Comparison activity of pure and chromium-doped nickel oxide nanoparticles for the selective removal of dyes from water.

The current study involves a synthesis of a composite of nickel oxide nanoparticles (NiONPs) with a chromium dopant to yield (Cr/NiONPs). Synthesis of nickel oxide was performed by the co-precipitation method. The synthesis of the composite was conducted by the impregnation method. FTIR, EDX, SEM, and XRD were used to characterize the synthesized materials. The synthesised materials' point zero charges (PZC) were performed using the potentiometric titration method. The obtained results show that the PZC for neat nickel oxide was around 5, and it was around 8 for Cr/NiONPs. The adsorption action of the prepared materials was examined by applying them to remove Reactive Red 2 (RR2) and Crystal Violate (CV) dyes from solutions. The outcomes demonstrated that Cr/NiONPs were stronger in the removal of dyes than NiONPs. Cr/NiONPs achieved 99.9% removal of dyes after 1 h. Adsorption isotherms involving Freundlich and Langmuir adsorption isotherms were also conducted, and the outcomes indicated that the most accurate representation of the adsorption data was offered by Langmuir adsorption isotherms. Additionally, it was discovered that the adsorption characteristics of the NiONPs and Cr/NiONPs correspond well with the pseudo-second-order kinetic model. Each of the NiONPs and Cr/NiONPs was reused five times, and the results display that the effectiveness of the removal of RR2 dye slightly declined with the increase in reuse cycles; it lost only 5% of its original efficiency after the 5 cycles. Generally, Cr/NiONPs showed better reusability than NiONPs under the same conditions.

Simulation study of a practical approach to enhance cadmium removal via biological treatment by controlling the concentration of MLSS.

The fate of cadmium at the Muharram Aisha wastewater treatment plant in Karbala governorate, Iraq was studied using the TOXCHEM model. Cadmium, a known carcinogen, and is considered one of the most dangerous heavy metals and high concentrations, greater than permissible limits, were found in the treated wastewater. The plant operates using an activated sludge system and this was modeled via TOXCHEM with a sensitivity analysis carried out on the extended aeration system. Prior to analysis, the model was calibrated and validated for cadmium, with the adjustments leading to a mean square error (RMSE) and correlation coefficient (R) of 0.0001 and 0.81, respectively. The mass balance of cadmium in the Muharram Aisha treatment plant was found to be 4832.44 g/day (37.1726%) in the treated wastewater and 8164.52 g/day (62.804%) in the sludge, which indicated that the mix liquor suspended solid (MLSS) was the most sensitive factor. The sensitivity to cadmium was analyzed via MLSS in the extended aeration system and the results o indicated that the higher the MLSS concentration (mg/L), the greater the removal of cadmium in the treated wastewater. It was found that increasing the MLSS through a biological treatment method reduced the concentration of cadmium without the need for additional of any (potentially harmful) chemical treatments. The plant was subsequently operated for a period of 5 months with the MLSS increased from 1500 to 4500 mg/L, and this reduced the concentration of cadmium in the wastewater from 0.36 to 0.01 mg/L as a consequence. This research demonstrates how the novel application of TOXCHEM can be a useful tool in the reduction of heavy metal contamination in the environment.

Bilateral Pheochromocytoma and Paraganglioma Tumors Due to Von Hippel-Lindau Syndrome in a 15-Year-Old Boy: A Case Report.

Pheochromocytomas and paragangliomas are catecholamine-secreting tumors that originate from chromaffin cells of the adrenal medulla and autonomic neural ganglia, respectively. Patients with pheochromocytomas and paragangliomas typically present with paroxysmal headache, sweating, tachycardia, and hypertension. Although most pheochromocytoma cases are sporadic, many of the cases occur as part of a genetic disorder. Here, we report the case of a 14-year-old male patient who presented with hypertension. Laboratory tests showed elevated levels of serum and urinary catecholamines, metanephrines, and chromogranin. Abdominal ultrasound and computed tomography studies revealed bilateral solid adrenal masses and an isolated splenic mass. Further assessment identified an underlying Von Hippel-Lindau syndrome. The patient was initially treated medically and later surgically. This case highlights the importance of always considering pheochromocytomas and paragangliomas as rare differentials of secondary hypertension, especially in the presence of episodic headaches, sweating, and tachycardia. Furthermore, screening for underlying genetic disorders, such as in our case, should be considered in cases of bilateral tumors, onset at a young age, and presence of extra-adrenal tumors.

