Distinct subsets of anti-pulmonary autoantibodies correlate with disease severity and survival in severe COVID-19 patients.

Autoantibodies targeting the lung tissue were identified in severe COVID-19 patients in this retrospective study. Fifty-three percent of 104 patients developed anti-pulmonary antibodies, the majority of which were IgM class, suggesting that they developed upon infection with SARS-CoV-2. Anti-pulmonary antibodies correlated with worse pulmonary function and a higher risk of multiorgan failure that was further aggravated if 3 or more autoantibody clones were simultaneously present (multi-producers). Multi-producer patients were older than the patients with less or no autoantibodies. One of the identified autoantibodies (targeting a pulmonary protein of ~ 50 kDa) associated with worse clinical outcomes, including mortality. In summary, severe COVID-19 is associated with the development of lung-specific autoantibodies, which may worsen the clinical outcome. Tissue proteome-wide tests, such as the ones applied here, can be used to detect autoimmunity in the post-COVID state to identify the cause of symptoms and to reveal a new target for treatment.

Review of Central-Eastern European Propagation and Larvae Nursing Method for Common Carp (Cyprinus carpio L.).

Common carp (Cyprinus carpio L.) as a cultivated fish species has huge importance all over the world. According to FAO statistics, carp is the third most widely bred freshwater pond fish species; only two other Cyprinids (silver carp and grass carp) are bred in higher amounts. Carp is native all over Asia and in a large part of Europe. As a result of human intervention, at present, carp are widespread all over the world, except for the Arctic region. Carp breeding was launched in the antique period, in the ancient Chinese Empire and the Roman Empire. The presently applied method of breeding of common carp has a long evolution. From the effectiveness point of view, the propagation and early-life nursing are crucial parts of carp production, as they provide seed stocks for the further growing section. Without effective propagation, there is no intensive carp production. Nowadays, more advanced propagation methods are available all over the world; however, in the current review, only the main milestones and production efficiency of the propagation and nursing method used in the ponds of Eastern Central Europe are discussed. In the historical overview of carp reproduction, first the natural reproduction, then the semi-extensive and intensive hatchery propagation are presented and investigated in detail. The analysis focuses on the advantages and disadvantages of the method. In particular, the different important milestones of the advanced hatchery method are shown and explained. The effectiveness is proven even with practical calculations. Not only the reproduction, but the pond nursing method is also presented and discussed, concentrating on the management of evolutionarily adapted natural feeds (Zooplankton) and their effect on the survival of fish larvae.

Effect of anti-SARS-CoV-2 BNT162b2 mRNA vaccination on thrombin generation in children with inflammatory bowel disease.

Background: Inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC), are associated with higher thrombotic risk and enhanced thrombin generation (TG) in adults. Despite encouraging data reporting vaccine safety and low IBD flare rates in adults with IBD, vaccine hesitancy was demonstrated to be high in families of children with IBD. We aimed to find out whether TG is increased in children with IBD as compared to healthy controls and whether TG parameters show significant changes following SARS-CoV-2 mRNA vaccination. Patients and methods: In this observational case-control study, 38 children with IBD (CD:18, UC: 20) aged 12-18 years and 62 healthy age-and sex-matched children were enrolled. Blood was collected before the first dose and 2-6 weeks after the second dose of BNT162b2 (Pfizer-BioNTech) mRNA vaccine dose. Blood cell counts, fibrinogen, inflammatory markers (hsCRP, ferritin), anti-SARS-CoV-2 antibody levels were investigated, TG assay was carried-out using platelet-poor plasma. Detailed clinical parameters including disease activity scores (PUCAI, PCDAI) were registered pre-and post- vaccination. A guided questionnaire was used to collect data on adverse reactions (AEs) post- vaccination. Results: Baseline TG parameters did not differ between patients and controls. Endogenous thrombin potential showed a significant positive correlation with markers of inflammation and with PCDAI. Inflammatory parameters and TG did not increase in patients and controls post-vaccination. Vaccination significantly increased antibody levels in all three investigated groups, but post-vaccination anti-SARS-CoV-2 S IgG/IgM levels were below the 5th percentile value of healthy children in more than one third of patients. Those receiving TNFα inhibitor therapy presented significantly lower SARS-CoV-2 S IgG/IgM levels as compared to patients on other immunosuppressive regimens. Systemic AEs did not differ between patients and controls while lower rate of local symptoms was found post-vaccination in children with IBD. Only 2 IBD flares were detected 2-6 weeks after the second dose of vaccination. Conclusion: Our study is the first to support the safety and efficacy of anti-SARS-CoV-2 BNT162b2 vaccination in children with IBD with detailed pre-and post-vaccination laboratory data including TG. Results of this study may further increase confidence and reduce vaccine hesitancy in caretakers of pediatric IBD patients.

