Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care

OBJECTIVE

The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis.

METHODS

We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded.

RESULTS

We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers.

CONCLUSION

In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.

Near-surface termination of upward-propagating strike-slip ruptures on the Yangsan Fault, Korea

We present a new example of the termination of strike-slip paleoearthquake ruptures in near-surface regions on the Yangsan Fault, Korea, based on multi-scale structural observations. Paleoearthquake ruptures occur mostly along the boundary between the inherited fault core and damage zone (N10-20°E/> 75°SE). The ruptures propagated upward to the shallow subsurface along a < 3-cm-wide specific slip zone with dextral-slip sense, along which the deformation mechanism is characterized mainly by granular flow in near-surface region. The ruptures either reach the surface or are terminated in unconsolidated sediment below the surface. In the latter case, the rupture splays show westward bifurcation, and their geometry and kinematics show a change to NNW-strike with low-angle dip and dextral-reverse oblique-slip sense in the strata. We suggest that the upward termination of the contractional strike-slip ruptures is controlled by the inherited fault geometry that is unfavorable with respect to the stress field (ENE-WSW σ_Hmax) at basement depths in terms of movement on the fault, and the lack of extension of the fault into shallow subsurface; a depth-dependent change in stress from σ_Hmax > σ_v > σ_Hmin to σ_Hmax > σ_Hmin > σ_v at depth of a ~ 200 m; and the physical properties of unconsolidated sediment, which have low inter-granular cohesion, resulting in distributed deformation.

Opportunities and challenges of machine learning in bioprocesses: Categorization from different perspectives and future direction

Recent advances in machine learning (ML) have revolutionized an extensive range of research and industry fields by successfully addressing intricate problems that cannot be resolved with conventional approaches. However, low interpretability and incompatibility make it challenging to apply ML to complicated bioprocesses, which rely on the delicate metabolic interplay among living cells. This overview attempts to delineate ML applications to bioprocess from different perspectives, and their inherent limitations (i.e., uncertainties in prediction) were then discussed with unique attempts to supplement the ML models. A clear classification can be made depending on the purpose of the ML (supervised vs unsupervised) per application, as well as on their system boundaries (engineered vs natural). Although a limited number of hybrid approaches with meaningful outcomes (e.g., improved accuracy) are available, there is still a need to further enhance the interpretability, compatibility, and user-friendliness of ML models.

An open-source deep learning model for predicting effluent concentration in capacitive deionization

To effectively evaluate the performance of capacitive deionization (CDI), an electrochemical ion separation technology, it is necessary to accurately estimate the number of ions removed (effluent concentration) according to energy consumption. Herein, we propose and evaluate a deep learning model for predicting the effluent concentration of a CDI process. The developed deep learning model exhibited excellent prediction accuracy for both constant current and constant voltage modes (R² ≥ 0.968), and the accuracy increased with the data size. This model was based on the open-source language, Python, and the code has since been distributed with proper instructions for general use. Owing to the nature of the data-oriented deep learning model, the findings of this study are not only applicable to conventional CDI but also to various types of CDI (membrane CDI, flow CDI, faradaic CDI, etc.). Therefore, by referring to the examples shown in this study, we hope that this open-source deep learning code will be widely used in CDI research.

Automation of membrane capacitive deionization process using reinforcement learning

Capacitive deionization (CDI) is an alternative desalination technology that uses electrochemical ion separation. Although several attempts have been made to maximize the energy efficiency and productivity of CDI with conventional control methods, it is difficult to optimize the CDI processes because of the complex correlation between the operational conditions and the composition of feed water. To address these challenges, we applied deep reinforcement learning (DRL) to automatically control the membrane capacitive deionization (MCDI) process, which is one of the representative CDI processes, to accomplish high energy efficiency while desalinating water. In the DRL model, the numerical model is combined as the environment that provides states according to the actions. The feed water conditions, that is, the input state of the DRL, were assumed to have a random salt concentration and constant foulant concentration. The model was constructed to minimize energy consumption and maximize desalted water volume per cycle. After training of 1,000 episodes, the DRL model achieved a 22.07% reduction in specific energy consumption (from 0.054 to 0.042 kWh m^-3) and 11.60% increase in water desalted water volume per cycle (from 1.96×10^-5 to 2.19×10^-5 m³), achieving the desired degree of desalination, compared to the first episode. This improved performance was because the trained model selected the optimized operating conditions of current, voltage, and the number and intensity of flushing. Furthermore, it was possible to train the model depending on demand by modifying the reward function of the DRL model. The fundamental principle described in this study for applying the DRL model in MCDI operations can be the cornerstone of a fully automated water desalination process.

