Concomitant urea stabilization and phosphorus recovery from source-separated fresh urine in magnesium anode-based peroxide-producing electrochemical cells.

In this study, we investigated the recovery of nitrogen (N) and phosphorus (P) from fresh source-separated urine with a novel electrochemical cell equipped with a magnesium (Mg) anode and carbon-based gas-diffusion cathode. Recovery of P, which exists primarily as phosphate (PO43-) in urine, was achieved through pH-driven precipitation. Maximizing N recovery requires simultaneous approaches to address urea and ammonia (NH3). NH3 recovery was possible through precipitation in struvite with soluble Mg supplied by the anode. Urea was stabilized with electrochemically synthesized hydrogen peroxide (H2O2) from the cathode. H2O2 concentrations and resulting urine pH were directly proportional to the applied current density. Concomitant NH3 and PO43- precipitation as struvite and urea stabilization via H2O2 electrosynthesis was possible at lower current densities, resulting in urine pH under 9.2. Higher current densities resulted in urine pH over 9.2, yielding higher H2O2 concentrations and more consistent stabilization of urea at the expense of NH3 recovery as struvite; PO43- precipitation still occurred but in the form of calcium phosphate and magnesium phosphate solids.

A quantitative comparison of urine centrifugation and filtration for the isolation and analysis of urinary nucleic acid biomarkers.

Urine is a rich source of nucleic acid biomarkers including cell-free DNA (cfDNA) and RNA for monitoring the health of kidney allografts. In this study, we aimed to evaluate whether urine filtration can serve as an alternative to the commonly used method of centrifugation to collect urinary fluid and cell pellets for isolating cfDNA and cellular messenger RNA (mRNA). We collected urine specimens from kidney allograft recipients and obtained the urine supernatant and cell pellet from each specimen using both filtration and centrifugation for paired analyses. We performed DNA sequencing to characterize the origin and properties of cfDNA, as well as quantitative PCR of mRNAs extracted from cell fractions. Our results showed that the biophysical properties of cfDNA, the microbial DNA content, and the tissues of origin of cfDNA were comparable between samples processed using filtration and centrifugation method. Similarly, mRNA quality and quantity obtained using both methods met our criteria for downstream application and the Ct values for each mRNA were comparable between the two techniques.The Ct values demonstrated a high degree of correlation. These findings suggest that urine filtration is a viable alternative to urine centrifugation for isolation of nucleic acid biomarkers from urine specimens.

Impact of four different extraction methods and three different reconstitution solvents on the untargeted metabolomics analysis of human and rat urine samples.

Unsuitable sample preparation may result in loss of important analytes and consequently affect the outcome of untargeted metabolomics. Due to species differences, different sample preparations may be required within the same biological matrix. The study aimed to compare the in-house sample preparation method for urine with methods from literature and to investigate the transferability of sample preparation from human urine to rat urine. A total of 12 different conditions for protein precipitation were tested, combining four different extraction solvents and three different reconstitution solvents using an untargeted liquid-chromatography high resolution mass spectrometry (LC-HRMS) metabolomics analysis. Evaluation was done based on the impact on feature count, their detectability, as well as the reproducibility of selected compounds. Results showed that a combination of methanol as extraction and acetonitrile/water (75/25) as reconstitution solvent provided improved results at least regarding the total feature count. Additionally, it was found that a higher amount of methanol was most suitable for extraction of rat urine among the tested conditions. In comparison, human urine requires significantly less volume of extraction solvent. Overall, it is recommended to systematically optimize both, the extraction method, and the reconstitution solvent for the used biofluid and the individual analytical settings.

Synergistic catalysis of TiO2/WO3 photoanode and Sb-SnO2 electrode with highly efficient ClO• generation for urine treatment.

