Starch modified NiFe layered double hydroxide composites for better adsorption and photocatalytic removal of reactive dye and piroxicam-20 drug.

One of the most omnipresent problems to the environment is the efficient removal of textile dyes and non-steroidal drugs from wastewater. For this purpose, renewable, sustainable, and biodegradable biopolymers are used. In this study, starch (S) modified NiFe-layered double hydroxide (LDH) composites were successfully synthesized by the co-precipitation method and have been examined as a catalyst for the effective adsorption of reactive blue 19 dye, reactive orange 16 dye, and piroxicam-20 NSAID from wastewater and photocatalytic degradation of reactive red 120 dye. The physicochemical properties of the prepared catalyst were assessed by XRD, FTIR, HRTEM, FE-SEM, DLS, ZETA, and BET. The coarser and more porous micrographs are shown in FESEM, indicating the homogeneous dispersion of layered double hydroxide on starch polymer chains. The S/NiFe-LDH composites have a slightly greater SBET (6.736 m2/g) than NiFe LDH (4.78 m2/g). The S/NiFe-LDH composite shows remarkable ability in the removal of reactive dyes. The band gap value of NiFe LDH, S/NiFe LDH (0.5:1), and S/NiFe LDH (1:1) composites was calculated as 2.28 eV, 1.80 eV, and 1.74 eV, respectively. The qmax assessed from Langmuir isotherm for removal of piroxicam-20 drug, reactive blue 19 dye, and reactive orange 16 was 2840 mg/g, 149.47 mg/g, and 182.4 mg/g, respectively. The activated chemical adsorption without product desorption is predicted by the Elovich kinetic model. With reactive red 120 dye, S/NiFe-LDH shows photocatalytic degradation within 3 h of irradiation of visible light with 90% removal efficiency and follows a pseudo-first-order kinetic model. The scavenging experiment confirms the involvement of electrons and holes in photocatalytic degradation. With a little decline in adsorption capacity up to five cycles, starch/NiFe LDH was easily regenerated. So, the suitable adsorbent required for wastewater treatment is nanocomposites of LDHs and starch as they enhance the chemical and physical attributes of the composite structure with greater absorption capabilities.

Improved survival in children with HPS: Experience from two high volume liver transplant centers across continents.

BACKGROUND: Severe HPS increases morbidity and mortality after LT in children. We reviewed the combined experience of LT for HPS in children from two LT centers in Europe and Asia. METHODS: All children with "proven" HPS as per ERS Task Force criteria (detailed in manuscript) who underwent LT were categorized into M (PaO2 ≥80 mmHg), Mo (PaO2  = 60-79 mmHg), S (50-59 mmHg), and VS (PaO2 <50 mmHg) HPS, based on room air PaO2 . RESULTS: Twenty-four children with HPS underwent 25 LT (one re-transplantation) at a median age of 8 years (IQR, 5-12), after a median duration of 8 (4-12) months following HPS diagnosis. Mechanical ventilation was required for a median of 3 (1.5-27) days after LT. Ten children had "S" post-operative hypoxemia, requiring iNO for a median of 5 (6-27) days. "VS" category patients had significantly prolonged invasive ventilation (median 35 vs. 3 and 1.5 days; p = .008), ICU stay (median 39 vs. 8 and 8 days; p = .007), and hospital stay (64 vs. 26.5 and 23 days; p < .001) when compared to "S" and "M/Mo" groups, respectively. The need for pre-transplant home oxygen therapy was the only factor predicting need for re-intubation. Patient and graft survival at 32 (17-98) months were 100% and 95.8%. All children ultimately had complete resolution of HPS. CONCLUSIONS: VS HPS is associated with longer duration of mechanical ventilation and hospital stay, which emphasizes the need for early LT in these children.

Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care.

Children seem to be less severely affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) as compared to adults. Little is known about the prevalence and pathogenesis of acute kidney injury (AKI) in children affected by SARS-CoV-2. Dehydration seems to be the most common trigger factor, and meticulous attention to fluid status is imperative. The principles of initiation, prescription, and complications related to renal replacement therapy are the same for coronavirus disease (COVID) patients as for non-COVID patients. Continuous renal replacement therapy (CRRT) remains the most common modality of treatment. When to initiate and what modality to use are dependent on the available resources. Though children are less often and less severely affected, diversion of all hospital resources to manage the adult surge might lead to limited CRRT resources. We describe how these shortages might be mitigated. Where machines are limited, one CRRT machine can be used for multiple patients, providing a limited number of hours of CRRT per day. In this case, increased exchange rates can be used to compensate for the decreased duration of CRRT. If consumables are limited, lower doses of CRRT (15-20 mL/kg/h) for 24 h may be feasible. Hypercoagulability leading to frequent filter clotting is an important issue in these children. Increased doses of unfractionated heparin, combination of heparin and regional citrate anticoagulation, or combination of prostacyclin and heparin might be used. If infusion pumps to deliver anticoagulants are limited, the administration of low-molecular-weight heparin might be considered. Alternatively in children, acute peritoneal dialysis can successfully control both fluid and metabolic disturbances. Intermittent hemodialysis can also be used in patients who are hemodynamically stable. The keys to successfully managing pediatric AKI in a pandemic are flexible use of resources, good understanding of dialysis techniques, and teamwork.

Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections' Collaborative of the European Society of Pediatric and Neonatal Intensive Care.

OBJECTIVES: In children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach. STUDY SELECTION: From inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care. DATA EXTRACTION: There is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology. DATA SYNTHESIS: Even though basic treatment and organ support considerations seem not to differ much from other critical illness, such as pediatric septic shock and multiple organ failure, seen in PICUs, some specific issues must be considered when caring for children with severe coronavirus disease 2019 disease. CONCLUSIONS: In this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.

Effects of mini-implant facilitated micro-osteoperforations in alleviating mandibular anterior crowding: A randomized controlled clinical trial.

OBJECTIVES: To investigate the effectiveness of mini-implant (MI)-facilitated micro-osteoperforations (MOPs) in accelerating mandibular anterior teeth alignment. MATERIALS AND METHODS: Thirty teenage patients with mandibular crowding (Little's irregularity index between 4 and 6 mm) were randomly allocated to either "experimental" group (micro-osteoperforation assisted alignment) or "control" group (conventional orthodontics). Blinding was done at the data analysis stages. Six MOPs were performed using MI on the labial aspect in the mandibular anterior region. The primary outcome was the overall treatment time needed to complete alignment of mandibular anterior teeth. The secondary outcomes were to compare the marginal bone height loss and volumetric root resorption around mandibular incisors along with subject's perception of pain, comfort and satisfaction. RESULTS: There was statistically significant difference in the total treatment duration for complete alignment of mandibular incisors. The completion of cases in experimental group was 43.93% times faster than the control group. There were no statistically significant differences in volumetric root resorption and marginal alveolar bone height loss around mandibular incisors as well as pain perception between the two groups. CONCLUSIONS: MI-facilitated MOPs accelerated tooth movement significantly upto nine weeks without any significant pain and discomfort, with no increase in root resorption and marginal alveolar bone height loss.