Effect of carbon-rich biochar on mechanical properties of PLA-biochar composites

Agricultural biomass residues are emerged from harvesting and processing of agricultural crops. When the crop production increases, a large amount of biomass residues is produced and remained after cutting of peel, bunch, straw and stalk of crops. In this work, agricultural biomass residues (cassava rhizome, durian peel, pineapple peel and corncob) were selected as feedstock for carbon-rich biochar (CRB) production using a facile pyrolysis method. Proximate analysis and thermogravimetric analysis (TGA) were used to characterize biomass feedstock. The results showed that the percentage of fixed carbon in biomass feedstock ranged between 11.91% and 17.51%. Characteristic differences of the CRB were investigated using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy. The carbon content in the CRB was found to significantly depend on biomass origin. Interestingly, cassava rhizome, which has a higher percentage of fixed carbon, is a superior precursor for CRB production. The study of different pyrolysis temperature indicated that the carbon content of cassava rhizome derived CRB is increased with pyrolysis temperature. The tensile properties of composite between poly(lactic acid) PLA and different types of biomass-derived CRB were investigated. PLA composite incorporated with a higher carbon content-CRB tended to exhibit improved mechanical properties. Specifically, the elastic modulus and impact energy of PLA/CRB composite specimens increased remarkably with the incorporation of CRB powder. The current research indicates that CRB prepared from agricultural biomass residues could be a sustainable material for utilization in PLA biocomposites.     

Hepatocellular carcinoma screening and surveillance in 2293 chronic hepatitis B patients in an endemic area

AIM To determine the role of screening and surveillance of hepatocellular carcinoma(HCC) in treatment-na?ve chronic hepatitis B(CHB) patients. METHODS We recruited 2293 CHB patients(both males and females; aged 20-65 years). All patients were screened and underwent surveillance using abdominal ultrasonography(AUS) and serum alpha-fetoprotein(AFP) assay every 6 mo. The diagnosis,staging and treatment of HCC followed the American Association for the Study of Liver Diseases practice guidelines and the Barcelona Clinic Liver Cancer guidelines. The exclusion criteria included: decompensated cirrhosis; a history of any cancer in the last 5 years; previous antiviral treatment for CHB; concurrent infection with hepatitis C virus or human immunodeficiency virus; a Karnofsky Performance Status score 60%; or any medical condition preventing eligibility to complete the protocol. The prevalence and incidence rates of HCC were determined; survival rates were calculated at 3-year post HCC diagnosis. The sensitivity and specificity were calculated on a per-patient basis.RESULTS Among 2293 treatment-na?ve CHB patients,seven cases had HCC at initial screening,giving a prevalence rate of 305 per 100000 persons; 3.3% were diagnosed with liver cirrhosis,all of which were Child-Pugh class A. With a median follow-up time of 42(range,3-48) mo,10 additional cases were diagnosed with HCC,resulting in an incidence rate of 143 per 100000 persons per year. This burden was as high as that reported in other studies from East Asian countries. All HCC patients were aged ≥ 40 years. Most were at an early stage(Stage 0,A or B); 14/17 cases were successfully treated with surgical resection or radiofrequency ablation,with a high 3-year survival rate of 90%. Hemangioma was the most common focal liver lesion in CHB patients detected by AUS; the main causes of AFP elevation at the initial screening were cirrhosis,increased alanine aminotransferase level and HCC. AUS detected 16/17 HCC cases whereas AFP levels ≥ 20 mg/L at diagnosis were observed in only 7/17 patients,most with a tumor size 5 cm. For HCC screening and surveillance,AUS had a sensitivity and specificity of 94% and 82%,respectively,whereas the sensitivity and specificity of AFP at a cut-off value of ≥ 20 mg/L were 41% and 98%,respectively. Combined use of AUS and AFP assay did not improve effectiveness. CONCLUSION Implementation of active screening and surveillance using AUS to detect early-stage HCC in na?ve CHB patients aged ≥ 40 years in an endemic area is of benefit.     