The relationship between OXT gene polymorphisms and reproductive hormones in pregnant and lactating Awassi Ewes.

BACKGROUND: Numerous genetic loci interact intricately to control reproduction in mammals. The oxytocin gene (OXT) is a promising candidate for reproductive traits in mammals. Previously, sheep and goats have been studied for the presence of the OXT polymorphism. As of yet, no polymorphisms have been identified in the OXT gene of Awassi sheep. Thus, this study was conducted to determine the effects of OXT polymorphism and litter size on reproductive hormones in pregnant and lactating Awassi ewes. METHODS AND RESULTS: This study evaluated 232 ewes aged 3 and 4 years (123 single-progeny ewes and 109 twin-producing ewes). Serum was collected to measure reproductive hormones using ELISA kits manufactured by ELK Biotechnology. DNA was extracted from sheep blood for genotyping and sequencing to identify variations in OXT gene (exon 2, 266 bp). Genotyping analysis revealed three genotypes within 266 bp: CC, CA, and AA. Sequence analysis revealed a novel mutation in exon 2: 188 C > A. Statistical analysis showed significant associations between the 188 C > A SNP and phenotypic traits. Twin-pregnant ewes carrying CC genotypes had higher estrogen, progesterone, and follicle-stimulating hormone/luteinizing hormone levels (65.86 ± 3.87) (pg/mL), (6.51 ± 0.39) (ng/mL), and (20.22 ± 1.27) (ng/mL)/( 23.37 ± 2.14) (ng/mL) respectively, compared to CA and AA genotypes in the fourth month of twin-pregnant ewes compared to single-pregnant ewes. CONCLUSIONS: This study found that the 188 C > A SNP negatively affected reproductive hormone levels in Awassi sheep. These findings provide breeders with a new insight into the sheep OXT gene, useful for future breeding.

Metastasectomy for colorectal pulmonary metastases: a survey among members of the European Society of Thoracic Surgeons.

OBJECTIVES: Surgical management of pulmonary metastases in colorectal cancer patients is a debated topic. There is currently no consensus on this matter, which sparks considerable risk for international practice variation. The European Society of Thoracic Surgeons (ESTS) ran a survey to assess current clinical practices and to determine criteria for resection among ESTS members. METHODS: All ESTS members were invited to complete an online questionnaire of 38 questions on current practice and management of pulmonary metastases in colorectal cancer patients. RESULTS: In total, 308 complete responses were received (response rate: 22%) from 62 countries. Most respondents consider that pulmonary metastasectomy for colorectal pulmonary metastases improves disease control (97%) and improves patients' survival (92%). Invasive mediastinal staging in case of suspicious hilar or mediastinal lymph nodes is indicated (82%). Wedge resection is the preferred type of resection for a peripheral metastasis (87%). Minimally invasive approach is the preferred approach (72%). For a centrally located colorectal pulmonary metastasis, the preferred form of treatment is a minimally invasive anatomical resection (56%). During metastasectomy, 67% of respondents perform mediastinal lymph node sampling or dissection. Routine chemotherapy is rarely or never given following metastasectomy (57% of respondents). CONCLUSIONS: This survey among the ESTS members underlines the change in practice of pulmonary metastasectomy with an increasing tendency in favour of minimally invasive metastasectomy and surgical resection is preferred over other types of local treatment. Criteria for resectability vary and controversy remains regarding lymph node assessment and the role of adjuvant treatment.

Recent advances and applicable flexibility potential of electrochemical processes for wastewater treatment.

This study examined >140 relevant publications from the last few years (2018-2021). In this study, classification was reviewed depending on the operation's progress. Electrocoagulation (EC), electrooxidation (EO), electroflotation (EF), electrodialysis (ED), and electro-Fenton (EFN) processes have received considerable attention. The type of action (individual or hybrid) for each electrochemical procedure was evaluated, and statistical analysis was performed to compare them as a new manner of reviewing cited papers providing a massive amount of information efficiently to the readers. Individual or hybrid operation progress of the electrochemical techniques is critical issues. Their design, operation, and maintenance costs vary depending on the in-situ conditions, as evidenced by surveyed articles and statistical analyses. This work also examines the variables affecting the elimination efficacy, such as the applied current, reaction time, pH, type of electrolyte, initial pollutant concentration, and energy consumption. In addition, owing to its efficacy in removing toxins, the hybrid activity showed a good percentage among the studies reviewed. The promise of each wastewater treatment technology depends on the type of contamination. In some cases, EO requires additives to oxidise the pollutants. EF and EFN eliminated lightweight organic pollutants. ED has been used to treat saline water. Compared to other methods, EC has been extensively employed to remove a wide variety of contaminants.

