Usefulness of a Simple Protein-Energy Wasting Score for Predicting Hospitalization in Maintenance Hemodialysis Patients: A Prospective Cohort Study

Background: Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. Objectives: In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. Methods: In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. Results: Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2. Conclusion: The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.

Classical bovine spongiform encephalopathy and chronic wasting disease:two sides of the prion coin

Transmissible spongiform encephalopathies(TSEs)are a group of progressive and ultimately fatal neurologic diseases of man and animals,all resulting from the propagated misfolding of the host's normal cellular prion protein.These diseases can be spontaneous,heritable,anthropogenic/iatrogenic,or in some cases horizontally transmissible,and include such notable TSEs as bovine spongiform encephalopathy(BSE)of cattle and chronic wasting disease(CWD)of cervids.Although they are both unequivocally protein misfolding disorders,they differ markedly in their pathogenesis,transmissibility,and zoonotic potential.While the BSE epidemic has largely abated over the past three decades following global feed bans on ruminant meat and bone meal,CWD,which is readily transmitted through various forms of excreta,has rapidly expanded from its original endemic zone to encompass much of North America,along with recently identified foci in Scandinavia.Most importantly,although the classical form of BSE has proven transmissible to humans consuming contaminated beef or beef products,so far there have been no conclusive reports on the zoonotic transmission of cWD to humans.The underlying basis for these differences-whether host or agent directed-are not well understood,though may be due to inherent differences in the three-dimensional structure of the misfolded BSE or CWD prion proteins or the expression levels and tissue distribution of respective cellular prion proteins.With the uncontrolled geographic spread of CWD,it is imperative that we improve our understanding of the factors governing prion disease pathogenesis,transmission,and zoonotic potential.

Impact of muscle wasting on survival in patients with liver cirrhosis

Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease foundin approximately 40% of patients with cirrhosis. Its etiology is multifactorial subsequent to liver failure and its prevalence increases along with disease severity. Cross-sectional analytic morphometry using computed tomography(CT) scan or magnetic resonance imaging are considered by consensus the gold standards to assess muscle size in cirrhosis for research purposes because they are not biased by fluid accumulation. Several studies have assessed the impact of muscle wasting on overall survival of patients in the waiting list for liver transplantation and there is a general agreement that decreased muscle size assessed by CT scan is an independent predictor for mortality in cirrhosis. It has been proposed that the addition of cross-sectional muscle area into the Model for End-stage Liver Disease can increase its prognostic performance. Nevertheless, the use of CT scan in assessing muscle size is inappropriate for routine clinical practice and an alternative cost-effective, easy to use and accurate tool should be developed. In conclusion, muscle wasting has a detrimental impact on survival of patients with cirrhosis and, thus, it remains to be elucidated if nutritional interventions and exercise could improve muscle wasting and, subsequently, survival in this setting.

Muscle wasting in rheumatoid arthritis:The role of oxidative stress

Rheumatoid arthritis(RA), the commonest inflammatory arthritis, is a debilitating disease leading to functional and social disability. In addition to the joints, RA affects several other tissues of the body including the muscle. RA patients have significantly less muscle mass compared to the general population. Several theories have been proposed to explain this. High grade inflammation, a central component in the pathophysiology of the disease, has long been proposed as the key driver of muscle wasting. More recent findings however, indicate that inflammation on its own cannot fully explain the high prevalence of muscle wasting in RA. Thus, thecontribution of other potential confounders, such as nutrition and physical activity, has also been studied. Results indicate that they play a significant role in muscle wasting in RA, but again neither of these factors seems to be able to fully explain the condition. Oxidative stress is one of the major mechanisms thought to contribute to the development and progression of RA but its potential contribution to muscle wasting in these patients has received limited attention. Oxidative stress has been shown to promote muscle wasting in healthy populations and people with several chronic conditions. Moreover, all of the aforementioned potential contributors to muscle wasting in RA(i.e., inflammation, nutrition, and physical activity) may promote pro- or antioxidative mechanisms. This review aims to highlight the importance of oxidative stress as a driving mechanism for muscle wasting in RA and discusses potential interventions that may promote muscle regeneration via reduction in oxidative stress.

