Effectiveness of low-dose theophylline for the management of biomass-associated COPD (LODOT-BCOPD): study protocol for a randomized controlled trial

BACKGROUND: COPD is a leading cause of death globally, with the majority of morbidity and mortality occurring in low- and middle-income country (LMIC) settings. While tobacco-smoke exposure is the most important risk factor for COPD in high-income settings, household air pollution from biomass smoke combustion is a leading risk factor for COPD in LMICs. Despite the high burden of biomass smoke-related COPD, few studies have evaluated the efficacy of pharmacotherapy in this context. Currently recommended inhaler-based therapy for COPD is neither available nor affordable in most resource-limited settings. Low-dose theophylline is an oral, once-a-day therapy, long used in high-income countries (HICs), which has been proposed for the management of COPD in LMICs in the absence of inhaled steroids and/or bronchodilators. The Low-dose Theophylline for the Management of Biomass-Associated COPD (LODOT-BCOPD) trial investigates the clinical efficacy and cost-effectiveness of low-dose theophylline for the management of biomass-related COPD in a low-income setting. METHODS: LODOT-BCOPD is a randomized, double-blind, placebo-controlled trial to test the efficacy of low-dose theophylline in improving respiratory symptoms in 110 participants with moderate to severe COPD in Central Uganda. The inclusion criteria are as follows: (1) age 40 to 80 years, (2) full-time resident of the study area, (3) daily biomass exposure, (4) post-bronchodilator FEV1/FVC below the 5th percentile of the Global Lung Initiative mixed ethnic reference population, and (5) GOLD Grade B-D COPD. Participants will be randomly assigned to receive once daily low-dose theophylline (200 mg ER, Unicontin-E) or placebo for 52 weeks. All participants will receive education about self-management of COPD and rescue salbutamol inhalers. We will measure health status using the St. George's Respiratory Questionnaire (SGRQ) and quality of life using the EuroQol-5D (EQ-5D) at baseline and every 6 months. In addition, we will assess household air pollution levels, serum inflammatory biomarkers (fibrinogen, hs-CRP), and theophylline levels at baseline, 1 month, and 6 months. The primary outcome is change in SGRQ score at 12 months. Lastly, we will assess the cost-effectiveness of the intervention by calculating quality-adjusted life years (QALYs) from the EQ-5D. TRIAL REGISTRATION: ClinicalTrials.gov  NCT03984188 . Registered on June 12, 2019 TRIAL ACRONYM: Low-dose Theophylline for the Management of Biomass-Associated COPD (LODOT-BCOPD)

Cellulose nanofiber backboned Prussian blue nanoparticles as powerful adsorbents for the selective elimination of radioactive cesium

On 11 March 2011, the day of the unforgettable disaster of the 9 magnitude Tohoku earthquake and quickly followed by the devastating Tsunami, a damageable amount of radionuclides had dispersed from the Fukushima Daiichi’s damaged nuclear reactors. Decontamination of the dispersed radionuclides from seawater and soil, due to the huge amounts of coexisting ions with competitive functionalities, has been the topmost difficulty. Ferric hexacyanoferrate, also known as Prussian blue (PB), has been the most powerful material for selectively trapping the radioactive cesium ions; its high tendency to form stable colloids in water, however, has made PB to be impossible for the open-field radioactive cesium decontamination applications. A nano/nano combinatorial approach, as is described in this study, has provided an ultimate solution to this intrinsic colloid formation difficulty of PB. Cellulose nanofibers (CNF) were used to immobilize PB via the creation of CNF-backboned PB. The CNF-backboned PB (CNF/PB) was found to be highly tolerant to water and moreover, it gave a 139 mg/g capability and a million (106) order of magnitude distribution coefficient (Kd) for absorbing of the radioactive cesium ion. Field studies on soil and seawater decontaminations in Fukushima gave satisfactory results, demonstrating high capabilities of CNF/PB for practical applications.National Science Foundation (U.S.) (DMR-1507806

Self-assembled polyoxovanadate-intercalated layered double hydroxide nanosheets hybridized with graphene oxide for extrinsic supercapacitors

