Effects of salinity and betaine addition on anaerobic granular sludge properties and microbial community succession patterns in organic saline wastewater.

In this study, the effects of different salinity gradients and addition of compatible solutes on anaerobic treated effluent water qualities, sludge characteristics and microbial communities were investigated. The increase in salinity resulted in a decrease in particle size of the granular sludge, which was concentrated in the range of 0.5-1.0 mm. The content of EPS (extracellular polymeric substances) in the granular sludge gradually increased with increasing salinity and the addition of betaine (a typical compatible solute). Meanwhile, the microbial community structure was significantly affected by salinity, with high salinity reducing the diversity of bacteria. At higher salinity, Patescibacteria and Proteobacteria gradually became the dominant phylum, with relative abundance increasing to 13.53% and 12.16% at 20 g/L salinity. Desulfobacterota and its subordinate Desulfovibrio, which secrete EPS in large quantities, dominated significantly after betaine addition.Their relative abundance reached 13.65% and 7.86% at phylum level and genus level. The effect of these changes on the treated effluent was shown as the average chemical oxygen demand (COD) removal rate decreased from 82.10% to 79.71%, 78.01%, 68.51% and 64.55% when the salinity gradually increased from 2 g/L to 6, 10, 16 and 20 g/L. At the salinity of 20 g/L, average COD removal increased to 71.65% by the addition of 2 mmol/L betaine. The gradient elevated salinity and the exogenous addition of betaine played an important role in achieving stability of the anaerobic system in a highly saline environment, which provided a feasible strategy for anaerobic treatment of organic saline wastewater.

Fluid bolus resuscitation with hypertonic saline albumin solution in critically ill children: a prospective observational pilot study.

To evaluate the hemodynamic effects and the safety profile of fluid bolus resuscitation with hypertonic saline albumin (HSA) in critically ill children, we performed a prospective observational pilot study between October 2018 and May 2021 in the pediatric intensive care unit (PICU) in a tertiary hospital in Madrid, Spain. Sixty-four HSA boluses were analyzed in 23 patients. A mean volume of 5.7 ml/kg (Standard Deviation, SD 2.3 ml/kg) per bolus was infused. Acute hypotension was the main indication. 91% of the patients had a cardiac disease, 56% of them had undergone cardiac surgery in the previous 72 h, and 47.8% associated right ventricular dysfunction. A significant increase in systolic, mean, and diastolic blood pressure and a decrease in the vasoactive index was observed after the infusion of HSA. This effect lasted for twenty-four hours (p < 0.05). Moreover, the amount of fluid requirements decreased significantly in the 6 h following HSA infusion [8.7 ml/kg (SD 9.6) vs. 15.1 ml/kg (SD 13.6) in the previous 6 h (p < 0.05)]. Serum levels of sodium and chloride increased after the infusion, reaching their peak concentration after one hour (143 mEq/L (SD 3.5) and 109.7 mEq/L (SD 6) respectively). HSA-related metabolic acidosis or acute kidney injury were not observed in this study. Hypertonic saline albumin is safe and effective when infused at a dose of 5 ml/kg in critically ill children. However, further research is required to confirm our findings.

Effectiveness of hypertonic saline with or without hyaluronic acid among patients with cystic fibrosis: a systematic review and meta-analysis.