Prolonged coexistent central diabetes insipidus and cerebral salt wasting syndrome following neurosurgery

The coexistence of different water homeostasis abnormalities following neurosurgery represents a diagnostic and therapeutic challenge for intensive care units. This paper reports the case of a 13 year-old boy who underwent surgery for a suprasellar tumour and, immediately after surgery, developed a cerebral abscess, persistent diabetes insipidus (DI) as well as cerebral salt wasting syndrome (CSWS). The early onset of CSWS following DI has been associated with a poor prognosis and increased mortality. In cases in which these abnormalities coexist, the increased polyuria secondary to the rise in natriuresis associated with CSWS might be erroneously interpreted as a sign of poor control of the DI, thereby leading to therapeutic mistakes. Treatment basically consists of restoring electrolytes and the joint administration of desmopressin and fludrocortisone.

Advanced wasting in peritoneal dialysis patients

AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD) who had zero body fat(BF) as determined by analysis of body composition using anthropometric formulas estimating body water(V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODS Body weight(W) consists of fat-free mass(FFM) andBF.Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,where 0.73 is the water fraction of FFM at normal hydration.Wasting from loss of BF has adverse survival outcomes in PD.Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W.This study,which analyzed 439 PD patients at their first clearance study,used the Watson formulas estimating V to identify patients with V_(Watson)/0.73 ≥ W and compared their nutritional indices with those of PD patients with V_(Watson)/0.73 < W.RESULTS The study identified at the first clearance study two male patients with V_(Watson)/0.73 ≥ W among 439 patients on PD.Compared to 260 other male patients on PD,the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration.The first of the two subjects also had very low values for serum creatinine concentration and total(in urine and spent peritoneal dialysate) creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due,most probably,to non-compliance with the PD prescription.CONCLUSION Advanced wasting(zero BF) in PD patients,identified by the anthropometric formulas that estimate V,while rare,is associated with indices of poor somatic and visceral nutrition.

Hyponatremia during a Severe Pneumococcal Meningitis with Renal Salt Wasting: A Cerebral Salt Wasting Syndrome?

Background: The existence and prevalence of cerebral salt wasting and its differentiation from syndrome of inappropriate antidiuretic hormone have been controversial. This controversy stems from overlapping clinical and laboratory findings and an inability to assess the volume status of these patients. Objectives:To present a case of a cerebral salt wasting syndrome secondary to a bacterial mengitis and to emphasize the difficulty to assess the diagnosis. Case report: A 51-year-old male admitted to the ICU for a severe bacterial meningitis who developed, four days later, hyponatremia associated with hypovolemia due to a renal salt wasting. Clinical and biological parameters were collected;electrolytes balances and salt clearances were calculated to best investigate this hydroelectrolytic disorder. Patient's volume status and improvement after fluid and sodium replacement highly suggests the diagnosis of a cerebral salt wasting syndrome. Conclusion: A thorough analysis of this case showed that occurrence of hyponatremia and renal salt wasting after brain agression is not univocal underlying the fact that the diagnosis of cerebral salt wasting should be assessed only after a careful examination of the different determinants of the hydroelectrolytical balance.

Geographic Information Technologies for the Study of Mass Wasting Hazards

The purpose of the research was to obtain the mass wasting hazard map for the state of Vargas, central coast of Venezuela, using GIS technology. The work was developed through the heuristic method with the generation of thematic digital maps, univariate statistical treatment, weighting of each variable and quantifying the relationship of each parameter unit regarding mass wasting processes. The algorithm designed to perform map algebra was designed using the variables: surface geology, slope, slope orientation, terrain curvature, moisture topographic index, power index surface flow rate and capacity sediment transport and the rate normalized difference vegetation. The results show a distribution of landslide hazard with the highest values in the west central part of Vargas state, where the dominant lithology is incompetent, and combined with topographic elements, determining high instability, meanwhile the lower hazard areas were found in specific areas such as the middle watershed areas east of the state. The calibration of this model shows a reliability of 80%, so it is highly advisable to use the information generated in this work by governmental and non-governmental organizations in the planning, management and use of land.

