Tuberculous meningitis remains highly lethal. In this trial, an intensified regimen of levofloxacin and higher-dose rifampin added to standard therapy was compared with standard antituberculosis ...therapy alone. The intensified regimen did not result in a higher survival rate.
Early treatment with antituberculosis chemotherapy and adjunctive treatment with glucocorticoids reduce the rate of death and disability from tuberculous meningitis, but the disease still kills or disables almost half the patients with the condition.
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The current guidelines recommend treatment with four antituberculosis drugs for at least the first 2 months of therapy, followed by treatment with two drugs (rifampin and isoniazid) for an additional 7 to 10 months.
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However, these recommendations are based on data from pulmonary tuberculosis and do not take into account the differential ability of antituberculosis drugs to penetrate the brain.
Rifampin is considered to . . .
This study investigated methyl orange (MO) dye adsorption using three biochars produced from agro-waste and invasive plants; the latter consisted of wattle bark (BA), mimosa (BM), and coffee husks ...(BC). BC had the lowest specific surface area (2.62 m2/g) compared to BA (393.15 m2/g) and BM (285.53 m2/g). The adsorption efficiency of MO was stable at pH 2–7 (95%–96%), whilst it had reduced stability at pH 7–12. Between 0 and 30 min, MO adsorption efficiency was >82%, and at 120 min, representative adsorption equilibrium had occurred. The maximum adsorption capacity of the biochars was 12.3 mg/g. The underlying adsorption mechanisms of the three biochars were governed by electrostatic adsorption and pore diffusion. There was an abundance of active sites for adsorption in BA and BM, while chemical adsorption appeared to be more vital for BC, as it contained more functional groups on its surface. The highest MO adsorption efficiency occurred with BM. BC was not recommended for MO removal, as it was observed to stain the water when a dose exceeding 5.0 g/L was utilized.
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•Biochars were successfully derived from agro-waste and invasive plants.•After only 30 min the methyl orange adsorption efficiency on biochar was more than 82%.•The adsorption equilibrium was established at 120 min.•The highest adsorption occurred with biochar from mimosa.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
CONTEXT There are few data on long-term mortality following osteoporotic fracture and fewer following subsequent fracture. OBJECTIVES To examine long-term mortality risk in women and men following ...all osteoporotic fractures and to assess the association of subsequent fracture with that risk. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort from the Dubbo Osteoporosis Epidemiology Study of community-dwelling women and men aged 60 years and older from Dubbo, Australia, who sustained a fracture between April 1989 and May 2007. MAIN OUTCOME MEASURES Age- and sex-specific standardized mortality ratios (SMRs) compared with the overall Dubbo population for hip, vertebral, major, and minor fractures. RESULTS In women, there were 952 low-trauma fractures followed by 461 deaths, and in men, 343 fractures were followed by 197 deaths. Age-adjusted SMRs were increased following hip fractures (SMRs, 2.43 95% confidence interval CI, 2.02-2.93 and 3.51 95% CI, 2.65-4.66), vertebral fractures (SMRs, 1.82 95% CI, 1.52-2.17 and 2.12 95% CI, 1.66-2.72), major fractures (SMRs, 1.65 95% CI, 1.31-2.08 and 1.70 95% CI, 1.23-2.36), and minor fractures (SMRs, 1.42 95% CI, 1.19-1.70 and 1.33 95% CI, 0.99-1.80) for both women and men, respectively. Mortality was increased for all ages for all fractures except minor fractures for which increased mortality was only apparent for those older than 75 years. Increased mortality risk persisted for 5 years for all fractures and up to 10 years for hip fractures. Increases in absolute mortality that were above expected, for 5 years after fracture, ranged from 1.3 to 13.2 per 100 person-years in women and from 2.7 to 22.3 per 100 person-years in men, depending on fracture type. Subsequent fracture was associated with an increased mortality hazard ratio of 1.91 (95% CI, 1.54-2.37) in women and 2.99 (95% CI, 2.11-4.24) in men. Mortality risk following a subsequent fracture then declined but beyond 5 years still remained higher than in the general population (SMR, 1.41 95% CI, 1.01-1.97 and SMR, 1.78 95% CI, 0.96-3.31 for women and men, respectively). Predictors of mortality after any fragility fracture for both men and women included age, quadriceps weakness, and subsequent fracture but not comorbidities. Low bone mineral density, having smoked, and sway were also predictors for women and less physical activity for men. CONCLUSIONS In a sample of older women and men, all low-trauma fractures were associated with increased mortality risk for 5 to 10 years. Subsequent fracture was associated with increased mortality risk for an additional 5 years.
