liraglutide in patients with type 2 diabetes mellitus treated under routine clinical practice conditions in India.

BACKGROUND: This 26-week, open-label observational study assessed the incidence and type of adverse events (AEs) associated with liraglutide use according to the standard clinical practice settings and the local label in India. MATERIALS AND METHODS: A total of 1416 adults with type 2 diabetes (T2D) treated with liraglutide in 125 sites across India were included in the study. Participants were newly diagnosed or already receiving antidiabetic medications. Safety and efficacy data were collected at baseline and at approximately weeks 13 and 26. The primary outcome was incidence and type of AEs while using liraglutide, with events classified by Medical Dictionary for Regulatory Activities system organ class and preferred term. The secondary objective was to assess other clinical parameters related to effective T2D management. RESULTS: Twenty AEs, predominately gastrointestinal, were reported in 1.3% of the study population in scheduled visits up to week 26. No serious AEs, including death, were reported. Hypoglycemic episodes were reported in 7.3% of participants at baseline and 0.7% at week 26. No major hypoglycemic events were reported up to week 26 (baseline: 0.4%). Glycated hemoglobin was reduced from baseline (8.8 ± 1.3%) to week 26 by 1.6 ± 1.1% (P < 0.0001); significant improvements in fasting blood glucose, and 2-h postprandial blood glucose (post-breakfast, -lunch, and -dinner) were also observed. Mean body weight decreased by 8.1 ± 6.5 kg from baseline (92.5 ± 14.6 kg; P < 0.0001). CONCLUSIONS: From the number of AEs reported, it is suggested that liraglutide was well tolerated in subjects with T2D treated under standard clinical practice conditions in India. Liraglutide was effective, and no new safety concerns were identified.

Clinical experience of switching from biphasic human insulin to biphasic insulin aspart 30 in Indian patients with type 2 diabetes in the A1chieve study.

AIM: The aim of the following study is to evaluate the safety and effectiveness of switching from biphasic human insulin (BHI) to biphasic insulin aspart 30 (BIAsp 30) in Indian patients with type 2 diabetes as a sub-analysis of the 24-week, non-interventional A1chieve study. MATERIALS AND METHODS: Indian patients switching from BHI to BIAsp 30 based on the physicians' decisions were included. The primary outcome was the incidence of serious adverse drug reactions (SADRs), including major hypoglycemic events; secondary outcomes included changes in hypoglycemia in the 4 weeks preceding baseline and week 24 and changes from baseline to week 24 in glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), body weight and quality of life (QoL). RESULTS: Overall, 1976 patients (mean ± standard deviation age, 55.1 ± 10.6 years and diabetes duration, 10.1 ± 5.3 years) on a mean pre-study BHI dose of 0.44 ± 0.18 U/kg were included. The mean BIAsp 30 dose was 0.43 ± 0.17 U/kg at baseline and 0.44 ± 0.17 U/kg at week 24. No SADRs were reported. The proportion of patients reporting overall hypoglycemic events reduced significantly from baseline to week 24 (15.0% vs. 2.9%, P < 0.0001). The mean HbA1c level improved significantly from 9.1 ± 1.4% at baseline to 7.5 ± 1.0% at week 24, along with improvements in FPG, post-breakfast PPPG and QoL (P < 0.001). The mean body weight decreased from 69.3 ± 10.8 kg at baseline to 69.1 ± 10.4 kg at week 24 (P = 0.003). CONCLUSION: Switching from BHI to BIAsp 30 therapy was well-tolerated and was associated with improved glycemic control.

Clinical experience of switching from glargine or neutral protamine Hagedorn insulin to insulin detemir in type 2 diabetes: Observations from the Indian cohort in the A1chieve study.