Associations between daily affective experiences, trait and daily rumination on negative and positive affect: a diary study.

BACKGROUND: Rumination has mostly been studied in relation to depression, however, it may also occur in response to positive emotions (i.e., positive rumination) and therefore may be a protective factor related to the maintenance of positive mood. OBJECTIVE: We hypothesized that daily positive and negative affect would be associated with daily positive and negative rumination even after controlling for trait-level rumination. METHOD: We carried out a diary study with university students (n = 178), where participants had to answer short surveys online about their daily affect and daily rumination every evening for 10 days. We analyzed our data with multilevel regression in R. RESULTS: Daily positive and negative affect were significantly associated with daily negative and positive rumination, while trait-level rumination scores were not. Daily and trait-level rumination were moderately correlated (r = 0.333-0.440). CONCLUSIONS: Our findings highlight that daily rumination plays a more significant role in daily emotional experiences than trait rumination across positive and negative valence domains. Daily negative affect appears to be more closely related to higher daily negative rumination than the lack of daily positive rumination, which could be relevant for intervention strategies.

Significant changes in advanced lung cancer survival during the past decade in Hungary: impact of modern immunotherapy and the COVID-19 pandemic.

Objective: The approval of immunotherapy (I-O) for the treatment of late-stage non-small cell lung cancer (NSCLC) opened new perspectives in improving survival outcomes. However, survival data have not yet been provided from the period of the Covid-19 pandemic. The aims of our study were to assess and compare survival outcomes of patients with advanced LC receiving systemic anticancer treatment (SACT) before and after the approval of immunotherapy in Hungary, and to examine the impact of pandemic on survival outcomes using data from the Hungarian National Health Insurance Fund (NHIF) database. Methods: This retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with advanced stage lung cancer (LC) (ICD-10 C34) between 1 January 2011 and 31 December 2021 and received SACT treatment without LC-related surgery. Survival rates were evaluated by year of diagnosis, sex, age, and LC histology. Results: In total, 35,416 patients were newly diagnosed with advanced LC and received SACT during the study period (mean age at diagnosis: 62.1-66.3 years). In patients with non-squamous cell carcinoma, 3-year survival was significantly higher among those diagnosed in 2019 vs. 2011-2012 (28.7% [95% CI: 26.4%-30.9%] vs. 14.45% [95% CI: 13.21%-15.69%], respectively). In patients with squamous cell carcinoma, 3-year survival rates were 22.3% (95% CI: 19.4%-25.2%) and 13.37% (95% CI: 11.8%-15.0%) in 2019 and 2011-2012, respectively, the change was statistically significant. Compared to 2011-2012, the hazard ratio of survival change for non-squamous cell carcinoma patients was 0.91, 0.82, and 0.62 in 2015-2016, 2017-2018, and 2019, respectively (p<0.001 for all cases). In the squamous cell carcinoma group, corresponding hazard ratios were 0.93, 0.87, and 0.78, respectively (p<0.001 for all cases). Survival improvements remained significant in both patient populations during the Covid-19 pandemic (2020-2021). No significant improvements were found in the survival of patients with small cell carcinoma. Platinum-based chemotherapy was the most common first-line treatment in all diagnostic periods, however, the proportion of patients receiving first- or second-line immunotherapy significantly increased during the study period. Conclusion: 3-year survival rates of NSCLC almost doubled among patients with non-squamous cell carcinoma and significantly improved at squamous cell carcinoma over the past decade in Hungary. Improvements could potentially be attributable by the introduction of immunotherapy and were not offset by the Covid-19 pandemic.

Opposite trends in incidence of breast cancer in young and old female cohorts in Hungary and the impact of the Covid-19 pandemic: a nationwide study between 2011-2020.