Deep reinforcement learning in an ultrafiltration system: Optimizing operating pressure and chemical cleaning conditions

Enhancing engineering efficiency and reducing operating costs are permanent subjects that face all engineers over the world. To effectively improve the performance of filtration systems, it is necessary to determine an optimal operating condition beyond conventional methods of periodic and empirical operation. Herein, this paper proposes an effective approach to finding an optimal operating strategy using deep reinforcement learning (DRL), particularly for an ultrafiltration (UF) system. Deep learning was developed to represent the UF system utilizing a long-short term memory and provided an environment for DRL. DRL was designed to control three actions; operating pressure, cleaning time, and cleaning concentration. Ultimately, DRL proposed the UF system to actively change the operating pressure and cleaning conditions over time toward better water productivity and operating efficiency. DRL denoted ∼20.9% of specific energy consumption can be reduced by increasing average water flux (39.5-43.7 L m^-2 h^-1) and reducing operating pressure (0.617-0.540 bar). Moreover, the optimal action of DRL was reasonable to achieve better performance beyond the conventional operation. Crucially, this study demonstrated that due to the nature of DRL, the approach is tractable for engineering systems that have structurally complex relationships among operating conditions and resultants.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BACKGROUND

Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.

METHODS

In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.

RESULTS

One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.

CONCLUSION

High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Prediction of biogas production in anaerobic co-digestion of organic wastes using deep learning models

Interest in anaerobic co-digestion (AcoD) has increased significantly in recent decades owing to enhanced biogas productivity due to the utilization of different organic wastes, such as food waste and sewage sludge. In this study, a robust AcoD model for biogas prediction is developed using deep learning (DL). We propose a hybrid DL architecture, i.e., DA-LSTM-VSN, wherein a dual-stage-attention (DA)-based long short-term memory (LSTM) network is integrated with variable selection networks (VSNs). To enhance the model predictability, we perform hyperparameter optimization. The model accuracy is validated using long-term AcoD monitoring data measured over two years of municipal wastewater treatment plant operation and then compared with those of two other DL-based models (i.e., DA-LSTM and the standard LSTM). In addition, the feature importance (FI) is analyzed to investigate the relative contribution of input variables to biogas production prediction. Finally, we demonstrate the successful application of the validated DL model to the AcoD process optimization. Results show that the model accuracy improved significantly by incorporating DA into LSTM, i.e., the coefficient of determination (R²) increased from 0.38 to 0.68; however, the R² can be further increased to 0.76 by combining DA-LSTM with a VSN. For the biogas prediction of the AcoD model, the VSN contributes significantly by employing the discontinuous time series of measurement data on biodegradable organic-associated variables during AcoD. In addition, the VSN allows the AcoD model to be interpretable via FI analysis using its weighted input features. The FI results show that the relative importance is vital to variables associated with food waste leachate, whereas it is marginal for those associated with the primary and chemically assisted sedimentation sludges. In conclusion, the AcoD model proposed herein can be utilized in practical applications as a robust tool because it can provide the optimal sludge conditions to improve biogas production. This is because it facilitates the time-series biogas prediction at the full scale using unprocessed datasets with either missing value imputation or outlier removal.

Simultaneous Energy Storage and Seawater Desalination using Rechargeable Seawater Battery: Feasibility and Future Directions

Rechargeable seawater battery (SWB) is a unique energy storage system that can directly transform seawater into renewable energy. Placing a desalination compartment between SWB anode and cathode (denoted as seawater battery desalination; SWB-D) enables seawater desalination while charging SWB. Since seawater desalination is a mature technology, primarily occupied by membrane-based processes such as reverse osmosis (RO), the energy cost has to be considered for alternative desalination technologies. So far, the feasibility of the SWB-D system based on the unit cost per desalinated water ($ m^-3 ) has been insufficiently discussed. Therefore, this perspective aims to provide this information and offer future research directions based on the detailed cost analysis. Based on the calculations, the current SWB-D system is expected to have an equipment cost of ≈1.02 $ m^-3 (lower than 0.60-1.20 $ m^-3 of RO), when 96% of the energy is recovered and stable performance for 1000 cycles is achieved. The anion exchange membrane (AEM) and separator contributes greatly to the material cost occupying 50% and 41% of the total cost, respectively. Therefore, future studies focusing on creating low cost AEMs and separators will pave the way for the large-scale application of SWB-D.

Pharmaceutical removal at low energy consumption using membrane capacitive deionization

The performance of the membrane capacitive deionization (MCDI) system was evaluated during the removal of three selected pharmaceuticals, neutral acetaminophen (APAP), cationic atenolol (ATN), and anionic sulfamethoxazole (SMX), in batch experiments (feed solution: 2 mM NaCl and 0.01 mM of each pharmaceutical). Upon charging, the cationic ATN showed the highest removal rate of 97.65 ± 1.71%, followed by anionic SMX (93.22 ± 1.66%) and neutral APAP (68.08 ± 5.24%) due to the difference in electrostatic charge and hydrophobicity. The performance parameters (salt adsorption capacity, specific capacity, and cycling efficiency) and energy factors (specific energy consumption and recoverable energy) were further evaluated over ten consecutive cycles depending on the pharmaceutical addition. A significant decrease in the specific adsorption capacity (from 24.6 to ∼3 mg-NaCl g^-1) and specific capacity (from 17.6 to ∼2.5 mAh g^-1) were observed mainly due to the shortened charging and discharging time by pharmaceutical adsorption onto the electrode. This shortened charging time also led to an immediate drop in specific energy consumption from 0.41 to 0.04 Wh L^-1. Collectively, these findings suggest that MCDI can efficiently remove pharmaceuticals at a low energy demand; however, its performance changes dramatically as the pharmaceuticals are present in the target water.