Our study investigated magnetic resonance imaging measurements for differentiating cerebellopontine angle (CPA) meningioma from vestibular schwannoma (VS).
This retrospective study compared 36 ...meningioma and 36 VS patients. The tumor volume (Vtumor) and peritumor edema index (EI) relationship was analyzed. T2-weighted three-dimensional gradient-echo image signal intensity (T23D) and apparent diffusion coefficient (ADC) differentiation cutoff values were defined. Mann-Whitney U test, independent-samples t-test, receiver operating characteristic curve, and Spearman's correlation analyses were applied.
Meningioma had higher Vtumor (p=0.009) and EI (p=0.031) values than VS. Meningioma had significantly (p<0.001) lower values than VS for mean ADC (ADCmean: 0.841±0.083×10-3 vs.1.173±0.190×10-3 mm2/s), minimum ADC (ADCmin: 0.716±0.078×10-3 vs.1.045±0.178×10-3 mm2/s), tumor:white matter ADC ratio (rADC: 1.198±0.19 vs. 1.59±0.30), mean T23D (T23Dmean: 142.91±19.9 vs. 218.72±84.73), and tumor:adipose T23D ratio (rT23d: 0.19±0.06 vs. 0.30±0.28) Cutoff, sensitivity (Se), and specificity (Sp) values were ADCmin, 0.856×10-3 mm2/s (Se: 96.6%, Sp: 100%); ADCmean, 0.963×10-3 mm2/s (Se: 96.6%, Sp: 95.5%); rADC, 1.3189 (Se: 93.1%, Sp: 81.8%), T23Dmean (Se: 96.6%, Sp: 100%); rT23D, 0.1951 (Se: 89.7%, Sp: 100%), Vtumor, 14828.65 mm3 (Se: 75.0%, Sp: 66.7%), and EI, 1.1025 (Se: 47.2%, Sp: 100%).
ADCmin, ADCmean, rADC, T23Dmean, rT23D, Vtumor, and EI, effectively discriminated meningioma from VS.
In this randomized trial, HIV-positive adults with tuberculous meningitis were assigned to receive 6 to 8 weeks of dexamethasone or placebo in addition to tuberculosis treatment. No benefit of ...dexamethasone was observed.
We report herein investigation on crystallization of amorphous molybdenum sulfide a-MoS x induced by electron and laser beam resulting in formation of crystalline molybdenum disulfide c-MoS2. This ...crystallization occurred in situ during transmission electron microscopic and Raman analyses of a-MoS x material. It was also found that a-MoS x to c-MoS2 phase transformation was not fully beneficial for H2-evolving catalytic performance. c-MoS2 showed better robustness but significantly lower catalytic performance. Furthermore, c-MoS2 was less tolerant to oxidation stress, as the one caused by photogenerated holes within the light harvester, compared with a-MoS x catalyst. Thus, a-MoS x is a better candidate for implementation within photocatalysts for overall solar water-splitting application.
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IJS, KILJ, NUK, PNG, UL, UM
In this study, activated carbon in the form of carbonaceous hydrochar adsorbents with highly functionalized surface-active sites were produced from coffee husk waste via hydrothermal carbonization ...under low-temperature conditions (180 °C) and subsequent chemical activation. Thereafter, the hydrochars were characterized using diverse analytical techniques, and batch experiments of methylene blue (MB) adsorption were performed under various operating conditions. The results indicated that the activated hydrochar (AH) had a larger specific surface area (862.2 m2 g−1) compared to that of its carbonaceous precursor (33.7 m2 g−1). The maximum MB sorption capacity of the hydrochar activated with potassium hydroxide was extremely high (415.8 mg g−1 at 30 °C). In addition, adsorption isotherms and kinetics were studied using experimental data fitting to further understand and describe the dynamic equilibrium, dynamic kinetics, and mechanism of MB adsorption onto the prepared hydrochars. As compared to the Freundlich isotherm model, the Langmuir isotherm model provided a better fit with the experimental data exhibiting a maximum monolayer adsorption capacity of 418.78 mg g−1. The linear pseudo-second-order kinetic model was found to be suitable for describing the adsorptive kinetics of the hydrochar. The results demonstrated the immense potential of coffee husk waste to produce activated carbon as an alternative green hydrochar that can be applied to dye removal from wastewater as well as improvement of waste management.