Background: This nationwide study examined breast cancer (BC) incidence and mortality rates in Hungary between 2011-2019, and the impact of the Covid-19 pandemic on the incidence and mortality rates in 2020 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary. Methods: Our nationwide, retrospective study included patients who were newly diagnosed with breast cancer (International Codes of Diseases ICD)-10 C50) between Jan 1, 2011 and Dec 31, 2020. Age-standardized incidence and mortality rates (ASRs) were calculated using European Standard Populations (ESP). Results: 7,729 to 8,233 new breast cancer cases were recorded in the NHIF database annually, and 3,550 to 4,909 all-cause deaths occurred within BC population per year during 2011-2019 period, while 2,096 to 2,223 breast cancer cause-specific death was recorded (CSO). Age-standardized incidence rates varied between 116.73 and 106.16/100,000 PYs, showing a mean annual change of -0.7% (95% CI: -1.21%-0.16%) and a total change of -5.41% (95% CI: -9.24 to -1.32). Age-standardized mortality rates varied between 26.65-24.97/100,000 PYs (mean annual change: -0.58%; 95% CI: -1.31-0.27%; p=0.101; total change: -5.98%; 95% CI: -13.36-2.66). Age-specific incidence rates significantly decreased between 2011 and 2019 in women aged 50-59, 60-69, 80-89, and ≥90 years (-8.22%, -14.28%, -9.14%, and -36.22%, respectively), while it increased in young females by 30.02% (95%CI 17,01%- 51,97%) during the same period. From 2019 to 2020 (in first COVID-19 pandemic year), breast cancer incidence nominally decreased by 12% (incidence rate ratio [RR]: 0.88; 95% CI: 0.69-1.13; 2020 vs. 2019), all-cause mortality nominally increased by 6% (RR: 1.06; 95% CI: 0.79-1.43) among breast cancer patients, and cause-specific mortality did not change (RR: 1.00; 95%CI: 0.86-1.15). Conclusion: The incidence of breast cancer significantly decreased in older age groups (≥50 years), oppositely increased among young females between 2011 and 2019, while cause-specific mortality in breast cancer patients showed a non-significant decrease. In 2020, the Covid-19 pandemic resulted in a nominal, but not statistically significant, 12% decrease in breast cancer incidence, with no significant increase in cause-specific breast cancer mortality observed during 2020.

Stimulator of Interferon Genes (STING) Triggers Adipocyte Autophagy.

Innate immune signaling in adipocytes affects systemic metabolism. Cytosolic nucleic acid sensing has been recently shown to stimulate thermogenic adipocyte differentiation and protect from obesity; however, DNA efflux from adipocyte mitochondria is a potential proinflammatory signal that causes adipose tissue dysfunction and insulin resistance. Cytosolic DNA activates the stimulator of interferon response genes (STING), a key signal transducer which triggers type I interferon (IFN-I) expression; hence, STING activation is expected to induce IFN-I response and adipocyte dysfunction. However, we show herein that mouse adipocytes had a diminished IFN-I response to STING stimulation by 2'3'-cyclic-GMP-AMP (cGAMP). We also show that cGAMP triggered autophagy in murine and human adipocytes. In turn, STING inhibition reduced autophagosome number, compromised the mitochondrial network and caused inflammation and fat accumulation in adipocytes. STING hence stimulates a process that removes damaged mitochondria, thereby protecting adipocytes from an excessive IFN-I response to mitochondrial DNA efflux. In summary, STING appears to limit inflammation in adipocytes by promoting mitophagy under non-obesogenic conditions.

Interrelationship of hemoglobin A1c level lipid profile, uric acid, C-reactive protein levels and age in a large hospital database.