Metal-Ion Depletion Impacts the Stability and Performance of Battery Electrode Deionization over Multiple Cycles

Prussian blue hexacyanoferrate (HCF) materials, such as copper hexacyanoferrate (CuHCF) and nickel hexacyanoferrate (NiHCF), can produce higher salt removal capacities than purely capacitive materials when used as electrode materials during electrochemical water deionization due to cation intercalation into the HCF structure. One factor limiting the application of HCF materials is their decay in deionization performance over multiple cycles. By examining the performance of CuHCF and NiHCF electrodes at three different pH values (2.5, 6.3, and 10.2) in multiple-cycle deionization tests, losses in capacity (up to 73% for CuHCF and 39% for NiHCF) were shown to be tied to different redox-active centers through analysis of dissolution of electrode metals. Both copper and iron functioned as active centers for Na⁺ removal in CuHCF, while iron was mainly the active center in NiHCF. This interaction of Na⁺ and active centers was demonstrated by correlating the decrease in performance to the concentration of these metal ions in the effluent solutions collected over multiple cycles at different pHs (up to 0.86 ± 0.14 mg/L for iron and 0.42 ± 0.17 mg/L for copper in CuHCF and 0.38 ± 0.05 mg/L for iron in NiHCF). Both materials were more stable (<11% decay for CuHCF and no decay for NiHCF) when the appropriate metal salt (copper or nickel) was added to the feed solutions to inhibit electrode dissolution. At a pH of 2.5, there was an increased competition between protons and Na⁺ ions, which decreased the Na⁺ removal amount and lowered the thermodynamic energy efficiency for deionization for both electrode materials. Therefore, while an acidic pH provided the most stable performance, a circumneutral pH would be useful to produce a better balance between performance and longevity.

Influence of natural organic matter on membrane capacitive deionization performance

Membrane capacitive deionization (MCDI) is a prospective desalination technology that removes ions using an electric potential difference across charged porous carbon electrodes. Natural organic matter (NOM) in feed water could influence the electrochemical process by leading to pore-blockages or forming a cake layer on the ion-exchange membrane-coated porous carbon electrode, thereby hindering ion removal. In this study, we explored the influence of different types of NOM, namely, humic acid (HA) and tannic acid (TA), on the MCDI desalination process for feed waters with inorganic salts (NaCl and CaCl₂). HA significantly interfered with the adsorption process and reduced the salt removal rate by up to 68% in the case of NaCl-based feed water. However, the influence of HA on salt removal in the case of CaCl₂-based feed water was marginal owing to the formation of a charge-neutralized complex, which was caused by the egg-box effect between Ca²⁺ and HA. TA reduced removal rates of salts (NaCl and CaCl₂) by 37% and 60%, respectively. This is because of the lower molecular weight and smaller hydrodynamic diameter of TA relative to that of HA, owing to which TA exhibits a stronger adhesion to the electrode pore structure. Furthermore, as TA substantially reduces MCDI performance with regard to the adsorption of inorganic salts, its presence in feed water results in higher electrical resistance and energy consumption.

Electrically Polarized Graphene-Blended Spacers for Organic Fouling Reduction in Forward Osmosis

In membrane processes, a spacer is known to play a key role in the mitigation of membrane fouling. In this study, the effect of electric polarization on a graphene-blended polymer spacer (e.g., poly(lactic acid), PLA) for organic fouling on membrane surfaces was investigated. A pristine PLA spacer (P-S), a graphene-blended spacer (G-S), and an electrically polarized graphene-blended spacer (EG-S) were successfully fabricated by 3D printing. Organic fouling tests were conducted by the 5-h filtration of CaCl₂ and a sodium alginate solution through commercially available membranes, which were placed together with the fabricated spacers. Membranes utilizing P-S, G-S, and EG-S were characterized in terms of the fouling amount on the membrane surface and fouling roughness. Electrostatic forces of EG-S provided 70% less and 90% smoother fouling on the membrane surface, leading to an only 14% less water flux reduction after 5 h of fouling. The importance of nanomaterial blending and polarization was successfully demonstrated herein.

Recent Progress in One- and Two-Dimensional Nanomaterial-Based Electro-Responsive Membranes: Versatile and Smart Applications from Fouling Mitigation to Tuning Mass Transport

Membrane technologies are playing an ever-important role in the field of water treatment since water reuse and desalination were put in place as alternative water resources to alleviate the global water crisis. Recently, membranes are becoming more versatile and powerful with upgraded electroconductive capabilities, owing to the development of novel materials (e.g., carbon nanotubes and graphene) with dual properties for assembling into membranes and exerting electrochemical activities. Novel nanomaterial-based electrically responsive membranes have been employed with promising results for mitigating membrane fouling, enhancing membrane separation performance and self-cleaning ability, controlling membrane wettability, etc. In this article, recent progress in novel-nanomaterial-based electrically responsive membranes for application in the field of water purification are provided. Thereafter, several critical drawbacks and future outlooks are discussed.