Urine is the major source of nitrogen pollutants in domestic sewage and is a neglected source of H2. Although ClO• is used to overcome the poor selectivity and slow kinetics of urea decomposition, the generation of ClO• suffers from the inefficient formation reaction of HO• and reactive chlorine species (RCS). In this study, a synergistic catalytic method based on TiO2/WO3 photoanode and Sb-SnO2 electrode efficiently producing ClO• is proposed for urine treatment. The critical design is that TiO2/WO3 photoanode and Sb-SnO2 electrode that generate HO• and RCS, respectively, are assembled in a confined space through face-to-face (TiO2/WO3//Sb-SnO2), which effectively strengthens the direct reaction of HO• and RCS. Furthermore, a Si solar panel as rear photovoltaic cell (Si PVC) is placed behind TiO2/WO3//Sb-SnO2 to fully use sunlight and provide the driving force of charge separation. The composite photoanode (TiO2/WO3//Sb-SnO2 @Si PVC) has a ClO• generation rate of 260% compared with the back-to-bake assembly way. In addition, the electrons transfer to the NiFe LDH@Cu NWs/CF cathode for rapid H2 production by the constructed photoelectric catalytic (PEC) cell without applied external biasing potential, in which the H2 production yield reaches 84.55 µmol h-1 with 25% improvement of the urine denitrification rate. The superior performance and long-term stability of PEC cell provide an effective and promising method for denitrification and H2 generation.

Oral regimen for high dose methotrexate urine alkalinization: a systematic review and meta-analysis.

OBJECTIVE: Urine alkalinization prevents nephrotoxicity in patients receiving high-dose methotrexate (HDMTX). While the standard approach involves IV sodium bicarbonate, alternative oral bicarbonate regimens are crucial in drug shortages and outpatient settings. This study aims to review the efficacy and safety of such regimens. METHODS: PubMed, WOS, and Scopus were systematically searched using the PRISMA protocol for relevant studies involving human subjects, including randomized clinical trials, retrospective, prospective, cohort, case reports, and case series studies. There were no restrictions on language, time, or age group. Qualified and eligible papers were used to extract data on efficacy and safety indicators, and the final relevant records were assessed for quality using the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) assessment tool. RESULTS: 12 studies with 1212 participants were included in the systematic review, with pooled data from 8 studies used for meta-analysis. No significant differences in mean differences (MDs) or odds ratio (OR) were found after the oral bicarbonate regimen, except for when urine pH fell to < 7 (MD: 0.91, 95% CI: 0.32, 1.5, P < 0.05) and the incidence of diarrhea (OR: 2.92, 95% CI: 1.69, 5.05, P < 0.05). CONCLUSION: An oral bicarbonate regimen is a safe and effective way to alkalize HDMTX urine, providing a viable and cost-effective alternative to IV protocols. Further prospective multicenter studies are necessary. Systematic review registration identifier: CRD42023379666.

[Urinalysis in dogs and cats, part 2: Urine sediment analysis]. / Die Urinuntersuchung bei Hund und Katze, Teil 2: Urinsedimentanalyse.

Examination of the urine sediment is part of a routine urinalysis and is undertaken in order to identify insoluble particles in the urine. This procedure is mainly used in the context of diagnostic evaluation of urinary tract diseases, but may also be useful for the diagnosis of systemic diseases and intoxications. Analysis of fresh urine is recommended as changes in cell morphology, cell lysis and in vitro crystal formation may occur in the course of its storage. Manual urine sediment analysis is still performed in many veterinary practices. Native wet-mount preparations are suitable for the identification and quantification of urine sediment particles. The examination of stained wet-mount preparations or air-dried smears may be necessary to further differentiate cells and to identify bacteria. For several years, automatic urine sediment analyzers have been available in veterinary medicine. These save considerable time and staff resources, however verification of the automatically generated results by an experienced observer remains necessary. Urine sediment particles that are frequently identified and clinically relevant include red blood cells, white blood cells, different types of epithelial cells, crystals, and casts as well as bacteria. Furthermore, parasite eggs, fungal hyphae, lipid droplets, spermatozoa, fibres, hair, mucus, plant parts or environmental contaminations may be found in the urine sediment and result in a complication of the result interpretation.

Prediction of clinically significant prostate cancer through urine metabolomic signatures: A large-scale validated study.