Kidney replacement therapy in neonates: utilization trends and outcomes.

BACKGROUND: We aimed to assess prevalence and clinical characteristics of newborns receiving kidney replacement therapy (KRT). METHODS: We used the National Inpatient Sample (NIS) dataset for the years 2000-2017. Newborns treated with peritoneal dialysis (PD), hemodialysis (HD), and continuous KRT (CKRT) were included. Trend analysis using the Cochran-Armitage test was used to assess prevalence over the years. RESULTS: A total of 64,532,552 hospitalized newborns were included. Among the 4281 infants treated with KRT, 2501 (58.4%) were treated with PD, 997 (23.3%) had HD, and 783 (18.3%) used CKRT. Associated diagnoses included congenital kidney anomalies (37.4% vs. 15% vs. 9.5%), urinary tract anomalies (35% vs. 12.5% vs. 6.3%), and congenital heart disease (68% vs. 25.7% vs. 72.3%). Median length of stay was longest in PD patients (39 days vs. 18 days vs. 26 days), respectively. However, cost of hospitalization was greatest in CKRT patients (US $490,916 vs. US $218,514 vs. US $621,554), respectively. In the entire cohort, 54,424 newborns had acute kidney injury (AKI); of them 16,999 (31%) died. KRT was used in 2,688 (4.9%) of infants with AKI. Over the study period, trends for utilization of PD (from 0.042 to 0.06%) and CKRT (from 0.03 to 0.21%) increased whereas the hemodialysis trend decreased (from 0.021 to 0.013%). CONCLUSIONS: Congenital heart disease (CHD) and congenital anomalies of the kidneys and urinary tract (CAKUT) are the major diagnoses in newborns receiving KRT. Utilization of PD was greater than HD and CKRT. Trends of PD and CKRT utilization increased over time. Less than 5% of infants diagnosed with AKI received KRT.

Outcomes of complete surgical repair versus palliative intervention in neonates with Tetralogy of Fallot.

Using the US National Inpatient Sample dataset (2010 to 2018), we compared outcomes of neonates with Tetralogy of Fallot who had early primary surgical repair (1726 neonate) and those who had staged palliative intervention with transcatheter (1702 neonate) or surgical palliative shunt (2661 neonate).

A novel deleterious oxytocin variant is associated with the lower twinning ratio in Awassi ewes.

This study aimed to assess the possible association of oxytocin (OXT) gene with reproductive traits in two groups of Awassi ewes that differ in their reproductive potentials. Sheep were genotyped using PCR-single-stranded conformation polymorphism approach. Three genotypes were detected in exon 2, CC, CA, and AA, and a novel SNP was identified with a missense effect on oxytocin (c.188C > A → p.Arg55Leu). A significant (p < 0.01) association of p.Arg55Leu with the twinning rate was found as ewes with AA and CA genotypes exhibited, respectively a lower twinning ratio than those with the wild-type CC genotype. The deleterious impact of p.Arg55Leu was demonstrated by all in silico tools that were utilized to assess the effect of this variant on the structure, function, and stability of oxytocin. Molecular docking showed that p.Arg55Leu caused a dramatic alteration in the binding of oxytocin with its receptor and reduced the number of interacted amino acids between them. Our study suggests that ewes with AA and CA genotypes showed a lower reproductive performance due to the presence of p.Arg55Leu, which caused damaging impacts on oxytocin and is binding with the OXT receptor. The utilization of the p.Arg55Leu could be useful for improving Awassi reproductive potential.

Effect of Graphene Oxide and Temperature on Electrochemical Polymerization of Pyrrole and Its Stability Performance in a Novel Eutectic Solvent (Choline Chloride-Phenol) for Supercapacitor Applications.