Boron Nitride Nanotube (BNNT) Membranes for Energy and Environmental Applications

Owing to their extraordinary thermal, mechanical, optical, and electrical properties, boron nitride nanotubes (BNNTs) have been attracting considerable attention in various scientific fields, making it more promising as a nanomaterial compared to other nanotubes. Recent studies reported that BNNTs exhibit better properties than carbon nanotubes, which have been extensively investigated for most environment-energy applications. Irrespective of its chirality, BNNT is a constant wide-bandgap insulator, exhibiting thermal oxidation resistance, piezoelectric properties, high hydrogen adsorption, ultraviolet luminescence, cytocompatibility, and stability. These unique properties of BNNT render it an exceptional material for separation applications, e.g., membranes. Recent studies reported that water filtration, gas separation, sensing, and battery separator membranes can considerably benefit from these properties. That is, flux, rejection, anti-fouling, sensing, structural, thermal, electrical, and optical properties of membranes can be enhanced by the contribution of BNNTs. Thus far, a majority of studies have focused on molecular simulation. Hence, the requirement of an extensive review has emerged. In this perspective article, advanced properties of BNNTs are analyzed, followed by a discussion on the advantages of these properties for membrane science with an overview of the current literature. We hope to provide insights into BNNT materials and accelerate research for environment-energy applications.

Membrane and Electrochemical Processes for Water Desalination: A Short Perspective and the Role of Nanotechnology

In the past few decades, membrane-based processes have become mainstream in water desalination because of their relatively high water flux, salt rejection, and reasonable operating cost over thermal-based desalination processes. The energy consumption of the membrane process has been continuously lowered (from >10 kWh m-3 to ~3 kWh m-3) over the past decades but remains higher than the theoretical minimum value (~0.8 kWh m-3) for seawater desalination. Thus, the high energy consumption of membrane processes has led to the development of alternative processes, such as the electrochemical, that use relatively less energy. Decades of research have revealed that the low energy consumption of the electrochemical process is closely coupled with a relatively low extent of desalination. Recent studies indicate that electrochemical process must overcome efficiency rather than energy consumption hurdles. This short perspective aims to provide platforms to compare the energy efficiency of the representative membrane and electrochemical processes based on the working principle of each process. Future water desalination methods and the potential role of nanotechnology as an efficient tool to overcome current limitations are also discussed.

Improving the Thermodynamic Energy Efficiency of Battery Electrode Deionization Using Flow-Through Electrodes

Ion intercalation electrodes are being investigated for use in mixed capacitive deionization (CDI) and battery electrode deionization (BDI) systems because they can achieve selective ion removal and low energy deionization. To improve the thermodynamic energy efficiency (TEE) of these systems, flow-through electrodes were developed by coating porous carbon felt electrodes with a copper hexacyanoferrate composite mixture. The TEE for ion separation using flow-through electrodes was compared to a system using flow-by electrodes with the same materials. The flow-through BDI system increased the recoverable energy nearly 3-fold (0.009 kWh m^-3, compared to a 0.003 kWh m^-3), which increased the TEE from ∼6% to 8% (NaCl concentration reduction from 50 to 42 mM; 10 A m^-2, 50% water recovery, and 0.5 mL min^-1). The TEE was further increased to 12% by decreasing the flow rate from 0.50 to 0.25 mL min^-1. These findings suggest that, under similar operational conditions and materials, flow-through battery electrodes could achieve better energy recovery and TEE for desalination than flow-by electrodes.

Adapting Aluminum-Doped Zinc Oxide for Electrically Conductive Membranes Fabricated by Atomic Layer Deposition

The use of electrically conductive membranes has recently drawn great interest in water treatment as an approach to reduce biofouling. Most conductive membranes are made by binding nanoparticles (carbon nanotubes or graphene) to a polymeric membrane using additional polymers, but this method risks leaching these nanomaterials into the environment. A new approach was developed here based on producing an electrically conductive layer of aluminum-doped zinc oxide (AZO) by atomic layer deposition. The aqueous instability of AZO, which is a critical challenge for water applications, was solved by capping the AZO layer with an ultrathin (∼11 nm) TiO₂ layer (AZO/TiO₂). The combined film exhibited prolonged stability in water and had a low sheet resistance of 67 Ω/sq with a 120 nm-thick coating, while the noncapped AZO coating quickly deteriorated as shown by a large increase in membrane resistance. The AZO/TiO₂ membranes had enhanced resistance to biofouling, with a 72% reduction in bacterial counts in the absence of an applied current due to its higher hydrophilicity than the bare polymeric membrane, and it achieved an additional 50% reduction in bacterial colonization with an applied voltage. The use of TiO₂-capped AZO layers provides a new approach for producing conductive membranes using abundant materials, and it avoids the risk of releasing nanoparticles into the environment.