INTRODUCTION: Hemoglobin A1c (HbA1c) is used to monitor glucose homeostasis and to identify risk for diabetes. As diabetic patients are frequently present with dyslipidaemia, low-grade inflammation and hyperuricemia, we tested whether HbA1c levels can be estimated having the information about lipid profile, uric acid (UA) and C-reactive protein (CRP) levels. We developed formulas to describe the association of these parameters with HbA1c levels. METHODS: Data of 9599 male and 10,817 female patients, measured between 2008 and 2018, were analysed. Patients represented a general hospital patient population with overrepresentation of those with elevated HbA1c over 5.6%. The impact of gender, age, CRP, lipid profile and UA levels on HbA1c % on HbA1c levels was tested with multiple linear regression model. The magnitude of effects of individual factors was used to develop formulas to describe the association between HbA1c and other cardiometabolic parameters. With these formulas we estimated median HbA1c values in each age in both gender and compared them to measured HbA1c levels. RESULTS: The developed formulas are as follow: HbA1c (estimated) in women = 0.752 + 0.237*log10(HDL/cholesterol) + 0.156*log10 (cholesterol) + 0.077*log10 (triglyceride) + 0.025*log10(CRP) +0.001*log10 (age) -0.026*log10(HDL/LDL) -0.063*log10 (uric acid)-0.075*log10 (LDL)-0.199*log10(HDL); HbA1c (estimated) in men = 1.146 + 0.08*log10 (triglyceride) + 0.046*log10(CRP) + 0.01*log10 (cholesterol) + 0.001*log10 (age) -0.014*log10(HDL)-0.018*log10(HDL/LDL)-0.025*log10(HDL/cholesterol) -0.068*log10 (LDL)-0.159*log10 (uric acid) Between 20 and 70 years of age, estimated HbA1c matched perfectly to measured HbA1c in. CONCLUSION: At population level, HbA1c levels can be estimated almost exactly based on lipid profile, CRP and uric acid levels in female patients between 20 and 70 years.

T cell immune response predicts survival in severely ill COVID-19 patients requiring venovenous extracorporeal membrane oxygenation support.

Introduction: There is a critical gap in understanding which SARS-CoV-2 patients would benefit most from venovenous extracorporeal membrane oxygenation (VV-ECMO) support. The potential role of a dysregulated immune response is still unclear in this patient population. Objectives: To assess the potential predictive value of SARS-CoV-2 specific cellular and humoral immune responses for survival in critically ill COVID-19 patients requiring VV-ECMO. Methods: We conducted a prospective single-center observational study of unvaccinated patients requiring VV-ECMO support treated at the intensive care unit of Semmelweis University Heart and Vascular Center between March and December 2021. Peripheral blood samples were collected to measure the humoral and cellular immune statuses of the patients at the VV-ECMO cannulation. Patients were followed until hospital discharge. Results: Overall, 35 COVID-19 patients (63% men, median age 37 years) on VV-ECMO support were included in our study. The time from COVID-19 verification to ECMO support was a median (IQR) of 10 (7-14) days. Of the patients, 9 (26%) were discharged alive and 26 (74%) died during their hospital stay. Immune tests confirmed ongoing SARS-CoV-2 infection in all the patients, showing an increased humoral immune response. SARS-CoV-2-specific cellular immune response was significantly higher among survivors compared to the deceased patients. A higher probability of survival was observed in patients with markers indicating a higher T cell response detected by both QuantiFeron (QF) and flow cytometry (Flow) assays. (Flow S1 CD8+ ≥ 0.15%, Flow S1 CD4+ ≥ 0.02%, QF CD4 ≥ 0.07, QF whole genome ≥ 0.59). In univariate Cox proportional hazard regression analysis BMI, right ventricular (RV) failure, QF whole genome T cell level, and Flow S1 CD8+ T cell level were associated with mortality, and we found that an increased T cell response showed a significant negative association with mortality, independent of BMI and RV failure. Conclusion: Evaluation of SARS-CoV-2 specific T cell response before the cannulation can aid the risk stratification and evaluation of seriously ill COVID-19 patients undergoing VV-ECMO support by predicting survival, potentially changing our clinical practice in the future.

Colloidal Interactions of Microplastic Particles with Anionic Clays in Electrolyte Solutions.

Homoaggregation of polystyrene microplastics (MPs) and heteroaggregation of MPs with anionic clay minerals, namely, layered double hydroxide (LDH), in different salt (NaCl, CaCl2, and Na2SO4) solutions were systematically investigated using light scattering techniques. The salt type and ionic strength had significant effects on the stability of both MPs and LDH particles individually and the results could be explained by DLVO theory and the Schulze-Hardy rule. However, once stable colloidal dispersions of the individual particles were mixed, heteroaggregation occurred between the oppositely charged MPs and LDH, which was also confirmed by transmission electron microscopy and X-ray scattering. Adsorption of the LDH particles resulted in neutralization and reversal of MPs surface charge at appropriate LDH doses. Once LDH adsorption neutralized the negative charges of the MP spheres, rapid aggregation was observed in the dispersions, whereas stable samples formed at high and low LDH concentrations. The governing interparticle interactions included repulsive electrical double-layer forces, as well as van der Waals and patch-charge attractions, the strength of which depended on the mass ratio of the interacting particles and the composition of the aqueous solvent. Our results shed light on the colloidal behavior of MPs in a complex aquatic environment and, in the long term, are also useful for developing LDH-based approaches for water remediation to remove contamination with MP particles.