Polypyrrole (Ppy)-modified graphene oxide (GO) electrodes were synthesized for the first time in a choline chloride-phenol-based deep eutectic solvent at various temperatures via electrochemical methods without the addition of any inorganic or organic catalysts. The surface morphologies and structures of the modified films were assessed via scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and X-ray diffraction techniques. The electrochemical properties and stability of the modified electrodes were investigated via cyclic voltammetry and impedance spectroscopy at various temperatures and scan rates. The results showed that the specific capacitance of the nanocomposites decreased with increasing scan rate during cycling. Additionally, the specific capacitances of the pure Ppy and Ppy/GO films increased with increasing temperature of the electrolyte (monomer-free), attributed to the reduction in viscosity at elevated temperature. The specific capacitances at 5 mV s-1 were found to be 1071.78 and 594.79 F g-1 for Ppy/GO (20 wt %) at 50 and 25 °C, respectively. It was also observed that the resistance in the cell decreased with increasing electrolyte temperature. Ppy/GO at 50 mV s-1 was found to have the highest capacitance retention of 85% after 2000 cycles, showing better cycling stability than the pure Ppy film. Herein, the incorporation of GO in the Ppy matrix led to improved specific capacitance and cyclic stability, suggesting that Ppy/GO could represent a promising electrode material for supercapacitor applications.

Voltammetric Determination of Hg2+, Zn2+, and Pb2+ Ions Using a PEDOT/NTA-Modified Electrode.

A novel electrochemical sensor for determining trace levels of Hg2+, Pb2+, and Zn2+ ions in water using square wave voltammetry (SWV) is reported. The sensor is based on a platinum electrode (Pt) modified by poly(3,4-ethylenedioxythiophene) and N α,N α-bis-(carboxymethyl)-l-lysine hydrate (NTA lysine) PEDOT/NTA. The modified electrode surface (PEDOT/NTA) was prepared via the introduction of the lysine-NTA group to a PEDOT/N-hydroxyphthalimide NHP electrode. The (PEDOT/NTA) was characterized via cyclic voltammetry (CV), Fourier transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). The effects of scan rates on the electrochemical properties of the polymer electrode were also investigated. The electrochemical results were used to estimate the coverage of the electrode polymer surface and its electrostability in background electrolyte solutions. Several analytical parameters, such as polymer film thickness, metal deposition time, and pH of the electrolyte, were examined. Linear responses to Hg2+, Pb2+, and Zn2+ ions in the concentration range of 5-100 µg L-1 were obtained. The limits of detection (LODs) for the determination of Hg2+, Pb2+, and Zn2+ ions were 1.73, 2.33, and 1.99 µg L-1, respectively. These promising results revealed that modified PEDOT/NTA films might well represent an important addition to existing electrochemical sensor technologies.

Stroke in pediatric ECMO patients: analysis of the National Inpatient Sample (NIS) database.

BACKGROUND: The rates, outcomes, and long-term trends of stroke complicating the use of extracorporeal membrane oxygenation (ECMO) have been inconsistently reported. We compared the outcomes of pediatric ECMO patients with and without stroke and described the frequency trends between 2000 and 2017. METHODS: Using the National Inpatient Sample (NIS) database, pediatric patients (age ≤18 years) who received ECMO were identified using ICD-9&10 codes. Binary, regression, and trend analyses were performed to compare patients with and without stroke. RESULTS: A total of 114,477,997 records were reviewed. Overall, 28,695 (0.025%) ECMO patients were identified of which 2982 (10.4%) had stroke, which were further classified as hemorrhagic (n = 1464), ischemic (n = 1280), or combined (n = 238). Mortality was higher in the hemorrhagic and combined groups compared to patients with ischemic stroke and patients without stroke. Length of stay (LOS) was significantly longer in stroke vs. no-stroke patients. Hypertension and septicemia were more encountered in the hemorrhagic group, whereas the combined group demonstrated higher frequency of cardiac arrest and seizures. CONCLUSIONS: Over the years, there is an apparent increase in the diagnosis of stroke. All types of stroke in ECMO patients are associated with increased LOS, although mortality is increased in hemorrhagic and combined stroke only. IMPACT: Stroke is a commonly seen complication in pediatric patients supported by ECMO. Understanding the trends will help in identifying modifiable risk factors that predict poor outcomes in this patient population.