Electro-Forward Osmosis

The impact of ion migration induced by an electrical field on water flux in a forward osmosis (FO) process was examined using a thin-film composite (TFC) membrane, held between two cation exchange membranes. An applied fixed current of 100 mA (1.7 mA cm^-2) was sustained by the proton flux through the TFC-BW membrane using a feed of 34 mM NaCl, and a 257 mM NaCl draw solution. Protons generated at the anode were transported through the cation exchange membrane and into the draw solution, lowering the pH of the draw solution. Additional proton transport through the TFC-BW membrane also lowered the pH of the feed solution. The localized accumulation of the protons on the draw side of the TFC-BW membrane resulted in high concentration polarization modulus of 1.41 × 10⁵, which enhanced the water flux into the draw solution (5.56 LMH at 100 mA), compared to the control (1.10 LMH with no current). These results using this electro-forward osmosis (EFO) process demonstrated that enhanced water flux into the draw solution could be achieved using ion accumulation induced by an electrical field. The EFO system could be used for FO applications where a limited use of draw solute is necessary.

Investigation of the performance behavior of a forward osmosis membrane system using various feed spacer materials fabricated by 3D printing technique

Recently, feed spacer research for improving the performance of a membrane module has adopted three-dimensional (3D) printing technology. This study aims to improve the performance of membrane feed spacers by using various materials and incorporating 3D printing. The samples were fabricated after modeling with 3D computer-aided design (CAD) software to investigate the mechanical strength, water flux, reverse solute flux, and fouling performances. This research was performed using acrylonitrile butadiene styrene (ABS), polypropylene (PP), and natural polylactic acid (PLA) as printing material, and the spacer model was produced using a diamond-shaped feed spacer, with a commercially available product as a reference. The 3D printed samples were initially compared in terms of size and precision with the 3D CAD model, and deviations were observed between the products and the CAD model. Then, the spacers were tested in terms of mechanical strength, water flux, reverse solute flux, and fouling (alginate-based waste water was used as a model foulant). Although there was not much difference among the samples regarding the water flux, better performances than the commercial product were obtained for reverse solute flux and fouling resistance. When comparing the prominent performance of natural PLA with the commercial product, PLA was found to have approximately 10% less fouling (based on foulant volume per unit area and root mean square roughness values), although it showed similar water flux. Thus, another approach has been introduced for using bio-degradable materials for membrane spacers.

Threshold regulation and stochasticity from the MecA/ClpCP proteolytic system in Streptococcus mutans competence

Many bacterial species use the MecA/ClpCP proteolytic system to block entry into genetic competence. In Streptococcus mutans, MecA/ClpCP degrades ComX (also called SigX), an alternative sigma factor for the comY operon and other late competence genes. Although the mechanism of MecA/ClpCP has been studied in multiple Streptococcus species, its role within noisy competence pathways is poorly understood. S. mutans competence can be triggered by two different peptides, CSP and XIP, but it is not known whether MecA/ClpCP acts similarly for both stimuli, how it affects competence heterogeneity, and how its regulation is overcome. We have studied the effect of MecA/ClpCP on the activation of comY in individual S. mutans cells. Our data show that MecA/ClpCP is active under both XIP and CSP stimulation, that it provides threshold control of comY, and that it adds noise in comY expression. Our data agree quantitatively with a model in which MecA/ClpCP prevents adventitious entry into competence by sequestering or intercepting low levels of ComX. Competence is permitted when ComX levels exceed a threshold, but cell‐to‐cell heterogeneity in MecA levels creates variability in that threshold. Therefore, MecA/ClpCP provides a stochastic switch, located downstream of the already noisy comX, that enhances phenotypic diversity.

Integrating seawater desalination and wastewater reclamation forward osmosis process using thin-film composite mixed matrix membrane with functionalized carbon nanotube blended polyethersulfone support layer

Thin-film composite mixed matrix membrane (TFC MMM) with functionalized carbon nanotube (fCNT) blended in polyethersulfone (PES) support layer was synthesized via interfacial polymerization and phase inversion. This membrane was firstly tested in lab-scale integrating seawater desalination and wastewater reclamation forward osmosis (FO) process. Water flux of TFC MMM was increased by 72% compared to that of TFC membrane due to enhanced hydrophilicity. Although TFC MMM showed lower water flux than TFC commercial membrane, enhanced reverse salt flux selectivity (RSFS) of TFC MMM was observed compared to TFC membrane (15% higher) and TFC commercial membrane (4% higher), representing membrane permselectivity. Under effluent organic matter (EfOM) fouling test, 16% less normalized flux decline of TFC MMM was observed compared to TFC membrane. There was 8% less decline of TFC MMM compared to TFC commercial membrane due to fCNT effect on repulsive foulant-membrane interaction enhancement, caused by negatively charged membrane surface. After 10 min physical cleaning, TFC MMM displayed higher recovered normalized flux than TFC membrane (6%) and TFC commercial membrane (4%); this was also supported by visualized characterization of fouling layer. This study presents application of TFC MMM to integrated seawater desalination and wastewater reclamation FO process for the first time. It can be concluded that EfOM fouling of TFC MMM was suppressed due to repulsive foulant-membrane interaction.