Dual-Role Peptide with Capping and Cleavage Site Motifs in Nanoparticle-Based One-Pot Colorimetric and Electrochemical Protease Assay.

A new method for enzyme substrate assembly and its use in proteolytic enzyme assays with colorimetric and electrochemical detection is presented. The novelty of the method is the use of dual-function synthetic peptide containing both gold clustering and protease-sensitive moieties, which not only induces the simple formation of the peptide-decorated gold nanoparticle test substrates but also allows for the detection of proteolysis in the same batch. Protease-treated nanoparticles with a destabilized peptide shell became more prone to electroactivity, and thus, the model enzyme plasmin activity could be quantified with stripping square wave voltammetry analysis as well, giving an alternative method to conduct aggregation-based assays. Spectrophotometric and electrochemical calibration data proved to be linear within the 40-100 nM active enzyme concentration range, with possible extensions of the dynamic range by varying substrate concentration. The simple initial components and the ease of synthesis make the assay substrate preparation economic and easy to implement. The possibility of cross-check analytical results with two independent measurement techniques in the same batch greatly increases the applicability of the proposed system.

Exploring Patient Adherence to Post-Surgical Follow-Up in Pelvic Endometriosis.

Endometriosis is a significant cause of disability that affects 5-10% of reproductive-aged women. Laparoscopy with histological confirmation is the gold standard in establishing the diagnosis as therapeutic management surgery is addressed to a certain category of patients. The objective of this study was to assess patient adherence to follow-up after surgery for endometriosis as the primary endpoint, pain symptoms, quality of life, mental health, and fertility as the secondary endpoints. We have analyzed patients' adherence to follow-up after surgery for endometriosis after 1, 3, 5, and 7 years. Out of the 2538 total number of surgeries, 453 patients replied just to the first questionnaire (group A), 528 to the first and second (group B), and only 356 carried out the entire follow-up schedule. General health was significantly lower for group A (46.6 vs. 56.4) but with no statistical difference in the post-surgical improvement in both groups. Pain level score improvement was lower for group A (10.5 vs. 18.8), which is statistically significant. In this light, laparoscopy still remains the gold standard in diagnosis only. Furthermore, no malignancy was discovered. The mental component was improved by laparoscopy based on SF-36 in group B. Studies on patient preference for surgery versus alternative treatment are needed.

[The new target population of stroke awareness campaign: Kindergarten students]. / "Stroke-ovi". A lakossági felvilágosítás új célközönsége: az óvodások.

Background and purpose:

 Thrombolysis and/or thrombectomy have been proven effective in the treatment of acute ischemic stroke. Due to the narrow time window, the number of patients suitable for these treatments is low. The main limitation is the pre-hospital stage, few people call an ambulance in time. The delay may be caused by the population’s insufficient health knowledge, but also by the loneliness and isolation of the population most prone to stroke. Among the latter, there are many grandparents who spend considerable time with their grandchildren. This gave rise to the idea of educating even younger children about the symptoms of a stroke, enabling them to call an ambulance if necessary. To this end, we adapted the Angels Initiative project previously tested in Greece. The Hungarian pilot study Budapest District XII. took place in district kindergartens. The Angels’ original role-playing program could not be implemented due to the COVID epidemic, so the necessity called for a new, Hungarian version: the online “Stroke Ovi” program. We introduced this in several stages, and in the third we also carried out an impact study.