Background: The clinical effectiveness of hypertonic saline (HS) in individuals with cystic fibrosis (CF) can be compromised by adverse effects. The objective of this study was to examine the efficacy of hyaluronic acid (HA) in mitigating these negative occurrences. Methods: A comprehensive review of the literature was carried out using three electronic databases: Medline, Cochrane Central, and Embase. This systematic review and meta-analysis investigate the efficacy of hypertonic saline (HS) with and without hyaluronic acid (HA) in treating cystic fibrosis. Primary outcomes include the incidence of cough, throat irritation, unpleasant taste, and changes in FEV1. Our findings suggest that adding HA to HS significantly reduces adverse effects and enhances patient tolerability, marking a potential improvement in cystic fibrosis therapy. Risk ratios (RRs) and mean differences (MDs) with 95% CI were used to present evaluations. The quality of RCTs was evaluated using the Cochrane Risk of Bias Tool (CRBT). The quality of the observational study was evaluated using the Newcastle-Ottawa Scale. Results: From the 1960 articles retrieved from the initial search, five relevant studies (n=236 patients) were included in the final analysis. Compared with patients only on HS, patients with HS and HA were significantly less likely to experience cough (RR: 0.45; 95% CI, 0.28-0.72, P=0.001), throat irritation (RR: 0.43; 95% CI, 0.22-0.81, P=0.009), and unpleasant smell (RR: 0.43; 95% CI, 0.23-0.80, P=0.09). In addition, patients with HS with HA had significantly less forced expiratory volume (FEV1) (MD: -2.97; 95% CI, -3.79--2.15, P=0.52), compared to patients only on HS. Patients on HA + HS had significantly lower rates of cough (RR: 0.45; 95% CI, 0.28-0.72, P=0.001), throat irritation (RR: 0.43; 95% CI, 0.22-0.81, P=0.009), and bad smell (RR: 0.43; 95% CI, 0.23-0.80, P=0.09) when compared to patients on HS alone. Furthermore, compared to patients solely on HS, patients with HS plus HA exhibited a substantially lower forced expiratory volume (FEV1) (MD: -2.97; 95% CI, -3.79 to -2.15, P=0.52) as well. Conclusion: For CF patients who need ongoing HS therapy and have a history of poor therapy tolerance, adding HA is beneficial.

Should Hypertonic Saline Be Considered for the Treatment of Intracranial Hypertension? A Review of Current Evidence and Clinical Practices.

Intracranial hypertension (IH) is a critical neurological emergency that requires prompt intervention because failure to treat it properly can lead to severe outcomes, including secondary brain injury. Traditionally, mannitol (MNT) has been the cornerstone of hyperosmolar therapy. However, the use of hypertonic saline (HTS) has become increasingly important because of its unique advantages. Both HTS and MNT effectively reduce intracranial pressure by creating an osmotic gradient that draws fluid from brain tissue. However, unlike MNT, HTS does not induce diuresis or significantly lower blood pressure, making it more favorable for maintaining cerebral perfusion. Additionally, HTS does not cause rebound edema and carries a lower risk of renal injury than MNT. However, it is important to note that the use of HTS comes with potential risks, such as hypernatremia, hyperchloremia, and fluid overload. Due to its unique properties, HTS is a crucial agent in the management of IH, and understanding its appropriate use is essential to optimize patient outcomes.

Effect of nitrogen reduction combined with biochar application on soda saline soil and soybean growth in black soil areas.

The combination of biochar and nitrogen (N) fertilization in agricultural salt-affected soils is an effective strategy for amending the soil and promoting production. To investigate the effect of nitrogen reduction combined with biochar application on a soda saline soil and soybean growth in black soil areas, a pot experiment was set up with two biochar application levels, 0 (B0) and 4.5 t/hm2 (B1); two biochar application depths, 0-20 cm (H1) and 0-40 cm (H2); and two nitrogen application levels, conventional nitrogen application (N0) and nitrogen reduction of 15% (N1). The results showed that the application of biochar improved the saline soil status and significantly increased soybean yield under lower nitrogen application. Moreover, increasing the depth of biochar application enhanced the effectiveness of biochar in reducing saline soil barriers to crop growth, which promoted soybean growth. Increasing the depth of biochar application increased the K+ and Ca2+ contents, soil nitrogen content, N fertilizer agronomic efficiency, leaf total nitrogen, N use efficiency, AN, Tr, gs, SPAD, leaf water potential, water content and soybean yield and its components. However, the Na+ content, SAR, ESP, Na+/K+, Ci and water use efficiency decreased with increasing biochar depth. Among the treatments with low nitrogen input and biochar, B1H1N1 resulted in the greatest soil improvement in the 0-20 cm soil layer compared with B0N0; for example, K+ content increased by 61.87%, Na+ content decreased by 44.80%, SAR decreased by 46.68%, and nitrate nitrogen increased by 26.61%. However, in the 20-40 cm soil layer, B1H2N1 had the greatest effect on improving the soil physicochemical properties, K+ content increased by 62.54%, Na+ content decreased by 29.76%, SAR decreased by 32.85%, and nitrate nitrogen content increased by 30.77%. In addition, compared with B0N0, total leaf nitrogen increased in B1H2N1 by 25.07%, N use efficiency increased by 6.7%, N fertilizer agronomic efficiency increased by 32.79%, partial factor productivity of nitrogen increased by 28.37%, gs increased by 22.10%, leaf water potential increased by 27.33% and water content increased by 6.44%. In conclusion, B1H2N1 had the greatest effect on improving the condition of saline soil; it not only effectively regulated the distribution of salt in soda saline soil and provided a low-salt environment for crop growth but also activated deep soil resources. Therefore, among all treatments investigated in this study, B1H2N1 was considered most suitable for improving the condition of soda saline soil in black soil areas and enhancing the growth of soybean plants.