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•High-performance activated hydrochar (AH) was derived from coffee husks and tested.•AH had an excellent specific surface area of 862.2 m2 g−1.•Derived AH efficiently removed methylene blue (MB) dye.•The highest MB removal (415.8 mg g−1) was achieved under experimental conditions.•Adsorption isotherm and kinetic studies were conducted by experimental data fitting.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Significant long-term mortality reduction was demonstrated in women with and without fractures taking oral bisphosphonates, compared to no therapy.
Context:
Osteoporotic fractures are associated with ...premature mortality. Antiresorptive treatment reduces refracture but mortality reduction is unclear.
Objective:
The objective of the study was to examine the effect of osteoporosis treatment bisphosphonates (BP), hormone therapy (HT), and calcium ± vitamin D only (CaD) on mortality risk.
Design:
This was a prospective cohort study (April 1989 to May 2007).
Setting:
The study was conducted with community-dwelling elderly (aged 60+ yr) subjects in Dubbo, a semiurban city, Australia.
Subjects:
Subjects included 1223 and 819 women and men in the Dubbo Osteoporosis Epidemiology Study.
Main Outcome Measure:
Mortality according to treatment group was recorded.
Results:
There were 325 (BP, n = 106; HT, n = 77; CaD, n = 142) women and 37 men (BP, n = 15; CaD, n = 22) on treatment. In women, mortality rates were lower with BP 0.8/100 person-years (0.4, 1.4) and HT 1.2/100 person-years (0.7, 2.1) but not CaD 3.2/100 person-years (2.5, 4.1) vs. no treatment 3.5/100 person-years (3.1, 3.8). Accounting for age, fracture occurrence, comorbidities, quadriceps strength, and bone mineral density, mortality risk remained lower for women on BP hazard ratio (HR) 0.3 (0.2, 0.6) but not HT HR 0.8 (0.4, 1.8). For 429 women with fractures, mortality risk was still reduced in the BP group adjusted HR 0.3 (0.2, 0.7), not accounted for by a reduction in subsequent fractures. In men, lower mortality rates were observed with BP but not CaD BP 1.0/100 person-years (0.3, 3.9) and CaD 3.1/100 person-years (1.5, 6.6) vs. no treatment 4.3/100 person-years (3.9, 4.8). After adjustment, mortality was similar, although not significant HR 0.5 (0.1, 2.0).
Conclusions:
Osteoporosis therapy appears to reduce mortality risk in women and possibly men.
Adsorption in the continuous mode plays a significant role in wastewater treatment. In this study, Mimosa pigra-derived biochar modified with 2 M AlCl3 salt was used to pack a lab-scale column to ...eliminate PO43− from aqueous solutions. The influence of the operational factors, such as inlet PO43− concentration (25–100 mg/L), flow rate (6–18 mL/min), and biochar bed height (1.5–4.5 cm), on the breakthrough curve was evaluated. The kinetic models of Adam–Bohart and Yoon–Nelson were utilized to analyze the experimental results. The best conditions were determined to be the influent PO43− strength of 50 mg/L, injection speed of 6 mL/min, and column height of 4.5 cm. These results can be applied in the design of large-scale columns for the sequestration of PO43− from wastewater.
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•Phosphate was successfully removed using fixed-bed modified biochar column.•The inlet PO43−, flow rate, and bed height affected the breakthrough curve.•The optimal conditions were 50 mg/L of PO43−, 6 mL/min flow rate, and 4.5 cm height.•Adam–Bohart and Yoon–Nelson models were utilized to describe experimental results.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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