A case of successful treatment of severe COVID‐19 pneumonia with favipiravir and tocilizumab in post–kidney transplant recipient

We report a case of COVID‐19 in kidney transplant patient in Thailand. A 58‐year‐old 2 years post–kidney transplant recipient, with maintenance immunosuppression of tacrolimus, mycophenolate mofetil (MMF), and prednisolone, presented with acute diarrhea which followed by fever on day 12. Symptoms of pneumonia together with lymphopenia from complete blood count were developed on day 7 after onset of fever with the x‐ray finding of bilateral multifocal patchy infiltration. COVID‐19 infection has been confirmed by reverse real‐time polymerase chain reaction (PCR) in nasal swab as well as found in stool. Darunavir together with ritonavir, hydroxychloroquine, azithromycin, and favipiravir was initiated on the first day of admission at primary hospital. Patient has been transferred to our hospital on day 2 of admission in which tacrolimus together with MMF was discontinued. High‐flow nasal cannula oxygen therapy was required on days 4‐5 of hospitalization. Tocilizumab was administered after rising of serum IL‐6 level. Symptoms of pneumonia were improved in which no oxygen treatment required from day 10 of hospitalization. Drug interaction between tacrolimus and anti‐viral treatment leads to severely high level of tacrolimus which caused reversible acute kidney injury (AKI) after supportive treatment.     

Performance of Thailand’s universal health coverage scheme: Evaluating the effectiveness of annual public hearings

BackgroundLegislative provisions in Thailand''s National Health Security Act 2002 mandate annual public hearings for providers, beneficiaries and other stakeholders in order to improve the performance of the Universal Health Coverage Scheme (UCS).ObjectiveThis study aims to explore the annual public hearing process, evaluate its effectiveness and propose recommendations for improvement.MethodIn‐depth interviews were conducted with 29 key informants from various stakeholder groups involved in annual public hearings.ResultsThe evaluation showed that the public hearings fully met the criteria of influence over policy decision and partially met the criteria of appropriate participation approach and social learning. However, there are rooms for improvement on public hearing''s inclusiveness and representativeness of participants, adequacy of information and transparency.ConclusionsThree recommendations were proposed a) informing stakeholders in advance of the agenda and hearing process to enable their active participation; b) identifying experienced facilitators to navigate the discussions across stakeholders with different or conflicting interests, in order to reach consensus and prioritize recommendations; and c) communicating policy and management responses as a result of public hearings to all stakeholders in a timely manner.     

Basal ganglia and brainstem encephalitis, optic neuritis, and radiculomyelitis in Epstein-Barr virus infection

The neurologic complications of Epstein-Barr virus (EBV) infection are rare. We describe a healthy adult with acute EBV meningoencephalomyeloradiculitis. The clinical manifestations, a serologic study, and a dynamic change of EBV DNA in the cerebrospinal fluid with spontaneous recovery confirmed the diagnosis of EBV infection of the nervous system. In addition, we provide other clinical clues for suspicion of EBV infection in patients with encephalitis. These include bilateral basal ganglia and brainstem lesions on magnetic resonance imaging, optic neuritis, or involvement of all levels of the nervous system.     

The aryl hydrocarbon receptor regulates gut immunity through modulation of innate lymphoid cells

Innate lymphoid cells (ILCs) expressing the nuclear receptor RORγt are essential for gut immunity presumably through production of interleukin-22 (IL-22). The molecular mechanism underlying the development of RORγt(+) ILCs is poorly understood. Here, we have shown that the aryl hydrocarbon receptor (Ahr) plays an essential role in RORγt(+) ILC maintenance and function. Expression of Ahr in the hematopoietic compartment was important for accumulation of adult but not fetal intestinal RORγt(+) ILCs. Without Ahr, RORγt(+) ILCs had increased apoptosis and less production of IL-22. RORγt interacted with Ahr and promoted Ahr binding at the Il22 locus. Upon IL-23 stimulation, Ahr-deficient RORγt(+) ILCs had reduced IL-22 expression, consistent with downregulation of IL-23R in those cells. Ahr-deficient mice succumbed to Citrobacter rodentium infection, whereas ectopic expression of IL-22 protected animals from early mortality. Our data uncover a previously unrecognized physiological role for Ahr in promoting innate gut immunity by regulating RORγt(+) ILCs.     