Mechanisms of calcium-mediated As(V) immobilization by undissolved and dissolved biochar in saline-alkali environments.

The environmental impact of arsenic (As) pollution has been a focal point within environmental science. In arsenic-polluted saline-alkali environment, the addition of exogenous biochar can affect the morphological transformation of As both through direct and indirect mechanisms, with calcium ions (Ca(II)) playing a crucial role. This study investigates the immobilization mechanisms of undissolved biochar (UOB) and dissolved biochar (DOB) on As(V) in the absence and presence of Ca(II) under alkaline conditions and aerobic atmosphere. While UOB and DOB alone are insufficient for As(V) immobilization, their combined action in the presence of Ca(II) achieves remarkable immobilization rates of 91.9% and 98.1%, respectively. Precipitation of calcium arsenate is identified as the primary immobilization pathway in both the UOB-Ca(II)-As(V) and DOB-Ca(II)-As(V) systems. Furthermore, Ca(II) acts as a mediator for As(V) immobilization through the formation of ternary UOB/DOB-Ca-As complexes, which are corroborated by Density Functional Theory (DFT) analysis from a microscopic perspective. Notably, the synergistic immobilization of As by DOB and newly generated CaCO3 in DOB-Ca(II)-As(V) system is highlighted. Additionally, the increase in Ca(II) concentration (0-100 mM) and solution pH (9.0-12.0) both significantly enhance the immobilization of As(V). An increase in the dosage of UOB (0.4-4 g/L) reduces the immobilization of As(V), while effect of the DOB concentration is insignificant. This study provides new insights into how the release of two biochar fractions into a typical Ca(II)-rich saline-alkali environment may alter the fate and transport of As species.

Aquaculture faecal waste generates different products during anaerobic digestion depending on nutrient composition.