A multifunctional α-Fe2O3@PEDOT core-shell nanoplatform for gene and photothermal combination anticancer therapy.

Exploration of versatile nanoplatforms within one single nanostructure for multidisciplinary treatment modalities, especially achieving a synergistic therapeutic efficacy of combinational gene/photothermal cancer therapy is still a great challenge in biomedicine and nanotechnology. In this study, a unique photothermal nanocarrier has successfully been designed and developed for a combination of gene therapy (GT) and photothermal therapy (PTT) of cancer cells. Surface-engineered iron oxides (α-Fe2O3) nanoparticles (NPs) with poly(3,4-ethylenedioxythiophene) (PEDOT) polymer coatings are synthesized using a one-pot in situ oxidative polymerization method. The results show that the as-prepared α-Fe2O3@PEDOT core-shell NPs with a uniform particle size exhibit positively charged surfaces, facilitating efficient siRNA Bcl-2 (B-cell lymphoma-2) uptake for delivery to breast cancer cells. More importantly, α-Fe2O3@PEDOT core-shell NPs not only display good biocompatibility and water dispersibility but also strong optical absorption enhancement in the Vis-NIR region as compared to α-Fe2O3 NPs. The obtained α-Fe2O3@PEDOT core-shell NPs show an efficient photothermal conversion efficacy (η = 54.3%) and photostability under NIR laser irradiation. As a result, both in vitro and in vivo biological studies on two types of breast cancer cells/tumors treated with α-Fe2O3@PEDOT-siRNA nanocomplexes demonstrate high cancer cell apoptosis and tumor inhibition induced by synergistic GT/PTT therapy under mild conditions compared to an individual GT or PTT alone. Taken together, this is the first example of the use of an α-Fe2O3@PEDOT core-shell nanoagent as a siRNA delivery nanocarrier for highly effective gene/photothermal combination anticancer therapy.

The U.S. National Trend for Retinopathy of Prematurity.

OBJECTIVE: The use of supplemental oxygen in premature infants is essential for survival. However, its use has been associated with unintended complications. The restricted use of oxygen is associated with increased mortality and necrotizing enterocolitis (NEC), whereas its liberal use is associated with increased risk for retinopathy of prematurity (ROP). Although there is no clear consensus on the acceptable oxygen saturation range, clinicians have recently become more liberal with the use of oxygen. We aim to assess (1) the national trends for ROP in very low birth weight preterm infants, and (2) the associated trends in mortality, NEC, intraventricular hemorrhage (IVH), and length of hospital stay (LOS). STUDY DESIGN: We analyzed deidentified patient data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) from 2002 to 2017. All infants with gestational age ≤32 weeks and birth weight <1,500 g were included. Trends in ROP, severe ROP, mortality, NEC, IVH, severe IVH, and LOS were analyzed using Jonckheere-Terpstra test. RESULTS: A total of 818,945 neonates were included in the study. The overall mortality was 16.2% and the prevalence of ROP was 17.5%. There was a significant trend for increased ROP over the years (p < 0.001). Severe ROP was also significantly increased (p < 0.001). This was associated with a significant trend for increased median LOS in survived infants (p < 0.001). Mortality was significantly decreased (p < 0.001), whereas NEC and severe NEC did not change over time (p = 0.222 and p = 0.412, respectively). CONCLUSION: There is a national trend for increased ROP and severe ROP over the 16 years of the study period. This trend was associated with a significant increase in the LOS in survived infants without change in NEC. KEY POINTS: · Prevalence of ROP and severe ROP has increased in VLBW infants over the 16-year study period.. · The prevalence of NEC did not change over the same time period.. · Increased ROP and severe ROP were consistent in all three GA and BW subgroups..

Outcomes of Cardiac Arrest and Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Device; an Insight From a National Inpatient Sample.

BACKGROUND: Outcomes of patients with implanted left ventricular assist device (LVAD) implantation experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the in-hospital outcomes of patients with implanted LVAD experiencing a CA. METHODS: The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients older than 18 years with implanted LVAD and CA between 2010-2018. We excluded patients with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation and do not resuscitate (DNR) status. RESULTS: A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were identified. Only 578 of these hospitalisations had experienced CA and of those, 173 (33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33 for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01), and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease and history of coronary artery bypass graft (CABG) were independently associated with increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were independently associated with in-hospital mortality. During the study period, there was a significantly decreasing trend in performing CPR in LVAD hospitalisations with CA. CONCLUSION: In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and CPR were independently associated with in-hospital mortality in LVAD hospitalisations who experienced CA.