AIM: To explore the clinical safety and effectiveness of insulin detemir (IDet) in a subgroup of Indian patients with type 2 diabetes (T2D) switched from either insulin glargine (IGlar) or neutral protamine Hagedorn (NPH) insulin in the 24-week, non-interventional A1chieve study. MATERIALS AND METHODS: Indian patients with T2D switching from pre-study IGlaror NPH insulin to IDet were included. Safety and effectiveness outcomes were evaluated by the physicians in local clinical settings. RESULTS: A total of 102 patients switched from IGlar to IDet (GLA group) and 39 patients switched from NPH insulin to IDet (NEU group). At baseline, the mean glycated hemoglobin A1c (HbA1c) levels were 9.9 ± 1.8% in the GLA group and 9.1 ± 1.2% in the NEU group. No serious adverse drug reactions, serious adverse events, or major hypoglycemic events were reported in either group throughout the study. At baseline and Week 24, 11.8% and 7.5% of patients, respectively, reported overall hypoglycemic events in the GLA group. No hypoglycemic events were reported at Week 24 in the NEU group. At Week 24, the mean HbA1c levels were 7.6 ± 0.9% in the GLA group and 7.3 ± 0.7% in the NEU group. The mean fasting plasma glucose, postprandial plasma glucose and quality of life also appeared to improve over 24 weeks. CONCLUSION: Switching to IDet therapy from IGlar and NPH insulin was well-tolerated and appeared to be associated with improved glycogenic control in Indian patients.

Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study.

OBJECTIVES: DiabCare India 2011 was a cross-sectional study in patients with diabetes mellitus, undertaken to investigate the relationship between diabetes control, management and complications in a subset of urban Indian diabetes patients treated at referral diabetes care centres in India. MATERIALS AND METHODS: This was a cross-sectional, multicentre (330 centres) survey in 6168 diabetes patients treated at general hospitals, diabetes clinics and referral clinics across India. Patient data, including medical and clinical examination reports during the past year were collected during their routine visit. The patients' and physicians' perceptions about diabetes management were recorded using a questionnaire. RESULTS: A total of 6168 subjects with diabetes (95.8% type 2), mean age 51.9 ± 12.4 years and mean duration of diabetes, 6.9 ± 6.4 years were included. Mean HbA1c was 8.9 ± 2.1% and the mean fasting (FPG), post prandial (PPG) and random (RBG) plasma glucose levels were 148 ± 50 mg/dl 205 ± 66 mg/dl and 193 ± 68mg/dl respectively. Neuropathy was the most common complication (41.4%); other complications were: Foot (32.7%), eye (19.7%), cardiovascular (6.8%) and nephropathy (6.2%). The number of diabetic complications increased with mean duration of diabetes. Most (93.2%) of the patients were on oral anti-diabetic drugs (OADs) and 35.2% were on insulin (±OADs). More than 15% physicians felt that the greatest barrier to insulin therapy from patient's perspective were pain and fear of using injectable modality; 5.2% felt that the greatest barrier to insulin therapy from physician's perspective was the treatment cost; 4.8% felt that the major barriers to achieve optimum diabetic care in practice was loss to follow-up followed by lack of counselling (3.9%) and treatment compliance (3.6%). CONCLUSION: DiabCare India 2011 has shown that type 2 diabetes sets in early in Indians and glycaemic control is often sub-optimal in these patients. These results indicate a need for more structured intervention at an early stage of the disease and need for increased awareness on benefits of good glycaemic control. It cannot be overemphasized that the status of diabetes care in India needs to be further improved. (ClinTrials.gov identifier: NCT01351922).

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Tamil Nadu cohort of the A1chieve study.

BACKGROUND: The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. MATERIALS AND METHODS: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Tamil Nadu, India. RESULTS: A total of 2221 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 1707), insulin detemir (n = 270), insulin aspart (n = 85), basal insulin plus insulin aspart (n = 79) and other insulin combinations (n = 80). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 9.2%) and insulin user (mean HbA1c: 9.2%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.7%, insulin users: -1.7%). SADRs including major hypoglycaemic events did not occur in any of the study patients. CONCLUSION: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

Sexually transmitted infections in Pakistan.

BACKGROUND AND OBJECTIVES: Sexually transmitted infections (STIs) represent a major global health problem leading to morbidity, mortality and stigma. Prior to this study there was no information on the prevalence and knowledge of STIs in Faisalabad, Pakistan. DESIGN AND SETTING: Prospective, cross-sectional study in patients attending STI clinics from July 2006 to September 2009. PATIENTS AND METHODS: After obtaining consent, patients completed structured questionnaires used for behavioral surveys. Blood and urethral swabs were collected and tested for syphilis, gonococcus, genital herpes, chlamydia and chancroid. RESULT: Mean (standard deviation) age of the 1532 participants was 38.9 (9.4) years, including 37.8 (10.2) years for males and 35.5 (6.3) years females. Male gender (n=1276, 83.3%), low socioeconomic class (n=1026, 67.0%) and residence in rural suburbs (n=970, 63.3%) were more common. Most (n=913, 59.6%) were aware of the modes of transmission of STIs and the associated complications, 20% (n=306) were condom users, and 21.2% (n=324) had knowledge of safe sex. Opposite-sex partners were preferred by 972 (63.4%) patients, while 29.9% (n=458) had both homosexual and heterosexual sex partners. Syphilis was present in 29.5% of patients (n=452); gonorrhea, in 13% (n=200), HSV-2, in 3.2% (n=49), chlamydia, in 4.7% (n=72) and chancroid, in 1.3% (n=20). CONCLUSION: This report establishes baseline local prevalence rates for STIs. Syphilis emerged as the most prevalent STI in Faisalabad. Population-based studies are required to study the epidemiology of STIs, along with initiation of national health-education campaign.