Influence of extreme concentrations of hydrophilic pore-former on reinforced polyethersulfone ultrafiltration membranes for reduction of humic acid fouling

To address the issue of membrane fouling by ubiquitous humic substances, a hydrophilic pore-former-blended polyethersulfone UF membrane was successfully synthesized via the phase inversion method. For the first time, extremely high concentrations of polyvinylpyrrolidone (PVP), up to 20 wt%, were tested as the hydrophilic pore-former in order to determine the optimum concentration for humic acid fouling. Intrinsic membrane parameters such as permeability and selectivity were evaluated using a cross-flow UF filtration setup. Interestingly, as little as 1 wt% added PVP can significantly improve membrane permeability. That tiny amount of added PVP increased membrane flux to 1107 L/m²h·bar from zero flux, with over 90% rejection of humic acid. In addition, pure water permeation increased to over 2400 L/m²h·bar without sacrificing humic acid rejection (around 90%) when 10 wt% PVP was added; pure water permeation decreased to around 1000 L/m²h·bar as added PVP was increased to 20 wt%. The order of water flux increased with the amount of added PVP up to 20 wt% during humic acid fouling while maintaining membrane selectivity. However, the membrane with 10 wt% added PVP showed the best fouling resistance in terms of flux recovery ratio (98%), total flux loss, reversible fouling ratio, and irreversible fouling ratio. Therefore, the addition of 10 wt% PVP is recommended considering cleaning efficiency and the moderately high flux during humic acid fouling for field operation in wastewater reclamation and water treatment processes.

Alginate fouling reduction of functionalized carbon nanotube blended cellulose acetate membrane in forward osmosis

Functionalized multi-walled carbon nanotube blended cellulose acetate (fCNT-CA) membranes were synthesized for forward osmosis (FO) through phase inversion. The membranes were characterized through SEM, FTIR, and water contact angle measurement. AFM was utilized to investigate alginate fouling mechanism on the membrane. It reveals that the fCNT contributes to advance alginate fouling resistance in FO (57% less normalized water flux decline for 1% fCNT-CA membrane was observed than that for bare CA membrane), due to enhanced electrostatic repulsion between the membrane and the alginate foulant. Furthermore, it was found that the fCNT-CA membranes became more hydrophilic due to carboxylic groups in functionalized carbon nanotube, resulting in approximately 50% higher water-permeated flux than bare CA membrane. This study presents not only the fabrication of fCNT-CA membrane and its application to FO, but also the quantification of the beneficial role of fCNT with respect to alginate fouling in FO.

Improved antifouling performance of polyethersulfone (PES) membrane via surface modification by CNTs bound polyelectrolyte multilayers

This study investigated the improved anti-fouling properties of CNTs bound polyelectrolyte membrane and proposed the mechanisms for anti-fouling.

Efficacy of CNT-bound polyelectrolyte membrane by spray-assisted layer-by-layer (LbL) technique on water purification

This study demonstrates anti-fouling properties of surface-modified polyethersulfone composite ultrafiltration membranes prepared by a spray-assisted layer-by-layer technique.

pH impact on reductive dechlorination of cis-dichloroethylene by Fe precipitates: an X-ray absorption spectroscopy study

The pH impact on reductive dechlorination of cis-dichloroethylene (cis-DCE) was investigated using in situ Fe precipitates formed under iron-rich sulfate-reducing conditions. The dechlorination rate of cis-DCE increased with pH, which was attributed to changes in the solid-phase Fe concentration, the composition of Fe minerals, and the surface speciation of Fe minerals. With increasing pH, larger quantities of Fe minerals, having much greater reactivity than dissolved Fe(II), were produced. Fe-K edge X-ray absorption spectroscopy (XAS) analysis of Fe precipitates revealed the presence of multiple Fe phases with their composition varying with pH. Correlation analyses were performed to examine how the solid-phase Fe concentration, the composition of Fe minerals, and their surface speciation were linked with the cis-DCE dechlorination rate. Such analyses revealed that neither mackinawite (FeS) nor magnetite (Fe3O4) was reactive with cis-DCE dechlorination, but that Fe (oxyhydr)oxides including green rusts and Fe(OH)2 were reactive. Based on a proposed model of the surface acidity of Fe minerals, the increasing deprotonated surface Fe(II) groups with pH correlated well with the enhanced cis-DCE dechlorination.

Regional variation in T1ρ and T2 times in osteoarthritic human menisci: correlation with mechanical properties and matrix composition

OBJECTIVE

Changes in T1ρ and T2 magnetic resonance relaxation times have been associated with articular cartilage degeneration, but similar relationships for meniscal tissue have not been extensively investigated. This work examined relationships between T1ρ and T2 measurements and biochemical and mechanical properties across regions of degenerate human menisci.

DESIGN

Average T1ρ and T2 relaxation times were determined for nine regions each of seven medial and 13 lateral menisci from 14 total knee replacement patients. Sulfated glycosaminoglycan (sGAG), collagen and water contents were measured for each region. Biomechanical measurements of equilibrium compressive, dynamic compressive and dynamic shear moduli were made for anterior, central and posterior regions.

RESULTS

T1ρ and T2 times showed similar regional patterns, with longer relaxation times in the (radially) middle region compared to the inner and outer regions. Pooled over all regions, T1ρ and T2 times showed strong correlations both with one another and with water content. Correlations with biochemical content varied depending on normalization to wet or dry mass, and both imaging parameters showed stronger correlations with collagen compared to sGAG content. Mechanical properties displayed moderate inverse correlations with increasing T1ρ and T2 times and water content.