Epidemiologic evaluation of inhaled nitric oxide use among neonates with gestational age less than 35 weeks.

BACKGROUND AND OBJECTIVES: The use of inhaled nitric oxide (iNO) in +late preterm and term infants with pulmonary hypertension is Food and Drug Administration (FDA) approved and has improved outcomes and survival. iNO use is not FDA approved for preterm infants and previous studies show no mortality benefit. The objectives were 1) to determine the usage of iNO among preterm neonates <35 weeks before and after the 2010 National Institutes of Health consensus statement and 2) to evaluate characteristics and outcomes among preterm neonates who received iNO. METHODS: This is a population-based cross-sectional study. Billing and procedure codes were used to determine iNO usage. Data were queried from the National Inpatient Sample from 2004 to 2016. Neonates were included if gestational age was <35 weeks. The epochs were spilt into 2004-2010 (Epoch 1) and 2011-2016 (Epoch 2). Prevalence of iNO use, mortality, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage, length of stay, mechanical ventilation, and cost of hospitalization. RESULTS: There were 4865 preterm neonates <35 weeks who received iNO. There was a significant increase in iNO use during Epoch 2 (p < 0.001). There was significantly higher use in Epoch 2 among neonates small for gestational age (SGA) 2.3% versus 7.2%, congenital heart disease (CHD) 11.1% versus 18.6%, and BPD 35.2% versus 46.8%. Mortality was significantly lower in Epoch 2 19.8% versus 22.7%. CONCLUSION: Usage of iNO was higher after the release of the consensus statement. The increased use of iNO among preterm neonates may be targeted at specific high-risk populations such as SGA and CHD neonates. There was lower mortality in Epoch 2; however, the cost was doubled.

Comics as a body image intervention among adolescents in Indian Hindi medium schools: insights from an acceptability study.

Background: Indian adolescents experience body dissatisfaction. However, empirically supported interventions are lacking, particularly in lower socio-economic regions of India. This paper describes the acceptability testing of a six-session teacher-led comics-based intervention, aiming to improve body image and related outcomes among adolescents in Indian Hindi medium schools. Methods: Thirty-five students (50% girls; M age, girls = 12.3 years; M age, boys = 13 years) and nine teachers (11% women) from Hindi medium schools in Rajasthan, India, completed a quantitative acceptability questionnaire regarding comics that target body dissatisfaction and associated risk factors. They also participated in online or telephone semi-structured interviews to share in-depth feedback, with teachers providing additional feedback on an accompanying teacher guide. The quantitative data were analysed descriptively, with the interviews analysed using qualitative codebook thematic analysis. Results: Quantitative analyses revealed that 73% of students felt the comics made them feel good about themselves. Qualitative analyses revealed four themes: (1) body dissatisfaction is a concern; (2) the comics are powerful; (3) increasing ease of understanding; (4) a teacher guide to aid delivery. Conclusion: This study demonstrates acceptability of a novel teacher-led comics-based body image intervention for adolescents in Indian Hindi medium schools from lower socio-economic settings. These findings are currently informing intervention optimizations, which will be evaluated in a randomized controlled effectiveness trial. If found to be effective, this intervention will be disseminated across eight Indian states by UNICEF. Trial registration. This trial has been registered with ClinicalTrials.gov; a database of privately and publicly funded studies conducted around the world. Registration date: 2nd May 2020; Registration ID: (NCT04317755). https://clinicaltrials.gov/ct2/show/NCT04317755?term=NCT04317755&draw=2&rank=1.

Reduction of Calciprotein Particles in Adults Receiving Infliximab for Chronic Inflammatory Disease.