Adverse drug reaction profile of cisplatin-based chemotherapy regimen in a tertiary care hospital in India: An evaluative study.

AIMS: This prospective study was designed to monitor and analyze the pattern of occurrence of adverse drug reactions (ADRs) to cisplatin-based chemotherapy regimen in the cancer ward of a tertiary care hospital. MATERIALS AND METHODS: Cancer patients who received cisplatin-based cancer chemotherapy were monitored for adverse reactions. The collected reports were analyzed for demographic and drug details, causality, preventability and severity of adverse effects. Causality was assessed by the World Health Organization (WHO) causality assessment scale and Naranjo's Algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale respectively. RESULTS: Among 51 patients, 48 developed ADRs to cisplatin chemotherapy. The reactions observed were nausea, alopecia, anorexia, vomiting, taste alteration, diarrhea, constipation, tinnitus, and hypocalcaemia. The WHO causality assessment scale indicated 69% "possible" and 31% "probable" but no "certain" reactions. Naranjo's Algorithm showed 62% "probable" and 38% "possible" reactions. Most of the reactions belonged to the category of "not preventable". Reactions like nausea and vomiting belonged to the category of "definitely preventable". Modified Hartwig and Siegel scale of severity assessment showed that most of the reactions were of "mild level 1" severity except for vomiting, diarrhea and hypocalcaemia, which were of "moderate level 3" severity. CONCLUSION: Cisplatin-based chemotherapy has a high potential to cause adverse effects. Most of the reactions were of milder nature but not preventable. The common adverse effects such as nausea and vomiting were preventable, but reactions like hypersensitivity reactions and anaphylaxis were not predictable.

Web-based multilayer viewing interface for knee cartilage.

Many adults suffer from osteoarthritis (OA) with the majority of people over 65 showing radiographic evidence of the disease. To carry out effective diagnosis and treatment, it is necessary to understand the progression of cartilage loss and study the effectiveness of therapeutic interventions. Hence, it is important to have accurate, fast diagnosis of the disease. In this paper, we describe a Web-based user interface that enables the direct viewing of 2-D and 3-D image data from the visceral and tissue levels of the biological continuum (i.e., the continuum comprising systems, viscera, tissue, cells, proteins, and genes)--while preserving geometric integrity. This is achieved despite the fact that the data are from different modalities (i.e., magnetic resonance (MR) and light microscopy). The user interface was tested using image data acquired from a study of articular cartilage thickness in the porcine knee. The interface allows the clinician to view both MR and light microscopy images in an integrated manner-with the information linked geometrically.

Cognitive-behavioural therapy in first-episode and early schizophrenia. 18-month follow-up of a randomised controlled trial.

BACKGROUND: The initial phase of a trial of cognitive-behavioural therapy (CBT) for acutely ill patients with schizophrenia of recent onset showed that it speeded recovery. AIMS: To test the hypothesis that CBT in addition to treatment as usual (TAU) during the first or second acute episode of schizophrenia will confer clinical benefit over a follow-up period. METHOD: This was an 18-month follow-up of a multicentre prospective trial of CBT or supportive counselling administered as an adjunct to TAU, compared with TAU alone, for patients hospitalised for an acute episode of schizophrenia of recent onset. Primary outcomes were total and positive symptom scales, time to relapse and re-hospitalisation. RESULTS: There were significant advantages for CBT and supportive counselling over TAU alone on symptom measures at 18 months but no group difference was seen for relapse or re-hospitalisation. There was a significant centre-treatment interaction, reflecting centre differences in the effect of introducing either treatment, but not in the comparison of CBT and supportive counselling. Medication dosage and compliance did not explain group differences. CONCLUSIONS: Adjunctive psychological treatments can have a beneficial long-term effect on symptom reduction.