CONCLUSION

Both T1ρ and T2 relaxation times correlated strongly with water content and moderately with mechanical properties in osteoarthritic menisci, but not as strongly with sGAG or collagen contents alone. While the ability of magnetic resonance imaging (MRI) to detect early osteoarthritic changes remains the subject of investigation, these results suggest that T1ρ and T2 relaxation times have limited ability to detect compositional variations in degenerate menisci.

Discrimination of meniscal cell phenotypes using gene expression profiles

The lack of quantitative and objective metrics to assess cartilage and meniscus cell phenotypes contributes to the challenges in fibrocartilage tissue engineering. Although functional assessment of the final resulting tissue is essential, initial characterization of cell sources and quantitative description of their progression towards the natural, desired cell phenotype would provide an effective tool in optimizing cell-based tissue engineering strategies. The purpose of this study was to identify quantifiable characteristics of meniscal cells and thereby find phenotypical markers that could effectively categorize cells based on their tissue of origin (cartilage, inner, middle, and outer meniscus). The combination of gene expression ratios collagen VI/collagen II, ADAMTS-5/collagen II, and collagen I/collagen II was the most effective indicator of variation among different tissue regions. We additionally demonstrate a possible application of these quantifiable metrics in evaluating the use of serially passaged chondrocytes as a possible cell source in fibrocartilage engineering. Comparing the ratios of the passaged chondrocytes and the native meniscal cells may provide direction to optimize towards the desired cell phenotype. We have thus shown that measurable markers defining the characteristics of the native meniscus can establish a standard by which different tissue engineering strategies can be objectively assessed. Such metrics could additionally be useful in exploring the different stages of meniscal degradation in osteoarthritis and provide some insight in the disease progression.

The effect of variable yield strength and variable fractal dimension on flocculation of cohesive sediment

A new formulation for floc yield strength of cohesive sediment is theoretically derived and incorporated into a flocculation model based on variable fractal dimension. The new flocculation model is validated with existing data on the temporal evolution of floc size measured in the laboratory. Comparing with existing flocculation models using a constant yield strength, it is found that new flocculation model based on variable yield strength and variable fractal dimension is superior in predicting the temporal evolution of floc size. It is also demonstrated that the present model results are very similar to that using an empirical formulation of variable yield strength suggested by Sonntag and Russel (1987. Structure and breakup of floccs subjected to fluid stresses. II. Theory. J. Colloid Interface Sci. 115(2), 378-389) when the empirical coefficient is specified according to our theoretical value. Hence, it is concluded that the new variable yield strength formulation derived in this study and the variable fractal dimension are effective in improving the prediction of flocculation process.

Protection by tetracyclines against ion transport disruption caused by nystatin in human airway epithelial cells

Polyene antifungal antibiotics like nystatin form monovalent cation pores on the plasma membrane that perturb the intracellular electrolyte milieu, resulting in cell damage. In the present study, we investigated the effects of tetracyclines (minocycline and tetracycline) on ion transporters disrupted by nystatin in cultured human airway Calu-3 cells. Apical application of nystatin (50 microM) on a monolayer of the cells stimulated Na(+)-K(+) pump activity as estimated by ouabain (1 mM)-sensitive short-circuit current (I(sc)). The nystatin-potentiated I(sc) was inhibited by minocycline (IC(50) = 25 microM) or tetracycline (IC(50) = 150 microM) applied only from the apical (nystatin-treated) side. Nystatin increased monolayer conductance that was reversed by the application of tetracyclines. In contrast, ouabain potentiated the nystatin-induced change in the conductance. Further, Na(+)-glucose transport affected by nystatin was also normalized by tetracyclines from the nystatin-treated side of the membrane. These data suggest that tetracyclines may lower the cell permeability potentiated by nystatin, protecting cells against damage.

[A case of pulmonary eosinophilic granuloma arising rapidly 30 years after the start of smoking and remitting spontaneously without smoking cessation]

A case of pulmonary eosinophilic granuloma which arose rapidly after 30 years of smoking and remitted spontaneously without smoking cessation is reported. The patient was a 54-year-old man complaining of a dry cough who had been smoking 30 cigarettes a day for 30 years. Chest roentgenography showed multiple nodular shadows and cystic lesions in the upper and middle fields of both lungs. Chest computed tomography revealed multiple small cysts and small nodular lesions, mainly in both upper lung fields. CT findings strongly suggested pulmonary eosinophilic granuloma. A transbronchial lung biopsy (TBLB) was performed and 4 specimens were obtained, of which 3 showed granulomatous lesions with eosinophils and histiocytes. Furthermore, the granulomatous lesions were positive for S-100 protein staining. The symptoms and radiographic findings improved markedly within about 6 months after the onset of symptoms without treatment. Many cases of this disease were diagnosed in the past by open lung biopsy, but the number of cases diagnosed by TBLB is now increasing. The effectiveness of open lung biopsy has been emphasized in the diagnosis of pulmonary eosinophilic granuloma, but TBLB is also useful for diagnosis, especially in the active or early stage of the disease.