Association of Protein Energy Wasting with Income in CKD Stage 3 Patients

Protein energy wasting (PEW) is a major challenge in CKD. Objective: To assess PEW in predialysis patients on their first visit to a nephrologist. Methods: Three day dietary intake of 484 CKD stage 3 patients was taken. Appetite was assessed with ADAT. Patients were divided into groups based on appetite and BMI. Results: Male and female parameters are serum albumin 3.7 ± 0.84/3.68.8 ± 0.81 g/dL, total protein 7.02 ± 1.27/6.94 ± 1.26 g/dL, creatinine 4.68 ± 4.19/3.74 ± 3.36 mg% creatinine clearance 33.22 ± 30.48/37.55 ± 33.87 ml/minute, BMI 22.60 ± 4.29/23.43 ± 4.77kg/m2 energy/kg 16.97 ± 0.65/16.8 ± 0.64, protein g/kg 0.65 ± 0.28/0.64 ± 0.30, carbohydrate g/kg 2.98 ± 1.54/2.98 ± 0.1.36, fat g/kg 2.98 ± 0.23/2.79 ± 0.22, respectively. As appetite decreased, dietary protein and energy intake decreased significantly. Appetite in males and females: Average 14.46%, 4.13%, poor 9.7%, 18.18%, anorexic 13.2%, 7.4%. Income had strong correlation with BMI (p 0.000), dietary protein (p 0.000), energy (p 0.000) and carbohydrate (p 0.000). Appetite correlated with creatinine (p 0.019), dietary energy, protein, carbohydrate and fat (p 0.000) intake. BMI correlated (p 0.000) with fat, carbohydrate, energy and creatinine clearance. ANOVA showed significant difference within and between appetite groups in energy, protein, fat, carbohydrate, creatinine clearance (p 0.000) and serum albumin (p 0.025). There was significant difference in protein (p 0.026), energy intake (p 0.000) and creatinine clearance (p 0.038) within and between BMI groups. Based on income, there was significant difference among groups in BMI (p 0.000), energy (p 0.019), protein (p 0.031) and albumin (0.001).

Particle agglomeration and inhibition method in the fluidized pyrolysis reaction of waste resin

This work investigated the pyrolysis reaction of waste resin in a fluidized bed reactor.It was found that the pyrolysis-generated ash would adhere to the surface of ceramic particles,causing particle agglomeration and defluidization.Adding kaolin could effectively inhibit the particle agglomeration during the fluidized pyrolysis reaction through physical isolation and chemical reaction.On the one hand,kaolin could form a coating layer on the surface of ceramic particles to prevent the adhesion of organic ash generated by the pyrolysis of resin.On the other hand,when a sufficient amount of kaolin(-0.2%(mass))was added,the activated kaolin could fully contact with the Na+ ions generated by the pyrolysis of resin and react to form a high-melting aluminosilicate mineral(nepheline),which could reduce the formation of low-melting-point sodium sulfate and thereby avoid the agglomeration of ceramic particles.

Ionic Disorders Observed in Infants with Severe Wasting at the Yalgado Ouedraogo Teaching Hospital and the Charles de Gaulle Pediatric Teaching Hospital in Ouagadougou, Burkina Faso

Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m2. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.

Potential of GIS Evaluation for Mass Wasting Processes in Mountain Ranges of South West Coast of India

The aim of the study is to monitor and assess landslide hazards by remote sensing data processing and GIS （Geographic Information Service） spatial analysis. Idukki district, the western Ghats of India was chosen as test area, because of frequent destructive mass wasting processes. Western Ghats is a prominent orographic feature that runs parallel to the south west coast of India. Predicting landslide hazard on a regional scale, namely the assessment of actual and potential mass movement over large area is carried out using Remote Sensing and GIS. A numerical weightage to the causative factors of slope instability such as slope, relative relief, aspect, curvature, drainage density, drainage frequency, land use, road buffer and drainage buffer are assigned as per earlier workers for the purpose of landslide susceptibility zonation. A high degree of match is found between observed and predicted landslide hazard by the procedure employed in the study.