PURPOSE: Currently, there are no accurate markers for predicting potentially lethal prostate cancer (PC) before biopsy. This study aimed to develop urine tests to predict clinically significant PC (sPC) in men at risk. METHODS: Urine samples from 928 men, namely, 660 PC patients and 268 benign subjects, were analyzed by gas chromatography/quadrupole time-of-flight mass spectrophotometry (GC/Q-TOF MS) metabolomic profiling to construct four predictive models. Model I discriminated between PC and benign cases. Models II, III, and GS, respectively, predicted sPC in those classified as having favorable intermediate risk or higher, unfavorable intermediate risk or higher (according to the National Comprehensive Cancer Network risk groupings), and a Gleason sum (GS) of ≥ 7. Multivariable logistic regression was used to evaluate the area under the receiver operating characteristic curves (AUC). RESULTS: In Models I, II, III, and GS, the best AUCs (0.94, 0.85, 0.82, and 0.80, respectively; training cohort, N = 603) involved 26, 24, 26, and 22 metabolites, respectively. The addition of five clinical risk factors (serum prostate-specific antigen, patient age, previous negative biopsy, digital rectal examination, and family history) significantly improved the AUCs of the models (0.95, 0.92, 0.92, and 0.87, respectively). At 90% sensitivity, 48%, 47%, 50%, and 36% of unnecessary biopsies could be avoided. These models were successfully validated against an independent validation cohort (N = 325). Decision curve analysis showed a significant clinical net benefit with each combined model at low threshold probabilities. Models II and III were more robust and clinically relevant than Model GS. CONCLUSION: This urine test, which combines urine metabolic markers and clinical factors, may be used to predict sPC and thereby inform the necessity of biopsy in men with an elevated PC risk.

The Role of Hyposthenuria in Enuresis Among Paediatric Patients With Sickle Cell Disease.

Objectives: Enuresis is common among children with sickle cell disease (SCD). Many risk factors have been postulated, but its relation to hyposthenuria is debatable. This study aimed to determine the prevalence of enuresis in children with SCD in Basrah, Iraq, and to examine its relation with hyposthenuria. Methods: A cross-sectional epidemiological study was performed on children with SCD who met the inclusion criteria at the Basrah Center for Hereditary Blood Diseases from December 2020 to May 2021. A questionnaire was used to collect relevant data. Blood samples were tested for haemoglobin genotype, certain blood indices and serum haemoglobin. Urine was tested for albumin and creatinine, and the specific gravity was measured using urine dipsticks. The relationships between enuresis and various sociodemographic and clinical variables were assessed. Binary logistic regression analysis was done to examine the independent risk factors of enuresis. Results: A total of 161 out of 200 eligible children were included in this study (response rate: 80.5%). The majority of participants (60.9%) were males. The mean age of the participants was 10.9 ± 2.9 years. Enuresis was reported in 50 (31.1%) patients. The independent risk factors for enuresis included family history of enuresis (adjusted odds ratio [OR] = 5.94, 95% confidence interval [CI]: 2.54-13.89; P <0.001), hyposthenuria (OR = 3.76, 95% CI: 1.25-11.30; P = 0.018) and sleep disorders (OR = 2.90, 95% CI: 1.19-7.06; P = 0.019. Conclusion: Enuresis is common among children with SCD in Basrah, Iraq. Hyposthenuria was significantly associated with enuresis. Family history of enuresis and sleep disorders were also found to be significantly related to enuresis.

Flow-through laminar anodes with variable interlaminar distance to modulate the current density of urine-fed bio-electrochemical systems.

Three-dimensional (3D) porous anodes used in urine-powered bio-electrochemical applications usually lead to the growth of electro-active bacteria on the outer electrode surface, due to limited microbial access to the internal structure and lack of permeation of culture medium through the entire porous architecture. In this study, we propose the use of 3D monolithic Ti4O7 porous electrodes with controlled laminar structures as microbial anodes for urine-fed bio-electrochemical systems. The interlaminar distance was tuned to modulate the anode surface areas and, thus, the volumetric current densities. To profit from the true area of the electrodes, urine feeding was performed as a continuous flow through the laminar architectures. The system was optimized according to the response surface methodology (RSM). The electrode interlaminar distance and the concentration of urine were selected as independent variables, with the volumetric current density as the output response to optimize. Maximum current densities of 5.2 kA.m-3 were produced from electrodes with 12 µm-interlaminar distance and 10 %v/v urine concentrations. The present study demonstrates the existence of a trade-off between the accesibility to the internal electrode structure and the effective usage of the surface area to maximize the volumetric current density when diluted urine is used as flowing-through feeding fuel.

Factors influencing the recovery of organic nitrogen from fresh human urine dosed with organic/inorganic acids and concentrated by evaporation in ambient conditions.