Novel effects of minocycline on Ca(2+)-dependent Cl(-) secretion in human airway epithelial Calu-3 cells

The present study concerns previously unreported effects of the antibiotic minocycline on the transepithelial Cl(-) transport in Calu-3 cells, which display electrophysiological properties consistent with human airway serous cells. Basolateral 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS, 200 microM) augmented Cl(-) secretion, which was detected as a 5-nitro-2-(3-phenylpropylamino)-benzoate (NPPB, 100 microM, a Cl(-) channel blocker)-sensitive short-circuit current (I(sc)). The DIDS-induced I(sc) was composed of Ca(2+)-activated K(+) (K(Ca)) channel-dependent and -independent components. The former was selectively inhibited by 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetra(acetoxymethyl)ester (BAPTA/AM, 10 microM), charybdotoxin (ChTx, 100 nM), clotrimazole (10 microM), basolateral Ca(2+) removal, and basolateral minocycline (IC(50) = 20 microM). The latter was attenuated by basolateral BaCl (5 mM). In contrast, forskolin (10 microM)-induced I(sc), which is insensitive to BAPTA/AM and ChTx, was unaffected by minocycline (100 microM). ATP-induced I(sc) was partially inhibited by basolateral but not by apical minocycline. I(sc) due to basolateral application of ionomycin (1 microM) was markedly suppressed by NPPB and basolateral Ca(2+) removal. These inhibitory effects were mimicked by minocycline applied only from the basolateral side of the monolayer. In the basolateral absence of Ca(2+), 1-ethyl-2-benzimdazolinone (500 microM), a K(Ca) channel opener, generated a sustained I(sc) sensitive to ChTx. Minocycline had no significant effect on the ChTx-sensitive component of the I(sc). It is concluded that minocycline inhibits K(Ca) channel-dependent Cl(-) secretion via a blockade of Ca(2+) influx across the basolateral membrane from the extracellular side.

[Two cases of multi-drug-resistant pulmonary tuberculosis with para-aminosalicylic acid (PAS)-induced hypothyroidism]

Two cases of multi-drug-resistant pulmonary tuberculosis with para-aminosalicylic acid (PAS)-induced hypothyroidism were reported. Case 1; a 73-year-old male, complaining of edema, was admitted to our hospital. He had been treated for his multi-drug-resistant pulmonary tuberculosis during the past 1 year with an antituberculous regimen consisting of ethambutol (EB), ethionamide (ETH) and PAS. A thyroid profile performed when he was admitted to our hospital showed several marked abnormalities: serum thyroid stimulating hormone (TSH) was elevated (69.4 microIU/ml: normal, 0.4-4.2 mIU/ml), free thyroxine level (T4) (0.01 ng/dl; normal, 0.70-1.60 ng/dl) and free triiodothyronine level (Ts) (0.60 pg/ml; normal, 2.3-4.1 pg/ml) were low. PAS was discontinued after he was admitted to our hospital, since PAS was believed to be the cause of the hypothyroidism. A thyroid profile that was repeated after the exclusion of PAS from treatment showed the following results: the TSH level was decreased (13.4 mIU/ml), the free T4 (0.93 ng/dl) were normal. During treatment with PAS, he had never received thyroid replacement therapy. Case 2; A 22-year-old female, complaining of hemosputum. She had been treated for her multi-drug-resistant pulmonary tuberculosis during the past 11 months with an antituberculous regimen consisting of EB, ETH and PAS. A thryoid profile performed when she was admitted to our hospital showed several marked abnormalities: elevated serum TSH (112.7 mIU/ml), and low T4 (2.0 micrograms/dl) and T3 (1.1 ng/ml). A thyroid profile that was repeated after the exclusion of PAS from treatment showed the following results: the TSH level was decreased (5.1 mIU/ml). Drug-induced hypothyroidism is an infrequent side effect of therapy with PAS, and only a few cases of PAS-induced hypothyroidism have been reported so far. In this report, we describe patients with hypothyroidism who were receiving therapy for multi-drug-resistant tuberculosis, tuberculosis namely, resistant to at least isoniazid (INH) and rifampicin (RFP), with a regimen that contained PAS.

[A case of tuberculous peritonitis diagnosed by a direct smear of ascitic fluid complicated with an active pulmonary tuberculosis and intestinal tuberculosis]

We sometimes encounter difficulties in differentiating tuberculous peritonitis from other inflammatory disorders or ascites due to carcinomatous peritonitis. Acid-fast bacilli are very rarely detected in ascites. In this study, we reported a case of tuberculous peritonitis accompanied with active pulmonary tuberculosis in which acid-fast bacilli were detected in ascites. The patient was a 37-year-old single man who had been admitted to our hospital on February 28, 2000, because acid-fast bacilli were detected in sputum, faces and ascites by a direct smear. He had a lower abdominal distention and pain. His serum CA 125 level was high, 121 U/ml. Abdominal ultrasonography showed marked ascites in Douglas pouch. However adenosine deaminase level was not high in his ascites. During treatment by the combination chemotherapy with INH, RFP, EB, and PZA, serum CA 125 level was decreased.