Optimizing Household Wastes (Rice, Vegetables, and Fruit) as an Environmentally Friendly Electricity Generator

The high consumption of electricity and issues related to fossil energy have triggered an increase in energy prices and the scarcity of fossil resources.Consequently,many researchers are seeking alternative energy sources.One potential technology,the Microbial Fuel Cell(MFC)based on rice,vegetable,and fruit wastes,can convert chemical energy into electrical energy.This study aims to determine the potency of rice,vegetable,and fruit waste assisted by Cu/Mg electrodes as a generator of electricity.The method used was a laboratory experiment,including the following steps:electrode preparation,waste sample preparation,incubation of the waste samples,construction of a reactor using rice,vegetable,and fruit waste as a source of electricity,and testing.The tests included measuring electrical conductivity,electric current,voltage,current density,and power density.Based on the test results,the maximum current and voltage values for the fruit waste samples were 5.53 V and 11.5 mA,respectively,with a current density of 2.300 mA/cm^(2) and a power density of 12.719 mW/cm^(2).The results indicate the potential for a future development.The next step in development involves determining the optimum conditions for utilizing of rice,vegetable,and fruit waste.The results of the electrical conductivity test on rice,vegetable,and fruit waste samples were 1.51,2.88,and 3.98 mS,respectively,with the highest electrical conductivity value found in the fruit waste sample.

Bearing capacity of circular footings on multi-layered sand-waste tire shreds reinforced with geogrids

The presence of waste tires poses an environmental challenge as they occupy a significant amount of land and are expensive to dispose in landfills.However,reusing waste tires can address this issue when waste tires are used in geotechnical applications.To determine the viability of this approach,laboratoryscale tests were conducted to investigate load-bearing capacity of circular footings on sand-tire shred(STS)mixtures with shredded waste tire contents of 5%e15%by weight and three different widths of shreds.The investigation focused on analyzing the thickness of layers composed of STS mixtures,the soil cap,and the impact of geogrids on bearing capacity.The results indicate that a specific mixture of sand and tire shreds provides the highest footing-bearing capacity.In addition,the optimal shred content and size were found to be 10%by weight and 2 cm×10 cm,respectively.Furthermore,for a given tire shred width,a particular length provides the largest bearing capacity.The results agree well with that of previous research conducted by the first author and his colleagues in direct shear and California bearing ratio(CBR)tests.The primary finding of this research is that the use of two-layered STS mixtures reinforced by geogrids significantly enhances the bearing capacity.

A functionalized activated carbon adsorbent prepared from waste amidoxime resin by modifying with H_(3)PO_(4) and ZnCl_(2) and its excellent Cr(Ⅵ)adsorption

With the application of resins in various fields, numerous waste resins that are difficult to treat have been produced. The industrial wastewater containing Cr(Ⅵ) has severely polluted soil and groundwater environments, thereby endangering human health. Therefore, in this paper, a novel functionalized mesoporous adsorbent PPR-Z was synthesized from waste amidoxime resin for adsorbing Cr(Ⅵ). The waste amidoxime resin was first modified with H3PO4 and ZnCl_(2), and subsequently, it was carbonized through slow thermal decomposition. The static adsorption of PPR-Z conforms to the pseudo-second-order kinetic model and Langmuir isotherm, indicating that the Cr(Ⅵ) adsorption by PPR-Z is mostly chemical adsorption and exhibits single-layer adsorption. The saturated adsorption capacity of the adsorbent for Cr(Ⅵ) could reach 255.86 mg/g. The adsorbent could effectively reduce Cr(Ⅵ) to Cr(Ⅲ) and decrease the toxicity of Cr(Ⅵ) during adsorption. PPR-Z exhibited Cr(Ⅵ) selectivity in electroplating wastewater. The main mechanisms involved in the Cr(Ⅵ) adsorption are the chemical reduction of Cr(Ⅵ) into Cr(Ⅲ) and electrostatic and coordination interactions. Preparation of PPR-Z not only solves the problem of waste resin treatment but also effectively controls Cr(Ⅵ) pollution and realizes the concept of “treating waste with waste”.

Cyberloafing:The line between rejuvenating and wasting time

Research shows that workers drift from their contracted tasks to personal email,social networks and the far corners of the internet for anything between a few hours a week to a few hours a day.Six out of 10people admit they can’t get through the workday without checking their social media.

Photocatalytic Degradation of Plastic Waste: Recent Progress and Future Perspectives

Microplastics are persistent anthropogenic pollutants that have become a global concern due to their widespread distribution and unfamiliar threat to the environment and living organisms. Conventional technologies are unable to fully decompose and mineralize plastic waste. Therefore, there is a need to develop an environmentally friendly, innovative and sustainable photocatalytic process that can destroy these wastes with much less energy and chemical consumption. In photocatalysis, various nanomaterials based on wide energy band gap semiconductors such as TiO2 and ZnO are used for the conversion of plastic contaminants into environmentally friendly compounds. In this work, the removal of plastic fragments by photocatalytic reactions using newly developed photocatalytic composites and the mechanism of photocatalytic degradation of microplastics are systematically investigated. In these degradation processes, sunlight or an artificial light source is used to activate the photocatalyst in the presence of oxygen.