Patients with chronic inflammatory diseases (CID) experience accelerated loss of bone mineral density, which is often accompanied by increased vascular calcification. These disturbances can be attenuated by therapies for inflammation, such as the tumor necrosis factor inhibitor infliximab. Calciprotein particles (CPP) are circulating colloidal aggregates of calcium and phosphate together with the mineral-binding protein fetuin-A, which have emerged as potential mediators of vascular calcification. The precise origins of serum CPP are unclear, but bone turnover may be an important source. In this longitudinal observational study, we studied patients with CID undergoing treatment with infliximab to assess the temporal relationship between bone turnover and circulating CPP. Ten patients with active CID receiving infliximab induction therapy and an additional 3 patients with quiescent CID on maintenance infliximab therapy were studied for 8 weeks with repeated measures of bone turnover markers as well as CPP (calciprotein monomers [CPM], primary CPP [CPP-I], and secondary CPP [CPP-II]). Therapeutic response was appraised using validated disease activity scores. At baseline, those with active CID had elevated markers of bone resorption and suppressed bone formation markers as well as higher CPM and CPP-I compared with those with quiescent CID. In responders, there was an early but transient reduction in resorption markers by week 1, but a more sustained increase in bone formation markers compared with non-responders at week 8. This was accompanied by reductions in CPM (ß = -6.5 × 103 AU [95% CI -11.1, -1.8], p = 0.006) and CPP-I (ß = -23.4 × 104 particles/mL [95% CI -34.8, -11.9], p < 0.001). In contrast, no significant changes in any markers were observed in non-responders or those receiving maintenance therapy. Thus, CPP have a dynamic association with changes in bone turnover in response to infliximab therapy, adding to accumulating evidence of the role of bone as a determinant of systemic levels. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Predictive Value of HATCH Scoring and Waist-to-Height Ratio in Atrial Fibrillation Following Coronary Artery Bypass Operations Performed with Cardiopulmonary Bypass.

OBJECTIVES: Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. METHODS: Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. RESULTS: A total of 255 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 196, mean age = 58.9 ± 9.4 years), and those who did were included in Group 2 (n = 59, mean age = 61.1 ± 12 years). There were no statistically significant differences between the two groups in terms of age, gender, presence of hypertension and hyperlipidemia. Rates of chronic obstructive pulmonary disease and previous percutaneous coronary interventions, waist circumference, waist to height ratio and HATCH score values were significantly higher in Group 2 compared to Group 1 ( p values: 0.019, 0.034, 0.001, <0.001, <0.001, respectively). In multivariate analysis, WHR (Odds ratio: 1.068, Confidence interval: 1.032-1.105, p < 0.001) and HATCH score (Odds ratio: 2.590, Confidence interval: 1.850-3.625, p < 0.001) were independent predictors of PoAF. CONCLUSIONS: With this current prospective study, we showed that calculating WHR and HATCH score in the preoperative period can help us predict PoAF.

Platelet Transfusion and Outcomes of Preterm Infants: A Cross-Sectional Study.

BACKGROUND: Prophylactic platelet transfusion has been adopted as a ubiquitous practice in management of thrombocytopenia in preterm infants to reduce the risk of bleeding. OBJECTIVES: The objectives of this study were to report the prevalence of platelet transfusion among preterm infants with thrombocytopenia and to assess the association of platelet transfusion with mortality and morbidity in this population. METHODS: A cross-sectional study that utilized National Inpatient Sample for the years 2000-2017 was conducted. All preterm infants delivered nationally with birth weight (BW) <1,500 g or gestational age <32 weeks were included. Analyses were repeated after stratifying the population into 2 BW subcategories <1,000 g and 1,000-1,499 g. Logistic regression analysis was performed to adjust for confounding variables. RESULTS: The study included 1,780,299 infants; of them, 22,609 (1.27%) were diagnosed with thrombocytopenia and 5,134 (22.7%) received platelet transfusion. Platelet transfusion was associated with significant increase in mortality (24.8 vs. 13.8%), retinopathy of prematurity (22.3 vs. 19.2%), severe intraventricular hemorrhage (18.3 vs. 10.1%), median length of hospital stays (51 vs. 47 days), and cost of hospitalization (USD 298,204 vs. USD 219,760). Increased mortality was noted in <1,000-g infants (aOR = 1.96, CI: 1.76-2.18, p < 0.001) and 1,000-1,499-g infants (aOR = 2.02, CI: 1.62-2.53, p < 0.001). Platelet transfusion increased over the years in infants with BW <1,000 g (p = 0.001) and in infants with BW 1,000-1,499 g (p < 0.001). CONCLUSIONS: Platelet transfusion is associated with increased mortality and comorbidities in premature infants. There is a trend for increased utilization of platelet transfusions over the study period.