The inclusion of carbohydrate-rich ingredients in aquafeeds has resulted in an increased fraction of undigested material, culminating in faecal waste enriched in unutilized nutrients containing carbon, nitrogen and phosphorus. This study explored the impact of faecal composition, as influenced by diet, on the products of anaerobic digestion with a focus on organic acids (OAs). The aim was to in vitro assess the potential of faeces as internal carbon for denitrification, promoting circularity in recirculating aquaculture systems. In this regard, settleable faeces originating from six diets (DDGS, Dried distillers' grains with solubles; HFM, Hydrolyzed feather meal; IM, Insect meal; SCP, Single-cell protein; SSM, Shrimp shell meal; SWP, Seaweed protein) fed to European seabass, were incubated for a 14-day period in anoxic batch reactors. Nutrient solubilization (chemical oxygen demand, total Kjeldhal nitrogen, total phosphorus) was measured over time, and the final yield of OA was studied in relation to prokaryotic community composition. Results showed that digestion of faecal waste with a high crude-protein-to-carbohydrate ratio leads to an increased amount of OA which is greatly dominated by acetate. Among them, SSM faeces exhibited the highest final OA yield, resulting from a continuous increase over time. Despite variations in OA quantity and profile, prokaryotic composition did not substantially differ among treatments at the end of the trial, with only the relative abundance of three genera varying significantly (Anaerostignum, Bythopirellula, Mycobacterium). Yet, lactate concentration positively correlated with several taxa (Trichococcus, Oleispira, Defluviitaleaceae, Anaerocolumna, and Carboxyliverga) and butyrate with Anaerostignum. Alongside, ammonia release was minimal for all treatments, while phosphorus dissolution did not correlate to the faecal phosphorus content but was rather a result of acidification due to OA production. Overall, considering that an optimal carbon source for denitrification should produce a high amount of end OAs (i.e. acetate) along with low dissolved nitrogen and phosphorus, this research suggests that faecal waste originating from certain carbohydrate-rich aquafeed ingredients can be suitable as internal carbon source for denitrification.

Which Intravenous Isotonic Fluid Offers Better Outcomes for Patients with a Brain Injury?

Administering intravenous fluids is a common therapy for critically ill patients. Isotonic crystalloid solutions, such as saline or balanced solutions, are frequently used for intravenous fluid therapy. The choice between saline or a balanced crystalloid has been a significant question in critical care medicine. Recent large randomized controlled trials (RCTs) have investigated whether balanced crystalloids yield better outcomes in general or specific critical care populations, and many of them have confirmed this hypothesis. Although the broad eligibility criteria of these RCTs suggest applicability to neurocritical care patients, it is important to discuss whether using balanced crystalloids, as opposed to saline, would benefit patients who primarily have neurological disorders or diseases. This review considers the relevance of this question, weighs the pros and cons of the two fluid types, examines available data, and anticipates results from ongoing RCTs to guide clinicians in selecting the optimal fluid for patients with brain injury.

Effects of normal saline versus lactated Ringer's solution on organ function and inflammatory responses to heatstroke in rats.

BACKGROUND: Heatstroke is a life-threatening condition characterized by severe hyperthermia and multiple organ dysfunction. Both normal saline (NS) and lactated Ringer's solution (LR) are commonly used for cooling and volume resuscitation in heatstroke patients; however, their specific impacts on patient outcomes during heatstroke management are poorly understood. Given that the systemic inflammatory response and multiple-organ damage caused by heat toxicity are the main pathophysiological features of heatstroke, the aim of this study was to evaluate the effects of NS and LR on the production of inflammatory cytokines and the functional and structural integrity of renal and cardiac tissues in a rat model of heatstroke. METHODS: Fifty-five male Sprague‒Dawley rats were randomly divided into four groups: cold NS or LR infusion postheatstroke (4 â„ƒ, 4 ml/100 g, over 10 min) and NS or LR infusion without heatstroke induction (control groups). Vital signs, arterial blood gases, inflammatory cytokines, and renal and cardiac function indicators, such as serum creatinine and cTnI, were monitored after treatment. Tissue samples were analysed via HE staining, electron microscopy, and fluorescence staining for apoptosis markers, and protein lysates were used for Western blotting of pyroptosis-related proteins. RESULTS: Compared with LR-treated heatstroke rats, NS-treated heatstroke rats presented lower mean arterial pressures, worsened metabolic acidosis, and higher levels of IL-6 and TNF-α in both the serum and tissue. These rats also presented increased serum creatinine, troponin, catecholamines, and NGAL and reduced renal clearance. Histological and ultrastructural analyses revealed more severe tissue damage in NS-treated rats, with increased apoptosis and increased expression of NLRP3/caspase-1/GSDMD signalling molecules. Similar differences were not observed between the control groups receiving either NS or LR infusion. One NS-treated heatstroke rat died within 24 h, whereas all the LR-treated and control rats survived. CONCLUSIONS: NS resuscitation in heat-exposed rats significantly promotes metabolic acidosis and the inflammatory response, leading to greater functional and structural organ damage than does LR. These findings underscore the necessity of selecting appropriate resuscitation fluids for heatstroke management to minimize organ damage and improve outcomes.