 We adapted the Angels Initiative’s international program and its Hungarian translation to our program. We prepared the original, live role-playing form, with a parent meeting in the selected “test kindergarten”. Due to the uncertainly lingering impact of the COVID epidemic, we reevaluated our plan, using the Hungarian storybook and take-home workbook created in the meantime, we developed our own online version in several kindergartens in Budapest. We held 10 and then 25 minute sessions a week for 5 weeks. In the third educational cycle, which always targets new groups, we already examined the impact of the program by taking pre- and post-tests, in which not only the children but also their parents participated. In addition to neurologists and kindergarten teachers, we also included psychologists and speech therapists in our work, because we believed that in a social environment that includes parents and children, results can only be achieved through multidisciplinary cooperation.

 In the third cycle of the program, tests were taken before (pre-test) and after (post-test) among children and their parents. We only took into account those answers where we received an evaluable answer in the survey before and after the program. Our most important results: 1. there was no negative change in any question, so it was not the case that the total score of any question in the pre-test was higher than in the post-test. 2. The children learned that not only adults can call the ambulance. 3. Before the program, all children were already aware that if “someone is very ill”, the ambulance should be called. 4. Among the questions about stroke symptoms, it is important that hemiparesis, facial paresis and speech/language disorder are clear symptoms for children. Based on the parental questionnaires, the knowledge of the adults can be judged to be very good. The same number of correct answers were received during the pre-test and the post-test, on the basis of which we could not calculate a transfer effect. However, it is important that the parents considered the program useful, motivating and important for the children, so cooperation can be expected in the future.

The Hungarian “Stroke Ovi” program has so far proven to be clearly effective. This was proven by the impact assessments even if, instead of the original role-playing game, we implemented it “only” online due to the COVID epidemic. This constraint also forced and created a new “Hungarian version”. Despite the small number of samples caused by the circumstances, we consider this positive effect to be measurable. However, as the main result and evidence, we evaluated the children’s reaction, which took shape in spontaneous drawings and displayed professional values in addition to positive emotional reactions, such as the drawing of ambulances, the recurring representation of the 112 number. With the involvement of the media, we think online education is also a good option in the series of stroke campaigns, but we think the original role-playing form is really effective. At the same time, we can see that the application of the new method requires great caution due to the education of developing children. For this reason, results can only be achieved through social and multidisciplinary cooperation involving neurologists, psychologists, kindergarten teachers, and parents.

Prevention of Chronic Morbidities in Extremely Premature Newborns with LISA-nCPAP Respiratory Therapy and Adjuvant Perinatal Strategies.

Less invasive surfactant administration techniques, together with nasal continuous airway pressure (LISA-nCPAP) ventilation, an emerging noninvasive ventilation (NIV) technique in neonatology, are gaining more significance, even in extremely premature newborns (ELBW), under 27 weeks of gestational age. In this review, studies on LISA-nCPAP are compiled with an emphasis on short- and long-term morbidities associated with prematurity. Several perinatal preventative and therapeutic investigations are also discussed in order to start integrated therapies as numerous organ-saving techniques in addition to lung-protective ventilations. Two thirds of immature newborns can start their lives on NIV, and one third of them never need mechanical ventilation. With adjuvant intervention, these ratios are expected to be increased, resulting in better outcomes. Optimized cardiopulmonary transition, especially physiologic cord clamping, could have an additively beneficial effect on patient outcomes gained from NIV. Organ development and angiogenesis are strictly linked not only in the immature lung and retina, but also possibly in the kidney, and optimized interventions using angiogenic growth factors could lead to better morbidity-free survival. Corticosteroids, caffeine, insulin, thyroid hormones, antioxidants, N-acetylcysteine, and, moreover, the immunomodulatory components of mother's milk are also discussed as adjuvant treatments, since immature newborns deserve more complex neonatal interventions.

Improved thermal conductivity of polyurethane (PU)-/SiC composite fabricated via solution casting method and its mechanical model for prediction and comparison.

Polymer composites having high thermal conductivity (TC) gained great interest, including the advancement of electronic devices to become more functionalized, scaled, and integrated. In view of these, herein, highly thermal conductive polyurethane (PU)-/SiC composites are fabricated via the solution casting method. Silicon carbide is used as the filler in both flexible and rigid-polyurethane matrices to enhance the value of TC for electronic applications. A novel model has also been developed based on the Coran-Patel model for analysis and comparison of TC of as-synthesized composites. Calculated thermal conductivities by the model are found to be consistent with the experimental results. The highest measured TC for flexible as well as rigid-PU composites is 0.521 and 0.542 Wm-1K-1 representing improvements of 106% and 87% over their pure equivalents, respectively. SEM and DSC techniques are employed to analyze the samples' morphology, and other thermal properties, respectively.

