A novel interpretable machine learning and metaheuristic-based protocol to predict and optimize ciprofloxacin antibiotic adsorption with nano-adsorbent.

The existence of antibiotics in water sources poses substantial hazards to both the environment and public health. To effectively monitor and combat this problem, accurate predictive models are essential. This research focused on employing machine learning (ML) techniques to construct some models for analyzing the adsorption capacity of ciprofloxacin (CIP) antibiotic from contaminated water. The robustness of ten machine learning algorithms was evaluated using performance metrics such as the Coefficient of determination (R2), Mean Square Error (MSE), Median Absolute Error (MedAE), Mean Absolute Error (MAE), Correlation coefficient (R), Nash-Sutcliffe Efficiency (NSE), Kling-Gupta Efficiency (KGE), and Root Mean Square Error (RMSE). The hyperparameters of the ML models were fine-tuned using the Bayesian optimization algorithm. The optimized models were comprehensively evaluated using feature importance analysis to quantify the relative significance of operational variables accurately. After a thorough assessment and comparison of various machine learning models, it was evident that the HistGradientBoosting (HGB) model outperformed others in terms of CIP adsorption performance. This was supported by their low MAE value of 0.1865 and high R2 value of 0.9999. The modeling projected the highest antibiotic adsorption (99.28%) under optimized conditions, including 10 mg/L of CIP, 357 mg/L of CuWO4@TiO2 adsorbent, a contact time of 60 min at room temperature, and near neutral pH (7.5). The combination of advanced ML algorithms and nano adsorbents has great potential for addressing the problem of antibiotic pollution in water sources.

Assessment of selected pharmaceuticals in Riyadh wastewater treatment plants, Saudi Arabia: Mass loadings, seasonal variations, removal efficiency and environmental risk.

Despite increasing interest in pharmaceutical emissions worldwide, studies of environmental contamination with pharmaceuticals arising from wastewater discharges in Saudi Arabia are scarce. Therefore, this study examined occurrence, mass loads and removal efficiency for 15 pharmaceuticals and one metabolite (oxypurinol) from different therapeutic classes in three wastewater treatment plants (WWTPs), in Riyadh city in Saudi Arabia. A total of 144 samples were collected from the influents and effluents between March 2018 and July 2019 and analyzed using Solid Phase Extraction followed by triple quadrupole LC-MS/MS. The average concentrations in the influents and effluents were generally higher than their corresponding concentrations found either in previous Saudi Arabian or global studies. The four most dominant compounds in the influent were acetaminophen, ciprofloxacin, caffeine, and diclofenac, with caffeine and acetaminophen having the highest concentrations ranging between 943 and 2282 µg/L. Metformin and ciprofloxacin were the most frequently detected compounds in the effluents at concentrations as high as 33.2 µg/L. Ciprofloxacin had the highest mass load in the effluents of all three WWTPs, ranging between 0.20 and 20.7 mg/day/1000 inhabitants for different WWTPs. The overall average removal efficiency was estimated high (≥80), with no significant different (p > 0.05) between the treatment technology applied. Acetaminophen and caffeine were almost completely eliminated in all three WWTPs. The samples collected in the cold season generally had higher levels of detected compounds than those from the warm seasons, particularly for NSAID and antibiotic compounds. The estimated environmental risk from pharmaceutical compounds in the studied effluents was mostly low, except for antibiotic compounds. Thus, antibiotics should be considered for future monitoring programmes of the aquatic environment in Saudi Arabia.

The Safety and Efficacy of One Anastomosis Gastric Bypass as a Revision for Sleeve Gastrectomy.

INTRODUCTION: Failure of sleeve gastrectomy poses a potential challenge for surgeons as variable options exist for revision. One anastomosis gastric bypass (OAGB) is a potential revisional option, and in this study, we sought to determine the safety and efficacy of OAGB post sleeve gastrectomy. METHOD: Prospective study on our initial experience with a consecutive group of patients who underwent OAGB as a revisional surgery for sleeve gastrectomy in the period between January 2015 and December 2018 was carried out. Morbidity and mortality data were recorded as well as the effect on comorbidities and weight loss. RESULTS: A total of 56 patients underwent OAGB as a revision of sleeve gastrectomy. The average weight prior to OAGB was 112 ± 24.6 kg. The minimum weight they have reached after is 85 ± 21.3 kg after a duration of 19 ± 9.2 months. Percentage of total weight loss (TWL%) at 1, 3, 6, and 12 months postoperatively was found to be 7.6%, 9.8%, 14.1%, and 28.8%, respectively. TWL% on the last day of follow-up was 24%. Two patients had marginal ulcers, in which one had a perforation. CONCLUSION: OAGB is safe and effective for weight regain post sleeve gastrectomy.

Obesity surgery and Ramadan: a prospective analysis of nutritional intake, hunger and satiety and adaptive behaviours during fasting.

BACKGROUND: Fasting for religious or lifestyle reasons poses a challenge to people who have undergone bariatric surgery. A total fast (abstaining from all forms of nourishment including liquids) during long summer days puts these patients at risk of dehydration and poor calorie and nutrient intake. METHODS: We undertook telephone surveys of 24-h food recall, hunger and satiety scores, medication use, adverse symptoms and depression scores on a fasting day in Ramadan and a non-fasting day subsequently. RESULTS: We studied 207 participants (166 women) who had undergone sleeve gastrectomy. The mean (standard error) age was 35.2 (0.7) years. Men and women consumed 20.4 % (P = 0.018) and 16.9 % (P < 0.001) fewer calories and 44.8 % (P < 0.001) and 32.4 % (P < 0.001) less protein during fasting, respectively. There was no significant difference in the intake of fluids or incidence of adverse gastrointestinal, hypoglycaemic and sympathoadrenal symptoms. Of participants on pharmacotherapy, 89.5 % took their prescribed medications; 86.3 % made no changes to the doses, but 80.4 % changed the timing of the medications. Both women and men reported feeling less hungry and a preference for savoury foods during Ramadan. There was no difference in depression and work impairment scores. CONCLUSIONS: Fasting was well tolerated in persons who had undergone sleeve gastrectomy. It may be advisable to raise awareness about dietary protein intake and managing medications appropriately during fasting.