[Volume therapy: which preparation for which situation?] / Volumentherapie ­ welches Präparat in welcher Situation?

The most commonly used fluids for volume therapy are crystalloids and colloids. Crystalloids comprise 0.9% sodium chloride and balanced crystalloids (BC). Colloids can be divided into artificial colloids and human albumin (a natural colloid). Large studies show advantages for BC over 0.9% NaCl with respect to renal endpoints, probably due to the unphysiologically high chloride content of 0.9% NaCl. However, other studies, such as the BaSICS and PLUS trials, showed no significant differences in mortality in a heterogeneous population. Despite this, meta-analyses suggest advantages for BC. Therefore, BC should be preferred, especially in patients at increased risk of acute kidney injury, with acidemia and/or hyperchloremia. Except for specific indications (e.g., in patients with cirrhosis, sepsis resuscitation after initial volume therapy with BC), albumin should not be used. There is clear evidence of harm from hydroxyethyl starch in intensive care patients.

Investigation of the Effectiveness of Nasal Sprays in Allergic Rhinitis.

Objectives: We investigated the effectiveness of different types of nasal irrigation sprays in adult allergic rhinitis (AR) patients. Methods: A total of 1700 patients with AR (866 males and 834 females) were assigned to: Group 1: Hypertonic nasal spray group (n = 600) (Sinomarin® hypertonic nasal spray); Group 2: Algae-containing hypertonic nasal spray group (n = 600) (Sinomarin Plus Algae ENT); and Group 3: Isotonic saline nasal spray group (n = 500). All patients underwent an otolaryngological examination, continued their standard AR treatment, and received the assigned nasal spray additionally (1 spray to each nostril, 3 times a day, for 3 weeks). Allergic symptom scores, turbinate examination, total symptom scores, and quality of life (QoL) scores were evaluated during pre- and post-treatment periods. Results: In groups 1 and 2, symptom scores and turbinate color and edema, total symptom scores, and QoL scores increased after treatment (P < .05). In the saline group, there were no significant differences in symptom scores and total symptom scores after treatment; however, improvement was detected in turbinate color and edema values after treatment. QoL scores increased after treatment. When comparing the 3 groups, the total symptom scores of groups 1 and 2 were significantly lower, and the QoL scores of groups 1 and 2 were considerably higher than those of the saline group. There were no significant differences between groups 1 and 2. Conclusion: Algae-containing and hypertonic nasal spray may be added to the standard AR treatment to increase QoL and decrease total symptom scores.

Reduced Injection Site Pain with Altered pH in 24-h Reconstituted Botulinum Toxin: Findings from a Randomized Controlled Study on Cosmetic Applications.

BACKGROUND: Botulinum toxin (BTX) injections are widely recognized for many cosmetic applications, but still commonly encounter a challenge: injection site pain (ISP). This discomfort can impact the overall patient experience and satisfaction, highlighting a need for innovative solutions to this problem. OBJECTIVE: This randomized controlled study aimed to determine whether adjusting the pH levels in a 24-h reconstituted botulinum toxin can serve as a strategy to mitigate ISP. METHODS: A controlled trial involving 24 volunteers was executed. Participants received incobotulinum toxin A. One side of each participant's face was treated with fresh toxin, while the other received a 24-h reconstituted version. Pain perceptions post-injection were assessed using the visual analogue scale (VAS). RESULTS: pH values of the fresh toxin were more acidic (6.17) than the 24-h reconstituted toxin (7.17). Out of 24 patients, 13 reported reduced ISP with the 24-h reconstituted toxin. The mean VAS score for the fresh toxin was 5.92, in contrast to 4.17 for the reconstituted toxin, indicating a significant difference (p<0.01). CONCLUSION: Limitations include the use of a VAS and a relatively small sample size. Altering the pH of BTX demonstrates potential in ISP reduction. However, broader, large-scale investigations are important for comprehensive validation. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Liberal Fluid Resuscitation is Associated with Improved Outcomes in Pediatric Acute Pancreatitis.