Corrosion Protection and Heat Resistance of Paints for Outdoor Use.

Innovative heat- and corrosion-resistant coating approaches, applicable in indirect-food-contact outdoor environments, have been developed. Two systems, a direct-to-metal single-layer, polysiloxane-based, oven-dried system and a bilayer, zinc phosphate active pigment-containing, ambient-cured system were developed to overcome the shortcomings of the traditional bilayer, zinc-rich primer-based heat-resistant surface-protective solutions for outdoor cooking equipment, such as barbecue grills. This case study aims to optimize the application conditions, measure and evaluate the impact of surface preparation and compare thermo-resistant and anticorrosive properties of different coating systems focusing on eco-efficiency. The anticorrosion efficiency of the coatings was characterized using salt-spray chamber corrosion tests and electrochemical impedance spectroscopy. The thermo-resistant character of the coatings was tested by cyclic and constant heat treatment, after which the physical integrity of the coatings was evaluated by optical microscopy. In the overall performance of the coatings, the roughening of the steel substrate surface and the thickness of the coatings were also considered as influential parameters. The study revealed that the newly developed coatings have superior anticorrosion performance to the usually applied Zn-rich coating. The Single-layered Coating has excellent corrosion resistance under certain conditions and has the advantage of fast layer application. The Bilayered Coating showed excellent heat- and corrosion-resistance properties even on a surface without sand-blasting.

Investigation of Different Pre-Treatment Techniques and 3D Printed Turbulence Promoter to Mitigate Membrane Fouling in Dairy Wastewater Module.

This study investigates the enhancement of dairy wastewater treatment using chemical and physical pre-treatments coupled with membrane separation techniques to reduce membrane fouling. Two mathematical models, namely the Hermia and resistance-in-series module, were utilized to comprehend the mechanisms of ultrafiltration (UF) membrane fouling. The predominant fouling mechanism was identified by fitting experimental data into four models. The study calculated and compared permeate flux, membrane rejection, and membrane reversible and irreversible resistance values. The gas formation was also evaluated as a post-treatment. The results showed that the pre-treatments improved UF efficiency for flux, retention, and resistance values compared to the control. Chemical pre-treatment was identified as the most effective approach to improve filtration efficiency. Physical treatments after microfiltration (MF) and UF showed better fluxes, retention, and resistance results than ultrasonic pre-treatment followed by UF. The efficacy of a three-dimensionally printed (3DP) turbulence promoter was also examined to mitigate membrane fouling. The integration of the 3DP turbulence promoter enhanced hydrodynamic conditions and increased the shear rate on the membrane surface, shortening filtration time and increasing permeate flux values. This study provides valuable insights into optimizing dairy wastewater treatment and membrane separation techniques, which can have significant implications for sustainable water resource management. The present outcomes clearly recommend the application of hybrid pre-, main- and post-treatments coupled with module-integrated turbulence promoters in dairy wastewater ultrafiltration membrane modules to increase membrane separation efficiencies.

Multicolored MIS-C, a single-centre cohort study.