To feed the world without transgressing regional and planetary boundaries for nitrogen and phosphorus, one promising strategy is to return nutrients present in domestic wastewater to farmland. This study tested a novel approach for producing bio-based solid fertilisers by concentrating source-separated human urine through acidification and dehydration. Thermodynamic simulations and laboratory experiments were conducted to evaluate changes in chemistry of real fresh urine dosed and dehydrated using two different organic and inorganic acids. The results showed that an acid dose of 1.36 g H2SO4 L-1, 2.86 g H3PO4 L-1, 2.53 g C2H2O4·2H2O L-1 and 5.9 g C6H8O7 L-1 was sufficient to maintain pH ≤3.0 and prevent enzymatic ureolysis in urine during dehydration. Unlike alkaline dehydration using Ca(OH)2 where calcite formation limits the nutrient content of fertiliser products (e.g. <15 % nitrogen), there is greater value proposition in acid dehydration of urine, as the products contain 17.9-21.2 % nitrogen, 1.1-3.6 % phosphorus, 4.2-5.6 % potassium and 15.4-19.4 % carbon. While the treatment recovered all phosphorus, recovery of nitrogen in the solid products was 74 % (±4 %). Follow-up experiments revealed that hydrolytic breakdown of urea to ammonia, chemically or enzymatically, was not the reason for the nitrogen losses. Instead, we posit that urea breaks down to ammonium cyanate, which then reacts with amino and sulfhydryl groups of amino acids excreted in urine. Overall, the organic acids evaluated in this study are promising for decentralised urine treatment, as they are naturally present in food and therefore already excreted in human urine.

Concentrating stabilized human urine using eutectic freeze crystallization for liquid fertilizer production.

Resource recovery from source-separated urine can be used to produce fertilizers and provide a more sustainable alternative to mineral fertilizers. Reverse osmosis can be used to remove up to 70% of the water in urine that has been stabilized with Ca(OH)2 and pre-treated with air bubbling. However, further water removal is limited because of membrane scaling and equipment operating pressure limitations. A novel hybrid eutectic freeze crystallization (EFC) and RO system was investigated as a method to concentrate human urine, whilst simultaneously crystallizing salt and ice under EFC conditions. A thermodynamic model was used to predict the type of salts that would crystallize, their associated eutectic temperatures, and how much additional water removal was required (using freeze crystallization) to reach eutectic conditions. This innovative work showed that at eutectic conditions, Na2SO4∙10H2O crystallizes simultaneously with ice in both real and synthetic urine, thus providing a new method to concentrate human urine for liquid fertilizer production. A theoretical mass balance of a hybrid RO-EFC process, including ice washing and recycle streams, showed that 77% of the urea and 96% of the potassium could be recovered with a 95% water removal. The final liquid fertilizer would have a composition of 11.5% N and 3.5% K, and 3.5 kg of Na2SO4∙10H2O could be recovered from 1000 kg of urine. Over 98% of the phosphorus would be recovered as calcium phosphate during the urine stabilization step. A hybrid RO-EFC process would require 60 kWh m-3 of energy, which is substantially less than other concentration methods.

The urinary proteome infers dysregulation of mitochondrial, lysosomal, and protein reabsorption processes in chronic kidney disease of unknown etiology (CKDu).

Chronic kidney disease (CKD) of uncertain etiology (CKDu) is a global health concern affecting tropical farming communities. CKDu is not associated with typical risk factors (e.g., diabetes) and strongly correlates with environmental drivers. To gain potential insights into disease etiology and diagnosis, here we report the first urinary proteome comparing patients with CKDu and non-CKDu controls from Sri Lanka. We found 944 differentially abundant proteins. In silico analyses identified 636 proteins of likely kidney and urogenital origin. As expected, renal tubular injury in patients with CKDu was evinced by increases in albumin, cystatin C, and ß2-microglobulin. However, several proteins typically elevated under CKD, including osteopontin and α-N-acetylglucosaminidase, were decreased in patients with CKDu. Furthermore, urinary excretion of aquaporins found higher in CKD was lower in CKDu. Comparisons with previous CKD urinary proteome datasets revealed a unique proteome for CKDu. Notably, the CKDu urinary proteome was relatively similar to that of patients with mitochondrial diseases. Furthermore, we report a decrease in endocytic receptor proteins responsible for protein reabsorption (megalin and cubilin) that correlated with an increase in abundance of 15 of their cognate ligands. Functional pathway analyses identified kidney-specific differentially abundant proteins in patients with CKDu denoted significant changes in the complement cascade and coagulation systems, cell death, lysosomal function, and metabolic pathways. Overall, our findings provide potential early detection markers to diagnose and distinguish CKDu and warrant further analyses on the role of lysosomal, mitochondrial, and protein reabsorption processes and their link to the complement system and lipid metabolism in CKDu onset and progression.NEW & NOTEWORTHY CKDu is a global health concern debilitating a number of tropical rural farming communities. In the absence of typical risk factors like diabetes and hypertension and the lack of molecular markers, it is crucial to identify potential early disease markers. Here, we detail the first urinary proteome profile to distinguish CKDu from CKD. Our data and in silico pathway analyses infer the roles of mitochondrial, lysosomal, and protein reabsorption processes in disease onset and progression.