OBJECTIVE: To evaluate outcomes of children from an observational cohort registry of index acute pancreatitis (AP) admissions managed with different types and rates of intravenous fluid therapy. STUDY DESIGN: Patients with index admission of AP between 2013 and 2023 were included. Those who received >1.5x the maintenance intravenous fluid rate were assigned to the liberal fluid group, and patients who received <1.5x maintenance fluids were assigned to the conservative group. Outcomes including intensive care unit admission rate, organ dysfunction, local pancreatic complications, and AP severity were evaluated. Influence of early enteral feeding and fluid composition on outcomes and clinical course were also analyzed. RESULTS: Patients who received liberal fluids were less likely to be admitted or transferred to the intensive care unit compared with those receiving conservative management (OR, 0.32; 95% CI, 0.12-0.80; P = .015). The liberal fluid group with early feeding had the lowest rate of moderate/severe manifestations of AP compared with other combinations of diet and fluid orders. Patients within the liberal fluid group who received the highest fluid rates (>2x maintenance) did not have higher rates of organ dysfunction or severe disease. CONCLUSIONS: Children with AP may stand to benefit from liberal fluid therapy and continued diet compared with more conservative fluid resuscitation and nothing by mouth status.

Capsular contracture in breast reconstruction: A systematic review and meta-analysis.

BACKGROUND: Capsular contracture after implant-based breast reconstruction is not an uncommon problem and affects reconstruction outcomes. It can be influenced by various factors, such as the plane of implant placement, implant surface and implant type. This systematic review and meta-analysis aimed to evaluate how the abovementioned risk factors can affect capsular contracture rates. METHODS: A systematic review and meta-analysis was performed. PubMed MEDLINE, EMBASE (OvidSP) and Cochrane Library were searched. Comparison groups included subpectoral versus prepectoral implant placement, smooth versus textured implants and saline versus silicone implants. Odds ratios (ORs) were calculated for capsular contracture for each group. The level of evidence was evaluated using the Oxford Centre for Evidence-Based Medicine. RESULTS: Twenty-three studies met the inclusion criteria. Sixteen studies compared subpectoral versus prepectoral implant placement, with no statistically significant differences in capsular contracture rates [OR, 1.21; 95% confidence interval (95% CI), 0.75-1.95; P = 0.44]. Five studies compared smooth versus textured implants, with no statistically significant differences in capsular contracture rates (OR, 0.99; 95% CI, 0.50-1.93; P = 0.97). Two studies compared saline versus silicone implants for capsular contracture. Patients receiving saline implants had significantly lower capsular contracture rates than silicone implants (OR, 0.19; 95% CI, 0.08-0.43; P < 0.0001). CONCLUSIONS: Implant-based breast reconstruction using saline implants demonstrated reduced capsular contracture rates compared to silicone implants. However, no significant differences were observed in capsular contracture rates between subpectoral versus prepectoral implant placement and smooth versus textured implants.

Ameliorative effect of poly-γ-glutamic acid biopreparation on coastal saline soil.