Association of MTHFR polymorphisms and chromosomal abnormalities in leukemia

Genetic variation in MTHFR gene might explain the interindividual differences in the reduction of DNA repaired and the increase of chromosome breakage and damage. Nowadays, chromosomal rearrangement is recognized as a major cause of lymphoid malignancies. In addition, the association of MTHFR polymorphisms with aneuploidy was found in several studies, making the MTHFR gene as a good candidate for leukemia etiology. Therefore, in this study, we investigated the common sequence variation, 677C>T and 1298A>C in the MTHFR gene of 350 fixed cell specimens archived after chromosome analysis. The distribution of the MTHFR polymorphisms frequency was compared in leukemic patients with structural chromosome abnormality and chromosome aneuploidy, as well as in those with no evidence of chromosome abnormalities. We observed a significant decrease in the distribution of T allele in 677C>T polymorphisms among patients with chromosomal abnormalities including both structural aberration and aneuploidy. The same significance result also found in patients with structural aberration when compare with the normal karyotype patients. Suggesting that polymorphism in the MTHFR gene was involved in chromosome abnormalities of leukemia. However, further investigation on the correlation with the specific types of chromosomal aberrations is needed.     

Extracellular Water Excess and Increased Self-Reported Fatigue in Chronic Hemodialysis Patients

Hemodialysis patients (HD) commonly report fatigue. Muscle wasting (sarcopenia) and extracellular water (ECW) excess have been reported to be associated with fatigue in other conditions. We wished to determine whether muscle loss and ECW excess were associated with fatigue in HD patients. Patients completed the Multidimensional Fatigue Inventory (MFI), Beck Depression Inventory-II (BDI-II), Patient Health Questionnaires (PHQ-9) and recorded their post-dialysis recovery time. Sessional dialysis data were recorded along with pre- and post-dialysis multi-frequency bioimpedance assessments (MFBIA). One hundred and ten patients, median age 64 (52–79) years, 67% male, 35% diabetic completed questionnaires and had pre- and post-HD MFBIAs. Median total MFI score was 60 (48–72), with the physical domain having the highest score. Modal (30.8%) recovery time post-dialysis was 1–4 h. Of the participants, 35% and 34% had increased BDI-II and PHQ-9 scores, respectively. Total MFI score was associated with increased BDI-II (>16) (standardized (Std) β 0.54, P < 0.001), PHQ-9 (>10) scores (Std β 0.49, P < 0.001, past history of depression (Std β 0.28, P = 0.003), post-HD ECW/total body water ratio (Std β 0.25, P = 0.002), recovery time > 8 h (Std β 0.26, P = 0.001), post dialysis mean arterial pressure (MAP) (Std β −0.19, P = 0.02), and muscle wasting (Std β −0.15, P = 0.05). Self-reported fatigue in HD patients is associated with self-reported depression, but also dialysis-related factors including increased ECW post HD, low MAP, and longer recovery times. Patients with reduced muscle mass were less likely to report fatigue, possibly accepting physical limitations. As such, interventions to reduce fluid overload and improve dialysis experience may help improve fatigue.     

Determination of Human Anticytokine Autoantibody Profiles Using a Particle-Based Approach

Background  

Anticytokine autoantibodies cause numerous human diseases, ranging from pure red cell aplasia to acquired immunodeficiencies. Rapid, simple, and affordable detection and monitoring of these antibodies is essential. We sought to develop a standardizable assay that is rapid, sensitive, and specific and able to simultaneously detect multiple anticytokine autoantibodies in small volumes (<10 μl).     

Dasatinib therapy results in decreased B cell proliferation, splenomegaly, and tumor growth in a murine model of lymphoma expressing Myc and Epstein-Barr virus LMP2A

Epstein-Barr virus (EBV) infection and latency has been associated with malignant diseases including nasopharyngeal carcinoma, Hodgkin lymphoma, Burkitt lymphoma, and immune deficiency associated lymphoproliferative diseases. EBV-encoded latent membrane protein 2A (LMP2A) recruits Lyn and Syk kinases via its SH2-domain binding motifs, and modifies their signaling pathways. LMP2A transgenic mice develop hyperproliferative bone marrow B cells and immature peripheral B cells through modulation of Lyn kinase signaling. LMP2A/λ-MYC double transgenic mice develop splenomegaly and cervical lymphomas starting at 8 weeks of age. We reasoned that targeting Lyn in LMP2A-expressing B cells with dasatinib would provide a therapeutic option for EBV-associated malignancies. Here, we show that dasatinib inhibits B cell colony formation by LMP2A transgenic bone marrow cells, and reverses splenomegaly and tumor growth in both a pre-tumor and a syngeneic tumor transfer model of EBV-associated Burkitt lymphoma. Our data support the idea that dasatinib may prove to be an effective therapeutic molecule for the treatment of EBV-associated malignancies.