[The risk prediction value of paraquat poisoning dose, urine protein and myocardial enzymes].

Objective: To explore the value of paraquat (PQ) intake, urine protein and myocardial enzyme indexes in judging the prognosis of patients with acute PQ poisoning. Methods: From September to December 2021, all 201 patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital from January 2010 to December 2019 were selected as the research objects. Based on follow-up results 60 days after poisoning, the research objects were divided into survival group (n=78) and death group (n=123) . The differences in information about poisoning, treatment plan, PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase between the two groups of patients were compared and analyzed. Logistic regression and Cox regression were used to analyze the correlation between poisoning outcome and PQ intake, urine protein and myocardial enzymes. ROC curve and principal component analysis were used to explore high-efficiency indicators for predicting the outcome of acute PQ poisoning. Results: The PQ intake[50 (20, 100) ml], urine protein (total rank 15570.50) , creatine kinase[ (336.36±261.96) U/L], creatine kinase isoenzyme[ (43.91±43.74) U/L], lactate dehydrogenase [ (346.01±196.50) U/L], α-hydroxybutyrate dehydrogenase content[ (271.23±11.92) U/L] of patients in the death group were all higher than the survival group[15 (10, 20) ml, 4730.50, (187.78±178.06) U/L, (18.88±15.50) U/L, (190.92±60.50) U/L, (152.60±48.34) U/L, respectively] (P<0.05) . The outcome of acute PQ poisoning was positively correlated with PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase (P<0.05) . Multivariate logistic regression and multivariate Cox regression analysis showed that creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase was positively correlated with the prognosis of patients with acute PQ poisoning (P<0.05) . ROC curve analysis and principal component analysis showed that the combined indexes of PQ intake, urine protein and myocardial enzymes had the highest efficacy and weight in judging the prognosis of patients (AUC=0.91, weight coefficient=0.19, sensitivity=0.76, specificity=0.89) . When the combined score was ≥4, the probability of accurately predicting the death of patients was as high as 91% (positive predictive value=0.91) . Conclusion: PQ intake, urine protein combined with creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase has high value in predicting the prognosis of patients with acute PQ poisoning.

Optimization and kinetic modeling of phosphate recovery as struvite by electrocoagulation from source-separated urine.

Phosphorus recovery is indispensable due to the rapid depletion of its natural reserves and excessive utility in agriculture. Though human urine has high nutrient content including phosphate, nitrogen and potassium; direct use as a fertilizer is restricted due to hygienic, environmental, social and ethical issues. To overcome these limitations, the nutrients are precipitated by the external addition of magnesium (Mg) to form a slow-releasing fertilizer called struvite. The present study aims to maximize phosphate recovery through optimizing struvite production by an emerging electrocoagulation technique. A maximum of 95% phosphate recovery was achieved using inter-electrode distance of 0.5 cm, 2 A current from undiluted urine using Mg-Mg electrodes in a reaction time of 30 min. Further, kinetic modeling of phosphate recovery through electrocoagulation was conducted to comprehend the intended mechanism through the order of kinetics. The results revealed that the data best correlated with first-order kinetics with a correlation coefficient of 0.95. Electrocoagulation improved the supernatant quality by reducing the ion concentrations other than phosphate (30-50%), salinity (40-45%), and microbial population (99%). Qualitative assessment of the precipitate through sophisticated analysis further confirmed the presence of struvite crystals.