To investigate the effect of poly-γ-glutamic acid (γ-PGA) biopreparation on ameliorating coastal saline soil, three treatments were established: soil salt washed treatment (CK), soil salt washed with added γ-PGA (PGA), soil salt washed with added γ-PGA biopreparation (PGAB). This study determined the effects of γ-PGA on coastal saline soil by analyzing soil aggregate, soil evaporation, soil vertical water and salt distribution, and soil cation content, soil pH, soil nutrient content and soil microorganism quantity. Results showed that γ-PGA had an ameliorative effect on saline soil, with the PGAB treatment exhibiting the most pronounced ameliorative effect compared to CK. Adding PGAB reduced soil evaporation by 30.45 %, soil salt content by 27.91 %, meanwhile increasing plant height by 33.86 %, plant fresh weight by 98.54 %, soil aggregate diameter by 6.68 times, soil water content by 26.47 % (P < 0.05). Additionally, soil total nitrogen was increased by 50.0 % in PGAB treatment, and available nitrogen and phosphorus contents were increased by 1.68 times and 85.83 % (P < 0.05), respectively. Populations of soil-culturable bacteria and fungi of PGAB treatment increased by 65.96 % and 1.23 times, respectively (P < 0.05). After salt-washing process, adding PGAB improved soil physicochemical properties, which altered the ecological environment of rhizosphere soil and promoted plant growth. The results can provide a practical approach for ameliorating coastal saline soils.

Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID-19.

OBJECTIVE: Nasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS-CoV-2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP-I), and intranasal corticosteroids (INCS) at reducing SARS-CoV-2 NVL and transmissibility. DATA SOURCES: Databases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov. REVIEW METHODS: A systematic review was completed with pre-defined search criteria using keywords related to nasal irrigation and COVID-19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in-vivo studies testing nasal irrigation with either saline, PVP-I, or INCS for reducing NVL were included. RESULTS: Nine out of ten studies on saline-based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP-I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP-I. No studies were found on INCS. CONCLUSION: Saline nasal irrigation showed the best efficacy in reducing SARS-CoV-2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP-I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. Laryngoscope, 2024.

Assessment of brine discharges dispersion for sustainable management of SWRO plants on the South American Pacific coast.

Seawater desalination is one of the most feasible technologies for producing fresh water to address the water scarcity scenario worldwide. However, environmental concerns about the potential impact of brine discharge on marine ecosystems hinder or delay the development of desalination projects. In addition, scientific knowledge is lacking about the impact of brine discharges on the South America Pacific coast where desalination, is being developed. This paper presents the first monitoring results of brine discharge influence areas from seawater reverse osmosis desalination plants (SWRO) on the South America Pacific coast, using Chile as case study. Our results indicate that the combination of favorable oceanographic conditions and diffusers, results in the rapid dilution of brine discharge on coastal ecosystems; showing a faster dilution than other SWRO plants in other regions, such as Mediterranean or Arabian Gulf, with similar production characteristics. Also, the increase in salinity over the natural salinity in the brine-discharge-affected area was <5 % in a radius of <100 m from the discharge points. Further, according to the published literature and on our monitoring results, we propose a number of considerations (environmental regulation, best scientifically tested measures, environmental requirements) to achieve a long-term sustainable desalination operation.

Comparative efficacy of balanced crystalloids versus 0.9% saline on delayed graft function and perioperative outcomes in kidney transplantation: a meta-analysis of randomised controlled trials.

BACKGROUND: Delayed graft function after kidney transplantation is linked to poor graft survival and increased chronic allograft injury. Recent guidelines suggest using balanced crystalloids over 0.9% saline owing to better metabolic profiles, but their impact on DGF remains unclear. METHODS: We searched PubMed, Embase, and Cochrane Central Registry of Clinical Trials from inception until February 29, 2024, and included RCTs that randomised adult participants to receive either intravenous balanced fluids or 0.9% saline intraoperatively. We pooled data using a random-effects model and present risk ratios (RRs) or mean differences, with 95% confidence intervals (CIs). We assessed individual study risk of bias using the modified Cochrane tool and certainty of evidence using GRADE. Outcomes analysed were delayed graft function incidence, vasopressor requirements, length of hospital stay, and postoperative metabolic profiles. RESULTS: Of 106 publications identified, we included 11 RCTs (n=1717). Pooled analysis showed that the use of balanced fluids was associated with a lower incidence of delayed graft function compared with 0.9% saline (RR 0.82, 95% CI: 0.69 to 0.98, P=0.01, moderate certainty). Balanced crystalloids were associated with higher postoperative serum pH, higher serum bicarbonate, and lower serum chloride concentration, but effects on vasopressor requirements, length of hospital stay, and serum creatinine were uncertain. CONCLUSIONS: Balanced crystalloid intravenous fluid therapy reduced delayed graft function incidence and maintained more favourable serum chemistry profiles compared with 0.9% saline in patients undergoing kidney transplantation. However, crystalloid type did not significantly influence vasopressor requirements and length of hospital stay.