Hybrid materials integrate unique organic and inorganic compounds to create innovative materials that harness the optimal characteristics of each component, enhancing the electrochemical performance. Herein, a novel lattice engineering strategy has been established to synthesize self-assembled 2D nickel chromium layered double hydroxide (NC-LDH) nanosheets intercalated with 0D polyoxovanadate (POV) and hybridized with graphene oxide (GO) nanosheets (NCVG). The control of the POV/GO ratio is demonstrated to be crucial in optimizing the layer-by-layer-ordered porous stacking structure and the charge transport behavior, resulting in a remarkable increase in the cycling stability and rate performance of lattice-engineered NCVG nanoarchitecture as compared to NC-LDH. Later, a hybrid supercapacitor device was fabricated using NCVG as the cathode and activated carbon (AC) as the anode. The resulting device (NCVG-2//KOH//AC) delivered a specific energy of 73.8 W h kg−1 at a specific power of 1.06 kW kg−1. The practical feasibility of the device in wearable applications was demonstrated by assembling a hybrid all-solid-state supercapacitor (NCVG-2//PVA-KOH//AC), which achieved an excellent capacitance retention of 92% over 12 000 cycles. This work provides a new opportunity to develop outstanding porous layer-by-layer assembled architectures for the development of efficient materials for energy-oriented applications.</p

Mechanistic Modelling of Alkaline/Surfactant/ Polymer Flooding Process at Under-Optimum Salinity Condition for Enhanced Oil Recovery

Abstract Alkaline-Surfactant-Polymer (ASP) flooding is potentially the most efficient chemical EOR methods. It yields extremely high incremental recovery factors in excess of 95% of residual oil for water flooding. The current opinion is that such extremely high recoveries can only be achieved at optimum salinity conditions, i.e. for the Winsor type III micro-emulsion phase characterized by an ultra-low interfacial tension (IFT). This represents a serious limitation since several factors including alkali-rock interaction, initial state of reservoir water and salinity of injected water may shift the ASP flood design to either under or over optimum conditions. A recent experimental study of ASP floods, based on a single internal olefin sulfonate (IOS), in natural sandstone cores varying salinity from under-optimum to optimum conditions indicated that indeed high recovery factors can be obtained also at under-optimum salinity conditions (see parent paper in this conference by Battistutta et al (2015). In this paper a mechanistic model is developed to explore the causes behind the observed phenomena. The numerical simulations were done using the UTCHEM research simulator (University of Texas at Austin) together with the geochemical module EQBATCH. UTCHEM combines multiphase multicomponent simulator with a robust phase behaviour modelling. An excellent match of the numerical simulations with the experiments was obtained for oil cut, cumulative oil recovery, pH profile, surfactant, and carbonate concentration at effluents. The simulations gave additional insight into the propagation of alkali consumption, salinity, surfactant and polymer profiles within the core. The study showed that the initial condition of the core is important in designing an ASP flood. Due to the uncertainties in the various chemical reactions taking place in the formation, an accurate geochemical model is essential for operating the ASP flood at a particular salinity region. Moreover, simulation results demonstrate for the crude oil with considerably low acid number, the ultralow IFT and low surfactant adsorption can be achieved over a wide range of salinities less than optimal salinity. The results provide a basis to perform better modelling of the under-optimum series of experiments and optimizing the design of ASP floods methods for the fields scale with more complicated geochemical condition.</jats:p

Feasibility of the home isolation programme for adults and children with COVID-19

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused an upsurge of cases in many countries leading to inadequate quarantine facilities and hospital beds. Studies on the feasibility of home isolation for COVID-19 patients are the need of the hour. This is the first study from India on the feasibility of home isolation to the best of the author's knowledge.Methods: This methodical study was conducted at a designated COVID-19 tertiary care hospital in India, which included all patients enrolled for the home isolation programme from the 4 July to 3 August 2020. Laboratory confirmed COVID-19 patients were assessed during the enrolment for their eligibility for home isolation. The enrolled patients were followed up once daily over a telephonic call with objective parameters like temperature, pulse and oxygen saturation.Results: There were a total of 447 adults and 67 children. Amongst adults, hypertension was the most common co-morbid condition seen in 23 (5.15%) followed by diabetes in 18 (4.03%) patients. Only 24 (5.37%) patients were hospitalised during the duration of home isolation due to reasons like persistent fever, decreased SpO2, and non-medical ones like anxiety regarding the disease. Age and the presence of co-morbidities were directly related to the requirement of hospitalisation. No children required hospitalisation. There were no deaths.Conclusions: Home isolation is effective for COVID-19 patients in resource limited settings. We provide strong evidence for adapting it for asymptomatic and mild symptomatic cases with judicious use of resources and without compromising the risk to patients.</jats:p