BACKGROUND: The aim of this study was to investigate the clinical and laboratory parameters that can predict the severity of Multisystem Inflammatory Syndrome in Children (MIS-C) at admission. METHODS: We conducted a single-center, partly retrospective, partly prospective, observational cohort study between November 1, 2020 and December 31, 2021, which included patients aged from 1 month to 19 years, meeting the diagnostic criteria of MIS-C. We categorized the patients into three subgroups based on clinical and laboratory markers and assessed the predictive value of these factors in terms of ICU administration and cardiac abnormalities. RESULTS: 53 patients were classified in the following subgroups: Kawasaki-like disease (group 1) (47.2%, n = 25), shock with or without acute cardiac dysfunction (group 2) (32%, n = 17), fever and inflammation (group 3) (20.8%, n = 11). Subgroup analysis revealed that patients with shock and KD at initial presentation had significantly more severe manifestation of MIS-C requiring intensive care unit (ICU) treatment. Of the initial laboratory values, only CRP showed a significant difference between the 3 clinical groups, being lower in group 3. 52.6% of patients were admitted to the ICU. The median length of ICU stay was 3 days (range 3-20). ICU admission was more likely in patients with shortness of breath, renal failure (AKI) and patients with significantly increased concentrations of ferritin, D-dimer, INR and significantly milder increase concentration of fibrinogen. We found that fibrinogen and ferritin levels are independent risk factors for ICU admission. Cardiac abnormalities were found in 56.6% of total (30/53), with the following findings: decreased left ventricular function (32%), coronary abnormality (11.3%), pericardial effusion (17%), arrhythmia (32.1%) and mitral regurgitation (26.6%). Diarrhea and conjunctivitis at the initial presentation with significantly elevated CRP, Pro-BNP and blood pH concentrations were found to be a potential predisposing factor for decreased cardiac function while Pro-BNP and pH were independent risk factors for MIS-C. Regardless of the initial symptoms of MIS-C, the outcome was generally favorable. CONCLUSIONS: Clinical characteristics and baseline laboratory values ​​may help identify patients at increased risk for severe disease outcome, such as need for intensive care, presence of shock and decreased cardiac function. TRIAL REGISTRATION: Participation consent was not reqired and ethical considerations were unnecessary, since we did not perform any extra interventions, only the necessary and usual therapeutic and diagnostic methods were used.

Daily serum phosphate increase as early and reliable indicator of kidney injury in children with leukemia and lymphoma developing tumor lysis syndrome.

BACKGROUND: Tumor lysis syndrome (TLS) and its most serious complication, acute kidney injury (AKI) are one of the emergency conditions in onco-hematology. It is difficult to predict the degree of kidney involvement. Therefore, we studied children with leukemia and lymphoma treated in four Hungarian tertiary centers (inpatient university clinics) retrospectively (2006-2016) from a nephrological aspect. METHOD: Data of 31 pediatric patients were obtained from electronic- and paper-based medical records. Physical status, laboratory test results, treatments, and outcomes were assessed. Patients were analyzed according to both "traditional" TLS groupings, as laboratory TLS or clinical TLS, and nephrological aspect based on pRIFLE classification, as mild or severe AKI. RESULTS: Significant differences were found between the changes in parameters of phosphate homeostasis and urea levels in both classifications. Compared to age-specific normal phosphate ranges, before the development of TLS, hypophosphatemia was common (19/31 cases), while in the post-TLS period, hyperphosphatemia was observed (26/31 cases) most frequently. The rate of daily change in serum phosphate level was significant in the nephrological subgroups, but peaks of serum phosphate level show only a moderate increase. The calculated cut-off value of daily serum phosphate level increased before AKI was 0.32 mmol/L per ROC analysis for severe TLS-AKI. The 24-h urinalysis data of eight patients revealed transiently increased phosphate excretion only in those patients with TLS in whom serum phosphate was elevated in parallel. CONCLUSION: Daily serum phosphate level increase can serve as a prognostic factor for the severity of pediatric TLS, as well as predict the severity of kidney involvement. A higher resolution version of the Graphical abstract is available as Supplementary information.

Modeling of Organic Fouling in an Ultrafiltration Cell Using Different Three-Dimensional Printed Turbulence Promoters.

Designing turbulence promoters with optimal geometry and using them for ultrafiltration systems has been a key challenge in mitigating membrane fouling. In this study, six different turbulence promoters were created using three-dimensional printing technology and applied in dead-end ultrafiltration. Three-dimensional-printed (3DP) turbulence promoter configurations were integrated into a classical batch ultrafiltration cell. The effects of these configurations and the stirring speeds on the permeate filtration flux, organic rejections, and membrane resistances were investigated. The fouling control efficiency of the 3DP promoters was evaluated using two polyethersulfone membranes in a stirred ultrafiltration cell with model dairy wastewater. The Hermia and resistance-in-series models were studied to further investigate the membrane fouling mechanism. Of the Hermia models, the cake layer model best described the fouling in this membrane filtration system. It can be concluded that the 3DP turbulence promoters, combined with intense mechanical stirring, show great promise in terms of permeate flux enhancement and membrane fouling mitigation. Using a well-designed 3DP turbulence promoter improves the hydrodynamic flow conditions on the surface of the stirred membrane separation cells based on computational fluid dynamics modeling. Therefore, the factors effecting the fabrication of 3DP turbulence promoters are important, and further research should be devoted to revealing them.