Self-reported chronic therapy use after 24-weeks of follow-up by participants who completed the simplify randomized, controlled trial.

BACKGROUND: Highly effective CFTR modulator therapy (HEMT) has improved the health of many people with cystic fibrosis (pwCF), offering opportunities to discontinue burdensome therapies. SIMPLIFY included randomized, controlled trials that confirmed non-inferiority of discontinuing versus continuing dornase alfa (DA) or hypertonic saline (HS) for 6 weeks in pwCF on HEMT. In this study of post-trial treatment use by SIMPLIFY participants, we hypothesized that randomization to discontinue DA or HS during the trial would be associated with a higher likelihood of non-use of each medication during follow-up. METHODS: We electronically surveyed SIMPLIFY participants every 4 weeks for 24 weeks after trial completion but before the main trial results were publicly disclosed. We asked them how often they used medications during the previous week. We estimated covariate-adjusted odds ratios (ORs) of DA or HS non-use by logistic regression with generalized estimating equations. RESULTS: After exclusions mostly due to lack of any surveys, 472 participants were included in the analysis population, 181 from the HS trial and 291 from the DA trial. Approximately half of the analysis population completed all six surveys. At every month of follow-up in both trials, the percentage of individuals reporting non-use of DA or HS during the previous week was greater among those randomized to discontinue therapy. Among participants with responses at 24 weeks, 30/122 (24.6 %) in the HS trial and 79/222 (35.6 %) in the DA trial reported non-use of the respective study medication. After adjusting for covariates, participants randomized to discontinue DA were 8.7-times (95 % CI: 4.3-17.7) more likely to not use DA during follow-up than those randomized to continue DA, and participants randomized to discontinue HS were 5.2-times (95 % CI: 2.1-12.8) more likely to not use HS during follow-up compared to those randomized to continue. CONCLUSIONS: In healthy pwCF on ETI, randomization to discontinue DA or HS during SIMPLIFY was associated with greater odds of not using each medication after the trial compared to randomization to continue. These findings suggest that participation in a treatment discontinuation trial can influence participants' post-trial treatment decisions. This possibility may be relevant during discussions about research participation and clinical care.

GDSL in Lilium pumilum (LpGDSL) Confers Saline-Alkali Resistance to the Plant by Enhancing the Lignin Content and Balancing the ROS.

In order to explore the response mechanism of Lilium pumilum (L. pumilum) to saline-alkali stress, we successfully cloned LpGDSL (GDSL lipase, Gly-Asp-Ser-Leu) from L. pumilum. The qRT-PCR results indicated that the LpGDSL expression was higher in the leaves of L. pumilum, and the expression of the LpGDSL reached the highest level at 12 h in leaves under 11 mM H2O2, 200 mM NaCl, 25 mM Na2CO3, and 20 mM NaHCO3. The bacteriophage overexpressing LpGDSL was more tolerant than the control under different NaHCO3 contents. Overexpressed and wild-type plants were analyzed for phenotype, chlorophyll content, O2- content, H2O2 content, lignin content, and so on. Overexpressed plants had significantly higher resistance than the wild type and were less susceptible to saline-alkali stress. The yeast two-hybrid and BiFC assays demonstrated the existence of an interaction between LpGDSL and LpBCP. The yeast one-hybrid assay and transcriptional activation assay confirmed that B3 transcription factors could act on LpGDSL promoters. Under saline-alkali stress, L. pumilum will promote the expression of LpGDSL, which will then promotes the accumulation of lignin and the scavenging of reactive oxygen species (ROS) to reduce its damage, thus improving the saline-alkali resistance of the plant.