Impact of Plastic Waste on the Human Health in Low-Income Countries: A Systematic Review

Background: Plastic pollution is the accumulation of waste composed of plastic and its derivatives all over the environment. Whether in the form of visible garbage or microparticles, as it slowly degrades, plastic pollution poses significant threats to terrestrial and aquatic habitats and the wildlife that call them home, whether through ingestion, entanglement or exposure to the chemicals contained in the material. Unfortunately, there is a lack of documentation on the impact of plastic waste on human health in low- and middle-income countries (LMICs). Methods: We searched five electronic databases (PubMed, Embase, Global Health, CINAHL and Web of Science) and gray literature, following the preferred reporting elements for systematic reviews and meta-analyses (PRISMA), for the impact of plastic waste on human health in developing countries. We included quantitative and qualitative studies written in English and French. We assessed the quality of the included articles using the Mixed Methods Appraisal tool (MMAT). Results: A total of 3779 articles were initially identified by searching electronic databases. After eliminating duplicates, 3167 articles were reviewed based on title and abstract, and 26 were selected for full-text review. Only three articles were retained. The three articles dealt with practices likely to lead to oral exposure to plastic chemicals in human health, as well as the level of awareness of participants concerning the possible impact of plastic on human health, namely, the use of plastic baby bottles, the use of microwaves to cook food and reheat precooked food, the use of plastic bottles to store water in the refrigerator, water purifier containers with plastic bodies and plastic lunch boxes, the reuse of plastic bags and the inadequacy of treatment facilities. Conclusion: Plastic waste poses different risks to human health at every stage of its life cycle. Hence, strategies must be adopted to raise public awareness of the dangers of plastic waste to their health. Trial registration: The review protocol is registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42023409087).

Household Solid Waste Awareness and Practices among Residents of Windhoek, Namibia

This study explores household solid waste management (HSWM) practices and awareness among residents of Windhoek West, a rapidly urbanizing constituency in the Khomas Region of Namibia. Employing a descriptive methodology, the research investigates the interplay between public awareness, regulatory frameworks, and the availability of waste management facilities to assess their impact on waste management behaviors. Our findings indicate significant gaps in both knowledge and infrastructure that hinder effective waste management. The study reveals that while there is a high willingness among residents to engage in recycling and waste reduction, actual practices are limited due to inadequate facilities and lack of stringent enforcement of waste policies. This research identifies key factors that influence waste management practices, including demographic characteristics and access to waste management facilities. It also proposes actionable strategies such as expanding recycling and sorting facilities, enhancing educational campaigns tailored to local needs, and implementing regular enforcement mechanisms. These strategies are aimed at improving compliance with waste management protocols and fostering a culture of environmental responsibility. The results of this investigation show the critical role of ongoing education and infrastructural improvement in bridging existing knowledge gaps and facilitating effective waste management practices. This research lays a foundational step toward enhancing sustainable urban development and effective waste management in Windhoek, providing valuable insights for policymakers, community leaders, and stakeholders engaged in urban environmental management.

Study on synergistic leaching of potassium and phosphorus from potassium feldspar and solid waste phosphogypsum via coupling reactions

To achieve the resource utilization of solid waste phosphogypsum(PG)and tackle the problem of utilizing potassium feldspar(PF),a coupled synergistic process between PG and PF is proposed in this paper.The study investigates the features of P and F in PG,and explores the decomposition of PF using hydrofluoric acid(HF)in the sulfuric acid system for K leaching and leaching of P and F in PG.The impact factors such as sulfuric acid concentration,reaction temperature,reaction time,material ratio(PG/PF),liquid–solid ratio,PF particle size,and PF calcination temperature on the leaching of P and K is systematically investigated in this paper.The results show that under optimal conditions,the leaching rate of K and P reach more than 93%and 96%,respectively.Kinetics study using shrinking core model(SCM)indicates two significant stages with internal diffusion predominantly controlling the leaching of K.The apparent activation energies of these two stages are 11.92 kJ·mol^(-1)and 11.55 kJ·mol^(-1),respectively.